A cost-utility analysis of medium vs. high-fidelity human patient simulation manikins in nursing education
A cost-utility analysis of medium vs. high-fidelity human patient simulation manikins in nursing education
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DOI：
10.1111/j.1365-2702.2011.03843.x
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发表时间：
2011-12-01
影响因子：
4.2
通讯作者：
Levett-Jones, Tracy
中科院分区：
文献类型：
--
作者：
Lapkin, Samuel;Levett-Jones, Tracy
目的和目标。本研究提出了比较中等与中等水平的成本效用分析。高保真病人模拟模型在护理教育中的应用。该分析旨在确定与高保真人体模型相关的额外成本是否可以证明临床推理、知识获取和学生满意度结果方面的差异（如果有的话）是合理的。背景。对模拟学习环境的投资以前所未有的速度增加。驱动力之一是模拟体验有可能提高学生的学习和参与度。需要进行成本效益分析来为与模拟设备的投资和使用相关的决策提供信息。方法。计算与使用中保真度和高保真度人体模型相关的成本，以确定每个模型的总成本。然后使用多属性效用函数进行成本效用分析，将成本和准实验研究中的临床推理、知识获取和学生满意度三个结果结合起来，得出总体成本效用结果。成本分析表明，为了获得同等的临床推理、知识获取和学生满意度分数，使用中保真度每个学生需要 AU1.21 美元（1.14 美元；（原文如此）0.85），而使用高保真度人类患者模拟模型则需要 AU6.28 美元（6.17 美元；（原文如此）4.40）。结论。根据成本效用分析的结果，中保真人体模型更具成本效益，只需高保真人体模型五分之一的成本即可在临床推理、知识获取和学生满意度方面获得相同的效果。与临床实践相关。重要的是，决策者必须进行经济分析，考虑模拟的成本和结果，以确定对于任何特定结果测量而言成本最低的方法或对于特定成本而言最佳结果的方法。
Aims and objectives. This study presents a cost-utility analysis that compared medium-vs. high-fidelity human patient simulation manikins in nursing education. The analysis sought to determine whether the extra costs associated with high-fidelity manikins can justify the differences, if any, in the outcomes of clinical reasoning, knowledge acquisition and student satisfaction.Background. Investment in simulated learning environments has increased at an unprecedented pace. One of the driving forces is the potential for simulation experiences to improve students' learning and engagement. A cost-effectiveness analysis is needed to inform decisions related to investment in and use of simulation equipment.Method. Costs associated with the use of medium-and high-fidelity manikins were calculated to determine the total cost for each. A cost-utility analysis using multiattribute utility function was then conducted to combine costs and three outcomes of clinical reasoning, knowledge acquisition and student satisfaction from a quasi-experimental study to arrive at an overall cost utility.Results. The cost analysis indicated that to obtain equivalent clinical reasoning, knowledge acquisition and student satisfaction scores, it required $AU1.21 (US$ 1.14; (sic)0.85) using medium-fidelity as compared with $AU6.28 (US$6.17; (sic)4.40) for high-fidelity human patient simulation manikins per student.Conclusion. Based on the results of the cost-utility analysis, medium-fidelity manikins are more cost effective requiring one-fifth of the cost of high-fidelity manikins to obtain the same effect on clinical reasoning, knowledge acquisition and student satisfaction.Relevance to clinical practice. It is important that decision-makers have an economic analysis that considers both the costs and outcomes of simulation to identify the approach that has the lowest cost for any particular outcome measure or the best outcomes for a particular cost.