| Article Number | Author and Date | Evidence Type | Sample, Sample Size, Setting | Findings That Help Answer the EBP Question | Observable Measures | Limitations | Evidence Level, Quality |
| 1. | Blanie, Benhamou, Figueiredo, Gorse, Roulleau, 2018 [2] | Prospective randomized study | (N = 109) third and fourth-year anesthesia residents in Paris. | Immediate improvement of learning outcomes for both active participant and observer roles after immersive simulation contributed to avoidance of knowledge decay. | A 16 multiple-choice questionnaire was constructed and used to measure learning outcomes. | Non-technical skills and learning transfer were assessed by using self-reported questionnaires. Non-technical skills might be different according to the role of the participants. In the active group, active players were active participants during one scenario but observers in the 3 others. | Level: 1 Quality: B |
| 2. | Gisriel, Dalley, Walker, 2020 [5] | Research study | A convenience sample of 15 Student Registered Nurse Anesthetists (SRNAs) was obtained. A university skills lab and adjacent conference room were used for simulation and debriefing activities. | Knowledge retention and absence of knowledge decay was observed in SRNAs that utilized a simulation activity compared to those who did not. | A 25-question test was administered right after the simulation activity and one month after. Students who did not participate in the simulation were given the test on the same days as those that did. | Small sample size (N = 15) All students were enrolled in the same nurse anesthesia program. | Level: 1 Quality: B |
| 3. | Kumar, Purva, Chander, Parameswari, 2019 [6] | Single arm, prospective, interventional, pre and post design study | (N = 10) anesthesiology residents underwent simulation-based education at a single simulation center. | Repeated simulations over a longer period help in better reinforcement, retention of knowledge, recapitulation and implementation of technical and non-technical skills. | Individual performance and the total score obtained against the assessment tool. | The absence of video recording may have influenced the capture of information during the scenario as the assessors may have been distracted and not captured the adherence to the assessment protocol in a consistent and rigorous manner. Results cannot be definitively proven to be from the simulation-based scenario and not from more exposure in the clinical setting. | Level: 2 Quality: B |
| 4. | Miller, Jackson, Lee, Gottschalk, Shiavi, 2022 [7] | Quasi-experimental study | 281 first-year anesthesia providers at Johns Hopkins Hospital Simulations conducted in the operating room simulation center | Self-efficacy improved after simulation in every technical skill surveyed and remained stable over a decade | A 25 question, 5-point Likert scale survey assessed self-efficacy in 25 anesthesia related crises | Evaluation of self-efficacy, not response times, accurate symptom recognition, or provider performance Does not compare simulation style learning to other methods | Level: 2 Quality: B |
| 5. | Nofi, Roberts, Demyan, Sodhi, DePeralta, Zimmern, Aronsohn, Molmenti, Patel, 2022 [3] | Web-based cross-sectional survey | 91 residents and 36 faculty members across all specialties. Two large academic tertiary medical centers, North Shore University Hospital and Long Island Jewish Medical Center, of the Northwell Health System in New York. | The redeployment of residents due to COVID-19 into specialties they were not familiar with affected how they handle crisis situations. Knowledge decay was present in these situations. | An online survey was sent to residents and faculty members that consisted of multiple-choice questions. | Recall bias could potentially affect findings. Perceived skill decay and improvement in other competencies are self-reported by residents. | Level: 4 Quality: B |