There is limited research investigating the usefulness of high-fidelity simulations (HFS) for early-stage students. Some argue the additional expense of HFS over low-fidelity simulation (LFS) is unnecessary as early-stage students are too easily distracted by non-relevant stimuli inhibiting student’s ability to focus on the core task. However, the extent to which this is true is yet to be empirically tested.


First-year paramedicine students were randomly assigned to complete either a LFS or HFS involving a collapsed patient with an obstructed airway. Level of distraction was measured via eye-tracking, arousal via heart-rate (HR), task difficulty via the NASA TLX, and clinical decision making via time-to-action. Student’s perceptions of HFS and LFS were also explored via in-depth interviews immediately following simulations.


Proportion of time attending to non-relevant stimuli was greater for HFS than LFS students (8.1% vs. 0.9%, ppp=.001). More students from the HFS group revived the patient than the LFS group (58% vs. 30% respectively). Students from the HFS condition achieved time-to-action significantly quicker than those in the LFS condition (p=.010), a trend that remained constant when isolating those removing the obstruction (p<.05).


Students in HFS suffered from greater distraction, perceived the task as being more difficult and were more aroused than students in LFS. However, HFS students outperformed LFS students with respect to clinical decision making and patient outcomes.