Council on Medical Student Education in Pediatrics

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COMSEP 2011 San Diego Meeting with AMSPDC

Poster Presentation:


THE IMPORTANCE OF SIMULATION IN THE PEDIATRIC CLERKSHIP IN IMPROVING KNOWLEDGE AND SELF-CONFIDENCE.

Authors:
Rebecca Tenney-Soeiro, MD, Jeanine C. Ronan, MD, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA

Background:  Medical students depend on experiences as resources; yet real-life experiences with direct patient care are declining. Simulation plays an important role in medical education to enhance learning experiences and improve patient safety outcomes.  However, use in the pediatric clerkship has been limited and little evaluation has been done of its success. Study Objectives:  Three scenarios of common pediatric emergencies were created to allow students to identify gaps in their knowledge surrounding pathophysiology, rapid data collection, and therapeutic options; to build confidence in their initial assessment and management of ill children; and gain awareness of teamwork principles. Research Methods:  All pediatric clerkship students participated in simulation or traditional case based learning scenarios.  Initially, all students completed a questionnaire to assess their knowledge, comfort level, and self-confidence in managing acutely ill children.  During both simulation and CBL, a review of the major educational points was provided. In simulation a group of 4-5 students participated in each scenario.  Following a debriefing session, the remaining 4-5 students performed the scenario again to reinforce the medical approach and teamwork principles.  CBL students were presented a case on paper to discuss. After the final scenario, a post-questionnaire was administered to all students. Results/Analysis:  145 students participated with 72 in simulation and 73 in CBL. Independent sample t-tests comparing item means for pre-post scores within each arm, as well as pretest and post test item scores between arms were performed. Knowledge acquisition between the 2 groups was similar; there were no significant differences in the posttest percent correct on six multiple choice questions (p’s > 0.05), though shelf exam scores were a mean of 2.45 points higher for the simulation group. Of significance for the simulation group was the better score in self-confidence in the use of equipment (p = 0.001) and endorsing the importance of teamwork in caring for patients (p < 0.001). No difference was found between the groups’ confidence in managing pediatric patients (p=.89). On multiple items regarding usefulness of the exercise, results favored the simulation group. Discussion with Interpretation of Results:  Simulation exercises are valuable teaching tools that allow hands-on experience for students to improve their medical knowledge and build their technical skills.  The lack of increase in self-confidence within the simulation students may signify their recognition of the need to practice their management and technical skills