Name
Same Snake Envenomation, Different Clinical Presentation: A Novel
Approach to Simulated Cases Presenting with Snake Bites
Date & Time
Sunday, June 7, 2026, 4:38 PM - 4:53 PM
Location Name
Hamilton
Speakers
Authors
Alexander Goldman, Virginia Commonwealth University School of Medicine
Morrigan McKernan, Virginia Commonwealth University School of Medicine
Asma Ibrahim, Virginia Commonwealth University School of Medicine
Sarah Barringer, Virginia Commonwealth University School of Medicine
Arleen Trieu, Virginia Commonwealth University School of Medicine
Michelle Troendle, Virginia Commonwealth University School of Medicine
Venkat Abbaraju, Virginia Commonwealth University School of Medicine
Presentation Topic(s)
Instructional Methods
Description
PURPOSE
Envenomation by North American crotalids presents a diagnostic and
management challenge due to the diversity of toxins present, which can
produce varied clinical manifestations. Although CroFab and Anavip can treat
crotalid envenomation, they differ in availability, composition, and cost,
adding complexity for learners. To help medical students navigate the diverse
presentations and treatment decisions in crotalid snakebite care, we
developed and evaluated a simulated crotalid envenomation case.
METHODS
Fourth-year medical students and residents participated in a
quasi-experimental pretest-posttest study. Learners took a pretest to assess
baseline knowledge of snakebite envenomation and management. In groups of
3-5, students participated in a simulated clinical case involving a patient
with snakebite envenomation, each with varying clinical manifestations that
would modify treatment, including a dry bite, myotoxicity, neurotoxicity,
hemotoxicity, and anaphylaxis from snake venom. Students then took a posttest
to evaluate learning outcomes. The simulation was designed to provide
experience in obtaining focused histories, performing physical exams,
interpreting lab values, and formulating treatment plans with consideration
to antivenom composition and cost.
RESULTS
Twenty-one learners participated. Mean pretest and posttest scores were 52%
and 88%, respectively. A Wilcoxon signed-rank test demonstrated a
statistically significant improvement in scores (test statistic: 0.0, p <
0.001). On a Likert questionnaire, learners reported increased confidence in
recognizing physical exam findings, ordering appropriate diagnostic tests,
and treating patients with N. American snake envenomations.
CONCLUSION
Incorporating branching scenarios into the snake envenomation simulation
allowed learners to adapt their clinical management strategies to a range of
presentations, enhancing both diagnostic reasoning and decision-making
skills. Our pedagogical approach is practical to implement and can be
integrated into any undergraduate medical education curriculum with access to
a simulation lab.
Envenomation by North American crotalids presents a diagnostic and
management challenge due to the diversity of toxins present, which can
produce varied clinical manifestations. Although CroFab and Anavip can treat
crotalid envenomation, they differ in availability, composition, and cost,
adding complexity for learners. To help medical students navigate the diverse
presentations and treatment decisions in crotalid snakebite care, we
developed and evaluated a simulated crotalid envenomation case.
METHODS
Fourth-year medical students and residents participated in a
quasi-experimental pretest-posttest study. Learners took a pretest to assess
baseline knowledge of snakebite envenomation and management. In groups of
3-5, students participated in a simulated clinical case involving a patient
with snakebite envenomation, each with varying clinical manifestations that
would modify treatment, including a dry bite, myotoxicity, neurotoxicity,
hemotoxicity, and anaphylaxis from snake venom. Students then took a posttest
to evaluate learning outcomes. The simulation was designed to provide
experience in obtaining focused histories, performing physical exams,
interpreting lab values, and formulating treatment plans with consideration
to antivenom composition and cost.
RESULTS
Twenty-one learners participated. Mean pretest and posttest scores were 52%
and 88%, respectively. A Wilcoxon signed-rank test demonstrated a
statistically significant improvement in scores (test statistic: 0.0, p <
0.001). On a Likert questionnaire, learners reported increased confidence in
recognizing physical exam findings, ordering appropriate diagnostic tests,
and treating patients with N. American snake envenomations.
CONCLUSION
Incorporating branching scenarios into the snake envenomation simulation
allowed learners to adapt their clinical management strategies to a range of
presentations, enhancing both diagnostic reasoning and decision-making
skills. Our pedagogical approach is practical to implement and can be
integrated into any undergraduate medical education curriculum with access to
a simulation lab.
Presentation Tag(s)
Student Presentation