Council on Medical Student Education in Pediatrics


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COMSEP 2012 Indianapolis Meeting

Poster Presentation:

Use of Simulation to Teach Appropriate Management of a Crying Infant

Matthew W Zackoff, B.S. - Vanderbilt School of Medicine; Stephanie W Israel, M.D. - Vanderbilt School of Medicine; Whitney L Browning, M.D. - Vanderbilt School of Medicine; Amy E Fleming, M.D. - Vanderbilt School of Medicine


Simulation has become a major component of medical student education, with institutions providing standardized patients as well as high fidelity mannequins allowing management and treatment of a variety of diseases in simulated medical scenarios.  Despite advancing technology, available evidence demonstrating that simulated learning leads to increased retention is limited in its scope, with little research done involving pediatric medical student education [1].


During the 2nd year physical diagnosis course, students are taught the 5 S’s of calming an infant (swaddling, sucking, shushing, swaying and side positioning).  A new teaching method was investigated by dividing the students into two study groups: a control consisting of traditional lecture/question format by a faculty instructor; and an exposure group where students were presented with unanticipated simulated infants containing speakers that play a soundtrack of an infant crying and are controlled remotely.  The exposure group was observed for five minutes as they attempted to soothe the child, followed by a faculty led discussion of what students attempted and what was successful.

Approximately five months later, students were asked to evaluate the Physical Diagnosis course via an online survey.  Included within that survey were questions pertaining to the 5 S's to determine how well the information was retained.  


The survey was administered to 109 students, and completed by 83% (N=90; 44 control, 46 exposure).  Responses received a score from 0 to 5 for the number of methods recalled for soothing a crying infant.  The students exposed to the simulated crying infants demonstrated a statistically significant increase in recall of soothing methods as compared to the traditional lecture/question group (2.33 vs. 1.39, p=0.0122; 95%CI: 0.21, 1.67).  


This result helps to demonstrate the utility of simulation instruction in medical education in increasing student recall as compared to the traditional lecture/question format.  This study also highlights the need for continued work in translating existing as well as developing new simulated instruction for pediatrics training at the medical student level.


[1] Ortiz N, Pedrogo Y, Bonet N (2011).  Integration of high-fidelity simulator in third-year paediatrics clerkship. Clinical Teacher. 2011; 8(2): 105-108