title: Design and effectiveness of a required pre-clinical simulation-based curriculum for fundamental clinical skills and procedures.
abstract: BACKGROUND
  For more than 20 years, medical literature has increasingly documented the need for students to learn, practice and demonstrate competence in basic clinical knowledge and skills. In 2001, the Louisiana State University Health Science Centers (LSUHSC) School of Medicine - New Orleans replaced its traditional Introduction in to Clinical Medicine (ICM) course with the Science and Practice of Medicine (SPM) course. The main component within the SPM course is the Clinical Skills Lab (CSL). The CSL teaches 30 plus skills to all pre-clinical medical students (Years 1 and 2).
  
  
  METHODS
  Since 2002, an annual longitudinal evaluation questionnaire was distributed to all medical students targeting the skills taught in the CSL. Students were asked to rate their self- confidence (Dreyfus and Likert-type) and estimate the number of times each clinical skill was performed (clinically/non-clinically). Of the 30 plus skills taught, 8 were selected for further evaluation.
  
  
  RESULTS
  An analysis was performed on the eight skills selected to determine the effectiveness of the CSL. All students that participated in the CSL reported a significant improvement in self-confidence and in number performed in the clinically/non-clinically setting when compared to students that did not experience the CSL. For example, without CSL training, the percentage of students reported at the end of their second year self-perceived expertise as "novice" ranged from 21.4% (CPR) to 84.7% (GU catheterization). Students who completed the two-years CSL, only 7.8% rated their self-perceived expertise at the end of the second year as "novice" and 18.8% for GU catheterization.
  
  
  CONCLUSIONS
  The CSL design is not to replace real clinical patient experiences. It's to provide early exposure, medial knowledge, professionalism and opportunity to practice skills in a patient free environment.
authors.affiliation: LSUHSC School of Medicine - Office of Medical Education, Louisiana State University Health Sciences Center: School of Medicine - New Orleans 70112, USA. dlofas@lsuhsc.edu
authors.forename: Daryl P
authors.initials: DP
authors.lastname: Lofaso
authors.forename: Peter M
authors.initials: PM
authors.lastname: DeBlieux
authors.forename: Richard P
authors.initials: RP
authors.lastname: DiCarlo
authors.forename: Charles
authors.initials: C
authors.lastname: Hilton
authors.forename: Tong
authors.initials: T
authors.lastname: Yang
authors.forename: Sheila W
authors.initials: SW
authors.lastname: Chauvin
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D005260:Female; D006801:Humans; D008297:Male; D055820:New Orleans; D016730:Program Development; D015397:Program Evaluation; D012577:Schools, Medical; D020377:Self Efficacy; D013337:Students, Medical; D011795:Surveys and Questionnaires