title: Comparison of 2 resident learning tools-interactive screen-based simulated case scenarios versus problem-based learning discussions: a prospective quasi-crossover cohort study.
abstract: OBJECTIVE
  Simulation-based learning is emerging as an alternative educational tool in this era of a relative shortfall of teaching anesthesiologists. The objective of the study is to assess whether screen-based (interactive computer simulated) case scenarios are more effective than problem-based learning discussions (PBLDs) in improving test scores 4 and 8 weeks after these interventions in anesthesia residents during their first neuroanesthesia rotation.
  
  
  METHODS
  Prospective, nonblinded quasi-crossover study.
  
  
  METHODS
  Cleveland Clinic.
  
  
  METHODS
  Anesthesiology residents.
  
  
  METHODS
  Two case scenarios were delivered from the Anesoft software as screen-based sessions, and parallel scripts were developed for 2 PBLDs. Each resident underwent both types of training sessions, starting with the PBLD session, and the 2 cases were alternated each month (ie, in 1 month, the screen-based intervention used case 1 and the PBLD used case 2, and vice versa for the next month).
  
  
  METHODS
  Test scores before the rotation (baseline), immediately after the rotation (4 weeks after the start of the rotation), and 8 weeks after the start of rotation were collected on each topic from each resident. The effect of training method on improvement in test scores was assessed using a linear mixed-effects model.
  
  
  RESULTS
  Compared to the departmental standard of PBLD, the simulation method did not improve either the 4- or 8-week mean test scores (P = .41 and P = .40 for training method effect on 4- and 8-week scores, respectively). Resident satisfaction with the simulation module on a 5-point Likert scale showed subjective evidence of a positive impact on resident education.
  
  
  CONCLUSIONS
  Screen-based simulators were not more effective than PBLD for education during the neuroanesthesia rotation in anesthesia residency.
authors.affiliation: Staff Anesthesiologist, Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Ave- E30, Cleveland, OH 44195. Electronic address: Rajans@mail.amc.edu.
authors.forename: Shobana
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Staff Intensivist, Center for Critical Care, and Staff Anesthesiologist, Department of General Anesthesiology and Department of Outcomes Research, Cleveland Clinic Foundation, Cleveland, OH 44195. Electronic address: khannaa@ccf.org.
authors.forename: Ashish
authors.initials: A
authors.lastname: Khanna
authors.affiliation: Residency Program Director, Anesthesiology Institute and Associate Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Ave- E30, Cleveland, OH 44195. Electronic address: argalim@ccf.org.
authors.forename: Maged
authors.initials: M
authors.lastname: Argalious
authors.affiliation: Vice Chair for Education, Anesthesiology Institute and Chairman, Pediatric Anesthesiology, Pediatric Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue/P20, Cleveland, OH 44195. Electronic address: kimatis@ccf.org.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kimatian
authors.affiliation: Associate Staff Biostatistician, Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue/P77, Cleveland, OH 44195. Electronic address: maschae@ccf.org.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mascha
authors.affiliation: Biostatistician, Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195. Electronic address: makaron@ccf.org.
authors.forename: Natalya
authors.initials: N
authors.lastname: Makarova
authors.affiliation: Anesthesiology Resident, Department of General Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Electronic address: emnada@uams.edu.
authors.forename: Eman M
authors.initials: EM
authors.lastname: Nada
authors.affiliation: Assistant Professor of Anesthesiology Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Staff Anesthesiologist, Department of General Anesthesiology, 9500 Euclid Ave- E30, Cleveland, OH 44195. Electronic address: elsharh@ccf.org.
authors.forename: Hesham
authors.initials: H
authors.lastname: Elsharkawy
authors.affiliation: Anesthesiology Resident, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195. Electronic address: firoozf@ccf.org.
authors.forename: Farhad
authors.initials: F
authors.lastname: Firoozbakhsh
authors.affiliation: Vice Chair for Professional Development, Department of General Anesthesiology and Associate Professor of Anesthesiology Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Department of General Anesthesiology, 9500 Euclid Ave- E30, Cleveland, OH 44195. Electronic address: avitsir@ccf.org.
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
mesh_terms: D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D015331:Cohort Studies; D018592:Cross-Over Studies; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D016014:Linear Models; D016544:Patient Simulation; D018794:Problem-Based Learning; D011446:Prospective Studies
keywords: Anesthesia; Computer simulation; Education; Neuroanesthesia; Problem-based learning