Cited by 384Simulation-Based Education in HealthcareSurgical Simulation and TrainingInnovations in Medical Education

Patient Outcomes in Simulation-Based Medical Education: A Systematic Review

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Zendejas, Benjamin, Brydges, Ryan, Wang, Amy T., Cook, David A.·2013·Journal of General Internal Medicine

Abstract

Objectives Evaluating the patient impact of health professions education is a societal priority with many challenges. Researchers would benefit from a summary of topics studied and potential methodological problems. We sought to summarize key information on patient outcomes identified in a comprehensive systematic review of simulation-based instruction.Data sources Systematic search of MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, key journals, and bibliographies of previous reviews through May 2011.Study eligibility Original research in any language measuring the direct effects on patients of simulation-based instruction for health professionals, in comparison with no intervention or other instruction.Appraisal and synthesis Two reviewers independently abstracted information on learners, topics, study quality including unit of analysis, and validity evidence. We pooled outcomes using random effects.Results From 10,903 articles screened, we identified 50 studies reporting patient outcomes for at least 3,221 trainees and 16,742 patients. Clinical topics included airway management (14 studies), gastrointestinal endoscopy (12), and central venous catheter insertion (8). There were 31 studies involving postgraduate physicians and seven studies each involving practicing physicians, nurses, and emergency medicine technicians. Fourteen studies (28 %) used an appropriate unit of analysis. Measurement validity was supported in seven studies reporting content evidence, three reporting internal structure, and three reporting relations with other variables. The pooled Hedges' g effect size for 33 comparisons with no intervention was 0.47 (95 % confidence interval [CI], 0.31-0.63); and for nine comparisons with non-simulation instruction, it was 0.36 (95 % CI, -0.06 to 0.78).Limitations Focused field in education; high inconsistency (I(2) > 50 % in most analyses).Conclusions Simulation-based education was associated with small-moderate patient benefits in comparison with no intervention and non-simulation instruction, although the latter did not reach statistical significance. Unit of analysis errors were common, and validity evidence was infrequently reported.

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  1. [30]30. Kerry SM, Bland JM. Analysis of a trial randomised in clusters (Statistics notes). BMJ. 1998;316:54.
  2. [60]60. Hosking EJ. Does practising intubation on a manikin improve both understanding and clinical performance of the task by medical stu- dents? Anaesthesia Points West. 1998;31:25-8.
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Authors
Zendejas, B., Brydges, R., Wang, A. T., & Cook, D. A.
Affiliations
  • Mayo Clinic (US)
  • University of Toronto (CA)
Venue
Journal of General Internal Medicine
Published
2013-04-18
Volume
28
Issue
8
Pages
1078-1089
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
OpenAlex
W2092716151
Cited by
384
References
99
Citations by year
2026: 36 · 2025: 31 · 2024: 29 · 2023: 28 · 2022: 35 · 2021: 27 · 2020: 39 · 2019: 33 · 2018: 26 · 2017: 22 · 2016: 31 · 2015: 25 · 2014: 15 · 2013: 6 · 2012: 1
FWCI
2.83
Type
journal article
Language
en
Open access
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
  • Health Sciences › Medicine › Surgery › Surgical Simulation and Training
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords
simulation-based medical education, patient outcomes, health professions education, unit of analysis, measurement validity, airway management, gastrointestinal endoscopy, central venous catheterization, nurses, effect size
MeSH terms
Clinical Competence, Computer Simulation, Education, Medical, Patient Care, Humans, Randomized Controlled Trials as Topic, Treatment Outcome

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