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Knowledge transfer and retention of simulation-based learning for neurosurgical instruments: a randomised trial of perioperative nurses
  1. David B Clarke1,2,
  2. Alena I Galilee1,
  3. Nelofar Kureshi1,
  4. Murray Hong1,
  5. Lynne Fenerty1,
  6. Ryan C N D’Arcy3,4
  1. 1 Division of Neurosurgery, Dalhousie University, Halifax, Canada
  2. 2 Brain Repair Centre, Dalhousie University, Halifax, Canada
  3. 3 Health Sciences and Innovation, Surrey Memorial Hospital, Surrey, Canada
  4. 4 Faculty of Applied Sciences, Simon Fraser University, Burnaby, Canada
  1. Correspondence to David B Clarke, Division of Neurosurgery, Dalhousie University, 1796 Summer Street, Halifax NS B3H 3A7, Canada; d.clarke{at}


Introduction Previous studies have shown that simulation is an acceptable method of training in nursing education. The objectives of this study were to determine the effectiveness of tablet-based simulation in learning neurosurgical instruments and to assess whether skills learnt in the simulation environment are transferred to a real clinical task and retained over time.

Methods A randomised controlled trial was conducted. Perioperative nurses completed three consecutive sessions of a simulation. Group A performed simulation tasks prior to identifying real instruments, whereas Group B (control group) was asked to identify real instruments prior to the simulation tasks. Both groups were reassessed for knowledge recall after 1 week.

Results Ninety-three nurses completed the study. Participants in Group A, who had received tablet-based simulation, were 23% quicker in identifying real instruments and did so with better accuracy (93.2% vs 80.6%, p<0.0001) than Group B. Furthermore, the simulation-based learning was retained at 7 days with 97.8% correct instrument recognition in Group A and 96.2% in Group B while maintaining both speed and accuracy.

Conclusion This is the first study to assess the effectiveness of tablet-based simulation training for instrument recognition by perioperative nurses. Our results demonstrate that instrument knowledge acquired through tablet-based simulation training results in improved identification and retained recognition of real instruments.

  • Education
  • Knowledge transfer
  • Nursing
  • Simulation based learning

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  • Contributors DBC, AIG, NK, LF, MH and RCND contributed to study conception and design, acquisition of data and analysis of data. DBC, AIG, NK, MH and RCND were involved in drafting the manuscript. All authors approved the final version of the manuscript to be published. DBC and RCND are guarantors of the work.

  • Funding This study was supported by Dalhousie University’s Brain Repair Center Knowledge Translation Grant (2015) awarded to Dr David Clarke.

  • Competing interests DBC and RCND are members of the medical advisory board and stock option holders with Conquer Experience. The authors have no financial relationships with Conquer Experience that may have influenced the submitted work; specifically, the authors did not receive research funding or financial compensation from Conquer Experience for this study. Furthermore, study conception, study design, acquisition of data, statistical analysis, interpretation and drafting of the manuscript were performed independently by the research team without participation from Conquer Experience. No one from Conquer Experience has seen, or participated in, any part of the writing of the manuscript.

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

  • Data availability statement Data are available upon reasonable request.

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