Computer-Based Simulation Training to Improve Learning Outcomes in Mannequin-Based Simulation Exercises

By Curtin, Lindsay B.; Finn, Laura A. et al. | American Journal of Pharmaceutical Education, August 2011 | Go to article overview

Computer-Based Simulation Training to Improve Learning Outcomes in Mannequin-Based Simulation Exercises


Curtin, Lindsay B., Finn, Laura A., Czosnowski, Quinn A., Whitman, Craig B., Cawley, Michael J., American Journal of Pharmaceutical Education


INTRODUCTION

Simulation is used to train many professionals including pilots, military personnel, business managers, and health care professionals, and is an effective active-learning technique that encourages the application of knowledge and skills in real-world scenarios. (1-4) Simulation in medical education (eg, role-playing, standardized patients or patient actors, computer programs, and virtual reality) allows mastery of skill sets in a controlled environment and may result in improved patient outcomes in medical emergencies when caregivers are trained with simulation. (4-6) Simulation of clinical cases requires participants to have baseline clinical knowledge, demonstrate clinical skills, and have the ability to apply treatment algorithms, analyze patient response, and evaluate outcomes to be successful. Simulation has been shown to be superior to problem-based learning as a teaching method. (7)

The Philadelphia College of Pharmacy has used various simulation techniques for over 10 years, including MegaCode Kelly (Laerdal Medical AS, Stavanger, Norway), a high-fidelity mannequin, and more recently, the MicroSim Inhospital self-directed simulation learning system (Laerdal Medical AS, Stavanger) to practice the provision of critical care. The value of such simulation in pharmacy education is recognized and encouraged by the Accreditation Council for Pharmaceutical Education and has shown improvement in skills and improved retention of knowledge in doctor of pharmacy (PharmD) programs. (8-15) Additionally, simulation is consistent with the college's curricular assessment plan that focuses on independent critical thinking, optimization of pharmaceutical care, and integration of multidisciplinary care teams.

Despite the ongoing use of simulation in education and training, little data exist on the use of multimodal simulation, including optimal preparation for simulation and proper sequencing of simulation activities. A variety of outcomes from simulation have been investigated in pharmacy education, but there are no recommendations for integrating multiple modes of simulation. (10,11,13,15-18) In what we believe is a unique approach to simulation training, this study used computer-based simulation in addition to traditional teaching methods to prepare students for participation in mannequin-based simulation. The purpose of this study was to assess the impact of completing computer-based simulation sessions on student achievement of learning outcomes during mannequin-based simulation.

DESIGN

This study was developed after the acquisition of the computer-based simulation program and responded to the need to discover the best way to integrate 2 methods of simulation to achieve learning outcomes. This was a single-center, randomized, parallel-group, observational study of advanced cardiac life support (ACLS) outcomes in mannequin-based simulation. The study was conducted in a required multisection, multi-instructor pharmacotherapeutics practice laboratory course at a large, private pharmacy school. All students had completed prerequisite therapeutics courses that included pharmacotherapeutics of arrhythmias.

The Center for Advanced Pharmacy Studies (CAPS) laboratory is a collaborative learning environment set up in 4-student working stations or "pods" equipped with 4 computers each. The MicroSim Inhospital simulationprogram is available to 26 working stations in the classroom portion of the CAPS laboratory, and the MegaCodeKelly high-fidelity human patient simulator is located in an adjacent simulated hospital room. Study participants were third-year PharmD students enrolled in the pharmacotherapeutics laboratory course.

Participants were organized randomly into teams of 5 or 6 to simulate a hospital rapid response team, which in acute care is a multidisciplinary team that responds to cardiac arrest alerts. Rapid response teams were assigned randomly to the group completing the mannequin-based simulation first or to the group completing the computer-based simulation first. …

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