International Journal of Healthcare Simulation

Background:

When placed in District General Hospitals, medical students have reported limited exposure to major trauma, which is a key part of their Acute and Critical Care curriculum. Several studies have been conducted showing that simulation-based trauma education for undergraduate students can effectively prepare medical students for trauma resuscitation [1]. Targeting 4^th year medical students, we sought to enhance their knowledge of, and confidence in, assessment and management of major trauma presentations in an Emergency Department setting through simulation. Key learning outcomes were to understand and perform a primary survey, identify key life-threatening injuries, and perform early interventions in life and limb threatening situations.

Methods:

A one-day session was designed, including a pre-course video, practical demonstrations, and an introductory presentation covering primary surveys and management of common trauma presentations. 5 scenarios covered situations across the trauma spectrum, such as tension pneumothorax, severe intracranial bleed and loss of airway, major haemorrhage, and spinal injury. Students were expected to independently assess patients and perform practical procedures if required. Self-reported confidence in trauma management was measured with a pre- and post-course questionnaire. Responses were recorded on a 7-point Likert scale with open fields for direct feedback.

Results:

In the pre-course questionnaire, students reported low levels of confidence in their assessment and management of trauma. In the post-course questionnaire, students reported feeling substantially more confident in assessing, investigating, and managing common diagnoses in trauma patients. Many reported feeling they had insufficient teaching about traumatic presentations during medical school and little prior exposure to simulation-based teaching. After the session, students reported feeling better prepared to work within a trauma team. All students who attended the day found simulation-based teaching to be a useful part of their learning experience.

Conclusion:

Targeted trauma teaching introduced as a direct response to students’ expressed needs improved knowledge of, and confidence in, managing common and serious trauma presentations. Simulation sessions such as these can help fill gaps in experience that may be associated with placements in non-specialist centres.

Reference

1. Borggreve AS, Meijer JM, Schreuder HW, Ten Cate O. Simulation-based trauma education for medical students: a review of literature. Medical teacher. 2017;39(6):631–638.