title: Examining the impact of high and medium fidelity simulation experiences on nursing students' knowledge acquisition.
abstract: OBJECTIVE
  This paper describes a study that measured and compared knowledge acquisition in nursing students exposed to medium or high fidelity human patient simulation manikins.
  
  
  BACKGROUND
  In Australia and internationally the use of simulated learning environments has escalated. Simulation requires a significant investment of time and money and in a period of economic rationalisation this investment must be justified. Assessment of knowledge acquisition with multiple choice questions is the most common approach used to determine the effectiveness of simulation experiences.
  
  
  METHODS
  This study was conducted in an Australian school of nursing; 84 third year nursing students participated. A quasi-experimental design was used to evaluate the effect of the level of manikin fidelity on knowledge acquisition. Data were collected at three points in time: prior to the simulation, immediately following and two weeks later.
  
  
  RESULTS
  Differences in mean scores between the control (medium fidelity) and experimental (high fidelity) groups for Tests 1, 2 and 3 were calculated using independent t tests and were not statistically significant. Analysis of covariance (ANCOVA) was conducted to determine whether changes in knowledge scores occurred over time and, while an improvement in scores was observed, it was not statistically significant.
  
  
  CONCLUSIONS
  The results of this study raise questions about the value of investing in expensive simulation modalities when the increased costs associated with high fidelity manikins may not be justified by a concomitant increase learning outcomes. This study also suggests that multiple choice questions may not be the most appropriate measure of simulation effectiveness.
authors.affiliation: School of Nursing and Midwifery, The University of Newcastle, Callaghan NSW 2308, Australia. Tracy.Levett-jones@newcastle.edu.au
authors.forename: Tracy
authors.initials: T
authors.lastname: Levett-Jones
authors.forename: Samuel
authors.initials: S
authors.lastname: Lapkin
authors.forename: Kerry
authors.initials: K
authors.lastname: Hoffman
authors.forename: Carol
authors.initials: C
authors.lastname: Arthur
authors.forename: Jan
authors.initials: J
authors.lastname: Roche
mesh_terms: D001315:Australia; D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate / Q000191:economics / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D008348:Manikins; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D013338:Students, Nursing / Q000523:psychology