Simulation-Based Training in Emergency Skills: A Narrative Review Across Diverse Learner Populations.

Background: Emergency skills are critical competencies for managing sudden medical events, reducing disability, and lowering mortality rates. Traditional training methods are often limited by deficiencies in knowledge retention, skill acquisition, and clinical application. Despite growing evidence on simulation-based training, a comprehensive synthesis across diverse learner populations and training modalities remains lacking. This narrative review aims to provide a comprehensive narrative synthesis of current evidence regarding the implementation of simulation training in emergency skills education. Main Body: A literature search was conducted across PubMed, Web of Science, and Scopus (2010-2026) using keywords related to simulation training, emergency skills, cardiopulmonary resuscitation, virtual reality, and medical education. The review is organized around four thematic areas: (1) theoretical foundations and core design elements of simulation training, including feedback, repetition, and scenario fidelity; (2) simulation training for practicing professionals, encompassing layered training models and crisis resource management; (3) simulation training for diverse learner populations, including school-age learners, health profession students, and community participants; and (4) emerging technologies including virtual reality, augmented reality, and wearable devices, which offer immersive and scalable alternatives despite distinct limitations. These modalities demonstrated significant improvements in knowledge acquisition, skill proficiency, and long-term retention, alongside self-reported gains in learner confidence, a subjective outcome that should be distinguished from objectively assessed competence. However, methodological limitations such as small sample sizes, brief follow-up periods, and heterogeneous outcome measures were pervasive. Conclusions: Simulation training enhances emergency skills across diverse populations, but long-term retention and cost-effectiveness require further investigation. Future directions include multicenter randomized controlled trials with extended follow-up, standardized outcome measures, and rigorous cost-effectiveness analyses to strengthen the evidence base for simulation-based emergency skills education.