AHRQ Commentary: Simulation-Based Training More Effective Than Traditional Methods

Simulation-based learning is a more effective way for trainees to acquire expertise and competency at performing bedside procedures than the traditional “see one, do one, teach one” approach, according to the author of a commentary from the July 2012 edition of the Agency for Healthcare Research and Quality’s (AHRQ) online case study review, WebM&M. In the spotlight case, a 67-year-old woman with a history of cirrhosis who recently underwent a procedure to remove her gallbladder was admitted to the hospital with abdominal pain and required a paracentesis. After a second-year resident, who had performed six paracenteses as an intern, decided to perform the procedure without the supervision of the overnight hospitalist, the woman experienced bleeding complications and needed to undergo an emergent laparotomy. According to the commentary’s author, the case illustrates that expertise, instead of experience, is a more useful predictor of high reliability and safe systems because the number of procedures required to attain expertise varies widely and unpredictably.