Simulation-based teaching in the emergency management of status epilepticus: A scoping review

This scoping review synthesizes evidence on simulation-based education (SBE) in status epilepticus (SE) emergency training. A systematic search of six databases (PubMed, Embase, Web of Science, CINAHL, Cochrane CENTRAL, Scopus) identified 21 eligible studies published between 2015 and 2025, encompassing 1,425 trainees across eight countries. Findings are interpreted through Kolb's experiential learning cycle and McGaghie's mastery learning model. Outcomes varied by domain: 17 of 21 studies (81%) demonstrated significant gains in SE-related knowledge or procedural skills, and team-based designs consistently improved task delegation and crisis resource management; however, improvements in protocol adherence under realistic time pressure were less uniformly achieved, and patient-level evidence remains almost entirely absent, with the single study to assess downstream clinical endpoints finding no significant effect. Methodological quality, assessed using the Medical Education Research Study Quality Instrument (MERSQI; mean 12.38 ± 1.07, range 10-15), showed no temporal improvement over the study period (β₁=-0.024/yr, R2 = 0.004; descriptive analysis). Persistent limitations include small sample sizes, non-randomized designs, short follow-up, geographic concentration in high-resource settings, outcome assessment heterogeneity, reliance on locally developed or self-report measures, the absence of validated SE-specific outcome instruments, and the near-complete absence of patient-centered endpoints. SE simulation should be understood as an educationally promising but clinically unproven intervention; future research should prioritize pre-registered, multicenter, adequately powered trials with clinical endpoints to establish whether simulation training ultimately improves SE care.