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      Comparison of high- and low equipment fidelity during paediatric simulation team training: a case control study


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          High-fidelity patient simulators in team training are becoming popular, though research showing benefits of the training process compared to low-fidelity models is rare. We explored in situ training for paediatric teams in an emergency department using a low-fidelity model (plastic doll) and a high-fidelity paediatric simulator, keeping other contextual factors constant. The goal was to study differences in trainees’ and trainers’ performance along with their individual experiences, during in situ training, using either a low-fidelity model or a high-fidelity paediatric simulator.


          During a two-year period, teams involved in paediatric emergency care were trained in groups of five to nine. Each team performed one video-recorded paediatric emergency scenario. A case control study was undertaken in which 34 teams used either a low-fidelity model (n = 17) or a high-fidelity paediatric simulator (n = 17). The teams’ clinical performances during the scenarios were measured as the time elapsed to prescribe as well as deliver oxygen. The trainers were monitored regarding frequency of their interventions. We also registered trainees’ and trainers’ mental strain and flow experience.


          Of 225 trainees’ occasions during 34 sessions, 34 trainer questionnaires, 163 trainee questionnaires, and 28 videos, could be analyzed. Time to deliver oxygen was significantly longer (p = 0.014) when a high-fidelity simulator was used. The trainees’ mental strain and flow did not differ between the two types of training. The frequency of trainers interventions was lower (p < 0.001) when trainees used a high-fidelity simulator; trainers’ perceived mental strain was lower (<0.001) and their flow experience higher (p = 0.004) when using high-fidelity simulator.


          Levels of equipment fidelity affect measurable performance variables in simulation-based team training, but trainee s’ individual experiences are similar. We also note a reduction in the frequency of trainers’ interventions in the scenarios as well as their mental strain, when trainees used a high-fidelity simulator.

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          Most cited references 23

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          I present an account of the origins and development of the multicomponent approach to working memory, making a distinction between the overall theoretical framework, which has remained relatively stable, and the attempts to build more specific models within this framework. I follow this with a brief discussion of alternative models and their relationship to the framework. I conclude with speculations on further developments and a comment on the value of attempting to apply models and theories beyond the laboratory studies on which they are typically based.
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              The science of training: a decade of progress.

              This chapter reviews the training research literature reported over the past decade. We describe the progress in five areas of research including training theory, training needs analysis, antecedent training conditions, training methods and strategies, and posttraining conditions. Our review suggests that advancements have been made that help us understand better the design and delivery of training in organizations, with respect to theory development as well as the quality and quantity of empirical research. We have new tools for analyzing requisite knowledge and skills, and for evaluating training. We know more about factors that influence training effectiveness and transfer of training. Finally, we challenge researchers to find better ways to translate the results of training research into practice.

                Author and article information

                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                18 October 2014
                : 14
                : 1
                [ ]Division of Anaesthesia and Intensive care, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, SE 141 86 Sweden
                [ ]Division of Orthopaedics and Biotechnology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, SE 141 86 Sweden
                [ ]Division of Paediatrics, Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, SE 141 86 Sweden
                [ ]Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden
                [ ]Department of Psychology, Umeå University, Umeå, Sweden
                © Meurling et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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