Comparison of three simulation-based training methods for management of medical emergencies

SummaryTrainee medical officers (TMOs) participated in a study comparing three methods of simulation-based training to treat medical emergencies occurring in a hospital setting. The methods were:Group 1:Computer screen-based training (CSBT), scripted presentations on medical emergencies and practice on simple part-task trainers.Group 2:As above but with some practice on whole-body patient simulators.Group 3:As above plus some practice using patient simulators in ‘full-mission’ simulation.All groups had the same total teaching time. Participants (n = 61) had an initial (pre-training) assessment by written tests, self assessment and simulations of medical emergencies (‘VT’ and ‘HYPOglycaemia’). Participants were tested again post-training using similar simulations to the initial scenario and a new scenario (‘ANAphylaxis’). Trained ‘experts’, blinded to the teaching group of participants, watched video-CDs of the simulations to assess participants’ performance.All groups demonstrated increased knowledge and confidence (pre-training scores compared to post-training) but no differences could be detected between the three groups. In simulated emergencies, post-training scores were also improved. There was no difference between groups in the ‘HYPO’ scenario but in the ‘VT’ scenario there was moderate evidence that Group 3 was superior. In the ‘ANA’ scenario, Group 3 had far better test scores, especially in behavioural items.There did not appear to be any significant advantage of using whole body manikins over CSBT and simple part-task trainers. Full-mission simulation training helped develop the ability to recognise when skills learnt to manage one type of medical emergency can be useful in managing another emergency not previously encountered.