It is hard to determine if the decrease in performance is due to stress or cognitive overload. I tend to think that anxiety is a larger factor. To decrease stress, practice does make perfect. Students also need to be reminded that nursing is stressful and how important it is to function at a safe level with stress. This takes time and clinical experience.

Thank you for your feedback Cecelia and just to be clear I am not saying “less is more” it is the conclusion of the researchers who conducted the studies who are making this point. When cognitive load theory is understood in the science of learning this is one hypothesis for this conclusion. I agree that educators need to be careful and make sure that if high fidelity simulation is implemented there is strong evidence to support this change.
In my literature review I came across a recent article titled Effect of simulation training on the development of nurses and nursing students’ critical thinking: A systematic literature review (2017) that found that of 16 research articles the findings were inconclusive and eight studies or half found no improvement in developing critical thinking using high fidelity simulation. More research needs to be done on this important topic as learning benefits have also been demonstrated using HFS.
Remember that no one is born a nurse and a nurse educator and takes time to develop the skills and confidence to teach. My passion is to point educators to educational best practice so that needed transformational change can be implemented that is often as simple as changing the way you teach!