The use of Technology Simulations, such as computer-based virtual reality models, high-fidelity and static mannequins, plastic models, live animals, inert animal products, and human cadavers is shown to assist health care professionals in improving their knowledge and skill, as well as increasing the patients’ results.

An article published in the Sept. 7th issue of JAMA (Journal of the American Medical Association), which carries a theme on medical education, analyses previous studies, carrying out a through review and meta-analysis with the goal of identifying and quantitatively summarizing previous studies of technology-enhanced simulation involving health professions learners.

David A. Cook, M.D., M.H.P.E., of the Mayo Clinic College of Medicine, Rochester, Minn., and colleagues conducted the review.

The researchers examined existing medical publications for original research that evaluated simulation type training and compared outcomes with practitioners that had no simulation. They covered practicing and student physicians, nurses, dentists, and other health care professionals. There were 609 eligible studies identified, enrolling 35,226 trainees. Of these, 137 were randomized studies, 67 were nonrandomized studies with 2 or more groups, and 405 used a single-group pretest-posttest design.

The background information provided in their article, defines simulation technology as materials and devices created or adapted to solve practical problems.

The researchers found that technology-enhanced simulations were with only rare exceptions, associated with better learning outcomes. Pooling the data showed that practitioners knowledge, skill, behavior and presumably confidence increased to a large degree, whilst patient outcomes increased less, but still showed a moderate improvement over practitioners with no simulation training.

As would be expected, the results of individual studies varied substantially, however, exploring the design of the different simulations that were used for training, largely failed to explain this variation.

The researchers noted that technology-enhanced simulation has widespread appeal, as it does in many industries, and many teachers and practitioners are in agreement as to its educational value. However, such beliefs tend to be just that, because they currently lack empirical support.

They wrote:

“Despite the large volume of research on simulation, its effectiveness remains uncertain in part because of the difficulty in interpreting research results one study at a time.”

The Authors conclude that the most important area in regards to simulation training is answering when and how simulation training should be used, and how if can be most effective, and most cost effective.

They state:

“Unfortunately, the evidence synthesized herein largely fails to inform the design of future simulation activities. Subgroup analyses weakly suggested a benefit to extending training beyond 1 day and using a mastery model but otherwise did not identify consistent associations involving instructional designs. However, between-study (rather than within-study) comparisons are an inefficient research method.

Thus, theory-based comparisons between different technology-enhanced simulation designs (simulation vs. simulation studies) that minimize bias, achieve appropriate power, and avoid confounding, as well as rigorous qualitative studies, are necessary to clarify how and when to effectively use technology-enhanced simulations for training health care professionals.”

Written by Rupert Shepherd B.Sc