Beth Vukin, MD - Univeristy of Utah; Adam Stevenson, MD - University of Utah; Brian Good, MD - Univeristy of Utah
As senior medical students transition to internship, they face increased responsibility and autonomy. They will need to care for urgent clinical situations that they may not have encountered before. This may be stressful as well as pose risk for patients. The simulated environment allows for experiential learning in a low-risk setting.
In 2011, fourth year medical students were offered a two-week elective, “Transition to Pediatric Internship,” that focused on skills needed at the beginning of Pediatric Residency. In one component of the course, students participated in five one-hour high-fidelity simulations of common emergencies:
Students worked in teams of 4-6, with an actor playing the bedside nurse. The objectives were to assess the patient, call the senior resident, give concise, pertinent information and start basic interventions. The scenarios were filmed. Groups reviewed their performances and were guided though debriefings by a faculty member. At the end of the course, students completed a survey evaluating the utility and effectiveness of this teaching method.
Thirteen students participated in the course. Survey response rate was 100%. All agreed that:
92% agreed that they learned a concept during simulation that they have not yet learned elsewhere. 83% agreed that simulation exposed them to areas they need to learn more about. In the course evaluation, 77% reported that the simulation was the most valuable part of the Transition to Pediatric Internship course.
Sample size may not be sufficient to show significance. Self-reported perception and opinion may not be generalizable to actual clinical performance.
Students valued the simulation experience and believed it would be applicable to internship. Simulation exposed them to concepts they had not learned elsewhere in medical school. Students unanimously felt simulation should be included in training and that it helped them feel more prepared for internship. Further studies could evaluate whether this perceived preparedness for internship translates to reduced intern stress and/or improves patient outcomes.