Enhancing a SimMan Experience through Team-Based Learning J. Pasley, M. Petty, M. Jennings, M. Soulsby, J. Firnhaber, M. Palacios, J.White UAMS, Little.

Enhancing a SimMan Experience through Team-Based Learning

Enhancing a SimMan Experience through Team-Based Learning

J. Pasley, M. Petty, M. Jennings, M. Soulsby,

J. Firnhaber, M. Palacios, J.White

UAMS, Little Rock, AR, USA

J. Pasley, M. Petty, M. Jennings, M. Soulsby,

J. Firnhaber, M. Palacios, J.White

UAMS, Little Rock, AR, USA

IntroductionIntroduction

Physiology educators formerly used animal-based laboratory exercises to reinforce basic physiological concepts.

Medical simulation is now used to provide a

link between basic science education and clinical bedside teaching.

Physiology educators formerly used animal-based laboratory exercises to reinforce basic physiological concepts.

Medical simulation is now used to provide a

link between basic science education and clinical bedside teaching.

IntroductionIntroduction

Patient simulation brings learning concepts to life in a clinical setting.

Patient simulation brings learning concepts to life in a clinical setting.

OverviewOverview Implementation of Simulation in Physiology

Cardiovascular Pulmonary

Implementation of Simulation in Physiology Cardiovascular Pulmonary

Implementation of TBL to encourage Preparation for SimMan Experience

Implementation of TBL to encourage Preparation for SimMan Experience

The ProcessThe Process

Spring 2000 - 2002

Spring 2003 - 2005

Spring 2005

2007

Modification of Courses

Included TBL

Modified TBLAdded 3 mannequins

Spring 2000-2002Spring 2000-2002

Standard use of ECG and Spirometer Cardiovascular Physiology

ECG interpretation Myocardial blood flow Heart failure

Respiratory Physiology Airway resistance Restrictive lung disease Obstructive lung disease

Mediocre Examination Performance by Students in both areas of Physiology

Standard use of ECG and Spirometer Cardiovascular Physiology

ECG interpretation Myocardial blood flow Heart failure

Respiratory Physiology Airway resistance Restrictive lung disease Obstructive lung disease

Mediocre Examination Performance by Students in both areas of Physiology

Spring 2003-2005Spring 2003-2005

Modified courses to include SimMan computer-driven patient simulator

Groups of 10 students 20 minute experience

Observations Students not well prepared prior to simulator Hands-on activity by 3-5 students Interested students, but still passive

Modified courses to include SimMan computer-driven patient simulator

Groups of 10 students 20 minute experience

Observations Students not well prepared prior to simulator Hands-on activity by 3-5 students Interested students, but still passive

Spring 2005Spring 2005

Added TBL to encourage preparation First implementation in medical curriculum at UAMS

Group size = 10 IRAT given as members arrive for Simulator in waiting

area GRAT given just outside of Simulator

Lively questioning by most students Faculty learned how lecture/questions needed clarification

Application Next classroom session In conjunction with review session for test

Problematic

Added TBL to encourage preparation First implementation in medical curriculum at UAMS

Group size = 10 IRAT given as members arrive for Simulator in waiting

area GRAT given just outside of Simulator

Lively questioning by most students Faculty learned how lecture/questions needed clarification

Application Next classroom session In conjunction with review session for test

Problematic

ResultsResults

Scores on the cardiovascular and respiratory exams with SimMan experience increased significantly compared to non SimMan experience.

Scores on the cardiovascular and respiratory exams with SimMan experience increased significantly compared to non SimMan experience.

2003 2004 2005 No SIM-MAN

2006

Pre SIM-MAN

2000 - 2002

SEM

5.30

SEM

2.01

SEM

2.84

SEM

2.25

SEM

6.50

Cardiovascular PhysiologyCardiovascular Exams

% c

orr

ect

% C

orr

ect

SEM 3.45

Respiratory PhysiologyRespiratory Questions

SEM

7.14

SEM5.65

SEM4.76

SEM

9.84

Pre SIM-MAN

2000 - 2002

2003 2004 2005 No SIM-MAN

2006

Modified TBL 2007Modified TBL 2007

Day before SimMan Experience IRAT- based on lecture concepts GRAT-group quiz and discussion over same

questions as IRAT

Application quiz administered during classroom review of SimMan exercise

Day before SimMan Experience IRAT- based on lecture concepts GRAT-group quiz and discussion over same

questions as IRAT

Application quiz administered during classroom review of SimMan exercise

More experience with TBL needed to demonstrate improvement by TBL use Critical to get all concerned faculty involved

Need to Examine impact of TBL on Learning Physiologic concepts using SimMan

Collect more data to determine whether TBL has an impact on learning.

More experience with TBL needed to demonstrate improvement by TBL use Critical to get all concerned faculty involved

Need to Examine impact of TBL on Learning Physiologic concepts using SimMan

Collect more data to determine whether TBL has an impact on learning.

SIM-Man/TBL 2007SIM-Man/TBL 2007

Three mannequins allowed smaller group size (6) and more time enhanced SIM-Man experience

Problems in test administration nullified our ability to measure impact of TBL

Three mannequins allowed smaller group size (6) and more time enhanced SIM-Man experience

Problems in test administration nullified our ability to measure impact of TBL

Results

ConclusionsConclusions

Simulator encounters reinforce Basic Science Concepts presented in Physiology Lectures

Simulator experience Significantly Impacted Learning TBL Enhanced student Preparation for the SIM-Man

experience

Simulator encounters reinforce Basic Science Concepts presented in Physiology Lectures

Simulator experience Significantly Impacted Learning TBL Enhanced student Preparation for the SIM-Man

experience

Future PlansFuture Plans

RationaleRationale

To shift focus from learning key concepts to using concepts

To replace lecture format with a more “hands on” experience

To encourage students to come prepared

To shift focus from learning key concepts to using concepts

To replace lecture format with a more “hands on” experience

To encourage students to come prepared

RationaleRationale Demonstrate cardiovascular and pulmonary

physiology concepts in a Medical Physiology course using simulation.

Demonstrate cardiovascular and pulmonary physiology concepts in a Medical Physiology course using simulation.

Examine student performance on exam questions in cardiovascular and respiratory physiology before and after the simulation experience.

Examine student performance on exam questions in cardiovascular and respiratory physiology before and after the simulation experience.

Cardiovascular Physiology

Question Topic

Pre SIM-MAN

% correct

SIM-MAN% correct

NO SIM-MAN

% correct

ECG Interpretati

on65 85 72

Cardiac Blood Flow 56 84 52Ischemic

Heart Disease/Hea

rt Failure

60 82 48

Question Topic

Pre SIM-MAN

% correct

SIM-MAN% correct

NO SIM-MAN% correct

Airway

Resistance

56 90 51

Obstructive Lung Disease 53 82 70

Restrictive Lung Disease 50 72 54

Respiratory Physiology