Table 1.

Studies and Study Features Included in a Meta-Analysis of Articles Published from 1990 to 2010, Comparing the Effectiveness of Traditional Clinical Education with Simulation-Based Medical Education with Deliberate Practice (DP)

Research design and study	No. of participants	Intervention (with DP)	Competency assessed	Assessment
Randomized trials
1. Wayne et al, 2005²¹	38	Four standardized practice sessions with feedback on a patient simulator^*	Advanced Cardiac Life Support (ACLS)	Checklist scores on 6 simulated ACLS scenarios
2. Ahlberg et al, 2007²²	13	Practice with virtual reality simulator with feedback to proficiency demonstrated twice on six tasks^*	Laparoscopic cholecystectomy	Scoring matrix during 10 actual cholecystectomies
3. Andreatta et al, 2006²³	19	Practice with laparoscopic simulator until expert criterion levels demonstrated twice on six skills^*	Laparoscopic skills	Checklist scores on laparoscopic skills using porcine models
4. Korndorffer et al, 2005²⁴	17	Practice with a videotrainer suturing model until proficiency demonstrated 12 times^*	Laparoscopic suturing	Laparoscopic suturing scores in porcine models
5. Korndorffer et al, 2005²⁵	20	Practice using laparoscopic camera navigation simulator until expert level demonstrated on two consecutive attempts^*	Laparoscopic camera navigation	Laparoscopic suturing scores in porcine models
6. Van Sickle et al, 2008²⁶	22	Practice with virtual reality simulator and a box trainer until expert criteria achieved on two consecutive trials^*	Intracorporeal Suturing	Checklist scores of operative performance
Cohort studies
7. Issenberg et al, 2002²⁷	98	Five standardized practice sessions using a cardiology patient simulator with defined learning objectives^*	Cardiology bedside skills	Computerized assessment
8. Barsuk et al, 2009²⁸	18	Two practice sessions with feedback on a central line simulator^*	Hemodialysis catheter insertion	Checklist score on a simulated hemodialysis catheter insertion
9. Butter et al 2010²⁹	108	Standardized practice sessions and computer-based interactive self-tutorial until minimum passing standard achieved^*	Cardiac auscultation	Computerized assessment and patient examination
Case-control studies
10. Wayne et al, 2008³⁰	78	Standardized practice sessions with feedback on patient simulator until minimum passing standard achieved^*	ACLS	Medical record abstraction based on American Heart Association guidelines
Pre-post baseline studies
11. Wayne et al, 2008³¹	40	Standardized practice with feedback on a thoracentesis simulator until minimum passing standard achieved^†	Thoracentesis skills	Checklist score on a simulated thoracentesis procedure
12. Barsuk et al, 2009³²	41	Standardized practice sessions with feedback on a central line simulator until minimum passing standard achieved^†	Central venous catheter (CVC) insertion	Checklist score on a simulated CVC insertion
13. Barsuk et al, 2009³³	103	Standardized practice sessions with feedback on a central line simulator until minimum passing standard achieved^†	CVC insertion	Checklist score on a simulated CVC insertion
14. Stefanidis et al, 2006³⁴	18	Standardized practice sessions with feedback using a videotrainer on laparoscopic suturing and knot tying until proficiency was reached on two consecutive attempts^†	Laparoscopic suturing	Score on assessment of laparoscopic skills on videotrainer using time and accuracy

Comparison intervention: traditional clinical education.

^†

Comparison intervention: pre-intervention baseline.