title: Role of SimMan in teaching clinical skills to preclinical medical students.
abstract: BACKGROUND
  Simulation training has potential in developing clinical skills in pre-clinical medical students, but there is little evidence on its effectiveness.
  
  
  METHODS
  Twenty four first year graduate entry preclinical medical students participated in this crossover study. They were divided into two groups, one performed chest examination on each other and the other used SimMan. The groups then crossed over. A pretest, midtest and post-test was conducted in which the students answered the same questionnaire with ten questions on knowledge, and confidence levels rated using a 5 point Likert scale. They were assessed formatively using the OSCE marking scheme. At the end of the session, 23 students completed a feedback questionnaire. Data was analyzed using one-way ANOVA and independent t-test.
  
  
  RESULTS
  When the two groups were compared, there was no significant difference in the pretest and the post-test scores on knowledge questions whereas the midtest scores increased significantly (P< 0.001) with the group using SimMan initially scoring higher. A significant increase in the test scores was seen between the pre-test and the mid-test for this group (P=0.009). There was a similar albeit non significant trend between the midtest and the post-test for the group using peer examination initially.Mean confidence ratings increased from the pretest to midtest and then further in the post-test for both groups. Their confidence ratings increased significantly in differentiating between normal and abnormal signs [Group starting with SimMan, between pretest and midtest (P= 0.01) and group starting with peer examination, between midtest and post-test (P=0.02)]. When the students' ability to perform examination on each other for both groups was compared, there was a significant increase in the scores of the group starting with SimMan (P=0.007).
  
  
  CONCLUSIONS
  This pilot study demonstrated a significant improvement in the students' knowledge and competence to perform chest examination after simulation with an increase in the student's perceived levels of confidence. Feedback from the students was extremely positive. SimMan acts as a useful adjunct to teach clinical skills to preclinical medical students by providing a simulated safe environment and thus aids in bridging the gap between the preclinical and clinical years in medical undergraduate education.
authors: School of Medicine and Health, The Holliday Building, Durham University Queen's Campus, University Boulevard, Stockton on Tees, TS17 6BH, UK. meenakshi.swamy@durham.ac.uk
authors: Meenakshi
authors: M
authors: Swamy
authors: Thomas C
authors: TC
authors: Bloomfield
authors: Robert H
authors: RH
authors: Thomas
authors: Harnaik
authors: H
authors: Singh
authors: Roger F
authors: RF
authors: Searle
mesh_terms: D002983:Clinical Competence; D018592:Cross-Over Studies; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D008348:Manikins; D010808:Physical Examination; D010865:Pilot Projects; D013337:Students, Medical / Q000523:psychology
references: Hawaii Med J. 2010 Jan;69(1):4-7
references: 20222489
references: Med Educ. 2003 Nov;37 Suppl 1:22-8
references: 14641635
references: Med Teach. 2005 Jan;27(1):10-28
references: 16147767
references: BMC Med Educ. 2006 Oct 05;6:49
references: 17020624
references: Med Teach. 2006 Jun;28(4):326-9
references: 16807170
references: Med Educ. 2006 Mar;40(3):254-62
references: 16483328
references: Med Educ. 2004 Jan;38(1):32-8
references: 14962024
references: Acad Med. 2007 Oct;82(10):970-8
references: 17895662
references: Med Teach. 2010 Jan;32(1):e12-7
references: 20095761