Simulation-Based Education for Urgent Medical Complications Common to the Rehabilitation Setting: An Educational Program for Physical Medicine and Rehabilitation Residents.

BACKGROUND: Simulation technology is being increasingly adopted into medical education and is consistently associated with positive effects on knowledge, skills, and patient-related outcomes. There is little evidence on the use of simulation technology for the instruction of urgent medical complications to Physical Medicine and Rehabilitation (PM&R) residents.

OBJECTIVE: To examine whether a simulation-based educational program can improve PM&R resident confidence and knowledge in the assessment and management of urgent medical complications.

DESIGN: Pretest-posttest design.

SETTING: Academic free-standing acute inpatient rehabilitation hospital.

PARTICIPANTS: Twelve PGY-2 PM&R residents at the start of the academic year.

METHODS: Residents completed an integrated didactic and simulation-based curriculum on the assessment and management of five urgent medical complications: seizures, agitation, ventricular assist device (VAD)-associated complications, sympathetic storming, and autonomic dysreflexia. Simulations were conducted using a high-fidelity manikin.

MAIN OUTCOME MEASUREMENTS: Surveys and knowledge assessments were completed at baseline and immediately following training. Survey responses were recorded on a Likert scale ranging from 1=strongly disagree to 5=strongly agree. Multiple choice knowledge assessments were scored out of 100%. Within-group differences from baseline to post-intervention were analyzed.

RESULTS: There was a positive correlation between baseline experience and baseline confidence scores (r = .877). Knowledge assessment scores significantly improved from 57.8% (95% confidence interval [CI] 50.6% to 65.4%) at baseline to 85.0% (95% CI 81.6% to 88.4%) following the course (p < .001). Improved confidence was demonstrated in the assessment and management of all five topics (p < .05). The education program was rated highly by both learners (mean satisfaction score, Likert Score (LS) = 4.6) and instructors (mean satisfaction score, LS = 4.5).

CONCLUSIONS: Application of a simulation-based educational model to the instruction of urgent medical complications to PM&R residents resulted in increased knowledge with added benefits of confidence-building and high levels of enjoyment.

LEVEL OF EVIDENCE: II This article is protected by copyright. All rights reserved.