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J Emerg Trauma Shock. 2019 Jul-Sep;12(3):176-178. doi: 10.4103/JETS.JETS_115_18.

High-Fidelity Simulation versus Case-Based Discussion for Teaching Bradyarrhythmia to Emergency Medical Services Students.

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Symbiosis Centre for Health Skills, Symbiosis International Deemed University, Pune, Maharashtra, India.



Bradyarrhythmias are a common clinical finding yet can be life-threatening in certain situations. Accordingly, diagnosis and prompt intervention remain the cornerstone of effective management of bradyarrhythmia. The study compares the two methods by assessing improvement in knowledge acquisition using pretest, posttest, and satisfaction survey with the teaching pedagogy.

Materials and Methods:

A randomized control trial of simulation-based teaching compared with case-based discussion was conducted among Postgraduate Diploma in Emergency Medical Services students. The students anonymously filled out pretest, posttest, and a satisfaction questionnaire composed of six statements in three domains (quality of instruction, debriefing, and overall satisfaction). The statements were rated using a 10-point scale. Test results were compared using t-test for equality of means of independent samples.

Results and Discussion:

All 40 students selected completed all the steps of the study. Knowledge improvement from pretest to posttest was observed in both teaching methods derived using paired sample t-test (P < 0.05). However, no significant difference was observed while comparing improvement scores of posttest versus pretest between both the groups. Mean satisfaction score of simulation group was significantly higher at 8.40 compared to case-based group which was at 7.87. Satisfaction survey showed marked significance (P = 0.03) for simulation-based teaching.


As a single intervention, simulation-based teaching is superior to case-based discussion in terms of student satisfaction but remains similarly effective in terms of knowledge acquisition.


Bradyarrhythmias; debriefing; high fidelity; simulation

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