A comparison of high-fidelity and virtual reality simulation as assessment tools in undergraduate medical education

Simulation is widely used across many aspects of health professions education and, in recent years, has begun to be explored as an assessme nt tool, particularly in relation to examining technical clinical skills. Although previous research has suggested that simulation may be an effective tool for assessing clinical skills, there is a lack of evidence exploring which form of technology may be a more reliable assessment tool. This crossover study aimed to compare two forms of simulation technology-a high-fidelity manikin and virtual reality, as potential tools for assessing acute clinical care assessment skills.

The participating students completed two different simulation scenarios: one scenario using a high-fidelity manikin and one using a virtual reality system. The two scenarios were then marked using a checklist created for the research and a global assessment score. The results for each simulation technology were compared with one another and compared with the participants' medical final summative assessment scores.

Sixteen students participated in the research. The assessment checklist scores from the two technologies were comparable, with no statistically significant difference (p = 0.918) and a strong positive correlation between the two (correlation coefficient = 0.665, p = 0.005). However, neither simulation technology had a statistically significant correlation with the summative final written examination paper (high-fidelity manikin: correlation coefficient = - 0.25, p = 0.927; virtual reality: correlation coefficient = 0.363, p = 0.167) or final clinical examination scores (high-fidelity manikin: correlation coefficient = - 0.204, p = 0.449; virtual reality: correlation coefficient = - 0.201, p = 0.455).

The findings from this research suggest that virtual reality simulation is comparable to high-fidelity simulation when comparing student scores across the two forms of simulation. However, neither method demonstrated a strong correlation with final summative examination outcomes, suggesting that a single scenario assessment using either technology may not provide an appropriate alternative to existing final summative examinations. To better understand the role of simulation in assessment, further research is needed to compare these two simulation technologies in more depth and provide additional evidence to support educators in understanding how they can be best used within health professions education.