Effectiveness of Peer-Led vs. Instructor-Led Debriefing in High-Fidelity Simulation-Based Healthcare Education: A...

Simulation-based training enhances medical education by improving learners' experience and proficiency. High-fidelity simulation (HFS) increases skill acquisition and retention when compared to standard training techniques. Debriefing is a key part of simulation education and peer-led debriefing (PLD) may also be appropriate. This study aims to determine whether PLD is as effective as instructor-led debriefing (ILD) in improving learner outcomes in HFS.

This SRMA followed the PRISMA and Cochrane guidelines and was registered on PROSPERO (CRD420251082121). PubMed, Cochrane and Embase were databases searched from inception to June 2025. Two independent reviewers screened studies, extracted data and assessed risk of bias using RoB 2. Outcomes were pooled using random-effects models; heterogeneity was assessed using I² using RevMan 5.4.

Six studies (five quasi-experimental and one RCT) containing 476 participants (peer-led: 245; instructor-led: 231) were included. No statistically significant differences were found between PLD and ILD. The overall certainty of the evidence was low to moderate. For Debriefing Assessment for Simulation in Healthcare (DASH), MD = -1.06 (95% CI: -3.81, 1.69; p = 0.45; I² = 87%). Organised debriefing: MD 0.19 (95% CI: -0.64, 1.02; p = 0.65; I² = 91%). Other outcomes (e.g., helping achieve good practice, identifying performance gaps and establishing engaging learning environment) also showed nonsignificant differences.

No statistically significant differences were observed between PLD and ILD across the included studies. Limited and heterogeneous evidence base means the findings should be interpreted cautiously. Robust, well-designed RCTs are needed to confirm these findings, address heterogeneity and explore long-term effects.