Learning Outcomes of High-fidelity versus Table-Top Simulation in Undergraduate Emergency Medicine Education: Prospective, Randomized, Crossover-Controlled Study.

Publisher: Department of Emergency Medicine, University of California, Irvine Country of Publication: United States NLM ID: 101476450 Publication Model: Electronic Cited Medium: Internet ISSN: 1936-9018 (Electronic) Linking ISSN: 1936900X NLM ISO Abbreviation: West J Emerg Med Subsets: MEDLINE

Publication: <2011>- : Irvine, CA : Department of Emergency Medicine, University of California, Irvine
Original Publication: Orange, CA : California Chapter of the American Academy of Emergency Medicine

Education, Medical, Undergraduate* ; Emergency Medicine*/education; Clinical Competence ; Humans ; Learning ; Prospective Studies

Introduction: Over the last several decades simulation, in both graduate and undergraduate emergency medicine education, has continued to develop as a leading and highly effective teaching modality. Limited research exists to evaluate the efficacy of low-fidelity (table-top) simulation, as compared to high-fidelity standards, as it relates to medical knowledge learning outcomes. We sought to assess the efficacy of a low-fidelity simulation modality in undergraduate emergency medicine education, based on quantitative medical knowledge learning outcomes.
Methods: A prospective, randomized, crossover-control study comparing objective medical knowledge learning outcomes between simulation modalities. Analysis was designed to evaluate for the statistical equivalence of learning outcomes between the two cohorts. This was done by comparing a calculated 95% confidence interval (CI) around the mean difference in post-test scores, between experimental and control modalities, to a pre-established equivalence margin.
Results: Primary outcomes evaluating student performance on post-test examinations demonstrated a total cohort CI (95% CI, -0.22 and 0.68). Additional course-subject subgroup analysis demonstrated non-inferior CIs with: Shortness of Breath (95% CI, -0.35 and 1.27); Chest Pain (95% CI, -0.53 and.94); Abdominal Pain (95% CI, -0.88 and 1.17); Cardiovascular Shock (95% CI, -0.04 and 1.29). Secondary outcome analysis was done to evaluate medical knowledge acquisition by comparing the difference in pre and post-test examination between the cohorts. CI of the full cohort ranged from (95% CI, -0.14 and 0.96).
Conclusion: The student's performance on quantitative medical-knowledge assessment was equivalent between the high-fidelity control and low-fidelity experimental simulation groups. Analysis of knowledge acquisition between the two groups also demonstrated statistical equivalence.

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Date Created: 20220121 Date Completed: 20220125 Latest Revision: 20220304

20221213

PMC8782127

10.5811/westjem.2021.12.53926

35060855