Fostering healthy work environments through interprofessional simulation: teamwork, communication, psychological safety-systematic review of randomised controlled and quasi-experimental studies

Abstract

Aim : To evaluate the effectiveness of simulation-based interprofessional education (IPSE) interventions on teamwork, communication and psychological safety outcomes among healthcare professionals and students. Design : A systematic review. Data Sources : Searches were conducted across PubMed, CINAHL, Scopus, Web of Science and Cochrane CENTRAL, supplemented by manual reference and citation tracking. Review Methods : The search strategy was developed with an academic librarian to ensure thoroughness and relevance. The review included randomised controlled trials (RCTs) and quasi-experimental studies published between 2010 and 2025. Eligible studies reported quantitative outcomes of IPSE interventions involving at least two healthcare professions. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for quasi-experimental studies. Results : Thirty studies (14 RCTs, 16 quasi-experimental) from 16 countries were included. Most studies reported positive effects on teamwork, including improved coordination, role clarity and adherence to structured protocols. Communication outcomes showed enhanced information exchange, clarity and structured behaviours, such as SBAR and closed-loop communication, although some studies noted inconsistent safety practices. Psychological safety outcomes demonstrated gains in self-confidence, self-efficacy, leadership and safety climate, with several studies also reporting reduced anxiety. However, findings on stress, workload and attitudinal change were mixed. Overall, RCTs were judged methodologically robust, and quasi-experimental studies were largely low risk with some moderate concerns. Conclusion : Simulation-based interprofessional training enhances teamwork, communication and psychological safety in fostering a healthy work environment, though effects vary by context and population. Impact : This review synthesises evidence from 30 trials, offering guidance for educators and policymakers on advancing interprofessional collaboration. Integrating IPSE into health curricula and clinical training can strengthen collaboration and contribute to safer patient care. Patient or Public Contribution : No patient or public contribution. Reporting Methods : The review adhered to PRISMA 2020 guidelines, and the protocol was registered in the PROSPERO international prospective register of systematic reviews (ID: CRD420251039410).