Abstract
IntroductionOver 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.MethodsA 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.ResultsPrimary 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).ConclusionThe 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.
Highlights
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
Additional course-subject subgroup analysis demonstrated non-inferior confidence interval (CI) with: Shortness of Breath; Chest Pain; Abdominal Pain; Cardiovascular Shock
Its medical knowledge content is in line with generally accepted national standards set forth by Council of Residency Directors in Emergency Medicine (CORD) and Clerkship Directors in Emergency Medicine (CDEM) guidelines and includes the subjects of: chest pain (CP), shortness of breath (SB), abdominal pain (AP) and cardiovascular shock (CS)
Summary
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. We sought to assess the efficacy of a low-fidelity simulation modality in undergraduate emergency medicine education, based on quantitative medical knowledge learning outcomes. In spite of the increasing utilization of simulation in emergency medicine education, significant challenges have persisted.[5] These include the need for technically skilled operators, simulation trained educators, and substantial material resources.[6,7,8] To date, the limited existing data has focused heavily on high-fidelity simulation for teaching both medical knowledge and clinical skills.[9,10,11,12] the integration of simulation into emergency medicine clerkship programs has remained selective, representing a secondary didactic adjunct at the undergraduate level.[13] In response to these challenges, undergraduate emergency medicine educators have expressed significant interest in the use of lowfidelity (table-top) simulation experiences, despite the lack of outcomes-based research.[14,15]
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