SIMULATION-BASED TEAM TRAINING IN EMERGENCY MEDICINE: A REVIEW OF INNOVATIVE EDUCATIONAL TECHNOLOGIES AND THEIR IMPACT ON CLINICAL PERFORMANCE
Abstract
Background: Simulation-based team training (SBTT) is increasingly applied in emergency medicine (EM) to enhance interprofessional collaboration and non-technical skills within high-acuity, time-critical scenarios in the emergency department. Effective teamwork—encompassing communication, leadership, situational awareness, and coordination—is critical for patient safety. Evidence on SBTT remains heterogeneous, particularly regarding clinical outcomes and adoption of emerging technologies.
Methods: This narrative review synthesizes literature from PubMed, Scopus, and Google Scholar (1984–2025) on SBTT in EM. Eligible studies included systematic and narrative reviews, randomized and non-randomized studies, and qualitative reports. Data extraction focused on simulation modalities, educational strategies, non-technical skill development, and reported effects on team performance and clinical outcomes.
Results: SBTT has been shown to improve communication, leadership, situational awareness, and coordination across diverse contexts and modalities, including low- and high-fidelity manikins, virtual reality, and augmented reality. Pilot applications of artificial intelligence have shown potential for adaptive scenarios, individualized feedback, and performance analytics, although evidence in EM remains limited. SBTT also supports workflow efficiency, protocol adherence, and simulated clinical performance. However, data linking training to sustained behavioral change and patient-level outcomes remain limited.
Conclusions: SBTT constitutes a valuable educational approach for interprofessional EM teams, fostering non-technical skills and team-based competencies. Its effectiveness relies on structured pedagogy, standardized frameworks, and high-quality debriefing rather than technological fidelity alone. Integration of innovative technologies may enhance scalability and individualized learning. Further longitudinal and multicenter research is required to clarify SBTT’s impact on clinical practice, patient outcomes, and sustainable implementation within EM training programs.
References
Flin, R., O’Connor, P., & Crichton, M. (2008). Safety at the sharp end: A guide to non-technical skills. Ashgate.
Rosen, M. A., Weaver, S. J., Lazzara, E. H., Salas, E., Wu, T., Silvestri, S., Schiebel, N., Almeida, S., & King, H. B. (2010). Tools for evaluating team performance in simulation‑based training. Journal of Emergencies, Trauma and Shock, 3(4), 353–359. https://doi.org/10.4103/0974-2700.70746
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149–154. https://doi.org/10.1136/postgradmedj-2012-131168
Manser, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiologica Scandinavica, 53(2), 143–151. https://doi.org/10.1111/j.1399-6576.2008.01717.x
Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hamstra, S. J. (2011). Technology-enhanced simulation for health professions education: A systematic review and meta-analysis. JAMA, 306(9), 978–988. https://doi.org/10.1001/jama.2011.1234
Capella, J., Smith, S., Philp, A., et al. (2010). Teamwork training improves the clinical care of trauma patients. Journal of Surgical Education, 67(6), 439–443. https://doi.org/10.1016/j.jsurg.2010.06.006
Weile, J., Nebsbjerg, M. A., Ovesen, S. H., Paltved, C., & Ingeman, M. L. (2021). Simulation‑based team training in time‑critical clinical presentations in emergency medicine and critical care: A review of the literature. Advances in Simulation, 6(1), Article 3 https://doi.org/10.1186/s41077-021-00154-4
Thim, S., Henriksen, T. B., Laursen, H., Schram, A. L., Paltved, C., & Lindhard, M. S. (2022). Simulation-based emergency team training in pediatrics: A systematic review. Pediatrics, 149(4), e2021054305. https://doi.org/10.1542/peds.2021-054305
Salas, E., DiazGranados, D., Klein, C., Burke, C. S., Stagl, K. C., Goodwin, G. F., & Halpin, S. M. (2008). Does team training improve team performance? A meta‑analysis. Human Factors: The Journal of the Human Factors and Ergonomics Society, 50(6), 903–933. https://doi.org/10.1518/001872008X375009
Shapiro, M. J., Morey, J. C., Small, S. D., Langford, V., Kaylor, C. J., Jagminas, L., Suner, S., Salisbury, M. L., Simon, R., & Jay, G. D. (2004). Simulation based teamwork training for emergency department staff: Does it improve clinical team performance when added to an existing didactic teamwork curriculum? Quality & Safety in Health Care, 13(6), 417–421. https://doi.org/10.1136/qshc.2003.005447
