A Randomized Comparison Trial of Case-based Learning versus Human Patient Simulation in Medical Student Education
Article first published online: 28 JUN 2008
© 2007 Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 14, Issue 2, pages 130–137, February 2007
How to Cite
Schwartz, L. R., Fernandez, R., Kouyoumjian, S. R., Jones, K. A. and Compton, S. (2007), A Randomized Comparison Trial of Case-based Learning versus Human Patient Simulation in Medical Student Education. Academic Emergency Medicine, 14: 130–137. doi: 10.1197/j.aem.2006.09.052
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received July 21, 2006; Received Revised September 13, 2006; Received Revised September 20, 2006; Accepted September 21, 2006
- medical education;
- randomized-comparison trial
Human patient simulation (HPS), utilizing computerized, physiologically responding mannequins, has become the latest innovation in medical education. However, no substantive outcome data exist validating the advantage of HPS. The objective of this study was to evaluate the efficacy of simulation training as compared with case-based learning (CBL) among fourth-year medical students as measured by observable behavioral actions.
A chest pain curriculum was presented during a one-month mandatory emergency medicine clerkship in 2005. Each month, students were randomized to participate in either the CBL-based or the HPS-based module. All students participated in the same end-of-clerkship chest pain objective structured clinical examination that measured 43 behaviors. Three subscales were computed: history taking, acute coronary syndrome evaluation and management, and cardiac arrest management. Mean total and subscale scores were compared across groups using a multivariate analysis of variance, with significance assessed from Hotelling's T2 statistic.
Students were randomly assigned to CBL (n= 52) or HPS (n= 50) groups. The groups were well balanced after random assignment, with no differences in mean age (26.7 years; range, 22–44 years), gender (male, 52.0%), or emergency medicine preference for specialty training (28.4%). Self-ratings of learning styles were similar overall: 54.9% were visual learners, 7.8% auditory learners, and 37.3% kinetic learners. Results of the multivariate analysis of variance indicated no significant effect (Hotelling's T2 [3,98] = 0.053; p = 0.164) of education modality (CBL or HPS) on any subscale or total score difference in performance.
HPS training offers no advantage to CBL as measured by medical student performance on a chest pain objective structured clinical examination.