Simulation in the Internet age: the place of web-based simulation in nursing education. An integrative review.

OBJECTIVE: The objective of this article was to review the literature on utilisation and place of Web-based simulation within nursing education. Web-based simulation combines electronic multimedia options with a central video or virtual world to produce interactive learning activities mediated by the learner. DESIGN: An integrative review. DATA SOURCES: A search was conducted of healthcare databases between 2000 and 2014 and of Internet sources for hosted simulation programs in nursing. Eighteen primary programs were identified for inclusion. REVIEW METHODS: A strategy for integrative review was adopted in which studies were identified, filtered, classified, analysed and compared. RESULTS AND DISCUSSION: Of 18 programs, two game-based programs were identified which represented a 'virtual world' in which students could simultaneously or individually immerse themselves in a character role-play. However, most programs (n=10) taught an aspect of procedural patient care using multimedia (e.g. video, audio, graphics, quiz, text, memo). Time-limited sequences, feedback and reflective activities were often incorporated. Other studies (n=8) taught interpersonal communication skills or technical skills for equipment use. Descriptive study outcomes indicated ease of program use, strong satisfaction with learning and appreciation of program accessibility. Additionally, four studies reported significant improvements in knowledge post-intervention. CONCLUSION: Web-based simulation is highly acceptable to students and appears to provide learning benefits that align with other simulation approaches and it augments face-to-face teaching. Web-based simulation is likely to have a major place in nursing curricula in the next decade, yet further research is necessary to objectively evaluate learner outcomes and to justify its use.