Background The use of high-fidelity simulation and the near-peer teaching approach are rapidly growing areas of under-graduate and post-graduate medical education.1,2 Current medical student simulation teaching programmes within the Wessex Deanery focus solely on the acutely unwell adult patient, despite children accounting for 40% of patients seen in primary care3 and 22% of ED attendances.4
Methodology We developed the simulation based near-peer pRESUS Course for final year medical students, with the aim to improve student confidence in assessing, treating and escalating care of acutely unwell paediatric patients. Two sessions are delivered during their paediatric hospital placement. The first is an interactive revision session based around the ‘ABCDE approach’. The second expands on this principle, where each student is the team leader of a simulated scenario, for example the bronchiolitic child. A high fidelity manikin and multidisciplinary team are used in the simulation and debrief to optimise realism. Student’s confidence in dealing with a variety of emergency paediatric situations is assessed by self-rated questionnaires before and after each session.
Outcomes 20 students have participated thus far and analysis of their questionnaires shows globally improved confidence in dealing with emergency paediatric situations following simulation sessions. For example, confidence in managing the child with breathing difficulties improved by 30.6% (p < 0.01) and overall management of the acutely unwell paediatric patient increased by 38.2% (p < 0.01). Written feedback is positive and students comment on the helpfulness of experiencing real-life scenarios in a safe learning environment, particularly in utilising the ABCDE approach.
Potential impact The pRESUS Course demonstrates that near-peer simulation is an effective model in improving medical student confidence when dealing with the acutely unwell paediatric patient. We plan to expand the programme to all medical students across the Deanery, and are in the process of developing a website to act as a parallel learning tool.
Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher 2005;27(1):10–28
Ten Cate O, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Medical Teacher 2007;29(6):591–599
Walker V, Wall DW, Goodyear HM. Paediatric training for GP VTS trainees: are we meeting the requirement? Educ Prim Care 2009;20(1):28–33(6)
NHS England. High quality care for all, now and for future generations: Transforming urgent and emergency care services in England. The Evidence Base from the Urgent and Emergency Care. June 2013
- Category: Course or curriculum evaluation/innovation/integration
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