Simulation-based medical education is no better than problem-based discussions and induces misjudgment in self-assessment

Abstract

Simulation-based teaching (SBT) is increasingly used in medical education. As an alternative to other teaching methods there is a lack of evidence concerning its efficacy. The aim of this study was to evaluate the potency of SBT in anesthesia in comparison to problem-based discussion (PBD) with students in a randomized controlled setting. Thirty-three fourth-year medical students attending a curricular anesthesiology course were randomly allocated to either a session of SBT or a session of PBD on an emergency induction method. Ten days later all students underwent examination in a simulator. The performance of each student was evaluated by weighted tasks, established according to a modified Delphi process. Confidence and a multiple-choice questionnaire were additionally performed pre- and post-intervention. A total of 32 students completed the study. Participants in the SBT group presented with significantly higher self-assessment scores after the intervention than students in the PBD group. However, students in the SBT group achieved only slightly and statistically insignificantly higher scores in the theoretical and simulator examination (p > 0.05) with only a moderate effect size of d = 0.52. The current study demonstrates that both PBD and SBT lead to comparable short-term outcomes in theoretical knowledge and clinical skills. However, undesirably, SBT students overrated their anticipated clinical abilities and knowledge improvement.

Developing clinical competency in crisis event management: an integrated simulation problem-based learning activity

“…Wenk et al (2008) demonstrated that both problem-based discussion and simulation-based teaching have comparable outcomes in theoretical knowledge and clinical skill. Steadman et al (2006) found simulation base learning to be superior to problem-based learning in the context of critical assessment and management skills acquisition.…”

“…Several studies have used a randomized controlled trial design to compare simulationbased learning with problem-based discussion but their findings were controversial (Steadman et al 2006;Wenk et al 2008). Wenk et al (2008) demonstrated that both problem-based discussion and simulation-based teaching have comparable outcomes in theoretical knowledge and clinical skill.…”

Simulation and Introductory Pharmacy Practice Experiences

“…For example, a simulation exercise using a blood pressure arm task trainer can improve students' blood pressure measuring technique but does little to develop their communication or assessment skills. 19,20 A significant disadvantage of the use of simulation in health professionals' education is the cost of sophisticated equipment. An individual high-fidelity simulator costs on average $30,000.…”

“…An institution will also need space to conduct the simulation and house the equipment. 3,14,20 Although one of the key advantages of simulation is the ability to provide immediate feedback to students, to do so requires adequate faculty resources to conduct the simulation and assess the students. Not only do faculty members need to be trained in conducting the simulation but they also must have the clinical knowledge to teach and assess students.…”

Review article: Simulation in anesthesia: state of the science and looking forward

“…Borges et al 55 did not observe significant changes in practicing anesthesiologists' airway management of a ''cannot intubate, cannot ventilate'' simulated scenario following simulation training. Wenk et al 56 compared simulation-based learning with problem-based learning on anesthesia students' ability to perform a rapid sequence intubation on a full-body mannequin. Following the training session, students in both groups performed equally well on the rapid sequence intubation task.…”