Technology-Enhanced Simulation for Health Professions Education
Top Cited Papers
- 7 September 2011
- journal article
- review article
- Published by American Medical Association (AMA) in JAMA
- Vol. 306 (9), 978-988
- https://doi.org/10.1001/jama.2011.1234
Abstract
Context Although technology-enhanced simulation has widespread appeal, its effectiveness remains uncertain. A comprehensive synthesis of evidence may inform the use of simulation in health professions education. Objective To summarize the outcomes of technology-enhanced simulation training for health professions learners in comparison with no intervention. Data Source Systematic search of MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Study Selection Original research in any language evaluating simulation compared with no intervention for training practicing and student physicians, nurses, dentists, and other health care professionals. Data Extraction Reviewers working in duplicate evaluated quality and abstracted information on learners, instructional design (curricular integration, distributing training over multiple days, feedback, mastery learning, and repetitive practice), and outcomes. We coded skills (performance in a test setting) separately for time, process, and product measures, and similarly classified patient care behaviors. Data Synthesis From a pool of 10 903 articles, we identified 609 eligible studies enrolling 35 226 trainees. Of these, 137 were randomized studies, 67 were nonrandomized studies with 2 or more groups, and 405 used a single-group pretest-posttest design. We pooled effect sizes using random effects. Heterogeneity was large (I2>50%) in all main analyses. In comparison with no intervention, pooled effect sizes were 1.20 (95% CI, 1.04-1.35) for knowledge outcomes (n = 118 studies), 1.14 (95% CI, 1.03-1.25) for time skills (n = 210), 1.09 (95% CI, 1.03-1.16) for process skills (n = 426), 1.18 (95% CI, 0.98-1.37) for product skills (n = 54), 0.79 (95% CI, 0.47-1.10) for time behaviors (n = 20), 0.81 (95% CI, 0.66-0.96) for other behaviors (n = 50), and 0.50 (95% CI, 0.34-0.66) for direct effects on patients (n = 32). Subgroup analyses revealed no consistent statistically significant interactions between simulation training and instructional design features or study quality. Conclusion In comparison with no intervention, technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviors and moderate effects for patient-related outcomes.Keywords
This publication has 25 references indexed in Scilit:
- Does Simulation-Based Medical Education With Deliberate Practice Yield Better Results Than Traditional Clinical Education? A Meta-Analytic Comparative Review of the EvidenceAcademic Medicine, 2011
- Computerized Virtual Patients in Health Professions Education: A Systematic Review and Meta-AnalysisAcademic Medicine, 2010
- The case of the misleading funnel plotBMJ, 2006
- Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic reviewMedical Teacher, 2005
- The future vision of simulation in health careQuality and Safety in Health Care, 2004
- Sub-group analysesJournal of Hypertension, 2004
- Measuring inconsistency in meta-analysesBMJ, 2003
- Adjusting for publication bias in the presence of heterogeneityStatistics in Medicine, 2003
- Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs.Psychological Methods, 2002
- Effectiveness of a simulator in training anesthesiology residentsAcademic Medicine, 1969