Componentes de la simulación clínica asociados con el desarrollo del razonamiento clínico en estudiantes de enfermería
DOI:
https://doi.org/10.56200/mentor.v5i15.13653Palabras clave:
razonamiento clínico, simulación clínica, estudiantes de enfermería, debriefing, educación en enfermeríaResumen
El razonamiento clínico constituye un proceso cognitivo mediante el cual los estudiantes de enfermería recopilan, interpretan, priorizan e integran información del paciente para orientar decisiones de cuidado. El estudio analizó los componentes de la simulación clínica asociados con el desarrollo del razonamiento clínico en estudiantes de enfermería. Se realizó una revisión documental de literatura científica sobre simulación aplicada a la formación en enfermería, con énfasis en diseño del escenario, prebriefing, fidelidad, facilitación, repetición, retroalimentación, debriefing y simulación virtual. La evidencia revisada mostró que el razonamiento clínico no se vinculó con el uso aislado de tecnología de alta fidelidad, sino con la interacción entre diseño intencionado del escenario, preparación previa, participación activa, exposición repetida a situaciones clínicas, facilitación guiada y reflexión estructurada posterior. La simulación virtual también presentó resultados favorables cuando incorporó varios escenarios, actividades de manejo del paciente, tiempo suficiente de interacción y retroalimentación posterior. Se concluyó que el valor formativo de la simulación dependió principalmente de la coherencia entre sus componentes y de su orientación hacia la interpretación de datos, priorización, justificación de decisiones, evaluación de respuestas y reconsideración del propio razonamiento.
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Abdulmohdi, N., & McVicar, A. (2023). Investigating the clinical decision-making of nursing students using high-fidelity simulation, observation and think aloud: A mixed methods research study. Journal of Advanced Nursing, 79(2), 811–824. https://doi.org/10.1111/jan.15507
Abelsson, A., & Bisholt, B. (2017). Nurse students learning acute care by simulation: Focus on observation and debriefing. Nurse Education in Practice, 24, 6–13. https://doi.org/10.1016/j.nepr.2017.03.001
Alshehri, F. D., Jones, S., & Harrison, D. (2023). The effectiveness of high-fidelity simulation on undergraduate nursing students’ clinical reasoning-related skills: A systematic review. Nurse Education Today, 121, 105679. https://doi.org/10.1016/j.nedt.2022.105679
Ayed, A., Khalaf, I. A., Fashafsheh, I., Saleh, A., Bawadi, H., Abuidhail, J., Thultheen, I., & Joudallah, H. (2022). Effect of high-fidelity simulation on clinical judgment among nursing students. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 59, 00469580221081997. https://doi.org/10.1177/00469580221081997
Blanié, A., Amorim, M.-A., & Benhamou, D. (2020). Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: A randomized study in nursing students. BMC Medical Education, 20, 53. https://doi.org/10.1186/s12909-020-1939-6
Brown Tyo, M., & McCurry, M. K. (2019). An integrative review of clinical reasoning teaching strategies and outcome evaluation in nursing education. Nursing Education Perspectives, 40(1), 11–17. https://doi.org/10.1097/01.NEP.0000000000000375
Bussard, M. E., Jacobs, L. A., Mahoney, S. A., Davis, L. L., Oberhaus, A. M., & Lavoie, P. (2025). Development of clinical judgment in prelicensure nursing students through simulation: A longitudinal study. Nurse Educator, 50(3), 117–122. https://doi.org/10.1097/NNE.0000000000001790
Cant, R. P., & Cooper, S. J. (2017). The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis. Nurse Education in Practice, 27, 45–62. https://doi.org/10.1016/j.nepr.2017.08.012
Chabrera, C., Curell, L., & Rodríguez-Higueras, E. (2025). Effectiveness of high versus mixed-level fidelity simulation on undergraduate nursing students: A randomised controlled trial. Nurse Education in Practice, 82, 104206. https://doi.org/10.1016/j.nepr.2024.104206
Decker, S., Alinier, G., Crawford, S. B., Gordon, R. M., Jenkins, D., & Wilson, C. (2021). Healthcare Simulation Standards of Best Practice™: The debriefing process. Clinical Simulation in Nursing, 58, 27–32. https://doi.org/10.1016/j.ecns.2021.08.011
Dreifuerst, K. T. (2012). Using debriefing for meaningful learning to foster development of clinical reasoning in simulation. Journal of Nursing Education, 51(6), 326–333. https://doi.org/10.3928/01484834-20120409-02
Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230–235. https://doi.org/10.1179/2047480615Z.000000000329
Forneris, S. G., Neal, D. O., Tiffany, J., Kuehn, M. B., Meyer, H. M., Blazovich, L. M., Holland, A. E., & Smerillo, M. (2015). Enhancing clinical reasoning through simulation debriefing: A multisite study. Nursing Education Perspectives, 36(5), 304–310. https://doi.org/10.5480/15-1672
Foronda, C. L., Fernandez-Burgos, M., Nadeau, C., Kelley, C. N., & Henry, M. N. (2020). Virtual simulation in nursing education: A systematic review spanning 1996 to 2018. Simulation in Healthcare, 15(1), 46–54. https://doi.org/10.1097/SIH.0000000000000411
Görücü, S., Türk, G., & Karaçam, Z. (2024). The effect of simulation-based learning on nursing students’ clinical decision-making skills: Systematic review and meta-analysis. Nurse Education Today, 140, 106270. https://doi.org/10.1016/j.nedt.2024.106270
Hu, F., Yang, J., Yang, B. X., Zhang, F.-J., Yu, S.-H., Liu, Q., Wang, A.-L., Luo, D., Zhu, X.-P., & Chen, J. (2021). The impact of simulation-based triage education on nursing students’ self-reported clinical reasoning ability: A quasi-experimental study. Nurse Education in Practice, 50, 102949. https://doi.org/10.1016/j.nepr.2020.102949
Kim, J., Park, J.-H., & Shin, S. (2016). Effectiveness of simulation-based nursing education depending on fidelity: A meta-analysis. BMC Medical Education, 16, 152. https://doi.org/10.1186/s12909-016-0672-7
Kim, H.-K., Ryu, S., & Jang, K.-S. (2019). Effect of structured pre-simulation preparation and briefing on student’s self-confidence, clinical judgment, and clinical decision-making in simulation. Contemporary Nurse, 55(4–5), 317–329. https://doi.org/10.1080/10376178.2019.1641420
Lee, J., Lee, H., Kim, S., Choi, M., Ko, I. S., Bae, J., & Kim, S. H. (2020). Debriefing methods and learning outcomes in simulation nursing education: A systematic review and meta-analysis. Nurse Education Today, 87, 104345. https://doi.org/10.1016/j.nedt.2020.104345
Levett-Jones, T., Hoffman, K., Dempsey, J., Jeong, S. Y.-S., Noble, D., Norton, C. A., Roche, J., & Hickey, N. (2010). The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today, 30(6), 515–520. https://doi.org/10.1016/j.nedt.2009.10.020
Madsgaard, A., Røykenes, K., Smith-Strøm, H., & Kvernenes, M. (2022). The affective component of learning in simulation-based education: Facilitators’ strategies to establish psychological safety and accommodate nursing students’ emotions. BMC Nursing, 21, 91. https://doi.org/10.1186/s12912-022-00869-3
McDermott, D. S., Ludlow, J., Horsley, E., & Meakim, C. (2021). Healthcare Simulation Standards of Best Practice™: Prebriefing: Preparation and briefing. Clinical Simulation in Nursing, 58, 9–13. https://doi.org/10.1016/j.ecns.2021.08.008
Miller, C., Deckers, C., Jones, M., Wells-Beede, E., & McGee, E. (2021). Healthcare Simulation Standards of Best Practice™: Outcomes and objectives. Clinical Simulation in Nursing, 58, 40–44. https://doi.org/10.1016/j.ecns.2021.08.013
Niu, Y., Liu, T., Li, K., Sun, M., Sun, Y., Wang, X., & Yang, X. (2021). Effectiveness of simulation debriefing methods in nursing education: A systematic review and meta-analysis. Nurse Education Today, 107, 105113. https://doi.org/10.1016/j.nedt.2021.105113
Oh, Y.-J., Kang, H.-Y., Song, Y., & Lindquist, R. (2021). Effects of a transformative learning theory based debriefing in simulation: A randomized trial. Nurse Education in Practice, 50, 102962. https://doi.org/10.1016/j.nepr.2020.102962
Oliveira Silva, G., Aredes, N. D. A., Siqueira, K. M., Fonseca, L. M. M., Vieira, F. V. M., Cavalcante, A. M. R. Z., & Campbell, S. H. (2026). Simulation and the translation into clinical practice of nursing students’ clinical judgement, knowledge of the nursing process and self-confidence: A mixed methods randomized controlled study. Journal of Clinical Nursing. Advance online publication. https://doi.org/10.1111/jocn.70392
Padilha, J. M., Machado, P. P., Ribeiro, A., Ramos, J., & Costa, P. (2019). Clinical virtual simulation in nursing education: Randomized controlled trial. Journal of Medical Internet Research, 21(3), e11529. https://doi.org/10.2196/11529
Page-Cutrara, K., & Turk, M. (2017). Impact of prebriefing on competency performance, clinical judgment and experience in simulation: An experimental study. Nurse Education Today, 48, 78–83. https://doi.org/10.1016/j.nedt.2016.09.012
