Translational simulation in anaesthesia: a systematic review of applications, processes, outcomes, and implementation factors.

In 30 seconds

This systematic review examined how translational simulation has been used to explore or improve multidisciplinary anaesthetic care, including its processes, outcomes, and implementation factors. Across 149 studies involving more than 3300 anaesthesia staff in 37 countries, simulation was used mainly to identify latent safety threats and optimise protocols; structural or procedural changes followed in 113 studies. Reported applications focused more on crisis management than routine perioperative care. Signals of improved patient outcomes were described, but causal attribution was limited because quasi-experimental designs predominated.

Key findings

• The review included 149 studies involving more than 3300 anaesthesia staff across 37 countries.
• Structural or procedural modifications were reported in 113 studies, commonly after identifying latent safety threats or optimising protocols.
• Applications predominantly addressed crisis management rather than routine perioperative care; conceptual frameworks and contemporary safety sciences were infrequently used.
• Patient-outcome improvement signals were reported, but causal attribution was limited by the predominance of quasi-experimental designs.

Why it matters

The review characterises translational simulation as a practical systems-engineering approach in anaesthesia, with reported changes to structures and procedures. It also highlights that evidence of patient benefit remains difficult to interpret causally. More consistent terminology, attention to routine perioperative care, and theory-informed programmes integrated with quality and safety structures may help develop the field and clarify its contribution.

What to keep in mind

The evidence base was predominantly quasi-experimental, limiting causal attribution of reported patient-outcome improvements.