Does Simulation-Based Training Increase Athletic Training Students' Clinical Confidence and Competence in Performing a Cardiovascular Screening?

CONTEXT: The incidence of sudden cardiac death (SCD) in athletes is higher than previously estimated. The need for increased screening to detect cardiac diseases in preparticipation physical examinations (PPE) has become a focus in athletic training. The use of simulation-based training in healthcare professionals' education has increased clinical confidence and competence, but research is limited.

OBJECTIVE: To examine if a simulation-based educational intervention can increase athletic training students' self-reported confidence and clinical competence in conducting a cardiovascular screening.

DESIGN: Pretest-posttest design.

METHODS: 25 first-year athletic training students in a professional master's program participated. The intervention consisted of a standardized cardiovascular curriculum consisting of a 45-minute, interactive instructor-led session and a 45-minute audio session which included repetitions of heart murmurs. Learner self-reported confidence scale, multiple-choice knowledge exam, and objective structured clinical examination (OSCE) of cardiovascular assessment skills and auditory recognition of heart murmurs were recorded.

RESULTS: Self-reported confidence increased significantly from 4.4±2.1 to 9.2±3.0 post-intervention (F=78.7, p<0.001) with a moderately high effect size (n2=0.789). Knowledge exam scores increased significantly from 11.0±2.5 to 13.6±4.0 post-intervention (F=5.3, p=0.031) with a low effect size (n2=0.191). The history-taking assessment of the OSCE increased significantly from 2.6±1.6 to 5.7±1.7 post-intervention (F=70.1, p<0.001) with a moderately high effect size (n2=0.751). The clinical skills assessment of the OSCE increased significantly from 4.1±2.8 to 15.6±1.6 post-intervention (F=415.4, p<0.001) with a high effect size (n2=0.952).

CONCLUSIONS: Simulation-based training is an effective tool for increasing athletic training students' self-reported confidence and competence in conducting a cardiovascular screening.