The Effectiveness Of Simulation-Based Code Training On Emergency Preparedness And Clinical Decision-Making Among Healthcare Professionals: A Systematic, Multidisciplinary Study

Abstract

In modern healthcare, the ability of professionals to respond swiftly and effectively to emergencies is critical to patient safety and clinical outcomes. This study evaluated the effectiveness of simulation-based code training in improving emergency preparedness and clinical decision-making among multidisciplinary healthcare teams. A quasi-experimental, mixed-methods design was employed, involving 118 physicians, nurses, and allied health professionals at a tertiary teaching hospital equipped with a high-fidelity simulation center. Participants completed pre- and post-training assessments using validated instruments: the Emergency Preparedness Questionnaire (EPQ), the Clinical Decision-Making in Nursing Scale (CDMNS), and the Teamwork and Communication Scale (TCS). Results revealed significant post-intervention improvements in preparedness (Δ = +1.20, p < .001), decision-making accuracy (Δ = +0.85, p < .001), and teamwork (Δ = +1.23, p < .001). Regression analysis identified clinical experience and discipline as significant predictors of post-training performance (R² = 0.41). Thematic analysis of qualitative data highlighted four key benefits: enhanced cognitive readiness, interprofessional trust, psychological safety, and translation of learned behaviors to real clinical contexts. These findings demonstrate that simulation-based code training not only strengthens technical and cognitive competencies but also fosters interprofessional collaboration, leadership, and confidence under pressure. The study underscores the value of integrating simulation into continuous professional development programs and accreditation standards to enhance institutional emergency readiness and patient safety. Future research should adopt longitudinal and multicenter designs to assess the sustainability and long-term clinical impact of simulation-based learning.