Simulation-based training in critical resuscitation procedures improves residents' competence

Trevor S Langhan, Ian J Rigby, Ian W Walker, Daniel Howes, Tyrone Donnon, Jason A Lord
CJEM 2009, 11 (6): 535-9

OBJECTIVE: Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures.

METHODS: We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station.

RESULTS: We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods ( p < 0.001). The participants' year of postgraduate training influenced their self assessment of knowledge ( F = 4.91, p< 0.01) and clinical 2,25 skills ( F = 10.89, p< 0.001). At the 3-month follow-up, junior 2,25 level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course.

CONCLUSION: Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.

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