(606) Outcomes of Simulation Training in Neurocritical Care: A Systematic Review

Introduction: In the realm of critical care, where every second counts, the demand for proficient healthcare providers is paramount. Neurocritical care (NCC), in particular, requires specialized knowledge and skills to manage acute and complex neurological conditions. To enhance patient’s safety, clinical education has increasingly turned to innovative methodologies, among which simulation training has emerged as a promising approach. Yet, the pooled impact of simulation training in NCC remains unclear. This systematic review aimed to critically appraise and synthesize the best evidence about the outcomes used to assess the effectiveness of simulation training in NCC and whether simulation training is associated with improvement in these outcomes.

Methods: This systematic review was registered at PROSPERO Registry (CRD42023410279). Databases searched included CINAHL, Medline, PsycInfo, Scopus, and Cochrane. Inclusion criteria were: studies that investigated simulation training in NCC, and published in English between 2000-2023. Two reviewers performed critical appraisal and data extraction independently using the standardized Joanna Briggs Institute (JBI) tools. Meta-analysis could not be performed due to clinical, methodological, and statistical heterogeneity.

Results: The search yielded 718 studies that were screened for title and abstract, while 53 studies were screened for full text. Twelve studies were found eligible with acceptable methodological quality. One study was a quality improvement project, while the rest were quasi experimental studies. The simulation scenarios addressed acute stroke, status epilepticus, traumatic brain injury, electroencephalogram, brain death, intracerebral hemorrhage, and seizures. The outcomes used post simulation included: technical knowledge, nontechnical knowledge (leadership/communication), self-perceived knowledge, and trainee’s confidence and satisfaction. All analytical studies showed a statistically significant improvement (p <.05) in these outcomes following simulation training.

Conclusions: Despite the heterogeneity in the participants, simulation approaches, and outcomes, all relevant studies reported significant improvement in learning outcomes post simulation. Standardization of these factors is warranted and can help to perform meta-analysis in the future.