Effectiveness of non-technical skills training for healthcare professionals in emergency departments: a systematic review
Abstract
Objectives: This systematic review evaluated the effectiveness of non-technical skills (NTS) training for healthcare professionals working in emergency departments (EDs) and assessed the certainty of the evidence.
Methods: Peer-reviewed studies of NTS training for ED staff, including physicians, nurses, and allied health professionals, were systematically identified from PubMed, Scopus, Web of Science, the Cochrane Library, CINAHL, EMBASE, and PsycINFO, with supplementary searches of Google Scholar and reference lists (search date: 19 August 2025). Eligible studies reported learning outcomes, observed behavioural performance, and/or patient- or process-level outcomes in ED settings. Two reviewers independently screened records, extracted data, and assessed risk of bias using RoB 2 for randomised controlled trials, ROBINS-I for non-randomised comparative studies, and the NIH/NHLBI tool for before-and-after studies. Owing to methodological heterogeneity, findings were synthesised narratively, and certainty of evidence was assessed using the GRADE approach (PROSPERO: CRD420251181995).
Results: Of 6,359 records identified, 15 studies met inclusion criteria, comprising two randomised controlled trials, one quasi-experimental study with a control group, and twelve before-and-after studies, predominantly from single-centre adult EDs in North America, Europe, and Asia. NTS training was commonly delivered through simulation-based courses with structured debriefing and was associated…
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