ijier logo

The Effect of Simulation based Training on Medical Students’ Perceptions, Knowledge, and Skill at Baseline and 6 month Follow up 114 88

Authors

  • Cameron Garth Shultz St. Mary Mercy Livonia Hospital, USA Author
    • James M Cooke University of Michigan, USA Author
      • Keri L Denay University of Michigan, USA Author
        • Mikel Llanes University of Michigan, USA Author
          • Philip Zazove University of Michigan, USA Author
            • Scott A Kelley University of Michigan, USA Author

              DOI:

              https://doi.org/10.31686/ijier.vol4.iss5.547

              Keywords:

              Clinical simulation, education, medical student, knowledge, skill

              Abstract

              The principal goal of most simulation-based learning is enhanced clinical skill, with the desired outcome being skill retention and improved performance over time. While evide nce supports simulation based training at the clerkship, graduate, and post graduate level, the evidence supporting its long term benefit at the pre clerkship level is less well established. Using quantitative methods, this research assessed the effect of skill based clinical simulation training on all second year medical students’ enrolled in two simulation courses at the University of Michigan during the 2013 2014 academic year (n=39). Pre course, post course, and 6 month follow up questionnaires were adm inistered, and analysis of variance was used to assess change in students' knowledge, self reported confidence, and competency. Students in Course 1 (n=12) completed a post course and 6 month follow up skills test, and results were compared to faculty cont rols. Differences between groups were assessed using t tests. Odds ratios were calculated.
              Knowledge improved from pre course to post course; the gain was retained at follow up only for students in Course 1. Students perceived the courses as improving know ledge, confidence, and skill, though scores were significantly lower at follow up. For the subset of students participating in the skills test, the time to complete central line and thoracentesis at follow up did not significantly differ from post course; however, an increase was observed for lumbar puncture. Compared to faculty, students took significantly more time to complete the central line procedure. Outcomes for needle redirects and correct sequencing were mixed, with most procedures showing no signi ficant difference between measurement periods. Assessing students’ skill and the maintenance of that skill over time using objective and empirically derived measures can be challenging. The evaluation strategy described herein could be adapted to many proc edures commonly practiced within primary care and other medical specialties. Brief exposure to clinical simulation early in medical training and prior to clerkships can have a positive and lasting effect
              on medical students’ knowledge, confidence, and skil l for selected procedures.

              Author Biographies

              • Cameron Garth Shultz, St. Mary Mercy Livonia Hospital, USA

                Graduate Medical Education

              • James M Cooke, University of Michigan, USA

                Department of Family Medicine and Learning Health Sciences

              • Keri L Denay, University of Michigan, USA

                Department of Family Medicine

              • Mikel Llanes, University of Michigan, USA

                Department of Family Medicine

              • Philip Zazove, University of Michigan, USA

                Department of Family Medicine

              • Scott A Kelley, University of Michigan, USA

                Department of Family Medicine

              References

              Ahya, S. N., Barsuk, J. H., Cohen, E. R., Tuazon, J., McGaghie, W. C., & Wayne, D. B. (2012). Clinical

              performance and skill retention after simulation based e ducation for nephrology fellows. Semin Dial,

              (4), 470 473. doi: 10.1111/j.1525 139X.2011.01018.x DOI: https://doi.org/10.1038/470473a

              Barsuk, J. H., Cohen, E. R., McGaghie, W. C., & Wayne, D. B. (2010). Long

              term retention of central

              venous catheter insertion skills after simulation based m astery learning. Acad Med, 85(10 Suppl), S9 12.

              doi: 10.1097/ACM.0b013e3181ed436c DOI: https://doi.org/10.1097/ACM.0b013e3181ed436c

              Bradley, P. (2006). The history of simulation in medical education and possible future directions. Med DOI: https://doi.org/10.1111/j.1365-2929.2006.02394.x

              Educ, 40(3), 254 262. doi: 10.1111/j.1365 2929.2006.02394.x DOI: https://doi.org/10.1111/j.1365-2929.2006.02394.x

              Chou, D. S.

              S., Abdelshehid, C., Clayman, R. V., & McDougall, E. M. (2006). Comparison of results of

              virtual reality simulator and training model for basic ureteroscopy training. [Comparative Study

              Randomized Controlled Trial]. J Endourol, 20(4), 266

              Cohen, J. (19

              . Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: L.

