Simulation-based training in anaesthesiology

A systematic review and meta-analysis

G. R. Lorello, David Allan Cook, R. L. Johnson, R. Brydges

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Simulation has long been integrated in anaesthesiology training, yet a comprehensive review of its effectiveness is presently lacking. Using meta-analysis and critical narrative analysis, we synthesized the evidence for the effectiveness of simulation-based anaesthesiology training. We searched MEDLINE, ERIC, and SCOPUS through May 2011 and included studies using simulation to train health professional learners. Data were abstracted independently and in duplicate. We included 77 studies (6066 participants). Compared with no intervention (52 studies), simulation was associated with moderate to large pooled effect sizes (ESs) for all outcomes (ES range 0.60-1.05) except for patient effects (ES -0.39). Compared with non-simulation instruction (11 studies), simulation was associated with moderate effects for satisfaction and skills (ES 0.39 and 0.42, respectively), large effect for behaviours (1.77), and small effects for time, knowledge, and patient effects (-0.18 to 0.23). In 17 studies comparing alternative simulation interventions, training in non-technical skills (e.g. communication) and medical management compared with training in medical management alone was associated with negligible effects for knowledge and skills (four studies, ES range 0.14-0.15). Debriefing using multiple vs single information sources was associated with negligible effects for time and skills (three studies, ES range -0.07 to 0.09). Our critical analysis showed inconsistency in measurement of non-technical skills and consistency in the (ineffective) design of debriefing. Simulation in anaesthesiology appears to be more effective than no intervention (except for patient outcomes) and non-inferior to non-simulation instruction. Few studies have clarified the key instructional designs for simulation-based anaesthesiology training.

Original languageEnglish (US)
Pages (from-to)231-245
Number of pages15
JournalBritish Journal of Anaesthesia
Volume112
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Anesthesiology
Meta-Analysis
MEDLINE
Communication
Simulation Training
Health

Keywords

  • anaesthesia
  • education
  • patient simulation
  • simulation training
  • simulators

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Simulation-based training in anaesthesiology : A systematic review and meta-analysis. / Lorello, G. R.; Cook, David Allan; Johnson, R. L.; Brydges, R.

In: British Journal of Anaesthesia, Vol. 112, No. 2, 02.2014, p. 231-245.

Research output: Contribution to journalArticle

Lorello, G. R. ; Cook, David Allan ; Johnson, R. L. ; Brydges, R. / Simulation-based training in anaesthesiology : A systematic review and meta-analysis. In: British Journal of Anaesthesia. 2014 ; Vol. 112, No. 2. pp. 231-245.
@article{6e49d650341b46e1b91b07ad99bd8fd1,
title = "Simulation-based training in anaesthesiology: A systematic review and meta-analysis",
abstract = "Simulation has long been integrated in anaesthesiology training, yet a comprehensive review of its effectiveness is presently lacking. Using meta-analysis and critical narrative analysis, we synthesized the evidence for the effectiveness of simulation-based anaesthesiology training. We searched MEDLINE, ERIC, and SCOPUS through May 2011 and included studies using simulation to train health professional learners. Data were abstracted independently and in duplicate. We included 77 studies (6066 participants). Compared with no intervention (52 studies), simulation was associated with moderate to large pooled effect sizes (ESs) for all outcomes (ES range 0.60-1.05) except for patient effects (ES -0.39). Compared with non-simulation instruction (11 studies), simulation was associated with moderate effects for satisfaction and skills (ES 0.39 and 0.42, respectively), large effect for behaviours (1.77), and small effects for time, knowledge, and patient effects (-0.18 to 0.23). In 17 studies comparing alternative simulation interventions, training in non-technical skills (e.g. communication) and medical management compared with training in medical management alone was associated with negligible effects for knowledge and skills (four studies, ES range 0.14-0.15). Debriefing using multiple vs single information sources was associated with negligible effects for time and skills (three studies, ES range -0.07 to 0.09). Our critical analysis showed inconsistency in measurement of non-technical skills and consistency in the (ineffective) design of debriefing. Simulation in anaesthesiology appears to be more effective than no intervention (except for patient outcomes) and non-inferior to non-simulation instruction. Few studies have clarified the key instructional designs for simulation-based anaesthesiology training.",
keywords = "anaesthesia, education, patient simulation, simulation training, simulators",
author = "Lorello, {G. R.} and Cook, {David Allan} and Johnson, {R. L.} and R. Brydges",
year = "2014",
month = "2",
doi = "10.1093/bja/aet414",
language = "English (US)",
volume = "112",
pages = "231--245",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Simulation-based training in anaesthesiology

T2 - A systematic review and meta-analysis

AU - Lorello, G. R.

