6649 Pilot evaluation of in-situ versus suite-based simulation for medical undergraduates

Objectives QUB was among the first medical schools to embrace and evaluate interprofessional high-fidelity simulation in undergraduate medical education.¹In-situ simulation (ISS) has proven useful for skill improvement, team development and organisational learning in the postgraduate arena.²–⁴ To date, we found no published evaluation of ISS as a tool in undergraduate medical education. Methods The pilot study aimed to compare ISS to suite-based simulation as a tool in undergraduate medical education. Twelve undergraduate medical students were invited to participate in ISS consisting of two acute scenarios within an inpatient paediatric ward. These students had previously participated in simulation training within a university- based simulation suite. Two focus groups were carried out immediately after their participation in ISS and an inductive thematic analysis carried out on transcripts. Results The analysis identified features of psychological fidelity that were influenced by the students' interactions with the 'true' clinical environment and the interprofessionals involved. The intentional blend of simulation with real clinical environment impacted on overall impressions of realism, and the perceived roles and expectations of undergraduate students. Embedding the presence of senior colleagues and other professional groups afforded a more authentic response which many students likened to readiness for clinical practice. Students perceived ISS as beneficial in improving their sense of involvement and belonging in clinical attachments. Some remarked that learning is better consolidated when contextualised in a real environment. Some features varied among student groups including the perceived fears and challenges of ISS for students in their preclinical years as well as the realism of lower physical fidelity manikins used in ISS. Conclusion This pilot study explored the role of ISS within undergraduate interprofessional education. ISS increased the physical and psychological fidelity of the educational experience with perceived benefits relating to learning in context. The educational value of the intentional blend of simulation and a real clinical environment was realised with many students associating this with improved readiness for practice and immersion into clinical placements.This pilot study highlights the potential value of ISS as a tool in undergraduate medical education to enhance learning and better prepare students for clinical practice. References Stewart M, Kennedy N, Cuene-Grandidier H. Undergraduate interprofessional education using high-fidelity paediatric simulation. The Clinical Teacher, 2010;7:90–96. Koens F, Mann KV, Custers EJ, Ten Cate OT. Analysing the concept of context in medical education. Med Educ. 2005;39:1243–9. Sørensen JL, Østergaard D, LeBlanc V, et al. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation. BMC Med Educ. 2017;17(1):20. Published 2017 Jan 21. doi:10.1186/s12909-016-0838-3. Hart C, McNaughten B, Thompson A, Bourke T. Off-ward paediatric in situ simulation: are we ready? BMJ Simul Technol Enhanc Learn. 2018 Jul 9;4(3):146–147.