title: Pilot program using medical simulation in clinical decision-making training for internal medicine interns.
abstract: BACKGROUND
  The use of high-fidelity medical simulation in cognitive skills training within internal medicine residency programs remains largely unexplored.
  
  
  OBJECTIVE
  To design a pilot study to introduce clinical decision-making training using simulation into a large internal medicine residency program, explore the practicability of using junior and senior residents as facilitators, and examine the feasibility of using the program to improve interns' clinical skills.
  
  
  METHODS
  Interns on outpatient rotations participated in a simulation curriculum on a voluntary basis. The curriculum consisted of 8 cases focusing on acute clinical scenarios encountered on the wards. One-hour sessions were offered twice monthly from August 2010 to February 2011. Internal medicine residents and simulation faculty served as facilitators.
  
  
  RESULTS
  A total of 36 of 75 total interns volunteered to participate in the program, with 42% attending multiple sessions. Of all participants, 88% rated the sessions as "excellent," 97% felt that the program improved their ability to function as an intern and generate a plan, and 81% reported improvement in differential diagnosis skills.
  
  
  CONCLUSIONS
  Simulation training was well received by the learners and improved self-reported clinical skills. Using residents as facilitators, supervised by faculty, was well received by the learners and enabled the implementation of the curriculum in a large training program. Simulation can provide opportunities for deliberate practice, and learners perceive this modality to be effective.
authors.forename: Eli M
authors.initials: EM
authors.lastname: Miloslavsky
authors.forename: Emily M
authors.initials: EM
authors.lastname: Hayden
authors.forename: Paul F
authors.initials: PF
authors.lastname: Currier
authors.forename: Susan K
authors.initials: SK
authors.lastname: Mathai
authors.forename: Fernando
authors.initials: F
authors.lastname: Contreras-Valdes
authors.forename: James A
authors.initials: JA
authors.lastname: Gordon