Wednesday, July 1, 2015

The relationship between cognitive-affective-behavioral components of attitude toward medical simulations

Stephen Cico, MD, MED
Sanford Health/Sanford USD Medical Center

Background: The use of simulation in medical education is increasing. High-fidelity simulation is being used in educating, evaluating, and accrediting professionals in all fields and at all levels of medicine, although it is expensive to incorporate this new technology in everyday use. There is concern in the medical community about the effectiveness of simulation and whether there is buy-in for this method of training. Students who have a positive attitude toward learning may benefit more from learning opportunities such as simulation, yet little is known about people’s attitude toward the new technology of high-fidelity simulation in the healthcare setting and how this may affect learning.

Design: This study was designed to assess whether there is a relationship between the cognitive, affective and behavioral components of attitude with regard to simulation; a positive attitude toward learning has been shown to improve involvement and learning from activities. The cognitive, affective, and behavioral components of attitude were assessed using a cross-sectional attitude survey of participants in simulations at Seattle Children’s Hospital, a regional quaternary-care hospital.
Results: 753 anonymous surveys were completed (452 by nurses, 245 by physicians, 56 other healthcare workers). There is a strong and statistically significant relationship between the cognitive, affective, and behavioral domains of attitude with regard to simulation. The majority of nurses and physicians had a very positive view of simulation, including being effective, useful and meeting expectations. Whether experienced or not, participants did not differ in their ability to treat the mannequin as a real patient, their belief in the usefulness and effectiveness of simulation, or their belief in simulation’s role in accreditation in pediatric medicine. People who had been involved in a greater number of simulations in the past were significantly more likely to want to attend more simulations than those who were less experienced with simulation (p <0.001).
Conclusions: There was an overall positive relationship between the cognitive, affective and behavioral components of attitude in our study sample. Physicians had a more positive view of simulation than did nurses in our study population. However, the overwhelmingly positive view of simulation and the overall positive relationship between the three domains of attitude and toward simulation stress the importance and acceptance of this mode of teaching among the particpants. Participants believe in the value of simulations and are able to suspend their disbelief and buy-in to the scenarios. Having clear goals and objectives tailored to the audience may increase the effectiveness of simulations in the medical setting.