Simulation-based Team Training Effects on Clinical Performance and Patient Outcomes: Systematic Review of Controlled Studies.

Simulation-based team training is widely implemented across health care systems, yet its contribution to clinical performance and patient outcomes remains variably documented. This review synthesizes controlled studies of postgraduate simulation-based team training in acute care settings, focusing on how interventions and effects vary across contexts. Eighteen controlled studies were included, reporting outcomes related to clinical performance, morbidity, or survival. While many studies demonstrated improvements in at least one outcome domain, findings were inconsistent and varied across intervention format and baseline conditions. Reported benefits were more commonly observed in lower-resource or district hospital settings, whereas brief training interventions showed fewer effects. Overall certainty of evidence was low. Rather than supporting a binary interpretation of whether simulation-based team training "works," the findings indicate that effects depend on how training is designed, implemented, and integrated within clinical systems, requiring interpretation at the level of individual studies.