Impact of an Anesthesia Simulated Experience on Pre-clinical Medical Student Perception of the Specialty

Impact of an Anesthesia Simulated Experience on Pre-clinical Medical Student Perception of the Specialty

Deborah Fretwell; Nancy Yerkes, PhD; Kyle Harrison, MD; and Ankeet Udani, MDDepartment of Anesthesia, Stanford University School of Medicine

BACKGROUND

Simulation is a valuable tool to expose students to technically challenging, high-stakes specialties such as anesthesia. We investigated whether a single, simulation-based teaching module could increase first and second-year (pre-clinical) student interest in anesthesiology, a medical specialty to which they have little exposure.

OBJECTIVES

METHODSAll Stanford University pre-clinical medical students were invited to attend a simulation-based anesthesia teaching module. The first 17 to reply formed our intervention group. The control group consisted of 18 case-matched, Stanford pre-clinical medical students. All participants were surveyed to assess past exposure to anesthesia, reasons anesthesia was not of interest, and their medical specialty of choice. After the module, the intervention group was surveyed again on their medical specialty of choice. In the intervention, students in groups of six or less rotated through three 40-minute stations staffed by Stanford anesthesiology faculty. Station A simulated a preoperative patient assessment using patient-doctor role-play. Station B coached basic airway management skills using partial-task trainers. Station C utilized high-fidelity simulation to place participants in the operating room managing the anesthetic of the patient discussed in station A. Following all simulation activities, anesthesia faculty led a 40-minute group debriefing.

RESULTSAfter IRB approval, 35 pre-clinical medical students participated in our study, 17 in the intervention group and 18 in the control group. 54% percent were male, 46% female, 37% were first year, and 63% were second year medical students at Stanford University. The median age was 24 years old. Eighty percent of all surveyed pre-clinical students reported having less than three days of anesthesia exposure (Figure 1). Forty-six percent stated they never really knew or had limited knowledge of the specialty, while 54% reported having “some” or “a pretty good idea” (Figure 2). When asked “what does not interest you about anesthesia,” five themes were identified: limited patient interaction (28.6%), repetition, boredom, lack of procedures (22.9%), lack of long- term patient care (17.1%), work schedule and high-stress environment (17.1%), and lack of respect from patients and surgeons (17.1%). Before the intervention, three students in the intervention group listed anesthesiology as their specialty of choice. After the intervention, one additional student listed anesthesiology as their specialty of choice (P = 1 by Fisher exact test).

DISCUSSIONWe investigated whether a single, simulation-based teaching module could increase first and second-year (pre-clinical) student interest in anesthesiology, a medical specialty to which they rarely have exposure. Our study was limited by its size and diversity. Nonetheless, our surveys suggest:

Pre-clinical students had little prior exposure to anesthesiology

Many pre-clinical students have negative perceptions about anesthesiology despite a lack of substantive exposure to the specialty

CONCLUSION

Figure 3: What does not interest you about anesthesia?

Anesthesia simulation has potential to expose and inform medical students about the medical specialty yielding dedicated and consequently successful residents.

Expose pre-clinical students to the activities of the anesthesiologist.

Increase student interest in anesthesiology using a simulation-based teaching module.

I don't really know what anesthesiologists do

I have limited knowledge

I have some idea

I have a pretty good idea

40%

37%

17%

Figure 2: How familiar are you with the daily activities of the anesthesiologist?

Figure 1: How much exposure have you had to the field of anesthesiology?

none

less than 3 days

less than 15 days

more than 15 days

40%

40%

17%

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REFERENCES

6%

1. J Vasc Surg 2011;54:1193-12002. J Vasc Surg 2010;52:775-813. Ann Acad Med Singap 2010;39:692-95