期刊名称：Journal of Educational Evaluation for Health Professions
电子版ISSN：1975-5937
出版年度：2016
卷号：13
期号：1
页码：1-7
DOI：10.3352/jeehp.2016.13.44
语种：English
出版社：Korea Health Insurance Licensing Examination Institute
摘要：Purpose:High-fidelity simulation training is effective for learning crisis resource management (CRM) skills,but cost is a major barrier to implementing high-fidelity simulation training into the curriculum.The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other.Methods:This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Can_x0002_ada.Each participant managed a pretest crisis scenario.Participants who were randomized to self-debrief used the video of their pretest scenario with no instructor present during their debriefing.Participants from the control group were de?briefed by a trained instructor using the video of their pretest scenario.Participants individually managed a post-test simulated crisis scenario.We compared the cost and effectiveness of self-debriefing versus instructor debriefing using net benefit regression.The cost-effectiveness estimate was reported as the incremental net benefit and the uncertainty was presented using a cost-effectiveness acceptability curve.Results:Self-debriefing costs less than instructor debrief?ing.As the WTP increased,the probability that self-debriefing would be cost-effective decreased.With a WTP ≤ Can$200,the self-debriefing program was cost-effective.However,when effectiveness was priced higher than cost-savings and with a WTP > Can$300,instructor debriefing was the preferred alternative.Conclusion:With a lower WTP (≤ Can$200),self-debriefing was cost-effective in CRM simulation training when compared to instructor debriefing.This study provides evidence regarding cost-effectiveness that will inform decision-makers and clinical educators in their decision?making process,and may help to optimize resource allocation in education.
关键词：Purpose:High-fidelity simulation training is effective for learning crisis resource management (CRM) skills,but cost is a major barrier to implementing high-fidelity simulation training into the curriculum.The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other.Methods:This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Can_x0002_ada.Each participant managed a pretest crisis scenario.Participants who were randomized to self-debrief used the video of their pretest scenario with no instructor present during their debriefing.Participants from the control group were de?briefed by a trained instructor using the video of their pretest scenario.Participants individually managed a post-test simulated crisis scenario.We compared the cost and effectiveness of self-debriefing versus instructor debriefing using net benefit regression.The cost-effectiveness estimate was reported as the incremental net benefit and the uncertainty was presented using a cost-effectiveness acceptability curve.Results:Self-debriefing costs less than instructor debrief?ing.As the WTP increased,the probability that self-debriefing would be cost-effective decreased.With a WTP ≤ Can$200,the self-debriefing program was cost-effective.However,when effectiveness was priced higher than cost-savings and with a WTP > Can$300,instructor debriefing was the preferred alternative.Conclusion:With a lower WTP (≤ Can$200),self-debriefing was cost-effective in CRM simulation training when compared to instructor debriefing.This study provides evidence regarding cost-effectiveness that will inform decision-makers and clinical educators in their decision?making process,and may help to optimize resource allocation in education.
