Use of Real Patients and Patient-Simulation-Based Methodologies for Teaching Gastroenterology to Pre-Clinical Medical Students

Abstract

In recent years, there has been an increasing focus on the need to integrate formal knowledge with clinical experience in the pre-clinical years since the initial years of medical education play an important role in shaping the attitudes of medical students towards medicine and support the development of clinical reasoning. In this study, we describe approaches that involve real patients and patient-simulation-based methodologies to teach gastroenterology to second year medical students. Our goals were to (i) demonstrate bio-psychosocial aspects of clinical practice, (ii) demonstrate commonality of gastrointestinal ailments, and (iii) help understand complex gastroenterology concepts. We used two main approaches including brief, pre-prepared questions and answers discussing with the patients in various sessions throughout the course and a two-hour session that included patient participation, patient simulation modalities with high fidelity mannequins, a lightening round of interactive cases, and a Patient Oriented Problem Solving (POPS) session. The approaches improved the effectiveness of the delivery of the content-heavy, fast-paced GI course and provided opportunities for the students to think about gastroenterology from both basic and clinical points of view. The approaches involved peer teaching, which supports knowledge acquisition and comprehension. Very positive feedback and overall engagement of students suggested that these approaches were well-received.

A student‐led telephone‐based clinical learning program for outreach to older adults

“…21 Unlike traditional in-person clinical experiences for pre-clerkship students, this telephone-based clinical learning pilot program allowed non-essential health professions students to continue with direct participation in patient care of highly vulnerable patients during the COVID-19 pandemic, while also providing opportunities to practice workplace learning. [22][23][24] Screening calls allowed students to apply clinical knowledge to triage healthcare concerns and unmet medical or social work needs. Social calls provided an opportunity to practice empathy-driven, relationship-centered communication in a longitudinal setting, since students were assigned to the same patients for the duration of their participation.…”

Fostering the development of non-technical competencies in medical learners through patient engagement: a rapid review

“…Nineteen (19) articles reported student reactions to and appreciation for interventions actively involving patients. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] A general conclusion is that students perceived patient engagement in medical training as a positive learning experience. Indeed, studies highlighted students' enthusiasm 22 for this rich 36 and authentic experience, 25 which they stated was helpful, 20,23,28 conducive to learning, 20,24 and a source of personal and professional growth.…”

“…[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] A general conclusion is that students perceived patient engagement in medical training as a positive learning experience. Indeed, studies highlighted students' enthusiasm 22 for this rich 36 and authentic experience, 25 which they stated was helpful, 20,23,28 conducive to learning, 20,24 and a source of personal and professional growth. 23,29,37 The experience was perceived either as informative; 24 innovative and surprising; 29 fascinating and invaluable; 36 insightful, eye opening and enlightening; 34 powerful, motivating and inspiring; 28,34 disarming and engaging; 25,30,33 or supportive on a human level.…”

“…Twenty-one (21) articles reported changes in attitudes and perceptions as a result of an educational intervention actively involving patients. 20,21,[23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40][41][42] First, it led to changes in attitudes towards patients, particularly through a renewed awareness of common misapprehensions, myths and stereotypes regarding patients and their reality. 20,23,27,29,39 Some authors noted that patient engagement allowed students to see the patient as a fellow human being, not just a disease or a care plan, 23,34,36 which fostered a sense of humility.…”

The GI Simulated Clinic: A Clinical Reasoning Exercise Supporting Medical Students' Basic and Clinical Science Integration

“…DeSipio, Gaughan, Perlis, and Phadtare describe a learning activity involving SPs to teach preclinical medical students during the GI block, though the SPs are used to demonstrate aspects of GI tract anatomy through an endoscopy demonstration rather than for students' clinical skills practice. 25 Mulligan and colleagues' SP-based learning activity involves evaluation of geriatric patients with weight loss; however, it is designed as an interprofessional team activity with team-oriented learning goals and practice using a specific screening tool rather than diagnostic reasoning. 26 Akins 27 and Krugler 28 have each published SP cases of acute abdominal pain representing acute cholecystitis intended for use with medical students.…”