Deception in simulation‐based education: a randomised controlled trial of the effect of deliberate deception on the performance of anaesthesia trainees

• Published in: Anaesthesia 2022-06, Vol.77 (6), p.684-690
• Main Authors: Friedman, Z., Bould, M. D., Pattni, N., Malavade, A., Nakatani, R., Bansal, S., Alam, F.
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesiology - education; Clinical Competence; Communication; Deception; Ethical standards; Humans; Internship and Residency; Learning; Medical education; medical simulation; Physicians; resident trainee; Simulation
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.15693

Summary The use of deliberate deception in simulation allows for a level of realism that is not normally feasible. However, the use of deception is controversial, and carries the risk of psychological harm to learners. There are currently no quantitative data on the effect of deception on learner performance, making it difficult to judge its usefulness. The objective of this study was to examine the impact of deception on learners' performance during a life‐threatening scenario. In this simulation study, second‐year anaesthesia residents were randomly allocated into two groups: the non‐deception group was told that the participating consultant was acting a part, while the deception group was told that the consultant was a subject in the study. Learners then participated in a simulated crisis that presented them with situational opportunities to challenge the consultant regarding clearly wrong decisions. Two independent raters scored the performances using the modified advocacy‐inquiry scale. Forty‐four participants were analysed. The median (IQR [range]) highest scoring modified advocacy‐inquiry scale was 5.0 (4.5–5.1 [4.0–5.5]) for the non‐deception group and 4.0 (3.0–4.0 [2.5–5.0]) for the deception group, (p