Session Details: 23rd Annual IAMSE Meeting

Presentation 1 - All the world's a stage: A theatre workshop for improving communication skills in medical students.
Christie Kohut
MD Undergraduate Program, University of British Columbia

PURPOSE Despite evidence that arts-based interventions are an effective tool for improving communication in medical students, they remain underutilized in medical education. The purpose of this project was to create a theatre-based workshop that can strengthen clinical communication amongst undergraduate medical students and can be implemented by medical faculties to enhance their existing communication skills curriculum. We examined whether attending our novel arts-based workshop fostered improvements in medical students' communication. METHODS A 2-hour pilot workshop was developed with input from medical students, drama teachers, theatre professors, and medical communication experts and piloted at the University of British Columbia. Participants were recruited from year 1 and 2 of the medical undergraduate program. 8 medical students volunteered to participate. The workshop was facilitated by 2 second year medical undergraduate students. A variety of theatre activities were utilized, including monologue delivery, role-play, and theatre games. Goals included building on delivery, interpersonal, and teaching skills; giving and receiving feedback; and reducing performance anxiety. Pre- and post-test data were collected using self-report surveys and objective assessment. RESULTS Preliminary data analysis showed that all participants (n=8) believed that participation helped develop communication skills and 7 (87.5%) felt participation increased their understanding and awareness of speaking or interpersonal skills. These data will inform changes to the design and delivery of future workshops and iterations of the study. Upon further optimization, we intend to publish the workshop as an open-source toolkit for medical schools who wish to implement the program into their curriculum. CONCLUSION This theatre-based workshop is an effective and engaging supplemental approach to communication skills education that is easy to implement, effective, and engaging.

Presentation 2 - The Impact of Simulation Competition on Pre-Clinical Medical Students
Alexander Piszker

Alabama College of Osteopathic Medicine

PURPOSE Simulation is utilized in medical education to teach clinical skills and clinical reasoning in a realistic yet low-risk environment. A simulation competition is conducted annually, by the American Medical Student Association (AMSA) chapter at the Alabama College of Osteopathic Medicine (ACOM). Our poster describes the 2018 competition and presents findings from a post-competition survey designed to assess the value of each element used in preparing students as well as the impact of the competition experience on perceived clinical skills and overall confidence. METHODS This year 45 year 1 and 2 students (9 teams of 5 each) participated in the competition following 7 weeks of preparation in which teamwork and clinical reasoning were reinforced via structured faculty-led training sessions. All scenarios incorporated a high degree of realism and clinical complexity, requiring that students apply teamwork, clinical reasoning and clinical skills as they worked through each scenario while being judged by a panel of clinical faculty. A 12-item survey was administered following the event and was designed to evaluate the educational value of the experience as well as the effectiveness of various components of the practice period. RESULTS Survey responses by students indicated that the simulation competition produced enhanced clinical reasoning and team-building skills as well as overall confidence in their developing clinical abilities. All twelve instructional methods (e.g. structured debriefing, realistic practice cases, etc.) used in the practice period were rated as "Effective or Very Effective." All survey data will be presented and discussed. CONCLUSION An in-house medical simulation competition demonstrates value and effectiveness in developing pre-clinical students' clinical skills and facilitates interpersonal development through teamwork that is invaluable to a healthcare professional. Participation in simulation competition enhances students' confidence and preparedness for encountering real clinical scenarios that will be encountered in 3rd year clinical clerkships.

Presentation 3 - REPLACING DIDACTIC LECTURES WITH INTEGRATED CASE-BASED SESSIONS IMPROVES STUDENT OUTCOMES IN AN INTEGRATED PRE-CLERKSHIP CURRICULUM
James Fong

Texas Tech, El Paso

PURPOSE Lecture-based dissemination of information is the traditional approach to presenting curricular materials in medical schools. Recent studies suggest team-based or case-based learning sessions are more effective than didactic lectures. However, it remains unclear whether replacement of didactic lectures with case-based sessions would improve learning outcomes in medicals schools with integrated, clinical presentation-based, pre-clerkship curricula. METHODS We converted the 6-week Endocrine Unit from didactic lectures to monographs, narrated Power Point slides or interactive modules for use as self-directed learning materials. All materials included quizzes for self-assessment. At the end of each week students were required to attend integrated case-based sessions. Each session started with an Individual Readiness Assurance Test (IRAT) on the material covered that week. IRAT scores comprised 12% of the Unit grade. Integrated cases incorporated questions from all basic science disciplines for the week. At the end of the unit a summative exam was administered which comprised 88% of the unit grade. RESULTS Summative exam scores were significantly higher than those of the previous class, which used didactic lectures (81.1% vs 76.6%, respectively, P<0.01). The largest improvement was in the lowest quartile of summative scores, and the Unit failure rate dropped from 11% (lectures) to 1% for integrated sessions. There was no significant difference in summative scores between the two classes for prior units which used didactic lectures for both classes. CONCLUSION These results suggest that students benefit from the addition of weekly case-based integrated sessions. The addition of graded quizzes insures that students stay current and come prepared for the integrated sessions, which likely contributes to improved student outcomes on the summative exam. These results provide a rationale for replacement of lectures with interactive sessions as part of the pre-clerkship curriculum.

Presentation 4 - TEACHING THE ABCDE APPROACH: LECTURE VS VIDEO-BASED INSTRUCTION
Marije Hogeveen

Department of Neonatology (804), Radboud University Medical Centre Amalia Children's Hospital

PURPOSE The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a widely accepted, expert-based algorithm for the management of emergencies in patients of all age categories. We evaluated whether video-based instruction is more effective than traditional lecturing in teaching the ABCDE approach. METHODS A randomised controlled simulation study was performed. Neonatal healthcare providers participated in multiple neonatal advanced life support (NALS) scenarios, using a high-fidelity neonatal patient simulator and realistic training environment. For each training day, the instruction method was randomised to an instructional video (VBI) or a conventional lecture (CL). One researcher, blinded to the received instruction type, evaluated adherence to the ABCDE approach with an assessment tool specifically designed and tested for this study. The primary outcome was adherence to the ABCDE approach, expressed as percentage score. Secondary outcomes were the scores of each profession category (nurses, neonatal ward physicians, fellows/neonatologists) independent of the study groups, and the scores for the domains (A, B, C, D, E) of the algorithm. RESULTS Seventy-two participants were assessed, resulting in 65 percentage scores (the performance of the 2 nurses in each scenario was combined). Overall mean (SD) percentage score was 31.5% (19.0). The VBI group (28 participants, 22 scores) performed the ABCDE approach better than the lecture group (44 participants, 43 scores), with mean (SD) scores of 38.8% (18.7) and 27.8% (18.2), respectively (p=0.026). Distribution of age, function, previous participation and working experience was not different between both groups. The difference in adherence between both groups could mainly be attributed to differences in the adherence to domain B (p=0.023) and C (p=0.007). Neonatal ward physicians demonstrated better adherence than nurses. CONCLUSIONS Video-based instruction was more effective than traditional lecturing in teaching the ABCDE approach during NALS training. Overall adherence to the ABCDE algorithm was low.