Objective The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students’ learning outcomes. Design A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references. Study selection To be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis. Review method Three independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria. Synthesis method For each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen’s d with a 95% CI. Results Thirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected. Conclusions Compared with other teaching methods, HFPS revealed higher effects sizes on nursing students’ knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students’ competence and patient outcomes.

This methodological study was conducted to test the psychometric properties of the Jefferson Scale of Empathy‐Health Professional Student's version (JSE‐HPS), in a convenience sample of 797 Italian nursing students and to describe their empathic engagement. Data were subjected to exploratory and confirmatory factor analysis, test–retest, correlation analysis, t‐test, and analysis of variance method. Principal component factor extraction with Oblimin rotation on the first half of the sample was conducted. The analysis suggested a three‐factor solution for 14 items: “compassionate care/emotional engagement,” “perspective‐taking,” and “standing in the patient's shoes.” Confirmatory factor analysis on the second half of the sample showed good fit indexes for the 14‐item solution, indicated by the exploratory factor analysis, and the 20 item solution of the scale, with the exception of one item. Test–retest correlation was 0.50 (P < 0.001) for the overall scale. Results from group comparisons and correlations are also provided and discussed. The Italian version of the JSE‐HPS is a psychometrically sound tool. The translated 20‐item solution is also suitable to carry out cross‐cultural comparisons.