Simulation curriculum can improve medical student assessment and management of acute coronary syndrome during a clinical practice exam.

DeWaay DJ, McEvoy MD, Kern DH, Alexander LA, Nietert PJ
Am J Med Sci. 2014 347 (6): 452-6

PMID: 24280987 · PMCID: PMC4031285 · DOI:10.1097/MAJ.0b013e3182a562d7

BACKGROUND - It has been noted that increased focus on learning acute care skills is needed in undergraduate medical curricula. This study investigated whether a simulation-based curriculum improved a senior medical student's ability to manage acute coronary syndrome as measured during a clinical performance examination (CPX). The authors hypothesized that simulation training would improve overall performance when compared with targeted didactics or historical controls.

METHODS - All 4th-year medical students (n = 291) over 2 years at the authors' institution were included in this study. In the 3rd year of medical school, the "control" group received no intervention, the "didactic" group received a targeted didactic curriculum, and the "simulation" group participated in small group simulation training and the didactic curriculum. For intergroup comparison on the CPX, the authors calculated the percentage of correct actions completed by the student. Data are presented as mean ± standard deviation with significance defined as P < 0.05.

RESULTS - There was a significant improvement in overall performance with simulation versus both didactics and control (P < 0.001). Performance on the physical examination component was significantly better in simulation versus both didactics and control, as was for diagnosis: simulation versus both didactics and control (P < 0.02 for all comparisons).

CONCLUSIONS - Simulation training had a modest impact on overall CPX performance in the management of a simulated acute coronary syndrome. Additional studies are needed to evaluate how to further improve curricula regarding unstable patients.

MeSH Terms (7)

Acute Coronary Syndrome Clinical Competence Curriculum Disease Management Educational Measurement Humans Students, Medical

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