The effective implementation and assessment of a surgical simulation programme for undergraduate medical students

Background: COVID-19 has impacted all non-emergent hospital activities, including on-site medical student education. In response, we implemented an on-site simulation programme to supplement our existing curriculum to ensure that our students’ clinical learning experience is optimised. Methods: Over the course of the academic year all students enrolled in the Surgery module received simulation training in the decommissioned original operating theatres of the Mater Misericordiae University Hospital. This incorporated biweekly surgical tutor-led simulated patient sessions over a twelve week period in semester one and surgical skills simulation throughout both semesters. Best practices in infection prevention were researched prior to implementing our programme. To ensure optimal benefit a systematic review evaluating performance benefits of simulation training was performed. To assess usefulness, independent clinical teams scored student clinical competence (using twelve components of the Surgical Ward Assessment Tool) in representative groups completing surgical rotations who had simulation training versus those completing same duration medicine rotations without. Student feedback was obtained before and after completing simulation training. Results: 3074 articles were initially identified using the search criteria with 92 full-text articles then screened for eligibility. Nineteen articles were selected for review. All articles reported a positive effect of simulation training on performance. 220 students underwent simulation training this semester over 96 hours of scheduled, direct teaching. 66 students (38 females, 29 graduate entry) were formally assessed by clinical staff from ten specialties at two clinical sites. Students who received simulation training (n=35) were significantly better at history taking (p=0.004) and appropriate laboratory (p=0.001) and radiological investigation (p=0.01) ordering. Conclusion: Simulation based medical education, as an adjunct to existing curricula, improves knowledge-based performance medical students. This pilot study shows the rapid implementation and feasibility of a simulation programme for medical students at our clinical site. This will provide a basis for further development of on-site simulation training.