Effectiveness of high- and low-fidelity simulation-based medical education in teaching cardiac auscultation: a systematic review and meta-analysis

Abstract

Simulation-based medical education (SBME) is an evolving method of teaching cardiac examination skills to healthcare learners. It has been deliberated how effective this teaching modality is and whether high-fidelity methods are more effective than low-fidelity methods. This systematic review aimed to assess the effectiveness of high-fidelity SBME in teaching cardiac auscultation compared with no intervention or another active teaching intervention (low-fidelity SBME) using evidence from randomized controlled trials (RCTs).Literature searches were performed on Medline, Embase, PsychInfo and Cinahl. RCTs that compared the effectiveness of high-fidelity simulation against no intervention or high-fidelity simulation against low-fidelity simulation in teaching cardiac auscultation to healthcare learners were included. Outcomes were knowledge, skills and satisfaction relating to cardiac auscultation education. Data were analyzed using Review Manager 5.3 software.Seventeen RCTs (n = 1055) were included. Twelve RCTs (n = 692) compared high-fidelity simulation with no intervention. The pooled effect sizes for knowledge and skills were 1.39 (95% confidence interval [CI], 0.39–2.38;This review’s findings suggest that high-fidelity SBME is an effective teaching method for cardiac auscultation education. Interestingly, there was no significant difference in knowledge or skills among learners when comparing high-fidelity simulation with low-fidelity simulation. Further research is needed to establish the effectiveness of different forms of SBME as educational interventions.