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0217 A Review Of The Literature Concerning The Use Of High-fidelity Simulation For Teaching Basic Sciences In A Pre-clinical Curriculum
  1. David Cox1,2
  1. 1Durham University School for Medicine Pharmacy and Health, Stockton-on-Tees, UK
  2. 2Aintree University Hospital NHS Trust, Liverpool, UK


Background/context High-fidelity simulation (HFS) is in widespread use throughout medical education for skills and professional training. A growing body of literature investigates the use of high-fidelity simulation in teaching in the cognitive domain for junior medical students. There is debate over the true effectiveness of this application of HFS, often in relation to its cost. Is HFS just a flashy tool or can it enhance the curriculum in this setting?

Methods A review of journal articles presenting primary data was conducted using a systematic search protocol and predefined inclusion criteria. Outcomes included could be qualitative or quantitative, describing any element of the learning process.

Results 20 papers were appraised. Outcomes measured were performance on written tests, quantitative and qualitative student evaluations. Large and small group teaching in cardiovascular, respiratory and neurophysiology were described. One paper described teaching of anatomy.

Outcomes The existing literature is patchy and subject to bias of study design and implementation in some cases. Key findings are that high-fidelity simulation improves learning of basic sciences to a level comparable to other modalities. Very little evidence suggests it improves performance on written tests beyond this, except when modalities are combined.

Conclusion High-fidelity simulation demonstrates efficacy in this educational context, although judgments must be made with the current evidence in light of resource implications. The practice should be investigated longitudinally and different outcome measures must be developed to capture long term effects.


  1. De Giovanni D, et al. (2009). "Relative effectiveness of high- versus low-fidelity simulation in learning heart sounds." Medical Education 43(7): 661–668

  2. Euliano TY. "Small group teaching: clinical correlation with a human patient simulator." Advances in Physiology Education 2001;25(1-4): 36–43

  3. Fitch MT. "Using high-fidelity emergency simulation with large groups of preclinical medical students in a basic science course." Medical Teacher 2007;29(2-3): 261–263

  4. Wenk M, et al. "Simulation-Based Medical Education Is No Better than Problem-Based Discussions and Induces Misjudgment in Self-Assessment." Advances in Health Sciences Education 2009;14(2): 159-171.f

  • Category: Course or curriculum evaluation/innovation/integration

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