Background Simulation is widely used in undergraduate medical programmes. Medical students are often discouraged from independently clerking acutely unwell patients which could lead to doubt in their abilities. The use of high fidelity patient simulation scenarios enables exposure to common acute medical conditions in a safe and controlled environment whilst promoting confidence. This programme was developed by a final year medical student, with support from a FY2 simulation fellow, for second year medical students. Near-peer to peer teaching offers the advantage of learning for both the facilitator and candidates whilst providing a facilitator who is familiar with the demands of the curriculum.1
Methodology A three hour simulation programme was devised to incorporate introduction to clinical simulation, assessment and management of an unwell patient and communication skills including effective handover. Two asthma simulation scenarios were developed with a more unwell patient in the second scenario. 22 s year medical students were taught over 2 sessions. Assessment was carried out using pre- and post- simulation confidence with ratings from 1–5, 5 being highly confident.
Results Overall confidence ratings improved from an average score of 2.3 pre-simulation to 3.8 post simulation. Improvement in confidence ratings was seen across all objectives measured particularly in assessing asthma and using SBAR. Constructive feedback from the students focused on the ‘realistic experience’ and the opportunity for ‘use of clinical equipment’.
Conclusions Simulation is a useful medium for introducing students to acutely unwell patients and the increased confidence ratings demonstrated post-simulation could help improve confidence in clinical placements. Enabling students through near-peer to peer simulation programme provides a non-threatening, realistic learning environment whilst supporting the development of ‘the doctor as a teacher’, as recommended by GMC guidance in ‘Tomorrows Doctors’.2
Bulte C, Betts A, et al. Student teaching: views of student near-peer teachers and learners. Med Teach. 2007;29(6):583–90
General Medical Council. Tomorrows doctors. London: GMC, 2009
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