PURPOSE: To evaluate the use of simulation-based teaching during medical training to increase future clinician knowledge in early goal-directed therapy for severe sepsis/septic shock.
METHODS: A prospective interventional study at a university-based medical simulation center was performed. A 5-hour curriculum including didactic lectures, skill workshops on central line insertion and intubation, and simulated case scenario of a septic shock patient were administered to medical students. The patient care team included 3 or 4 members. A skills checklist including 21 tasks was completed during the case scenario. An 18-question pre-test, post-test and 2-week post-test were given. The students completed a survey at the end of the curriculum utilizing a Likert scale 1 to 5. The Wilcoxon rank sum test was used to compare differences in test scores.
RESULTS: Sixty-three students at all levels of medical school were enrolled. The pre-test, post-test, and 2-week post-test scores were 57.5+13.0, 85.6+8.8, and 80.9+10.9%, respectively. There was statistical difference between the pre-test and each of the post-test scores, p<0.05. 20.6% of participants thought the pre-test was too difficult, whereas all participants thought the post-test was either appropriate or too easy. The task performance during the simulated septic shock patient was 94.1+6.0%. The participants noted improvements in their confidence levels at managing severe sepsis and septic shock patients, pre-curriculum Likert 1.2+0.6 and post-curriculum 3.4+0.7, p<0.05. The participants agreed that the curriculum should be a requirement during medical school training, Likert 4.6+0.7.
CONCLUSION: Medical simulation is an effective method of educating early goal-directed therapy to medical students with limited experience in patient care.
CLINICAL IMPLICATIONS: The results suggest that our curriculum may be of further benefit at increasing clinician experience with this intensive protocol for the management of severe sepsis/septic shock.
DISCLOSURE: H Nguyen, Grant monies (from industry related sources). This study was partially funded by Edwards Lifesciences as an unrestricted educational grant.; Consultant fee, speaker bureau, advisory committee, etc. H. Bryant Nguyen, MD, has received consultant and speaking honoraria from Edwards Lifesciences.; No Product/Research Disclosure Information