Application of high-fidelity simulation in critical care residency training as an effective learning, assessment, and prediction tool for clinical performance

Chih-Wei Yang; Shih-Chi Ku; Matthew Huei-Ming Ma; Tzong-Shinn Chu; Shan-Chwen Chang

doi:10.1016/j.jfma.2018.12.003

Application of high-fidelity simulation in critical care residency training as an effective learning, assessment, and prediction tool for clinical performance

J Formos Med Assoc. 2019 Sep;118(9):1347-1355. doi: 10.1016/j.jfma.2018.12.003. Epub 2018 Dec 21.

Authors

Chih-Wei Yang¹, Shih-Chi Ku², Matthew Huei-Ming Ma³, Tzong-Shinn Chu⁴, Shan-Chwen Chang⁵

Affiliations

¹ Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: scku1015@gmail.com.
³ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou City, Taiwan.
⁴ Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: tschu@ntu.edu.tw.
⁵ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medicine, National Taiwan University, College of Medicine, Taipei, Taiwan.

PMID: 30584004
DOI: 10.1016/j.jfma.2018.12.003

Abstract

Background/purpose: This study was conducted to assess: 1) the impact of the HFS curriculum on residents' knowledge and skills, and 2) the correlation between learning outcomes and the clinical performance.

Methods: An HFS-based curriculum was implemented for junior residents prior to their ICU rotations. Residents completed written tests before (pre-test) and after (post-test) the curriculum and were assessed on their performance during the simulation sessions. Clinical performance was evaluated using global rating for knowledge, clinical skills, and leadership and decision-making skills.

Results: Complete data on pre-, post-test, simulation performance assessment, and clinical performance evaluation were available for 69 residents. Residents scored higher on their written post-test (64.6) compared with the pre-test (57.0) (p < 0.01). The simulation performance of residents improved between their first (3.43) and second (3.60) sessions (p < 0.05). Post-test scores correlated poorly with simulation performance (r = 0.03-0.28). Multivariable linear regression analysis revealed that clinical performance correlated better and significantly with simulation performance than the post-test for knowledge and clinical skills.

Conclusion: HFS is an effective training strategy, and can also be a complementary assessment tool to the written examinations and has better correlation with clinical performance.

Keywords: Clinical performance; Critical care; Medical education; Residency training; Simulation.

Publication types

Clinical Trial

MeSH terms

Clinical Competence / standards*
Critical Care / standards*
Curriculum
Educational Measurement
High Fidelity Simulation Training*
Humans
Intensive Care Units
Internship and Residency*
Linear Models
Longitudinal Studies
Multivariate Analysis
Prospective Studies
Taiwan