Curriculum Innovations: How Real Is Real Enough? A Pilot Study Comparing Standardized Patients vs Manikin Simulators in a Neurologic Emergencies Training Course

Article (Faculty180)

cited authors

  • Malaiyandi, Deepa; Albin, Catherine SW; Petrusa, Emil; Gordon, James A; Zafar, Sahar F


  • Abstract <p>Background and Objectives Simulation training has been increasingly adopted in neurology as an engaging way to promote active learning in a safe environment while offering a reproducible platform for real-time feedback. However, despite the increase in simulation programs, there remains uncertainty about which type of high-fidelity platform would best promote trainee knowledge and confidence acquisition. The objective of this study is to investigate whether increases in resident knowledge and confidence differ when a simulation course for acute neurology emergencies uses a standardized patient vs a manikin-video format. We also investigated trainees' management deviations from the treatment guidelines.</p> <p>Methods Over 5 sessions, 20 junior neurology residents participated in a simulation training course in which they managed 3 neurologic emergencies: right middle cerebral artery stroke, status epilepticus, and pontine hemorrhage causing coma. Residents in the standardized patient group interacted with a live actor for the cases in which the patient was conscious. Residents in the manikin-video group interacted with a manikin for all 3 cases. Before and after the course, residents completed a 40-question multiple-choice test and a survey about their self-perceived confidence in handling 15 neurologic emergencies. To create an element of internal validity, 9 items were represented in the course curriculum and 6 were not. During the simulation, a detailed behavior checklist was used to assess decision-making and guideline adherence. All residents answered items about the educational quality of the simulation sessions.</p> <p>Results Residents had significantly higher scores on the knowledge assessment after the training session (pre: 49% vs post: 72%, p < 0.001, effect size 91%). There was no statistically significant difference between the 2 groups—each increasing 23% (p = 0.977). Regardless of group assignment, the median self-reported confidence score improved by 1 point on a Likert scale across the topics taught in the course. The behavior checklist demonstrated significant variations in treatment practices and provided targeted areas for feedback and teaching.</p> <p>Discussion This pilot study suggests that trainees' knowledge and confidence in the management of neurologic emergencies increase after simulated encounters, regardless of whether a live actor or manikin simulation platforms is used. The use of a behavior checklist uncovered important variations in guideline adherence among novice physicians.</p>

publication date

  • 2022

published in


  • 1