Emergency medicine clerkship goes online: Evaluation of a telesimulation programme

• Published in: Asia Pacific Scholar (Online) Vol. 6; no. 3; pp. 56 - 66
• Main Authors: Nadarajan, Gayathri Devi, Freeman, Kirsty J, Wan, Paul Weng, Lim, Jia Hao, Fernandez, Abegail Resus, Wong, Evelyn
• Format: Journal Article
• Language: English
• Published: Singapore National University of Singapore, Centre for Medical Education (CenMed) 01-07-2021; National University of Singapore
• Subjects: Anaphylaxis; Coronaviruses; COVID-19; Education; Emergency medical care; emergency medicine; Learning; Likert scale; Medical students; Meningitis; Patients; programme evaluation; Simulation; Skills; Software; Students; Telemedicine; telesimulation
• ISSN: 2424-9335; 2424-9270
• DOI: 10.29060/TAPS.2021-6-3/OA2440

Introduction: COVID-19 challenged a graduate medical student Emergency Medicine Clinical Clerkship to transform a 160-hour face-to-face clinical syllabus to a remotely delivered e-learning programme comprising of live streamed lectures, case-based discussions, and telesimulation experiences. This paper outlines the evaluation of the telesimulation component of a programme that was designed as a solution to COVID-19 restriction.
Methods: A mixed methods approach was used to evaluate the telesimulation educational activities. Via a post-course online survey student were asked to rate the pre-simulation preparation, level of engagement, confidence in recognising and responding to the four clinical presentations and to evaluate telesimulation as a tool to prepare for working in the clinical environment. Students responded to open-ended questions describing their experience in greater depth.
Results: Forty-two (72.4%) out of 58 students responded. 97.62% agreed that participating in the simulation was interesting and useful and 90.48% felt that this will provide a good grounding prior to clinical work. Four key themes were identified: Fidelity, Realism, Engagement and Knowledge, Skills and Attitudes Outcomes. Limitations of telesimulation included the inability to examine patients, perform procedures and experience non-verbal cues of team members and patients; but this emphasised importance of non-verbal cues and close looped communication. Additionally, designing the telesimulation according to defined objectives and scheduling it after the theory teaching contributed to successful execution.
Conclusion: Telesimulation is an effective alternative when in-person teaching is not possible and if used correctly, can sharpen non-tactile aspects of clinical care such as history taking, executing treatment algorithms and team communication.