Screen-based simulation assessment for emergency medicine learners: a rapid review

Simulation has played a vital role in training medical professionals. The COVID-19 Pandemic has highlighted the need for physically distant educational assessment methods. Screen-based simulation (SBS) demonstrates one alternative to traditional in-person simulation methods to assess learners clinical reasoning and communication skills. This study aims to compare in-person simulation to SBS as assessment methods in Emergency Medicine (EM).

A rapid review literature search methodology of an electronic database (PubMed) was performed in February 2022 with search terms such as "Computer Simulation," "Patient Simulation," "Simulation Training," "Education, Distance," "Virtual OSCE," "Academic Performance," or "Emergency Medicine." Reference lists of relevant articles were manually analyzed for additional studies. Studies were manually reviewed by multiple authors following strict inclusion/exclusion criteria.

751 articles were identified based on title and abstract. Sixty articles were selected for retrieval, of which seven pilot and small population studies were included. Study participants varied based on experience level. Three key findings were derived from these studies. First, SBS is comparable to in-person simulation as a clinical competence and communication skill assessment method when evaluated by independent raters and mock EM oral board examination scores. Second, SBS is capable of discerning EM learners by educational level given SBS/serious game mean clinical score clustering. Lastly, various SBS software demonstrated strong participant interest across the EM learner spectrum through subjective exit questionaries.

Current research regarding SBS as an assessment method for EM learners is severely limited as demonstrated by low number of included studies and small populations. Even so, SBS shows promise as a possible alternative and/or supplement to traditional in-person simulation to assess clinical reasoning/communication skills and discern learners by educational level. Further large-scale studies are required to establish the validity of SBS as an assessment method.