By Dr. Ellie Nash

Combined Paediatric Problem-based learning and Human Patient Simulation for

Undergraduate Medical StudentsAt Lancashire Simulation Centre and Royal

Preston Hospital

Overview

• Background• Proposal• Method• Outcomes• Future work

Background• PBL and Simulation are widely used in

Undergraduate Medical Education, – but as separate entities.

• Learning is enhanced when students are provided with the opportunity to apply their theoretical learning into a real life context1

• Merging these two teaching modalities together could positively enhance the students learning experience.

1. Liaw, S.Y., Chen, F.G., Klainin, P., Brammer, J., O’Brien, A., & Samarasekera, D.D. (2010). Developing clinical competency in crisis event management: An integrated simulated problem-based learning activity. Advances in Health Sciences Education, 15(3), 403-413.

Study proposal

• A small-scale study was developed to qualitatively compare Fourth Year Medical Students learning experiences from pure PBL to PBL-simulation combined, for their Paediatric placements

• Ethical approval was sort and advised that it was not required

Method

• Three of the six paediatric PBL scenarios were suitable to be adapted into simulation scenarios:– Neonatal shock; – Bronchiolitis;– Febrile convulsion

• As part of the closing of a PBL case each week, the students were given a simulation related to the PBL case.

• The students faced a high-fidelity simulated infant and a simulated parent (actor).

Simulation learning objectives

• An appropriate ABCDE assessment and management of an unwell infant;

• Communicating with a parent during an emergency situation;

• Obtaining a relevant history from the parent under time constraints

• Appropriate handover of the patient to a senior colleague;

• Development of non-technical skills, including team-working, leadership and situational awareness.

Obtaining feedback

• Turning-Point questionnaires pre and post every simulation session;

• Focus groups at the end of the rotation.

Results

• The HPS-PBL sessions have been positively received from the students

• Turning-point feedback:– students’ developed non-technical skills;– more confident at talking to parents when a child

is unwell• Both would not have been possible with pure

PBL

Focus group feedback

• HPS consolidated and reinforced students’ theoretical learning from PBL;

• Gaps in knowledge base become apparent during HPS that may not be revealed during PBL discussions;

• HPS motivated students to learn their PBL work;• Students’ confidence in their clinical placement

increased, especially with assessing children on the Paediatric Assessment Unit.

Outcomes

• The combining of these teaching modalities has improved the medical education the students receive.

• This consequently will improve their abilities as future clinicians and positively impact future patient care.

Future work

• The combined PBL-HPS sessions are now a permanent and popular feature of the Paediatric PBL at Royal Preston Hospital.

• The aim is to extend the combined sessions to the other placements for the Third and Fourth Year Medical Students.

• However, it is time, tutor and resource intensive in comparison to normal PBL sessions, which is a limiting factor in expanding these sessions.

Thank you