Effectiveness of Simulation-Based Instruction in Advancing Nursing Proficiency within Continuing Professional Development: systematic Review

Simulation-based instruction has become a central strategy in nursing education for strengthening clinical judgment, technical skills, and decision-making. While its effectiveness is well established in undergraduate training, less is known about its impact on post-registration nurses engaged in continuing professional development. Advancing nursing proficiency—defined as the enhancement of knowledge, psychomotor skills, confidence, leadership attributes, and teamwork performance—is essential for maintaining high-quality patient care in rapidly evolving clinical environments. This rapid review examined the effectiveness of simulation-based instruction in advancing nursing proficiency within the context of continuing professional development. Four databases (MEDLINE, EMBASE, Web of Science, Google Scholar) were searched for quantitative studies published between 2000 and 2023. Eligible studies included post-registration nurses exposed to simulation-based instructional interventions. The TAPUPAS tool guided quality appraisal, and only studies scoring ≥65 % were included. Given methodological heterogeneity, findings were synthesized narratively following PRISMA guidelines. Fourteen studies involving 1,204 nurses met inclusion criteria. Simulation-based instruction consistently improved knowledge and clinical skills across diverse specialties (e.g., critical care, NICU, emergency, geriatric care). Evidence for affective and behavioral outcomes—including confidence, self-efficacy, teamwork, and leadership—was mixed, largely due to limited study numbers and variations in simulation design, fidelity, and scenario emphasis. Simulation-based instruction is effective in strengthening key domains of nursing proficiency within continuing professional development. Tailoring simulation scenarios to the targeted competency domain may optimize outcomes. Policymakers and educators should integrate structured simulation programs into ongoing professional development and support further research to refine best practices.