Faking a Crisis: Examining the Effectiveness of Simulation Training for Emergency Situations

Objectives: As healthcare professional training programs and hospitals utilize simulation technology, it becomes increasingly important to determine the effectiveness of this teaching method. This presentation will examine the results of a literature review to determine if healthcare professionals with simulation training for emergency situations have higher clinical competence than healthcare professionals without simulation training.

Methods: Cochrane Library database was searched for journal articles using the key words “emergency simulations”. The search was limited to articles from 2006-2016. Additionally, OVID MEDLINE was searched using the key words “emergency simulations,” “clinical competence” and “patient simulation.” Inclusion criteria included articles published between 2011 and 2016, in the English-language, peer-reviewed systematic reviews or randomized controlled trials, and focus on physicians, nurses, Emergency Medical Services and students in emergency or critical care simulations. Studies including pharmacists, pharmacy students, and outcomes unrelated to clinical competence were excluded from the review.

Results: From the initial 75 articles identified, five studies fulfilled the criteria, including one systematic review and four randomized controlled trials. Among these five studies, outcomes measured included increased knowledge (often assessed with multiple choice tests), patient outcome, skills, teamwork, and clinical management. In all of the studies, all interventions (which included simulation training, case-based learning, and didactic lecturing) resulted in higher outcome scores than no intervention. However, the studies yielded mixed results when comparing the efficacy of simulation training to the other interventions.

Limitations: This review has several limitations including the small sample size, only one article that assessed multiple aspects of clinical competence, and few studies that utilized nurses as the primary participants, which lessened the applicability of the results to nursing-specific research.

Conclusion: The results of this search indicate that simulation training improves clinical competence when compared to no extra training. The limited number of applicable studies indicates that further research is needed to better assess the effectiveness of emergency situation simulations. In particular, no studies were found that specifically examined Post-Anesthesia Care Unit emergency simulations so this is an area which presents a research opportunity. Future research should further explore patient outcomes as a measurement of simulation effectiveness because they provide clinical evidence of staff competence along with the theoretical knowledge and skills gained.