Traditional teaching methods in critical care medicine have typically concentrated on imparting basic theoretical knowledge and fundamental practical skills. However, these methods often fall short in preparing trainees for real-world clinical emergencies, where critical thinking and rapid decision-making are crucial. Such emergencies demand a high level of precision in treatment and comprehensive management skills, which are not adequately developed through conventional training[9]. Our findings suggest that while traditional approaches solidify foundational knowledge, they do not sufficiently challenge trainees to apply this knowledge under the pressure and variability of actual clinical conditions.
The effectiveness of virtual simulation teaching in critical care has been increasingly recognized in medical education research[10]. Similar studies corroborate our findings, highlighting the utility of simulation-based methodologies in improving the readiness and skill set of healthcare professionals. For instance, Anderson and colleagues[11] demonstrated that virtual reality (VR) simulations improved the ability of critical care nurses to perform complex procedures under pressure, thereby reducing error rates in actual clinical settings. Nijland et al. evaluated the impact of VR on the self-perceived stress level of 66 ICU nurses during their breaks. Sixty-two percent of those stated that VR was helpful in reducing stress [12].This is consistent with our observation that the Clinical Scenario Group (CSG) showed superior performance in clinical skills assessments compared to the Traditional Teaching Group (TTG). In addition to improving practical skills, virtual simulation has also been shown to enhance diagnostic accuracy. A study by Kim et al.[13] found that trainees using simulation-based diagnostic tools were significantly more accurate in identifying complex conditions in critical care than those trained with traditional methods. In Alismail study found that the use of augmented reality in training, can significantly shorten the intubation or Central Line placement time[14].Chiang et al. evaluated the success of VR-based learning on tracheostomy care in a prospective,VR increased self-efficacy, including familiarity and confidence, and reduced anxiety about tracheostomy-related knowledge and skills[15]. This aligns with our results where the CSG participants not only excelled in practical skills but also displayed a better understanding and application of critical care concepts during simulations. The emotional and psychological readiness of healthcare professionals is another crucial aspect that benefits from simulation-based training. Brown and Edwards [16]noted that simulations could prepare individuals not only technically but also emotionally, by exposing them to high-pressure situations in a controlled environment. This aspect of training is particularly important in critical care, where decision fatigue and emotional stress can impact patient outcomes.
In contrast, the clinical scenario simulation (CSS) approach, as demonstrated in this study, addresses these educational gaps effectively. By integrating complex case simulations into the training curriculum, CSS enhances cognitive processing skills and decision-making under stress, which are vital for critical care environments[17]. These simulations provide a dynamic and interactive learning environment that traditional methods lack, thereby improving not only clinical skills but also critical thinking and problem-solving abilities. The adaptability of simulation technologies allows for tailored educational experiences that can address specific weaknesses or knowledge gaps in trainee skill sets. Parker and Lee[18]explored how adaptive simulation platforms could modify scenarios in real-time based on the performance of the trainee, enhancing learning outcomes and efficiency. This adaptive approach could be a future direction for improving the CSS framework in our own program, ensuring that it remains responsive to the evolving needs of trainees.Grossman et al. found that the introduction of complex cases into teaching can significantly improve academic performance, enhance communication skills and clinical decision-making [19]. This is the same as our observations. Moreover, our results highlighted that traditional training methods lead to variability in the educational experience due to differences in patient cases encountered during rotations. This variability can undermine the standardization of training outcomes. In contrast, CSS uses a consistent set of diverse and complex scenarios that ensure all trainees encounter and manage a wide range of critical conditions, thereby promoting a more uniform training experience [20].
The CSS also bridges the gap between residency training and specialized physician training. Specialized training demands a higher level of competency, which our findings indicate can be effectively developed through CSS. By simulating realistic clinical scenarios in an ICU setting with role-playing elements, CSS fosters not only individual competencies but also team-based skills such as communication and cooperation among trainees and between different levels of medical staff [21].The ability of handle MDT treatment for specialized physician is also important[22]. In the study of Li et al., it was found that the combination of case teaching and MDT teaching could improve the theoretical performance of Gepering students, improve their clinical operation and case analysis ability, and enhance their learning interest, which was consistent with our results[23]。Our study also observed that participants in the CSS group not only outperformed their TTG counterparts in terms of clinical skills assessments but also reported higher satisfaction across various educational outcomes. These include increased interest in learning, enhanced comprehensive abilities, and improved operational skills. Such holistic development is crucial for handling the multifaceted challenges of critical care and underscores the practical value of CSS in training programs.
Given these advantages, the implementation of CSS should be considered a priority in the standardized training programs for critical care medicine in China. It aligns well with the national healthcare goals of improving treatment outcomes and patient safety in high-stakes medical environments[24]. Despite the advantages, it is essential to recognize the limitations and challenges associated with integrating virtual simulation into existing medical curricula. The initial cost and resource allocation for setting up high-fidelity simulations can be substantial, and not all institutions may have immediate access to such technologies. Long-term studies are needed to assess the cost-effectiveness and scalability of these systems, particularly in resource-limited settings.