The Importance of Simulation in Medical Education and Improving the Emergency Team Performance on Cardiopulmonary Resuscitation by Using Simulation-Based Education
Abstract
Objective: This study investigated the importance of simulation in medical education, whether simulation training enhances team performance in cardiopulmonary resuscitation, and what measures are necessary to improve the quality of medical education.
Materials and Methods: The study was conducted by the Department of Emergency Medicine, Faculty of Medicine, Gaziantep University. 120 third-year medical students were divided into 4 groups and given Basic Life Support training. The training methods employed were traditional training, training using a simple mannequin simulation method, training with a high-tech mannequin simulation method, and self-training. Checklists were used for team performance assessment.
Results: There was no significant difference between the distributions of all groups according to gender and age averages (p=0.311, p=0.217, respectively). It was tested that the theoretical knowledge levels of all groups increased after the training (p<0.001, for all). There was no significant difference between the groups in this increase (p=0.067). However, this increase in theoretical knowledge levels was not compatible with the increase in team performance levels. The two groups trained with simulation were found to be significantly more successful than the other groups in team performance and skill competence (p<0.001). There was no significant difference in performance assessments between these two groups trained with simulation (p=1.000). There was no significant difference in team performance between the group trained with the traditional method and the self-trained group (p=1.000), but the self-trained group was more successful in skill assessment (p=0.018). According to the applied survey results, the students' self-confidence generally increased (p<0.001). The checklists used for performance assessments showed excellent correlation among themselves (p<0.001).
Conclusion: Simulation training technique increases team performance, skill level and students' self-confidence in managing complex events such as resuscitation. Therefore, it should be integrated into medical education.
Keywords
Simulation, resuscitation, team performance., medical education
Ethical Statement
Ethics committee approval was obtained for this study from the Gaziantep University Faculty of Medicine Medical Ethics Committee (Ethics committee decision no: 19.06.2012/277 Date: 19.06.2012). The Declaration of Helsinki was complied with.
Thanks
We thank to Prof. Dr. Yeşim Şenol and ATUDER.
References
- Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13 Suppl 1(Suppl 1):i2-10.
- McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010;44(1):50-63.
- López-Messa JB, Martín-Hernández H, Pérez-Vela JL, Molina-Latorre R, Herrero-Ansola P. Novedades en métodos formativos en resucitación [Novelities in resuscitation training methods]. Med Intensiva. 2011;35(7):433-441.
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):640-656.
- Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, et al. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation. 2010;81(4):446-452.
- Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580-588.
- King HB, Battles J, Baker DP, Alonso A, Salas E, Webster J, et al. TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug.
- Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al. Part 5: Adult Basic Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):685-705.
- McEvoy MD, Smalley JC, Nietert PJ, Field LC, Furse CM, Blenko JW, et al. Validation of a detailed scoring checklist for use during advanced cardiac life support certification. Simul Healthc. 2012;7(4):222-235.
- Rodgers DL, Bhanji F, McKee BR. Written evaluation is not a predictor for skills performance in an Advanced Cardiovascular Life Support course. Resuscitation. 2010;81(4):453-456.