Abstract
We conducted a systematic review of competency-based simulation education for medical procedural skills, encompassing a diverse range of healthcare domains and professions. Meta-analysis showed competency-based simulation is more effective than noncompetency-based simulation for skill outcomes (large effect). Outcomes are favorable, but small, for behaviors in practice and patient effects. Specific instructional design features examining different simulators and different types and sources of feedback were common themes identified among studies though no instructional design features were found to have significant impact on skill acquisition. This review also identified significant gaps in research including a lack of standardized terminology and reporting methods as well as a limited number of studies assessing the impact on behaviors in practice and patient effects. This study contributes to the ongoing evidence to support competency-based simulation training and highlights the need for further research to enhance the efficacy and efficiency of training of healthcare professionals.