title: High-fidelity simulation versus case-based discussion for teaching medical students in Brazil about pediatric emergencies.
abstract: OBJECTIVE
  To compare high-fidelity simulation with case-based discussion for teaching medical students about pediatric emergencies, as assessed by a knowledge post-test, a knowledge retention test and a survey of satisfaction with the method.
  
  
  METHODS
  This was a non-randomized controlled study using a crossover design for the methods, as well as multiple-choice questionnaire tests and a satisfaction survey. Final-year medical students were allocated into two groups: group 1 participated in an anaphylaxis simulation and a discussion of a supraventricular tachycardia case, and conversely, group 2 participated in a discussion of an anaphylaxis case and a supraventricular tachycardia simulation. Students were tested on each theme at the end of their rotation (post-test) and 4-6 months later (retention test).
  
  
  RESULTS
  Most students (108, or 66.3%) completed all of the tests. The mean scores for simulation versus case-based discussion were respectively 43.6% versus 46.6% for the anaphylaxis pre-test (p=0.42), 63.5% versus 67.8% for the post-test (p=0.13) and 61.5% versus 65.5% for the retention test (p=0.19). Additionally, the mean scores were respectively 33.9% versus 31.6% for the supraventricular tachycardia pre-test (p=0.44), 42.5% versus 47.7% for the post-test (p=0.09) and 41.5% versus 39.5% for the retention test (p=0.47). For both themes, there was improvement between the pre-test and the post-test (p<0.05), and no significant difference was observed between the post-test and the retention test (p>0.05). Moreover, the satisfaction survey revealed a preference for simulation (p<0.001).
  
  
  CONCLUSIONS
  As a single intervention, simulation is not significantly different from case-based discussion in terms of acquisition and retention of knowledge but is superior in terms of student satisfaction.
authors.affiliation: Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Thomaz Bittencourt
authors.initials: TB
authors.lastname: Couto
authors.affiliation: Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sylvia C L
authors.initials: SC
authors.lastname: Farhat
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Geis
authors.affiliation: Analítica Consultoria, São Paulo, SP, Brazil.
authors.forename: Orjan
authors.initials: O
authors.lastname: Olsen
authors.affiliation: Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Claudio
authors.initials: C
authors.lastname: Schvartsman
mesh_terms: D000328:Adult; D000707:Anaphylaxis; D001938:Brazil; D016022:Case-Control Studies; D002648:Child; D018592:Cross-Over Studies; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D019359:Knowledge; D008297:Male; D010549:Personal Satisfaction; D012153:Retention, Psychology; D011795:Surveys and Questionnaires; D013617:Tachycardia, Supraventricular; D013663:Teaching / Q000379:methods*