Simulation based training versus non-simulation based training in anesthesiology: A meta-analysis of randomized controlled trials

BACKGROUND: Simulation based training (SBT) has become an important tool in medical education, yet a comprehensive review of its effect in anesthesiology is currently lacking. This study was aimed to compare the effect of SBT versus non-simulation based training (NSBT) in anesthesia education. METHODS: Data were derived from PubMed, Ovid (EMBASE and MEDLINE), China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) from database inception up to June 2022. We included published randomized controlled trials (RCTs) that assessed the impact of Simulation-Based Training (SBT) on anesthesiology training and compared it to Non-Simulation-Based Training (NSBT). RESULTS: 25 eligible studies were included, with a total sample size of 1621 medical students. SBT was associated with improved theoretical scores [mean difference (MD):5.28, 95%CI 3.06 to 7.49, P < 0.01] and skill scores (MD: 7.63, 95% CI 5.7 to 9.57, P < 0.01) in comparison with NSBT. And SBT significantly improved teaching effects, including success rate, analytic skill in clinical setting, learning interest, learn efficiency and satisfaction survey. Also, a dramatic promotion was observed in the evaluation of non-technical ability consisting of cooperative ability, problem solving ability and situational awareness after trainees with SBT. CONCLUSIONS: Simulation-based training is an effective method for improving theoretical scores, skill scores, teaching effects and non-technical ability. Yet, further good-quality RCTs are required to confirm these changes translate to improved patient outcomes. Furthermore, it is important to carefully consider the cost-benefit effect to conduct simulation-based in anesthesiology education.