In order to meet the needs of student learning within a competency-based pedagogy, it is necessary to understand the current philosophies and modalities being used in dental and oral health simulation-based education. The aim of this literature review is to identify the existing research relating to the educational structure of dental and oral health simulation activities. The review is presented as a scoping review, formulated and conducted using a modified five stage methodological framework. Despite evidence showing that the healthcare simulation model is ideal for learning and assessments of non-clinical and clinical tasks such as psychomotor skills, there is a paucity of published literature relating to simulation in dental and oral health education. Out of 72 initial articles only six papers related to dental preclinical psychomotor skills in an educational setting, none of which were deemed high-quality. Deficiencies in these papers included no statements defining underpinning educational theory, limited acknowledgement of evidence-based simulation activities including preparation, briefing, simulation, feedback, debriefing, reflection and evaluation. Given the widespread use of simulation in dentistry, academics should be encouraged to publish their scholarly activities in simulation-based dental education in order so that all dental faculties can work towards developing contemporary simulation curriculum to provide optimum teaching and learning opportunities for students.

A simulation-based dental curriculum should be designed according to standards of best-practice with aligned educational theories that meet determined learning outcomes. 1 In order to design contemporary dental simulation curriculum within a student-centred, competency-based pedagogy, it is necessary to understand current best practice in healthcare simulation design. Whilst all areas of dental education benefit from simulation activities, simulation is necessary in dental fields involving invasive and non-reversible procedures. Specifically, the fields of operative and restorative dentistry benefit significantly, allowing students a safe environment in which to learn skills and develop competency prior to treating real patients. 2 Best-practice guidelines are available for healthcare simulation curriculum in medicine, nursing and anaesthesia. 3,4 The literature suggests using evidence-based, pedagogically sound simulation curriculum designs that are supported by frameworks and educational theories. 5 This paper will explore the influence of educational theory on simulation curriculum and simulation in health professionals' education. The parameters of contemporary best-practice simulation-based education will be defined and discussed, and the application of these standards to dental simulation-based education design will be explored. 2 | EDUC ATIONAL THEORY AND S IMUL ATION CURRICULUM Vygotsky's Experiential Learning Theory is a common theory referred to in healthcare simulation literature. Vygotsky theorised that if a learner is situated within a role they will experience the facility, staff interaction and on-the-job training in skills and

Background Evidence-based practice is an important component of pre-service professional learning in medicine and allied health degrees, including new programmes in paramedicine. Despite substantial interest in this area, there is still a lack of clear understanding of how the skills and understandings needed to develop the capacity to apply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of five steps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine students’ learning about the first three steps in a final year unit which explicitly aims to develop their skills in relation to these. Methods We conducted a qualitative study of learning journals recorded by 101 of 121 students in a final year unit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research or did not complete their journal entries). We used phenomenographic approaches to the data analysis in order to identify both variation in students’ learning and the factors affecting this variation. Results We observed variation in students’ understanding of the purpose of literature analysis, the nature of medical research and its relationship to practice. In all three, we identify two main factors contributing to the variation in student learning outcomes: epistemological stance, and opportunities for metacognitive learning generated through peer interactions and self-reflection. We also found that as students begin to grapple with the complexity of medical research, this sometimes produced negative attitudes towards its value; such unintended outcomes need to be recognised and addressed. Conclusions We suggest key factors that should be considered in developing coursework intended to enhance students’ understandings about the processes and application of evidence-based practice. Providing collaborative learning opportunities that address the architecture of variation we observed may be useful in overcoming epistemological and metacognitive barriers experienced by students.

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