Methodological Innovation in Evaluating the Cost-Effectiveness of Simulation Training Combining Transfer Effectiveness and Change-Point Analysis.

Abstract

Background: Simulation-based medical education has become increasingly prevalent. However, the high cost and lack of comprehensive effectiveness evaluations have raised questions about its feasibility. This study introduces a novel approach to assess the cost-effectiveness of simulation training.

Methods: This study uses simulated data from 120 medical students, set in a teaching hospital scenario, and randomly assigns them to 6 groups with different training durations. This was done to determine the optimal length of VR training that maximizes knowledge and skills transfer efficiency while minimizing costs, using 4 analytical methods: the transfer effectiveness ratio (TER) quantifying time savings, the incremental TER (ITER) assessing individual gains, isoperformance curves mapping cost-effectiveness, and change-point analysis identifying diminishing returns.

Results: The overall TER of 0.66 indicates 0.66 units of time saved per simulation training unit invested; peak ITER variability occurred in the 3h cohort, reflecting divergent individual responses to incremental training; isoperformance curves established a 4.5min minimum operative time threshold, defining inherent procedural constraints; and an inflection point at 8 VR training hours (80th data point) marked the onset of diminishing returns.

Conclusions: The methodological innovation of integrating TER, ITER, isoperformance curves, and change-point analysis offers a new framework for evaluating the cost-effectiveness of simulation training in medical education. The findings highlight the potential for simulation training to reduce the time required to achieve clinical competency and to optimize training strategies.