Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Current simulation training initiatives predominantly occur in uniprofessional silos and do little to integrate different disciplines working in the operating room (OR). The objective of this review was to determine the current status of work describing simulation for full OR multidisciplinary teams including barriers to conducting OR multidisciplinary team training and factors contributing to successful courses. We found a total of 18 articles from 10 research groups. ⋯ Measures of performance involved a variety of both technical and nontechnical ratings of the simulations. Challenges to conducting the simulations included recruitment, model realism, and financial costs. Future work should focus on how best to overcome the barriers to implementation of team training interventions for full OR teams, particularly on how to engage senior staff to aid recruitment.
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Review Meta Analysis
Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis.
To determine the comparative effectiveness of technology-enhanced simulation, we summarized the results of studies comparing technology-enhanced simulation training with nonsimulation instruction for health professions learners. We systematically searched databases including MEDLINE, Embase, and Scopus through May 2011 for relevant articles. Working in duplicate, we abstracted information on instructional design, outcomes, and study quality. ⋯ In random-effects meta-analysis, pooled effect sizes (positive numbers favoring simulation) were as follows: satisfaction outcomes, 0.59 (95% confidence interval, 0.36-0.81; n = 20 studies); knowledge, 0.30 (0.16-0.43; n = 42); time measure of skills, 0.33 (0.00-0.66; n = 14); process measure of skills, 0.38 (0.24-0.52; n = 51); product measure of skills, 0.66 (0.30-1.02; n = 11); time measure of behavior, 0.56 (-0.07 to 1.18; n = 7); process measure of behavior, 0.77 (-0.13 to 1.66; n = 11); and patient effects, 0.36 (-0.06 to 0.78; n = 9). For 5 studies reporting comparative costs, simulation was more expensive and more effective. In summary, in comparison with other instruction, technology-enhanced simulation is associated with small to moderate positive effects.
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This article is a review of the literature focused on simulation as an educational intervention in healthcare. The authors examined the literature based on four key levels: (1) the validity and reliability of the simulator, (2) the validity and reliability of the performance evaluation tool, (3) the study design, and (4) the translational impact. The authors found that the majority of research literature in healthcare simulation does not address the validity and reliability of the simulator or the performance evaluation tool. However, there are well-designed research studies that address the translation into clinical settings and have positive patient safety outcomes.
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Simulation is increasingly used to support learning of procedural skills. Our panel was tasked with summarizing the "best evidence." We addressed the following question: To what extent does simulation support learning and teaching in procedural skills? ⋯ The current state of the science finds that simulation usually leads to improved knowledge and skills. Learners and instructors express high levels of satisfaction with the method. While most studies focus on short-term gains attained in the simulation setting, a small number support the transfer of simulation learning to clinical practice. Further study is needed to optimize the alignment of learner, instructor, simulator, setting, and simulation for learning and teaching procedural skills. Instructional design and educational theory, contextualization, transferability, accessibility, and scalability must all be considered in simulation-based education programs. More consistently, robust research designs are required to strengthen the evidence.
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The aim of this review was to identify the strengths and weaknesses of the roles of real and simulated patients in undergraduate medical education. The literature was reviewed in relation to four patient roles: real patients as educational "resource" (passive role), real patients as teachers (active role), and simulated patients as educational resource and teachers. ⋯ Disadvantages were their limited availability and the variability in learning experiences among students. Despite the considerable amount of literature we found, many gaps in knowledge about patient roles in medical education remain and should be addressed by future studies.