              Erlbaum Associates.

              Consoli, A., Fraser, K., Ma, I., Sobczak, M., Wright, B., & McLaughlin, K. (2012). Diagnostic

              performance 1 h after simulation training predicts le arning. Adv Health Sci Educ Theory Pract, 18(5),

              800. doi: 10.1007/s10459 012 9431 7

              Crofts, J. F., Bartlett, C., Ellis, D., Hunt, L. P., Fox, R., & Draycott, T. J. (2007). Management of shoulder DOI: https://doi.org/10.1097/01.AOG.0000286779.41037.38

              dystocia: skill retention 6 and 12 months after training . Obstet Gynecol, 110(5), 1069 1074. doi:

              1097/01.aog.0000286779.41037.38

              Davis, D. A., Mazmanian, P. E., Fordis, M., Van Harrison, R. R., Thorpe, K. E., & Perrier, L. (2006).

              Accuracy of physician self assessment compared with observed measures of comp etence: a systematic

              review. JAMA, 296(9), 1094 1102. doi: 10.1001/jama.296.9.1094 DOI: https://doi.org/10.1001/jama.296.9.1094

              Didwania, A., McGaghie, W. C., Cohen, E. R., Butter, J., Barsuk, J. H., Wade, L. D., . . . Wayne, D. B.

              (2011). Progress toward improving the quality of cardiac arrest medic al team responses at an academic

              teaching hospital. J Grad Med Educ, 3(2), 211 216. doi: 10.4300/jgme d 10 00144.1

              Fraser, K., Peets, A., Walker, I., Tworek, J., Paget, M., Wright, B., & McLaughlin, K. (2009). The effect

              of simulator training on clinical s kills acquisition, retention and transfer. Med Educ, 43(8), 784 789. doi: DOI: https://doi.org/10.1111/j.1365-2923.2009.03412.x

              1111/j.1365 2923.2009.03412.x

              Fraser, K., Wright, B., Girard, L., Tworek, J., Paget, M., Welikovich, L., & McLaughlin, K. (2011).

              Simulation training improves diagnostic performan ce on a real patient with similar clinical findings.

              Chest, 139(2), 376 381. doi: 10.1378/chest.10 1107

              Goulart, J. M., Dusza, S., Pillsbury, A., Soriano, R. P., Halpern, A. C., & Marghoob, A. A. (2012).

              Recognition of melanoma: A dermatologic clinical com petency in medical student education. J Am Acad

              Dermatol, 67(4), 606 611. doi: http://dx.doi.org/10.1016/j.jaad.2011.12.007 DOI: https://doi.org/10.1016/j.jaad.2011.12.007

              Halm, B. M., Lee, M. T., & Franke, A. A. (2010). Improving medical student toxicology knowledge and

              self confidence using mannequin simulation. Hawaii Med J, 69(1), 4 7.

              Heitz, C., Brown, A., Johnson, J. E., & Fitch, M. T. (2009). Large group high

              fidelity simulation

              enhances medical student learning. [Research Support, N.I.H., ExtramuralResearch Support, Non

              U.S. Gov't]. Med Teach, 31(5), e206 210.

              Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese, R. J. (2005). Features and

              uses of high fidelity medical simulations that lead to effective learning: a BEME systematic review.

              [Research Support, Non U.S. Gov't

              Research Support, U.S. Gov't, Non

              P.H.S.

              Review]. Medical Teacher, 27(1), 10

              Karabilgin, O. S., Vatansever, K., Caliskan, S. A., & Durak, H. I. (2012). Assessing medical student

              competency in communication in the pre clinical phase: objective structu red video exam and SP exam.

              Patient Educ Couns, 87(3), 293 299.

              Kelley, S. A., & Cooke, J. M. (Society of Teachers of Family Medicine, 2013). Simulated procedures in

              family medicine in a pre clinical medical student curriculum Retrieved 19 August, 2014, from

              http://www.fmdrl.org/index.cfm?event=c.beginBrowseD&clearSelections=1&criteria=kelley#4384

              Kelly, L. P., Garza, P. S., Bruce, B. B., Graubart, E. B., Newman, N. J., & Biousse, V. (2013). Teaching

              ophthalmoscopy to medical students (the TOTeMS study). [Randomized Controlled Trial

              Research Support, N.I.H., Extramural]. Am J Ophthalmol, 156(5), 1056

              doi:

              http://dx.doi.org/10.1016/j.ajo.2013.06.022 DOI: https://doi.org/10.1016/j.ajo.2013.06.022

              Kneebone, R. (2005). Evaluating clinical simulations for learning procedural skills: a theory DOI: https://doi.org/10.1097/00001888-200506000-00006

              based

              app roach. Acad Med, 80(6), 549 553.

