Robert S. Greenberg, MD, Jennifer L. Trainor, MD, Melissa L. Brannen, MD, MEd, Julie K. Stamos, MD, Feinberg School of Medicine, Northwestern University, Chicago, IL
Objective: While simulation continues to gain acceptance as a means for experiencing high-risk patient encounters, it has most commonly been employed with trainees who have had at least some clinical experience. We report the first experience of using high-fidelity infant simulation as a mandatory activity in a pediatric clerkship to teach COMSEP competencies. Methods: During 2009-2010, all third-year Northwestern medical students rotating through the pediatric clerkship participated in two simulation sessions (using the SimBabyTM advanced infant simulator) and a post-simulation debriefing. The purpose of the program was to provide an educational platform for third-year medical students to apply their knowledge practically through history-taking and physical examinations as well as to work with their peers to problem-solve and clinically manage basic pediatric cases. Scenarios were developed in an iterative process throughout the study and centered on two COMSEP competencies: recognizing respiratory distress (croup or bronchiolitis) and cardiovascular compromise (dehydration/shock). Students completed a standard web-based, post-clerkship evaluation which included questions on the simulations. Results: Two hundred forty-four students participated in the simulations and completed the post-clerkship survey which used 5-point Likert scales. The most recent 61 students responded to seven more specific questions about their experience in simulation. Of the 244 students, 223 (91.4%) strongly agreed or agreed that the simulator sessions were 'educationally valuable'. Fifty-six students (23%) free-text responded that simulation was one of the three most educationally valuable aspects of the pediatrics clerkship. Greater than 90% of students rated simulation as a superior method for learning to recognize respiratory distress and shock than lecture or independent reading (56/61, 91.8% vs. lecture; 57/61 93.4% vs. reading). Fifty-seven of 61 students (93.4%) strongly agreed or agreed that the simulation sessions afforded them the opportunity to 'manage an ill patient to which they would have otherwise not been exposed’. Nearly all students (59/61, 96.7%) rated the debriefing sessions as a 'safe, non-threatening environment for learning and receiving feedback'. Conclusions: Medical students consider high-fidelity infant simulation a valuable and effective modality for learning core COMSEP competencies. Incorporating simulation into a pediatric clerkship adds a potentially successful adjunct to inpatient clinical education.