title: An educational course including medical simulation for early goal-directed therapy and the severe sepsis resuscitation bundle: an evaluation for medical student training.
abstract: OBJECTIVE
  Widespread application of early goal-directed therapy (EGDT) and the severe sepsis resuscitation bundle is limited by clinician knowledge, skills and experience. This study evaluated use of simulation-based teaching during medical training to increase future clinician knowledge in the above therapies for severe sepsis and septic shock.
  
  
  METHODS
  A prospective cohort study was performed with medical students at all levels of training. A 5-h course including didactic lectures, skill workshops, and a simulated case scenario of septic shock were administered to the participants. A checklist including 21 tasks was completed during the patient simulation. An 18-question pre-test, post-test and 2-week post-test were given. The participants completed a survey at the end of the course.
  
  
  RESULTS
  Sixty-three students were enrolled. There was statistical difference between the pre-test and each of the post-test scores: 57.5+/-13.0, 85.6+/-8.8, and 80.9+/-10.9%, respectively. 20.6% of participants thought the pre-test was too difficult, whereas all participants thought the post-test was either appropriate or too easy. The task performance during the simulated septic shock patient was 94.1+/-6.0%. The participants noted improvements in their confidence levels at managing severe sepsis and septic shock, and agreed that the course should be a requirement during medical school training.
  
  
  CONCLUSIONS
  Medical simulation is an effective method of educating EGDT and the severe sepsis resuscitation bundle to medical students with limited experience in patient care. The results suggest that our course may be of further benefit at increasing clinical experience with this intensive protocol for the management of severe sepsis and septic shock.
authors.affiliation: Department of Emergency Medicine, Loma Linda University, Loma Linda, CA 92354, United States. hbnguyen@llu.edu
authors.forename: H Bryant
authors.initials: HB
authors.lastname: Nguyen
authors.forename: Lynda
authors.initials: L
authors.lastname: Daniel-Underwood
authors.forename: Chad
authors.initials: C
authors.lastname: Van Ginkel
authors.forename: Melanie
authors.initials: M
authors.lastname: Wong
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: Anthony San
authors.initials: AS
authors.lastname: Lucas
authors.forename: Janice
authors.initials: J
authors.lastname: Palaganas
authors.forename: Daryl
authors.initials: D
authors.lastname: Banta
authors.forename: T Kent
authors.initials: TK
authors.lastname: Denmark
authors.forename: Kathleen
authors.initials: K
authors.lastname: Clem
mesh_terms: D002985:Clinical Protocols; D015331:Cohort Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D006801:Humans; D016544:Patient Simulation; D015397:Program Evaluation; D011446:Prospective Studies; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy; D012984:Software; D013337:Students, Medical