author(s)
Sharika Ratish

abstract
Simulation-based learning is an increasingly essential tool in nursing education, allowing students to practice clinical skills in a safe, controlled environment before entering real-life clinical settings. This systematic review evaluates the effectiveness of different types of simulation-high-fidelity, low-fidelity, virtual reality, and hybrid simulations on various competencies among nursing students. A comprehensive literature search across PubMed, CINAHL, Scopus, and Science Direct identified 25 relevant studies, 10 of which provided quantitative outcomes that were synthesized in a review matrix. Findings indicate that simulation-based learning significantly improves clinical competency, critical thinking, skill performance, and confidence, while reducing anxiety. High-fidelity and hybrid simulations demonstrated the most substantial impact on complex skill acquisition and clinical reasoning, while low-fidelity simulations were beneficial for basic skill practice. Virtual reality simulations also positively influenced confidence and decision-making skills. Overall, simulation-based learning proves to be a valuable component in nursing education, effectively bridging the gap between theoretical knowledge and clinical practice, and better preparing students for real-world healthcare challenges.