Effects of simulation-based education on improving leadership skills in medical and nursing students: a systematic review

Year 2023, Volume: 40 Issue: 4, 783 - 791, 03.01.2024

Salman Riaz Misbah Tabassum

Abstract

A systematic review was conducted to explore the effectiveness of simulation-based education to improve leadership skills in medical and nursing students. CINAHL and MEDLINE were searched from the first records until 12 November 2019. Free text terms and subject headings related to leadership skills, simulation and undergraduate medical education were searched in abstract and title. All types of original articles were included for intervention as simulation-based education, and outcomes as improvement in confidence, managing the patients, self-efficacy and leadership skills. Seventeen articles were shortlisted after initial screening and six with aims to improve leadership skills were selected for analysis after inspecting the full text. Heterogeneity was found in interventions and data collection methods. Sessions were held in healthcare settings and prior learning was used in only two studies. The lack of comparison or control group in studies limited the review to a narrative synthesis of evidence rather than a stronger quantitative meta-analysis. It was evident even after the limited number of studies that simulation-based leadership training could improve the confidence of students to start their practice with the required skills.

Keywords

high-fidelity simulation training, leadership, simulation, simulation training, medical students, systematic review

References

• 1. Flin RH, O’Connor P, Crichton, M. Safety at the sharp end: A guide to non-technical skills. CRC Press Inc; 2017.
• 2. Fernandez CSP, Noble CC, Jensen ET, Chapin J. (2016) Improving Leadership Skills in Physicians: A 6‐Month Retrospective Study. J Lead Stud. 2016; 9: 6-19.
• 3. Cummings GG, MacGregor T, Davey M, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud. 2010; 47(3): 363–385.
• 4. Freshman B, Rubino L. Emotional intelligence: A core competency for health care administrators. The Health Care Manager. 2002; 20(4): 1.
• 5. Gifford BD, Zammuto RF, Goodman EA. The relationship between hospital unit culture and nurses’ quality of work life. J Healthc Manag. 2002; 47(1): 13–25.
• 6. Loop F. Leadership and medicine. Gulf Breeze, FL: Fire Starter; 2009.
• 7. Pfifferling J. Physicians’ “disruptive” behavior: Consequences for medical quality and safety. Am J Med Qual. 2008; 23(3): 165–167.
• 8. Porath CL, Pearson CM. The cost of bad behavior. Organ Dyn. 2010; 39(1): 64–71.
• 9. Schwartz RW, Pogge C. Physician leadership: Essential skills in a changing environment. Am J Surg. 2000; 180(3): 187–192.
• 10. Wagner PJ, Moseley GC, Grant MM, et al. Physicians’ emotional intelligence and patient satisfaction. Fam Med. 2005; 34(10): 750–754.
• 11. Hill LG, Betz DL. Revisiting the retrospective pretest. Am J Eval. 2005; 26(4): 501–517.
• 12. Levinson W, D’Aunno T, Gorawara-Bhat R, et al. Patient-physician communication as organizational innovation in the managed care setting. Am J of Manag Care. 2002; 8(7): 622–630.
• 13. Awad SS, Hayley B, Fagan SP, et al. The impact of a novel resident leadership training curriculum. Am J Surg. 2004; 188(5): 481–484.
• 14. Nurmeksela A, Mikkonen S, Kinnunen J. Kvist, T. Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. BMC Health Serv Res. 2021; 21: 296.
• 15. Vattanavanit V, Kawla-ied J, Bhurayanontachai, R. High-fidelity medical simulation training improves medical students’ knowledge and confidence levels in septic shock resuscitation. Open Access Emerg Med. 2017; 9: 1-7.
• 16. Littlewood KE, Shilling AM, Stemland CJ, Wright EB, Kirk MA. High-fidelity simulation is superior to case-based discussion in teaching the management of shock. Med Teach. 2013; 35(3): e1003–e1010.
• 17. Al-Elq AH. Simulation-based medical teaching and learning. J Family Community Med. 2010; 17(1): 35-40.
• 18. Okuda Y, Bond W, Bonfante G, McLaughlin S, Spillane L, Wang E, Vozenilek J, Gordon J. National growth in simulation training within emergency medicine residency programs, 2003-2008. Acad Emerg Med. 2008; 15: 1113– 1116.
