Use of simulator-based medical procedural curriculum: the learner's perspectives

Abstract

BackgroundSimulation is increasingly used for teaching medical procedures. The goal of this study was to assess learner preferences for how simulators should be used in a procedural curriculum.MethodsA 26-item survey was constructed to assess the optimal use of simulators for the teaching of medical procedures in an internal medicine residency curriculum. Survey domains were generated independently by two investigators and validated by an expert panel (n = 7). Final survey items were revised based on pilot survey and distributed to 128 internal medicine residents.ResultsOf the 128 residents surveyed, 106 (83%) responded. Most responders felt that simulators should be used to learn technical skills (94%), refine technical skills (84%), and acquire procedural teaching skills (87%).Respondents felt that procedures most effectively taught by simulators include: central venous catheterization, thoracentesis, intubation, lumbar puncture, and paracentesis. The majority of learners felt that teaching should be done early in residency (97%).With regards to course format, 62% of respondents felt that no more than 3-4 learners per simulator and an instructor to learner ratio of 1:3-4 would be acceptable.The majority felt that the role of instructors should include demonstration of technique (92%), observe learner techniques (92%), teach evidence behind procedural steps (84%) and provide feedback (89%). Commonly cited barriers to procedural teaching were limitations in time, number of instructors and simulators, and lack of realism of some simulators.ConclusionsOur results suggest that residents value simulator-based procedural teaching in the form of small-group sessions. Simulators should be an integral part of medical procedural education.

Computerized training system for ultrasound-guided lumbar puncture on abnormal spine models: a randomized controlled trial

“…It is uncertain whether the abilities demonstrated in this simulated setting will translate to improved performance in the real clinical environment. Simulation-based education is generally considered effective, 6 and most studies conclude that it is beneficial before transitioning to clinical procedures. 15 Results of studies in laparoscopy, colonoscopy and central line insertion have shown that participants achieve better clinical performance in these skills when they are trained on a simulator beforehand.…”

“…The simulated environment is increasingly being used for learning procedural skills, including LP, 6 because it permits repetitive practice while avoiding undue risk to patients. It provides a safe environment to learn and practice technical skills with the advantages of reducing both time pressures and fear of harming the patient.…”

Simulación clínica y quirúrgica en la educación médica: aplicación en obstetricia y ginecología

“…La simulación se puede utilizar para introducir nuevos conceptos y evaluar competencias especificas (3) . Por otra parte, el marco teórico y conceptual de la simulación médica está centrado en el concepto de competencias.…”

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

“…10 Gaining a better understanding of learners' perspectives can assist educators in the implementation of a specific simulation curriculum. 3 Seattle Children's Hospital opened a new emergency department (ED) in April 2013 that includes a JIT training room, conveniently located within the ED clinical space, and is available 24 hours a day for procedural education in splinting, suturing, and lumbar puncture (LP). This room is used daily for physician and nurse education, but is always available for JIT training.…”

“…A number of studies [1][2][3][4][5][6][7][8][9] have examined JIT training, yet there are no known studies examining the use of dedicated JIT space to practice common procedures near the clinical space, rather than a simulation center. Simulation-based education, as in the JIT room, can provide a reproducible standard environment for deliberate practice as well as both formative and summative assessment.…”