Learning Outcomes of High-fidelity versus Table-Top Simulation in Undergraduate Emergency Medicine Education: Prospective, Randomized, Crossover-Controlled Study.
Joseph Offenbacher, Alexander Petti, Han Xu, Michael Levine, Mallika Manyapu, Debayan Guha, Maxim Quint, Andrew Chertoff, Andrew Restivo, Benjamin W Friedman, Joshua Silverberg
Author Information
Joseph Offenbacher: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Alexander Petti: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Han Xu: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Michael Levine: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Mallika Manyapu: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Debayan Guha: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Maxim Quint: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Andrew Chertoff: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Andrew Restivo: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Benjamin W Friedman: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
Joshua Silverberg: Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Hospitals, Bronx, New York.
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.
References
West J Emerg Med. 2011 Nov;12(4):455-60
[PMID: 22224137]
