Can simulation based training for health care emergency response teams improve mortality rates, reduce number of adverse events and risk of errors? A systematic literature review.

Abstract

Background: The objective of this master thesis was to examine the following research question: Can simulation-based training for health care emergency response teams reduce mortality rates, number of adverse events and risk of errors? Methods: A systematic literature review based on the PRISMA guidelines was conducted in the following databases: Medline, EMBASE, Epistemonikos, Google Scholar, PubMed, CINAHL and Cochrane. Three reviewers used pre-defined criteria and the Rayyan QRCI© tool to screen the retrieved studies independently for inclusion in the analyses. From those studies the results of simulation-based training according to Kirkpatrick level 4 where extracted. A tool for evaluation of quality of reporting the simulation-based training intervention was developed and applied. Results: 184 studies have been identified and 33 were further investigated. On the Kirkpatrick level 4 thirty studies (90%) described improvements, while three (9%) found no changes. 19(58%) of the studies were rated 4/7 points or higher for the quality of reporting of the simulation- based training intervention. 18 studies (55%) reported repeated simulation training as part of intervention and reported reduced mortality rates and reduced numbers of adverse events. None of the included studies reported numbers of medical errors. Conclusion: The results indicated that simulation based training can reduce mortality and adverse events. Repeated training seemed to increase the possibility for Kirkpatrick level 4 improvements. This systematic review was not able to identify other characteristics of simulation based training that affected patient outcome.