Michael S Ryan, MD - VCU School of Medicine; Cheryl N Bodamer, PhD, MPH, RN - VCU School of Medicine; Moshe Feldman, PhD - VCU School of Medicine
One of several important competencies in the APA/COMSEP curriculum is the ability of a student to identify normal from abnormal breath sounds and apply this to the care of a patient with respiratory distress. While simulation has been shown to improve specific skills (i.e. bag-mask ventilation), there is a paucity of literature evaluating its effectiveness in teaching knowledge-based competencies. The purpose of this study was to develop a simulation-based educational session as a primary method for teaching third year medical students how to assess and manage children with respiratory distress and evaluate its effectiveness in terms of knowledge acquisition and student satisfaction.
This study was approved by the Virginia Commonwealth University IRB. A survey was sent to all students (n= 175) who completed the Pediatrics Clerkship at the VCU School of Medicine in the 2009-2010 academic year. The survey asked students to rate their comfort in ten core competencies using a five point Likert scale. Results of the survey showed that pediatric respiratory distress was the area of greatest need. Using the COMSEP competencies combined with core PALS concepts, a high-fidelity simulation session was designed and provided to all students in 2010-2011. These students (n = 174) were then surveyed with the same tool as the 2009-2010 cohort. A Chi Square test (SPSS, Version 19) was performed to assess the relationship between the two groups.
A total of 68 and 106 survey responses were collected from the 2009-2010 and 2010-2011 cohorts, respectively. In comparing the two groups, a significant difference was found in students’ confidence managing children with respiratory distress (p=<.001); mean scores were 3.15 (SD 1.188) in 2009-2010 and 3.97 (SD 0.941) in 2010-2011. None of the other competencies demonstrated a valid significant difference. In addition, the simulation session was the highest rated educational conference of the 2010-2011 academic year.
High-fidelity simulation is an effective modality for teaching students how to evaluate and treat pediatric patients with respiratory distress. In addition to its use in teaching specific skills, consideration should be given to utilizing simulation as a primary method for teaching knowledge-based competencies.