Simulation-based education (SBE) has been used to enhance clinical decision-making skills among anesthesiology trainees. This systematic review and meta-analysis aimed to examine the effectiveness of SBE in improving the clinical decision-making skills of anesthesiology trainees. A systematic search of relevant studies published in English language was conducted in five electronic databases. Studies reporting the use of SBE in improving the clinical decision-making skills of anesthesiology trainees were included. The Cochrane risk of bias tool was used to assess the quality of included studies. Meta-analysis was performed using random-effects models, and subgroup analyses were conducted based on the type of simulation, type of outcome measures, and level of trainees. Thirteen studies met the inclusion criteria, and the overall quality of evidence was moderate to high. Meta-analysis showed a statistically significant improvement in clinical decisionmaking skills among anesthesiology trainees who received SBE compared to those who received traditional education (standardized mean difference 0.74, 95% CI 0.50 to 0.98, p<0.001). Subgroup analyses suggested that high-fidelity simulation and objective outcome measures were more effective in improving clinical decision-making skills. This study provides evidence to support the use of SBE in improving the clinical decision-making skills of anesthesiology trainees.
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Journal of Clinical Anesthesiology: Open Access received 31 citations as per Google Scholar report