​​Exploring the Efficacy of an Acute Coronary Syndrome Simulation Scenario for Fourth-Year Medical Students​

Acute coronary syndrome (ACS) is ​a critical medical condition characterized by a sudden reduction in blood flow to cardiac muscle. This condition encompasses unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI), requiring rapid diagnosis and intervention for optimal outcomes. Despite advances in treatment, ACS remains a leading cause of morbidity and mortality worldwide.​ Thus, it is essential to ensure that graduating medical students possess the requisite knowledge and confidence to effectively identify and manage patients with ACS as they transition to residency.​    ​Methods: To ensure the readiness of graduating medical students to recognize and initiate management of ACS, we developed and implemented a 45-minute simulation-based scenario during the CO 2023 transition to residency course at the Florida International University Herbert Wertheim College of Medicine (FIU-HWCOM).​ Knowledge gains were ​assessed​ through performance on voluntary pre- and post-session identical assessments consisting of seven multiple-choice questions. Pre- and post-session confidence and post-session satisfaction were assessed using voluntary 5-point Likert-style questions.    Results: All graduating FIU-HWCOM medical students (n=120) participated in the simulation. Students who completed both the pre- and post-session assessments (n=50, 41.7%) were included in the study. Mean knowledge performance improved from 3.74 (SD: 1.14) to 5.34 (SD: 1.19) (p=0.0001) post-session. Confidence in recognizing acute cardiac ischemia increased from 3.88 (SD: 0.66) to 4.42 (SD: 0.67), while confidence in initiating management of acute cardiac ischemia increased from 3.54 (SD: 0.76) to 4.32 (SD: 0.65) post-session (p=0.0001). Overall satisfaction was high, with 94% of participants finding the session a valuable use of their time and 90% agreeing that participation will positively affect the care of patients presenting with chest pain. ​ ​​Conclusion: ​Our findings suggest improvements in graduating medical students' knowledge and confidence in recognizing and managing ACS. The session was well received by students and is easily adaptable for integration into curricula at other medical schools.