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The effect of simulator training on clinical skills acquisition, retention and transfer
Author(s) -
Fraser Kristin,
Peets Adam,
Walker Ian,
Tworek Janet,
Paget Michael,
Wright Bruce,
McLaughlin Kevin
Publication year - 2009
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/j.1365-2923.2009.03412.x
Subject(s) - context (archaeology) , presentation (obstetrics) , medicine , cardiorespiratory fitness , physical therapy , dreyfus model of skill acquisition , surgery , biology , economic growth , economics , paleontology
Context Prior research has demonstrated that residents have poor clinical skills in cardiology and respirology. It is not clear how these skills can be improved because the number of patients with suitable clinical findings whose cooperation might help residents to better develop these clinical skills is limited. Objectives Our objective was to evaluate the effect of training on a cardiorespiratory simulator (CRS) on skills acquisition, retention and transfer. Methods We randomly allocated 146 students to CRS training in either chest pain or dyspnoea and compared each student’s performance on the clinical presentation in which he or she had received CRS training with performance on the control presentation. Results Immediately after training, students were more accurate in identifying abnormal clinical findings on the CRS (70.0% versus 52.2%; d = 7.6, P < 0.0001) and showed improved diagnostic performance (72.1% versus 55.6%; d = 4.3, P = 0.0007) on the training clinical presentation. At the end of the course they were still better at identifying abnormal findings (57.1% versus 51.7%; d = 2.5, P = 0.004) and diagnosing correctly (50.0% versus 38.1%; d = 3.0, P = 0.002) on problems included in the training clinical presentation. However, they showed no difference between training and control presentations in diagnostic performance when required to transfer their skills between problems (45.9% versus 43.8%; P = 0.5) or in performance on multiple‐choice questions (64.1% versus 63.6%; P = 0.8). Conclusions Students can acquire and retain clinical skills with CRS training, but demonstrate limited ability to transfer these to other problems. Further studies are needed to explore ways of improving learning and transfer with CRS training.