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Comparing the effectiveness of a hybrid simulation/lecture session versus simulation alone in teaching crew resource management (CRM) skills: a randomised controlled trial
  1. Roberto L Mempin,
  2. Wendy M Simon,
  3. Jason D Napolitano,
  4. Rachel P Brook,
  5. Owen L Hall,
  6. Sitaram Vangala,
  7. Edward S Lee
  1. Department of Internal Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
  1. Correspondence to Dr Roberto L Mempin, Department of Internal Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90095, USA; rmempin{at}


Introduction Various methods have been used to teach crew resource management (CRM) skills, including high-fidelity patient simulation. It is unclear whether a didactic lecture added on to a simulation-based curriculum can augment a learner’s education.

Methods Using an already existing simulation-based curriculum for interdisciplinary teams composed of both residents and nurses, teams were randomised to an intervention or control arm. The intervention arm had a 10 min didactic lecture after the first of three simulation scenarios, while the control arm did all three simulation scenarios without any didactic component. The CRM skills of teams were then scored, and improvement was compared between the two arms using general estimating equations.

Results The differences in mean teamwork scores between the intervention and control arms in scenarios 2 and 3 were not statistically significant. Mean scores in the intervention arm were lower than in the control arm (−0.57, p=0.78 for scenario 2; −3.12, p=0.13 for scenario 3), and the increase in scores from scenario 2 to 3 was lower in the intervention arm than in the control arm (difference in differences: −2.55, p=0.73).

Conclusions Adding a didactic lecture to a simulation-based curriculum geared at teaching CRM skills to interdisciplinary teams did not lead to significantly improved teamwork.

  • crew resource management (CRM) skills
  • medical education
  • simulation
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  • Contributors RLM and ESL conceived the idea, designed the study and organised the simulation sessions. RLM, WMS, JDN, RPB and ESL reviewed the simulations and scored the CRM skills of each team. OLH and SV devised the data analysis and performed the computations. RLM and ESL wrote the manuscript with input from all the authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval UCLA Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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