Promoting critical thinking through simulation-based healthcare training (SBHT): A scoping review

Main Article Content

K Henrico
N Oostdam


Background. Critical thinking (CT) is an essential graduate attribute for health professions (HP) students. Yet, achieving a higher level of CT in HP students through education is often difficult for educators. SBHT has proven to be an effective strategy to promote CT, but it is not clear how this educational pedagogy should be implemented to achieve higher levels of CT.
Objective. To identify and describe the use of simulation-based healthcare training (SBHT) strategies to promote CT in HP students.

Methods. Based on the revised methodology of Levac et al., a scoping review was conducted on studies reporting an improvement in CT through simulation-based healthcare education published between January 2010 and August 2021.
Results. Twenty articles were included. Through thematic analysis, three main themes were identified: contact simulations, computer-based simulations, and debriefing. The focus was on how these approaches were used to promote CT. Various subthemes were also identified.

Conclusion. Correctly planning and implementing a simulation-based experience that relates to the relevant learning activities, combined with repeat practice and guided reflection during the debriefing stage, improves the CT skills of HP students.


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Promoting critical thinking through simulation-based healthcare training (SBHT): A scoping review. (2022). African Journal of Health Professions Education, 14(4), 160-164.
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Promoting critical thinking through simulation-based healthcare training (SBHT): A scoping review. (2022). African Journal of Health Professions Education, 14(4), 160-164.


Levac D, Colquhoun H, O’Brien KK. Scoping studies: Advancing the methodology. Implement Sci 2010;5(1).

World Health Organization. Global standards for the initial education of professional nurses and midwives. Switzerland: WHO; 2009. (accessed 9 February 2022).

South Africa. South African Qualifications Authority Act of 1995. NSB Regulations No. 452 of 1998. Government Gazette No. 18787, 1998. (Published under Government Notice R452) default/files/2019-11/NSB%20Regulation%20No.%20R.%20482%2C%201998%20-%20English%20Version.pdf (accessed 9 February 2022).

Von Colln-Appling C, Giuliano D. A concept analysis of critical thinking: A guide for nurse educators. Nurse Educ Today 2017;1(49):106-109.

Ertmer PA, Strobel J, Cheng X, et al. Expressions of critical thinking in role-playing simulations: Comparisons across roles. J Comput High Educ 2010;22(2):73-94.

Scheffer C, Valk-Draad MP, Tauschel D, et al. Students with an autonomous role in hospital care – patients’ perceptions. Med Teach 2018;40(9):944-952.

Blakeslee JR. Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study. Nurse Educ Today 2020;92:104494. nedt.2020.104494

Svellingen AH, Søvik MB, Røykenes K, Brattebø G. The effect of multiple exposures in scenario-based simulation – A mixed study systematic review. Nurs Open 2021;8(1):380-394.

Persico L. A Review: Using Simulation-based Education to Substitute Traditional Clinical Rotations. JOJ Nurse Health Care 2018; 9(3):555762

Turrise SL, Thompson CE, Hepler M. Virtual simulation: Comparing critical thinking and satisfaction in RN- BSN students. Clin Simul Nurs 2020;46:57-61.

Deitz GD, Fox AK, Fox JD. The effect of individual and team characteristics on simulation-enhanced critical thinking: A multilevel analysis. Market Educ Rev 2021;1-14.

Louw A. Cognitive load theory in simulations to facilitate critical thinking in radiography students. Afr J Health

Prof Educ 2021;13(1):41.

Salleh SM, Tasir Z, Shukor NA. Web-based simulation learning framework to enhance students’ critical thinking

skills. Procedia – Social Behav Sci. 2012;64:372-381.

Albert S. Applied critical thinking in strategy: Tools and a simulation using a live case. J Educ Business


Bunt B, Gouws G. Using an artificial life simulation to enhance reflective critical thinking among student

teachers. Smart Learning Environments 2020;7:12

Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Method 2005;8:19-

Sucharew H, Macaluso M. Methods for research evidence synthesis: The scoping review approach. J Hosp Med 2019;14(7):416-418.

Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018(169):467-473.

Ka Ling F, Lim Binti Abdullah K, Seng Chiew G, Danaee M, Chan CMH. The impact of high fidelity patient simulation on the level of knowledge and critical thinking skills in code blue management among undergraduate nursing students in Malaysia. SAGE Open Nurs. 2021;11(2).

