ADAPTING LONGITUDINAL CLINICAL CLERKSHIP IN INTERNAL MEDICINE TO SIMULATION MODE LEARNING

Abstract

Background: During the current COVID-19 pandemic, non-availability of public hospitals for undergraduate teaching purposes has stalled the face to face clinical experiential learning for all medical students world over including Malaysia. We designed, developed, implemented and assessed a simulated longitudinal clinical clerkship programme in our Clinical Simulation Centre (CSC). Materials and Methods: The pilot study was conducted in the CSC of the institution in Feb 2021 for five days. A total of 20, year-5 medical students were included in the pilot study. Structured simulation-based clinical teaching of the cardiovascular and respiratory systems was undertaken. The hybrid simulation model combined simulated patients, normal volunteers, high-fidelity mannequins and other simulation devices were used. Communication, perceptual, psychomotor and cognitive skills of the learners were assessed before and after the week-long (five days) session. Focus Group Discussion on the teaching-learning process was performed on randomly selected students and near-peer supervisor. Results: All parameters, Communication skills (P<0.001), Perceptual Skills (auscultation) (P=0.044), Psychomotor skills (physical examination) (P=0.007) and Cognitive skills (P< 0.001), have shown statistically significant improvement. All students found this simulated programme useful. Conclusion: Our adaptation of longitudinal clinical clerkship in internal medicine to simulation mode learning has been an original effort as there are very sparse references in medical literature to similar simulation. Our initial pilot study results are very encouraging and we plan to conduct a larger study to validate the data. This simulation mode model of longitudinal clinical clerkship may be used as a supplement to normal year-5 clinical teaching.