Abstract Details

Medical simulation exercises have become a standard of modern medical education and proved beneficial for trainees in acquiring both technical (1) and non-technical (2) skills. However, simulation exercises are often purposefully emotionally and physiologically stressful for learners (3,4). No research was found that studied simulation efficacy and trainee perspectives when simulation stress was minimized, and demonstration, self-pacing, and frequent debriefing were emphasized. 

Our aim is to evaluate the perceptions of medical students regarding a novel “Walk-Through/Talk-Through” style stroke simulation in which trainee stress is minimized, and demonstration, self-pacing, and frequent debriefing are emphasized. 

Thirty-two upper-level medical students (study ongoing) participated in a one-hour “code-stroke” small-group simulation led by upper-level neurology residents utilizing a novel Walk-Through/Talk-Through model of learning. This simulation began with an overview presentation, followed by a resident-led NIH-SS demonstration, a student Walk-Through/Talk-Through NIH-SS exam, a resident-led code-stroke demonstration, and lastly a student Walk-Through/Talk-Through code-stroke session. Pre-/post-simulation questionnaires were collected regarding medical students’ perspectives of the simulation. 

Of the 27/32 students who completed both questionnaires, significant improvement (p<0.001) in trainee comfort scale (1-10) was found in pre-/post-simulation scores in managing a code-stroke (median 4 pre-sim vs. 8 post-sim), performing the NIH-SS (median 4 pre-sim vs. 8 post-sim), performing a focused stroke history (median 5 pre-sim vs. 8 post-sim), and making decisions regarding thrombolytics (median 5 pre-sim vs. 8 post-sim). The pace, frequent debriefing, and overall Walk-Through/Talk-Through simulation model were perceived as very helpful for student learning in 81%, 78%, and 78% of participants, respectively. Additionally, 85% of participants indicated that the Walk-Through/Talk-Through model would be helpful in other clinical simulations. 

This novel Walk-Through/Talk-Through stroke simulation model that aims to minimize stress while maximizing demonstration, self-pacing, and frequent debriefing is perceived by medical student as beneficial for their learning and likely applicable to other clinical simulations.