Simulationbased Education Improves Clinical Knowledge and Confidence in Management of Common Urgent Inpatient Conditions

1Mayo Clinic Arizona, Scottsdale, AZ
2Mayo Clinic Arizona, Phoenix, AZ

Meeting: Hospital Medicine 2012, April 1-4, San Diego, Calif.

Abstract number: 97622

Background:

Simulation–based training has been extensively evaluated in non–medical disciplines, and has been shown to have value in procedure–based medical education. However, fewer data are available with respect to the role of simulation in teaching clinical decision making. In this study, we compared simulation–based instruction to conventional lecture–based didactic instruction of clinical management of common urgent hospital situations among internal medicine residents.

Methods:

Two semi–emergent conditions, status epilepticus and atrial fibrillation with rapid ventricular response, were selected on the basis of relevance to hospital medical care. Core principles specific to each topic were identified and incorporated into a case–based didactic lecture on each condition. Simulation scenarios for each topic using an automated clinical mannequin in our institution’s simulation lab were designed to simulate a clinical situation wherein participants were required to apply core principles to acute management of the patient. The lecture was standardized and presented to the residents on each occasion by a content expert. Prior to the lecture, a knowledge assessment of core principles and a brief Likert–type survey evaluating participants’ level of confidence in managing each condition were administered. These metrics were re–administered at a midpoint several days after the didactic and before the simulation. The simulation was then performed one week after the didactic lecture, and included a post–simulation debriefing. Following simulation, the post–test and survey were re–administered.

Results:

In both atrial fibrillation and seizure management, the didactic lecture resulted in increases in both knowledge (Afib 39.6%; Seizure 32.8%) and clinical confidence (Afib 18.1%; Seizure 23.3%) compared to baseline. The simulation–based instruction resulted in additional improvement in knowledge (13.8%; Seizure 15.1%) and clinical confidence (Afib 12.4%; Seizure 19.6%). The combination of lecture–based instruction followed by simulation resulted in significant summative educational benefit in both clinical knowledge (Afib 58.8%; Seizure 52.8%) and clinical confidence (Afib 32.8%; Seizure 47.6%).

Conclusions:

Conventional didactic teaching improves both knowledge and clinical confidence in managing urgent in–hospital conditions. However, the addition of novel simulation–based instruction significantly augmented learning and improved the learners’ comprehension of core principles and confidence in applying them to real–life situations.

To cite this abstract:

Webb B, Vucicevic D, Mookadam F, Charles J, Barr P. Simulationbased Education Improves Clinical Knowledge and Confidence in Management of Common Urgent Inpatient Conditions. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97622. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/simulationbased-education-improves-clinical-knowledge-and-confidence-in-management-of-common-urgent-inpatient-conditions/. Accessed September 17, 2019.

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