P3D188: Use of Simulation-based Clinical Skills Innovation in Third Year Pediatric Clerkship

Background: Simulation-based education (SBE) is becoming an integral part of undergraduate medical education curriculum. We describe the implementation and evaluation of a simulation-based curriculum, with objectives based on the AAMC Core Entrustable Professional Activities (EPAs), delivered to medical students to augment their emergent medical management and procedural comfort within a pediatric clerkship. The objective of this abstract is to see if students who underwent a simulation-based clinical skill session had an imp rovement in their comfort and their performance of pediatric emergent medical management/procedural comfort.

Methods: Our 6-week pediatric clerkship included a SBE curriculum with pre-course material on pediatric resuscitation and approach to informed consent. Students participated in a 3-hour in-person small group session including: 1) a febrile neonate simulated case, 2) peer-to-peer medical informed consent, and 3) lumbar puncture practice on task-trainers. An electronic pre- and post-session survey was distributed to all third-year medical students assessing their pediatric emergent medical management/procedural comfort and their performance on ten knowled ge-based questions. Paired data were analyzed using Wilcoxon Signed-Rank Analysis.

Results: A total of 70 students (82%) completed both the pre- and post-surveys. Overall, all students reported an increase in confidence on the post-session survey (Figure 1), increasing from a median of 1 or 2 to a median of 4 (equates to “quite a bit”) on a five-point Likert scale in the following domains: 1) able to assess a critically ill pediatric patient (p < 0.01), 2) obtain informed consent for medical procedures (p < 0.01), 3) describe the indication/contraindications and performance of a diagnostic lumbar puncture (p < 0.01). The majority of students responded, “quite a bit” and “to a high degree” regarding the curriculum’s impact on their pediatric clerkship experience. We found a significant increase in median test scores (pre-test:70 vs post-test:80) on students’ medical knowledge of pediatric resuscitation and medical informed consent (p < 0.05).

Conclusion: Current literature indicates that simulation is effective in achieving critical resuscitation knowledge and skills. Our SBE clinical skills curriculum, while demonstrating improvement consistent with prior literature, is intended to be a starting point to address gaps in medical student clinical competency through simulated experience s.