Abstract
Background: High-fidelity simulation is a key learning approach to enhance cardiopulmonary resuscitation (CPR) skills in nursing and emergency management. Purpose: The purpose of this review was to assess the effects of high-fidelity simulation on CPR knowledge, performance, confidence, teamwork and readiness for response. Method: A systematic review and meta-analysis approach was used. A total of 15 studies from 2022-2026 were reviewed. Eligibility criteria were established and studies were identified and evaluated using PRISMA guidelines, a research matrix, forest plot interpretation and Joanna Briggs Institute quality appraisal checklists. Results: High-fidelity simulation led to better CPR knowledge, chest compression quality, clinical judgment, self-confidence, self-efficacy, communication, teamwork, and preparedness for emergency response. The forest plot indicated a positive effect of simulation-based learning, while the quality assessment plots indicated most studies had acceptable quality. Conclusion: High-fidelity simulation was a successful intervention to improve CPR skills for nursing students, nurses and emergency professionals. Ongoing simulation-based CPR training with feedback and debriefing sessions is encouraged for improved clinical practice and patient safety.