International Journal of Healthcare Simulation

Background:

COVID-19 has undeniably impacted on learning for medical students, and one of their main concerns was the need for more course material when universities had to abruptly halt medical student placements due to social distancing restrictions. Our team had planned to have face-to-face simulation teaching with second-year medical students, focussing on the essential topic of A-E assessment and management of an acutely deteriorating patient. However, at short notice, we had to adapt this to an entirely online curriculum as a result of COVID-19 measures.

Aim:

The overall aim of the novel session was for students to virtually assess the simulated patient, manage any issues they found and use their examination and investigation findings to formulate a diagnosis and management plan. The presentation of the patient focussed on core conditions such as sepsis and hypoglycaemia.

Design:

We developed an innovative 2-hour online teaching session designed to be delivered to a group of eight second-year medical students, facilitated in an online capacity over Microsoft Teams. The session ran as follows: using a flipped-classroom approach, the students had been given reading material about the A-E assessment to read prior to the teaching, so we started by discussing this and clarifying key points. Then the facilitator explained how the session would run and briefed the students about the scenario in the style of an SBAR (Situation, Background, Assessment, Recommendation) handover. Following this, students took turns to direct the simulated doctor through the A-E assessment of a low-fidelity simulation mannikin, instructing the doctor of any examinations, interventions or investigations they would like. The facilitator guided the students through the scenario, providing necessary examination findings and investigations for students to interpret and act on. Equipment such as oxygen devices, airway adjuncts and blood bottles were demonstrated to the students throughout.

Implementation outline:

This session was an integral part of our second-year students’ 5-week virtual clinical placement. It was very well received; 95% (n = 21) of students strongly agreed or agreed that the session helped their learning. 90.5% strongly agreed or agreed that they enjoyed the use of technology-enhanced learning. Aspects specifically highlighted in the feedback were interactivity and being able to visualize the assessment of an acutely unwell patient. With online teaching likely to remain an important part of medical education, we have found that remote simulation is a suitable and effective way to introduce the assessment of a deteriorating patient.