Educational Outcomes and Implementation of Clinical Simulation in Geriatric and Gerontological Nursing Education: A Systematic Review
Firas A. Abu Hussein, Samer H. SharkiyaBackground
Population ageing has intensified the need for nurses who can provide safe, person-centred care for older adults with complex health needs. Clinical simulation is increasingly used to support gerontological nursing education; however, the evidence varies across learner levels, simulation modalities, study designs, outcome measures, and follow-up periods.
Aim
To synthesize evidence on simulation modalities, educational outcomes, implementation factors, methodological quality, and risk of bias in geriatric and gerontological nursing education.
Methods
This systematic review was conducted and reported in accordance with PRISMA 2020. Peer-reviewed primary studies published in English from January 2020 through December 2025 were eligible. Undergraduate, postgraduate, nurse practitioner, and advanced practice nursing learners were included. Two reviewers independently screened studies, extracted data, and applied design-specific JBI critical appraisal tools or the Mixed Methods Appraisal Tool. Narrative synthesis was used because of substantial clinical and methodological heterogeneity.
Results
Thirteen primary studies were included. Simulation modalities included standardized or simulated patients, high-fidelity simulation, role-play, telehealth simulation, virtual simulation, virtual reality, and blended approaches. Simulation was associated with improvements in confidence, preparedness, communication, empathy, clinical reasoning, decision-making, and selected performance outcomes. Nevertheless, the evidence was dominated by small, single-site studies, short follow-up periods, heterogeneous outcome measures, and self-reported outcomes.
Conclusion
Clinical simulation is a promising educational strategy for geriatric and gerontological nursing education, particularly for short-term learner outcomes. Confidence in sustained competence, transfer to clinical practice, and patient-level effects remains limited. Future research should use standardized and validated outcome measures, multicenter comparative designs, objective performance assessment, and longer-term follow-up.