The case for simulation

I’ve thought a bit about how the crewman and pilots learn and review ideas; rarely, do they have a lecture. Instead they spend much of their time learning via simulation. I recognize the differences between medicine and aviation (and the need for lectures) but I think it’s really powerful how they learn with their educational framework.

Helicopter parked inside at the base. Site of all my winch training…no lectures here!

Below is a the abstract from a recent article from the simulation literature that suggests the superiority of simulation as a learning/teaching method. There are obvious limitations with the research but it’s well addressed by the authors and I think the conclusions are definitely interesting! What’s even more interesting is that it’s compared to case-based discussion which has emerged as well accepted teaching method felt to be superior to traditional lectures.

The simulation centre at Li Ka Shing (St Michael’s Hospital, Toronto). Where we train as residents.

High-fidelity simulation is superior to case-based discussion in teaching the management of shock (KE Littlewood et al. Med Teach 2012 Nov 5. [Epub ahead of print])

Background: Case-based discussion (CBD) is an established method for active learning in medical education. High-fidelity simulation has emerged as an important new educational technology. There is limited data from direct comparisons of these modalities. slkdjf

Aims: The primary purpose of this study was to compare the effectiveness of high-fidelity medical simulation with CBD in an undergraduate medical curriculum for shock.

Methods: The subjects were 85 third-year medical students in their required surgery rotation. Scheduling circumstances created two equal groups. One group managed a case of septic shock in simulation and discussed a case of cardiogenic shock, the other group discussed septic shock and experienced cardiogenic shock through simulation. Student comprehension of the assessment and management of shock was then evaluated by oral examination (OE).

Results: Examination scores were superior in all comparisons for the type of shock experienced through simulation. This was true regardless of the shock type. Scores associated with patient evaluation and invasive monitoring, however, showed no difference between groups or in crossover comparison.

Conclusions: In this study, students demonstrated better understanding of shock following simulation than after CBD. The secondary finding was the effectiveness of an OE with just-in-time deployment in curriculum assessment.


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