title: A comprehensive, simulation-based approach to teaching clinical skills: the medical students' perspective.
abstract: The purpose of this study was to determine if third-year medical students participating in a mandatory 12-week simulation course perceived improvement in decision-making, communication, and teamwork skills. Students participated in or observed 24 acute emergency scenarios. At 4-week intervals, students completed 0-10 point Likert scale questionnaires evaluating the curriculum and role of team leader. Linear contrasts were used to examine changes in outcomes. P-values were Bonferroni-corrected for multiple pairwise comparisons. Student evaluations (n = 96) demonstrated increases from week 4 to 12 in educational value (p = 0.006), decision-making (p < 0.001), communication (p = 0.02), teamwork (p = 0.01), confidence in management (p < 0.001), and translation to clinical experience (p < 0.001). Regarding the team leader role, students reported a decrease in stress (p = 0.001) and increase in ability to facilitate team function (p < 0.001) and awareness of team building (p = <0.001). Ratings demonstrate a positive impact of simulation on both clinical management skills and team leadership skills. A simulation curriculum can enhance the ability to manage acute clinical problems and translates well to the clinical experience. These positive perceptions increase as the exposure to simulation increases.
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Leigh V
authors.initials: LV
authors.lastname: Evans
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Ashley C
authors.initials: AC
authors.lastname: Crimmins
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: James W
authors.initials: JW
authors.lastname: Bonz
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gusberg
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Alina
authors.initials: A
authors.lastname: Tsyrulnik
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: James D
authors.initials: JD
authors.lastname: Dziura
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Dodge
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003299:Cooperative Behavior; D003479:Curriculum; D004501:Education, Medical; D006801:Humans; D013337:Students, Medical
keywords: communication skills; medical education; simulation