Effectiveness of early cardiology undergraduate learning using simulation on retention, application of learning and level of confidence during clinical clerkships

Lin, Weiqin; Lee, Glenn K.; Loh, Joshua P.; Tay, Edgar; Sia, Winnie; Lau, Titus; Hooi, Shing Chuan; Poh, Kian‐Keong

doi:10.11622/smedj.2015023

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Studies on simulation-based training of postgraduate doctors on hemodialysis [ 65 ] and lumbar puncture [ 66 ] have shown to retain skills one-year after training. Notably, in undergraduate medical education, Lee and colleagues recruited ten medical students who had undergone a single simulation-based training on cardiovascular system examination one year ago [ 69 ]. These students have not had further training after the initial training session.…”

Section: Discussionmentioning

confidence: 99%

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Kodikara,

Seneviratne,

Premaratna

2023

BMC Med Educ

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Background The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated. Methods A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student’s communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT). Results Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)]. Conclusion Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.

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Section: Discussionmentioning

confidence: 99%

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Kodikara,

Seneviratne,

Premaratna

2023

BMC Med Educ

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“…The study designs adopted for investigating the transfer of skills to clinical practice ranged from randomized control trials (RCT) (Jensen et al, 2014;Kodikara et al, 2023a;Lee et al, 2015) and pre and post-test studies (Barsuk et al, 2016;Cannon et al, 2014;Kodikara et al, 2023b). reported a significant improvement in skill performance.…”

Section: Effectiveness Of Simulation For Acquiring Procedural Expertisementioning

confidence: 99%

“…They reported a significant improvement in skills in the simulator-trained group. Lee et al (2015) conducted a pre-and post-test study on cardiovascular system examinations among 20 medical students. They compared the simulator-trained group with the clerkship-trained group.…”

Section: Effectiveness Of Simulation For Acquiring Procedural Expertisementioning

confidence: 99%

Clinical Simulation for Procedural Expertise: State of Education and Application

Kodikara

2023

sljo-j-jdrra

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Procedural skills are a core component in the health care practice that extends across all medical practitioners, from novice trainees to specialists. Medical institutions have widely adopted simulation to develop the clinical and procedural skills of health profession students. This review evaluates the evidence regarding simulation-based training for developing procedural expertise among medical students and junior doctors. For this purpose, Google Scholar and MEDLINE/PubMed databases were searched for articles published on simulation-based procedural training between January 2000 and October 2023. Reviews or studies published in languages other than English and research that showed evidence on communication, critical thinking, teamwork, decision-making, and cognitive skills were excluded from the search. The focus was placed on clinical and psychomotor skills as this review intends to inform clinical skills teaching and research practice. The results reveal that simulation-based training has been utilized increasingly to train medical students and junior doctors in procedural skills. Varying levels of fidelity have been incorporated to train psychomotor skills about a multitude of common and rare procedures. The evidence supports the acquisition of knowledge and procedural skills via simulation. Evidence also supports the transfer of skills from the simulated environment to clinical practice and live patients. However, resource intensiveness has limited the implementation of this method of education in developing countries. When used consciously, simulation can complement clinical training to produce competent doctors capable of effective patient care.

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A brief simulation intervention increasing basic science and clinical knowledge

Sheakley

Gilbert

Leighton³

et al. 2016

Medical Education Online

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BackgroundThe United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application.PurposeTo evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors.MethodsThis study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (nl=515) and the intervention group received lecture plus a simulation exercise (nl+s=1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression.ResultsUndergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003).DiscussionSimulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

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Effectiveness of early cardiology undergraduate learning using simulation on retention, application of learning and level of confidence during clinical clerkships

Cited by 3 publications

References 18 publications

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Clinical Simulation for Procedural Expertise: State of Education and Application

A brief simulation intervention increasing basic science and clinical knowledge

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