Cost-Utility Analysis of Virtual and Mannequin-Based Simulation

INTRODUCTION: The purposes of this study were to (1) compare learning outcomes between students who participated in mannequin-based simulation activities and students who participated in virtual simulation activities and (2) describe a cost-utility analysis comparing the two types of simulation activities in terms of costs and multiple measures of effectiveness. METHODS: Nursing student participants were randomly assigned to one of two experimental groups to complete either a mannequin-based or virtual simulation activity. The simulation scenario was the same for both groups and involved the care of a hospitalized patient experiencing a chronic obstructive pulmonary disease exacerbation. Participants completed presimulation and postsimulation assessments reflecting qualitative and quantitative measures of learning. A random sample of participants from each group completed a postsimulation performance assessment during which they interacted one on one with a standardized patient. RESULTS: Eighty-four nursing students were enrolled in the study and completed the simulation activities. There were no significant differences in quantitative measures of learning or performance between participants in the mannequin-based and virtual simulation groups. Participants' qualitative responses to postintervention written reflections and questions yielded additional data for describing learning from the two interventions. In the cost-utility analysis, the virtual simulation activity had a more favorable cost-utility ratio of US $1.08 versus the mannequin-based simulation activity's US $3.62. CONCLUSIONS: Healthcare educators striving to make evidence-based decisions about how to best employ simulation pedagogy may consider these findings about the cost utility of various simulation modalities. However, additional research is needed.