Summary of the articles about the use of simulations in hospital pharmaceutical technologies continuing education
| Article information* | Article profile | Outcome | Results before and after simulation | Other key information |
| Loboda et al21 J Oncol Pharm Pract (2017; France) Assessing pharmaceutical assistants’ (PA) knowledge level in chemotherapy preparation according to their capacity to detect errors in preparation simulations | Participants: 15 PA Participation: NM Simulated training room Equipment: Laminar flow hood Topic: Chemo | Average score in finding errors (score/20) | Before: NA After: 59% (35–80%) | Positive staff feedback Negative comments: discrepancy between role-playing and reality +lack of feedback Study time: 1 year Simulation time: 20 min Kirkpatrick level: 1 |
| Detection rate of major errors (ME) | Before: NA After: Satisfactory for 2 out of 3 major errors | |||
| Cotteret et al22 J Oncol Pharm Pract (2019; France) Investigating pharmacy staff’s backgrounds and knowledge by replicating a cytotoxic preparation unit and 14 situations involving errors | Participants: 20 pharmacists and pharmacy technicians (PT) Participation: Voluntary Simulated training room Equipment: Isolator Topic: Chemo | Rate of correct answers (score/14) | Before: NA After: 58% (39–77%) | Satisfaction level: 8.7±1.0 out of 10 All respondents were satisfied/very satisfied: workshop considered relevant and improving expertise Study time: 1 month Kirkpatrick level: 1 Expert group: 2 senior hospital pharmacists and a pharmacy student |
| Which professional identifies which type of error? | Errors in dispensing steps: more were identified by pharmacists Errors in chemical contamination: more were identified by PT | |||
| Sarfati et al23 J Clin Pharm Ther (2014; France) Assessing the effectiveness of a simulation-based learning programme for preventing errors in the preparation of injectable antineoplastic agents | Participants: 12 pharmacy professionals Participation: NM Real-life room in daily use Equipment: NM Topic: Chemo | Detection of errors (score/25) | First simulation: 52% Second simulation: 80% (p=0.04) 1 year later: 84% 1 year +3 months later: 80%24 | Study time: 5 months Expert group: 5 senior hospital pharmacists, experts in oncology Impact: awareness of risks during the preparation of injectable cancer drugs Kirkpatrick level: 2 |
| Berthod et al25 J Oncol Pharm Pract (2019; Switzerland) Evaluating improvements in knowledge about GMP and assessing participants’ increase in certainty (personal confidence) and their appreciation of the programme | Participants: 72 professionals Participation: Voluntary Training room Equipment: Vertical hood Topic: Chemo | Correct answers | First questionnaire: 57% Third questionnaire: 80% (p<0.001) | 81%: experience would improve daily practice 17%: not relevant for daily work 27%: a few questions were ambiguous Study design and setting: many weeks Expert group: 4 senior pharmacists, 1 PT Kirkpatrick level: 1, 2 |
| Weighted score | Before: 229/460 After: 322/460 | |||
| Degree of certainty (personal confidence) | Before: 3.9/6 After: 5.1/6 (p<0.001) | |||
| Denami32 Pharm Technol Hosp Pharm (2016; France) Design and develop a cleanroom simulator, LabQuest (LQ), and show that professionals trained with LQ perform better than those trained using traditional methods (videos, QCM, PPT) | Participants: 45 professionals Participation: NM Virtual room Equipment: Aseptic filling machine Topic: As. Tech | Accomplishing gestures and procedures | Traditional: 57.5% LabQuest: 87.6% | Expert group: NM Kirkpatrick level: 2 |
| Detection of relevant errors | Traditional: 52.2% LabQuest: 89.3% | |||
| Harrison et al35 Am J Health Syst Pharm (1996; USA) Provide direct observation and feedback to assess proper techniques for handling cytotoxic agents using a fluorescein test (0.5 mg/mL) | Participants: 13 professionals Participation: NM Real-life room in daily use Equipment: Vertical hood Topic: As. Tech | Average score | Before: 61±11% After 3 months: 84±14% (p=0.006) | Expert group: NM Timing: 26 hours to conduct the study Kirkpatrick level: 2 |
| Positive contamination | Before: 92% After: 23% (p<0.008) | |||
| Written test scores | Before: 89±8.6% After: 85±5.9% (NS) | |||
| Favier et al36 J Pharm Clin (2003; France) Prove the benefits of using a fluorescein test to evaluate how procedures are followed and raise awareness about causes of environmental contamination by cytotoxic drugs | Participants: 9 professionals Participation: NM Real-life room in daily use Equipment: Hood Topic: As. Tech | Average score | Before: 75% (E1) After: 88% (E4) | Expert group: NM Timing: significant investment in time for the pharmacist Kirkpatrick level: 2 |
| Sadeghipour et al40 J Oncol Pharm Pract (2012; Switzerland) Using quinine as a tracer to evaluate contamination levels by simulating the preparation of injectable cytotoxic drugs and designing a procedure to check pharmacy technicians’ ability to work in a clean manner | Participants: 29 professionals Participation: NM Real-life room in daily use Equipment: Isolator Topic: As. Tech | Mean accumulated quantities of contamination | Before: NA After: 6.2 µL (0.6–23.8) and >10 spots (any pharmacy technician with a contamination level superior to mean level was a candidate for a new training programme) | Expert group: NM Timing: NM Kirkpatrick level: none |
| Sigward et al42 Am J Health Syst Pharm (2012; France) Improving media-fill tests results by introducing bacterial contamination to the upper surfaces of vial stoppers for the validation of pharmacy technicians | Participants: 10 professionals Participation: NM Training room Equipment: Workbench Topic: As. Tech | Contamination rate of 300 preparations | Before: NA After: 2.3% | Expert group: NM Timing: NM Kirkpatrick level: none |
| Savry et al43 Am J Health Syst Pharm (2014; France) Validate manufacturing processes and pharmacy technicians’ performances using MFT methods and develop an isolator blackout emergency procedure | Participants: 12 professionals Participation: NM Room: Real-life room in daily use Equipment: Isolator Topic: As. Tech | Validation of production equipment | Before: NA After: NM | Expert group: NM Timing: NM Kirkpatrick level: none |
| Validation of isolator blackout procedure | Before: NA After: NM | |||
| Validation of manufacturing processes | Before: NA After: NM |
*Article information: author, journal, year, country, type of education (continuing education or initial education), study’s objective
As. Tech, aseptic technique; Chemo, chemotherapy; GMP, good manufacturing practices; MFT, media-fill test; NA, not applicable; NE, not evaluated; NM, not mentioned; NS, non-significant; PPT, PowerPoint; QCM, multiple choice question.