The effect of deception in simulation-based education in healthcare: a systematic review and meta-analysis

Abstract

Simulation in healthcare education enables learners to practice in a realistic and controlled environment without putting real patients at risk. Deception can be incorporated to generate a realistic learning experience. We aim to perform a systematic review of the literature to study the effect of deception in SBE in healthcare. Online database search was performed from conception up to the date of search (December 2023). Qualitative descriptive analysis included all published and unpublished works as for the quantitative analysis, only randomized clinical trials with an objective measurement tool relating to learner’s performance were included. Forward citation tracking using SCOPUS to identify further eligible studies or reports was also applied. Twelve out of 9840 articles met the predefined inclusion criteria. Two randomized controlled trials were identified using deception for the intervention group and ten articles provided current knowledge about the use of deception in simulation-based education in healthcare. The aspects discussed in the latter articles related to the possible forms of deception, its benefits and risks, why and how to use deception appropriately, and the ethics related to deception. Although this meta-analysis shows that using deception in SBE in healthcare by challenging authority negatively affects the trainees’ performance on the mAIS scale, this approach and other forms of deception in SBE, when used appropriately and with good intent, are generally accepted as a valuable approach to challenge learners and increase the level realism of SBE situations. Further randomized trials are needed to examine and confirm the effect of other deceptive methods and the true psychological effect of those interventions on validated scales.