title: Effects of Using Human Patient Simulator (HPS) versus a CD-ROM on Cognition and Critical Thinking.
abstract: BACKGROUND
  Very little prospective randomized experimental research exists on the use of simulation as a teaching method, and no studies have compared the two strategies of using the HPS and a CD-ROM. In addition, no researchers have investigated the effects of simulation on various levels of cognition, specifically lower-level and higher-level cognition or critical thinking.
  
  
  OBJECTIVE
  A prospective pretest-posttest experimental mixed design (within and between) was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies in lower-level, higher-level cognition and critical thinking.
  
  
  RESULTS
  A repeated measures multivariate analysis of variance (RMANOVA) with LSD post-hoc tests were used to analyze the data. There were no significant differences between the HPS and CD-ROM groups on lower-level cognition scores. The HPS group did significantly better than the CD-ROM group on higher-level cognition and critical thinking scores.
  
  
  CONCLUSIONS
  This study demonstrated that the choice of teaching strategies for lower-level cognition does not make a statistically significant difference in outcome. However, the HPS is superior to using CD-ROM and should be considered as the choice in teaching.
authors.affiliation: US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas USA.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
authors.forename: Amanda
authors.initials: A
authors.lastname: Flagg
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Dremsa