Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Medical Education


Dr. Laura Witte


Purpose: The purpose of this article is to review whether high-fidelity simulation (HFS) is superior to low-fidelity simulation (LFS) in enhancing clinical knowledge and technical skills for physician assistant and medical students.

Method: A PubMed advanced literature search was conducted using search terms for “high-fidelity” and “low-fidelity” simulation with the added Medical Subject Heading (MeSH) terms for educational measurement in human subjects. Simulation fidelity was defined by the level of realism depicted in a simulation training activity. Ten relevant randomized controlled trials (RCTs) were retrieved for scholarly review.

Results: A scholarly review of RCTs found HFS and LFS to be equivalent in training novice medical learners. Medical knowledge advanced with training in both HFS and LFS groups. Inconsistent outcomes in skill acquisition amongst the various fidelities appeared to be task specific. Further studies should be performed comparing HFS and LFS with clear definitions of fidelity and learning objectives.

Conclusion: Educational institutions investing time, resources, and money into high-fidelity simulators may or may not be efficacious. Advancement of knowledge acquisition was equivalent in novice medical learners utilizing HFS vs LFS. Variable outcomes were seen in acquiring technical skills utilizing HFS vs LFS based upon the educational objective. Before institutions invest in HFS, further studies should be performed to evaluate the effectiveness of HFS compared to LFS in enhancing knowledge and skill for the novice medical learner.


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