Nursing Students' Cue Recognition in Educational Simulation: A Scoping Review : Nurse Educator

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Nursing Students' Cue Recognition in Educational Simulation

A Scoping Review

Poledna, Mari MSN, RN, CCRN; Gómez-Morales, Abigail MSN, RN; Hagler, Debra PhD, RN, ACNS-BC, CNE, CHSE, ANEF, FAAN

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Nurse Educator 47(5):p 283-287, September/October 2022. | DOI: 10.1097/NNE.0000000000001198



New nurses often struggle with recognizing cues and applying clinical judgment. Nurse educators develop educational simulation scenarios to support students in developing clinical judgment, which includes the foundational step of recognizing cues.


A scoping review on undergraduate nursing students' cue recognition during simulation was conducted to systematically map the existing research and identify knowledge gaps.


From initial identification of 228 studies published between 2010 and 2020, a total of 17 quantitative or qualitative studies were independently appraised using the Joanna Briggs Institute scoping review process and PRISMA-ScR reporting guidelines.


Cues were missed with varying levels of frequency. Participants frequently failed to recognize respiratory rates and physical assessment changes as salient cues to patient deterioration. Verbal cues from simulated patients were often missed or resulted in distancing behaviors.


Research is needed to determine the most effective methods for helping learners develop skills in cue recognition and analysis.

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