Haerling Katie A
From the Nursing and Healthcare Leadership, University of Washington, Tacoma WA.
Simul Healthc. 2018 Feb;13(1):33-40. doi: 10.1097/SIH.0000000000000280.
The purposes of this study were to (1) compare learning outcomes between students who participated in mannequin-based simulation activities and students who participated in virtual simulation activities and (2) describe a cost-utility analysis comparing the two types of simulation activities in terms of costs and multiple measures of effectiveness.
Nursing student participants were randomly assigned to one of two experimental groups to complete either a mannequin-based or virtual simulation activity. The simulation scenario was the same for both groups and involved the care of a hospitalized patient experiencing a chronic obstructive pulmonary disease exacerbation. Participants completed presimulation and postsimulation assessments reflecting qualitative and quantitative measures of learning. A random sample of participants from each group completed a postsimulation performance assessment during which they interacted one on one with a standardized patient.
Eighty-four nursing students were enrolled in the study and completed the simulation activities. There were no significant differences in quantitative measures of learning or performance between participants in the mannequin-based and virtual simulation groups. Participants' qualitative responses to postintervention written reflections and questions yielded additional data for describing learning from the two interventions. In the cost-utility analysis, the virtual simulation activity had a more favorable cost-utility ratio of US $1.08 versus the mannequin-based simulation activity's US $3.62.
Healthcare educators striving to make evidence-based decisions about how to best employ simulation pedagogy may consider these findings about the cost utility of various simulation modalities. However, additional research is needed.
本研究的目的是：（1）比较参与基于人体模型的模拟活动的学生与参与虚拟模拟活动的学生的学习成果；（2）描述一项成本效用分析，比较这两种模拟活动在成本和多种有效性指标方面的情况。
护理专业学生参与者被随机分配到两个实验组之一，以完成基于人体模型的或虚拟的模拟活动。两组的模拟场景相同，涉及对一名慢性阻塞性肺疾病急性加重的住院患者的护理。参与者完成了模拟前和模拟后的评估，这些评估反映了学习的定性和定量指标。从每组中随机抽取的参与者样本完成了模拟后表现评估，在此期间他们与一名标准化患者进行一对一互动。
84名护理专业学生参与了该研究并完成了模拟活动。基于人体模型的模拟组和虚拟模拟组的参与者在学习或表现的定量指标方面没有显著差异。参与者对干预后书面反思和问题的定性回答产生了用于描述从这两种干预中学习情况的额外数据。在成本效用分析中，虚拟模拟活动的成本效用比更有利，为1.08美元，而基于人体模型的模拟活动为3.62美元。
努力就如何最佳运用模拟教学法做出循证决策的医疗保健教育工作者可能会考虑这些关于各种模拟方式成本效用的研究结果。然而，还需要更多研究。
