• Don Johnson, Amanda Flagg, and Theresa L Dremsa.
• US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas USA.
• Med Educ Online. 2008 Jan 1;13:1.

BackgroundVery little prospective randomized experimental research exists on the use of simulation as a teaching method, and no studies have compared the two strategies of using the HPS and a CD-ROM. In addition, no researchers have investigated the effects of simulation on various levels of cognition, specifically lower-level and higher-level cognition or critical thinking.ObjectivesA prospective pretest-posttest experimental mixed design (within and between) was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies in lower-level, higher-level cognition and critical thinking.ResultsA repeated measures multivariate analysis of variance (RMANOVA) with LSD post-hoc tests were used to analyze the data. There were no significant differences between the HPS and CD-ROM groups on lower-level cognition scores. The HPS group did significantly better than the CD-ROM group on higher-level cognition and critical thinking scores.ConclusionThis study demonstrated that the choice of teaching strategies for lower-level cognition does not make a statistically significant difference in outcome. However, the HPS is superior to using CD-ROM and should be considered as the choice in teaching.

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