Efficacy of high-fidelity simulation in advanced life support training: a systematic review and meta-analysis of randomized controlled trials.
ALS
High-fidelity simulation
Meta-analysis
Participant’s confidence
Skill performance
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
14 Sep 2023
14 Sep 2023
Historique:
received:
25
04
2023
accepted:
05
09
2023
medline:
18
9
2023
pubmed:
15
9
2023
entrez:
14
9
2023
Statut:
epublish
Résumé
Simulation is an increasingly used novel method for the education of medical professionals. This study aimed to systematically review the efficacy of high-fidelity (HF) simulation compared with low-fidelity (LF) simulation or no simulation in advanced life support (ALS) training. A comprehensive search of the PubMed, Chinese Biomedicine Database, Embase, CENTRAL, ISI, and China Knowledge Resource Integrated Database was performed to identify randomized controlled trials (RCTs) that evaluated the use of HF simulation in ALS training. Quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions version 5.0.1. The primary outcome was the improvement of knowledge and skill performance. The secondary outcomes included the participants' confidence and satisfaction at the course conclusion, skill performance at one year, skill performance in actual resuscitation, and patient outcomes. Data were synthesized using the RevMan 5.4 software. Altogether, 25 RCTs with a total of 1,987 trainees were included in the meta-analysis. In the intervention group, 998 participants used HF manikins, whereas 989 participants received LF simulation-based or traditional training (classical training without simulation). Pooled data from the RCTs demonstrated a benefit in improvement of knowledge [standardized mean difference (SMD) = 0.38; 95% confidence interval (CI): 0.18-0.59, P = 0.0003, I Learners using HF simulation more significantly benefited from the ALS training in terms of knowledge and skill performance at the course conclusion. However, further research is necessary to enhance long-term retention of knowledge and skill in actual resuscitation and patient's outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Simulation is an increasingly used novel method for the education of medical professionals. This study aimed to systematically review the efficacy of high-fidelity (HF) simulation compared with low-fidelity (LF) simulation or no simulation in advanced life support (ALS) training.
METHODS
METHODS
A comprehensive search of the PubMed, Chinese Biomedicine Database, Embase, CENTRAL, ISI, and China Knowledge Resource Integrated Database was performed to identify randomized controlled trials (RCTs) that evaluated the use of HF simulation in ALS training. Quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions version 5.0.1. The primary outcome was the improvement of knowledge and skill performance. The secondary outcomes included the participants' confidence and satisfaction at the course conclusion, skill performance at one year, skill performance in actual resuscitation, and patient outcomes. Data were synthesized using the RevMan 5.4 software.
RESULTS
RESULTS
Altogether, 25 RCTs with a total of 1,987 trainees were included in the meta-analysis. In the intervention group, 998 participants used HF manikins, whereas 989 participants received LF simulation-based or traditional training (classical training without simulation). Pooled data from the RCTs demonstrated a benefit in improvement of knowledge [standardized mean difference (SMD) = 0.38; 95% confidence interval (CI): 0.18-0.59, P = 0.0003, I
CONCLUSIONS
CONCLUSIONS
Learners using HF simulation more significantly benefited from the ALS training in terms of knowledge and skill performance at the course conclusion. However, further research is necessary to enhance long-term retention of knowledge and skill in actual resuscitation and patient's outcomes.
Identifiants
pubmed: 37710261
doi: 10.1186/s12909-023-04654-x
pii: 10.1186/s12909-023-04654-x
pmc: PMC10500810
doi:
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
664Subventions
Organisme : Sichuan Province Science and Technology Support Program
ID : 2023NSFSC1475
Organisme : Health Commission of Sichuan Province
ID : 2023-207
Organisme : Sichuan Provincial People's Hospital
ID : 2021ZX01
Organisme : Ministry of Education Hainan Medical University
ID : KLET-202104
Organisme : Peking Union Medical Foundation
ID : R2021012
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Cheng A, Lockey A, Bhanji F, Lin Y, Hunt EA, Lang E. The use of high-fidelity manikins for advanced life support training–A systematic review and meta-analysis. Resuscitation. 2015;93:142–9.
Roberts F, Cooper K. Effectiveness of high fidelity simulation versus low fidelity simulation on practical/clinical skill development in pre-registration physiotherapy students: a systematic review. JBI Database System Rev Implement Rep. 2019;17(6):1229–55.
Dillon S. Simulation in Obstetrics and Gynecology: a review of the past, Present, and Future. Obstet Gynecol Clin North Am. 2021;48(4):689–703.
Weller J, Robinson B, Larsen P, Caldwell C. Simulation-based training to improve acute care skills in medical undergraduates. N Z Med J. 2004;117(1204):U1119.
Ranger C, Paradis MR, Morris J, Perron R, Drolet P, Cournoyer A, Paquet J, Robitaille A. Transcutaneous cardiac pacing competency among junior residents undergoing an ACLS course: impact of a modified high fidelity manikin. Adv Simul (Lond). 2018;3:24.
