NURS 6331 Week 4 Evidence Review Example

Evidence Review: Simulation for Teaching Medication Administration, Organized by What Studies Measured

Student Name

College of Nursing, Walden University

NURS 6331: Teaching Learning Strategies: Integrating Technology Into Nursing Education

Instructor Name

Month Day, Year

Evidence Review: Simulation for Teaching Medication Administration, Organized by What Studies Measured

Scope

This review gathers the education research behind simulation, both screen-based and manikin-based, for teaching nursing students to prepare and give medications safely. It supports the Week 3 decision to teach interrupted IV push administration with manikin simulation. Studies are grouped by the outcome they measured: knowledge, observed performance, retention and transfer into practice, and learner satisfaction. A study that measured two outcomes appears in both sections. The central finding is that simulation reliably improves knowledge and satisfaction, that its effect on observed performance depends on the modality and the skill, and that almost nothing is known about whether performance holds up under interruption at the bedside.

Knowledge

The strongest design in this group is a multicenter randomized trial of 351 nursing students in which a screen-based simulation of four infusion cases was compared with the same content taught by paper and pencil (Mahou et al., 2024). The simulation group gained more on a dosage calculation knowledge test. A smaller randomized trial of 103 first-year students found that a web-based parenteral medication simulation produced pretest-to-posttest gains in knowledge but no difference from conventional teaching between groups (Biyik Bayram et al., 2026). These two trials point in different directions, and the difference may lie in what was taught: dosage calculation, a cognitive task, in the first, and injection technique in the second. A quasi-experimental study at one school, in which 79 students attended a simulation review and 79 a lecture review before a medication administration examination, found higher examination scores after simulation, 95% against 90% (Harris et al., 2014). The examination tested calculation and administration knowledge on paper, and allocation was not random. Across virtual worlds more broadly, a systematic review found their clearest benefit on knowledge (Shorey & Ng, 2021).

Observed Performance

Evidence here is thinner and more mixed. In the multicenter trial, students trained on the screen-based simulation also scored higher on an objective structured clinical examination of dosage calculation, an observed performance measured shortly after training (Mahou et al., 2024). The web-based parenteral simulation trial, by contrast, found no difference in observed intramuscular, subcutaneous or intravenous administration skills between groups (Biyik Bayram et al., 2026). The contrast suggests that screen-based simulation may improve performance of cognitive steps, such as calculation, more than of physical technique. For manikin-based simulation with repeated practice and feedback, a meta-analysis of 14 studies in medical education found a large advantage over traditional clinical teaching for specific skills (McGaghie et al., 2011), although none of those skills was medication administration, and the studies were drawn from medicine rather than nursing.

No study located measured performance under interruption, which is the capability the Week 1 objective requires. Practice studies show that interruptions increase errors among working nurses (Westbrook et al., 2010), but the education literature has not tested whether any simulation modality reduces that effect.

Retention and Transfer

Almost every study measured outcomes within days of teaching. The only large study with follow-up into practice is the national simulation trial, in which students whose clinical time was as much as 50% simulated were followed into their first six months as nurses and rated by their managers; their clinical competency ratings did not differ from those of traditionally taught graduates (Hayden et al., 2014). That result supports simulation as a substitute for clinical time in general, but it did not isolate medication administration or interruption. For the specific objective here, retention and transfer are untested.

Satisfaction

Students trained with screen-based simulation reported higher satisfaction and self-confidence than those taught with paper cases, with no difference in anxiety (Mahou et al., 2024). Satisfaction is reported here as satisfaction. It shows that students liked the method and felt more confident, which may help them persist, but it is not evidence that they learned more or perform better, and confidence without competence is itself a safety risk in medication administration.

Limits of the Evidence

The literature is small for this purpose. Most studies come from single schools or small multicenter groups, cohorts range from about 100 to 350, outcomes were measured minutes to days after teaching, and comparison groups often received less practice time as well as a different modality, which confounds the two. No study examined interrupted administration. The conclusion must fit within those limits: simulation improves medication knowledge and learner confidence; screen-based simulation may help with cognitive steps but has not been shown to improve physical technique; manikin-based practice with feedback has strong support for skills in general; and whether any method produces performance that holds up when a family member interrupts at the bedside remains an open question. The program's own evaluation of its interrupted IV push simulation would add evidence where none exists.

References

Biyik Bayram, S., Gülnar, E., Çalişkan, N., Özyurt, H., & Bayram, A. (2026). The effect of virtual simulation of parenteral medication administration on nursing students' knowledge and skills. CIN: Computers, Informatics, Nursing. Advance online publication. https://doi.org/10.1097/CIN.0000000000001581

Harris, M. A., Pittiglio, L., Newton, S. E., & Moore, G. (2014). Using simulation to improve the medication administration skills of undergraduate nursing students. Nursing Education Perspectives, 35(1), 26-29. https://doi.org/10.5480/11-552.1

Hayden, J. K., Smiley, R. A., Alexander, M., Kardong-Edgren, S., & Jeffries, P. R. (2014). The NCSBN National Simulation Study: A longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation, 5(2 Suppl), S3-S40. https://doi.org/10.1016/S2155-8256(15)30062-4

Mahou, F. Z., Decormeille, G., Changuiti, O., Mouhaoui, M., & Khattabi, A. (2024). The effects of screen-based simulation on nursing students' acquisition of medication administration and dosage calculation skills: A randomized controlled trial. BMC Nursing, 23, Article 777. https://doi.org/10.1186/s12912-024-02436-4

McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706-711. https://doi.org/10.1097/ACM.0b013e318217e119

Shorey, S., & Ng, E. D. (2021). The use of virtual reality simulation among nursing students and registered nurses: A systematic review. Nurse Education Today, 98, Article 104662. https://doi.org/10.1016/j.nedt.2020.104662

Westbrook, J. I., Woods, A., Rob, M. I., Dunsmuir, W. T. M., & Day, R. O. (2010). Association of interruptions with an increased risk and severity of medication administration errors. Archives of Internal Medicine, 170(8), 683-690. https://doi.org/10.1001/archinternmed.2010.65