AU - Cook, David Allan

AU - Johnson, R. L.

AU - Brydges, R.

PY - 2014/2

Y1 - 2014/2

N2 - Simulation has long been integrated in anaesthesiology training, yet a comprehensive review of its effectiveness is presently lacking. Using meta-analysis and critical narrative analysis, we synthesized the evidence for the effectiveness of simulation-based anaesthesiology training. We searched MEDLINE, ERIC, and SCOPUS through May 2011 and included studies using simulation to train health professional learners. Data were abstracted independently and in duplicate. We included 77 studies (6066 participants). Compared with no intervention (52 studies), simulation was associated with moderate to large pooled effect sizes (ESs) for all outcomes (ES range 0.60-1.05) except for patient effects (ES -0.39). Compared with non-simulation instruction (11 studies), simulation was associated with moderate effects for satisfaction and skills (ES 0.39 and 0.42, respectively), large effect for behaviours (1.77), and small effects for time, knowledge, and patient effects (-0.18 to 0.23). In 17 studies comparing alternative simulation interventions, training in non-technical skills (e.g. communication) and medical management compared with training in medical management alone was associated with negligible effects for knowledge and skills (four studies, ES range 0.14-0.15). Debriefing using multiple vs single information sources was associated with negligible effects for time and skills (three studies, ES range -0.07 to 0.09). Our critical analysis showed inconsistency in measurement of non-technical skills and consistency in the (ineffective) design of debriefing. Simulation in anaesthesiology appears to be more effective than no intervention (except for patient outcomes) and non-inferior to non-simulation instruction. Few studies have clarified the key instructional designs for simulation-based anaesthesiology training.

AB - Simulation has long been integrated in anaesthesiology training, yet a comprehensive review of its effectiveness is presently lacking. Using meta-analysis and critical narrative analysis, we synthesized the evidence for the effectiveness of simulation-based anaesthesiology training. We searched MEDLINE, ERIC, and SCOPUS through May 2011 and included studies using simulation to train health professional learners. Data were abstracted independently and in duplicate. We included 77 studies (6066 participants). Compared with no intervention (52 studies), simulation was associated with moderate to large pooled effect sizes (ESs) for all outcomes (ES range 0.60-1.05) except for patient effects (ES -0.39). Compared with non-simulation instruction (11 studies), simulation was associated with moderate effects for satisfaction and skills (ES 0.39 and 0.42, respectively), large effect for behaviours (1.77), and small effects for time, knowledge, and patient effects (-0.18 to 0.23). In 17 studies comparing alternative simulation interventions, training in non-technical skills (e.g. communication) and medical management compared with training in medical management alone was associated with negligible effects for knowledge and skills (four studies, ES range 0.14-0.15). Debriefing using multiple vs single information sources was associated with negligible effects for time and skills (three studies, ES range -0.07 to 0.09). Our critical analysis showed inconsistency in measurement of non-technical skills and consistency in the (ineffective) design of debriefing. Simulation in anaesthesiology appears to be more effective than no intervention (except for patient outcomes) and non-inferior to non-simulation instruction. Few studies have clarified the key instructional designs for simulation-based anaesthesiology training.

KW - anaesthesia

KW - education

KW - patient simulation

KW - simulation training

KW - simulators

UR - http://www.scopus.com/inward/record.url?scp=84892737039&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892737039&partnerID=8YFLogxK

U2 - 10.1093/bja/aet414

DO - 10.1093/bja/aet414

M3 - Article

VL - 112

SP - 231

EP - 245

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 2

ER -