Do clinical simulations using a human patient simulator in the education of paramedics in trauma care reduce error rates in preclinical performance?

Abstract

Introduction: Evidence suggests that simulation training improves preclinical and possibly actual clinical performance in a range of health disciplines and could therefore be expected to do the same for paramedics. This project is based on the observations of the Consultative Committee on Road Traffic Fatalities in Victoria (British Columbia, Canada) that identified over a five-year period consistent management, diagnostic, and technique errors in prehospital trauma care associated with adverse outcomes. Hypothesis: This study aimed to answer the question: “Do clinical simulations using a human patient simulator (HPS) in the education of paramedics in trauma care reduce error rates in preclinical performance?” Methods: The research design was a randomized, controlled study using a pre/post-test design. The participants were student ambulance and intensive care paramedics (n = 120) at three different phases of training. Ethics approval was obtained. Results: Significant improvement in post-test performance was demonstrated by students undertaking simulation-based learning compared with students undertaking case study-based learning (p = 0.008). A subgroup analysis demonstrated that the most significant difference between control and study groups was evident in novice paramedics (p = 0.014). This diminished in the more experienced student ambulance paramedic group (p = 0.059) and was not evident in the student intensive care paramedic group (p = 0.767). Conclusion: Clinical simulations using an HPS in the education of paramedics in trauma care results in reduced errors in preclinical performance when compared with case-study based learning in junior paramedics. These findings have implications for the development of future paramedic education programs. Future studies should explore the transition of improved preclinical performance to actual clinical performance.