High-fidelity simulation vs video-assisted teaching for early ECG learning - Randomised controlled trial.

Abstract

Introduction: Electrocardiography (ECG) interpretation is a vital yet challenging competency for preclinical medical students due to limited clinical exposure. While high-fidelity simulation teaching (HFST) offers immersive, experiential learning, video-assisted teaching (VAT) provides scalable, consistent instruction. Despite growing interest in both methods, comparative evidence remains limited. This study aimed to evaluate the effectiveness of HFST versus VAT in enhancing ECG knowledge and retention among preclinical students using a Multiple-Choice Question (MCQ) assessment for knowledge cognition.

Materials and methods: It was a randomised controlled trial study where 136 first year undergraduate medical students were randomised into control (VAT) and intervention (HFST) groups. The intervention group received a 20-minute simulation session using SimMan, demonstrating ECG lead placement, interpretation, and basic management, followed by a 20-minute interactive discussion whereas the control group underwent a VAT session mirroring the HFST content with a 20-minute pre-recorded video followed by a 20-minute faculty-led discussion. MCQs were used to assess the acquisition and retention of knowledge, both as a pre-test (week 1) and a post-test (week 12). The outcomes were measured using the mean and standard deviation of the total scores of MCQ. Intragroup analyses were conducted using a dependent sample t-test, whereas intergroup analyses were performed using an independent samples t-test. ANCOVA was used to assess the difference in post-test MCQ scores among the groups after adjusting the Pre-test scores. The Pvalue was set at 0.05. "Institutional research trial registration number": RMC_NUIR_2024_21 RESULTS: Both groups demonstrated significant enhancement in knowledge gain and retention from the pretest to the post-test. The VAT group showed a greater mean score improvement compared to the HFST group. While the VAT group outperformed the HFST group in the post-test, this difference was not statistically significant. Adjusting for pre-test scores using ANCOVA further confirmed the nonsignificance of post-test score differences between the two groups. Two-way mixed ANOVA revealed no significant interaction between group and time point, indicating comparable patterns of knowledge gain across both teaching methods.

Conclusion: Both HFST and VAT significantly increased knowledge and retention among preclinical medical students. The VAT group showed a slightly higher knowledge gain than the HFST group, although the difference was statistically insignificant. The study demonstrated that both VAT and HFST were effective in midterm knowledge acquisition and may offer a viable alternative for inclusion in undergraduate preclinical curricula.