The Impact of High-Fidelity Simulation on Student Performance on the National Board Exams in Respiratory Therapy

Abstract

Background: The National Board of Respiratory Care (NBRC) reports that the national first-time pass rate for the Clinical Simulation Exam (CSE) is < 65%. This relatively low performance coincides with the results of the closed CSE given to Middle Georgia State University students within the respiratory therapy (RT) program. The purpose of this study is to compare student performance on the CSE before and after implementation of high-fidelity simulation in the respiratory curriculum. The secondary purpose is to determine the progression of students’ performance with high-fidelity simulation exposure over time. Methods: The RT program implemented a high-fidelity simulation program into the curriculum in 2016. The program utilizes certified patient case scenarios based on the NBRC matrix. Each simulation involves pre-brief, simulation, debrief and post-debrief questions written for NBRC Board preparation. Data was collected over a 2-year period (2016-2018) over the course of two semesters for each cohort increasing the number of simulations completed between groups (none, 3, and 8 simulations) including grade point averages (GPA). GPAs were compared between each group using one-way ANOVA with Tukey HSD analysis via 95% confidence intervals (N = 58 students). Results: There is no statistical difference between students’ first time CSE pass rate (.625) and the national pass rate (.579) for students completing three high fidelity simulations (z = .37, P = .36). Respiratory therapy students’ first time CSE pass rate for students completing eight high fidelity simulations (.937) is significantly greater than the national pass rate (.712), (z = 1.99, P = .023). Conclusions: The use of eight high-fidelity simulations improved the performance of MGA students on the closed CSE and national board exam, whereas the use of three simulations did not. Therefore, increased exposure to high-fidelity simulation improves student performance on the National CSE.