Simulation-based learning (SBL) has been evaluated empirically across a variety of sectors – especially healthcare and higher education – and there is a growing body of research showing that simulations improve performance, skill acquisition, and learner engagement compared with traditional instruction.
A recent systematic review and meta-analysis compared simulation-based learning with non-simulation methods across 22 studies involving 2,517 learners.
It found that simulation significantly enhanced theoretical knowledge and practical skills, with large positive standardised differences in both domains compared with traditional methods. The review also reported higher learner satisfaction and interest in learning with simulation-based approaches.
Another systematic review of 33 nursing education studies involving more than 3,600 participants concluded that simulation consistently improved knowledge and skill acquisition, particularly in life-critical procedures and clinical decision-making tasks. While long-term retention requires further research, the immediate and medium-term effects on practical skills are robust.
A broad meta-analysis of simulation-based learning in higher education — synthesising 145 empirical studies across domains such as medical, teacher, and management education — found a large overall effect (g ≈ 0.85).
Narrative reviews and empirical research indicate that simulation increases learner confidence, critical thinking, and clinical reasoning abilities.
Students trained with simulation methods often report greater comfort applying skills in real-world scenarios, including improved decision-making under pressure.
Additional meta-analytical evidence also supports the idea that simulation improves technical and non-technical competencies, such as communication and teamwork, by providing realistic interactive experiences that are difficult to replicate in traditional formats.
Systematic evidence shows that learners tend to report higher satisfaction and engagement with simulation-based training compared with lectures, reading modules, or purely observational methods. One meta-analysis tracked both knowledge gains and learner satisfaction, finding effect sizes that indicate consistent learner preference for simulation environments.
Research outside of healthcare further supports simulation effectiveness.
Simulation methods have long been applied in aviation and military training for high-risk operational performance, where traditional methods cannot safely replicate real-world complexity. These sectors have documented that simulation improves procedural competence, situational awareness, and decision quality without exposing learners to harm.
Not all reviews find unequivocal superiority in every domain: some focused studies (e.g., on critical care nurse continuing education) noted insufficient evidence due to small sample sizes and methodological limitations.
Long-term retention remains an area needing more high-quality longitudinal research, although available evidence suggests sustained improvements beyond immediate post-training assessments.
Empirical research supports the effectiveness of simulation-based learning in multiple ways:
Taken together, this body of evidence supports simulation-based training as an effective pedagogical strategy — especially when the goal is practical competence, applied judgement, and real-world readiness.