Mannequin-Based Immersive Simulation Improves Resident Understanding of a Clinical Decision Rule

摘要

Objective. Simulation-based medical education may aid to standardize clinicalrnperformance measures, though there is little evidence for using an immersive,rnmannequin-based simulation for knowledge acquisition. We predictedrnthat residents who had participated in an immersive simulation exercisernillustrating the use of a clinical decision rule plus routine instructional methodsrn(experimental group) would understand and implement this tool better thanrninterns who participated in an immersive simulation focused on traumaticrnbrain injury with intracranial hypertension plus routine instructional methodsrn(control group 1). We further predicted that interns in the experimental grouprnwould understand and implement this tool as well as senior residents withrnmore clinical experience (control group 2).rnMethods. This was a single center, prospective, simulation-based, randomizedrncontrolled trial. Pediatric interns were randomly assigned to clinicallyrnintegrated teaching, plus a single, immersive simulation and structuredrndebrief aimed at teaching this tool in minor head trauma (intervention), orrnclinically integrated teaching plus a related simulation on intracranial hypertension. Senior residents were used as an historical control arm and didrnnot participate in a simulated encounter.rnResults. 20 interns (ten per group) participated in the study. Senior residentsrn(n=40) served as historical comparisons. Interns in the intervention grouprnscored similar to senior residents on a structured clinical observationrnscore (median 64% vs. 57%), and better than interns in the placebo grouprn(median 64% vs. 43%).rnConclusions. In this study, a single immersive simulation improved residentrnlearning and application of a clinical prediction rule when compared to standardrnresident education.