Anxiety and Clinical Performance in Simulated Setting in Undergraduate Health Professionals Education: An Integrative Review

Amal Z. Al-Ghareeb, Simon J. Cooper, Lisa G. McKenna

Research output: Contribution to journalReview ArticleResearchpeer-review

24 Citations (Scopus)


Background Undergraduate health professionals clearly experience anxiety during simulation. However, little is known regarding learners’ physiological and psychological responses and the influence of these responses on performance. Method An integrative review was undertaken to provide a comprehensive understanding of the influence of anxiety on undergraduate health professionals’ performance during simulation, and to review the tools and measurements reported in the healthcare literature. Result Eleven articles were included showing simulation aroused learners physiologically and psychologically, either improving or declining clinical performance. Conclusion Two contrasting perceptions emerged, which are indicative of the current lack of understanding regarding the effects of anxiety on performance in a simulation setting.

Original languageEnglish
Pages (from-to)478-491
Number of pages14
JournalClinical Simulation in Nursing
Issue number10
Publication statusPublished - 1 Oct 2017


  • anxiety
  • clinical performance
  • memory
  • simulation
  • stress
  • undergraduate health professional

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