Background Simulation is often used in healthcare education because it enables students to practise clinical skills in a safe environment where mistakes can occur without the risk of patient harm. Simulation can involve varying levels of fidelity (realism), ranging from low fidelity (for example, using role play) to high fidelity (for example, using sophisticated technology such as augmented or virtual reality).

Aim To investigate if a high-fidelity simulation environment improves confidence and the performance of cardiopulmonary resuscitation (CPR) in first-year undergraduate adult nursing students.

Method This small pilot study involved a sample of 15 participants who were randomised into an intervention group (n=7) and a control group (n=8). The control group received teaching and were tested on the skill of CPR using a manikin in a medium-fidelity simulation scenario in a modified classroom environment, while the intervention group received the same teaching, testing and simulation scenario but in a high-fidelity ‘immersion suite’. Quantitative data were collected using a pre-intervention and post-intervention self-report confidence questionnaire and from performance data generated by the Laerdal Medical ‘Little Anne’ manikin QCPR software.

Results Overall, there were no statistically significant improvements in performance metrics for the intervention group compared with the control group. Both groups reported overall improvements in confidence regarding their knowledge and skills in managing a critically ill patient, but these results were not deemed to be statistically significant.

Conclusion The results of this study indicate that the use of simulation increases nursing students’ confidence in undertaking CPR, but that a high-fidelity simulation environment does not necessarily improve their performance of CPR.