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“What happens if a big asteroid hits Earth? Judging from realistic simulations involving a sledgehammer and a common laboratory frog, we can assume it will be pretty bad.”

-Dave Barry


  • Discuss the primary areas of study in which simulation-based education has been the focus.

  • Discuss the translation of findings from simulation-based research to the bedside.

  • Discuss the design and implementation of simulation-based research.

  • Understand the nuances of simulation-based training for participants when research is involved.

Not all simulation-based interventions produce a straightforward outcome. Despite numerous published studies that indicate the benefit of simulation-based education (SBE), the question “Where is the evidence that simulation makes a difference in learning or patient outcomes?” remains common. Measurements in simulation and dissemination of findings provide pieces of a fuller picture of how SBE affects learning and patient outcomes. This chapter provides a framework for educators who want to explore research and SBE.

Research on Simulation-Based Education

The strength of SBE is its ability to provide learners with opportunities for repetitive practice and timely feedback in settings where actual patients cannot be harmed. Research on SBE activities is needed to justify the implementation of time- and resource-intensive simulation-based curricula. Although practitioners of SBE may have extensive experience with simulation as a teaching tool, experience and knowledge of research are less common. Research provides a structured framework and methodology to measure whether interventions have an actual effect and to identify best practices for integrating simulation into health profession education (Hatala & Cook, 2019).

The published literature for a given subject, including SBE, can be divided into primary and secondary literature. Published studies on a given topic constitute the primary literature in the field. These single studies are foundational to the evolution of both research and curriculum development. Any individual study, however, reveals only a limited part of the general effectiveness of SBE. For this reason, experts periodically publish secondary literature, or reviews of single studies/primary literature. There are several types of secondary literature reviews, all of which summarize the current state of understanding on a specific topic.

Key Terms

The following terms are commonly used when describing research.

  • Human subject: A living person about whom a researcher collects either 1) data through interaction or intervention with the person or 2) identifiable information.

  • Reliability: The extent to which a measure is reproducible in other settings.

  • Validity: The extent to which the observed measurement truly measures the outcome or the characteristic it is attempting to measure.

Kane's Validity Framework

Whether you are trying to understand advantages and pitfalls of simulation to create your own SBE or are looking to design your own simulation-based research, a review of existing literature is an essential step to guiding development. A framework may be helpful when interpreting current published research on simulation-based education.

Although it is not the ...

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