Background
Occupational violence and aggression (OVA) are a widespread issue in healthcare, with nurses at high risk due to frequent interactions with patients, families, and visitors. Entry-to-practice nurses are particularly vulnerable due to transition stress, workload challenges, and exposure to aggressive or distressed individuals. OVA has significant consequences, including psychological distress, increased turnover, and reduced job satisfaction. Simulation-based education is increasingly used to prepare nursing students to recognise, respond to, and manage OVA effectively. The effectiveness of different simulation methodologies in improving students' preparedness remains unclear.
Objective
This scoping review explores the use of simulation in nursing education for OVA and examines its impact on student learning outcomes.
Methods
A systematic search was conducted across multiple databases, including CINAHL, MEDLINE, EMBASE, PsycINFO, and ERIC. Studies were included if they focused on simulation-based training for OVA in entry-to-practice nursing education. Thematic analysis was used to synthesise findings.
Results
Twenty-three studies were included, with the most common simulation modalities being standardised patients (n = 8) and role-play (n = 6), followed by virtual and video-based simulations. Most studies reported improvements in knowledge, de-escalation skills, and confidence in managing OVA, where several studies demonstrated significant improvements in knowledge, confidence, and de-escalation skills with reported p-values ranging from p < 0.05 to p < 0.001. Some challenges included high student anxiety, difficulty translating skills to practice, and inconsistencies in simulation reporting.
Conclusion
Simulation enhances nursing students' ability to manage OVA, but its long-term impact remains uncertain. Future research should focus on refining simulation methods, reducing student distress, and ensuring real-world applicability.
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