High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students

Abstract

BackgroundSimulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees’ outcomes is currently controversial and there are few data on the effects of these simulators on participants’ personal confidence and self-assessment.MethodsOne-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students’ performance in simulated scenarios was recorded and rated by experts.ResultsParticipants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated.ConclusionThe use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.

Testing a diabetes keotacidosis simulation in critical care nursing: A randomized control trial

“…In this study, supportive and diverse ways of learning provided a chance for achieving objectives/information and problem-solving while teaching concepts using problem identification, logic of argument, synthesis and problem-solving in assessing, planning and intervening in the DKA patient care scenario that are difficult to integrate and learn effectively on an acute and critical care setting. There was a significant improvement in knowledge and self-confidence in the post-test as compared to the pre-test 16,17 and a more extended period of knowledge retention and self-confidence credited to repeated simulation teaching 18 (Orique and Phillips, 2018). In this study, HFS reproduced an actual clinical scenario and promoted critical thinking through interpretation, analysis and inference and to clinical practice.…”

Promoting anaesthesia providers' non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting

“…Simulation fidelity is increasingly viewed as a continuum, with a limited additional benefit of high-cost simulation for certain learners and learning objectives. 34,35 For the development of non-technical skills, low-cost simulators have been shown to be non-inferior to high-cost simulators. 26 The elements of simulation training that promote effective learning are repetitive practise, provision of feedback, and curriculum integration.…”

Does simulation suffice? Teaching procedural skills in undergraduate medical students- observational quasi-experimental study.

“…Three implemented educational intervention possess some limitations, reported in the literature. The absence of changing conditions can be used as a counterargument to the benefits of low fidelity simulations (6,11,57). Whereas, in the case of instructional videos, there is research that found no correlation between the introduction of the instructional videos themselves during the courses and improving the results during the exam (58)(59)(60).…”

“…On the other hand, rapid technological development and the introduction of advanced educational devices do not always improve the quality of education (6). Repeatedly, expensive technology without relying on its adaptation curricula does not meet the expectations of either educators nor learners themselves.…”