title: Remotely Versus Locally Facilitated Simulation-based Training in Management of the Deteriorating Patient by Newly Graduated Health Professionals: A Controlled Trial.
abstract: BACKGROUND
  This study evaluated delivery of immersive simulation-based training (SBT) by distance education. Newly graduated health professionals' experience of and learning outcomes from videoconference-enabled remotely facilitated (RF) were prospectively compared with a locally facilitated (LF) format within a course addressing management of the deteriorating patient.
  
  
  METHODS
  Participants were exposed to both RF and LF formats in an intervention course (IC). The primary outcome measure was a questionnaire detailing participants' experience of 1 RF scenario and 1 LF scenario. The 16-item questionnaire measured perceived learning, comfort, interaction with other learners and instructor, as well as quality of instruction, factors that are considered essential in both SBT and distance education. As a secondary outcome measure, learning outcomes, measured as precourse and postcourse scores and pass rates in multiple-choice question tests, were also measured and compared with those of participants completing control courses, in which only the LF format was used.
  
  
  RESULTS
  The study was conducted between April 2013 and April 2014. Among the 155 participants who participated in ICs, questionnaire results revealed a small, significantly higher median total score (25-75 interquartile range) for LF versus RF format scenarios [78 (72-80) vs. 76 (68-80), P = 0.01]. Multiple-choice question test scores compared between 155 IC and 150 control course participants showed no significant differences.
  
  
  CONCLUSIONS
  Participants' experience of SBT using the RF format was slightly less positive than the LF format; however, it had no measured impact on knowledge. The impact of RF-SBT on more complex training applications remains poorly understood. Instructors could potentially optimize learner comfort and engagement by improving their interactive skills.
authors.affiliation: From the Sydney Clinical Skills and Simulation Centre (M.D.C., K.R., S.T., L.M.W.), Royal North Shore Hospital, St Leonards; and Sydney Medical School (L.M.W.), University of Sydney, Sydney, NSW, Australia; Danish Institute for Medical Simulation (P.D., D.Ø.), Capital Region of Denmark and Copenhagen University, Herlev, Denmark.
authors.forename: Margrethe Duch
authors.initials: MD
authors.lastname: Christensen
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rieger
authors.forename: Shane
authors.initials: S
authors.lastname: Tan
authors.forename: Peter
authors.initials: P
authors.lastname: Dieckmann
authors.forename: Doris
authors.initials: D
authors.lastname: Østergaard
authors.forename: Leonie M
authors.initials: LM
authors.lastname: Watterson