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Simulation in the Development of Non-Technical Skills in Cardiopulmonary Resuscitation: A Scoping Review

Year: 2026

Type: article

Abstract: Background: Cardiopulmonary resuscitation (CPR) requires a coordinated and effective response, with non-technical skills (NTS) playing an important role in patient safety. Deficiencies in these skills may contribute to preventable clinical errors. Objectives: To map the scientific evidence on the contribution of simulation to the development of NTS among healthcare teams in the context of CPR. Methods: This scoping review followed JBI guidance and PRISMA-ScR reporting recommendations. MEDLINE, CINAHL, Nursing & Allied Health Collection: Comprehensive and the Cochrane Central Register of Controlled Trials were searched via EBSCOhost up to 7 July 2026. Eligibility followed Population, Concept and Context criteria; two reviewers independently selected and charted the evidence. Results: The 27 included sources yielded three themes: simulation as a strategy for skill development; NTS in CPR; and complementary educational interventions. Communication was the most frequently reported NTS, alongside leadership, teamwork, situational awareness, and decision-making. Reported improvements varied across sources and skills, and some diminished or were only partially retained over time. Debriefing was addressed in 21 sources (77.8%). Evidence on complementary technologies remained preliminary, with some tools lacking formal evaluation or validation. Conclusions: The findings provide a descriptive map of heterogeneous evidence and suggest that simulation may support NTS development, particularly with structured debriefing. They do not establish effectiveness or effects on clinical outcomes. Robust quantitative and longitudinal studies using validated measures are needed to confirm observed trends and assess retention, transfer to practice, team performance, patient safety, and clinical outcomes.

Source: Nursing Reports

DOI: 10.3390/nursrep16100364

Authors: Leila Sales, Bárbara Marques, Ângela Mendes, Florbela Machado, Inês Lopes, Rita Marques