title: Comparing effectiveness of 3 learning strategies: simulation-based learning, problem-based learning, and standardized patients.
abstract: BACKGROUND
  Curricula must not only provide students with knowledge but also foster the development of critical thinking and reasoning skills. Several learning strategies, including problem-based learning (PBL), standardized patients, and high-fidelity human simulation, have been incorporated into courses; however, it is currently unknown which technique is the most effective.
  
  
  METHODS
  This is a prospective, randomized, crossover study that was conducted during two 90-minute seizure disorder laboratory sessions for PharmD students in their third professional year. Students rotated between 3 different seizure disorder cases (A, B, and C), with each student experiencing 3 learning strategies including PBL, standardized patients, and high-fidelity human simulation. Evaluation of knowledge consisted of quizzes at the end of each case, and student perception and satisfaction were evaluated by an anonymous survey at the conclusion of the laboratory sessions.
  
  
  RESULTS
  Student quiz scores from the simulation learning strategy were statistically better than those from the standardized interview and modified PBL (mPBL) strategies in cases A and B (P < 0.001). The student quiz scores for the standardized interview were also statistically better than the mPBL scores in case C (P = 0.001). When surveyed, 91% of students agreed or strongly agreed that simulation improved their knowledge, whereas only 69% and 67% of students agreed or strongly agreed that mPBL or standardized patients, respectively, improved their knowledge (P < 0.001).
  
  
  CONCLUSIONS
  High-fidelity simulation is an effective learning strategy. When it is compared with standardized patients and mPBL strategies, students performed better on knowledge-based quizzes and had higher levels of satisfaction.
authors.affiliation: Department of Pharmacy and Therapeutics, UPMC Presbyterian Shadyside, Pittsburgh, PA 15213, USA. smithburgerpl@upmc.edu
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Smithburger
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Kane-Gill
authors.forename: Christine M
authors.initials: CM
authors.lastname: Ruby
authors.forename: Amy L
authors.initials: AL
authors.lastname: Seybert
mesh_terms: D000704:Analysis of Variance; D003198:Computer Simulation; D016001:Confidence Intervals; D018592:Cross-Over Studies; D003479:Curriculum; D004512:Education, Pharmacy / Q000379:methods*; D004521:Educational Measurement; D004827:Epilepsy / Q000628:therapy; D006801:Humans; D010414:Pennsylvania; D018794:Problem-Based Learning; D011446:Prospective Studies; D013223:Statistics as Topic; D013663:Teaching / Q000379:methods*