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SAGE Open Med. 2020 Mar 19;8:2050312120913451. doi: 10.1177/2050312120913451. eCollection 2020.

A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare.

SAGE open medicine

Daniel S Hippe, Rachel A Umoren, Alex McGee, Sherri L Bucher, Brian W Bresnahan

Affiliations

  1. University of Washington, Seattle, WA, USA.
  2. Indiana University School of Medicine, Indianapolis, IN, USA.

PMID: 32231781 PMCID: PMC7082864 DOI: 10.1177/2050312120913451

Abstract

Over the past two decades, there has been an increase in the use of simulation-based education for training healthcare providers in technical and non-technical skills. Simulation education and research programs have mostly focused on the impact on clinical knowledge and improvement of technical skills rather than on cost. To study and characterize existing evidence to inform multi-stakeholder investment decisions, we performed a systematic review of the literature on costs in simulation-based education in medicine in general and in neonatal resuscitation as a particular focus. We conducted a systematic literature search of the PubMed database using two targeted queries. The first searched for cost analyses of healthcare simulation-based education more broadly, and the second was more narrowly focused on cost analyses of neonatal resuscitation training. The more general query identified 47 qualified articles. The most common specialties for education interventions were surgery (51%); obstetrics, gynecology, or pediatrics (11%); medicine, nursing, or medical school (11%); and urology (9%), accounting for over 80% of articles. The neonatal resuscitation query identified five qualified articles. The two queries identified seven large-scale training implementation studies, one in the United States and six in low-income countries. There were two articles each from Tanzania and India and one article each from Zambia and Ghana. Methods, definitions, and reported estimates varied across articles, implying interpretation, comparison, and generalization of program effects are challenging. More work is needed to understand the costs, processes, and outcomes likely to make simulation-based education programs cost-effective and scalable. To optimize return on investments in training, assessing resource requirements, associated costs, and subsequent outcomes can inform stakeholders about the potential sustainability of SBE programs. Healthcare stakeholders and decision makers will benefit from more transparent, consistent, rigorous, and explicit assessments of simulation-based education program development and implementation costs in low- and high-income countries.

© The Author(s) 2020.

Keywords: Obstetrics/gynecology; cost analysis; cost-effectiveness; neonatal resuscitation; review; simulation; training

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Mr Hippe report

References

  1. Value Health. 2012 Sep-Oct;15(6):835-42 - PubMed
  2. Surgery. 2013 Feb;153(2):160-76 - PubMed
  3. PLoS One. 2014 Jul 09;9(7):e102080 - PubMed
  4. Semin Perinatol. 2016 Nov;40(7):438-446 - PubMed
  5. Global Health. 2017 Dec 06;13(1):88 - PubMed
  6. J Perinatol. 2014 Oct;34(10):781-6 - PubMed
  7. Creat Nurs. 2017 Aug 1;23(3):184-191 - PubMed
  8. Adv Med Educ Pract. 2016 Dec 23;8:11-19 - PubMed
  9. BMJ Glob Health. 2017 Sep 29;2(3):e000497 - PubMed
  10. Surg Oncol. 2011 Sep;20(3):134-9 - PubMed
  11. BMC Health Serv Res. 2016 Dec 1;16(1):681 - PubMed
  12. Indian J Public Health. 2017 Apr-Jun;61(2):92-98 - PubMed
  13. BMJ Open. 2016 Jun 02;6(6):e010192 - PubMed
  14. J Surg Educ. 2011 Nov-Dec;68(6):519-25 - PubMed
  15. J Vasc Interv Radiol. 2008 Feb;19(2 Pt 1):233-8 - PubMed
  16. PLoS One. 2016 Sep 22;11(9):e0161957 - PubMed
  17. Ann Surg. 2012 May;255(5):833-9 - PubMed
  18. Am Surg. 2015 Jul;81(7):747-52 - PubMed
  19. Simul Healthc. 2011 Dec;6(6):327-36 - PubMed
  20. J Urol. 2011 Jul;186(1):26-34 - PubMed
  21. Antimicrob Resist Infect Control. 2019 Mar 28;8:58 - PubMed
  22. Pediatrics. 2011 May;127(5):e1176-81 - PubMed
  23. Simul Healthc. 2015 Feb;10(1):31-7 - PubMed
  24. J Educ Eval Health Prof. 2016 Dec 26;13:44 - PubMed

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