Playing Doctor – Simulations A Big Help In Medical Training
When should simulations be used in class? Do they matter or are they eye candy, empty demonstrations and a waste of time? A recent study published in Medical Teacher suggests that medical students benefit significantly in both learning and retention when high fidelity simulations are used in training. Authors Corey Heitz, Ashley Brown, James E. Johnson & Michael T. Fitch of Wright State University and Wake Forest University School of Medicine, compared the educational effects of a 90-minute live simulation to a traditional lecture.
A team of physicians assisted the in the presentation by acting the roles emergency medical staff, nurses and even family members. A computerized Laerdal SimMan(tm) was programmed to represent the patient who displayed symptoms like nausea, mental confusion and vomiting. As reported in Heitz, et al. (2009) the students were immersed in a theatrical enactment of the medial crisis:
“A Laerdal SimManTM was transported from the simulation center to the medical school lecture hall where a prerecorded EMS radio call announced the arrival of the fully clothed simulation mannequin. Resident physician actors portrayed EMS provi- ders, nurses, and family members. Student volunteers ran the case as emergency physicians and patient management decisions were guided by class input. The clinical scenario was enhanced with group discussion of the relevant basic science mechanisms underlying the autonomic nervous system, neurotransmitters, receptors, and neuropharmacology.” – Heitz et al. (2009)
The authors note that one of the key differences in this trial was the size of the group – 112 students in two groups. The live simulation was based on a clinical scenario designed to bring out basic concepts in neuroscience already presented in a lecture several days earlier by a participant who was unaware of the study.
Results of the training were measured using four multiple-choice pre-tests and post-tests.
“The primary study outcome was this comparison of student performance on a pretest compared to a posttest administered immediately after the simulation session, and participants were significantly more likely to get all four posttest questions correct after experiencing the simulation.” Heitz et al. (2009)
A follow-up post-test was given to students eleven days later to assess retention. The researchers suspect that immersion in the simulation contributed to recall:
“The concepts presented during our simulation session improved student testing immediately and may have facilitated performance on an examination 11 days later.” - Heitz et al. (2009)
The authors conclude that the use of simulations of this kind can be valuable in medical education:
“The students not only felt the simulation experience correlated well with basic science concepts, but also showed statistically significant improvement on the pre- and posttest examinations. Our results show that this type of learning exercise may provide an alternative for ‘‘typical’’ lecture-style education.” – Heitz et al. (2009)
References.
Wake Forest University Baptist Medical Center (2009, July 14). “Simulating Medical Situations Helps Students Learn, Retain Basic Science Concepts”. ScienceDaily. Retrieved April 22, 2010, from http://www.sciencedaily.com/releases/2009/07/090714085822.htm
Heitz, Corey , Brown, Ashley , Johnson, James E. and Fitch, Michael T.(2009) “Large group high-fidelity simulation enhances medical student learning”, Medical Teacher, 31: 5, e206 — e210
Emergency Simulations at Wake Forest University School of Medicine