A dissertation on Enhancing Undergraduate Medical Education through Simulation: A Pathway to Realistic Clinical Training

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Medical educators encounter numerous challenges nowadays. These factors include growing class sizes, a restricted number of educators, and limited educational facility capacity. Students in the twenty-first century are keen on technology and expect innovative teaching, learning, and evaluation methods. Curricula are constantly evolving to fulfil the numerous demands of teaching and evaluation. The problems of ensuring an effective curriculum are the constructive alignment of learning outcomes, teaching and learning techniques, and assessment (Morris, 2020). Junior doctors are frequently among the first to assess and care for new patients in the hospital setting, particularly trauma patients. Many medical students are not adequately prepared to do so when they complete medical school. According to research conducted in the United Kingdom, only 49.5% of students felt prepared for patient care, and an alarming 72.5% of recently graduated doctors responded “yes” when asked if they had been involved in a challenging medical emergency (Borggreve, 2017).

Clinical skill development is essential to medical education since it prepares medical students to become qualified clinicians (Wang, 2013). Clinical skills development necessitates a systematic approach to problem-solving and giving abilities adequate for working with a team of clinicians; nevertheless, acquiring these skills is a significant difficulty for undergraduate medical students.

To address this issue, simulation has been introduced into undergraduate medical education courses because it provides students with a realistic experience without causing harm to patients (Vattanavanit, 2016). Research shows that simulation based medical education increases clinical skills and student comprehension more than case-based discussions (Littlewood, 2013). Patient safety concerns, the hectic schedules of consultants/specialist doctors, the scarcity of patients for training, and other issues have led to the establishment of simulation laboratories and clinical skills training facilities to train medical students. Medical simulation is becoming a more common technique in several countries, and it is becoming increasingly prominent in medical and surgical training. Research and development are required to establish strategies that can be employed to handle the issue of training pupils for clinical skills effectively (McGaghie, 2010).

Literature review

Gaba (2004) defines simulation as a “ technique-not a technology-to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner.” Simulation models can be physical models that represent a part/whole of a body. Examples are intravenous injection training arms and suturing training pads. Although these are made for a specific purpose, they can be highly realistic in depicting the relevant task. Simple everyday items, such as oranges, can be used for teaching intramuscular injections. Computer based models are typically programmes built for a computer-based simulation that include case situations in which students are given several options. Depending on their selection, additional menu pages guide them through the scenario. In the end, the students are given feedback indicating the proper selections and explanations. These models can also be graphical, depicting, for example, a medical ward and allowing the student to interact with people or things by clicking on them.

Virtual reality simulators, like computer-based screens, allow trainees to interact with tools with simulated tips to perform various procedures with haptic feedback or the feel of tissue resistance. They can be used for minimally invasive surgical operations, endoscopic procedures, and, in some cases, open surgical procedures. In immersive models, trainees typically wear a wearable device that produces a whole virtual world around them, similar to an operating room, with which they can interact.

Mannequin based simulations, also called full-missile or cold simulations, are advanced computer-controlled full-body simulators capable of simulating numerous physiological derangements, particularly those relating to cardiovascular and pulmonary physiology. Typically, these mannequins are used to act out a crucial medical or surgical event or emergency scenario, allowing students to practise diagnosing and managing the simulated patient as a team (Pai, 2018).

A study by Ayesha (2014) in Saudi Arabia revealed that simulation learning significantly improved learning outcomes. Simulation learning helped improve students’ communication diagnostic and procedural skills. When used effectively, simulation can increase patient safety while lowering healthcare costs. Another study was conducted by Riaz(2020), where it was discovered that students trained using simulation were more satisfied and were more useful for OBGYN students than those pursuing internal medicine. Simulation can be especially effective for enhancing clinical abilities in specialities that require hands-on practice. Still, there are fewer opportunities to practise due to the critical nature of situations or patient concerns. Undergraduates can be trained in technical and non-technical abilities through simulation-based education, promoting greater knowledge retention and improving the future practice of the students.

The studies that analyse the effects of simulation-based learning for undergraduate students seem to be lacking in the UK. In addition, there is a need to assess the confidence levels of undergraduate medical students.

Aim and objectives

The study aims to assess how simulation-based learning improves students’ capacity to handle real-life emergencies. The study also seeks to assess the confidence levels of undergraduate medical students.

Method

This study is an example of empirical research. For more guidance on the differences between empirical and non empirical dissertations, check out our blog on What is the difference in the length of an empirical and non empirical dissertation.

A qualitative research method was employed for this study. The qualitative research method allows for an in-depth understanding of students’ perspectives and assesses the confidence levels of undergraduate medical students at Staffordshire University. A convenience sampling technique was employed, wherein final-year undergraduate students were selected per convenience. Ten students pursuing their final year in medicine were chosen for this study and were named A, B, C, D, E, F, G, H, I, J. Focus Group Discussions and semi-structured interviews were used for data collection purposes. Focus Group Discussions with undergraduate students who have participated in simulation-based learning allowed the participants to share their experiences, challenges and perceived benefits of simulation learning. Semi-structured interviews helped to analyse their confidence levels. The responses from the Focus group discussions were transcribed, and the responses to the questions in the semi-structured interviews were assessed on a Likert scale for the confidence level, with 1 being the least confident to 5 being the most confident. The data collected were entered in Microsoft Excel for ease of recording answers. Once all of the necessary data had been acquired, the data was evaluated using the MAXQDA programme. The information was condensed and arranged.

