Most LMIC simulation-based education studies testing significance demonstrate at least partial improvement in patient-level (Kirkpatrick Level 4) outcomes¶

Claim · All claims
Evidence · 1 study · quant-synthesis r2 · q3
Currency · newest study 2024 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q3 i? Of 81 studies that tested for statistical significance, 42 (52%) showed partial improvement and 19 (23%) showed complete improvement in Level 4 outcomes. → Robinson SJA 2024

Evidence¶

Robinson SJA 2024¶

Robinson SJA, Ritchie AMA, Pacilli M, Nestel D, McLeod E, Nataraja RM. (2024). Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review. Glob Health Sci Pract. https://doi.org/10.9745/GHSP-D-24-00187

q3 · i? · quant-synthesis · r2

Systematic review of 97 studies of SBE in LMICs, synthesized with descriptive statistics and narrative synthesis due to heterogeneity. The review reports that of the subset testing significance, "42 (52%) demonstrated a partial improvement in outcomes and 19 (23%) demonstrated a complete improvement." No pooled effect size was computed.

"Eighty-one studies tested for statistical significance (84%). Of this subset, 42 (52%) demonstrated a partial improvement in outcomes and 19 (23%) demonstrated a complete improvement."

Discussion¶

Related Claims¶

• Reporting of LMIC SBE initiatives is typically insufficient to judge against reporting standards, with minimal detail on design, prebriefing, debriefing, and educational factors — related
• Simulation-based education studies in pediatric and neonatal critical care more consistently report system-level process improvements (Level 4a) than significant direct patient-level outcome improvements (Level 4b) — related
• Evidence on transfer to clinical behavior and patient outcomes is scarce: only 2 studies reached Kirkpatrick level 3 and 1 reached level 4 — reports the opposite
• Competency-based simulation effects are large for skills measured in the simulation lab but small and non-significant for clinical behaviors and patient outcomes — related
• Helping Babies Breathe simulation training was associated with reduced neonatal mortality in LMIC facilities, but skills decayed within 4–6 months without maintenance — a narrower finding that bears on this claim
• No included SDL studies measured Kirkpatrick Level 4 (patient/system) outcomes — related
• Standardized SBE programs were more likely to improve outcomes than independent programs in LMICs (78% vs. 71%) — a narrower finding that bears on this claim