The minimal relationship between simulation fidelity and transfer of learning
Article first published online: 23 MAY 2012
© Blackwell Publishing Ltd 2012
Volume 46, Issue 7, pages 636–647, July 2012
How to Cite
Norman, G., Dore, K. and Grierson, L. (2012), The minimal relationship between simulation fidelity and transfer of learning. Medical Education, 46: 636–647. doi: 10.1111/j.1365-2923.2012.04243.x
- Issue published online: 12 JUN 2012
- Article first published online: 23 MAY 2012
- Received 28 September 2011; editorial comments to authors 11 November 2011; accepted for publication 5 January 2012
Medical Education 2012
Context High-fidelity simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between simulator fidelity and learning, and whether comparable gains might be achieved at substantially lower cost.
Objectives This analysis was conducted to review studies that compare learning from high-fidelity simulation (HFS) with learning from low-fidelity simulation (LFS) based on measures of clinical performance.
Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation.
Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%.
Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.