title: Progress toward improving medical school graduates' skills via a "boot camp" curriculum.
abstract: BACKGROUND
  Medical school graduates are expected to possess a broad array of clinical skills. However, concerns have been raised regarding the preparation of medical students to enter graduate medical education. We designed a simulation-based "boot camp" experience for students entering internal medicine residency and compared medical student performance with the performance of historical controls who did not complete boot camp.
  
  
  METHODS
  This was a cohort study of a simulation-based boot camp educational intervention. Twenty medical students completed 2 days (16 hours) of small group simulation-based education and individualized feedback and skills assessment. Skills included (a) physical examination techniques (cardiac auscultation); technical procedures including (b) paracentesis and (c) lumbar puncture; (d) recognition and management of patients with life-threatening conditions (intensive care unit clinical skills/mechanical ventilation); and (e) communication with patients and families (code status discussion). Student posttest scores were compared with baseline scores of postgraduate year 1 (PGY-1) historical controls to assess the effectiveness of the intervention.
  
  
  RESULTS
  Boot camp-trained medical students performed significantly better than PGY-1 historical controls on each simulated skill (P<0.01). Results remained significant after controlling for age, sex, and US Medical Licensing Examination step 1 and 2 scores (P<0.001).
  
  
  CONCLUSIONS
  A 2-day simulation-based boot camp for graduating medical students boosted a variety of clinical skills to levels significantly higher than PGY-1 historical controls. Simulation-based education shows promise to help ensure that medical school graduates are prepared to begin postgraduate training.
authors.affiliation: From the Department of Medicine (D.B.W., E.R.C., B.D.S., F.M., J.H.B., E.A.L. J.B.), and Augusta Webster MD Department of Medical Education and Faculty Development (W.C.M.), Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Diane B
authors.initials: DB
authors.lastname: Wayne
authors.forename: Elaine R
authors.initials: ER
authors.lastname: Cohen
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Singer
authors.forename: Farzad
authors.initials: F
authors.lastname: Moazed
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Barsuk
authors.forename: Elizabeth Allison
authors.initials: EA
authors.lastname: Lyons
authors.forename: John
authors.initials: J
authors.lastname: Butter
authors.forename: William C
authors.initials: WC
authors.lastname: McGaghie
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D008297:Male; D016544:Patient Simulation; D013337:Students, Medical; D013663:Teaching / Q000379:methods*; D014481:United States; D055815:Young Adult