Just like the simulations: Improving medical student confidence with simulated emergency medicine scenarios

Abstract

Background: Incoming emergency medicine residents may feel unsure of their ability to handle common emergency department scenarios, even if they are well educated on the proper steps to take in those scenarios. This may not stem from a lack of skill so much as a lack of confidence in their ability to perform with skills they have. Objective: We look to establish a link between completion of simulationbased training in common emergency medicine scenarios and learner self-reported confidence in their ability to perform competently in those scenarios. Methods: Fourth-year medical students who matched into an emergency medicine residency program participated in a Transitional Educational Program (TEP) at the Interprofessional Immersive Simulation Center at the University of Toledo in April 2021. Simulations of 16 procedural skills and clinical judgement cases were carried out using high-fidelity mannequins and real medical equipment in a hospital-based setting. Subjects were given pre-and post-TEP survey questionnaires assessing their self-reported confidence to competently perform in common emergency medicine clinical scenarios, using a 5-grade Likert scale. Data was analyzed using a one-tailed Wilcoxon signed-rank matched-pairs test. Results: Of 19 participating subjects, 16 (84.2%) consented and responded to the pre-survey. Of those 16 subjects, 10 (62.5%) completed the surveys at the correct time and order. The pre-and post-surveys consisted of the same 14 questions. In 11 of 14 survey questions, there was a significant increase in subject self-reported confidence (p<.05) between pre-and post-survey. Conclusions: Simulation-based training in the setting of high-fidelity equipment and faculty guidance improved the self-reported confidence of incoming emergency medicine residents to perform in common emergency medicine scenarios.