Standardized Patient Simulation as an Effective Tool for Teaching Gastrointestinal Bleeding to Preclinical Medical...

Medical simulations are a well-established educational tool, allowing students hands on practice before starting clinical practice. In this study, we created a medical simulation to guide preclinical first-year medical students through a gastrointestinal (GI) bleed patient encounter. Our objective was to evaluate the educational impact of simulation cases, particularly in the context of GI pre-clinical medical education.

Students participated in a standardized patient (SP) simulation of a patient with abdominal discomfort and rectal bleeding suggestive of cirrhosis. Sixteen sessions with two SPs were facilitated by five GI attendings and fellows. Student teams performed history-taking, physical examination, differential diagnosis, and management of a dynamically evolving, critically ill patient. Following the simulation, facilitators led a debrief linking clinical findings to preclinical pathophysiology. Students completed post-simulation surveys assessing perceived skills and learning.

Seventy-seven students participated; 63 were included in analysis. Sixty-three percent were female. Students demonstrated significant improvement in perceived history and physical exam skills (pre: 3.23±1.06 vs post: 4.21±0.58, P<0.01) and in developing differential diagnoses (pre: 3.02±0.91 vs post: 4.13±0.61, P<0.01). Ninety-seven percent reported improved understanding of GI bleeding. Additionally, 83% preferred more simulation-based learning prior to clerkships, and 83% desired more GI-focused simulations during clerkship.

This simulation case proved to be an effective tool to enhance pre-clinical medical students' abilities to understand and manage GI bleeding. The simulation allowed for the realistic practice of critical clinical skills while demonstrating to students the relevance of their pre-clinical learning. The perceived improvements observed in knowledge and confidence suggest that integrating simulation-based training early into the medical curriculum could improve the transition from theoretical learning to clinical practice. Future studies should evaluate long-term skill retention and impact on clinical performance.