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      The effectiveness of improving healthcare teams’ human factor skills using simulation-based training: a systematic review

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          Abstract

          Background

          Simulation-based training used to train healthcare teams’ skills and improve clinical practice has evolved in recent decades. While it is evident that technical skills training is beneficial, the potential of human factor training has not been described to the same extent. Research on human factor training has been limited to marginal and acute care scenarios and often to validate instruments. This systematic review aimed to investigate the effectiveness of simulation-based training in improving in-hospital qualified healthcare teams’ human factor skills.

          Method

          A review protocol outlining the study was registered in PROSPERO. Using the PRISMA guidelines, the systematic search was conducted on September 28th, 2021, in eight major scientific databases. Three independent reviewers assessed title and abstract screening; full texts were evaluated by one reviewer. Content analysis was used to evaluate the evidence from the included studies.

          Results

          The search yielded 19,767 studies, of which 72 were included. The included studies were published between 2004 and 2021 and covered research from seven different in-hospital medical specialisms. Studies applied a wide range of assessment tools, which made it challenging to compare the effectiveness of human factor skills training across studies. The content analysis identified evidence for the effectiveness. Four recurring themes were identified: (1) Training human factor skills in qualified healthcare teams; (2) assessment of human factor skills; (3) combined teaching methods, and (4) retention and transfer of human factor skills. Unfortunately, the human factor skills assessments are variable in the literature, affecting the power of the result.

          Conclusion

          Simulation-based training is a successful learning tool to improve qualified healthcare teams’ human factor skills. Human factor skills are not innate and appear to be trainable similar to technical skills, based on the findings of this review. Moreover, research on retention and transfer is insufficient. Further, research on the retention and transfer of human factor skills from simulation-based training to clinical practice is essential to gain knowledge of the effect on patient safety.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s41077-022-00207-2.

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          Most cited references101

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          World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

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            AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

            The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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              The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers

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                Author and article information

                Contributors
                lotte.abildgren@rsyd.dk
                Journal
                Adv Simul (Lond)
                Adv Simul (Lond)
                Advances in Simulation
                BioMed Central (London )
                2059-0628
                7 May 2022
                7 May 2022
                2022
                : 7
                : 12
                Affiliations
                [1 ]GRID grid.7143.1, ISNI 0000 0004 0512 5013, Anesthesiology and Intensive Care Unit, , Odense University Hospital, ; Odense, Denmark
                [2 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, OPEN, Open Patient data Explorative Network, Odense University Hospital/Department of Clinical Research, , University of Southern Denmark, ; Odense, Denmark
                [3 ]GRID grid.7143.1, ISNI 0000 0004 0512 5013, Emergency Research Unit, Hospital Sønderjylland, , University Hospital of Southern Denmark, ; Odense, Denmark
                [4 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Centre for Human Interactivity, Department of Language and Communication, , University of Southern Denmark, ; Odense, Denmark
                [5 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Department of Clinical Research, , University of Southern Denmark, ; Odense, Denmark
                [6 ]GRID grid.425874.8, ISNI 0000 0004 0639 1911, SimC, Regional Center for Technical Simulation, Region of Southern Denmark, ; Odense, Denmark
                [7 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Department of Design and Communication, , University of Southern Denmark, ; Kolding, Denmark
                [8 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Danish Institute for Advanced Study, , University of Southern Denmark, ; Odense, Denmark
                [9 ]GRID grid.20561.30, ISNI 0000 0000 9546 5767, Center for Ecolinguistics, , South China Agricultural University, ; Guangzhou, People’s Republic of China
                [10 ]GRID grid.263906.8, ISNI 0000 0001 0362 4044, College of International Studies, Southwest University, ; Chongqing, People’s Republic of China
                [11 ]GRID grid.449721.d, Institute of Nursing & Health Science, Ilisimartusarfik, , University of Greenland, ; Nuuk, Greenland
                [12 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, Center for Mental Health Nursing and Health Research (CPS), Mental Health Services, Region of Southern Denmark, , University of Southern Denmark, ; Odense, Denmark
                Author information
                http://orcid.org/0000-0001-9299-2358
                Article
                207
                10.1186/s41077-022-00207-2
                9077986
                35526061
                807e73c8-cf1c-4e49-94c5-de5e3d602963
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 September 2021
                : 5 April 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                systematic review,simulation-based training,medical simulation,human factor skills,non-technical skills (nts),adverse events,teamwork,crisis resource management (crm),qualified healthcare team,in-hospital

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