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Comparison of Learning Experience With On-Site Versus Off-Site Telesimulation for Medical Students in Pediatric
Mizue Kishida1, Tatsuya Kubo2, Akira Nishisaki3,4,5
1Division of Critical Care Medicine, National Center for Child Health and Development, Tokyo.
Objective:
The learner experience with on-site versus off-site telesimulation participation is not well described. We hypothesized that off-site participation was associated with lower debriefing effectiveness, higher taskload, and less performance improvement.
Design:
In a telesimulation program between the Children's Hospital of Philadelphia, USA, and Kanazawa University, Japan, fifth-year medical students in Japan were assigned to either on-site (simulation room) or off-site (different location) participation in a 1-hour simulation session during a 4-week pediatric rotation. Facilitators in Philadelphia remotely ran the session with 2 on-site and 2 off-site students (4 total) using an emergency department scenario of an infant. Debriefing effectiveness was assessed using Debriefing Assessment for Simulation in Healthcare student version: DASH-SV (score 1 to 7). The taskload was evaluated by the NASA Task Load Index (taskload, maximum 100). Student's performance was measured by pre-test and post-test simulation with a checklist (15 items, maximum 30) at the beginning and end of pediatric rotation.
Results:
Between December 2020 and October 2022, 225 students (on-site 90, off-site 135) participated. Debriefing effectiveness was not different (DASH on-site median: 6.7, IQR: 6 to 7 vs. off-site median: 6.5, IQR: 5.8 to 7, P =0.864). Taskload was higher among the on-site group: 59.6±12.9 versus off-site 55.2±14.4, P =0.026. In the taskload subscale, physical demand and frustration were higher among on-site participants ( P <0.001, P =0.023). There was no difference in performance improvement (on-site: 10.4±3.5 vs. off-site: 9.6±3.9, P =0.121).
Conclusions:
The experience of on-site versus off-site learners participating in pediatric emergency telesimulation was similar in debriefing effectiveness and performance improvement, but the taskload was higher for on-site learners.