Persico, L., Belle, A., DiGregorio, H., Wilson-Keates, B., & Shelton, C. (2021). Healthcare Simulation Standards of Best Practice™: Facilitation. Clinical Simulation in Nursing, 58, 22–26. https://doi.org/10.1016/j.ecns.2021.08.010
Sales, L., Ferreira, M., Pereira, R., Lucas, I., Marques, R., & Bento, I. (2026). Early development of clinical reasoning through virtual patient simulation: Nursing students’ perceptions of collaborative decision-making. Nursing Reports, 16(5), 152. https://doi.org/10.3390/nursrep16050152
Saragih, I. D., Tarihoran, D. E. T. A. U., Lin, W.-T., & Lee, B.-O. (2024). Outcomes of scenario-based simulation courses in nursing education: A systematic review and meta-analysis. Nurse Education Today, 136, 106145. https://doi.org/10.1016/j.nedt.2024.106145
Shin, S., Park, J.-H., & Kim, J.-H. (2015). Effectiveness of patient simulation in nursing education: Meta-analysis. Nurse Education Today, 35(1), 176–182. https://doi.org/10.1016/j.nedt.2014.09.009
Sim, J. J. M., Rusli, K. D. B., Seah, B., Levett-Jones, T., Lau, Y., & Liaw, S. Y. (2022). Virtual simulation to enhance clinical reasoning in nursing: A systematic review and meta-analysis. Clinical Simulation in Nursing, 69, 26–39. https://doi.org/10.1016/j.ecns.2022.05.006
Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, 66(5), 1151–1158. https://doi.org/10.1111/j.1365-2648.2010.05262.x
Skoronski Chavez, L., & Lovecchio, C. (2026). Senior nursing students in a repeating simulation experience: A pilot study. Nursing Education Perspectives, 47(3), 183–185. https://doi.org/10.1097/01.NEP.0000000000001421
Skoronski Chavez, L., & Murphy, J. (2026). Repeating simulation experience as part of competency-based education: A quasiexperimental study. Journal of Nursing Education, 65(7), 424–427. https://doi.org/10.3928/01484834-20251124-01
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204–211. https://doi.org/10.3928/01484834-20060601-04
Theobald, K. A., Tutticci, N., Ramsbotham, J., & Johnston, S. (2021). Effectiveness of using simulation in the development of clinical reasoning in undergraduate nursing students: A systematic review. Nurse Education in Practice, 57, 103220. https://doi.org/10.1016/j.nepr.2021.103220
Tong, L. K., Li, Y. Y., Au, M. L., Wang, S. C., & Ng, W. I. (2022). Prebriefing for high-fidelity simulation in nursing education: A meta-analysis. Nurse Education Today, 119, 105609. https://doi.org/10.1016/j.nedt.2022.105609
Tutticci, N., Theobald, K. A., Ramsbotham, J., & Johnston, S. (2022). Exploring the observer role and clinical reasoning in simulation: A scoping review. Nurse Education in Practice, 59, 103301. https://doi.org/10.1016/j.nepr.2022.103301
Watts, P. I., McDermott, D. S., Alinier, G., Charnetski, M., Ludlow, J., Horsley, E., Meakim, C., & Nawathe, P. A. (2021). Healthcare Simulation Standards of Best Practice™: Simulation design. Clinical Simulation in Nursing, 58, 14–21. https://doi.org/10.1016/j.ecns.2021.08.009
Yoshioka-Maeda, K., Honda, C., Sumikawa, Y., Okamoto, Y., Iwasaki-Motegi, R., Miura, T., Otsuki, M., Fujii, H., & Shimada, M. (2026). Comparison of immersive virtual reality and video-based home visit simulations for developing nursing students’ perceived clinical reasoning, learning satisfaction, and engagement: A randomized controlled trial. BMC Nursing, 25, 532. https://doi.org/10.1186/s12912-026-04520-3
Zhao, L., Yan, H., Liu, L., Zhou, R., Yang, Y., Li, K., Wan, F., & Li, Y. (2026). Effect of desktop virtual patient simulation on clinical reasoning skills of nursing students: A systematic review and meta-analysis. Nurse Education in Practice, 93, 104822. https://doi.org/10.1016/j.nepr.2026.104822
Zulkosky, K., Minchhoff, D., Dommel, L., Price, A., & Handzlik, B. M. (2021). Effect of repeating simulation scenarios on student knowledge, performance, satisfaction and self-confidence. Clinical Simulation in Nursing, 55, 27–36. https://doi.org/10.1016/j.ecns.2021.03.004
Zweifel, A. R., Emery, K. A., & Gilbert, G. E. (2022). Exploring learning effectiveness for participant roles during healthcare simulation. Nurse Education Today, 119, 105561. https://doi.org/10.1016/j.nedt.2022.105561
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Derechos de autor 2026 Vilma Rocío Quijije Chávez , Mariuxi Johanna Zurita Desiderio , Yulitza Geomara Villamar Torres , María Priscila Rodríguez Benítez

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