Effectiveness of simulation-based peripheral intravenous catheterization training for nursing students and hospital nurses: A systematic review and meta-analysis

Background Peripheral intravenous catheterisation (PIVC) is a complex procedure. Aim This study reviewed studies evaluating the effects of different simulators in comparison with traditional methods used in PIVC training for nursing students and hospital nurses. Design A systematic review and meta-analysis of randomised (RCT) and non-randomised controlled (N-RCT) studies. Methods MEDLINE, Cochrane, Scopus, ERIC, Web of Science, and ScienceDirect were searched using PIVC, simulation and nursing education. The quality of evidence was assessed using the GRADE system; the risk of bias was assessed using the RoB 2 (for RCTs) and A Cochrane Risk of Bias Assessment Tool for N-RCTs. The study was conducted as per the PRISMA guidelines. Results In total, 2,812 records were identified, and 12 studies published between 2002 and 2018 were finally included. Most studies included Virtual IV simulator and the plastic IV arm model in PIVC training for hospital nurses and nursing students, reported on outcomes such as PIVC-related knowledge, skills, confidence, state/trait anxiety and satisfaction. Seven studies were included in the meta-analysis, the effect sizes for all the outcomes ranged from small to moderate. However, the effect sizes were non-significant for all outcomes. The quality of evidence was assessed as being low for skills, knowledge, satisfaction, and trait/state anxiety, and moderate for confidence. Conclusions The effect of Virtual IV training on PIVC-related skills, knowledge, satisfaction and anxiety among nursing students and hospital nurses, in comparison with the plastic arm training method, remains unclear. However, Virtual IV training was found to increase PIVC confidence. Relevance to clinical practice There is a small effect in favour of VR in PIVC education although non-significant. More evidence is needed to determine the superiority of simulation methods. In PIVC training of nurses and nursing students, hospitals and schools can choose a method in accordance with their resources. Trial registration PROSPERO 2019 CRD42019124599.