Comparison of high- and low-fidelity mannequins for clinical performance assessment


  • Kenneth Lee, MB BS, MBus, FACEM, FJFICM, Clinical Associate Lecturer University of Adelaide and ICU Consultant; Hugh Grantham, MB BS, FRACGP, Medical Director South Australian Ambulance Service; Russell Boyd, BsC, MBChB, MRCP(UK), FFAEM, FACEM, Emergency Department Director.

  • Study location: Lyell McEwin Health Service, Haydown Road, Elizabeth Vale 5112, South Australia.

Dr Kenneth Lee, Intensive Care Unit, The Queen Elizabeth Hospital, Woodville Road, Woodville South, SA 5011, Australia. Email:


Objective:  A pilot study exploring the differences between high- and low-fidelity mannequins in the assessment of clinical performance.

Methods:  Standardized clinical scenarios were used to test 12 intensive care paramedics (ICP). Each ICP was randomly assigned to a scenario using either a high-fidelity (SimMan) or low-fidelity mannequin (Laerdal Heart Start 2000), followed by a crossover assessment using the alternative scenario. We examined both the objective and subjective outcomes. Objective performance was assessed by three independent assessors, all accredited Advanced Paediatric Life Support instructors. Subjective outcomes were measured by assessment questionnaires and a rating scale.

Results:  The overall proportion that passed the high-fidelity mannequin scenario was 0.47 compared with 0.58 in the low-fidelity mannequin scenario. The difference was −0.11 (95% CI −0.32–0.11). The subjective outcomes were charted and presented within the article. The ICP preferred the use of high-fidelity mannequin for assessment purpose.

Conclusion:  There was no significant objective difference between the two mannequins.