In-situ simulation (ISS) has many known benefits. This systematic review examined the effectiveness of ISS in the acute care setting for registered nurses' clinical competence, as defined by cognitive, skills, and affective learning outcomes. The PRISMA 2020 guidelines were utilized and PUBMED, EMBASE, and CINAHL databases were searched to identify peer-reviewed randomized controlled trials. Inclusion criteria were peer-reviewed randomized controlled trials, acute care setting, ISS, nursing profession, and skill or knowledge learning outcomes. The exclusion criteria were nonintervention simulations, nonpeer-reviewed articles, and a population of no registered nurses or only nursing students. The search yielded 22 articles, seven of which met inclusion criteria. The articles were appraised and found to have acceptable methodology using the Joanna Briggs Institute Critical Appraisal Tool. ISS was found to overall increase clinical competence in registered nurses. ISS has been demonstrated to maintain clinical competence in registered nurses. Further research needs to be done to determine effective frequency, high-fidelity vs low-fidelity, and effectiveness compared to Off-site simulation.

Keywords: clinical competence; in-situ simulation; nursing; off-site simulation; systematic review.

现场模拟（ISS）有许多已知的好处。这项系统综述探讨了ISS在急性护理环境中对注册护士临床能力的影响，其中临床能力的定义包括认知、技能和情感学习成果。该研究遵循PRISMA 2020指南，并搜索了PUBMED、EMBASE 和CINAHL数据库以识别同行评审的随机对照试验。纳入标准为：同行评审的随机对照试验、急性护理环境、ISS、护理专业以及技能或知识学习结果。排除标准包括非干预模拟、非同行评审的文章，以及没有注册护士或者仅有护理学生的群体。搜索共发现22篇文章，其中7篇符合纳入标准。这些文章经过评价，使用Joanna Briggs Institute 批判性评价工具被认为具有可接受的方法学质量。ISS总体上提高了注册护士的临床能力。ISS已被证明能够维持注册护士的临床能力。需要进一步的研究来确定有效的频率、高保真度与低保真度之间的差异以及与离场模拟相比的效果。

关键词： 临床能力；现场模拟；护理；离场模拟；系统综述。