High-fidelity simulation improves acute pain management competency in final-year medical students

Effective acute pain management requires integrating multimodal analgesia, clinical decision-making, and patient safety considerations. Although simulation-based education is increasingly used in medical training, its value for teaching complex acute pain management in undergraduate curricula has not been well established. This study evaluated whether high-fidelity simulation-based learning improved educational outcomes compared with traditional lecture-based teaching among final-year medical students.

A quasi-experimental pre-post controlled study was conducted at the University of Tabuk Simulation Center in Saudi Arabia between September 2025 and February 2026. Final-year medical students were assigned, according to the academic teaching schedule, to either simulation-based learning or traditional lecture-based instruction. The simulation intervention included three clinically relevant acute pain scenarios. Outcomes included knowledge acquisition, assessed using a 15-item multiple-choice questionnaire; learner confidence, assessed using an 8-item Likert-scale questionnaire; and post-intervention clinical performance, assessed using a standardized competency-based checklist with scores ranging from 0 to 50. Between-group differences and pre-post changes were analyzed.

A total of 147 students were included in the final analysis: 73 in the simulation group and 74 in the traditional teaching group. Baseline demographic characteristics, knowledge scores, and confidence scores were comparable between groups (all p > 0.05). After the intervention, both groups improved; however, the simulation group showed greater gains in knowledge (12.8 ± 1.5 vs. 10.2 ± 1.8, p < 0.001), higher clinical performance scores (41.3 ± 3.8 vs. 34.0 ± 4.6, p < 0.001), and larger improvements in confidence (+9.8 vs. + 5.5 points, p < 0.001). Students reported high satisfaction with the simulation experience, with an overall satisfaction score of 4.7 ± 0.4. Effect size analysis showed a large effect for knowledge improvement (Cohen's d = 1.12) and a very large effect for clinical performance (Cohen's d = 1.58).

Simulation-based training was associated with higher knowledge, confidence, and post-intervention performance scores. These findings should be interpreted in light of the quasi-experimental design, nonrandom allocation, and nonblinded assessment. The results support the use of simulation-based approaches in undergraduate pain education.