Implementing team-based sequential simulation for medical students in clinical clerkship: preliminary findings and...

Simulation is a key teaching tool for preparing medical students for clinical practice. Combining team-based learning with sequential simulation enhances problem-solving skills. The Clinical Learning through Extended Immersion in Medical Simulation (CLEIMS), a week-long program integrating simulated interprofessional education, has shown promising results at Griffith University. However, its application outside Australia remains largely unexamined. This study herein evaluates the feasibility of a modified 'CLEIMS' (mCLEIMS), condensed into a 2-day course, for second-year clinical clerkship (SY-CC) students. We analyze preliminary results, learners' perceptions, and learning efficiency through Advanced Cardiac Life Support (ACLS) certification.

This prospective, non-randomized controlled observational study enrolled 108 SY-CC students across three sessions (36 per session) from August to November 2020. All participants completed the 2-day mCLEIMS program, which included simulated patient assessment, on-call modules, handoff/briefing, suturing, interprofessional ward rounds, and high-fidelity ACLS training for cardiac arrest. Afterward, they completed a questionnaire assessing satisfaction, learning perception, and core competencies. All SY-CC students, including those in mCLEIMS, underwent ACLS training and exams before January 2021. Questionnaire and ACLS exam results were analyzed using appropriate statistical tests, with statistical significance set at a two-sided p value < 0.05. Open-ended responses were analyzed using thematic analysis, in which recurring concepts were coded and grouped into major themes through investigator discussion and consensus.

The questionnaire response rate was 99.1% (n = 107), with a global satisfaction score of 4.93 (5-point Likert scale). Most participants reported gaining competencies in interprofessional education (87.0%), communication and clinical needs (84.1%), teamwork and empathy (84.1%), and professional knowledge and skills (76.6%). Open-ended responses highlighted mCLEIMS' role in providing real-world medical experience (51.5%), particularly through simulation patients (32.0%) and interprofessional education (20.6%). ACLS pass rates were higher for mCLEIMS participants (96.8% vs. 84.7%, p = 0.012), who also scored better on the exam (83.1 ± 7.4 vs. 76.8 ± 18.1, p = 0.007).

Our experience suggests that mCLEIMS is a practical teaching tool for SY-CC students, integrating team-based sequential simulation to enhance learning perception and ACLS skill retention before clinical practice.