Abstract
Background: Simulation technology is being increasingly adopted into medical education and is consistently associated with positive effects on knowledge, skills, and patient-related outcomes. There is little evidence on the use of simulation technology for the instruction of urgent medical complications to physical medicine and rehabilitation (PM&R) residents. Objective: To examine whether a simulation-based educational program can improve PM&R resident confidence and knowledge in the assessment and management of urgent medical complications. Design: Pretest-posttest design. Setting: Academic freestanding acute inpatient rehabilitation hospital. Participants: Twelve Post-Graduate Year (PGY)-2 PM&R residents at the start of the academic year. Methods: Residents completed an integrated didactic and simulation-based curriculum on the assessment and management of five urgent medical complications: seizures, agitation, ventricular assist device (VAD)-associated complications, sympathetic storming, and autonomic dysreflexia. Simulations were conducted using a high-fidelity manikin. Main Outcome Measurements: Surveys and knowledge assessments were completed at baseline and immediately following training. Survey responses were recorded on a Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Multiple-choice knowledge assessments were scored out of 100%. Within-group differences from baseline to postintervention were analyzed. Results: There was a positive correlation between baseline experience and baseline confidence scores (r = 0.877). Improved confidence was demonstrated in the assessment and management of all five topics (P <.05). Knowledge assessment scores significantly improved from 57.8% (95% confidence interval [CI] 50.6% to 65.4%) at baseline to 85.0% (95% CI 81.6% to 88.4%) following the course (P <.001). The education program was rated highly by both learners (mean satisfaction score, Likert score [LS] = 4.6) and instructors (mean satisfaction score, LS = 4.5). Conclusions: Application of a simulation-based educational model to the instruction of urgent medical complications to PM&R residents resulted in increased knowledge with added benefits of confidence building and high levels of enjoyment. Level of Evidence: II.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1272-1277 |
| Number of pages | 6 |
| Journal | PM and R |
| Volume | 11 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2019 |
Funding
We thank the Northwestern University/Shirley Ryan AbilityLab PGY-2 PM&R residents for participating in the simulations and their enthusiasm for learning. We thank attending physicians Dr. Matthew Oswald, Dr. Deena Hassaballa, Dr. Nenad Brkic, and Dr. Steven Nussbaum for their outstanding instruction and dedication to teaching. We acknowledge the members of the PM&R medical education track for writing the simulation cases. We thank clinical nurse educators Ellen Jo Suerth, RN and Pamela B. Pfeifer, MS, RN-BC for running the simulations.
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation
- Rehabilitation
- Neurology
- Clinical Neurology
