The Impact of High-Fidelity Simulation on Undergraduate Nursing Students’ Attitudes Toward Older Adults

This scoping review examined the impact of high-fidelity simulation on undergraduate nursing students' attitudes toward older adults. Fifteen studies were included, representing diverse simulation modalities such as standardized patients, Mask-Ed, manikin-based, hybrid, and electronic formats. Across settings, simulation consistently improved attitudes toward older adults, reduced stereotyping, and fostered empathy and respect. Standardized patients and Mask-Ed were most effective for relational outcomes, whereas manikin-based and hybrid approaches supported technical skills alongside attitudinal change. Electronic simulation demonstrated potential for remote and resource-limited contexts. Despite these positive outcomes, measurement tools and analytic approaches varied, and only one study evaluated retention beyond 6 weeks. The long-term impact of simulation on professional practice remains unclear. Future research should apply standardized measures, compare modalities, and conduct longitudinal evaluations. Simulation designed with intentional affective objectives can help prepare a nursing workforce that values older adults and delivers person-centered gerontological care.