Comparing the Learning Effectiveness of Healthcare Simulation in the Observer Versus Active Role: Systematic Review...

Area of Science:

• Medical Education
• Simulation-Based Learning
• Healthcare Training

Background:

• Observation in healthcare simulation education is recognized for its benefits.
• The comparative effectiveness of observation versus active participation is not well-established.
• Kirkpatrick's 4-level model is a framework for evaluating training effectiveness.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials comparing observation and active participation in healthcare simulation.
• To evaluate effectiveness across Kirkpatrick's levels: reactions, learning, behavior, and patient outcomes.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Searched 8 major databases and gray literature.
• Included 13 trials with 426 active participants and 374 observers.

Main Results:

• No significant difference in participant reactions (Kirkpatrick Level 1).
• Active participants demonstrated significantly better learning outcomes (Kirkpatrick Level 2) than observers (SMD = -0.2, P = 0.03).
• Limited data on behavior change (Level 3) and no data on patient outcomes (Level 4).

Conclusions:

• Active participation in simulation-based education appears more effective for learning than observation.
• Further research is required to optimize the integration of observation in healthcare simulation.
• Understanding how to leverage observation for behavioral and patient outcomes needs investigation.