Hybrid simulation helps students to engage more in a scenario than the use of patient simulators? The students’ perception

Introduction:
Simulation is not only about the use of patient simulators[1]. There are various modalities to engage students in simulated activities. This abstract explores the students’ perception of their responses to scenarios making use of either patient simulators (Laerdal SimMan/SimBaby) or simulated patients (tutor) with a pelvic model and basic infant mannequin. The latter combination can be referred to as hybrid simulation as it mixes two types of simulation[2].
Methods:
All students taking part in simulation sessions can complete a feedback questionnaire. This process has been granted ethical approval so the results can be analysed for research purposes and to inform our practice. For this enquiry only the 2008-09 feedback returned by undergraduate students from uniprofessional high-fidelity simulation sessions was analysed. The latter factor allows us to determine what type of patient was used for each discipline during their session (i.e. patient simulator or simulated patient) and ensures a comparable simulation experience. Scenarios for adult branch nursing and paramedic students made use of SimMan, while SimBaby was used with child branch nursing students. All sessions with only midwifery students made use of a simulated patient and an appropriately concealed part-task trainer to simulate the delivery.
Results:
The above inclusion criteria were met by 167 questionnaires. They included feedback from the following disciplines: Paramedics=9, Midwives=23, Child branch nurses=47, Adult branch nurses=88. The response rate cannot be determined. To find out if hybrid simulation helps students to engage more in a scenario than the use of patient simulators, the data was separated as “midwives” and “others”. Independent sample t-tests for equality of means were carried for each question. When asked if the scenarios prompted realistic responses from them on a 5-point Likert scale (1-5=strongly disagree to strongly agree), the midwives rated 3.78 (SD 0.90) and the others 3.71 (n valid=132, SD 0.96, P=0.74). When asked if the scenarios were realistic both groups respectively rated that question 4.52 (SD 0.99) and 4.19 (n valid 135, SD 0.98, P=0.14). When asked if they learnt from participating in their scenario they respectively responded 4.52 (SD 0.95) and 4.08 (SD 0.87, P=0.03). When asked if being observed by the tutors made them under-perform, they respectively answered 2.09 (SD 1.00) and 2.69 (n=132, SD 1.07, P=0.01)
Conclusions:
The results were often not statistically significant for the above questions probably due to the small sample of midwifery students. They however suggest that scenarios prompt equally realistic responses from the students irrespective of the type of patient modality used. The midwives rated the realism of their scenarios and their perceived learning benefits higher than the other students. The presence of their tutor did not seem to inhibit their performance. This is an encouraging result that shows the highly perceived teaching value of low-fidelity and relatively inexpensive technology over costly patient simulators. This study has however limitations as the responses are from students from different disciplines having taken part in different scenarios, and this is only the view of a small sample of students who voluntarily returned their feedback questionnaire.




Midwives n=23OthersIndependent sample t-test
The scenarios prompted realistic responses from me3.78
(SD 0.90)3.71 (SD 0.96) n=132P=0.74
The scenarios were realistic4.52
(SD 0.99)4.19 (SD 0.98) n=135P=0.14
I learnt from participating in my scenario4.52
(SD 0.95)4.08 (SD 0.87) n=135P=0.03
if being observed by the tutors made them under-perform2.09
(SD 1.00)2.69 (SD 1.07) n=132P=0.01