Learning in the simulated setting: a comparison of expert-, peer-, and computer-assisted learning

To compare the effectiveness of expert-assisted learning (EAL), peer-assisted learning (PAL), and computer-assisted learning (CAL) on participants' procedural skills acquisition in the simulated setting.

Sixty medical and nursing students practiced urinary catheterization in an expert-, peer- or computer-assisted, simulation-based, learning environment. Effectiveness of training was evaluated in the simulated setting using an immediate posttest and, one week later, on a retention and standardized patient-based transfer test. Measures included number of breaks in aseptic technique and blinded expert assessments.

All groups performed similarly on the pre-, post-, and retention tests. At transfer, the EAL group performed significantly better than the PAL group as measured by global clinical performance, catheterization checklist scores, and number of breaks in aseptic technique (P < .05). Communication and catheterization global ratings were equivalent for all groups (P > .05).

CAL is as effective as expert feedback for teaching procedural skills to novices in the simulated setting. When extrinsic feedback is provided, the expertise level of the teacher seems to be a critical factor influencing effectiveness of training, with EAL being more effective than PAL.