High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
21 Jan 2019
Historique:
received: 22 10 2018
accepted: 09 01 2019
entrez: 23 1 2019
pubmed: 23 1 2019
medline: 14 6 2019
Statut: epublish

Résumé

Simulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees' outcomes is currently controversial and there are few data on the effects of these simulators on participants' personal confidence and self-assessment. One-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students' performance in simulated scenarios was recorded and rated by experts. Participants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated. The use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.

Sections du résumé

BACKGROUND BACKGROUND
Simulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees' outcomes is currently controversial and there are few data on the effects of these simulators on participants' personal confidence and self-assessment.
METHODS METHODS
One-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students' performance in simulated scenarios was recorded and rated by experts.
RESULTS RESULTS
Participants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated.
CONCLUSION CONCLUSIONS
The use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.

Identifiants

pubmed: 30665397
doi: 10.1186/s12909-019-1464-7
pii: 10.1186/s12909-019-1464-7
pmc: PMC6341720
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

29

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Auteurs

Christina Massoth (C)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Hannah Röder (H)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Hendrik Ohlenburg (H)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Michael Hessler (M)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Alexander Zarbock (A)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Daniel M Pöpping (DM)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany.

Manuel Wenk (M)

Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149, Münster, Germany. manuelwenk@uni-muenster.de.

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