Comparative Effectiveness of Technology-Enhanced Simulation Versus Other Instructional Methods

Abstract

To determine the comparative effectiveness of technology-enhanced simulation, we summarized the results of studies comparing technology-enhanced simulation training with nonsimulation instruction for health professions learners. We systematically searched databases including MEDLINE, Embase, and Scopus through May 2011 for relevant articles. Working in duplicate, we abstracted information on instructional design, outcomes, and study quality. From 10,903 candidate articles, we identified 92 eligible studies. In random-effects meta-analysis, pooled effect sizes (positive numbers favoring simulation) were as follows: satisfaction outcomes, 0.59 (95% confidence interval, 0.36-0.81; n = 20 studies); knowledge, 0.30 (0.16-0.43; n = 42); time measure of skills, 0.33 (0.00-0.66; n = 14); process measure of skills, 0.38 (0.24-0.52; n = 51); product measure of skills, 0.66 (0.30-1.02; n = 11); time measure of behavior, 0.56 (-0.07 to 1.18; n = 7); process measure of behavior, 0.77 (-0.13 to 1.66; n = 11); and patient effects, 0.36 (-0.06 to 0.78; n = 9). For 5 studies reporting comparative costs, simulation was more expensive and more effective. In summary, in comparison with other instruction, technology-enhanced simulation is associated with small to moderate positive effects.

Patient Outcomes in Simulation-Based Medical Education: A Systematic Review

“…Certain study subgroups were absent or present in lower proportions compared with the larger cohort from which this sample was extracted, [13][14][15] including nonprocedural activities such as physical exam, patient counseling, or clinical reasoning; procedures such as surgery and anesthesiology; and some learner groups (notably medical students). This suggests selection bias in the topics and learners represented.…”

“…71,[80][81][82][83][84][85][86] These comparisons with active interventions were included in previous meta-analyses. 14,15 Three articles omitted the number of trainees; we contacted these authors and two provided needed information.…”

“…[10][11][12] Previous reports from our review have demonstrated that simulation is superior to no intervention (609 studies) 13 and to nonsimulation instruction (92 studies), 14 and have used comparisons of different simulation interventions (289 studies) to identify evidence-based best practices. 15 The present study is a planned sub-analysis of these data.…”

Simulation for Teaching Orthopaedic Residents in a Competency-based Curriculum: Do the Benefits Justify the Increased Costs?

“…Simulation-based training allows trainees to practice skills in a low-pressure environment, without risk to patients, and allows trainees to make and learn from mistakes before they occur in surgery [13]. Previous research has shown that simulation can be highly effective for learning technical and nontechnical surgical skills [3,4,9,[14][15][16][17] and that the skills learned can transfer to clinical settings [5]. Furthermore, simulation-based training can shorten the learning curve, enhance later intraoperative learning [8,14], and improve patient outcomes [19].…”

Pedagogy before Technology: A Design-Based Research Approach to Enhancing Skills Development in Paramedic Science Using Mixed Reality

“…In health education, there is growing evidence that simulation improves learners' safety [1], competence, and skills [2], especially when compared to traditional didactic methods and/or no simulation training [3]. Of significant importance to the health profession is airways management [4], where inadequate skill and poor judgment can lead to patient complications and death [5].…”