A systematic review of selected evidence on improving knowledge and skills through high-fidelity simulation.

A systematic review of the evidence published between 2000 and 2010 was undertaken using the following databases: CINAHL, ProQuest, MEDLINE, Science Direct, OVID and Chinese Academic Journal. Empirical studies determining the effects of high-fidelity simulation on knowledge and skills in nursing or medical education were considered. As a result, nine English and seventeen Chinese studies were retrieved. They included sixteen randomized controlled trails (RCTs), one nonrandomized-controlled trial, and nine quasi-experimental studies. The high-fidelity simulation did enhance the scores on knowledge and skill exams but its contribution to objective structured clinical evaluation is mixed. The majority of reviewed RCTs are of low methodological quality. It is necessary to conduct additional RCTs with larger sample sizes to determine whether performance can be enhanced by high-fidelity simulation.