Comparison of the Efficacy of High-Fidelity Patient Simulation Versus Traditional Lecturebased Didactics in Emergency Medicine Toxicology Education

摘要

Background: High fidelity patient simulation (SIM) hasbeen gaining widespread use in medical education. Evidenceregarding advantages in both knowledge retention and learnersatisfaction is growing. There is scant data pertaining toinstruction in toxicology, where SIM is particularly appealing.Objectives: We compared two models of toxicologyeducation - one involving simulated toxicology cases, and the other using a more traditional, lecture-based approach, withan effort to determine the efficacy of patient simulation inEmergency Medicine Toxicology education.Methods: DESIGN - Prospective, randomized studycomparing performance on pre- and post-test within a specificeducation modality. A satisfaction survey was used to assessthe participants’ subjective experience with the SIM cases.SETTING -The study was conducted at a large academicinstitution with a Toxicology consult service. PARTICIPANTS- Residents and medical students rotating through thetoxicology department at a single academic institution, overone academic year.INTERVENTIONS/OBSERVATIONS - Three toxicologycases were presented during a month-long rotation using eitherthe SIM- or lecture-based format. For each case, participantswere randomized to one of two learner groups, varying by theteaching modality applied. Knowledge gained was quantifiedby comparing their performance on pre- and post-test writtenassessments. Improvements in scores of the SIM group werecompared to those of the lecture group. A survey assessing theparticipants’ subjective experience in the SIM cases was sent.Results: A total of 22 rotators participated in the learningmodules, of which 14b completed the pre-and post-tests fordata collection. There was no statistical difference in pre-testscores (mean 2.62 points, p=0.43, 95% CI of -9.35 to 4.11)amongst the 2 groups. There was significant improvementin scores after both learning modalities (SIM: mean 17.21,p=0.0016, 95% CI of 7.3-27.08; Lecture: mean 9.72,p=0.0016, 95%CI of 3.9-15.5). The SIM group experienceda higher jump in their scores, compared to the lecture group(mean 10.08, p=0.0057, 95% CI 3.27-16.9). Five participantsresponded to the satisfaction survey and all felt thatparticipation in SIM improved their confidence, engagement,and clinical knowledge.Conclusions: While both the SIM- and lecture-basedformat improved toxicology knowledge, the SIM modalitywas more effective. This pilot study suggests that SIM can bea useful educational tool in toxicology education.