Exploring the impact of simulation-based learning (SBL) on the acquisition of psychomotor skills, knowledge, retention, satisfaction and confidence in teaching urinary catheterization in nursing education: Systematic review

Background: Urinary catheterization is a vital yet challenging skill for nursing students, as improper technique can lead to catheter-associated urinary tract infections (CAUTIs). Simulationbased learning (SBL) provides a safe and controlled environment for students to practice and refine such procedures. Methods: Following PRISMA guidelines, comprehensive searches were conducted across MEDLINE, CINAHL, Embase, PsycINFO, and Cochrane databases. The Cochrane Risk of Bias 2 (RoB 2) tool was used to assess randomized controlled trials (RCTs), while the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Quasi-Experimental Studies was applied to non-randomized studies. A narrative synthesis approach was employed for data analysis. Results: Eight studies (three RCTs and five quasi-experimental) from six countries met the inclusion criteria. Most studies reported immediate positive outcomes. However, only one study assessed long-term effects and one evaluated knowledge acquisition, highlighting key gaps in the current evidence. Conclusion: SBL appears effective in enhancing nursing students' competencies in urinary catheterization. Nevertheless, further robust research is needed to evaluate long-term retention, cost-effectiveness, and transferability across diverse educational contexts.