High-fidelity simulation is a cornerstone of emergency medicine (EM) education and is used by a majority of EM clerkships. Traditional high-fidelity simulation involves learners working through a predesigned case to meet learning objectives. Our third-year clerkship employs a novel simulation activity where teams of students design their own case scenarios as prework for what we call our “flipped sim-room” model. The activity was then evaluated using a survey. This activity was a required part of students’ EM rotation. All students received full credit for participation. Focus groups were held with previous years’ students in order to create a voluntary and anonymous survey tool which was distributed after each cohort completed the activity. Comparative analysis reported with independent t-tests and Cohen’s d effect size. Relational analysis reported with Pearson (r) correlations and stepwise multivariate linear regression. 70% of respondents had no prior simulation experience. Students reported a combined mean of 3.7 (4-point scale) on the quality of their efforts to work as a team. Students reported a mean of 4.2 (out of 5) on the effectiveness that writing the simulation case had on improving their ability to perform a variety of clinical actions. Students considering EM residency (63%) reported a statistically significant higher overall comfort level with creating a simulation again. We found no significant differences in the teamwork or clinical skills-related questions analyzed by gender. Most students had no prior simulation experience, yet all were able to design and implement simulation cases. Students enjoyed the active learning component and reported high levels of improvement in a variety of clinical tasks. This study suggests that student-designed simulations could be a beneficial addition to EM curriculums and should be further researched with larger groups of students as well as in graduate medical education.
Wilbanks et al. (Tue,) studied this question.