Clinical simulation does not replace hands-on training for medical lab tech students: study

Hamilton, ON – A research study released today by CSMLS concludes that there is little evidence to support the use of ‘clinical simulation’ as a replacement for clinical training – the ‘hands on’ work experience – that is part of the educational preparation of medical laboratory technology students in Canada.

The study, which was conducted by the CSMLS and funded by Health Canada, was initiated to examine issues related to the use of clinical simulation in medical laboratory technology programs. An earlier study published by CSMLS in 2004 revealed that a shortage of clinical placements was jeopardizing the ability of educational institutions to deliver the clinical component of their MLT programs. At that time, clinical sites – the vast majority of which were hospital laboratories – were finding it difficult to devote resources to educating students due to staffing shortages and a lack of government funding.

“Clinical simulation, which attempts to facilitate learning by recreating the real-life laboratory situations in a controlled environment, was seen in some circles as a solution to the shortage of clinical placements,” says Dr Moira Grant, the study’s lead investigator. “It was thought that simulation-based training would be cheaper, faster and would relieve the burden on the clinical sites. We wanted to put those assumptions to the test.”

The study concludes that there is very little evidence to support the use of clinical simulation in medical laboratory technology programs.

“This lack of information presents problems on several fronts,” says Dr Grant. “We don’t have a knowledge base from which to determine the components of the education program that are best suited for delivery in a simulated environment, or the appropriate length for the simulation training.”

Many of those who were interviewed for the study said that even if simulation were to be used to some extent, it would never completely replace the need for students to have direct exposure to the ‘real world’ of the medical laboratory.

Cost was also found to be a significant issue. Simulation-based training is very demanding, in terms of both money and teaching expertise. In fact, two institutions have terminated their simulation programs because of a lack of ongoing government funding.

“Sustained funding is a critical success factor for simulation-based training,” says Dr Grant. “Consider, for example, the cost to education institutions of purchasing and maintaining the type of high-tech laboratory equipment that is used in hospitals. These start-up and ongoing expenses must be duplicated in the educational institution when the program adopts simulation-based training.”

“Decision makers in government and in educational institutions have a responsibility to ensure that education programs for future health care professionals such as medical laboratory technologists are delivered in a cost-effective manner and are based on evidence-informed educational theory,” says Kurt Davis, CSMLS executive director and study co-investigator.

Clinical simulation may have a place in medical laboratory technology education programs, but until there is more evidence to support its use, the CSMLS says it is urging provincial governments to reinvest in clinical education.

“We are recommending that provincial and federal governments target funds to support onsite clinical education for medical laboratory technologists,” says Mr Davis. “We further recommend that funding also be made available to conduct research into the value and effectiveness of clinical simulation. A reinvestment today may help to ease the future impact of a shortage of medical laboratory technologists – half of whom will be eligible to retire within the next ten years.”

A report on the results of the study is available at www.csmls.org