Making Sense of Methods and Measurement: Cost-Effectiveness Research

Abstract

The evidence is in and high quality simulation activities can provide an effective alternative to traditional clinical experiences (Hayden, Smiley, Alexander, KardongEdgren, & Jeffries, 2014). Research in nursing and health science education overwhelmingly supports the use of simulation for improving a variety of student and patient outcomes. However, few studies include costeffectiveness or cost-benefit analyses of simulation activities (Zendejas, Wang, Brydges, Hamstra, & Cook, 2013). The question remains, ‘‘Do the effects of clinical simulation outweigh the costs?’’ To answer this simple yet challenging question, simulation researchers need to adopt new methods for assessing the effectiveness and the costs associated with simulation (Zendejas, Wang, Brydges, Hamstra, & Cook, 2013). Previously, in Making Sense of Methods and Measurement ,w e underscored the importance of conducting, ‘‘rigorous research that produces valid and reliable data about the effectiveness of clinical simulation’’ (Prion & Adamson, 2012, p. e193). It is equally important to produce evidence describing the costs associated with clinical simulation. Accurately demonstrating both sides of this costeffectiveness equation is the only way nurse educators will be able to provide maximum effectiveness with limited resources. Although cost-effectiveness research is a specialty of its own and the intricacies of the calculations involved are beyond the scope of this column, we hope to inspire readers with a brief explanation and a few resources for conducting cost-effectiveness analyses as a part of their own research. The basic idea behind cost-effectiveness research involves (a) calculating the costs associated with the intervention (simulation), (b) calculating the effectiveness of the intervention, and then (c) comparing the costs and effectiveness to draw conclusions about the value of the intervention. Figure illustrates an example of this comparison.