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Effectiveness of a Simulation-Based Medical Student Course on Managing Life-Threatening Medical Conditions

Objectives: To assess the competency and the comfort level of medical students in lifesaving skills after a simulation-based training session and then determine skill retention after 1 year. Methods: Prospective observational before-after case series of medical students entering the third year. Each student participated in a half-day “How to Save a Life” course. The course consisted of a half-hour lecture on lifesaving skills followed by small group simulation-based skill sessions. Critical resuscitation actions were reviewed and demonstrated by the instructor using case-based scenarios and mannequins. The emergency medicine faculty and residents evaluated individual students’ performance of clinical skill using a standardized checklist at each skill station. Each checklist specified the critical actions necessary to perform the procedure properly. Outcome measures included global competency and level of comfort questionnaire for each skill, using a 5-point Likert scale, with 1 being “strongly disagree” and 5 “strongly agree.” Retention of lifesaving skills was assessed approximately 1.5 years later using a subset of the original group of the third year medical students. Without prior notification, students were assessed on the same skills using the same scenarios and outcome measures. Comparison of competency and level of comfort data between the initial group and the follow-up group were analyzed using descriptive statistics. Results: One hundred fifteen third year students participated in the initial training program. Initial demographic information was available on 104 students and revealed that 96% of the students had previous experience with basic life support. After the initial training course, all students were rated as competent in all procedures. In the retention group, the proportion of students achieving competence in each procedure ranged from 47% to 100%. The level of comfort decreased during the interval period. Conclusion: A short course in simulation-based life-saving clinical skills is an effective means to teach the third year medical students. We observed a decline in competency over time for recognition of ventricular fibrillation, defibrillation, airway management, and management of a choking child. Cardiopulmonary resuscitation and automatic external defibrillator competency did not decrease over time.