Simulation-integrated problem-based learning improves interns’ anaphylactic shock knowledge in randomized study

A randomized educational intervention study involving 54 pre-graduation medical and nursing interns found that adding simulation-based training to a problem-based learning framework was associated with greater improvements in knowledge of anaphylactic shock management than structured problem-based learning alone. Both approaches produced significantly higher written-examination scores after training than at baseline, according to the study abstract published in BMC Medical Education.

The participants were medical and nursing interns undergoing emergency medicine rotations and were organized into interdisciplinary teams composed of one physician and two nurses. All participants completed a pre-test and learning-needs assessment and received a brief One-Minute Preceptor session before being randomly assigned to either a control group or an intervention group. The control group received the preceptor session followed by structured problem-based learning. The intervention group received simulation-based training integrated into the problem-based learning framework, followed by Plus–Delta reflective debriefing. The simulation scenarios represented resource-limited primary care settings and emphasized teamwork and key treatment procedures.

Knowledge acquisition was evaluated through structured written examinations administered before and after training. Both groups improved significantly from baseline, with post-training differences of p<0.05. The intervention group also achieved significantly greater score improvements than the control group. Treatment implementation and teamwork were areas with relatively low baseline scores, and both improved markedly after training, particularly in the intervention group. Before training, participants reported the greatest uncertainty about the clinical manifestations of anaphylactic shock, cited by 42.6%, and treatment strategies, cited by 40.7%. During simulation-based formative assessment, approximately two-thirds of participants rated their own performance lower than the instructors did.

The findings support simulation-integrated problem-based learning as an educational approach for improving knowledge associated with treatment implementation and teamwork in anaphylactic shock management. The authors described the model as potentially feasible for emergency education in resource-limited primary care settings because it provides opportunities for experiential practice and reflective learning. The study was limited to 54 interns in emergency medicine rotations, and its reported endpoint was knowledge measured by written examinations rather than clinical performance or patient outcomes. The abstract also did not report longer-term retention, comparison of individual simulation components, or the extent to which the educational model could be implemented across different primary care settings. Accordingly, the results establish an association between the combined intervention and greater knowledge gains, without demonstrating effects on patient care.

Subject of Research: Randomized evaluation of simulation-integrated problem-based learning for interns’ anaphylactic shock management knowledge

Article Title: Integrating simulation-based training into a problem-based learning framework to improve knowledge of anaphylactic shock management: a randomized educational intervention study

Article References: Chen, J., Ruan, Z., Zhang, M., Lin, J., Lin, W., Zhou, Y., Du, Y., Liu, Y., Zheng, X., & Chen, X. (2026). Integrating simulation-based training into a problem-based learning framework to improve knowledge of anaphylactic shock management: a randomized educational intervention study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10601-3

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10601-3

Keywords: anaphylactic shock, simulation training, problem-based learning, medical education, nursing education, interprofessional teams, knowledge assessment, emergency medicine, primary care, Integrating, simulation-based, training