• 19. LeBlanc VR, Bould MD, McNaughton N, et al. Simulation in postgraduate medical education. Members of the FMEC PG consortium; 2011.
• 20. Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005; 27: 10–28.
• 21. McGaghie WC, Issenberg SB, Petrusa ER, et al. A critical review of simulation based medical education research: 2003-2009. Med Educ. 2010; 44: 50–63.
• 22. Blackmore A, Kasfiki EV, Purva M. (2018) Simulation-based education to improve communication skills: a systematic review and identification of current best practice. BMJ Simul Technol Enhanc Learn. 2018; 4: 159-164.
• 23. Barnes T, Yu TW, Webster CS. Preparedness of medical students and junior doctors for their role as clinical leaders: A systematic review. Med Teach. 2019; 30: 1-7.
• 24. Darragh M, Traynor M, Joyce-McCoach M. Effectiveness of interventions for the development of leadership sills among nurses: a systematic review protocol. JBI Database of System Rev Implement Rep. 2016; 14(6): 3-13.
• 25. Moder D, Liberati A, Tetzlaff J. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009; 6(7): e1000097.
• 26. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011], The Cochrane Collaboration. www.handbook.cochrane.org; 2011.
• 27. Centre for Reviews and Dissemination. CRD’s guidance for undertaking reviews in healthcare. University of York: York Publishing Services Ltd; 2009.
• 28. Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon MP, Griffiths F, Nicolau B, O’Cathain A, Rousseau MC, Vedel I. Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (#1148552), Canadian Intellectual Property Office, Industry Canada. http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/129096360/MMAT_v2018_excel_2018-08-02_ENG.xlsx; 2019.
• 29. Martin D, B Furr S, Hayes Lane S, Bramlett M. Integration of leadership competencies in a community health simulation. Br J Nur. 2016; 25(14): 792–794.
• 30. Simones J, Wilcox J, Scott K, Goeden D, Copley D, Doetkott R, Kippley M. (2010) Collaborative simulation project to teach scope of practice. J Nurs Educ, 2010; (49) 4: 190–197.
• 31. Meurling L, Hedman L, Fellander-Tsai, et al. Leaders’ and followers’ individual experiences during the early phase of simulation-based team training: an exploratory study. BMJ Qual Saf. 2013; 22: 459-467.
• 32. Kaplan B, Ura D. Use of multiple patient simulators to enhance priotizing and delegating skills for senior nursing students. J Nurs Educ. 2010; 49(7): 371-377.
• 33. Jakobsen RB, Gran SF, Grimsmo B, et al. Examining participant perceptions of an interprofessional simulation-based trauma training for medical and nursing students. J Interprof Care. 2018;32(1):80-88.
• 34. Nowell LS. Delegate, collaborate, or consult? A capstone simulation for senior nursing students. Nurs Educ Perspect. 2016;37(1):54-55.
• 35. Kalaniti K, Campbell D. (2015) Simulation-based medical education: time for a pedagogical shift. Indian Paediatr. 2015; 52: 41-45.
• 36. Domuracki KJ, Moule CJ, Owen H, Kostandoff G, Plummer, J. L. (2009) Learning on a simulator does transfer to clinical practice. Resuscitation. 2009; 80(3): 346–349.
• 37. Kuduvalli PM, Parker CJ, Leuwer M, Guha A. Retention and transferability of team resource management skills in anaesthetic emergencies: the long-term impact of a high-fidelity simulation-based course. Eur J Anaesthesiol. 2009; 26(1): 17–22. Doi: 10.1097/EJA.0b013e32831bc665.
• 38. Ross SJ, Sen GT, Johnson, P. Why we need to teach leadership skills to medical students: a call to action. BMJ Leader. 2018; 3: 6-10.
• 39. McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, Thomas R, Harvey E, Garratt A, Bond J. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess. 2001; 5(31): 1–256.
• 40. Burke MJ, Day RR. A cumulative study of the effectiveness of managerial training. J Appl Psychol. 1996; 71: 232–45.
• 41. Collins DB, Holton EF. The effectiveness of managerial leadership development programs: a meta-analysis of studies from 1982 to 2001. Hum Resour Dev Q. 2004; 15: 217–48.
• 42. Frich JC, Brewster AL, Cherlin EJ, Bradley, E. H. (2015) Leadership development programs for physicians: a systematic review. J Gen Intern Med. 2015; 30(5): 656–674.
• 43. Riaz S. How simulation-based medical education can be started in low resource settings. J Ayub Med Coll Abbottabad. 2019; 31(4): 636-637.