{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:45:31Z","timestamp":1791949531800,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009192","name":"Alberta Innovates","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009192","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To map how simulation\u2010based education supports the development of critical thinking skills required for nurses to recognize delirium in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A scoping review guided by the Joanna Briggs Institute methodology and the framework developed by Arksey and O'Malley, refined by Levac and colleagues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two reviewers independently screened and extracted data to identify studies evaluating simulation\u2010based education designed to strengthen nurses' delirium recognition and associated critical thinking processes. A narrative approach was used to chart and synthesize findings across varied simulation modalities and clinical contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>The search was conducted on 4 September 2025, using MEDLINE, CINAHL and PsycINFO. No timeframe was applied to the search.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen studies met inclusion criteria. Simulation\u2010based education consistently enhanced skills aligned with critical thinking, including observational accuracy, recognition of fluctuating cognitive cues, clinical reasoning, reflective awareness, empathy and communication within interprofessional teams. Structured debriefing played a central role in helping nurses analyse decision\u2010making processes and integrate experiential learning into clinical judgement. Several studies reported changes in practice, including more consistent use of delirium identification tools and improved clarity of clinical documentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Simulation\u2010based education strengthens interconnected domains of critical thinking that underpin nurses' capacity to recognize delirium early and respond effectively to its fluctuating presentation. These findings highlight the educational value of immersive, theory\u2010informed simulation for developing the clinical judgement required in cognitively complex patient situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Integrating structured simulation into nursing education and professional development may enhance timely delirium recognition, foster more effective interprofessional communication and support safer, higher\u2010quality care for hospitalized adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Simulation\u2010based education offers a practical and scalable strategy for improving delirium recognition across care settings. By supporting nurses in noticing subtle cognitive changes, interpreting clinical patterns and communicating concerns with clarity and confidence, simulation contributes to stronger workforce preparedness and patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This review adhered to PRISMA\u2010ScR reporting guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study did not include patient or public involvement in its design, conduct or reporting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.70640","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:55:08Z","timestamp":1778306108000},"page":"9645-9661","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Simulation\u2010Based Education to Support Nurses' Critical Thinking in Delirium Recognition: A Scoping Review"],"prefix":"10.1111","volume":"82","author":[{"given":"Mohamed Toufic","family":"EL Hussein","sequence":"first","affiliation":[{"name":"Faculty of Health, Community and Education, School of Nursing and Midwifery Mount Royal University  Calgary Canada"},{"name":"University of Alberta, Faculty of Nursing, Nurse Practitioner program  Calgary Canada"},{"name":"Division of Cardiology, Coronary Care Unit\u2014 Rockyview General Hospital, Alberta Health Services  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawson S.","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Alberta Health Services PCU 44, Foothills Medical Center Trauma Surgery  Calgary Canada"},{"name":"School of Nursing and Midwifery Mount Royal University  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6579-5532","authenticated-orcid":false,"given":"Sandra","family":"Hirst","sequence":"additional","affiliation":[{"name":"Faculty of Nursing University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2017-000239"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-24-01"},{"key":"e_1_2_15_5_1","volume-title":"Johns Hopkins Evidence\u2010Based Practice for Nurses and Healthcare Professionals: Models and Guidelines","author":"Bisset K.","year":"2025"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/opn.70022"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13054\u2010021\u201003752\u2010W"},{"issue":"4","key":"e_1_2_15_8_1","article-title":"Alice's Delirium: A Theatre\u2010Based Simulation Scenario for Nursing","volume":"10","author":"Dale\u2010Tam J.","year":"2018","journal-title":"Cureus"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/JOCN.70034"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678\u2010022\u201000421\u2010x"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2155\u20108256(23)00028\u20105"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.3928\/01484834\u201020060601\u201006"},{"issue":"1","key":"e_1_2_15_13_1","first-page":"1","article-title":"Critical Thinking: What It Is and Why It Counts","volume":"1","author":"Facione P. A.","year":"2013","journal-title":"Insight Assessment"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-33484-9_12"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2019.102622"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ICCN.2025.104167"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2020.102818"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010020\u20105005\u20101"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14938"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12877\u2010022\u201003573\u20108"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijnmr.ijnmr_28_21"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.5005\/JP\u2010JOURNALS\u201010071\u201024626"},{"key":"e_1_2_15_23_1","volume-title":"Experiential Learning: Experience as the Source of Learning and Development","author":"Kolb D. A.","year":"1984"},{"issue":"12","key":"e_1_2_15_24_1","first-page":"22","article-title":"Simulation Training, Coaching, and Cue Cards Improve Delirium Care","volume":"33","author":"Kresevic D.","year":"2016","journal-title":"Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.3928\/01484834\u201020240108\u201005"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20105\u201069"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12519"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1166392"},{"issue":"3","key":"e_1_2_15_29_1","first-page":"187","article-title":"Simulation Training Exercise to Improve Outcomes of Emergence Delirium in Patients With Posttraumatic Stress Disorder","volume":"89","author":"Lovestrand D.","year":"2021","journal-title":"AANA Journal"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/S\u20100040\u20101710572"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12877\u2010024\u201005213\u20109"},{"key":"e_1_2_15_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NEDT.2024.106211"},{"key":"e_1_2_15_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"issue":"3","key":"e_1_2_15_34_1","first-page":"339","article-title":"Effects of a Standardized Patient\u2010Based Delirium Care Education Program","volume":"38","author":"Roh Y. S.","year":"2024","journal-title":"Research and Theory for Nursing Practice"},{"key":"e_1_2_15_35_1","volume-title":"The Reflective Practitioner: How Professionals Think in Action","author":"Sch\u00f6n D. A.","year":"1983"},{"key":"e_1_2_15_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NEDT.2025.106574"},{"key":"e_1_2_15_37_1","doi-asserted-by":"publisher","DOI":"10.3928\/00220124-20170418-09"},{"key":"e_1_2_15_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2020.10.018"},{"key":"e_1_2_15_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010021\u201006503\u20101"},{"key":"e_1_2_15_40_1","doi-asserted-by":"publisher","DOI":"10.3928\/01484834\u201020060601\u201004"},{"key":"e_1_2_15_41_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18\u20100850"},{"key":"e_1_2_15_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909\u2010024\u201005725\u20103"},{"key":"e_1_2_15_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJNURSTU.2024.104959"},{"key":"e_1_2_15_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.12522"},{"key":"e_1_2_15_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010022\u201002932\u20109"},{"key":"e_1_2_15_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ECNS.2024.101576"},{"key":"e_1_2_15_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NEPR.2024.103887"}],"container-title":["Journal of Advanced Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.70640","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jan.70640","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.70640","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:59:11Z","timestamp":1791946751000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jan.70640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/jan.70640"],"URL":"https:\/\/doi.org\/10.1111\/jan.70640","archive":["Portico"],"relation":{},"ISSN":["0309-2402","1365-2648"],"issn-type":[{"value":"0309-2402","type":"print"},{"value":"1365-2648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"assertion":[{"value":"2025-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}