Huang J, Tang Y, Tang J, Shi J, Wang H, Xiong T, Xia B, Zhang L, Qu Y, Mu D. Educational efficacy of high-fidelity simulation in neonatal resuscitation training: a systematic review and meta-analysis. BMC Med Educ. 2019;19(1):323.
Gardner R, Raemer DB. Simulation in obstetrics and gynecology. Obstet Gynecol Clin North Am. 2008;35(1):97–127.
Barsuk JHCE, McGaghie WC, Wayne DB. Long-term retention of central venous catheter insertion skills after simulation-based mastery learning. Acad Med. 2010;85(10 Suppl):9–12.
Wayne DB, Butter J, Siddall VJ, Fudala MJ, Wade LD, Feinglass J, McGaghie WC. Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice. J Gen Intern Med. 2006;21(3):251–6.
Wayne DB, Siddall VJ, Butter J, Fudala MJ, Wade LD, Feinglass J, McGaghie WC. A longitudinal study of internal medicine residents’ retention of advanced cardiac life support skills. Acad Med. 2006;81(10 Suppl):9–S12.
Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest. 2008;133(1):5.
Wayne DB, Butter J, Siddall VJ, Fudala MJ, Linquist LA, Feinglass J, Wade LD, McGaghie WC. Simulation-based training of internal medicine residents in advanced cardiac life support protocols: a randomized trial. Teach Learn Med. 2005;17(3):210–6.
Steadman RH, Coates WC, Huang YM, Matevosian R, Larmon BR, McCullough L, Ariel D. Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Crit Care Med. 2006;34(1):7.
Petscavage JM, Wang CL, Schopp JG, Paladin AM, Richardson ML, Bush WH Jr. Cost analysis and feasibility of high-fidelity simulation based radiology contrast reaction curriculum. Acad Radiol. 2011;18(1):107–12.
Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.0.1; updated September 2008. The Cochrane Collaboration. 2008; Available at: www.cochrane-handbook.org . Accessed October 15, 2009.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, et al. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
doi: 10.1136/bmj.d5928
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
Adams AJ, Wasson EA, Admire JR, Pablo Gomez P, Babayeuski RA, Sako EY, Willis RE. A comparison of Teaching Modalities and Fidelity of Simulation levels in teaching resuscitation scenarios. J Surg Educ. 2015;72(5):778–85.
Aqel AA, Ahmad MM. High-fidelity simulation effects on CPR knowledge, skills, acquisition, and retention in nursing students. Worldviews Evid Based Nurs. 2014;11(6):394–400.
Berger C, Brinkrolf P, Ertmer C, Becker J, Friederichs H, Wenk M, Van Aken H, Hahnenkamp K. Combination of problem-based learning with high-fidelity simulation in CPR training improves short and long-term CPR skills: a randomised single blinded trial. BMC Med Educ. 2019;19(1):180.
Campbell DM, Barozzino T, Farrugia M, Sgro M. High-fidelity simulation in neonatal resuscitation. Paediatr Child Health. 2009;14(1):19–23.
Chen S, Wen C. The applications of simbaby simulation training in the teaching of neonatal resuscitation. Chongqing Med J. 2015;44(6):856–7.
Cheng A, Hunt EA, Donoghue A, Nelson-McMillan K, Nishisaki A, Leflore J, Eppich W, Moyer M, Brett-Fleegler M, Kleinman M, et al. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr. 2013;167(6):528–36.
Cherry RA, Williams J, George J, Ali J. The effectiveness of a human patient simulator in the ATLS shock skills station. J Surg Res. 2007;139(2):229–35.
Conlon LW, Rodgers DL, Shofer FS, Lipschik GY. Impact of levels of simulation fidelity on training of interns in ACLS. Hosp Pract. 2014;42(4):135–41.
Coolen EH, Draaisma JM, Hogeveen M, Antonius TA, Lommen CM, Loeffen JL. Effectiveness of high fidelity video-assisted real-time simulation: a comparison of three training methods for acute pediatric emergencies. Int J Pediatr. 2012; 2012:709569.
Cortegiani A, Russotto V, Montalto F, Iozzo P, Palmeri C, Raineri SM, Giarratano A. Effect of High-Fidelity Simulation on Medical students’ knowledge about Advanced Life support: a randomized study. PLoS ONE. 2015;10(5):e0125685.
Curran V, Fleet L, White S, Bessell C, Deshpandey A, Drover A, Hayward M, Valcour J. A randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes. Adv Health Sci Educ Theory Pract. 2015;20(1):205–18.
Donoghue AJ, Durbin DR, Nadel FM, Stryjewski GR, Kost SI, Nadkarni VM. Effect of high-fidelity simulation on Pediatric Advanced Life Support training in pediatric house staff: a randomized trial. Pediatr Emerg Care. 2009;25(3):139–44.
Finan E, Bismilla Z, Whyte HE, Leblanc V, McNamara PJ. High-fidelity simulator technology may not be superior to traditional low-fidelity equipment for neonatal resuscitation training. J Perinatol. 2012;32(4):287–92.
Hoadley TA. Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation. Nurs Educ Perspect. 2009;30(2):91–5.
