| Título: | Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum |
| Autores: |
Sperling, Jeremy D.; Weill Cornell Medical College Clark, Sunday; Weill Cornell Medical College Kang, Yoon; Weill Cornell Medical College |
| Fecha: | 2013-01-14 |
| Publicador: | Medical Education Online |
| Fuente: |
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| Tipo: | |
| Tema: | Mental Status Change; Simulation; Pre-Clinical Medical Students |
| Descripción: | Introduction: Simulation-based medical education (SBME) is increasingly being utilized for teaching clinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teaching clinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS) is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students’ knowledge acquisition, comfort, and perceived competence with regards to the AMS patient. Methods: AMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS. Results: A total of 154 students completed the post-test and survey and 65 (42%) attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (p<0.001). Students who participated in a simulation session were more comfortable in their overall approach to treating AMS patients (p=0.05). They were also more likely to state that they could articulate a differential diagnosis (p=0.03), know what initial diagnostic tests are needed (p=0.01), and understand what interventions are useful in the first few minutes (p=0.003). Students who participated in a simulation session were more likely to find the overall AMS curriculum useful (p<0.001). Conclusion: Students who participated in a simulation exercise performed better on a knowledge-based test and reported increased comfort and perceived competence in their clinical approach to AMS. SBME shows significant promise for teaching clinical skills to medical students during pre-clinical curriculum.Keywords: mental status change; simulation; pre-clinical medical studentsPublished: 3 April 2013Citation: Med Educ Online 2013, 18: 19775 - http://dx.doi.org/10.3402/meo.v18i0.19775To access the supplementary material to this article please see Supplementary files under Article Tools online |
| Idioma: | Inglés |
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