Effectiveness of high-fidelity clinical simulation in cardiopulmonary resuscitation training: a systematic review and meta-analysis of controlled trials

Abstract

Background: High-fidelity simulation enhances cardiopulmonary resuscitation (CPR) training in a safe environment. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the effectiveness of high-fidelity simulation compared to traditional CPR training. Medline, CINAHL, Scopus and Web of Science were searched for studies, assessing theoretical knowledge and practical skills. RoB 2 was used to assess risk of bias and standardized mean difference (SMD) for effect sizes, assuming a random effects model. The protocol was registered in PROSPERO (ID: CRD42023441692). Results: Twelve studies with 1,520 participants were included. Simulation improved compression depth [SMD = 0.33, 95% CI 0.15-0.50, I² = 23%] and CPR knowledge retention [SMD = 1.53, 95% CI 0.94-2.12, I² = 79%]. Lack of data made follow-up analysis difficult. Conclusion: High-fidelity simulation improves CPR skills in the short term compared to traditional training. Further studies are needed to confirm its effectiveness in the medium and long term.