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Open research questions in Simulation-Based Education in Healthcare

696 gap statements mined from Simulation-Based Education in Healthcare papers in our 7.9M-paper local library, which holds 5,411 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Difficulty distinguishing cues, distraction, cultural variation, and over-interpretation were identified as challenges in recognizing and interpreting subtle facial and non-verbal cues. The study also notes the challenge of complete blinding, as standardised patients participated in the educational programme and could infer whether an encounter was the first or final assessment.

    The Micro-Expression Decoder: A Preliminary Mixed-Methods Evaluation of Training in Subtle Facial and Non-Verbal Cue Recognition in Final-Year Medical Students · 2026 · DOI

  • The language barrier for students who lack sufficient proficiency in English. The need for leaders of educational institutions to possess leadership qualities such as courage, entrepreneurship, experience, and a strong desire to successfully implement new technologies.

    Application of Virtual Reality, Artificial Intelligence, and Other Innovative Technologies in Healthcare Education (Nursing and Midwifery Specialties): Challenges and Strategies · 2024 · DOI

  • Despite cost reductions, overall prices for VR hardware devices remain high, making them less accessible for educational institutions. Currently created VR applications are mostly in English, which is a language barrier for students who lack sufficient proficiency in the language.

    Application of Virtual Reality, Artificial Intelligence, and Other Innovative Technologies in Healthcare Education (Nursing and Midwifery Specialties): Challenges and Strategies · 2024 · DOI

  • The need for objective assessment of clinical skills. The lack of effective methods for teaching clinical skills in traditional medical education. The potential of simulation-based medical education to improve clinical competence.

    Impact of Simulation-Based and Flipped Classroom Learning on Self-Perceived Clinical Skills Compared to Traditional Training · 2024 · DOI

  • Measuring motivation is limited since it evaluates perceived motivation, not the actual amount of effort, which is a more specific measure of motivational behavior since the effort is aimed at the actions to fulfill the activity. The sample was selected using a non-probabilistic convenience sampling technique.

    Comparison of the Effect of Motivation in Medical Students with the Use of Virtual Reality and Non-Immersive Digital Resources · 2024 · DOI

  • Consideration of the impact that participating in SBLE could have on several key measures of DPD program success could warrant understanding, such as the impact of SBLE participation on the RDN credentialing exam pass rate and on eventual employer satisfaction with the entry-level practice readiness of graduates.

    Increased Perceived Confidence in Professional Role Skills among Undergraduate Dietetic Students Following Simulation-Based Learning Experiences · 2024 · DOI

  • The gap in understanding how prior healthcare experience affects student confidence is also identified.

    Increased Perceived Confidence in Professional Role Skills among Undergraduate Dietetic Students Following Simulation-Based Learning Experiences · 2024 · DOI

  • Little is known about their combined effect on undergraduate nursing students' competence.

    The Impact of High‐Fidelity Simulation and Curriculum Integration on Nursing Students’ Competence and Satisfaction: A Quasiexperimental Study · 2026 · DOI

  • Simulated patients (SPs) play a key role in medical communication training, yet their contribution to feedback dialogues during post-simulation feedback sessions remains underexplored.

    From Simulation to Conversation: Simulated Patients’ Contribution to Meaningful Feedback Dialogues · 2026 · DOI

  • However, there is a gap in the literature regarding the use of virtual reality in teaching in this area of the curriculum.

    Evaluating an Education Program That Incorporated Virtual Reality for Teaching Aggression Management: A Pre‐Post Pilot Study With Nursing Students · 2026 · DOI

  • The association between artificial intelligence simulation-system usability and nursing students' learning engagement remains unclear.

    AI System Usability and Learning Engagement in Nursing Simulation: Cross‐Sectional Statistical Indirect Associations Through Extraneous Cognitive Load and Flow Experience · 2026 · DOI

  • However, objective assessments revealed overestimations of conceptual understanding, highlighting gaps in knowledge retention and indicating that tailored, multi-modal psychoeducation may be necessary to ensure consistent uptake and effectiveness across the nursing workforce.

    Working under pressure: How virtual reality and psychoeducation shape stress and moral distress responses in nurses · 2026 · DOI

  • Future research should explore long-term outcomes and broader applications of this method.

    Peer-assisted learning in critical care: a simulation-based approach for postgraduate medical training · 2025 · DOI

  • Despite its growing popularity, limited data are currently available on the perceived value and impact of SBME in oncology.

