International Journal of Healthcare Simulation

Background:

Between November 2020 and May 2021, 61 simulation sessions were run either face-to-face or remotely for foundation-level doctors and pre-registration pharmacists. A total of 346 participants attended. Thirty-three sessions were face-to-face (185 participants) and 28 were remotely via Microsoft Teams (161 participants). The content was the same for both modalities.

Aims:

The aim of the study was to discern whether there was a difference in learning points and confidence scores between face-to-face and remote participants.

Methods:

Participants were asked to rate their confidence (see Table 1) before and after the course. They were asked to provide their main learning points and what they gained from the course. Confidence scores were compared and assessed for change. Responses were compared between face-to-face and remote.

Table 1:

Confidence score change on Likert scale 1–5.

Q. no.	How confident do you feel…	Change
		F2F	REM
1	…that your clinical knowledge is appropriate for your role	+0.67	+0.89
2	… to manage a patient who is peri-arrest	+1.03	+1.27
3	…to manage a patient with a NEWS2 >7 and/or is deteriorating	+0.93	+1.23
4	…that you possess the skills required to communicate information to the rest of the MPT	+0.81	+0.83
5	… that you possess sufficient strategies to raise concerns when necessary	+0.51	+0.64

Results:

All participants reported increased confidence. Table 1 shows that the changes were comparable, with the changes in the remote participants all being marginally higher than in face-to-face. The distribution of learning points for remote and face-to-face participants was identical. For both modalities, the top two points were communication and escalation. The dominant theme in remote was escalation and communication in face-to-face. Remote participants were positive about the course, in their free-text responses, ‘most innovative use of technology I have seen during COVID’ and ‘My hands are sweating, I can’t believe how real that felt’ a common theme in the comments was that they would rather do the course face-to-face.

Implications for practice:

While not preferred, remote simulation appears to deliver equivalent learning and is a suitable alternative when face-to-face is impossible. The main difference seen was in communication skills, which is concurrent with Cheng et al. ^[1] related to the difficulties of communication in a virtual debriefing.