Miranda KronfliASEELAH ABDULLAH ALNAZAWI2022-05-262022-05-26https://drepo.sdl.edu.sa/handle/20.500.14154/33277High-fidelity simulation training is increasingly popular in medical education and represents a realistic approach to learning skills and developing knowledge. While evidence supports the use of this approach in a number of contexts, there is a lack of clarity over the value of high-fidelity simulation for decision-making skill development. The aim of this paper was to provide a systematic review of the value of high-fidelity simulation in undergraduate medical students with respect to decision-making skills. A systematic search process was completed focusing on primary research article (quasi-experimental studies or randomised controlled trials) published in the English language and conducted between 2000-2020. A structured approach to data refinement and analysis was used, including the use of thematic analysis to synthesise the data set. A total of nine studies was identified for analysis in the review. These studies suggested that the use of high-fidelity simulation training shows inconsistent benefits for decision-making among medical students when compared to other learning strategies. Heterogeneity in the literature was significant and precluded aggregative synthesis of the findings, although it was apparent results diverged regarding the value of this training approach to develop clinical reasoning, judgment or decision-making skills. The design of simulation techniques, number of sessions completed, scenario focused on, and the measures used to assess clinical decision-making, varied significantly across the studies. It is recommended that high-fidelity simulation can be used to develop clinical decision-making skills but is not superior to other techniques based on current evidence. A multimodal training approach should be used, inclusive of a range of learning techniques according to student preferences and available resources. More research is needed to establish clear outcomes of value for decision-making in undergraduate medical education.en