Background: Competency-Based Learning (CBL) and Simulation-Based Learning (SBL) support clinical skills, critical thinking, and professional competencies through personalized, experiential learning. Although CBL and SBL are conceptually complementary, their combined implementation and associated outcomes remain heterogeneous. This narrative review aimed to synthesize evidence on their implementation, educational outcomes, and contextual challenges in health professions education.
Methods: A structured search of PubMed, Scopus, ERIC, ProQuest, and Google Scholar identified studies published between 2015 and 2025 using relevant keywords. Following screening, eligible primary and secondary studies were narratively synthesized to examine educational outcomes, benefits, and challenges associated with CBL and SBL.
Results: Fourteen studies, including 12 primary studies and two systematic reviews, were included. In general, findings indicated that CBL and SBL were associated with improvements in skill acquisition, knowledge retention, learner engagement and performance-related outcomes across nursing, medicine, midwifery and other health professions education settings. High-fidelity simulation approaches appeared beneficial in procedural skill development, critical thinking, and performance in short- and long-term assessments. CBL may promote individualized learning, competency mastery, and soft-skill development, while integration with SBL increased learner engagement, confidence, and satisfaction. Together, these approaches may connect competency expectations with opportunities for practice, demonstration, and feedback. However, heterogeneous methodologies, implementation challenges, curriculum–practice mismatches, inconsistent assessment methods, and limited long-term follow-up rendered evidence regarding sustained competency outcomes inconclusive.
Conclusion: CBL and SBL may complement one another in supporting clinical skill development, competency assessment, learner engagement, knowledge retention, and performance. Simulation may be particularly valuable when aligned with deliberate practice, feedback-driven learning, and competency-based assessment. Nevertheless, heterogeneity in instructional design, implementation, and assessment, alongside limited long-term evidence and few studies evaluating integrated CBL–SBL models across diverse contexts, restricts generalizability. Methodologically rigorous research should establish standardized evaluation frameworks, identify optimal integration models, and assess the long-term sustainability and cross-context applicability of educational outcomes.