Background: Simulation requires involvement from participants. However, it is unknown to what extent simulation effectiveness is a function of the number of participants. Purpose: This study assessed the impact of varying group size on medical students' subjective experience of simulation and on postsimulation exam performance. Methods: Medical students were randomly assigned to groups of 2, 3, or 4. Retrospective assessment was done through a survey assessing confidence and knowledge as it relates to resuscitation and statements related to group size. Performance on a postsimulation exam was analyzed. Results: There were significant increases in students' confidence and knowledge following simulation. There were no significant differences in student perception of the effectiveness or realism of the simulation or in performance on the postsimulation exam as a function of group size. Conclusions: Students feel that simulation is an effective way to learn medical knowledge. Varying group size had no effect on students' subjective experience or exam performance.
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