Systematic Review and Meta-Analysis of Computer Based Simulation Training for Non-Technical Skills Training and Knowledge in Postgraduate Medical Education
AbstractIntroduction: The increase in simulation training across the range of medical education offers a potential route to train non-technical skills and knowledge. More recently, there has been a move towards the use of computer based, including virtual reality, simulation. However, studies evaluating the efficacy of computer based simulation training have used inconsistent methodology, limiting the capacity to construct an overview.
The goal of this study is to systematically review the existing literature and carry out a meta-analysis of the existing randomised controlled trials, evaluating the efficacy of computer based simulation on non-technical skills and knowledge, with sub analysis between doctors in training and those in continuing medical education.
Methods: A scoping search identified the relevant search terms, followed by a comprehensive database search of literature from 2007 until the present on MEDLINE, PubMed, CINHAL, ERIC, BEI, PsychINFO, Proquest Dissertations & Theses and Educational Abstracts databases with hand searching the table of contents of major medical education journals. The inclusion criteria were randomised controlled trials for the meta-analysis and cohort studies for the systematic review, with subjects being postgraduate doctors using a computer based simulation for training and education.
Results: This review found evidence to support the utilisation of computer based simulation for nontechnical skills and knowledge and understanding domains.
Discussion: Using computer based simulation offers an opportunity to enhance non-technical aspects of practicing doctors in a safe and effective manner. More high quality controlled studies are required to enable the demarcation of training boundaries.
Keywords: NON-TECHNICAL SKILLS; SIMULATION-BASED TRAINING; SIMULATION- BASED MEDICAL EDUCATION; TECHNOLOGY ENHANCED LEARNING
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Bmj. 2009;339:b2535. Doi: 10.1136/bmj.b2535
Kurrek MM, Devitt JH. The cost for construction and operation of a simulation centre. Can J Anaesth. 1997;44:1191-5. Doi:10.1007/bf03013344
Kleinert R, Plum P, Heiermann N, Wahba R, Chang DH, Holscher AH, et al. Embedding a Virtual Patient simulator in an interactive surgical lecture. J Surg Educ. 2016;73:433-41. Doi: 10.1016/j.jsurg.2015.11.006
Kleinert R, Heiermann N, Wahba R, Chang DH, Holscher AH, Stippel DL. Design, realization, and first validation of an immersive web-based virtual patient simulator for training clinical decisions in surgery. J Surg Educ. 2015;72:1131-8. Doi: 10.1016/j.jsurg.2015.05.009
McManus IC, Richards P, Winder BC. Clinical experience of UK medical students. Lancet. 1998;351:802-3. Doi:10.1016/s0140-6736(05)78929-7
Santen SA, Hemphill RR, McDonald MF, Jo CO. Patients’ willingness to allow residents to learn to practice medical procedures. Acad Med. 2004;79:144-7. Doi: 10.1097/00001888-200402000-00010
Graber MA, Pierre J, Charlton M. Patient opinions and attitudes toward medical student procedures in the emergency department. Acad Emerg Med. 2003;10:1329-33. Doi: 10.1111/j.1553-2712.2003.tb00006.x
Graber MA, Wyatt C, Kasparek L, Xu Y. Does simulator training for medical students change patient opinions and attitudes toward medical student procedures in the emergency department?
Acad Emerg Med. 2005;12:635-9. Doi:10.1197/j.aem.2005.01.009
Joseph N, Nelliyanil M, Jindal S, Utkarsha, Abraham AE, Alok Y, et al. Perception of simulation-based learning among medical students in South India. Ann Med Health Sci Res. 2015;5:247-52. Doi: 10.4103/2141-9248.160186
Grenvik A, Schaefer J. From Resusci-Anne to Sim-Man: the evolution of simulators in
medicine. Crit Care Med. 2004;32:S56-7. Doi: 10.1097/00003246-200402001-00010
Takashina T, Shimizu M, Katayama H. A new cardiology patient simulator. Cardiology.
;88:408-13. Doi: 10.1159/000177369
Husken N, Schuppe O, Sismanidis E, Beier F. MicroSim - a microsurgical training simulator. Stud Health Technol Inform. 2013;184:205-9.
Stillman PL, Regan MB, Philbin M, Haley HL. Results of a survey on the use of standardized patients to teach and evaluate clinical skills. Acad Med. 1990;65:288-92. Doi: 10.1097/00001888-199005000-00002
Dacre J, Nicol M, Holroyd D, Ingram D. The development of a clinical skills centre. J R Coll Physicians Lond. 1996;30:318-24.
Jarvis P, Holford J, Griffin C. The theory & practice of learning. 2nd ed. London: Kogan Page; 2003.
Schon DA. Educating the reflective practitioner. 1st ed. San Francisco: Jossey-Bass; 1987.
Mezirow J. Transformative dimensions of adult learning. San Francisco: Jossey-Bass; 1991.
Engeström Y, Miettinen R, Punamäki-Gitai R-L. Perspectives on activity theory. Cambridge: Cambridge University Press; 1999.
Small SD, Wuerz RC, Simon R, Shapiro N, Conn A, Setnik G. Demonstration of high-fidelity simulation team training for emergency medicine. Acad Emerg Med. 1999;6:312-23. Doi: 10.1111/j.1553-2712.1999.tb00395.x
Aggarwal R, Undre S, Moorthy K, Vincent C, Darzi A. The simulated operating theatre: comprehensive training for surgical teams. Qual Saf Health Care. 2004;13 Suppl 1:i27-32. Doi: 10.1136/qhc.13.suppl_1.i27
Haig A, Dozier M. BEME Guide no 3: systematic searching for evidence in medical education--Part 1: Sources of information. Med Teach. 2003;25:352-63. Doi: 10.1080/0142159031000136815
Review Manager [Computer Program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014.
Cleland J, Ford R, Hamilton NM, Nabavian S, Walker K. Breaking bad news: an interactive web-based e-learning package. Clin Teach. 2007;4(2):94-9. Doi: 10.1111/j.1743-498x.2007.00157.x
Wilson JI. (dissertation). Evaluating the effectiveness of Virtual Patients to promote clinical reasoning. San Diego: Northcentral University; 2011.
Gorrindo T, Baer L, Sanders KM, Birnbaum RJ, Fromson JA, Sutton-Skinner KM, et al. Web-based simulation in psychiatry residency training: A pilot study. Acad Psychiatry. 2011;35:232-7. Doi:10.1176/appi.ap.35.4.232
Balasundaram I, Aggarwal R, Darzi A. Short-phase training on a virtual reality simulator improves technical performance in tele-robotic surgery. Int J Med Robot. 2008;4:139-45. Doi: 10.1002/rcs.181
Borenstein M. When does it make sense to perform a meta-analysis? In: Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. Hoboken, New Jersey: Wiley; 2009.
Copyright is the term used to describe the rights related to the publication and distribution of research. It governs how authors (as well as their employers or funders), publishers and the wider general public can use, publish and distribute manuscripts or books. Authors who publish their manuscripts or studies in the JME agree to release their manuscripts. Any previous introductory work on the same or similar subject by the same authors must be well referenced in the new submission and permission must be acquired from the original publisher.
* Copyright is a set of exclusive rights that belongs to a publication and distribution of research. It also guides authors, publishers and general users how to use, publish and distribute manuscripts.