Simulation-Based Instruction in Continuing Education

Context: The results of this study will provide direction for integrating simulation into continuing professional education (CPE) for athletic trainers (ATs). Objective: Compare the effects of 2 simulation techniques on knowledge and skill acquisition of a cardiovascular assessment. Design: Randomized pretest-posttest design. Setting: Continuing professional education course hosted at a simulation center. Patients or Other Participants: Athletic trainers recruited to a CPE course. Twenty-two (age 22-49) of 30 ATs attended, consented, and completed the course. Participants were randomly assigned to a high-fidelity (12 participants) or low-fidelity (10 participants) group. Intervention(s): High-fidelity and low-fidelity simulation. Main Outcome Measures(s): A 31-question knowledge examination and a 4-station objective structured clinical examination (OSCE) measured knowledge and clinical skills, and specifically the ability to identify heart sounds as part of a comprehensive cardiovascular assessment. Results: From pretest to posttest, all participants significantly improved knowledge (P < 0.001), clinical skills (P < 0.001), and heart-sound identification skill (P = 0.010). The high-fidelity group scored significantly higher (P = 0.48) than the low-fidelity group on the clinical skills portion of the OSCE. Conclusions: Both simulation types can be used in CPE courses for ATs to reinforce the knowledge and skills that are a part of a cardiovascular assessment. High-fidelity simulation improved skill more than low-fidelity simulation because of the active nature of the intervention. Baseline scores were low, thereby strengthening the value to offer CPE to ATs specifically on the elements of conducting a comprehensive cardiovascular assessment. Adding a pretest can help identify knowledge and skill deficits before CPE participation.