BACKGROUND

Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.

This scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.

Following Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.

Ten studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.

While progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.

BACKGROUND

Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.

This scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.

Following Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.

Ten studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.

While progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.

BACKGROUND

Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.

This scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.

Following Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.

Ten studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.

While progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.

Computer Simulation ; Curriculum ; Education, Medical ; organization & administration ; trends ; Electronic Health Records ; Health Services Research ; Humans ; Interdisciplinary Communication ; Leadership ; Patient Care Team ; Public Health ; Schools, Medical ; Singapore

PURPOSE: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem- solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit.METHODS: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0.RESULTS: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem- solving ability, and confidence in clinical performance.CONCLUSION: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.
Airway Management ; Education ; Emergencies ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Nursing ; Patient Simulation ; Thinking

PURPOSE: The purpose of this study was to examine the effects of a virtual reality simulation and a blended simulation on nursing care for children with asthma through an evaluation of critical thinking, problem-solving processes, and clinical performance in both education groups before and after the educational intervention.METHODS: The participants were 48 nursing students. The experimental group (n=22) received a blended simulation, combining a virtual reality simulation and a high-fidelity simulation, while the control group (n=26) received only a virtual reality simulation. Data were collected from February 25 to 28, 2019 and analyzed using SPSS version 25 for Windows.RESULTS: The pretest and posttest results of each group showed statistically significant improvements in critical thinking, problem-solving processes, and clinical performance. In a comparison of the results of the two education groups, the only statistically significant difference was found for critical thinking.CONCLUSION: Simulation-based education in child nursing has continued to involve high-fidelity simulations that are currently run in many programs. However, incorporating a new type of blended simulation, combining a virtual reality simulation and a high-fidelity simulation, into the nursing curriculum may contribute to the further development of nursing education.
Asthma ; Child ; Computer User Training ; Curriculum ; Education ; Education, Nursing ; Humans ; Nursing ; Nursing Care ; Patient Simulation ; Pediatric Nursing ; Students, Nursing ; Thinking

PURPOSE: The purpose of this study is to identify the educational effect among nursing students who performed the patient role in women's health nursing simulations.METHODS: In this exploratory qualitative study, a sample of 31 third- and fourth-grade nursing students who participated in scenario-based patient roles in clinical performance examination of the women's health nursing simulation practice training. Data were collected through focus group interviews. Qualitative data were analyzed using qualitative content analysis.RESULTS: Three themes emerged from the data analysis. Participants experienced an enhancement of patient-centered nursing competence, deep learning immersion and display of self-regulated learning. The difficulty of performing the patient role contributed additional effects such as the difficulty to perform the patient role in the psychological training environment.CONCLUSION: It is recommended to utilize nursing students as patients in simulation practice training. On the other hand, the psychological training environment can cause difficulties in performing patient roles, a burden on the role of the patient, and involves the interruption of the role.
Clinical Competence ; Education ; Education, Nursing ; Focus Groups ; Hand ; Humans ; Immersion ; Learning ; Mental Competency ; Nursing ; Patient Simulation ; Patient-Centered Care ; Statistics as Topic ; Students, Nursing ; Women's Health

PURPOSE: Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy. METHODS: We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts' OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills. RESULTS: The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills. CONCLUSION: The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.
Australia ; Clinical Competence ; Cohort Studies ; Humans ; Non-Randomized Controlled Trials as Topic ; Patient Compliance ; Patient Simulation ; Retrospective Studies ; Students, Medical ; Volunteers

PURPOSE: This study focuses on investigating the effectiveness of simulation education on emergency management using a low-fidelity simulator as related to clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in new nurses. METHODS: A pre-post test experimental design of nonequivalent control group was applied. Fifty-five new nurses were recruited, 28 nurses for the experimental group and 27 nurses for the control group. A simulation education for emergency management comprising knowledge lecture, team learning, skill education, team simulation, and debriefing was developed and implemented from Feb. 14 to 27, 2015. Data were analyzed with percentage, average, and standard deviation, chi-square, and t-test using SPSS. RESULTS: The experimental group showed significantly higher knowledge (t=5.81, p<.001), clinical skill performance (t=10.08, p<.001), self-confidence (t=-6.24, p<.001), critical thinking disposition (t=2.42, p=.019), and learning satisfaction (t=4.21, p<.001) for emergency management compared with the control group who had traditional lecture education. CONCLUSION: The results indicate that a simulation education using a low-fidelity simulator is an efficient teaching method for new nurses to deepen their clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in learning emergency management.
Clinical Competence ; Education ; Emergencies ; Emergency Nursing ; Evaluation Studies as Topic ; Learning ; Patient Simulation ; Research Design ; Teaching ; Thinking

PURPOSE: The purpose of this study was to develop a model for handoff education for nursing students based on simulation using video and to identify educational effects of a simulated situation in pediatric care units. METHODS: Data were collected from May 1 to 30, 2016. Participants were 84 senior nursing students in Seoul(video group: 43, simulation group: 41). Both groups were given a lecture and pre-briefing on handoff education. The simulation group had nursing practice on resolving health issues for respiratory distress using a high-fidelity baby simulator. The video group watched a video recording of a scenario based simulation, and used a summarized handoff situation to practice patient handoff to another student. RESULTS: There was no significant difference between the two groups for handoff self-confidence, problem solving ability, handoff competence(self-assessment of students), or learning satisfaction. Self-confidence increased significantly in both groups. Handoff competency evaluated by the instructor was higher in the video group compared to the simulation group(t=2.33, p=.022). CONCLUSION: Nursing student education for handoff practice utilizing a video in the pediatric unit was more cost effective. Therefore, it could be a useful educational method for students in learning patient handoff practices and helpful for related research.
Clinical Competence ; Education ; Humans ; Learning ; Methods ; Nursing ; Patient Handoff ; Patient Simulation ; Pediatric Nursing ; Problem Solving ; Students, Nursing ; Video Recording