Simulcast Journal Club is a monthly series heavily inspired by the ALiEM MEdIC Series. It aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education. Each month we will publish a case and link a paper with associated questions for discussion. We will moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field.
Title : “The Theory of Evolution”
The Case :
Brad was furious.
That meeting should have been a triumph. All year he had worked hard at establishing a simulation program for the Intensive Care Unit. He had trained simulation faculty, found sponsorship to fund the purchase of two mannequins, converted the spare bed space to a sim lab and developed a curriculum for the junior doctors rotating through ICU. And today’s presentation to the other consultants was supposed to be a celebration of how far the program had come.
But yet again, his snarky colleagues couldn’t resist the temptation to cut him down.
“What’s the evidence any of this works?” Dr Snythe had snidely asked. “As far as I can see, the educational research that’s out there is a bunch of opinion pieces and inconsistently reported RCTs. With the money you got for those damn mannequins, we could have hired 2 more nurses to provide actual patient care!”
“What’s the evidence you do anything besides drink coffee on your non clinical shifts?” Brad had wanted to retort, but fortunately his frontal lobe had engaged at that point.
Well he’d show them.
Brad had been collecting data for 12 months prior to rolling out the sim program. He was armed with a swathe of Likert scales and survey responses and results from the junior doctors Advanced Life Support assessments. With the help of a keen epidemiology student at the local university, Brad was going to reassess the junior doctors this year in the same format. While they continued to attend their regular education program, Brad was certain that his survey outcomes would be better this year, and he had the staff numbers to hit a pretty decent p value.
Given his experience in clinical RCTs, Brad was confident his reporting standards would be exemplary, and publication would be likely.
“Can’t wait to see Synthe’s face when I finally prove this.” thought Brad.
Sometimes, success was the best revenge.
The Article :
“Reporting Guidelines for Health Care Simulation Research: Extensions to the CONSORT and STROBE Statements” – Cheng A, Kessler D, Mackinnon R, Chang TP, Nadkarni VM, Hunt EA, Duval-Arnould J, Lin Y, Cook DA, Pusic M, Hui J, Moher D, Egger M, Auerbach M; International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) Reporting Guidelines Investigators.
As simulation educators who see the fruits of our educational labours on a frequent basis, it can seem a foregone conclusion that simulation is an incredibly valuable teaching tool. But creating a strong evidence base to prove that has been a bigger challenge. For clinicians used to evaluating pharmaceutical RCTs, contributing and evaluating simulation research requires a surprisingly different skillset.
In August this year, Cheng et al published a series of standards and guidelines for reporting on simulation in research. The publication has been hailed as “A Joint Leap into a Future of High-Quality Simulation Research” and as such is an important read for simulation educators, both for those planning to contribute to simulation research and those wishing to be able to critique and assess the published literature.
This is a somewhat more ‘dry’ article than other articles we’ve run on journal club, but it’s critically important piece to be informed about and we look forward to your thoughts and reflections on the article.
Please comment below. Here are some questions to get you started:
- What advice would you have for Brad about engaging in his first foray into simulation research? What do you wish you knew before you started on a similar pathway?
- What issues have you had interpreting simulation literature?
- Do you have a structured approach to educational literature? How has this paper effected your approach to critical analysis of simulation literature?
- Cheng A, Kessler D, Mackinnon R, Chang TP, Nadkarni VM, Hunt EA, Duval-Arnould J, Lin Y, Cook DA, Pusic M, Hui J, Moher D, Egger M, Auerbach M; International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) Reporting Guidelines Investigators. Reporting Guidelines for Health Care Simulation Research: Extensions to the CONSORT and STROBE Statements. Simul Healthc. 2016 Aug;11(4):238-48. doi: 10.1097/SIH.0000000000000150.
- Sevdalis, Nick PhD; Nestel, Debra PhD; Kardong-Edgren, Suzan PhD, RN, ANEF, CHSE, FAAN; Gaba, David M. MD; A Joint Leap into a Future of High-Quality Simulation Research—Standardizing the Reporting of Simulation Science. Simul Healthc. 2016 Aug;11(4):236-37. doi: 10.1097/SIH.0000000000000179