Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: A randomized trial

Purpose: The purpose of this study is to determine the effect of simulation-based education on the knowledge and skills of internal medicine residents in the medical intensive care unit (MICU). Methods and Materials: From January 2009 to January 2010, 60 first-year residents at a tertiary care teaching hospital were randomized by month of rotation to an intervention group (simulator-trained, n = 26) and a control group (traditionally trained, n = 34). Simulator-trained residents completed 4 hours of simulation-based education before their medical intensive care unit (MICU) rotation. Topics included circulatory shock, respiratory failure, and mechanical ventilation. After their rotation, residents completed a standardized bedside skills assessment using a 14-item checklist regarding respiratory mechanics, ventilator settings, and circulatory parameters. Performance of simulator-trained and traditionally trained residents was compared using a 2-tailed independent-samples t test. Results: Simulator-trained residents scored significantly higher on the bedside skills assessment compared with traditionally trained residents (82.5% +/- 10.6% vs 74.8% +/- 14.1%, P = .027). Simulator-trained residents were highly satisfied with the simulation curriculum. Conclusions: Simulation-based education significantly improved resident knowledge and skill in the MICU. Knowledge acquired in the simulated environment was transferred to improved bedside skills caring for MICU patients. Simulation-based education is a valuable adjunct to standard clinical training for residents in the MICU. (C) 2012 Elsevier Inc. All rights reserved.