A Telesimulation Elective to Provide Medical Students With Pediatric Patient Care Experiences During the COVID Pandemic

Abstract

Objectives/Introduction The Association of American Medical Colleges suggested that medical students not be involved in direct patient care activities in the United States because of the COVID pandemic. Our objectives are to (1) describe the rapid creation and implementation of a fully online simulation-based pediatric emergency medicine training intervention for medical student learners using existing simulation center staff (faculty, technicians, actors) and resources (simulation technology, scenario files) and (2) report student and faculty feedback on the intervention. Methods The sessions involved the use of our existing simulation center faculty, staff, and resources. Feedbacks on the sessions were collected via a survey from faculty and students at the end of each session. Results Sixteen simulation sessions were conducted (8 febrile infant, 8 anaphylactic toddler). Forty-eight students, 2 technicians, 2 actors, and 10 faculty participated. Ninety percent of the students agreed with the statements, “I am more comfortable with pediatrics after this session,” “participating improved my pediatric knowledge/skills,” “this session was more useful than other learning activities I am involved in at this time.” Seventy percent of the students agreed with the statement, “I learned as much from observing as when I was actively involved.” All faculty agreed with the statement, “this was an effective educational strategy compared to other distance learning.” Most faculty (60%) disagreed with the statement, “virtual simulation was equal to or superior to in-person simulation.” All students and faculty strongly agreed with the statement, “I would highly recommend this to others.” Conclusions A telesimulation intervention involving all medical students, staff, and facilitators interacting remotely for pediatric emergency training during COVID was associated with high levels of satisfaction by the majority of learners and faculty.

Comparison of In-Person and Telesimulation for Critical Care Training during the COVID-19 Pandemic

“…The implementation of telesimulation can be quite varied and include 1 ) a remote facilitator and in-person learners with high-fidelity models ( 9 , 12 ); 2 ) an in-person facilitator with high-fidelity models and remote learners ( 11 , 19 ); 3 ) a remote facilitator, remote learners, and remote standardized patients ( 13 ); 4 ) a remote facilitator and remote learners with low-fidelity models ( 6 , 8 , 20 , 21 ); and 5 ) virtual reality simulations ( 22 ). Furthermore, telesimulation can be active, with the progression of the case from actions directed by remote learners ( 9 , 11 – 13 , 19 ), or passive, with the progression led by in-person learners and discussion of interventions by remote learners ( 10 , 14 ). We focused on this passive approach, as it allows for some in-person learners to actively participate and also has the ability to accommodate a large number of remote learners.…”

“…However, in the past year, telesimulation has grown because of the rise of pandemic-related distance learning. With the rapid adoption of telesimulation during the pandemic, new studies have evaluated the feasibility of telesimulation as an educational modality ( 9 – 13 ). Additionally, studies have demonstrated that active participants in telesimulation achieve increased self-reported confidence and knowledge, similar to active participants in in-person simulation ( 6 , 11 , 21 ).…”

“…Although telesimulation was initially used to train in resource-limited environments ( 6 – 9 ), it may be a reasonable alternative for replicating authentic patient experiences for medical students during the COVID-19 pandemic. There is still a paucity of literature on the effectiveness of telesimulation, with most studies focused on evaluating its feasibility ( 9 – 13 ). Only two studies directly compared in-person versus telesimulation techniques ( 10 , 14 ).…”

Telesimulation for remote simulation and assessment

“…The COVID‐19 pandemic has also had a dramatic impact on learners at the undergraduate medical education level, with many medical students at the clerkship stage pulled out of hospitals altogether in the spring of 2020. TS has been used to teach principles of management of acute pediatric emergencies to medical students 30 . In addition, TS has been leveraged to train neonatologists in the use of telehealth software during the COVID‐19 pandemic 31 …”

COVID-19 and Clinical Pastoral Education: How ACPE Educators Pivoted Amid the Pandemic

“…The use of simulation, a key but supplemental method of teaching, became the virtual tool of choice for some programs, especially for early learners in medicine and counseling ( Brydges et al, 2020 ; Donn et al, 2021 ; Hannon et al, 2020 ; Phillips et al, 2021 ; Yang et al, 2021 ). In other training programs, this transition took several forms, including shifting case-based learning to remote formats, virtual bedside teaching rounds employing videoconferencing, and increased use of telehealth ( Chandra et al, 2020 ; Diaz & Walsh, 2021 ; Hofmann et al, 2020 ; Keegan & Bannister, 2021 ; Sunavala-Dossabhoy & Spielman, 2020 ).…”