Subarachnoid Hemorrhage Causing a Seizure: An Assessment Simulation for Medical Students.

Area of Science:

• Medical Education
• Emergency Medicine
• Neurology

Background:

• Subarachnoid hemorrhage (SAH) is a critical diagnosis presenting as headache, often without classic thunderclap symptoms.
• Thunderclap headaches can be misleading, with SAH present in a significant minority of cases.
• Status epilepticus requires immediate recognition and management to prevent adverse outcomes.

Purpose of the Study:

• To develop and evaluate a simulation for 4th-year medical students focusing on diagnosing atypical SAH.
• To assess students' ability to manage patients experiencing status epilepticus.
• To evaluate competence in Entrustable Professional Activities (EPAs) related to urgent care and patient handover.

Main Methods:

• A high-fidelity manikin simulation was used for 4th-year medical students.
• The scenario involved diagnosing subarachnoid hemorrhage and managing a seizing patient.
• Post-simulation debriefings utilized a Gather-Analyze-Summarize technique.

Main Results:

• The simulation adequately assessed students' response to acute decompensation and diagnosis of SAH.
• Students frequently considered meningitis initially but correctly diagnosed SAH via lumbar puncture.
• The simulation was highly rated by students and facilitators for engagement and appropriateness.

Conclusions:

• This simulation effectively trains medical students in recognizing and managing critical conditions like atypical SAH and status epilepticus.
• The case successfully integrates assessment of EPA 10 (Urgent Care) and EPA 8 (Patient Handover).
• The simulation is a valuable addition to emergency medicine clerkship curricula.