A Randomized Comparison Trial of Case-based Learning versus Human Patient Simulation in Medical Student Education

Schwartz, Lawrence R; Fernandez, Rosemarie; Kouyoumjian, Sarkis; Jones, Kerin A.; Compton, Scott

doi:10.1111/j.1553-2712.2007.tb01757.x

Cited by 41 publications

(25 citation statements)

References 25 publications

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“…For example, one study found a positive impact of simulation on specific cardiac and pulmonary diagnostic skills for first year medical students (11) and another on the physiological effects of anesthetic agents on hemodynamic parameters (12). As described earlier, most simulation medical school interventions like ours have focused on third- and fourth-year students in clerkships like emergency medicine (13–15, 18, 19), surgery (16), and anesthesia (17). …”

Section: Discussionmentioning

confidence: 99%

“…Unlike many previous studies (13–15), the primary intent of this study was to assess whether simulation had an additive benefit to a traditional curriculum rather than as a replacement to existing formats such as lectures or problem-based learning (PBL) sessions. Our intention was to use the simulation experience for experiential learning (6) and deliberate practice (7, 8) as a method for reinforcing key teaching points that were emphasized in the lectures and PBL cases.…”

Section: Discussionmentioning

confidence: 99%

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Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

Sperling

Clark

Kang

2013

Medical Education Online

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IntroductionSimulation-based medical education (SBME) is increasingly being utilized for teaching clinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teaching clinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS) is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students’ knowledge acquisition, comfort, and perceived competence with regards to the AMS patient.MethodsAMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS.ResultsA total of 154 students completed the post-test and survey and 65 (42%) attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (p<0.001). Students who participated in a simulation session were more comfortable in their overall approach to treating AMS patients (p=0.05). They were also more likely to state that they could articulate a differential diagnosis (p=0.03), know what initial diagnostic tests are needed (p=0.01), and understand what interventions are useful in the first few minutes (p=0.003). Students who participated in a simulation session were more likely to find the overall AMS curriculum useful (p<0.001).ConclusionStudents who participated in a simulation exercise performed better on a knowledge-based test and reported increased comfort and perceived competence in their clinical approach to AMS. SBME shows significant promise for teaching clinical skills to medical students during pre-clinical curriculum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

Sperling

Clark

Kang

2013

Medical Education Online

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“…A study performed by Schwartz et al 34 in 2005 assessed the performance of fourth-year medical students after a month of instruction during their required EM clerkship by using either a Human Patient Simulator (HPS) or Case-based Learning (CBL) modules. The students were randomly assigned to either the CBL (n = 52) or HPS (n = 50) groups, and each group was taught a chest-pain curriculum.…”

Section: Introductionmentioning

confidence: 99%

Simulation in Medical School Education: Review for Emergency Medicine

Chakravarthy

Haar

Bhat

et al. 2011

WestJEM

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Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

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“…Although the literature addressing improved student performance may be inconclusive, 16–20 simulation has been shown to have a positive impact in a number of other trainee groups. 21–24 Incorporating high-fidelity simulation into emergency medicine clerkships allows reproduction of physiologic extremes, and students can practice critical care scenarios for critically ill patients without interruption from faculty.…”

Section: Discussionmentioning

confidence: 99%

Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine

Heitz

Eyck²,

Smith³

et al. 2011

WestJEM

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IntroductionThe objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges.MethodsWe solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting.ResultsCDEM members representing 60 EM programs on the list (80%) responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%), task trainers (55%), and low-fidelity models (30%). Respondents identified limited faculty time (88.7%) and clerkship hours (47.2%) as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years.ConclusionA focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

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A Randomized Comparison Trial of Case-based Learning versus Human Patient Simulation in Medical Student Education

Cited by 41 publications

References 25 publications

Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

Simulation in Medical School Education: Review for Emergency Medicine

Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine

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