title: Simulation-based training in critical resuscitation procedures improves residents' competence.
abstract: OBJECTIVE
  Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures.
  
  
  METHODS
  We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station.
  
  
  RESULTS
  We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods ( p < 0.001). The participants' year of postgraduate training influenced their self assessment of knowledge ( F = 4.91, p< 0.01) and clinical 2,25 skills ( F = 10.89, p< 0.001). At the 3-month follow-up, junior 2,25 level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course.
  
  
  CONCLUSIONS
  Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.
authors.affiliation: Division of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada. trevorlanghan@shaw.ca
authors.forename: Trevor S
authors.initials: TS
authors.lastname: Langhan
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Rigby
authors.forename: Ian W
authors.initials: IW
authors.lastname: Walker
authors.forename: Daniel
authors.initials: D
authors.lastname: Howes
authors.forename: Tyrone
authors.initials: T
authors.lastname: Donnon
authors.forename: Jason A
authors.initials: JA
authors.lastname: Lord
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005246:Feedback; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D016544:Patient Simulation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012151:Resuscitation / Q000193:education*; D011795:Surveys and Questionnaires