              Lee, J. T., Qiu, M., Teshome, M., Raghavan, S. S., Tedesco, M. M., & Dalman, R. L. (2009). The utility

              of endovascular simulation to improve technical performance and stimulate continued interest of

              preclinical medical stu dents in vascular surgery. [Comparative Study

              Research Support, Non

              U.S. Gov't]. J Surg Educ, 66(6), 367 373. doi:

              http://dx.doi.org/10.1016/j.jsurg.2009.06.002 DOI: https://doi.org/10.1016/j.jsurg.2009.06.002

              McGaghie, W. C., Issenberg, S. B., Barsuk, J. H., & Wayne, D. B. (2014). A critical review of

              s imulation based mastery learning with translational outcomes. Med Educ, 48(4), 375 385. doi: DOI: https://doi.org/10.1111/medu.12391

              1111/medu.12391

              McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does

              simulation based medical education with deliberate p ractice yield better results than traditional clinical

              education? A meta analytic comparative review of the evidence. Acad Med, 86(6), 706 711. doi:

              1097/ACM.0b013e318217e119

              McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2010). A

              critical review of

              simulation based medical education research: 2003 2009. Med Educ, 44(1), 50 63. doi:

              1111/j.1365 2923.2009.03547.x

              Mittal, M. K., Morris, J. B., & Kelz, R. R. (2011). Germ simulation: a novel approach for raising medical

              students awar eness toward asepsis. [Comparative Study

              Research Support, Non

              U.S. Gov't]. Simul Healthc, 6(2), 65 70.

              Passiment, M., Sacks, H., & Huang, G. (2011). Medical simulation in medical education: results of an

              AAMC Survey Retrieved 14 March, 2014, from https: https://www.aamc.org/download/259760/

              Schubart, J. R., Erdahl, L., Smith Jr, J. S., Purichia, H., Kauffman, G. L., & Kass, R. B. (2012). Use ofBreast Simulators Compared with Standardized Patients in Teaching the Clinical Breast Examination to DOI: https://doi.org/10.1016/j.jsurg.2011.10.005

              Medical Stud ents. J Surg Educ, 69(3), 416 422. doi: http://dx.doi.org/10.1016/j.jsurg.2011.10.005 DOI: https://doi.org/10.1016/j.jsurg.2011.10.005

              van Zuilen, M. H., Kaiser, R. M., & Mintzer, M. J. (2012). A competency

              based medical student

              curriculum: taking the medication history in older adults. [Comparative Stud y

              Research Support, Non

              U.S. Gov't]. J Am Geriatr Soc, 60(4), 781 785.

              Wayne, D. B., Butter, J., Siddall, V. J., Fudala, M. J., Wade, L. D., Feinglass, J., & McGaghie, W. C.

              (2006). Graduating internal medicine residents' self assessment and performance o f advanced cardiac life

              support skills. Med Teach, 28(4), 365 369. doi: 10.1080/01421590600627821 DOI: https://doi.org/10.1080/01421590600627821

              Wayne, D. B., Siddall, V. J., Butter, J., Fudala, M. J., Wade, L. D., Feinglass, J., & McGaghie, W. C.

              (2006). A longitudinal study of internal medicine resid ents' retention of advanced cardiac life support

              skills. Acad Med, 81(10 Suppl), S9 S12.

              Downloads

              Published

              2016-05-01

              How to Cite

              Shultz, C. G., Cooke, J. M., Denay, K. L., Llanes, M., Zazove, P., & Kelley, S. A. (2016). The Effect of Simulation based Training on Medical Students’ Perceptions, Knowledge, and Skill at Baseline and 6 month Follow up. International Journal for Innovation Education and Research, 4(5), 151-165. https://doi.org/10.31686/ijier.vol4.iss5.547