High fidelity human patient simulators in undergraduate nursing programmes : are they justified and do they improve student learning outcomes?

Simulated learning in undergraduate nursing programmes has escalated at an unprecedented rate over the last decade with many Institutions boasting high fidelity state of the art simulation labs and high fidelity human patient simulators (HFHPS) (Lapkin & Levett-Jones, 2011; Schiavenato, 2009; Wordsworth, 2013). Simulation, defined by Jeffries (2005) as an activity mimicking the reality of the clinical environment is used to demonstrate procedures, decision-making, and critical thinking and encompasses a wide range of techniques from role-play and scenario setting to computerised manikins. Delivery techniques in simulation are categorised depending on their fidelity or the degree to which they simulate the reality of the real-world (Dunnington, 2014) High technology in simulation undoubtedly attracts students but hard to ascertain is whether high fidelity simulation equipment is justified in terms of cost and student learning outcomes compared to low or medium fidelity (Brown et al., 2012; Handley & Dodge, 2013; Schiavenato, 2009). Norman, Dore & Grierson, (2012) aptly remind us that while studies involving HFHPS show beneficial outcomes for students (Glidewell & Conley, 2014; Liaw et al., 2013; Norman, 2012; Wordsworth, 2013) they commonly include a non-intervention control group thereby failing to acknowledge the relationship between fidelity and student learning.