Mannequin-Based Immersive Simulation Improves Resident Understanding of a Clinical Decision Rule

Abstract

Objective.Simulation-based medical education may aid to standardize clinical performance measures, though there is little evidence for using an immersive, mannequin-based simulation for knowledge acquisition. We predicted that residents who had participated in an immersive simulation exercise illustrating the use of a clinical decision rule plus routine instructional methods (experimental group) would understand and implement this tool better than interns who participated in an immersive simulation focused on traumatic brain injury with intracranial hypertension plus routine instructional methods (control group 1). We further predicted that interns in the experimental group would understand and implement this tool as well as senior residents with more clinical experience (control group 2). Methods. This was a single center, prospective, simulation-based, randomized controlled trial. Pediatric interns were randomly assigned to clinically integrated teaching, plus a single, immersive simulation and structured debrief aimed at teaching this tool in minor head trauma (intervention), or clinically integrated teaching plus a related simulation on intracranial hypertension. Senior residents were used as an historical control arm and did not participate in a simulated encounter. Results. 20 interns (ten per group) participated in the study. Senior residents (n=40) served as historical comparisons. Interns in the intervention group scored similar to senior residents on a structured clinical observation score (median 64% vs. 57%), and better than interns in the placebo group (median 64% vs. 43%). Conclusions. In this study, a single immersive simulation improved resident learning and application of a clinical prediction rule when compared to standard resident education.

Breaking Out of the Bubble Putting Simulation Into Context to Increase Immersion and Performance

“…In such situations simulation based training may form a middle ground to somewhat alleviate the transfer problem. In comparison with Harwayne-Gidansky (2017), the case of prehospital simulation holds particular circumstances of how tasks are performed, meaning that the context of the medical scenario becomes a part of the immersive simulation in another and more concrete way. Furthermore, generally in medicine there is a strong case for simulation, not least due to ethical considerations and safety (Gaba, 2004).…”

“…One of the main arguments is that training under realistic conditions will smooth out the transfer from training to clinical practice. There is a long tradition of simulation and simulation based training in medicine (Rosen, 2008) and recently Harwayne-Gidansky, Bellis, McLaren, Gerber, and Ching (2017) evaluated the use of a natural size patient simulator to train medical procedures in Simulation & Gaming 48(5) . Harwayne-Gidansky et al (2017) refer to the use of full-sized patient simulators as an “immersive simulation exercise” (p. 659).…”

Incorporating Simulation Into Your Plan-Do-Study-Act Cycle

“…By offering an immersive, engaging, and safe learning experience, simulation can enhance retention, transfer of knowledge and skills to the practice environment, and adherence to protocol changes when compared to traditional teaching methods. 17,18…”

Promoting Surgical Residents’ Basic Skills via the Design and Implementation of a Simulation Training Tool

“…Simulation training has been expected to upgrade traditional learning, including within practice-based learning in medical education (e.g. Ahlberg et al, 2007; Hämäläinen, Niilo-Rämä, Lainema, & Oksanen, 2018; Harwayne-Gidansky et al, 2017; Larsen et al, 2009). Nevertheless, although technology has advanced rapidly, many challenges remain for promoting simulation-based learning in working-life environments (Hämäläinen, Lanz, & Koskinen, 2018; Teodorczuk & Billett, 2017).…”