Table 1.

Simulation-based educational interventions

Study	Subjects	Intervention	Control group	Performance measure	Intervention sample	Control sample	Comparison of control versus intervention	Significance
Woodworth et al13	Residents and consultant anesthesiologists	Teaching video with interactive simulation	Sham video	Written test, live model scanning, and identification of sciatic nerve	16	7	Mean post-intervention written test scores in intervention group greater than control group	P<0.01
							No difference in posttest live- model scanning Intervention group improved confidence No difference in time to perform ultrasound scan of sciatic nerve	P<0.05
Udani et al14	Resident anesthesiologists	Deliberate practice training in simulation	Conventional training excluding simulation	Block performance in simulation and time to place clinical block	11	10	Greater increase in checklist score in intervention group versus control group No difference in time performing block in clinical setting	P<0.03
Niazi et al15	Resident anesthesiologists	1 hour simulation training on needling and proper hand–eye coordination	Conventional training excluding simulation	Clinical block success	10	10	Intervention group had more successful blocks than control group	P=0.02
							Intervention group reached proficiency more than control group (80% versus 40%)	P=0.08
Moore et al16	Resident pediatric anesthesiologists	Comprehensive curriculum (ie, didactics, apprenticeship, and simulations)	None	Written test and block performance in simulation	9	N/A	Written test score improvement over 12 months	P<0.01
							No improvement in block accuracy	P=0.08
							No improvement in block efficiency	P=0.12
Gasko et al17	Student nurse anesthetists	Combination of CD-ROM and simulation teaching	Simulation or CD-ROM teaching alone	Ultrasound scan of cadaver in simulation	7	11 (simulation alone), 11 (CD- ROM alone)	Combination teaching better at increasing scanning performance than CD-ROM or simulation alone	P<0.05
							No difference in scanning between CD-ROM and simulation alone groups	P>0.05
Garcia-Tomas et al18	Resident anesthesiologists	Comprehensive curriculum (ie, anatomy workshop, live model scanning, simulated scenarios, and didactics)	None	Written test and objective structured clinical examination (OSCE)	56		Post-intervention written test scores improved	P<0.01
							Post-intervention OSCE scores improved	P<0.01
Friedman et al19	Resident anesthesiologists	High-fidelity epidural simulator use	Low-fidelity model use	Clinical epidural block assessed by checklist and global rating scale	12	12	No difference in checklist score	P=0.29
							No difference in global rating score	P=0.09
Baranauskas et al20	Resident anesthesiologists	2 hours of simulation training	1 hour of simulation training or 0 hours of simulation training	Needling with ultrasound in simulation	3	3 (1 hour of simulation), 3 (0 hour of simulation)	Students with 2 hours of simulation training performed faster and with less technical flaws than students with 1 hour and 0 hours of simulation training	Not provided
Ouanes et al21	Resident anesthesiologists	Comprehensive curriculum (ie, anatomy lab, simulation on phantom models, high- fidelity scenarios, nerve stimulator techniques, oral board prep, journal club, PBLD, web-based lectures, clinical log, and lab research)	None	Written test and OSCE	Not reported	N/A	Post-intervention written test scores improved	P<0.05
							Post-intervention scores improved	P<0.05
Liu et al22	Resident anesthesiologists	Opaque phantom model use	Clear phantom model or olive-in- chicken phantom model use	Block performance in simulation	12 Opaque model	12 clear model; 12 olive-in- chicken model	Decreased number of errors with each attempt in simulation
							Decreased time to task completion with each attempt in simulation	P<0.05
							All participants agreed or strongly agreed that model could be used for teaching and enhancing skill of UGRA
Kim et al23	Medical students	Phantom model use	None	Time to block in simulation	18	None	Reduction in time to perform block after fifth trial	P<0.01
							Improved block quality after fifth trial	P<0.01
Cheung et al24	Undergraduate students	Simulation training	None	Needle targeting task in simulation	26	None	Less feedback was required after simulation training occurred No difference in needle passes	P<0.01
Bretholz et al25	Pediatric emergency medicine consultants	Comprehensive curriculum (ie, web-based and simulation-based instruction)	None	Questionnaires documenting comfort level and intention to use ultrasound-guided nerve block techniques	11	None	Comfort with ultrasound- guided nerve block increased immediately after course
							Intention to use ultrasound- guided nerve block increased immediately after course	Only for ulnar block (P=0.01) but not femoral block (P=0.16)
							No sustained increase in comfort nor intention to use ultrasound- guided nerve block 1 month after course
Brenner et al26	Interdisciplinary (pain management consultants, fellows, residents, nurses, and technicians)	Crisis resource management course in pain medicine	None	Satisfaction survey	68 Physicians and four non-Physicians	None	Trainees recommended repeated course every 6 months Consultant physicians recommended repeating course every 1–2 years Interprofessional debriefings led to richer discussions

Abbreviations: N/A, not applicable; PBLD, Problem Based Learning Discussion; UGRA, Ultrasound-Guided Regional Anesthesia.