EFFECT OF USING THEORETICAL REFERENCES IN TEACHING SIMULATION IN PRE-HOSPITAL EMERGENCIES: A SYSTEMATIC REVIEW PROTOCOL WITH META-ANALYSIS
Abstract
Objective: To analyze how the presence, level of explicitness, and operationalization of theoretical frameworks are described in clinical simulation studies in prehospital emergencies and to explore their possible association with educational outcomes in nursing. Method: This is a systematic review protocol with exploratory meta-analysis conducted in accordance with PRISMA recommendations and the Cochrane Handbook and registered in PROSPERO (CRD420251141475). Randomized controlled trials and quasi-experimental studies involving nursing students or professionals in prehospital simulation contexts will be included. Searches will be performed in BDENF, MEDLINE/PubMed, Cochrane Library, LILACS, Scopus, EMBASE, CINAHL, and Web of Science, with no language or time restrictions. Study selection will be conducted by two independent reviewers with standardized data extraction. Risk of bias will be assessed using RoB 2 and the JBI checklist. The use of theoretical frameworks will be classified as explicit, implicit/deductive, or absent, along with analysis of their operationalization during briefing, scenario execution, debriefing, and evaluation stages. Data synthesis: A narrative synthesis of methodological characteristics and the use of theoretical frameworks will be conducted. When homogeneity and comparable data are available, a meta-analysis using a random-effects model will be performed, applying mean difference or standardized mean difference, with heterogeneity assessed using the χ² test and I² statistic. The certainty of evidence will be evaluated using the GRADE approach. Expected results: The review is expected to identify patterns, gaps, and levels of incorporation of theoretical frameworks in clinical simulation interventions, contributing to greater pedagogical rigor and strengthening evidence-based practice in nursing education.
Author Biographies
Enfermeira, Mestranda em enfermagem pela Universidade Regional do Cariri.
Estudante de Enfermagem. Universidade Regional do Cariri.
Doutora em Enfermagem. Universidade Regional do Cariri.
Doutor em Farmacologia. Universidade Regional do Cariri.
Doutora em Enfermagem. Escola Superior de Enfermagem do Porto.
Doutora em Ciências da Saúde. Universidade Regional do Cariri.
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