Hagemann V, Herbstreit F, Kehren C, et al. Does teaching non-technical skills to medical students improve those skills and simulated patient outcome? Int J Med Educ 2017(8):101-113.

Munroe B, Buckley T, Curtis K, Morris R. Designing and implementing full immersion simulation as a research tool. Australas Emerg Nurs J 2016;19:90-105.

Mai JA, Pilcher RL, Frommelt-Kuhle M. Fostering interprofessional collaboration and critical thinking between nursing and physical therapy students using high-fidelity simulation. J Interprof Educ Pract 2018;10:37-40.

Louw A. Cognitive load theory in simulations to facilitate critical thinking in radiography students. Afr J Health Prof Educ 2021;13(1):41.

BartlettRS,BrueckerS,EcclestonB.High-fidelitysimulationimproveslong-termknowledgeofclinicalswallow evaluation. Am J Speech Lang Pathol 2021;30(2):673-686.

Arunachalam S, Priya E, Saxena K, Andiesta NS. Virtual role-playing simulation as clinic: A model for experiential learning of critical thinking skills. J Dent Educ 2021;85(S1):1055-1058.

Kim E. Effect of simulation-based emergency cardiac arrest education on nursing students’ self-efficacy and critical thinking skills: Roleplay versus lecture. Nurse Educ Today 2018;61:258-263. nedt.2017.12.003

Shin H, Ma H, Park J, Ji ES, Kim DH. The effect of simulation courseware on critical thinking in undergraduate nursing students: Multi-site pre-post study. Nurse Educ Today 2015;35(4):537-542. nedt.2014.12.004

Macauley K, Brudvig TJ, Kadakia M, Bonneville M. Systematic review of assessments that evaluate clinical decision making, clinical reasoning, and critical thinking changes after simulation participation. J Phys Ther Educ 2017;31(4):64-75.

Al Gharibi K, Arulappan J. Repeated simulation experience on self-confidence, critical thinking, and competence of nurses and nursing students – An integrative review. SAGE Open Nurs 2020;6 https://doi. org/10.1177/2377960820927377

Unver V, Basak T, Ayhan H, et al. Integrating simulation based learning into nursing education programs: Hybrid simulation. Technol Health Care 2018;26(2):263-270.

Abuzaid MM, Elshami W. Integrating of scenario-based simulation into radiology education to improve critical thinking skills. Rep Med Imaging 2016;9:17-22.

Rababa M, Masha’al D. Using branching path simulations in critical thinking of pain management among nursing students: Experimental study. Nurse Educ Today 2020;86:104323. 33. Peddle M. Participant perceptions of virtual simulation to develop non-technical skills in health professionals.

J Res Nurs 2019;24(3-4):167-180.

Chang CY, Kao CH, Hwang GJ, Lin FH. From experiencing to critical thinking: A contextual game-based

learning approach to improving nursing students’ performance in electrocardiogram training. Educ Technol Res

Dev 2020;68(3):1225-1245.

Luu C, Talbot TB, Fung CC, et al. Development and performance assessment of a digital serious game to assess

multi-patient care skills in a simulated pediatric emergency department. Simul Gaming 2020;51(4):550-570.

Padden-Denmead ML, Scaffidi RM, Kerley RM, Farside AL. Simulation with debriefing and guided reflective journaling to stimulate critical thinking in prelicensure baccalaureate degree nursing students. J Nurs Educ 2016;55(11):645-650.

Odreman HA, Clyens D. Concept mapping during simulation debriefing to encourage active learning, critical thinking, and connections to clinical concepts. Nurs Educ Perspect 2020;41(1):37-38. NEP.0000000000000445

Wolters Kluwer. Increasing fidelity and realism in simulation for nursing students. com/en/expert-insights/increasing-fidelity-and-realism-in-simulation (accessed 16 February 2022).

Ostovar S, Allahbakhshian A, Gholizadeh L, Dizaji S, Sarbakhsh P, Ghahramanian A. Comparison of the effects of debriefing methods on psychomotor skills, self-confidence, and satisfaction in novice nursing students: A quasi-experimental study. J Adv Pharm Technol Res 2018;9(3):107-112. JAPTR_291_18

Miller GE. The assessment of clinical skills/competence/performance. Acad Med 1990;65(9):S63-67. https://doi. org/10.1097/00001888-199009000-00045

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