SynthesisBMC medical education2026
From operating room to leadership room: a systematic review of simulation-based interventions for leadership development in general surgery.
Synthesis in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effect of simulation-based leadership training on behavioral and safety-related outcomes in surgical and clinical environments. Leadership and non-technical skills (NTS) are critical for safe surgical practice. Simulation-based education can be helpful in the improvement of these skills. While simulation-based education is widely used to improve technical skills, its influence on leadership, teamwork, and patient safety outcomes is reported inconsistently.
methodsFollowing the PRISMA guidelines, studies evaluating leadership or NTS using simulation within surgical or perioperative contexts were included. Study characteristics, simulation format, assessment frameworks, leadership outcomes, and patient safety indicators were extracted. Risk of bias was evaluated using ROBINS-I and RoB-2, and visualised through the robvis platform.
resultsTwelve studies with 430 participants met inclusion criteria. Sample sizes ranged from 14-69; most involving multidisciplinary teams of 2-6 members. High-fidelity modalities were used in approximately 70% of studies, while others incorporated wet-lab, video-based, or in-situ simulations. Leadership performance improved, with reported gains of 2-4 points on behavioral scales. Communication and teamwork scores increased by approximately 2-3 points, and Non-Technical Skills for Surgeons (NOTSS) domain means typically ranged from 2.8-3.5 on 4-point scales. Technical performance differences between senior and junior trainees averaged 30-40%. Checklist-supported teams missed only 6% of critical actions.
conclusionsSimulation-based training was consistently associated with improvements in leadership, communication, teamwork, and safety-related performance across surgical and multidisciplinary settings. Although results were positive, heterogeneity in design and measurement shows the need for further high-quality, standardised research.
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