Can a Simulated Critical Care Encounter Accelerate Basic Science Learning Among Preclinical Medical Students? A Pilot Study

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Abstract
To explore whether a simulated critical care encounter can accelerate basic science learning among preclinical medical students. Using a high-fidelity patient simulator, we “brought to life” a paper case of a myocardial infarction among a convenience sample of first-year medical students (n=22 [intervention]). Students discussed the case as part of a routine tutorial session, and then managed the case in the simulator laboratory. Using an identical six-item test of cardiac physiology, students were evaluated immediately after the simulator session and at 1 year (n=15). Performance was compared with controls (case discussion but no simulator session) at both baseline (n=37) and 1 year (n=48). Performance among simulator-exposed students was significantly enhanced on immediate testing (mean score 4.0 [control], 4.7 [intervention], P = .005). Gains among the simulator cohort were maintained at 1 year (mean score 4.1 [control], 4.7 [intervention], P = .045). Multivariable analysis confirmed that the intervention was a significant determinant of performance across time (P = .001). Compared with controls in this pilot study, an additional simulation exercise improved immediate performance on a short written test of cardiovascular physiology. Enhanced performance was again seen at 1 year, raising the possibility that the extra teaching session produced accelerated and sustained learning compared with the routine teaching method. Given the preliminary nature of this investigation, further study is required to distinguish transient from lasting effects of simulation versus alternative teaching approaches in the basic medical sciences.