King JM, Reising DL. Teaching advanced cardiac life support protocols: the effectiveness of static versus high-fidelity simulation. Nurse Educ. 2011;36(2):62–5.
Lo BM, Devine AS, Evans DP, Byars DV, Lamm OY, Lee RJ, Lowe SM, Walker LL. Comparison of traditional versus high-fidelity simulation in the retention of ACLS knowledge. Resuscitation. 2011;82(11):1440–3.
Massoth C, Röder H, Ohlenburg H, Hessler M, Zarbock A, Pöpping DM, Wenk M. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ. 2019; 19(29).
McCoy CE, Rahman A, Rendon JC, Anderson CL, Langdorf MI, Lotfipour S, Chakravarthy B. Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality cardiopulmonary resuscitation. West J Emerg Med. 2019;20(1):15–22.
Nimbalkar A, Patel D, Kungwani A, Phatak A, Vasa R, Nimbalkar S. Randomized control trial of high fidelity vs low fidelity simulation for training undergraduate students in neonatal resuscitation. BMC Res Notes. 2015;8:636.
Owen H, Mugford B, Follows V, Plummer JL. Comparison of three simulation-based training methods for management of medical emergencies. Resuscitation. 2006;71(2):204–11.
Rubio-Gurung SPG, Touzet S, Gauthier-Moulinier H, Jordan I, Beissel A, Labaune JM, Blanc S, Amamra N, Balandras C, Rudigoz RC, et al. In situ simulation training for neonatal resuscitation: an RCT. Pediatrics. 2014;134(3):e790–797.
Rubio-Gurung S, Putet G, Touzet S, Gauthier-Moulinier H, Jordan I, Beissel A, Labaune JM, Blanc S, Amamra N, Balandras C, et al. A randomized trial comparing didactics, demonstration, and simulation for teaching teamwork to medical residents. Ann Am Thorac Soc. 2015;12(4):512–9.
Settles J, Jeffries PR, Smith TM, Meyers JS. Advanced cardiac life support instruction: do we know tomorrow what we know today? J Contin Educ Nurs. 2011;42(6):271–9.
Thomas EJ, Williams AL, Reichman EF, Lasky RE, Crandell S, Taggart WR. Team training in the neonatal resuscitation program for interns: teamwork and quality of resuscitations. Pediatrics. 2010;125(3):539–46.
Wang JH, Zhang XH, Fan J. An application study of simulating teaching method on neonatal resuscitation training for medical students. China Contin Med Educ. 2017;9(24):15–7.
Mundell WC, Kennedy CC, Szostek JH, Cook DA. Simulation technology for resuscitation training: a systematic review and meta-analysis. Resuscitation. 2013;84(9):1174–83.
Ilgen JS, Sherbino J, Cook DA. Technology-enhanced simulation in emergency medicine: a systematic review and meta-analysis. Acad Emerg Med. 2013;20(2):117–27.
Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, et al. Resuscitation Education Science: Educational Strategies to improve outcomes from Cardiac arrest: a Scientific Statement from the American Heart Association. Circulation. 2018;138(6):e82–e122.
Anderson R, Sebaldt A, Lin Y, Cheng A. Optimal training frequency for acquisition and retention of high-quality CPR skills: a randomized trial. Resuscitation. 2019;135:153–61.
Lin Y, Cheng A, Grant VJ, Currie GR, Hecker KG. Improving CPR quality with distributed practice and real-time feedback in pediatric healthcare providers - a randomized controlled trial. Resuscitation. 2018;130:6–12.
Brogaard L, Hvidman L, Esberg G, Finer N, Hjorth-Hansen KR, Manser T, Kierkegaard O, Uldbjerg N, Henriksen TB. Teamwork and adherence to Guideline on Newborn Resuscitation-Video review of neonatal interdisciplinary teams. Front Pediatr. 2022;10:828297.
Hunziker S, Johansson AC, Tschan F, Semmer NK, Rock L, Howell MD, Marsch S. Teamwork and leadership in cardiopulmonary resuscitation. J Am Coll Cardiol. 2011;57(24):2381–8.
Edelson DP, Litzinger B, Arora V, Walsh D, Kim S, Lauderdale DS, Vanden Hoek TL, Becker LB, Abella BS. Improving in-hospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med. 2008;168(10):1063–9.
Wolfe H, Zebuhr C, Topjian AA, Nishisaki A, Niles DE, Meaney PA, Boyle L, Giordano RT, Davis D, Priestley M, et al. Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes. Crit Care Med. 2014;42(7):1688–95.
Sawyer T, Sierocka-Castaneda A, Chan D, Berg B, Lustik M, Thompson M. Deliberate practice using simulation improves neonatal resuscitation performance. Simul Healthc. 2011;6(6):327–36.
Scott DJ, Goova MT, Tesfay ST. A cost-effective proficiency-based knot-tying and suturing curriculum for residency programs. J Surg Res. 2007;141(1):7–15.
Isaranuwatchai W, Brydges R, Carnahan H, Backstein D, Dubrowski A. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training. Adv Health Sci Educ Theory Pract. 2014;19(2):219–32.