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BackgroundEmergency medicine (EM) physicians often practice in dynamic, high‐stress, and uncertain settings with limited resources. Although simulation has been shown to enhance various aspects of student development, its impact on medical students' personal growth initiative, resourcefulness, and tolerance of uncertainty—crucial traits for managing future crises as emergency physicians—remain unclear. The purpose of this study, therefore, was to determine a high‐fidelity prehospital simulation's impact on medical students' resourcefulness, personal growth, and tolerance of uncertainty.MethodsWe surveyed 107 fourth‐year medical students before and after a multiday, high‐fidelity prehospital simulation. The survey included items from the Intolerance of Uncertainty Scale‐12 Item Form, the Personal Growth Initiative Scale, and the Resourcefulness Skills Scale. We compared students' pre‐ and post‐simulation responses to investigate any change in their uncertainty intolerance, personal growth initiative, and resourcefulness following simulation participation.ResultsStudents’ scores significantly increased following the simulation for both resourcefulness (t(106) = −6.89, p < 0.001, d = −0.67) and personal growth initiative (t(106) = −6.22, p < 0.001, d = −0.60). Effect size calculations suggest that participating in the simulation had a medium to large effect on participants’ resourcefulness and personal growth initiative. However, participants’ tolerance of uncertainty scores prior to and following the simulation did not significantly differ (t(106) = 1.66, p = 0.100, d = 0.16), indicating that the simulation had little effect on participants’ tolerance of uncertainty.ConclusionsOur results indicate that simulation is a promising educational tool for developing students' resourcefulness and personal growth initiative so they can navigate high‐stress, low‐resource environments. Follow‐on research is needed to determine how to leverage simulation to enhance students’ uncertainty tolerance in high‐stress, low‐resource environments.
BackgroundEmergency medicine (EM) physicians often practice in dynamic, high‐stress, and uncertain settings with limited resources. Although simulation has been shown to enhance various aspects of student development, its impact on medical students' personal growth initiative, resourcefulness, and tolerance of uncertainty—crucial traits for managing future crises as emergency physicians—remain unclear. The purpose of this study, therefore, was to determine a high‐fidelity prehospital simulation's impact on medical students' resourcefulness, personal growth, and tolerance of uncertainty.MethodsWe surveyed 107 fourth‐year medical students before and after a multiday, high‐fidelity prehospital simulation. The survey included items from the Intolerance of Uncertainty Scale‐12 Item Form, the Personal Growth Initiative Scale, and the Resourcefulness Skills Scale. We compared students' pre‐ and post‐simulation responses to investigate any change in their uncertainty intolerance, personal growth initiative, and resourcefulness following simulation participation.ResultsStudents’ scores significantly increased following the simulation for both resourcefulness (t(106) = −6.89, p < 0.001, d = −0.67) and personal growth initiative (t(106) = −6.22, p < 0.001, d = −0.60). Effect size calculations suggest that participating in the simulation had a medium to large effect on participants’ resourcefulness and personal growth initiative. However, participants’ tolerance of uncertainty scores prior to and following the simulation did not significantly differ (t(106) = 1.66, p = 0.100, d = 0.16), indicating that the simulation had little effect on participants’ tolerance of uncertainty.ConclusionsOur results indicate that simulation is a promising educational tool for developing students' resourcefulness and personal growth initiative so they can navigate high‐stress, low‐resource environments. Follow‐on research is needed to determine how to leverage simulation to enhance students’ uncertainty tolerance in high‐stress, low‐resource environments.
Introduction Military physicians must be prepared to lead health care teams across complex landscapes of war during future small- and large-scale combat operations. This preparation optimally begins in medical school so that early career physicians are fully ready for their first deployment. Past qualitative research has suggested that military physicians who attended civilian medical school are not as well prepared for the operational environment as physicians who attended the Uniformed Services University (USU), our nation’s military medical school. However, there is a lack of larger-scale quantitative research comparing the readiness differences between the two medical school pathways. The purpose of this study, therefore, was to quantify any differences in first deployment preparation between students attending USU and civilian medical schools through the Health Professions Scholarship Program (HPSP). Materials and Methods We compared USU and HPSP graduates’ first deployment experiences by distributing a 14-item Likert survey to active duty military physicians in the U.S. Army, U.S. Navy, and U.S. Air Force who graduated within the past 10 years from medical school (USU or civilian). Results The USU graduates rated themselves significantly higher than the HPSP graduates on their readiness for deployment (3.83 vs. 3.24; P < .001); ability to navigate the operational environment (3.59 vs. 2.99; P < .001); confidence in communicating with their commanding officer (3.59 vs. 2.99; P = .002); navigating the combined role as physician and officer (3.33 vs. 2.84; P = .004); leading a health care team (3.94 vs. 3.43; P = .001); preparation by a medical school (3.78 vs. 2.52; P < .001); and overall readiness compared to peers (4.20 vs. 3.49; P < .001). There was no significant difference between the two pathways regarding their stress level at the beginning of deployment (2.74 vs. 2.68; P = .683); clinical preparation (3.94 vs. 3.76; P = .202); and success of first deployment (3.87 vs. 3.91; P = .792). The largest effect size of the difference between the two pathways was noted on the question “How well did medical school prepare you for your first deployment” (Cohen’s d = 1.02). Conclusions While both groups believed that they were prepared for their first deployment, USU graduates consistently reported being more prepared by medical school for their first deployment than HPSP graduates. To close this readiness gap, supplemental military unique curricula may help to optimize HPSP students’ readiness.
Introduction Past research has examined civilian and military medical schools’ preparation of physicians for their first deployment. Most recently, our research team conducted a large-scale survey comparing physicians’ perceptions of their readiness for their first deployment. Our results revealed that military medical school graduates felt significantly more prepared for deployment by medical school than civilian medical school graduates. In order to further investigate these results and deepen our understanding of the two pathways’ preparation of military physicians, this study analyzed the open-ended responses in the survey using a qualitative research design. Materials and Methods We used a descriptive phenomenological design to analyze 451 participants’ open-ended responses on the survey. After becoming familiar with the data, we coded the participants’ responses for meaningful statements. We organized these codes into major categories, which became the themes of our study. Finally, we labeled each of these themes to reflect the participants’ perceptions of how medical school prepared them for deployment. Results Four themes emerged from our data analysis: (1) Civilian medical school equipped graduates with soft skills and medical knowledge for their first deployment; (2) Civilian medical school may not have adequately prepared graduates to practice medicine in an austere environment to include the officership challenges of deployment; (3) Military medical school prepared graduates to navigate the medical practice and operational aspects of their first deployment; and (4) Military medical school may not have adequately prepared graduates for the realism of their first deployment. Conclusions Our study provided insight into the strengths and areas for growth in each medical school pathway for military medical officers. These results may be used to enhance military medical training regardless of accession pathway and increase the readiness of military physicians for future large-scale conflicts.
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