title: Medical students themselves as surrogate patients increased satisfaction, confidence, and performance in practicing injection skill.
abstract: BACKGROUND
  Injection skill is one of procedural skills usually taught to medical students. Lack of experience and confidence in their ability creates nervousness, anxiety, and leads to poor performance in giving an injection to patient.
  
  
  OBJECTIVE
  To evaluate the satisfaction on teaching method, perceptions of confidence and feeling of empathy to the patients, and performance in injection skill of medical students toward practicing injection skill using manikin only compared to additional training using themselves as surrogate patients.
  
  
  METHODS
  Control group consisted of year 5 medical students, who completed studying injection skill from computer assistant instruction, demonstration, and practicing with manikin. The intervention group in addition to those conventional learning methods, directly experienced injection skill using themselves as surrogate patients and received direct feedback from their peers. Both group had a chance to perform injection to actual children and were assessed while performing the injection for their performance of injection procedures. Upon completion of the entire learning process, the students were asked to answer questionnaire presented with Likert-type scales.
  
  
  RESULTS
  There were 57 students in the control group and 32 in the intervention group who completed the study. The intervention group reported significantly higher satisfaction on the teaching method, higher level of confidence and empathy to the children who were given injection, and had significantly better performance in preparing the children and giving injection. Both groups are not different in checking accuracy of order, preparing vaccine, selecting injection site, sterile techniques, handling of instruments and injection site, documentation, and explaining to children/parents.
  
  
  CONCLUSIONS
  Direct experience by medical students themselves as surrogate patients is an appropriate option for learning injection skill and can enhance the student performance, and therefore should be encouraged.
authors.affiliation: Mahidol University, Thailand. raacr@mahidol.ac.th
authors.forename: Amornsri
authors.initials: A
authors.lastname: Chunharas
authors.forename: Priyasuda
authors.initials: P
authors.lastname: Hetrakul
authors.forename: Rattanaporn
authors.initials: R
authors.lastname: Boonyobol
authors.forename: Thitiporn
authors.initials: T
authors.lastname: Udomkitti
authors.forename: Teerarat
authors.initials: T
authors.lastname: Tassanapitikul
authors.forename: Duangrurdee
authors.initials: D
authors.lastname: Wattanasirichaigoon
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D004645:Empathy; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008348:Manikins; D016544:Patient Simulation; D018709:Statistics, Nonparametric; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires