| # | 1st Author | Year | Level of research (or non-research) evidence | Sample Composition & Size | Results/ Recommendations | Limitations | Rating |
| Strength/ Quality | |||||||
| 1 | Gu | 2017 | Randomized controlled Trial | 27 undergraduates (13 experimental and 14 control group). The experimental group received 10 virtual cases in addition to the regular course procedure. The control group received standard course procedures only. | The experimental group had higher knowledge scores than the control group. vSim for nursing students’ fundamentals is effective, improving students’ knowledge when combined with the traditional lecture. Tool—Knowledge test and skill performances were compared. | Small sample size vSim is developing in English only. | I/A |
| 2 | Durmaz | 2019 | Randomized controlled Trial | 305 nursing students: *155 experimental group—received web-based preoperative and postoperative patient care education. *150 control group—received traditional education. From February to May 2017. | The experimental group showed a higher knowledge score. Web-based education is a useful tool to educate nurse students in preoperative and postoperative patient care. Preoperative and Postoperative Care Knowledge Test, Preoperative and Postoperative Care Skill Control List, Clinical Decision Making in Nursing Scale, and Nursing Student Clinical Performance Evaluation Scale. | Both groups were in the same environment, creating a possibility of interaction. Also, the control group was able to ask more questions in real-time. questions in real-time. | II/B |
| 3 | Gill | 2019 | Systematic Review | 20 peer-reviewed articles | Online simulation is beneficial for pharmacology education to undergraduate students. Tradition lectures were the least affected for the students. Evaluated Knowledge. | Only one group of students received the pretest to establish group equivalence. | III/A |
| 4 | Goldsworthy | 2019 | Quasi- experimental study | 59 undergraduate nursing students in their third year were randomly assigned to a control or treatment group (24 treatment group - 39 comparison group). From age 26 - 25 years Treatment received 2, 8 hrs each virtual simulation intervention on unstable patient. | Clinical self-efficacy was seen only in the treatment group after the intervention. The simulation does provide confidence and competency to students in responding and recognizing deteriorating patients. Evaluated knowledge. Clinical self-efficacy tool | Small sample size and a single site. | II/C |
| 5 | Ramsay | 2020 | Quasi- experimental | First-year undergraduate nursing students in Austria. 410 students enrolled in an online EBP research class and participated in post-class survey. | Online teaching does not create a positive attitude about nursing students’ research but benefits their knowledge outcome. Evaluate behave. | Online teaching does not create a positive attitude about nursing students’ research but benefits their knowledge outcome. Evaluate behave. | III/C |
| 6 | Stoffels | 2019 | Systematic review | From 9360 abstracts, 17 articles were included. 5 articles focus on learning in practice, and the others focus on social, unplanned, or active learning. | Learning in clinical practice allows students to learn from peers, professionals, and patients, creating knowledge through the transformation of experience (Experimental Learning Theory). Evaluated knowledge and competence. | The literature search only covered undergraduate nursing education, lacking understanding of other health professionals. | III/B |
| 7 | Terry | 2018 | Quasi- experimental studies | 102 first-year nursing students (89 female/13 male) enrolled in a medication course—from age 18 to 44 years, for 26 weeks. The 102 students were divided into 3 groups: #1 learned online, #2 learned on campus, in traditional face-to-face, and #3 trained online and on campus. | Nursing students retained clinical competence better when face-to-face and online combined. Evaluated knowledge and competency. Tool—Post test. | Age groups were in unequal intervals, and only 14% were in the older age category limiting the study on the possibility of age influence on retention competency and time to complete the tasks. | II/B |
| 8 | Sheikhahoumasoudi | 2017 | Experimental Study | 2 post-experimental group (Fundamental of nursing students in Iran) from 2/14 - 2/15. | The experimental group’s midterm and final scores were higher than the control group, suggesting that the combination of traditional and online classes effectively improves clinical skills. Evaluated knowledge. | The use of tradition and e-learn combined steady of e-learning alone to evaluate the effectiveness of e-learning alone. | I/A |
| 9 | Padilha | 2018 | Randomized controlled trial | 42 Portuguese undergraduate nursing students, divided into 2 groups, received the same objectives and timing. The experimental group received a case-based learning approach with a clinical virtual simulator. The Control group received a laboratory class 45 min and a simulation created by the teacher. | Evaluated knowledge. The experimental group students showed better outcomes in knowledge retention and learning satisfaction than the students in the control group. Tool—1 pre-test and 2 post-testes. | Was a single context, with second-year nursing students, and on a single subject (respiratory process). | II/B |
| 10 | Berg | 2020 | Randomized controlled trial | First-year medical and Nursing students. | Evaluated knowledge. Individual self-practicing the ABCDE approach (Airways, Breathing, Circulation, Disability, Exposure) in virtual reality (VR) is non-inferior to individual self-practicing with traditional practice (TP). Tool—Practice test on a simulator manikin. | Lack of blinding, the study tested only one type of VR application and a short follow-up time (30 days). | II/B |
| 11 | Jaberi | 2019 | Randomized controlled trial | 87 third-year undergraduate nursing students are divided into 2 groups: virtual simulation education and classroom education. They were evaluated into three phases, Pre-test knowledge, training session, and post-test/recall test OSCE evaluation. | Evaluate knowledge on physical examination of the abdomen. The nursing students’ abdominal physical examination skills improved regardless of whether they belonged to the virtual simulation group or the classroom education group. | Small sample size Single center. | II/B |
| 12 | Turrise | 2020 | Randomized Controlled Trial | 27 nursing students enrolled in a Pathophysiology- Pharmacology online class and were divided into 2 groups. The control group received written case studies, and the experimental group received digital clinical experience. | The experimental group made more significant improvements in knowledge after the intervention. Both groups tested with the same pre-test and 2 post-tests. Clinical virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning. Tool—Pre-test and post-test were used to compare critical thinking, confidence, and satisfaction. | Single center. Only evaluated one subject (Respiratory process). | II/A |
| 13 | AL-Dossary | 2014 | Systematic Review | 13 peer-review studies on residency program/clinical/ leadership over 33 years. | Nursing residency programs may contribute to new graduate nurses integrating into high-acuity settings and improving patients’ quality of care by promoting skills, clinical competency, confidence, retention, and satisfaction. | Variation and limited research findings. | III-A |
| 14 | Eckerson | 2018 | Systematic Review | 12 peer-review studies on new nursing graduate/nurse retention rates/nurse satisfaction/preceptor-based with nurse residency program participation/one-year nursing residency program/ from 2012-2017. | The nursing residency program increases the satisfaction and retention of new nurse graduates over a one-year period, reinforcing that nursing residency is more effective in promoting skills and clinical competency than traditional hospital orientation. | A risk for selection bias was identified as a limiting factor in two studies. The study only newly hired BSN graduates. | III-A |