Effectiveness of Clinical Learning Methods in Improving Clinical Skills of Nursing Students: Systematic Review



  • Muhammad Al-amin R. Sapeni Universitas Hasanuddin Makassar
  • Kadek Ayu Erika Universitas Hasanuddin Makassar
  • Ariyanti Saleh Universitas Hasanuddin Makassar


Introduction: Clinical skills are an important indicator that must be achieved in the application of clinical learning to nursing students. Method: The design of this study is a systematic review. This article was prepared in accordance with the PRISMA method. Search for articles using the Pubmed, Proquest, ScienceDirect, and Ebsco databases. Research questions were prepared using the PICO method, and search keywords were based on a database in MeSH Term. The inclusion criteria in this review article are the focus on the application of clinical learning methods, applied to nursing students, the type of Randomized Controlled Trial research, influencing clinical skills, and published since 2011-2020.  There were 2,078 articles found. The included articles were analyzed using the Critical Appraisal Skills Program. To assess the quality of articles used the Effective Public Health Practice Project. Result: There are six articles included in this study. From the results of the critical assessment in the included article, the application of Flipped Learning, Video Skills, Interactive Clinical Nursing Skills Mobile Applications, High-Fidelity, Clinical Teaching Associates, End-of-Life Care can significantly improve the clinical skills of nursing students. Conclusion: The clinical learning methods applied can improve the clinical skills of nursing students. Therefore, these clinical learning models can be recommended in nursing education.


Download data is not yet available.

Aktaş, Y. Y., & Karabulut, N. (2016). A survey on Turkish nursing students’ perception of clinical learning environment and its association with academic motivation and clinical decision making. Nurse Education Today, 36, 124–128. https://doi.org/10.1016/j.nedt.2015.08.015

Berragan, L. (2011). Simulation: An effective pedagogical approach for nursing? Nurse Education Today, 31(7), 660–663. https://doi.org/10.1016/j.nedt.2011.01.019

Brighton, L. J., Koffman, J., Hawkins, A., McDonald, C., O’Brien, S., Robinson, V., … Selman, L. E. (2017). A Systematic Review of End-of-Life Care Communication Skills Training for Generalist Palliative Care Providers: Research Quality and Reporting Guidance. Journal of Pain and Symptom Management, 54(3), 417–425. https://doi.org/10.1016/j.jpainsymman. 2017.04.008

Carbogim, F. da C., Barbosa, A. C. S., de Oliviera, L. B., de Sá Diaz, F. B. B., Toledo, L. V., Alves, K. R., … Püschel, V. A. de A. (2018). Educational intervention to improve critical thinking for undergraduate nursing students: A randomized clinical trial. Nurse Education in Practice, 33(January 2019), 121–126. https://doi.org/10.1016/j.nepr.2018.10.001

CASP. (2018). Critical appraisal skills programme (CASP), 1–32. Retrieved from https://casp-uk.net/wp-content/uploads/2018/01/CASP-Bibliography.pdf

Chesser-Smyth, P. A. (2005). The lived experiences of general student nurses on their first clinical placement: A phenomenological study. Nurse Education in Practice, 5(6), 320–327. https://doi.org/10.1016/j.nepr.2005.04.001.

Cho, M. K., & Kim, M. Y. (2019). Outcomes and influential factors applying flipped learning methods in a clinical adult nursing practicum. International Journal of Nursing Practice, 25(2), 1–10. https://doi.org/10.1111/ijn.12724

Chuang, Y. H., Lai, F. C., Chang, C. C., & Wan, H. T. (2018). Effects of a skill demonstration video delivered by smartphone on facilitating nursing students’ skill competencies and self-confidence: A randomized controlled trial study. Nurse Education Today, 66, July 2018, 63–68. https://doi.org/10.1016/j.nedt.2018.03.027

Cremonini, V., Ferri, P., Artioli, G., Sarli, L., Piccioni, E., & Rubbi, I. (2015). Nursing students’ experiences of and satisfaction with the clinical learning environment: The role of educational models in the simulation laboratory and in clinical practice. Acta Biomedica, 86, 194–204. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L608237023

Eldarir, S. A., & Hamid, N. A. A. E. (2013). Objective structured clinical evaluation (OSCE) versus traditional clinical students achievement at maternity nursing: A comparative approach. IOSR Journal of Dental and Medical Sciences, 4(3), 63–68. https://doi.org/10.9790/0853-0436368

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association, 106(4), 10–11. https://doi.org/10.5195/jmla.2018.345

Fawaz, M. A., & Hamdan-Mansour, A. M. (2016). Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students. Nurse Education Today, 46, 36–42. https://doi.org/10.1016/j.nedt.2016.08.026

Flott, E. A., & Linden, L. (2016). The clinical learning environment in nursing education: A concept analysis. Journal of Advanced Nursing, 72(3), 501–513. https://doi.org/10.1111/jan.12861

Gaberson, K. B., Oermann, M. H., & Shellenbarger, T. (2015). Clinical Teaching Strategies in Nursing. The Journal of Continuing Education in Nursing (4th ed., Vol. 39). New York: Springer Publishing Company, LLC.

Huang, H.-P., Chao, L.-F., Wang, Y.-H., Liu, Y.-M., Ni, L.-F., & Jane, S.-W. (2017). [The establishment and examination of the reliability, validity, discrimination, and difficulty of nursing objective structured clinical examination (OSCE)]. Hu li za zhi The Journal of Nursing, 64(6), 67–76. https://doi.org/10.6224/JN.000084

Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Kalyani, M. N. (2016). The Challenges of Nursing Students in the Clinical Learning Environment: A Qualitative Study. Scientific World Journal, 2016. https://doi.org/10.1155/2016/1846178

Jonsén, E., Melender, H. L., & Hilli, Y. (2013). Finnish and Swedish nursing students’ experiences of their first clinical practice placement - A qualitative study. Nurse Education Today, 33(3), 297–302. https://doi.org/10.1016/j.nedt.2012.06.012

Kabisch, M., Ruckes, C., Seibert-Grafe, M., & Blettner, M. (2011). Randomized controlled trials. Deutsches Ärzteblatt International, 108(39), 663–668. https://doi.org/10.1002/9781119171386.ch7

Kim, H., & Suh, Eunyoung, E. (2018). The Effects of an Interactive Nursing Skills Mobile Application on Nursing Students’ Knowledge, Self-efficacy, and Skills Performance: A Randomized Controlled Trial. Asian Nursing Research, 12(1), 17–25. https://doi.org/10.1016/j.anr.2018.01.001

Kim, Hyun, S., Kim, Mi, Y., Cho, Mi, K., & Jang, Sun, J. (2017). Effectiveness of applying flipped learning to clinical nursing practicums for nursing students in Korea: A randomized controlled trial. International Journal of Nursing Practice, 23(5), 1–10. https://doi.org/10.1111/ijn.12574

Mert Karadas, M., & Terzioglu, F. (2019). The impact of the using high-fidelity simulation and standardized patients to management of postpartum hemorrhage in undergraduate nursing students: A randomized controlled study in Turkey. Health Care for Women International, 40(5), 597–612. https://doi.org/10.1080/07399332.2019.1583229

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Rand et al. Supplement- additional resources: Systematic reviews and meta-analyses: The prisma statement. Annals of Internal Medicine, 151(4), 264–269. https://doi.org/10.1371/journal.pmed1000097

Oderinu, O., Adegbulugbe, I., Orenuga, O., & Butali, A. (2019). Comparison of students’ perception of problem‐based learning and traditional teaching method in a Nigerian dental school. European Journal of Dental Education. https://doi.org/10.1111/eje.12486

Parchebafieh, S., Gholizadeh, L., Lakdizaji, S., Ghiasvandiyan, S., & Davoodi, A. (2014). Effectiveness of the clinical teaching associate model to improve clinical learning outcomes: A randomized controlled trial. Nurse Educator, 39(4), 202–205. https://doi.org/10.1097/NNE.0000000000000054

Shim, J. S., Kim, J. Y., Pyun, J. H., Cho, S., Oh, M. M., Kang, S. H., … Kang, S. G. (2018). Comparison of effective teaching methods to achieve skill acquisition using a robotic virtual reality simulator expert proctoring versus an educational video versus independent training. Medicine (United States), 97(51), 1–5. https://doi.org/10.1097/MD.0000000000013569

Tamaki, T., Inumaru, A., Yokoi, Y., Fujii, M., Tomita, M., Inoue, Y., … Tsujikawa, M. (2019). The effectiveness of end-of-life care simulation in undergraduate nursing education: A randomized controlled trial. Nurse Education Today, 76(January), 1–7. https://doi.org/10.1016/j.nedt.2019.01.005

Thomas, B. H., Ciliska, D., Dobbins, M., & Micucci, S. (2004). A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing, 1(3), 176–184. https://doi.org/10.1111/j.1524-475X.2004.04006.x

Thukral, A., Joshi, M., Joshi, P., Prakash, V., Adkoli, B. V., & Deorari, A. K. (2014). Apps for management of sick newborn: Evaluation of impact on health care professionals. Journal of Tropical Pediatrics, 60(5), 370–376. https://doi.org/10.1093/tropej/fmu032



How to Cite

Sapeni, M. A.- amin R., Erika, K. A., & Saleh, A. (2020). Effectiveness of Clinical Learning Methods in Improving Clinical Skills of Nursing Students: Systematic Review. Indonesian Contemporary Nursing Journal , 5(1), 9-20. https://doi.org/10.20956/icon.v5i1.9795