A Comprehensive, Simulation-Based Approach to Teaching Clinical Skills: The Medical Students’ Perspective

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Abstract

The purpose of this study was to determine if third-year medical students participating in a mandatory 12-week simulation course perceived improvement in decision-making, communication, and teamwork skills. Students participated in or observed 24 acute emergency scenarios. At 4-week intervals, students completed 0-10 point Likert scale questionnaires evaluating the curriculum and role of team leader. Linear contrasts were used to examine changes in outcomes. P-values were Bonferroni-corrected for multiple pairwise comparisons. Student evaluations (n = 96) demonstrated increases from week 4 to 12 in educational value (p = 0.006), decision-making (p < 0.001), communication (p = 0.02), teamwork (p = 0.01), confidence in management (p < 0.001), and translation to clinical experience (p < 0.001). Regarding the team leader role, students reported a decrease in stress (p = 0.001) and increase in ability to facilitate team function (p < 0.001) and awareness of team building (p = <0.001). Ratings demonstrate a positive impact of simulation on both clinical management skills and team leadership skills. A simulation curriculum can enhance the ability to manage acute clinical problems and translates well to the clinical experience. These positive perceptions increase as the exposure to simulation increases.

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Simulation in undergraduate medical education: bridging the gap between theory and practice.

Susan J. Weller (2003)

To evaluate the use of simulation-based teaching in the medical undergraduate curriculum in the context of management of medical emergencies, using a medium fidelity simulator. Small groups of medical students attended a simulation workshop on management of medical emergencies. The workshop was evaluated in a post-course questionnaire. All Year 4 medical students allocated to the resuscitation rotation during the first half of 2002. Student perceptions of learning outcomes, the value of the simulation in the undergraduate curriculum and their self-assessed improved mastery of workshop material. A total of 33 students attended the workshop and all completed questionnaires. Students rated the workshop highly and found it a valuable learning experience. In all, 21 (64%) students identified teamwork skills as key learning points; 11 (33%) felt they had learnt how to approach a problem better, particularly in terms of using a systematic approach, and 12 (36%) felt they had learnt how to apply their theoretical knowledge in a clinical setting better. All 33 students were positive about the use of simulation in their training; 14 students wrote that simulation should be used more or should be mandatory in training; 5 students commented positively on the realism of the learning experience and a further 5 said they valued the opportunity to learn new skills in a safe environment. This study demonstrates that medical students value simulation-based learning highly. In particular, they value the opportunity to apply their theoretical knowledge in a safe and realistic setting, to develop teamwork skills and to develop a systematic approach to a problem. A medium fidelity simulator is a valuable educational tool in medical undergraduate education.

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A 1-week simulated internship course helps prepare medical students for transition to residency.

G. Goyal, Torrey A Laack, L Torsher … (2010)

The transition from medical student to intern is inherently stressful, with potentially negative consequences for both interns and patients. We describe Internship Boot Camp, an innovative course specifically designed to prepare fourth-year medical students for the transition from medical school to internship. An intensive 1-week course, Internship Boot Camp has simulated, longitudinal patient-care scenarios that use high-fidelity medical simulation, standardized patients, procedural task trainers, and problem-based learning to help students apply their knowledge and develop a framework for response to the challenges they will face as interns. In March 2007, 12 students participated in the course as an elective in their final year of medical school, and the other 28 students in their class did not. After beginning internship and 5 to 7 months after the completion of Internship Boot Camp, all 40 former students were asked to complete a blinded survey about their preparation for internship. The overall response rate for the survey was 80%. Of responders to an open-ended question about the aspects of medical school training that best prepared them for internship, 89% (8 of 9) of course participants listed "Internship Boot Camp." The next highest response ("subinternship") was given by 45% (9 of 20) of nonparticipants and 33% (3 of 9) of course participants. Internship Boot Camp is a unique learning environment that is recalled by participants as the most helpful, of all components of their medical school education, in preparation for internship.

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"Practicing" medicine without risk: students' and educators' responses to high-fidelity patient simulation.

Iain Gordon, Kate E. Armstrong, Christopher Shaffer … (2001)

To understand the responses of medical students and educators to high-fidelity patient simulation, a new technology allowing "practice without risk." Pilot groups of students (n = 27) and educators (n = 33) were exposed to a simulator session, then surveyed with multiple-choice and open-ended questions. Open-ended comments were transcribed and coded. They were analyzed for recurring themes and tested for inter-rater agreement. An independent focus group subsequently performed higher-level thematic analysis. Overall, 85% of the students rated the session excellent and 85% of the educators rated it excellent or very good. Over 80% of both groups thought that simulator-based training should be required for all medical students. Analytic categories derived from written comments were: Overall Assessment (i.e., "generally good experience"); Process Descriptors (i.e., "very realistic"); Teaching Utility (i.e., "broad educational tool"); Pedagogic Efficacy (i.e., "promotes critical thinking"); and Goals for Future Use (i.e., "more practice sessions"). Thirty percent of students and 38% of educators were impressed by the realism of the simulator, and they (37% and 25%, respectively) identified the ability to "practice" medicine as the primary advantage of simulation. The focus group rated cost as the major current disadvantage (66%). Students' and educators' responses to high-fidelity patient simulation were very positive. The ability to practice without risk must be weighed against the cost of this new technology.

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Author and article information

Journal

Journal ID (nlm-ta): Yale J Biol Med

Journal ID (iso-abbrev): Yale J Biol Med

Journal ID (pmc): yjbm

Journal ID (publisher-id): YJBM

Title: The Yale Journal of Biology and Medicine

Publisher: YJBM

ISSN (Print): 0044-0086

ISSN (Electronic): 1551-4056

Publication date (Electronic): 12 December 2014

Publication date Collection: December 2014

Volume: 87

Issue: 4

Pages: 575-581

Affiliations

[a ]Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut

[b ]Department of Surgery, Yale School of Medicine, New Haven, Connecticut

Author notes

[* ]To whom all correspondence should be addressed: Leigh V. Evans, MD, Assistant Professor, Director of Healthcare Simulation, Department of Emergency Medicine, Yale School of Medicine, 464 Congress Ave., Suite 260, New Haven, CT 06519; Tel: 203-737-2489; Fax: 203-785-4580; Email: leigh.evans@ 123456yale.edu .

Article

Publisher ID: yjbm874575

PMC ID: 4257042

PubMed ID: 25506290

SO-VID: 702945f8-5d15-4fc7-b656-ff5e4aafa661

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way.

A Comprehensive, Simulation-Based Approach to Teaching Clinical Skills: The Medical Students’ Perspective

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Abstract

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Journal of Medical Education Research

Most cited references 12

Simulation in undergraduate medical education: bridging the gap between theory and practice.

A 1-week simulated internship course helps prepare medical students for transition to residency.

"Practicing" medicine without risk: students' and educators' responses to high-fidelity patient simulation.

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