High-Fidelity Simulation in Nursing Education: A Narrative Review of Students’ Learning Outcomes

Introduction: High-Fidelity Simulation (HFS) is a key pedagogical approach in nursing education, offering immersive and realistic clinical scenarios that help bridge the gap between theory and practice. Despite a growing body of research, evidence on nursing students’ learning outcomes with HFS remains fragmented across diverse study designs, educational contexts, and theoretical perspectives. Many studies emphasize isolated outcomes, such as knowledge acquisition or self-confidence, limiting integrative understanding across learning domains and constraining quantitative synthesis. Aim: This narrative review synthesizes existing literature on nursing students’ learning outcomes with HFS, identifying recurring themes, perceptions, and educational outcomes across cognitive, affective, and psychomotor learning domains. Methods: A narrative review was conducted of 23 peer-reviewed studies published between 2019 and 2024. Literature was retrieved from Google Scholar, PubMed, JSTOR, and ScienceDirect using the keywords “high fidelity,” “high-fidelity,” “nursing,” “teaching,” and “simulation.” Included studies employed qualitative, quantitative, or mixed-methods designs and involved nursing students. Studies focusing exclusively on educators, no available full-text, review articles, or non-English publications were excluded. Results: The findings demonstrate that nursing students’ learning outcomes with HFS are multidimensional and consistently positive across varied educational and cultural contexts in three interrelated domains: (1) congnitive, (2) affective, and (3) psychomotor learning. Structured debriefing, experiential learning cycles, and effective faculty facilitation emerged as critical factors in optimizing learning outcomes. HFS consistently supported students’ development of knowledge, clinical reasoning, emotional readiness, and practical competence, reinforcing its value as a comprehensive pedagogical strategy in undergraduate nursing education. Conclusion: HFS is a transformative educational strategy that integrates cognitive, affective, and psychomotor learning that leads to enhancements of students’ competencies, confidence, and readiness for professional practice. Its curricular integration is a strategic educational approach that sets quality and standards, aligning to the complex demands of the contemporary nursing education with the aim to maximize positive impact to patient safety.