title: The effect of simulator training on clinical skills acquisition, retention and transfer.
abstract: BACKGROUND
  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.
authors: Office of Undergraduate Medical Education, University of Calgary, Calgary, Alberta, Canada.
authors: Kristin
authors: K
authors: Fraser
authors: Adam
authors: A
authors: Peets
authors: Ian
authors: I
authors: Walker
authors: Janet
authors: J
authors: Tworek
authors: Michael
authors: M
authors: Paget
authors: Bruce
authors: B
authors: Wright
authors: Kevin
authors: K
authors: McLaughlin
mesh_terms: D002309:Cardiology / Q000193:education*; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D002320:Cardiovascular Physiological Phenomena; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D016544:Patient Simulation; D012143:Respiratory Physiological Phenomena; D013223:Statistics as Topic