Effectiveness of Medical Student Training and Performance Assessment for Initial Evaluation and Management of Patients with Multiple Trauma, Using Realistic Patient Simulation

Abstract

Purpose: Simulation-based medical education allows medical students to experience scenarios that are otherwise rare to encounter during on-site training. The purpose of our study is to assess the performance of a medical student training program using a realistic, patient simulation for activities including initial evaluation and management, situational judgment, and decision making associated with patients with multiple trauma. Methods: After a slide lecture and patient simulation training,46 medical students in their sixth-year were trained using a multiple-trauma patient simulation scenario. The performance assessment checklist included possibilities for both appropriate and inappropriate actions. After debriefing,the students filled out a questionnaire and participated in a feedback session. Two specialists in emergency medicine evaluated the completed checklists. Inter-rater reliability was established for the results. Results: The appropriate action checklist items for obtainment of blood for type and crossmatch, initiation of emergency blood transfusion, and resuscitation with vigorous fluid therapy, resulted in low mean numbers. The inappropriate action checklist items for delay in recognition of tension pneumothorax, blood ordering type and crossmatch,and ordering blood transfusion, resulted in high mean numbers. The inter-rater reliability of these results were 0.90. Students responded in the questionnaire that they appreciated the opportunity to have this training before graduation and that they had learned more about multiple trauma treatment through this training. Conclusion: We suggest that this training program, using a realistic patient simulation, can be highly effective for teaching medical students about initial evaluation and management,situational judgment, and decision making in patients suffering with multiple traumas. We also demonstrated the efficacy of simulation as a trauma performance assessment tool for evaluating medical students.