The effect of an olfactory and visual cue on realism and engagement in a health care simulation experience.
BACKGROUND
Fidelity has been identified as an important element in a subject's perception of realism and engagement in learning during a simulation experience. The purpose of this study was to determine whether an isolated visual and olfactory sensory change to the simulation environment affects the subjects' perceptions of realism during simulation cases.


METHODS
Using an electrosurgical unit applied to bovine muscle tissue, we created a model to simulate the characteristic operating room smoke and burning odor that occur during many procedures. Anesthesiologist subjects were randomly assigned to an intervention group that participated in a simulation involving the characteristic smoke and odor or a control group whose simulation involved no smoke or odor. Subjects completed a 7-question survey on the fidelity of the simulation, their perception of realism, and their learning engagement.


RESULTS
We enrolled 103 subjects over 22 simulation courses in our study (intervention, n = 52; control, n = 51). The subjects' reactions to the physical (P = 0.73), conceptual (P = 0.34), and emotional (P = 0.12) fidelity and their perception of realism (P = 0.71) did not differ between the intervention and control groups.


CONCLUSIONS
In a high-fidelity simulation environment, a visual and olfactory increment to physical fidelity did not affect subjects' overall ratings of fidelity, perceptions of realism, and engagement in the learning experience.
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. knanji@partners.org
Karen C
KC
Nanji
Kirsten
K
Baca
Daniel B
DB
Raemer
D003198:Computer Simulation; D003463:Cues; D004598:Electrosurgery / Q000193:education*; D006801:Humans; D008404:Massachusetts; D012903:Smell; D013337:Students, Medical; D014584:User-Computer Interface; D014785:Vision, Ocular