Study of Virtual Simulated Resuscitation in Junior Clinicians

Plain-language summary

The investigators seek to examine the impact of virtual patient simulation on junior clinicians' resuscitation skills in an academic emergency department. Exposure to real life resuscitation cases is opportunistic, with variation in case mix across different junior clinicians. Junior clinicians are closely supervised during resuscitations, with limited independence to make decisions, for patient safety. High fidelity simulation, such as in-situ mock codes with a high fidelity manikin, is resource intensive. Constraints in facilitator and learner time and manpower reduce the feasibility of holding large numbers of simulations for large numbers of learners, leading to limited breadth of case mix exposure in simulation cases. Virtual patient simulation may allow greater and more uniform breadth of exposure and allow automated feedback and rapid cycle deliberate practiceacross a wide range of cases, with reduced resource intensiveness, and prepare them to better utilise limited opportunities for resuscitation during real life or high fidelity simulation. Virtual simulators have been found to be useful for improving skills rather than knowledge or attitudes in health professions education. Such skills include communication, radiograph interpretation, dermatological diagnosis, and cardiac arrest procedures. What is not known is: 1. Whether going directly to in-situ simulation with a high fidelity manikin is the best learning approach for resuscitation, given its potentially detrimental high cognitive load, compared to going first to virtual patient simulation. 2. Whether the benefits of virtual simulation extend beyond cardiac arrest and to other resuscitation scenarios, such as trauma, sepsis, and others. The investigators' hypothesis is that in junior clinicians in the emergency department who have received didactic materials in trauma and sepsis resuscitation, proceeding next to learning by virtual patient resuscitation simulation is associated with improved scores in resuscitation performance for trauma and sepsis, as measured by checklists of required actions during observed in-situ simulation with a high-fidelity manikin, compared to proceeding next to learning by team-based in-situ simulation with a high fidelity manikin. This pilot study aims to determine the feasibility of a randomised controlled trial to test the above hypothesis.

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