In situ simulation: the gain of self-confidence by nursing professionals during cardiopulmonary arrests




Simulation; Simulation Training; Trust; Critical Care; Nursing, Team.


Objective: to compare in situ simulation to the traditional didactic methodology, regarding the gain of self-confidence of nursing team professionals regarding cardiopulmonary arrest. Methods: quasi-experimental non-equivalent study, developed in an intensive care unit and emergency room of a general hospital. The intervention was an in situ simulation. For data collection, a professional characterization questionnaire was used, and the self-confidence aspect was assessed by the Self-Confidence Scale. Results with p≤0.050 were considered significant. Results: 37 nursing professionals participated. The pre-simulation experimental group was less self-confident (3.4±0.6) when compared to the control group (3.9±0.7). However, 30 days after the intervention, the experimental group showed a significant gain in confidence (p=0.040). Conclusion: the self-confidence of nursing professionals with regards to assisting patients in cardiopulmonary arrest improved significantly with the use of an in situ simulation, when compared to the traditional didactic methodology, through dialogue.


Mazzo A, Martins JCA, Jorge BM, Batista RCN, Almeida RGS, Henriques FMD, et al. Validation of the self-confidence scale of nursing care in urinary retention. Rev Latino-am Enfermagem. 2015; 23(5):814-20. doi:

Ribeiro RM, Pompeo DA, Pinto MH, Ribeiro RC. Coping strategies of nurses in hospital emergency care services. Acta Paul Enferm. 2015; 28(3):216-23.doi: 0194201500037

Ribeiro MNS, Diniz CX, Perdomo SB, Ribeiro JHS, Barbosa OG, Barros KMSC, et al. Self-esteem and resilience in people with type 2 diabetes mellitus. Mundo Saúde. 2017; 41(2):223-31. doi:

Sclafani A, Currier P, Chang Y, Eromo E, Raemer D, Miloslavsky EM. Internal medicine residents’ exposure to and confidence in managing hospital acute clinical events. J Hosp Med. 2019; 14(4):218-23. doi:

Barreto DG, Silva KGNS, Moreira SSCR, Silva TS, Magro MCS. Realistic simulation as a teaching strategy: an integrative review. Rev Baiana Enferm [Internet]. 2014 [cited Jun 20, 2019]; 28(2):208-14. Available from:

Silveira MS, Cogo ALP. The contributions of digital technologies in the teaching of nursing skills: an integrative review. Rev Gaúcha Enferm. 2017; 38(2):e66204. doi:

Van Dyk J, Siedlecki SL, Fitzpatrick JJ. Frontline nurse managers’ confidence and self-efficacy. J Nurs Manag. 2016; 24(4):533-9. doi:

Pisciottani F, Rocha DF, Costa MR, Figueiredo AE, Magalhães CR. In situ simulation in cardiopulmonary ressuscitation: implications for permanent nursing education. Rev Enferm UFPE on line. 2017; 11(7):2810-5. doi:

Kurup V, Matei V, Ray J. Role of in-situ simulation for training in healthcare: opportunities and challenges. Curr Opin Anaesthesiol. 2017; 30(6):755-60. doi:

Boling B, Hardin-Pierce M. The effect of high-fidelity simulation on knowledge and confidence in critical care training: an integrative review. Nurse Educ Pract. 2016; 16(1):287-93. doi:

Rashid P, Gianduzzo T. Urology technical and non-technical skills development: the emerging role of simulation. BJU Int. 2016; 117(Suppl 4):9-16. doi:

Barbeito A, Bonifacio A, Holtschneider M, Segall N, Schroeder R, Mark J et al. In situ simulated cardiac arrest exercises to detect system vulnerabilities. Simul Healthc. 2015; 10(3):154-62. doi:

Andrade PON, Oliveira SC, Morais SCRV, Guedes TG, Melo GP, Linhares FMP. Validation of a clinical simulation setting in the management of postpartum haemorrhage. Rev Bras Enferm. 2019; 72(3):624-631. doi:

Martins JC, Baptista RC, Coutinho VR, Mazzo A, Rodrigues MA, Mendes IA. Self-confidence for emergency intervention: adaptation and cultural validation of the Self-confidence Scale in nursing students. Rev Latino-Am Enfermagem. 2014; 22(4):554-61. doi:

Hicks F, Coke L, Li S. Report of findings from the effect of high-fidelity simulation on Nursing students’ knowledge and performance: a pilot study. Res Brief [Internet]. 2009 [cited July 20, 2019]; 40. Available from:

Fletcher RH, Fletcher SW, Fletcher GS. Epidemiologia clínica – elementos essenciais. Porto Alegre: Artmed; 2014.

American Heart Association. Destaques das atualizações específicas de 2017 da American Heart Association para suporte básico de vida em pediatria e para adultos e qualidade de ressuscitação cardiopulmonar [Internet]. 2017 [cited Jun 20, 2019]. Available from:

Zimmermann K, Holzinger IB, Ganassi L, Esslinger P, Pilgrim S, Allen M, et al. Inter-professional in situ simulated team and resuscitation training for patient safety: Description and impact of a programmatic approach. BMC Med Educ. 2015; 15:189. doi:

Muniandy RK, Nyein KK, Felly M. Improving the self-confidence level of medical under graduates during emergencies using high fidelity simulation. Med J Malaysia [Internet]. 2015 [cited Jun 20, 2019]; 70(5):300-2. Available from:

Woods C, West C, Mills J, Park T, Southern J, Usher K. Under graduate student nurses’ self-reported prepared ness for practice. Collegian. 2015; 22(4):359-68. foi:



How to Cite

Almeida, M. N., Duarte, T. T. da P. ., & Magro, M. C. da S. (2019). In situ simulation: the gain of self-confidence by nursing professionals during cardiopulmonary arrests. Rev Rene, 20, e41535.



Research Article

Most read articles by the same author(s)