    Global trends in the value of simulation as a pedagogical tool in oncology: a bibliometric analysis from 2010 to 2024 · 2025 · DOI

  • Role-playing as doctor in a simulated environment has shown to be of value for final-year students, but this has not been studied with third-year students, who may struggle to be active participants in the clinical environment.

    Stepping into the role of a doctor: an instrumental case study to explore the experiences of third-year medical students in a simulated general practice clinic · 2025 · DOI

  • Compared with foreign countries, there are few types of virtual situations in China, the depth and breadth of application research are insufficient, and the attention to nursing staff management ignores the spiritual level, which has a lot of room for improvement.

    Application of virtual reality technology in nursing management: A scoping review · 2025 · DOI

  • There is limited evidence describing the utilization of artificial intelligence (AI) to support medical learning.

    SP3.03 Artificially Intelligent Simulated Patients in undergraduate surgical teaching: A single blinded randomized controlled study · 2025 · DOI

  • However, the feasibility of integrating such technology into the training of immediate newborn care skills remains unexplored.

    Development and Evaluation of a Virtual Reality Program for Immediate Newborn Care Training in Nursing Education: A Feasibility Study · 2024 · DOI

  • Limited time for students to observe the impact of quality improvement initiatives in clinical rotations. Difficulty in demonstrating statistically significant improvement in certain areas due to high pretest scores and low posttest response rate. Ensuring that students understand the complexity and interdependency of health care processes.

    From Pieces to Processes: Teaching Health Care Process Optimization and Quality Improvement Through a Building Brick Simulation · 2026 · DOI

  • High pretest scores and low posttest response rate may have limited the ability to demonstrate statistically significant improvement in some areas. The study only included second-year medical students, which may limit the generalizability of the results.

    From Pieces to Processes: Teaching Health Care Process Optimization and Quality Improvement Through a Building Brick Simulation · 2026 · DOI

  • AI/VR simulation was found to be moderately useful for learning and the design of the software was found to be inclusive, but the findings were limited by the sample size.

    Identifying implementation considerations for the use of AI-VR simulation in undergraduate healthcare: A pilot feasibility study · 2026 · DOI

  • The study had no control group, - There was no follow-up, - The study was conducted in a simulation setting, - The sample size was limited to 60 final-year medical students, - Complete blinding was not…

    The Micro-Expression Decoder: A Preliminary Mixed-Methods Evaluation of Training in Subtle Facial and Non-Verbal Cue Recognition in Final-Year Medical Students · 2026 · DOI

  • The study was conducted in a simulated environment, - The sample size was limited to 12 expert pediatric diabetologists, - The study did not assess the guidelines in real-world clinical…

    High-fidelity simulation-based validation of applicability of the new Italian society for pediatric endocrinology and diabetes (ISPED) recommendations for pediatric diabetic ketoacidosis management · 2026 · DOI

  • Engaging students in anatomy sessions. Enhancing student motivation and learning experiences. Developing effective educational programs for future healthcare professionals.

    Comparison of the Effect of Motivation in Medical Students with the Use of Virtual Reality and Non-Immersive Digital Resources · 2024 · DOI

  • Future research should measure skill proficiency and retention, - The study suggests the need for objective…

    Impact of Simulation-Based and Flipped Classroom Learning on Self-Perceived Clinical Skills Compared to Traditional Training · 2024 · DOI

Most-cited papers in Simulation-Based Education in Healthcare

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Open questions raised by papers listed on this page include: (1) Little is known about their combined effect on undergraduate nursing students' competence (“The Impact of High‐Fidelity Simulation and Curriculum Integration on Nursing…”, 2026); (2) Simulated patients (SPs) play a key role in medical communication training, yet their contribution to feedback dialogues during post-simulation feedback sessions remains underexplored (“From Simulation to Conversation: Simulated Patients’ Contribution to Meaningful…”, 2026); (3) The association between artificial intelligence simulation-system usability and nursing students' learning engagement remains unclear (“AI System Usability and Learning Engagement in Nursing Simulation:…”, 2026); (4) Future research should explore long-term outcomes and broader applications of this method (“Peer-assisted learning in critical care: a simulation-based approach for…”, 2025); (5) Role-playing as doctor in a simulated environment has shown to be of value for final-year students, but this has not been studied with third-year students, who may struggle to be active participants in the clinical environment (“Stepping into the role of a doctor: an instrumental case study to explore the…”, 2025). 696 gap statements have been mined from Simulation-Based Education in Healthcare papers in our 7.9M-paper local library, which holds 5,411 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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