When teaching procedures in simulation, do simulation adjuncts translate to better performance?

Area of Science:

• Medical Education
• Simulation-based Training
• Procedural Skills Acquisition

Background:

• Low-frequency, high-acuity procedures require simulated training to minimize patient harm.
• Evidence comparing simulation with adjuncts versus traditional procedure laboratories for procedural training is lacking.
• This study investigated the impact of simulation adjuncts on procedural skills for balloon tamponade placement.

Purpose of the Study:

• To compare the effectiveness of simulation with adjuncts (SA) versus a procedure laboratory (PL) setting for teaching balloon tamponade placement.
• To assess the impact of different training modalities on procedural knowledge, skills, and self-assessed competence.

Main Methods:

• Fifty learners (emergency medicine residents, gastroenterology fellows) were randomized to SA or PL training groups.
• Training utilized a modified airway task trainer for balloon tamponade placement.
• Assessments included self-competence, knowledge, and observed skills at baseline, 1 month, and 5 months post-training.

Main Results:

• Both groups showed significant improvement in all assessments from baseline to 1 month.
• Self-assessed competence improved in both groups between 1 and 5 months.
• The PL group demonstrated significantly higher skills performance at the 5-month follow-up compared to the SA group.

Conclusions:

• All learners improved in knowledge, skills, and competence regardless of training method.
• Procedure laboratory training resulted in superior long-term skills performance for balloon tamponade placement.
• Structured practice alone may be sufficient, and simulation adjuncts might potentially lead to skills decay.