Hybrid simulation improves medical student procedural confidence during EM clerkship.
BACKGROUND
Medical students have limited opportunities to perform and learn procedures on live patients. This is particularly concerning at the Uniformed Services University of the Health Sciences (USUHS), where graduates may be assigned to an operational military unit immediately following completion of internship. The authors implemented a new hybrid simulation lab for fourth-year medical students at the Uniformed Services University of the Health Sciences consisting of procedural skills training for seven core emergency medicine skills combined with complex patient cases using high fidelity simulators and standardized patients.


OBJECTIVE
Measure changes in student procedural skills confidence due to the new hybrid simulation curriculum.


METHODS
This observational study used anonymous 5-point Likert-anchored questionnaires to measure student confidence at three different times: immediately before hybrid simulation training, immediately after training, and 3 weeks post-training.


RESULTS
Pretraining student confidence was 3.0 (out of 5) when averaged for all seven procedures. This improved to 4.2 immediately after training, and remained high (4.1) 3 weeks later at the end of the clerkship. Students retained this improved confidence despite performing few procedures on real patients during their clerkships. The training demonstrated statistically significant confidence improvement for all procedures, except bag-valve mask ventilation.


CONCLUSIONS
Hybrid simulation training improves student confidence with procedural skills during an emergency medicine clerkship.
Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Craig A
CA
Goolsby
Department of Emergency Medicine, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042.
Tress L
TL
Goodwin
Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Ryan M
RM
Vest
D002405:Catheterization, Central Venous / Q000379:methods; D002982:Clinical Clerkship; D002983:Clinical Competence; D003198:Computer Simulation; D004635:Emergency Medicine / Q000193:education*; D005500:Follow-Up Studies; D006801:Humans; D017148:Infusions, Intraosseous / Q000295:instrumentation; D007442:Intubation, Intratracheal / Q000379:methods; D008889:Military Personnel; D016544:Patient Simulation; D012121:Respiration, Artificial / Q000295:instrumentation; D012577:Schools, Medical; D012649:Self Concept; D000066908:Simulation Training; D013129:Spinal Puncture / Q000379:methods; D013337:Students, Medical; D013907:Thoracostomy / Q000379:methods; D014463:Ultrasonography; D014481:United States; D059030:United States Department of Defense; D014947:Wounds and Injuries / Q000000981:diagnostic imaging