Debriefing in prehospital simulation-based education: a scoping review of ambulance nurse and paramedic literature

Simulation is fundamental to the education of paramedics and ambulance nurses, with debriefing widely recognised as the educational component through which much of the learning is consolidated. However, how debriefing is implemented and reported within prehospital simulation for practising clinicians remains poorly understood. This scoping review mapped and critically examined debriefing approaches used in simulation involving paramedics, ambulance nurses, flight paramedics, and flight nurses. Using Arksey and O’Malley’s (2005) scoping review framework and the PRISMA-ScR reporting guideline, MEDLINE, EMCARE, CINAHL Plus, SCOPUS, and Google Scholar were searched for studies published in English or Arabic between 2005 and 2025. Following editorial review, all included studies were re-examined against the predefined eligibility criteria, and studies involving student-only populations were excluded. Findings were charted and synthesised thematically. From 974 identified records, 18 studies met the final inclusion criteria. Most studies originated from the United States, employed quantitative designs, and were published between 2012 and 2025. Two themes were identified: guided debriefing ( n = 15) and tool- and technology-assisted debriefing ( n = 3). Across the included literature, debriefing was associated with improvements in technical performance, communication, teamwork, clinical reasoning, and reflective practice. However, reporting of debriefing interventions remained inconsistent, with considerable variation in facilitation, structure, outcome measures, and theoretical underpinning. Many studies relied on self-reported educational outcomes, making it difficult to distinguish the specific contribution of debriefing from the broader effects of simulation-based education. Debriefing remains a central component of prehospital simulation-based education for practising clinicians, yet its design and reporting vary considerably across the literature. Guided debriefing was the predominant approach, while evidence supporting technology-assisted debriefing was comparatively limited. Future research should adopt clearer descriptions of debriefing interventions, strengthen theoretical and pedagogical foundations, and incorporate objective measures of learner performance to better understand how different debriefing approaches influence clinical practice.