International Journal of Healthcare Simulation

Background:

This study was designed in response to the pandemic. This was to increase the accessibility of Simulation Training whilst under lockdown restrictions and limited departmental capacity due to social distancing.

Aims:

The aim of the study was to assess final-year medical students’ perspectives on a new method of delivering a simulation course remotely.

Method/design:

The technique utilized in the intervention group was a guided experience via ‘Avatars’ – Faculty members who were physically present in the simulation room. Course participants joined via a live video stream and directed the ‘Avatar’ in real time. The scenarios were driven by a script that directed focus to the learning objectives. The debrief followed a ‘pause and perfect’ approach to enhance participation. During these pauses, the students, with guidance from a facilitator, reflected on developments so far and then gave their ‘Avatar’ instructions for the next stage of the scenario. The study took the form of a pragmatic cross-over trial, splitting the cohort into two groups. Group 1 received a face-to-face medicine simulation course and a remote surgery simulation course. Of this group, approximately half had the remote course first and the face-to-face second, the other half in the reverse order. Group 2 had a similar format, however with a face-to-face surgery simulation course and a remote medicine simulation course. The intention was to minimize the influence of pre-course perceptions based on what has already been experienced (i.e. a group might have a different perspective on a face-to-face course if they have had a remote course first and vice versa). Feedback was collected and compared for each.

Implementation outline:

A total of 44 final-year medical students took part in the trial. 40 feedback responses were collected for the face-to-face sessions and 37 for the remote. Overall, the face-to-face simulation sessions were received more positively with 100% of participants scoring face-to-face sessions overall as ‘Excellent’ or ‘Very Good’ compared with 70.2% for the remote simulation. Participants were asked to score out of 10 how much these sessions would change their future practice; the mean score for the face-to-face was 9.29 compared with 8.5 for the remote. Remote simulation produced lower student satisfaction scores compared with face-to-face teaching. Further research is needed to determine the differential impact on knowledge and skills transfer. If there is limited impact, remote simulation could be a viable and valuable alternative to face-to-face simulation, not only during a pandemic but also in diverse environments.