Background: The increasing complexity of healthcare systems and the emphasis placed on patient safety have highlighted the crucial role of non-technical skills (NTS). Simulation-based training (SBT) has been widely adopted to acquire these skills. Objective: To evaluate the impact of simulation on the development of non-technical skills in health sciences students. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251066518). MEDLINE, Scopus, and Web of Science were searched from their inception to July 2025. Results: Twelve studies met the inclusion criteria. Most used quasi-experimental, before-and-after study designs and relied primarily on self-reported measures. The majority of results were classified at Kirkpatrick level 2a (attitude changes). Three studies reached level 2b, demonstrating improvements in objectively observed teamwork and communication behaviors. MERSQI scores ranged from 6.5 to 17, indicating variable methodological quality. No studies assessed transfer to clinical practice (level 3) or patient-level outcomes (level 4). Conclusions: Simulation-based training appears effective in improving self-reported non-technical skills and, to a lesser extent, objectively observed teamwork behaviors among health sciences students. However, the predominance of lower-level outcomes and methodological heterogeneity limit the strength of the evidence. Rigorous longitudinal studies evaluating higher-level outcomes are needed.
Amrani et al. (Thu,) studied this question.