Learning and Peer Feedback in Undergraduate Medical Student Simulation

Simulation-based teaching is an integral part of medical training, providing the opportunity to apply clinical knowledge in a realistic yet controlled environment. The proportion of observers to active participants in the simulation is increasing, owing to the increasing number of medical students. Evidence suggests that using an observer tool can enhance learning, support debriefing and improve observer satisfaction. However, there is a lack of generalisable observer tools designed for use across different simulation scenarios, including both technical and nontechnical skills. We aimed to evaluate the acceptability and perceived usefulness of our novel observer tool and its impact on learning and peer feedback in a medical-student simulation.

We delivered a simulation series to 43 medical students in which observers of simulation completed our CARSEAT observer tool, an acronym for Communication, A-E assessment, Rapport, Situational awareness, Escalation, Application of clinical knowledge, and Teamwork. The participants completed the pre- and post-intervention questionnaires. The study used an unpaired pre-/post- intervention design, with 38 pre- and 34 post-survey respondents. Primary outcomes were perceived usefulness, engagement, and impact on learning and feedback. Descriptive statistics were used for quantitative data, and qualitative data were analysed thematically.

94% of respondents found observing simulation more useful when using the tool than without. The majority agreed that the tool improved aspects of learning and peer feedback. Thematic analysis identified six major themes: (1) impressions of observation, (2) engagement during observation, (3) enhancement of learning, (4) providing peer feedback, (5) useful aspects of the CARSEAT tool, and (6) suggested improvements for the CARSEAT tool.

Our novel observer tool improved engagement, enhanced learning, and supported peer feedback during the medical student simulation sessions. The tool's structure and clear domains make it easy to use and generalise across different simulation scenarios, with potential for integration into undergraduate curricula, and wider implementation across institutions.