AIMS: This article had two main objectives: to present a brief summary of introductory cognitive concepts on learning and instruction for simulation, including instructional design guidelines; and provide an overview of the current available evidence on the instructional perspectives on healthcare simulation training effectiveness, in particular with regards to simulation formats, fidelity and simulation site.METHODS: We searched for articles at MEDLINE/PubMed, Embase, Cochrane, ERIC, LILACS and SciELO databases, using the keywords "instructional design guidelines", "healthcare simulation", "simulation training", "simulation effectiveness", "complex learning", and "transfer of learning". No specific beginning date of publication was specified and last date of search was September 19th 2017. All articles in English and Portuguese were considered for inclusion with no specific exclusion criteria. A few articles were purposefully selected in search of introductory concepts on learning and instruction.RESULTS: Our search retrieved 3196 articles in the different databases. After preliminary title, abstract and content analysis, we selected 56 articles. Additionally, nine traditional articles and one book were included to present the best available evidence, reviews, reflections and critiques on simulation instructional perspectives, resulting in 66 references consulted in detail for this review.CONCLUSIONS: Simulation offers the opportunity for active learning for health professionals by providing a complex learning environment with integration of knowledge, skills and attitudes. With potential impact on the different levels of learning, behavior and results, special attention should be given to the instructional format of the simulation. Among the instructional design guidelines, authenticity stands out as one of the elements of fundamental relevance for learning. Other instructional elements, such as increasing complexity, proper training location, debriefing, self-assessment opportunity, and other forms of assessment, also have positive influence and should be used in planning different simulation instructional designs.
Surgical Simulation Training Systems: Box Trainers, Virtual Reality and Augmented Reality Simulators
