Original CommunicationCost: The missing outcome in simulation-based medical education research: A systematic review
Section snippets
Methods
This review was planned, conducted, and reported in adherence to PRISMA standards of quality for reporting systematic reviews.6 Our methods have been described in detail previously2; we focus this description on methods unique to the present study.
Trial flow
We identified 10,903 potentially relevant articles (Figure). From these, we identified 967 comparative studies of simulation training, of which 59 studies (6.1%) quantified costs involved with simulation training and 15 (1.6%) reported a cost comparison with another instructional modality. These 15 studies, enrolling 1,154 trainees, constitute the main focus of this study, though all 59 cost-reporting studies were used to determine the cost-components. Table I summarizes key features of the 15
Discussion
Evidence shows that SBME improves learner outcomes compared with no intervention2 and other educational activities.27 However, the cost entailed in achieving these outcomes is less clear. Fewer than 2% of the studies identified in our literature search reported information regarding the comparative costs associated with simulation training and other educational options. Even among these studies, cost accounting generally involved only 1 or 2 components and thus may fail to reflect the complete
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Supported by intramural funds, including an award from the Division of General Internal Medicine, Mayo Clinic.