Applying theory to practice in undergraduate education using high fidelity simulation

Figures & data

Figure 1. Residency program selection.

Figure 2. Student evaluation of simulator experience.

Table 1.  Means (%) and standard deviation of pre- and post-test scores

	Pre-test% Mean and SD	Post-test% Mean and SD
Pharmacology Test	48.52 ± 15.71	56.21 ± 16.88
Scenario 1 Team Scores	64.88 ± 14.52	75.86 ± 14.28
Scenario 2 Team Scores	48.91 ± 12.38	61.82 ± 15.73
Scenario 3 Team Scores	36.18 ± 26.14	71.14 ± 9.88
Scenario 4 Team Scores	57.62 ± 10.83	63.74 ± 10.12
All scenarios Team Scores	51.84 ± 20.02	68.18 ± 13.83

Table 2.  Comparison of simulator team performance scores and global ratings (repeated measures anova)

Scenario #	Checklist pre-/post-test	p-value	Global pre-/post-test	p-value
1	F1,26 = 18.38	p < 0.0001	F1,26 = 22.75	p < 0.0001
2	F1,26 = 25.99	p < 0.0001	F1,26 = 20.08	p < 0.0001
3	F1,26 = 51.32	p < 0.0001	F1,26 = 34.67	p < 0.0001
4	F1,25 = 7.54	p = 0.011	F1,25 = 8.20	p = 0.008

Table 3.  Correlation between checklist and global rating scores

Scenario	Pre-test: Υ	p-value	Post-test: Υ	p-value
1	0.470*	0.013	0.554**	0.003
2	0.257	0.195	0.372	0.056
3	0.497**	0.008	0.398*	0.040
4	0.430*	0.028	0.569**	0.002
ALL	0.449**	0.000	0.477**	0.000

^**Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed).

Table

•High-fidelity simulation can be used to allow students to apply theoretical knowledge to practice in a safe and realistic environment

•Individual student performance scores on a written test and team performance scores during a simulated scenario improved after videotape reflection of performance and review of advanced cardiac life support protocols

•Further work examining team interactions and dynamics of novice learners using high-fidelity simulation is warranted

Appendix 2. Sample team performance scenario checklist

Item
Initiate appropriate management
Increase IV
Increase oxygen/100% oxygen
Management of Pulseless ventricular tachycardia
Review airway and breathing
Begin CPR
Call for crash cart
Defibrillate 200 J
Defibrillate 300 J
Defibrillate 360 J
Epinephrine 1 mg IV push
Epinephrine dose other than above, specify dose
Vasopressin 40 U IV, single dose
Vasopressin dose not known
Repeat defibrillation sequence
State amiodorone as possible IV agent
State lidocaine as possible IV agent
State magnesium (if known to be hypomagnesemic)
State procainamide as possible IV agent
Repeat defibrillation sequence