Simulation-Based Training in Healthcare Education: An Economic Evaluation of Simulation-Based Training in the Education for Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Laura Reib Hansen & Kasper Magaard Koldby

Student thesis: Master thesis


Simulation-based training is an innovative approach to healthcare education that has the potential to increase patient safety and save costs by reducing the duration of the supervised clinical training on patients. The effectiveness of the approach has been demonstrated across multiple medical procedures, but evidence on its costs and cost-effectiveness is lacking. This thesis seeks to provide this evidence by examining whether a simulation-based program recently developed by the European Respiratory Society (ERS) is economically preferable to traditional apprenticeship training in the education for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS). The preferability of the simulation-based ERS program is examined by conducting an economic evaluation of the program with a dual analytical approach consisting of a costeffectiveness analysis covering the early phase of the education and a cost analysis covering the complete education. Building upon the results of the cost analysis, a budget impact analysis is performed to assess the financial consequences to the Danish society of adopting the program in EBUS education. The results of the thesis suggest that the simulation-based ERS program is economically preferable to traditional apprenticeship training in EBUS education from a Danish societal perspective. The cost-effectiveness analysis shows that simulation training in the initial phase of EBUS education results in more competent operators when compared to apprenticeship training, but the increased educational effectiveness is also achieved at marginally higher costs. However, when assessed over the complete education, the simulation-based ERS program is estimated to provide cost-savings of 19,544 DKK per educated EBUS operator when compared to traditional apprenticeship training. The estimated cost-savings of adopting the ERS program in EBUS education in Denmark are 390,887 DKK over a five-year time horizon, and when generalizing the results to a hypothetical budget impact analysis of adopting simulation-based training in the education of specialists in pulmonary medicine in Denmark, the estimated cost-savings are 18,273,990 DKK over a five-year time horizon. Based on the results of the thesis, it is recommended that the simulation-based ERS program is adopted in EBUS education and that further research is made in the cost-effectiveness of simulation-based training in the education of healthcare professionals across different medical procedures and specialties.

EducationsMSc in Business Administration and Innovation in Health Care, (Graduate Programme) Final Thesis
Publication date2018
Number of pages120