title: Instructional design affects the efficacy of simulation-based training in central venous catheterization.
abstract: BACKGROUND
  Simulation-based learning is a common educational tool in health care training and frequently involves instructional designs based on Experiential Learning Theory (ELT). However, little research explores the effectiveness and efficiency of different instructional design methodologies appropriate for simulations. The aim of this study was to compare 2 instructional design models, ELT and Guided Experiential Learning (GEL), to determine which is more effective for training the central venous catheterization procedure.
  
  
  METHODS
  Using a quasi-experimental randomized block design, nurse anesthetists completed training under 1 of the 2 instructional design models. Performance was assessed using a checklist of central venous catheterization performance, pass rates, and critical action errors.
  
  
  RESULTS
  Participants in the GEL condition performed significantly better than those in the ELT condition on the overall checklist score after controlling for individual practice time (F[1, 29] = 4.021, P = .027, Cohen's d = .71), had higher pass rates (P = .006, Cohen's d = 1.15), and had lower rates of failure due to critical action errors (P = .038, Cohen's d = .81).
  
  
  CONCLUSIONS
  The GEL model of instructional design is significantly more effective than ELT for simulation-based learning of the central venous catheterization procedure, yielding large differences in effect size.
authors.affiliation: Palmetto Learning, LLC, 7001 St Andrews Road, #322, Columbia, SC 29212, USA. Electronic address: chris@christophercraft.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Craft
authors.affiliation: Center for the Advanced Study of Teaching and Learning in Higher Education, University of Virginia, Charlottesville, VA, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Feldon
authors.affiliation: Palmetto Health - University of South Carolina School of Medicine Simulation Center, School of Medicine, University of South Carolina, Columbia, SC, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D002405:Catheterization, Central Venous; D057189:Checklist; D002983:Clinical Competence; D006801:Humans; D008348:Manikins; D017145:Models, Educational; D009719:Nurse Anesthetists / Q000193:education*; D018794:Problem-Based Learning; D013022:South Carolina
keywords: Central venous catheterization; Cognitive task analysis; Instructional design; Simulator; Training