Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial.
OBJECTIVE
The purpose of this study is to determine the effect of simulation-based education on the knowledge and skills of internal medicine residents in the medical intensive care unit (MICU).


METHODS
From January 2009 to January 2010, 60 first-year residents at a tertiary care teaching hospital were randomized by month of rotation to an intervention group (simulator-trained, n = 26) and a control group (traditionally trained, n = 34). Simulator-trained residents completed 4 hours of simulation-based education before their medical intensive care unit (MICU) rotation. Topics included circulatory shock, respiratory failure, and mechanical ventilation. After their rotation, residents completed a standardized bedside skills assessment using a 14-item checklist regarding respiratory mechanics, ventilator settings, and circulatory parameters. Performance of simulator-trained and traditionally trained residents was compared using a 2-tailed independent-samples t test.


RESULTS
Simulator-trained residents scored significantly higher on the bedside skills assessment compared with traditionally trained residents (82.5% ± 10.6% vs 74.8% ± 14.1%, P = .027). Simulator-trained residents were highly satisfied with the simulation curriculum.


CONCLUSIONS
Simulation-based education significantly improved resident knowledge and skill in the MICU. Knowledge acquired in the simulated environment was transferred to improved bedside skills caring for MICU patients. Simulation-based education is a valuable adjunct to standard clinical training for residents in the MICU.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. c-schroedl@md.northwestern.edu
Clara J
CJ
Schroedl
Thomas C
TC
Corbridge
Elaine R
ER
Cohen
Sherene S
SS
Fakhran
Daniel
D
Schimmel
William C
WC
McGaghie
Diane B
DB
Wayne
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D016000:Cluster Analysis; D003422:Critical Care / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D016544:Patient Simulation; D018794:Problem-Based Learning; D011446:Prospective Studies; D012121:Respiration, Artificial