Patient Outcomes in Simulation-Based Medical Education: A Systematic Review
Open accessAbstract
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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The current level of evidence for simulation-based education's downstream benefits is still low due to a lack of high-quality studies with patient-centered outcomes.
“While simulation-based education may bring downstream benefits of reducing medical errors and improving patient care, the current level of evidence is still low due to a lack of high-quality studies with patient-centered outcomes [8-12].”
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Jiang, N., Zhang, Y., Liang, S., Lyu, X., Chen, S., Huang, X., & Pan, H. (2024) · Journal of Medical Internet Research · doi:10.2196/56195 · Cited by 28 · see citing works
“While simulation-based education may bring downstream benefits of reducing medical errors and improving patient care, the current level of evidence is still low due to a lack of high-quality studies with patient-centered outcomes [8-12].”
- 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
- PMC
- PMC3710391
- OpenAlex
- W2092716151
- Semantic Scholar
- 5f7024bded11212f711da345e930719c6fcf880f
- 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
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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