Prioritize larger sample sizes, multicentre designs, and rigorous reporting in future simulation-based CRM transfer and patient-outcome research¶

Strategy · All strategies
Evidence · no claims cited

Description¶

The review's forward-looking research recommendations: moving forward, "larger sample sizes, more multicentre studies, and studies with less risk of bias are required to provide a precise measure of the effect that simulation-based education has on healthcare provider skills in the workplace and patient outcome." The authors also suggest the simulation community commit to rigorous research reports, that researchers consider risk of bias at an early stage when designing the protocol, and that larger and multicentre studies could balance the risk of contamination. They identify frequency of retraining, skill retention, and instructional design as research priorities for Level 3 and 4 outcomes, call for universally recognized rigorous assessment tools, and suggest future research explore the cost-effectiveness of simulation CRM training.

Design Implications¶

Context¶

Requirements¶

• Study designs examining patient-outcome improvements require larger sample sizes and a control group; only an RCT with a control group could show that the teaching intervention is the reason for better survival

Constraints¶

• It may be challenging to design studies on simulation-based CRM without risk of bias when investigating transfer of learning to the workplace and patient outcome, since in complex organizations it is very difficult to ensure risk of contamination is nonexistent and intervention is independent of other changes

Target Learners¶

• Healthcare providers across acute care specialties at all levels of practice, from trainees to staff

Target Learning Goals¶

• Transfer of CRM skills to the workplace and improvement of patient outcomes following simulation-based CRM training

Related Strategies¶

• Future simulation research should use rigorous designs, standardized tools, and transparent reporting
• Prioritize rigorous RCTs with retention tests and transfer measures before expanding distance simulation programs
• Future HFS trials for practising nurses need larger samples, rigorous randomised design and standardised, fully reported measures
• Future active-learning research should use randomised controlled designs with larger samples and standardised outcome measures
• Prioritise adequately powered multicentre comparative studies linked to objective metrics and clinical correlation, and develop standardised competency assessment frameworks

Examples¶

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Key Sources¶

• Boet Sylvain, Bould M. Dylan, Fung Lillia, Qosa Haytham, Perrier Laure, Tavares Walter, Reeves Scott, Tricco Andrea C. (2014). Transfer of learning and patient outcome in simulated crisis resource management: a systematic review. Canadian Journal of Anaesthesia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028539/