title: How do clinical clerkship students experience simulator-based teaching? A qualitative analysis.
abstract: OBJECTIVE
  To critically analyze the experience of clinical clerkship students exposed to simulator-based teaching, in order to better understand student perspectives on its utility.
  
  
  METHODS
  A convenience sample of clinical students (n = 95) rotating through an emergency medicine, surgery, or longitudinal patient-doctor clerkship voluntarily participated in a 2-hour simulator-based teaching session. Groups of 3-5 students managed acute scenarios including respiratory failure, myocardial infarction, or multisystem trauma. After the session, students completed a brief written evaluation asking for free text commentary on the strengths and weaknesses of the experience; they also provided simple satisfaction ratings. Using a qualitative research approach, the textual commentary was transcribed and parsed into fragments, coded for emergent themes, and tested for inter-rater agreement.
  
  
  RESULTS
  Six major thematic categories emerged from the qualitative analysis: The "Knowledge & Curriculum" domain was described by 35% of respondents, who commented on the opportunity for self-assessment, recall and memory, basic and clinical science learning, and motivation. "Applied Cognition and Critical Thought" was highlighted by 53% of respondents, who commented on the value of decision-making, active thought, clinical integration, and the uniqueness of learning-by-doing. "Teamwork and Communication" and "Procedural/Hands-On Skills" were each mentioned by 12% of subjects. Observations on the "Teaching/Learning Environment" were offered by 80% of students, who commented on the realism, interactivity, safety, and emotionality of the experience; here they also offered feedback on format, logistics, and instructors. Finally, "Suggestions for Use/Place in Undergraduate Medical Education" were provided by 22% of subjects, who primarily recommended more exposure. On a simple rating scale, 94% of students rated the quality of the simulator session as "excellent," whereas 91% felt the exercises should be "mandatory."
  
  
  CONCLUSIONS
  Full-body simulation promises to address a wide range of pedagogical objectives using a unified educational platform. Students value experiential "practice without risk" and want more exposure to simulation. In this study, students thought that that an integrated simulation exercise could help solidify knowledge across domains, foster critical thought and action, enhance technical-procedural skills, and promote effective teamwork and communication.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: James K
authors.initials: JK
authors.lastname: Takayesu
authors.forename: Susan E
authors.initials: SE
authors.lastname: Farrell
authors.forename: Adelaide J
authors.initials: AJ
authors.lastname: Evans
authors.forename: John E
authors.initials: JE
authors.lastname: Sullivan
authors.forename: John B
authors.initials: JB
authors.lastname: Pawlowski
authors.forename: James A
authors.initials: JA
authors.lastname: Gordon
mesh_terms: D001900:Boston; D002982:Clinical Clerkship / Q000379:methods*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000295:instrumentation; D003479:Curriculum; D018961:Educational Technology / Q000295:instrumentation; D004635:Emergency Medicine / Q000193:education*; D013502:General Surgery / Q000193:education*; D006801:Humans; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D018794:Problem-Based Learning; D015397:Program Evaluation; D011446:Prospective Studies; D036301:Qualitative Research; D012655:Self-Evaluation Programs; D013337:Students, Medical / Q000523:psychology*