C56-08 Bridging the Gap Between Theory and Practice: Simulation-Based Training Improves Shock Recognition and Resuscitation Skills for Internal Medicine Residents

Abstract Rationale Shock is a common emergency in inpatient rapid response settings. Internal medicine (IM) residents often serve as primary responders and must quickly recognize and stabilize patients with shock. Traditional didactic teaching may not reliably translate into effective bedside performance under high-stress conditions. This study aims to evaluate whether a structured, simulation-based curriculum can enhance residents’ confidence and competence in early shock recognition and resuscitation. Methods Internal medicine residents participated in a one-hour simulation-based training session, followed by structured debriefing and feedback led by a board-certified intensivist. This quasi-experimental study employed a pre- and post-test design using multiple-choice questions to assess knowledge and a 5-point Likert scale to evaluate confidence level. Paired t-tests and Wilcoxon rank tests were used to compare pre- and post-intervention scores. Results A total of eleven internal medicine residents completed the training. Pre- and post-intervention assessments comprised of two questions assessing confidence in shock management and three clinical vignette-based knowledge questions addressed early recognition of shock, differentiation of shock types, and initial stabilization strategies. Post-intervention, residents showed a statistically significant 38.3% mean increase in overall confidence in managing shock (p = 0.001). Confidence improved particularly in early resuscitation of hemorrhagic shock (mean difference MD = 1.0, p = 0.009) and management of atrial fibrillation with rapid ventricular response in unstable patients (MD = 0.6, p = 0.038). Overall knowledge scores also increased significantly from 54.5% pre-training to 90.9% post-training (p = 0.001). Proficiency in selecting the appropriate vascular access device improved from 45.5% to 100% (p = 0.041). Recognition of early shock and appropriate management of atrial fibrillation in the setting of hemorrhagic shock improved from 36.4% to 72.7% and from 81.8% to 100%, respectively. However, these changes did not reach statistical significance. Conclusions Our study highlights the effectiveness of simulation-based training, especially in critical care education. The exposure to realistic case scenarios, immediate debriefing, and hands-on management practice will lead to measurable gains in confidence and proficiency in recognizing shock subtypes and applying evidence-based resuscitation principles. Future iterations should incorporate larger cohorts and longitudinal follow-up to assess retention and clinical translation of these gains. This abstract is funded by: None