Discussion

All ten students felt that simulation learning was beneficial for their learning and subsequent practice. Participants stated that the hands-on nature of simulation enabled them to actively participate in clinical settings, use theoretical knowledge, and build practical skills. They reported increased clinical procedure proficiency, such as medical examination, suturing, intubation, and improved diagnostic skills. As a result of the immersive nature of simulation, students could learn from their mistakes and perform their techniques in a safe environment.

Many participants reported a significant gain in self-assurance, particularly when coping with critical and high-stress situations. They reported feeling more prepared and capable of dealing with real-life emergency circumstances, owing to the experiential aspect of simulation training. Students gained self-efficacy and a sense of preparedness for their future medical practice by being exposed to realistic and demanding events in a risk-free environment. Regarding their confidence levels, while most medical students felt confident, about three of them, D, H and J, felt that they needed more training by simulation.

Ethical issues

Informed Consent

The participants were given complete information about the research before proceeding with the interview and Focus Group Discussion.

Confidentiality

High standards of honesty and confidentiality have been maintained to ensure the accuracy of the data. The identity of the students was protected.

Limitation

Research methods are bound to have limitations, and qualitative research methods are no exception. The study focused on only one educational institution focusing on an in-depth understanding, which may not be generalised. In addition, participants may answer in ways they consider to be socially desirable, potentially impacting the accuracy of the findings. On the other hand, the detailed and context-rich data gathered from study participants provide significant insights into simulation-based learning in medical schools.

Conclusion

Simulation-based learning has been shown to improve learning outcomes and confidence levels in undergraduate medical students. Simulation training’s interactive and hands-on nature allows students to hone their clinical skills, improve decision-making, and increase self-assurance in preparation for real-life clinical practice. Medical educators should continue to enhance and expand simulation-based courses, embracing real-life scenarios and interdisciplinary teamwork, to better prepare the next generation of competent and confident healthcare workers. Further research might be conducted to investigate the long-term impact of simulation-based learning and compare its efficacy with traditional teaching methods to increase the evidence supporting its incorporation into medical school.

To learn more about how a dissertation is written in various fields, check out our dissertation examples.

References

1. Morris, M.C., Conroy, P. Development of a simulation-based sub-module in undergraduate medical education. Ir J Med Sci 189, 389–394 (2020). https://doi.org/10.1007/s11845-019-02050-3
2. Borggreve, Alicia & Meijer, Joost & Schreuder, HWR & ten Cate, Olle. (2017). Simulation-based trauma education for medical students: A review of literature. Medical teacher. 39. 1-8. https://doi.org/10.1080/0142159X.2017.1303135.
3. Wang Z, Liu Q, Wang H. Medical simulation-based education improves medicos’ clinical skills. J Biomed Res. 2013;27:81–4. https://doi.org/10.7555/JBR.27.20120131. Vattanavanit V, Kawla-Ied J, Bhurayanontachai R. High-fidelity medical simulation training improves medical students’ knowledge and confidence levels in septic shock resuscitation. Open Access Emerg Med. 2016;9:1–7. https://doi.org/10.2147/OAEM.S122525.
4. Littlewood KE, Shilling AM, Stemland CJ, Wright EB, Kirk MA. High-fidelity simulation is superior to case-based discussion in teaching the management of shock. Med Teach. 2013;35:e1003–10. https://doi.org/10.3109/0142159X.2012.733043.
5. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation based medical education research: 2003–2009. Med Educ. 2010;44:50–63. https://doi.org/10.1111/j.1365-2923.2009.03547.x.
6. Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004 Oct;13 Suppl 1(Suppl 1):i2-10. https://doi.org/10.1136/qhc.13.suppl_1.i2
7. Pai, Dinker. Use of Simulation for Undergraduate Medical Education. International Journal of Advanced Medical and Health Research 5(1):p 3-6, Jan–Jun 2018. https://doi.org/10.4103/IJAMR.IJAMR_63_17.
8. Ayesha Nuzhat, Raneem Osama Salem, Fatimah Nasser Al Shehri & Nasser Al Hamdan (2014) Role and challenges of simulation in undergraduate curriculum, Medical Teacher, 36:sup1, S69-S73. https://doi.org/10.3109/0142159X.2014.886017.
9. Riaz S, Jaradat AAK, Gutierrez R, Garadah TS. Outcome of Undergraduate Medical Education using Medical Simulation according to Students’ Feedback. Sultan Qaboos Univ Med J. 2020 Aug;20(3):e310-e315. https://doi.org/10.18295/squmj.2020.20.03.010.