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Prospective Randomized Crossover Study of Telesimulation Versus Standard Simulation for Teaching Medical Students the Management of Critically Ill Patients.

  • Author(s): McCoy, C Eric;
  • Sayegh, Julie;
  • Rahman, Asif;
  • Landgorf, Mark;
  • Anderson, Craig;
  • Lotfipour, Shahram
  • et al.


The objective was to evaluate the comparative effectiveness of telesimulation versus standard simulation in teaching medical students the management of critically ill patients.


Prospective, randomized crossover study of 32 fourth-year medical students at a university medical simulation center. Students were randomized to the standard simulation (SIM) or telesimulation (TeleSIM) group between September 2014 and February 2015. The SIM group experience included participating in a live, fully immersive simulation case followed by debriefing with their SIM cohort and a live TV Internet connection to the TeleSIM group. The TeleSIM group experience included remotely observing the live simulation case at an off-site location, followed by a shared group debriefing via live TV Internet connection. Subject assessment was performed with a written evaluation tool. During a second instructional session, the students crossed over and participated in a different simulation scenario and assessment. Mean evaluation scores were calculated along with 95% confidence intervals (CIs) and were analyzed via linear regression. Our secondary outcome was a survey evaluating the perceptions and attitudes held between the two simulation modalities.


Of 33 eligible students, 32 participated in the study (97.0%). We found no significant difference in the mean evaluation scores of the two groups: SIM group mean = 96.6% (95% CI = 94.5%-98.6%) and TeleSIM group mean = 96.8% (95% CI = 94.8%-98.9%). We also found no significant difference in the favorability of teaching modality (TeleSIM vs. SIM) on the survey.


In our prospective randomized crossover study evaluating telesimulation versus standard simulation, we found no significant difference in evaluation scores among the two groups. There was also no significant difference found in the favorability of one teaching modality on a posteducational session survey. Our data support and highlight the capability of telesimulation to provide educational benefit to learners who do not have direct access to simulation resources.

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