title: Web-conferenced simulation sessions: a satisfaction survey of clinical simulation encounters via remote supervision.
abstract: OBJECTIVE
  A critical barrier to expanding simulation-based instruction in medicine is the availability of clinical instructors. Allowing instructors to remotely observe and debrief simulation sessions may make simulation-based instruction more convenient, thus expanding the pool of instructors available. This study compared the impact of simulation sessions facilitated by in-person (IP) faculty versus those supervised remotely using Web-conferencing software (WebEx(®), Cisco [ www.webex.com/ ]).
  
  
  METHODS
  A convenience sample of preclinical medical students volunteered to "care for" patients in a simulation laboratory. Students received either standard IP or Web-conferenced (WC) instruction. WC sessions were facilitated by off-site instructors. A satisfaction survey (5-point Likert scale, where 1=strongly disagree and 5=strongly agree) was completed immediately following the sessions.
  
  
  RESULTS
  Forty-four surveys were analyzed (WC n=25, IP n=19). In response to the question "Was the communication between faculty and students a barrier to understanding the case?," the average student responses were 2.8 (95% confidence interval [CI] 2.4-3.2) for WC and 4.5 (95% CI 4.0-5.0) for IP (p<0.0001). In response to the question "Would you participate again in such a session?," the average student responses were 4.2 (95% CI 4.0-4.5) for WC and 4.9 (95% CI 4.6-5.2) for IP (p=0.0003). Both groups agreed that they acquired new skills (4.2 for WC, 4.5 for IP; p=0.39) and new knowledge (4.6 for WC, 4.7 for IP; p=0.41).
  
  
  CONCLUSIONS
  Telecommunication can successfully enhance access to simulation-based instruction. In this study, a Web interface downgraded the quality of student-faculty communication. Future investigation is needed to better understand the impact of such an effect on the learning process and to reduce barriers that impede implementation of technology-facilitated supervision.
authors: Gilbert Program in Medical Simulation, Harvard Medical School, Boston, Massachusetts, USA. emhayden@partners.org
authors: Emily M
authors: EM
authors: Hayden
authors: Deborah D
authors: DD
authors: Navedo
authors: James A
authors: JA
authors: Gordon
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003258:Consumer Behavior; D003625:Data Collection; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D014584:User-Computer Interface; D055815:Young Adult