Hybrid simulation improves medical student procedural confidence during EM clerkship

Abstract

Background: Medical students have limited opportunities to perform and learn procedures on live patients. This is particularly concerning at the Uniformed Services University of the Health Sciences (USUHS), where graduates may be assigned to an operational military unit immediately following completion of internship. The authors implemented a new hybrid simulation lab for fourth-year medical students at the Uniformed Services University of the Health Sciences consisting of procedural skills training for seven core emergency medicine skills combined with complex patient cases using high fidelity simulators and standardized patients. Objectives: Measure changes in student procedural skills confidence due to the new hybrid simulation curriculum. Methods: This observational study used anonymous 5-point Likert-anchored questionnaires to measure student confidence at three different times: immediately before hybrid simulation training, immediately after training, and 3 weeks post-training. Results: Pretraining student confidence was 3.0 (out of 5) when averaged for all seven procedures. This improved to 4.2 immediately after training, and remained high (4.1) 3 weeks later at the end of the clerkship. Students retained this improved confidence despite performing few procedures on real patients during their clerkships. The training demonstrated statistically significant confidence improvement for all procedures, except bag-valve mask ventilation. Conclusions: Hybrid simulation training improves student confidence with procedural skills during an emergency medicine clerkship.