Simulation as a Central Feature of an Elective Course: Does Simulated Bedside Care Impact Learning?

Abstract

A three-credit, simulation-based, emergency medicine elective course was designed and offered to doctor of pharmacy students for two years. The primary objective was to determine if there was a difference in exam performance stratified by student simulation experience, namely either as an active observer or as part of bedside clinical care. The secondary objective was to report student satisfaction. Examination performance for simulation-based questions was compared based on the student role (evaluator versus clinical) using the Student’s t-test. Summary responses from Likert scale-based student satisfaction responses were collected. A total of 24 students took the course: 12 in each offering. Performance was similar whether the student was assigned to the evaluation team or the clinical team for all of the comparisons (mid-term and final 2015 and 2016, all p-values > 0.05). Students were very satisfied with the course. Of the 19 questions assessing the qualitative aspects of the course, all of the students agreed or strongly agreed to 17 statements, and all of the students were neutral, agreed, or strongly agreed to the remaining two statements. Direct participation and active observation in simulation-based experiences appear to be equally valuable in the learning process, as evidenced by examination performance.

Overview of implementation and learning outcomes of simulation in pharmacy education

“…Although simulated patient survival increased after previous exposure to HFS in an elective (37%) or certification (86%) course, the outcome was statistically superior only after the certification course 26,41 . Other supplementary outcomes routinely assessed include attitudes, perceptions, confidence, and satisfaction related to HFS 15,26,40–47,49,50 . Increased learner confidence and satisfaction with HFS are routinely described 15,26,40–47,50,63 …”

“…Learning outcomes associated with HFS have been described for pharmacy students, 15,26,[40][41][42][43][44][48][49][50][63][64][65][66] pharmacy residents, [59][60][61][62] and interprofessional learners [51][52][53][54][55][56][57][58][67][68][69][70][71][72] (Table 1).…”

“…15,26,[40][41][42][43][44][45][46][47]49,50 Increased learner confidence and satisfaction with HFS are routinely described. 15,26,[40][41][42][43][44][45][46][47]50,63 Learning outcomes for pharmacy residents participating in HFS experiences of medical emergencies or ACLS focuses on global cognitive skills over discrete tasks and include outcomes such as confidence, knowledge, competency, satisfaction with the simulation, preparedness, and sustainability of preparedness. [59][60][61][62] These learning outcomes are typically evaluated using quantitative methods in the form of Likert scale surveys administered to participants either before and after or just after the simulation.…”

“…Knowledge as assessed by quizzes and examinations is the most commonly described learning outcome for pharmacy students participating in HFS 15,40,42–44,46–50,63,66 . Students' knowledge improves with HFS in a variety of clinical content areas 15,40,43,46–50,63,66 .…”

Structured incremental measurement of directed and objective simulation experiences-pilot (SIM DOSE-P)

“…programmes with positive results. Student perception is very positive (Seybert et al, 2006;Fernandez et al, 2007;Thomas et al, 2018;Davis et al, 2013). It is also an effective tool to teach and evaluate skill acquisition in a simulated clinical setting (Seybert et al, 2007;Seybert et al, 2008;Mieure et al, 2010;Vyas et al, 2010;Robinson et al, 2011;Seybert et al, 2011).…”