Evaluation of medical student retention of clinical skills following simulation training

Abstract

Background Adequate clinical skills training is a challenge for present day medical education. Simulation Based Education (SBE) is playing an increasingly important role in healthcare education worldwide to teach invasive procedures. The impact of this teaching on students along with retention of what is taught is not fully understood. The purpose of this study was to evaluate the retention levels of practical skills taught and assessed by SBE and to explore the degree of re-training required to restore decayed performance. In exploring this aim, the study further investigates how skilled performance decays over time and which dimensions of clinical skills were more likely to decay. Methods Study participants were 51 final year medical students. They were provided with online pre-course videos and procedural guides asynchronously with repeatedly access. 7 of the skills taught over 2 years using task trainers were selected. Following demonstration from faculty, students practiced in small groups with faculty facilitated supervision and peer support prior to formal testing. Score sheets with itemised procedure checklists detailing the minimum passing standard (MPS) for each skill were designed. To test retention of skills, 18 months later, there was an unannounced test to demonstrate proficiency in the skills. Students were asked to complete a questionnaire indicating how many times and where they had practiced or performed the skills. Results 55% of the students were deficient in 3 or more skills and 4% were not competent in 5 or more skills. A significant number of students had never practiced some skills following the initial teaching session. A relationship was noted with the number of times students self-declared that they had practiced and their performance. Decay is evident in both psychomotor and cognitive domains of the skills. Conclusion A curriculum with deliberate practice significantly increases the competence of students in defined clinical skills. Deliberate practice of clinical skills, under supervision of an engaged instructor, is a key component of the mastery model. Experiences and assessments in the clinical setting need to be augmented with focus on direct observation and focused feedback to reinforce the skills acquired in the simulated setting.

Relationships between objective structured clinical examination, computer-based testing, and clinical clerkship performance in Japanese medical students

“…To overcome this problem, we believe that simulation-based education (SBE) can be a powerful solution to compensate for the lack of opportunities to exercise these skills [22]. As SBE methods have been developed and are widely used to acquire both technical and non-technical skills in medical education [23] [24], combination of SBE and CC could potentially maximize the competency of medical students. For example, medical students can rephrase the resuscitation utilizing simulator which they watched in the emergency ward.…”

What is the best option to manage the bedside teaching for Neurology Clerkship -- Demonstration, Simulation or WeChat teaching?

“…Among the numerous evolving teaching methods in recent decades, simulation has been proved one of the most effective methods with the advantage of guarantying standardized learning experience (Weller et al, 2012). A recent study demonstrated that simulation-based education with deliberate practice significantly improved the confidence and clinical competence of students (Offiah et al, 2019). In addition to alleviating the fear of neurology, simulation-based education could also inspire the academic interest of students (Galtrey et al, 2018).…”

The Skill Training of Resident Anesthesiologists During the Outbreak Of COVID-19

“…Students can practice and reinforce newly learned skills to the level of mastery through simulation-based training combined with a feedback mechanism [8,9]. Compared to clinical training with real patients, simulation training is safer and allows for the acquisition of clinical skills through deliberate repeated practices [10,11]. During the pandemic period, students lacked access to PPE, which was in high demand.…”