Retention of Critical Procedural Skills After Simulation Training: A Systematic Review

Area of Science:

• Medical Education
• Emergency Medicine
• Simulation-Based Training

Background:

• Short-term performance gains in critical emergency procedures after simulation are well-documented.
• Long-term retention of these skills in nonsurgical physicians remains less certain.

Purpose of the Study:

• To evaluate the long-term retention of critical emergency procedure skills in nonsurgical physicians following simulation-based training.
• To determine if simulation promotes sustained proficiency in emergency procedures.

Main Methods:

• A systematic review of electronic databases was conducted to identify eligible studies (observational, quasi-experimental, RCTs).
• Studies assessed performance of intubation, cricothyrotomy, pericardiocentesis, tube thoracostomy, or central line placement by nonsurgical physicians post-simulation.
• Skill performance was evaluated immediately after and at ≥3 months post-simulation, with primary outcome being benchmark performance at ≥3 months.

Main Results:

• Ten studies met eligibility criteria, with moderate methodologic quality.
• Two studies showed maintenance of minimum performance benchmarks, while two indicated significant skill decay.
• Four of four studies showed a decline in mean performance scores over time, though scores generally remained significantly above baseline.

Conclusions:

• Limited studies exist on long-term skill retention after simulation for critical emergency procedures.
• While some skill retention is evident, most studies indicate a decline in performance over time.
• Further research is needed to understand and optimize long-term skill maintenance.