Ward round simulation in final year medical students: Does it promote students learning?

Abstract

Introduction: Ward round skills are essential for doctors in hospital settings. Literature shows medical students’ deficiencies in these skills. Simulation has been used to train these skills. However, exposing learners to simulation at an early stage may be associated with a high cognitive load and limited learning. This study aims to determine how students experience this load and its interplay with performance and which factors promote and impair learning.

Methods: Fifty-six final year medical students participated in a simulated ward round training exercise. Both students’ performance and cognitive load were measured to determine if there was any correlation and interviews were carried out to understand which factors support and impair learning.

Results: Performance scores revealed deficiencies in ward round skills. Students experienced a cognitive load that weakly correlated with performance. Qualitative findings provided important insights into simulated ward-based learning. It is clear that well-designed clinical scenarios, prioritization tasks, teamwork and feedback support students’ learning process whereas distractions impair learning.

Conclusions: WRS proved to be a good teaching method to improve clinical skills at this stage as the cognitive load is not too high to impair learning. Hence, including tasks in the simulation design can enhance the learning process.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Claudia Behrens, M.D., M.Med., is a Director of Simulation Center at Universidad Católica del Norte, Chile. Her special interest is learning in simulation.

Diana Dolmans, PhD, is a Professor at the School of Health Professions Education (SHE) Maastricht University in The Netherlands. Her special interest relates to teaching and learning in innovative learning environments.

Jimmie Leppink, PhD, is a Postdoctoral Researcher at the School of Health Professions Education (SHE), Maastricht University, The Netherlands. His research focuses on adaptive approaches to learning and assessment, cognitive load theory and measurement, and multi-level analysis of educational data.

Gerard Gormley, M.D. FRCGP, is a Senior Lecturer in the Centre for Medical Education, Queen’s University, Belfast, Northern Ireland. He has a special interest in complexity in simulation based learning and social cultural processes in summative clinical assessments.

Erik Driessen, PhD, is a Professor of Medical Education at the School of Health Professions Education (SHE) Maastricht University in the Netherlands. His area of expertise lies in evaluation and assessment. More specifically, topics such as learning and assessment in the workplace, mentoring, and the use of portfolios for learning and assessment.

Glossary

Ward round simulation: A specific type of simulation that involves complex clinical scenarios situated in a simulated clinical ward where a health care students visit patients for the purpose of making decisions concerning patient care. This involves multiple elements such as managing more than one patient, interacting with relatives and other healthcare professionals, and dealing with multiple competing tasks activities where interruptions and distractions happen.

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