Evidence map›Paper›PMID 40481503›Full record

SynthesisBMC medical education2025

Effectiveness of non-technical skills training in intensive care units: a systematic review.

Isac Davidson Santiago Fernandes Pimenta, Ádala Nayana de Sousa Mata, Isaac Newton Machado Bezerra, Rícia Medeiros Palmeira de Araújo, Jorge Lucas Alves Santana, Helaine Carneiro Capucho, Adriana Catarina de Souza-Oliveira, Paloma Echevarría-Pérez, Daniel Guillén-Martínez, Grasiela Piuvezam

Abstract readSystematic Review
In one paragraph

Synthesis in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. High-fidelity simulation programs in ICU-related ethical non-technical skills training: A narrative review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
    Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Isac Davidson Santiago Fernandes PimentaPostgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil.ORCID http://orcid.org/0000-0002-8246-0603
Ádala Nayana de Sousa MataSystematic Review and Meta-analysis Laboratory (LabSys - UFRN/CNPQ), Federal University of Rio Grande do Norte, Natal, Brazil.ORCID http://orcid.org/0000-0003-3929-2082
Isaac Newton Machado BezerraSystematic Review and Meta-analysis Laboratory (LabSys - UFRN/CNPQ), Federal University of Rio Grande do Norte, Natal, Brazil.ORCID http://orcid.org/0000-0002-5860-6588
Rícia Medeiros Palmeira de AraújoSystematic Review and Meta-analysis Laboratory (LabSys - UFRN/CNPQ), Federal University of Rio Grande do Norte, Natal, Brazil.ORCID http://orcid.org/0000-0002-4158-0748
Jorge Lucas Alves SantanaSystematic Review and Meta-analysis Laboratory (LabSys - UFRN/CNPQ), Federal University of Rio Grande do Norte, Natal, Brazil.ORCID http://orcid.org/0000-0001-7246-9535
Helaine Carneiro CapuchoDepartment of Pharmacy, University of Brasília, Brasília, Brazil.ORCID http://orcid.org/0000-0002-5438-7963
Adriana Catarina de Souza-OliveiraFaculty of Nursing, Catholic University of Murcia, Murcia, Spain.ORCID http://orcid.org/0000-0001-8600-4413
Paloma Echevarría-PérezFaculty of Nursing, Catholic University of Murcia, Murcia, Spain.ORCID http://orcid.org/0000-0002-2458-611X
Daniel Guillén-MartínezFaculty of Nursing, Catholic University of Murcia, Murcia, Spain.ORCID http://orcid.org/0000-0003-4968-1364
Grasiela PiuvezamSystematic Review and Meta-analysis Laboratory (LabSys - UFRN/CNPQ), Federal University of Rio Grande do Norte, Natal, Brazil. gpiuvezam@yahoo.com.br.ORCID http://orcid.org/0000-0002-2343-7251

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Finance code 001
6 · The paper itself

Abstract

backgroundNon-technical skills (NTS) are social, cognitive and psychological skills that are related to safety and efficiency in the healthcare process. These skills have an important role in the intensive care once are closely related to the occurrence of safety incidents. This study aims to examine the effectiveness of NTS training programs in intensive care units using Kirkpatrick's evaluation model, encompassing reaction, learning, behaviors, and organizational results.

methodWe conduct a systematic review of original articles in the following databases: Pubmed (Medline), Scopus, Web of Science, Science Direct, CINHAL (EBSCOhost), EMBASE (Elsevier), and PsycINFO. We include randomized clinical trials, quasi-experimental studies, and those employing a before-and-after design. Two pairs of independent reviewers selected and assessed the studies, with any discrepancies resolved by a fifth reviewer. Risk of bias and quality assessments were performed using Cochrane Risk of Bias 2, Risk of Bias in Non- randomized Studies of Interventions and Quality Assessment Tool developed by the National Heart, Lung, and Blood Institute.

resultsFourteen studies were included, with 11 employing a before-and-after design. Overall study quality was assessed as moderate or low. Simulation training was the main teaching strategy of the training programs. In the reaction dimension, participants (502 participants) generally perceived the training programs as beneficial, despite variations in teaching strategies. Only two studies evaluated the impact on the learning dimension (383 participants), with small improvements. A positive correlation was identified between the adoption of NTS training programs and improved teamwork (413 participants and 183 direct observations), situational awareness (444 participants and 183 direct observations), leadership (183 participants and 155 direct observations), and communication (183 participants and 1141 direct observations). Organizational results showed no significant changes in patient safety culture, length of stay or mortality rates (15776 patients). However, there was a reduction in response time to cardiopulmonary resuscitation and lower adjusted mortality and complications rates (7721 patients).

conclusionThe implementation of NTS training programs in intensive care units may improve healthcare professionals' performance, especially in teamwork, situational awareness and communication. However, it is necessary to conduct more robust experimental studies to establish causality and explore broader impacts on patient safety and costs. REGISTRATION: CRD42021244769.

Indexed as

Clinical CompetenceIntensive Care UnitsHumansPatient SafetySimulation TrainingIntensive care unitsNon-technical skillsPatient safetyQuality of health careSystematic review

Identifiers

PMID40481503
PMCPMC12142836

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.