title: High-fidelity medical simulation training improves medical students' knowledge and confidence levels in septic shock resuscitation.
abstract: BACKGROUND
  Septic shock resuscitation bundles have poor compliance worldwide partly due to a lack of knowledge and clinical skills. High-fidelity simulation-based training is a new teaching technology in our faculty which may improve the performance of medical students in the resuscitation process. However, since the efficacy of this training method in our institute is limited, we organized an extra class for this evaluation.
  
  
  OBJECTIVE
  The aim was to evaluate the effect on medical students' knowledge and confidence levels after the high-fidelity medical simulation training in septic shock management.
  
  
  METHODS
  A retrospective study was performed in sixth year medical students during an internal medicine rotation between November 2015 and March 2016. The simulation class was a 2-hour session of a septic shock management scenario and post-training debriefing. Knowledge assessment was determined by a five-question pre-test and post-test examination. At the end of the class, the students completed their confidence evaluation questionnaire.
  
  
  RESULTS
  Of the 79 medical students, the mean percentage score ± standard deviation (SD) of the post-test examination was statistically significantly higher than the pre-test (66.83%±19.7% vs 47.59%±19.7%,p<0.001). In addition, the student mean percentage confidence level ± SD in management of septic shock was significantly better after the simulation class (68.10%±12.2% vs 51.64%±13.1%,p<0.001). They also strongly suggested applying this simulation class to the current curriculum.
  
  
  CONCLUSIONS
  High-fidelity medical simulation improved the students' knowledge and confidence in septic shock resuscitation. This simulation class should be included in the curriculum of the sixth year medical students in our institute.
authors.affiliation: Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Veerapong
authors.initials: V
authors.lastname: Vattanavanit
authors.affiliation: Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Jarernporn
authors.initials: J
authors.lastname: Kawla-Ied
authors.affiliation: Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Rungsun
authors.initials: R
authors.lastname: Bhurayanontachai
keywords: medical simulation; medical students; resuscitation; septic shock