Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills*

Steadman, Randolph H.; Coates, Wendy C.; Huang, Yue Ming; Matevosian, Rima; Larmon, Baxter R.; McCullough, Lynne; Ariel, Danit

doi:10.1097/01.ccm.0000190619.42013.94

Cited by 565Simulation-Based Education in HealthcareInnovations in Medical EducationSurgical Simulation and Training

Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills*

Steadman, Randolph H., Coates, Wendy C., Huang, Yue Ming, Matevosian, Rima, Larmon, Baxter R., McCullough, Lynne, Ariel, Danit·2006·Critical Care Medicine

DOI 10.1097/01.ccm.0000190619.42013.94

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Abstract

OBJECTIVE: To determine whether full-scale simulation (SIM) is superior to interactive problem-based learning (PBL) for teaching medical students acute care assessment and management skills. DESIGN: Randomized controlled trial. SETTING: Simulation center at a U.S. medical school. SUBJECTS: Thirty-one fourth-year medical students in a week-long acute care course. INTERVENTIONS: After institutional review board approval and informed consent, eligible students were randomized to either the SIM or PBL group. On day 1, all subjects underwent a simulator-based initial assessment designed to evaluate their critical care skills. Two blinded investigators assessed each student using a standardized checklist. Subsequently, the PBL group learned about dyspnea in a standard PBL format. The SIM group learned about dyspnea using the simulator. To equalize simulator education time, the PBL group learned about acute abdominal pain on the simulator, whereas the SIM group used the PBL format. On day 5, each student was tested on a unique dyspnea scenario. MEASUREMENTS AND MAIN RESULTS: Mean initial assessment and final assessment checklist scores and their change for the SIM and PBL groups were compared using the Student's t-test. A p < .05 was considered significant. The SIM and PBL groups had similar mean (PBL 0.44, SIM 0.47, p = .64) initial assessment scores (earned score divided by maximum score) and were deemed equivalent. The SIM group performed better than the PBL group on the final assessment (mean, PBL 0.53, SIM 0.72, p < .0001). When each student's change in score (percent correct on final assessment minus percent correct on the initial assessment) was compared, SIM group students performed better (mean improvement, SIM 25 percentage points vs. PBL 8 percentage points, p < .04) CONCLUSIONS: For fourth-year medical students, simulation-based learning was superior to problem-based learning for the acquisition of critical assessment and management skills.

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Of the three studies reporting PBL less effective, two were randomized (one favoring simulation-based learning and another favoring lectures).
“two of them were randomized (in one case favoring simulation-based learning [80] and another favoring lectures [81])”
From Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review (2022) · cites this paper as [80]
Only three studies reported that PBL was less effective.
“Only three studies reported that PBL was less effective [79–81]”
From Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review (2022) · cites this paper as [80]
Two studies show neutral or superior results to simulation for the acquisition of specific clinical skills.
“There are two studies that show neutral [71] or superior [80] results to simulation for the acquisition of specific clinical skills.”
From Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review (2022) · cites this paper as [80]

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Authors: Steadman, R. H., Coates, W. C., Huang, Y. M., Matevosian, R., Larmon, B. R., McCullough, L., & Ariel, D.
Affiliations: University of California, Los Angeles (US)
ORCID: Coates, Wendy C.
Huang, Yue Ming
Ariel, Danit
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2006-01
Volume: 34
Issue: 1
Pages: 151-157
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/01.ccm.0000190619.42013.94
OpenAlex: W2081482807
Cited by: 565
References: 47
Citations by year: 2026: 6 · 2025: 13 · 2024: 24 · 2023: 52 · 2022: 15 · 2021: 25 · 2020: 27 · 2019: 36 · 2018: 24 · 2017: 23 · 2016: 34 · 2015: 33 · 2014: 25 · 2013: 40 · 2012: 29
FWCI: 11.59
Type: journal article
Language: en
Open access: closed
Locations: Critical Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Health Sciences › Medicine › Surgery › Surgical Simulation and Training
Keywords: simulation-based training, problem-based learning, medical education, dyspnea, acute abdominal pain, medical students, skill acquisition
MeSH terms: Adult, Clinical Competence, Critical Care, Curriculum, Education, Medical, Undergraduate, Educational Measurement, Female, Humans, Male, Sensitivity and Specificity, Students, Medical, Patient Simulation, Critical Illness, Problem-Based Learning

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Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills*

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