ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Simulation-based Training is Consistently Associated with Large Effects on Desired Training Outcomes
Clinical Question In health profession students, is technology enhanced simulation-based training (TEST) with recommended elements of instructional design, in comparison to no intervention, more effective in producing desired training outcomes?
Clinical Bottom Line Technology enhanced simulation-based training (TEST) is consistently associated with large and desirable effects on training outcomes. In health professional education, simulation based training is more effective in producing desired training outcome when compared with no intervention. This is supported by two systematic reviews and meta-analysis, which showed the large effects on the desired outcomes, such as knowledge outcomes, timed and processed skills.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21900138Cook/2011609 eligible studies involving health professions education students.Meta-Analysis
Key resultsLarge effects in student learner outcomes for skills, knowledge and behaviors are consistently associated with technology enhanced simulation training in health profession education programs when compared with no intervention. The following are the pooled effect sizes: knowledge outcomes (118 studies) were 1.20 (95% CI, 1.04-1.35), timed skills (210 studies) were 1.14 (95% CI, 1.03-1.25), process skills (54 studies) were 1.18 (95% CI, 0.98-1.37), timed behaviors (20 studies) were 0.79 (95% CI, 0.47-1.10), other behaviors (50 studies) were 0.81 (95% CI, 0.66-0.96) and direct effects on patients (32 studies) were 0.50 (95% CI, 0.34-0.66).
#2) 23807104Cook/201382 eligible studies involving health professions education studentsMeta-Analysis
Key resultsThe use of technology enhanced simulation, when compared to no intervention, for mastery learning in health profession education (in which student do not progress without demonstrated high levels of skill attainment) was found to have a large effect size (ES) on skills (41 studies) = 1.29 (95% CI, 0.36-1.10), and a moderate ES on patient outcomes (11 studies) = 0.73 (95% CI, 0.36-1.10). In 3 studies comparing mastery learning simulation based medical education (SBME) with nonmastery SBME, it was found that mastery learning requires more time, but has a larger benefit in skill acquisition = 1.17 (95% CI, 0.29-2.05).
Evidence Search (comparative[All Fields] AND effectiveness[All Fields]) AND (("technology"[MeSH Terms] OR "technology"[All Fields]) AND enhanced[All Fields] AND ("Simulation"[Journal] OR "simulation"[All Fields])) (("technology"[MeSH Terms] OR "technology"[All Fields]) AND enhanced[All Fields] AND ("Simulation"[Journal] OR "simulation"[All Fields])) AND (("health occupations"[MeSH Terms] OR ("health"[All Fields] AND "occupations"[All Fields]) OR "health occupations"[All Fields] OR ("health"[All Fields] AND "profession"[All Fields]) OR "health profession"[All Fields]) AND ("education"[Subheading] OR "education"[All Fields] OR "educational status"[MeSH Terms] OR ("educational"[All Fields] AND "status"[All Fields]) OR "educational status"[All Fields] OR "education"[All Fields] OR "education"[MeSH Terms]))
Comments on
The Evidence
Validity: The authors for this systematic review and meta-analysis (Cook 2011) concluded that technology enhanced simulation training (TEST) in health professions education has large positive correlations with student outcomes in knowledge, skills, and behaviors. This SR/MA provided a comprehensive, detailed search for relevant trials with 609 eligible studies and 35,226 trainees involved. Similarly, the authors for this systematic review and meta-analysis (Cook 2013) concluded that using TEST for mastery learning in health professions education was associated with large effects on skill acquisition, and moderate effects on patient outcomes. Additionally, this review stated that TEST required more time than nonmastery learning. This SR/MA provided a comprehensive, detailed search for relevant trials with 82 eligible studies and 3,498 participants involved. Perspective: Application of skills acquired in training settings to mileu of patient care is influenced by many intervening factors that may influence patient outcomes.
Applicability The outcomes of the 2011 and 2013 systematic reviews and meta-analyses by Cook, et. al., have implications for teachers in health professions education who teach procedural, surgical and other clinical skills in terms of instructional design and use of simulation-based training.
Specialty/Discipline (Public Health) (Basic Science)
Keywords Education, Simulation-based training
ID# 2657
Date of submission: 02/28/2014spacer
E-mail Lukm@livemail.uthscsa.edu
Author Mai Luk
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author William Hendricson
Faculty mentor/Co-author e-mail Hendricson@uthscsa.edu
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