Nielsen, R. P., Nikolajsen, L., Paltved, C., & Aagaard, R. (2021). Effect of simulation‑based team training in airway management: A systematic review. Anaesthesia, 76(10), 1404–1415. https://doi.org/10.1111/anae.15375
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298
Lateef, F. (2010). Simulation-based learning: Just like the real thing. Journal of Emergencies, Trauma, and Shock, 3(4), 348–352. https://doi.org/10.4103/0974-2700.70743
Gaba, D. M. (2004). The future vision of simulation in healthcare. Quality and Safety in Health Care, 13(Suppl 1), i2–i10. https://doi.org/10.1136/qshc.2004.009878
Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Lee Gordon, D., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27(1), 10–28. https://doi.org/10.1080/01421590500046924
Philp, N., Omran, A., Otorkpa, M. J., & Kirk, A. (2024). Medical students’ confidence after “CardioSim”: A low-fidelity, peer role-play simulation. Cureus, 16(8), e67192. https://doi.org/10.7759/cureus.67192
Gu, Y., Witter, T., Livingston, P., Rao, P., Varshney, T., Kuca, T., & Bould, M. D. (2017). The effect of simulator fidelity on acquiring non-technical skills: A randomized non-inferiority trial. Canadian Journal of Anesthesia = Journal canadien d’anesthésie, 64(12), 1182–1193. https://doi.org/10.1007/s12630-017-0973-2
Hildreth, A. F., Maggio, L. A., Iteen, A., Wojahn, A. L., Cook, D. A., & Battista, A. (2023). Technology-enhanced simulation in emergency medicine: Updated systematic review and meta-analysis 1991–2021. AEM Education and Training, 7(2), e10848. https://doi.org/10.1002/aet2.10848
Negi, R., Chopra, D., Maheshwari, K., Mahajan, A., Badyal, D., & Venkataramani, P. (2025). Artificial intelligence in simulation‑based training for health professions education: Navigating the rabbit hole. Medical Journal Armed Forces India. https://doi.org/10.1016/j.mjafi.2025.08.010
Michalczak, M., Zgoda, W., Michalczak, J., Żądło, A., Nasser, A., & Tokarek, T. (2025). Artificial intelligence in medical education: A narrative review. AI, 6(12), 322. https://doi.org/10.3390/ai6120322
AI‑Based Assessment of Non‑Technical Skills in Prehospital Simulations: A Comparative Validation Study. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare13233121
Huffman, E. M., Anton, N. E., Athanasiadis, D. I., Ahmed, R., Cooper, D., Stefanidis, D., et al. (2021). Multidisciplinary simulation‑based trauma team training with an emphasis on crisis resource management improves residents’ non‑technical skills. Surgery, 170(4), 1083–1086. https://doi.org/10.1016/j.surg.2021.03.015
Meurling, L., Hedman, L., Sandahl, C., Felländer-Tsai, L., & Wallin, C.-J. (2013). Systematic simulation-based team training in a Swedish intensive care unit: A diverse response among critical care professions. BMJ Quality & Safety, 22(6), 485–494. https://doi.org/10.1136/bmjqs-2012-000994
Weaver, S. J., Salas, E., Lyons, R., Lazzara, E. H., Rosen, M. A., DiazGranados, D., Grim, J. G., Augenstein, J. S., Birnbach, D. J., & King, H. (2010). Simulation‑based team training at the sharp end: A qualitative study of simulation‑based team training design, implementation, and evaluation in healthcare. Journal of Emergencies, Trauma and Shock, 3(4), 369–377. https://doi.org/10.4103/0974-2700.70754
Bracq, M.‑S., Michinov, E., & Jannin, P. (2019). Virtual reality simulation in nontechnical skills training for healthcare professionals: A systematic review. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 14(3), 188–194. https://doi.org/10.1097/SIH.0000000000000347
Peddle, M. (2019). Participant perceptions of virtual simulation to develop non‑technical skills in health professionals. Journal of Research in Nursing, 24(3‑4), 167–180. https://doi.org/10.1177/1744987119835873
Hess, O., Qian, J., Bruce, J., Wang, E., Rodriguez, S., Haber, N., & Caruso, T. J. (2022). Communication skills training using remote augmented reality medical simulation: A feasibility and acceptability qualitative study. Medical Science Educator, 32(5), 1005–1014. https://doi.org/10.1007/s40670-022-01598-7
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice-Hall.
Stefanidis, D., Cook, D. A., Kalantar‑Motamedi, S.‑M., Muret‑Wagstaff, S., Calhoun, A. W., Lauridsen, K. G., Paige, J. T., Lockey, A., Donoghue, A., Hall, A. K., Patocka, C., Palaganas, J., Gross, I. T., Kessler, D., Vermylen, J., Lin, Y., Aebersold, M., Chang, T. P., Duff, J., … & the Society for Simulation in Healthcare Guideline Development Group. (2024). Society for Simulation in Healthcare guidelines for simulation training. Simulation in Healthcare, 19(1S), S4–S22. https://doi.org/10.1097/SIH.0000000000000776
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