• Emerg Med J · Jul 2012

    Randomized Controlled Trial Multicenter Study Comparative Study

    A multinational randomised study comparing didactic lectures with case scenario in a severe sepsis medical simulation course.

    • Chih-Huang Li, Win-Sen Kuan, Malcolm Mahadevan, Lynda Daniel-Underwood, Te-Fa Chiu, H Bryant Nguyen, and ATLAS Investigators (Asia neTwork to reguLAte Sepsis care).
    • Department of Emergency Medicine, Chang-Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan.
    • Emerg Med J. 2012 Jul 1;29(7):559-64.

    BackgroundMedical simulation has been used to teach critical illness in a variety of settings. This study examined the effect of didactic lectures compared with simulated case scenario in a medical simulation course on the early management of severe sepsis.MethodsA prospective multicentre randomised study was performed enrolling resident physicians in emergency medicine from four hospitals in Asia. Participants were randomly assigned to a course that included didactic lectures followed by a skills workshop and simulated case scenario (lecture-first) or to a course that included a skills workshop and simulated case scenario followed by didactic lectures (simulation-first). A pre-test was given to the participants at the beginning of the course, post-test 1 was given after the didactic lectures or simulated case scenario depending on the study group assignment, then a final post-test 2 was given at the end of the course. Performance on the simulated case scenario was evaluated with a performance task checklist.Results98 participants were enrolled in the study. Post-test 2 scores were significantly higher than pre-test scores in all participants (80.8 ± 12.0% vs 65.4 ± 12.2%, p<0.01). There was no difference in pre-test scores between the two study groups. The lecture-first group had significantly higher post-test 1 scores than the simulation-first group (78.8 ± 10.6% vs 71.6 ± 12.6%, p<0.01). There was no difference in post-test 2 scores between the two groups. The simulated case scenario task performance completion was 90.8% (95% CI 86.6% to 95.0%) in the lecture-first group compared with 83.8% (95% CI 79.5% to 88.1%) in the simulation-first group (p=0.02).ConclusionsA medical simulation course can improve resident physician knowledge in the early management of severe sepsis. Such a course should include a comprehensive curriculum that includes didactic lectures followed by simulation experience.

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