Infectious Disease · Medical Literature
Application Effects and Optimization Strategies of Multi-Scenario Simulation Teaching in Practical Instruction of Infectious Diseases.
Abstract
This prospective randomized controlled trial evaluated the effectiveness of multi-scenario simulation teaching in improving practical competence among medical and nursing students during infectious disease training. A total of 121 students were randomly assigned to a simulation group (n = 60) or a traditional teaching group (n = 61). The simulation curriculum covered key clinical workflows, including triage, isolation, specimen collection, infection prevention, antimicrobial stewardship, and occupational exposure management. Primary outcomes were post-intervention Objective Structured Clinical Examination (OSCE) scores and critical action compliance rates. Secondary outcomes included clinical reasoning, teamwork and communication skills, learner satisfaction, self-efficacy, engagement, and cognitive load. Compared with the control group, the simulation group achieved significantly higher OSCE scores (mean difference 8.1; 95% CI, 5.4-10.9; Cohen's d = 1.14; P < 0.001) and critical action compliance rates (10.5% higher; 95% CI, 7.3-13.6; Cohen's d = 1.23; P < 0.001). The simulation group also demonstrated improved teamwork, greater satisfaction and self-efficacy, and lower cognitive load. These findings indicate that multi-scenario simulation teaching enhances practical competence, safety-critical performance, and learning experiences in infectious disease education.
Clinical relevance
Deficiencies in practical competence among medical and nursing trainees in infectious disease settings pose direct patient safety risks, particularly in high-stakes workflows such as triage, isolation, and occupational exposure management. This prospective RCT addresses the gap between traditional didactic instruction and real-world clinical performance in infectious disease education. Given the persistent global threat of emerging and re-emerging pathogens, optimizing simulation-based curricula for infectious disease training is an immediate institutional and public health priority.
Key findings
1. The simulation group achieved significantly higher post-intervention OSCE scores compared to the traditional teaching group (mean difference 8.1 points; 95% CI, 5.4–10.9; Cohen's d = 1.14; P < 0.001), indicating a large effect size favoring simulation-based instruction. 2. Critical action compliance rates were 10.5% higher in the simulation group versus controls (95% CI, 7.3–13.6; Cohen's d = 1.23; P < 0.001), again reflecting a large effect size and suggesting meaningfully improved safety-critical performance. 3. The simulation curriculum encompassed six core infectious disease competency domains: triage, isolation protocols, specimen collection, infection prevention and control, antimicrobial stewardship, and occupational exposure management. 4. Secondary outcomes demonstrated that the simulation group exhibited superior teamwork and communication skills compared to the traditional teaching cohort. 5. Learner satisfaction, self-efficacy, and academic engagement were all greater in the simulation group, while cognitive load was significantly lower, suggesting more efficient knowledge acquisition. 6. The study was a prospective RCT with 121 participants (simulation group n = 60; control group n = 61), providing moderate-quality evidence with balanced allocation and controlled conditions.
Practice implications
Infectious disease training programs should prioritize replacing or substantially supplementing traditional didactic instruction with multi-scenario simulation curricula, particularly for high-stakes competencies such as isolation protocols, occupational exposure response, and antimicrobial stewardship decision-making. Given the large effect sizes observed for both OSCE performance and critical action compliance (Cohen's d > 1.1 in both cases), simulation-based training should be considered a standard component of clinical onboarding for all medical and nursing staff rotating through infectious disease units. Institutions should design simulation scenarios that replicate authentic, multi-domain clinical workflows and incorporate structured debriefing to consolidate clinical reasoning, teamwork, and self-efficacy while minimizing cognitive overload in novice learners.