Clinical practice vs. clinical simulation: What is the impact on the learning of medical students?

Abstract

Introduction: Despite advances in traditional learning, we don't demonstrate changes in student's behavior. With simulation, students develop tools that improve attitudes and performance of medical competencies. Methods: This prospective and descriptive study evaluated the medical competencies of 81 medical students by conducting a mini-clinical evaluation exercise (mini-CEX), direct observation evaluation technique composed of 7 domains. All students perform 3 mini-CEX: at the beginning of the course before performing either simulation (SIM) or clinical practice (PC), in the middle of the course after performing simulation or clinical practice, and at the end of the course after performing both. Results: The average ratings were 2.7 in mini-CEX stage 1, 6.2 in stage 2 after SIM, and 2.5 in stage 2 after PC, and 7.2 in stage 3 after both SIM and PC. Approximately 29.6% of students passed the assessment satisfactorily or better in stage 1, 96.3% in stage 2 after SIM, 25.8% in stage 2 after PC, and 97.4% in stage 3. Students who initially performed PC throughout the course had average assessment rates of 2.6 in mini-CEX stage 1, 2.5 in stage 2, and 6.4 in stage 3. Students who initially performed SIM, had average assessment rates of 2.8, 6.2 and 7.6 in stage 1, 2, and 3, respectively. Conclusions: Simulation allows a significant improvement in medical skills. Students develop tools through simulation, that applied to real clinical practice achieve an even greater impact on these medical competencies.