Theme
eLearning
INSTITUTION
University College London, UK
Royal Free Hopsital, London, UK
Harefield Hospital, Uxbridge, UK
Simulation is increasingly used as a teaching tool for trainee doctors and clinical medical students, but is not often used to teach medical students in the early stages of training. There have been several interesting studies in the United States, for example Gordon et al (2010) discussed the use of a patient simulator to teach Harvard pre-clinical medical students. These authors highlight the importance of the emotional activation that occurs when dealing with a dynamic clinical case, real or simulated, and argue that this improves learning. In addition to the emotional component of simulation, the practical involvement with the case ties in with Kolb’s (1984) notion of experience within a learning cycle.
The renowned American medical education reformer, Flexner (1910), described the importance of applying knowledge:
“There is no cement like interest, no stimulus like the hint of a
coming practical application.”
It seems likely that if simulation, as a safe way for students to apply basic knowledge, had existed in the early 1900s, Flexner would have encouraged its use with early years medical students.
SimPhys is a method of teaching basic physiology using a high fidelity mannequin to simulate a real-time clinical scenario. Students are guided through the scenario with the focus on the underlying physiology. The pilot sessions looked at hypovolaemia and heart failure. The physiology leading to the observed clinical signs (such as tachycardia, hypotension, raised respiratory rate, falling oxygen saturations, reduced urine output etc.) was discussed as they occurred.
Twelve first year medical students volunteered for SimPhys, and two sessions were run. A focus group followed each session and explored the students' experiences of the session and their opinions on the potential for Simulated Physiology within the curriculum in the future.
Further details of the methodology can be found by clicking on the 'more detail' tab.
Four main themes were identified; the impact of SimPhys on learning, potential uses of SimPhys, aspects of the SimPhys session itself and suugestions for the future of SimPhys.
These themes were further subdivided as shown below:
Quotes from students to illustrate the themes above are included as further details, within the tab below.
This small study shows that the students involved felt that SimPhys had improved their understanding and memory of the basic cardiovascular physiology covered in the session. They also believed that context and motivation to learn were important factors.
These sessions ran close to examinations and revision was another key theme. Participants were enthusiastic about SimPhys as a revision tool, consolidating knowledge learnt in lectures.
There is an on-going drive within medical education to integrate pre-clinical and clinical curricula, yet many emphasise the importance of learning basic sciences. This pilot study suggests that simulation is a useful and safe environment to provide clinical context to basic sciences, which may enhance learning.
This study also adds to the simulation literature by showing that simulation can be used successfully within the earliest years of medical training.
Simulation can be a useful tool for teaching undergraduate as well as postgraduate learners.
Simulated Physiology may be a useful way to give basic sciences context, without needing to fully integrate curricula
The SimPhys programme has been extended this year and further findings will be published in due course.
Flexner, A (1910) Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. 4. Boston: Updyke; 1910.
Gordon J, Hayden E, Ahmed R, Pawlowski J, Khoury K, Oriol N (2010) ‘Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?’ Acad Med 2010 Feb;85(2):370-7
Kasturi R, Heimberger G, Nelson E, Phero J, Millard R (2009) ‘Does Human Simulator-Aided Learning mprove Long-Term Retention of Autonomic Pharmacology Concepts and Facts by Year II Medical Students?’ JIAMSE Vol 19 (3)
Kneebone R and Nestel D (2005) ‘Learning clinical skills – the place of simulation and feedback’ Clinical Teacher Vol 2 (86-90)
Kolb, D. (1984) Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs: Prentice Hall