Impact of Simulation-Based Training on Clinical Decision-Making Skills Among Medical Interns
Simulation-based education; Clinical decisionmaking; Medical interns; Clinical reasoning; Medical education; Patient safety; Highfidelity simulation; Experiential learning.
AuthorsAbstractBackground: Clinical decision-making (CDM) represents one of the most essential competencies expected of medical interns as they transition from supervised undergraduate education to independent clinical practice. Newly graduated physicians frequently encounter challenges in integrating theoretical knowledge with practical patient care, often resulting in diagnostic uncertainty, delayed management, and increased risk of medical errors. Simulation-based training (SBT) has emerged as a transformative educational strategy capable of providing realistic, risk-free environments in which interns can repeatedly practice clinical reasoning, procedural skills, communication, teamwork, and crisis resource management before caring for actual patients. Advances in high-fidelity simulation, standardized patient encounters, virtual reality, augmented reality, and computer-based simulation have significantly expanded opportunities for experiential learning across multiple clinical disciplines. Objective: This narrative review aims to comprehensively examine current evidence regarding the impact of simulation-based training on clinical decision-making skills among medical interns, explore the educational mechanisms underlying its effectiveness, identify factors influencing learning outcomes, discuss existing limitations, and provide recommendations for future educational practice and research. Methods: A narrative review methodology was adopted to synthesize evidence from peer-reviewed literature published primarily between 2010 and 2026. Major electronic databases including PubMed, Scopus, Web of Science, MEDLINE, and ERIC were searched using combinations of keywords related to simulation-based education, clinical decision-making, medical interns, clinical reasoning, and patient safety. Landmark earlier studies were included where appropriate because of their historical importance in simulation research. Studies involving undergraduate medical education, internship training, residency transition, and workplace-based simulation were critically evaluated and integrated into a comprehensive narrative synthesis. Results: Current literature consistently demonstrates that simulation-based training improves clinical decision-making by enhancing diagnostic reasoning, prioritization of critically ill patients, recognition of deteriorating conditions, communication skills, teamwork, leadership, confidence, and cognitive integration under stressful clinical conditions. Repeated deliberate practice combined with structured debriefing appears to produce sustained improvements in clinical judgment and patient safety outcomes. Nevertheless, considerable heterogeneity exists regarding simulation modalities, assessment instruments, intervention duration, and long-term outcome evaluation. Conclusion: Simulation-based training has become an indispensable component of contemporary medical education. When integrated longitudinally into internship curricula and supported by evidence-based debriefing, simulation substantially enhances clinical decision-making while promoting safer patient care. Future research should emphasize standardized assessment methods, multicenter randomized studies, cost-effectiveness analyses, and long-term evaluation of knowledge retention and patient outcomes. •••••••••••••••••••••••••••••••• ejprd.org - Published by Riset Publication Services LLC
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