Background Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, its usage within medical education has been declining, and COVID-19 has added additional challenges. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions, and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the use of online learning, social media platforms, and simulation. Simulation-based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with case standardization. The results demonstrate that simulation-based training can increase students’ confidence, increase the rates of correct clinical diagnoses, and improve retention of skills and knowledge when compared with traditional teaching methods. Objective To mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School amid closure of the cardiorespiratory wards, a high-fidelity simulation-based model of traditional bedside teaching was designed and implemented. The objectives of the teaching session were to enable students to perform history taking and a focused cardiorespiratory clinical examination in a COVID-19–safe environment using SimMan 3G. Methods Four clinical teaching fellows with experience of simulation-based medical education scripted histories for 2 common cardiorespiratory cases, which were asthma and aortic stenosis. The simulation sessions were designed for students to take a focused cardiorespiratory history and clinical examination using SimMan 3G. All cases involved dynamic vital signs, and the simulator allowed for auscultation of an ejection systolic murmur and wheezing in accordance with the cases chosen. Key aspects of the pathologies, including epidemiology, differential diagnoses, investigations, and management, were summarized using an interactive PowerPoint presentation, followed by a debriefing session. Results In total, 12 third year medical students undertook the sessions, and overall feedback was highly positive. Of the 10 students who completed the feedback questionnaires, 90% (n=9) felt more confident in their clinical examination skills following the teaching; 100% (n=10) of the students responded that they would recommend the session to a colleague; and implementation of regular simulation was frequently requested on feedback. These results are in keeping with the current literature. Conclusions Bedside teaching continues to face ongoing challenges from the COVID-19 pandemic as well as declining patient recruitment and fluctuations in clinical findings. The support for simulation-based medical education is derived from high-quality studies; however, studies describing the use of this technology for bedside teaching in the undergraduate curriculum are limited. The authors describe a highly effective teaching session amid the pandemic, which allowed for maintenance of staff and student safety alongside continued education during a challenging time for educators globally.
UNSTRUCTURED Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, it’s usage within medical education has been declining and additional challenges have been added during the COVID-19 pandemic. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the utilisation of online learning, social media platforms, virtual consultations, and simulation. Simulation based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with standardisation of cases. Several studies have been described in the literature, predominately using the Harvey simulator. The results demonstrate simulation-based training can increase student’s confidence, increase the rates of correct clinical diagnoses and improve retention of skills and knowledge when compared with traditional teaching methods. In order to mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School, a high-fidelity simulation based model of traditional bedside teaching was designed and implemented. The teaching sessions focused on asthma and aortic stenosis with all students having the opportunity to perform history taking and a focused cardiorespiratory clinical examination using SimMan 3G. Key aspects of the pathologies including epidemiology, differential diagnoses, investigation and management were summarised using an interactive powerpoint presentation, followed by a debriefing session. Overall feedback was highly positive with 91% of students feeling more confident in their clinical examination skills following the teaching session, all students recommending the session to a colleague and implementation of regular simulation being frequently requested amongst the responses.
Introduction Virtual simulation within health professions education can be categorized as two-dimensional or three-dimensional, dependent upon how users interact with the scenario. A core difference between these two categories is the degree of immersion experienced by the user. The importance of immersion for knowledge-based learning is unclear. Hence, this pilot study compares two virtual simulators to determine the impact of immersion on knowledge acquisition and retention and user experience. Methods This randomized crossover trial consisted of 25 fifth-year medical students attending two consecutive teaching sessions using two-dimensional and three-dimensional virtual simulation, respectively. Multiple-choice questions, completed immediately before and after, and one-month after the sessions, were employed to determine knowledge acquisition and retention. Questionnaires, consisting of Likert-scale and open-ended questions, evaluated user experience. Quantitative data was analyzed using a Student’s t-test and qualitative data was analyzed using thematic analysis. Results Both interventions demonstrated statistically significant levels of knowledge acquisition and retention, though there was no significant difference in the extent of learning between the simulators. The two interventions offered valuable and acceptable approaches to virtual simulation, though Likert-scale responses indicated that participants significantly preferred three-dimensional virtual simulation. Free-form responses revealed themes of education and technology, with subthemes of desirability, learning, curriculum integration, fidelity, hardware and software. Conclusions The findings indicate that higher levels of immersion do not appear to offer greater educational benefit, with two-dimensional simulation possibly offering an equally valuable learning experience to three-dimensional simulation. Participants appeared to significantly prefer three-dimensional virtual simulation, though potential uses for both simulators were identified.
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