Advances in Medical Education and Practice (May 2022)
Teaching and Assessment of Medical Students During Complex Multifactorial Team-Based Tasks: The “Virtual on Call” Case Study
Abstract
Elif Iliria Emin,1 Ece Emin,2 Alexios Bimpis,3 Michael Pierides,4 Aikaterini Dedeilia,5 Zibad Javed,6 Kathrine-Sofia Rallis,6 Ferha Saeed,6 Georgios Theophilou,7 Apostolos Karkanevatos,8 Dilek Kitapcioglu,9 Mehmet Emin Aksoy,9 Apostolos Papalois,10 Michail Sideris6 1Department of Acute Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; 2EGA Institute for Women’s Health, University College London, London, UK; 3Department of Neurosurgery, Tzaneio General Hospital, Piraeus, Greece; 4Department of Acute Medicine, Kettering General Hospital NHS Trust, Northamptonshire, UK; 5School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 6Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK; 7Department of Gynaecological Oncology, St James Institute of Oncology, Leeds, UK; 8Department of ENT Surgery, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK; 9Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey; 10Special Unit for Biomedical Research and Education, Aristotle University of Thessaloniki, Thessaloniki, GreeceCorrespondence: Michail Sideris, Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary university of London, London, UK, Email [email protected]: Although considerable efforts have been made to incorporate simulation-based learning (SBL) in undergraduate medical education, to date, most of the medical school curricula still focus on pure knowledge or individual assessment of objective structured clinical examination skills (OSCE). To this end, we designed a case study named “iG4 (integrated generation 4) virtual on-call (iVOC)”. We aimed to simulate an on-call shift in a high-fidelity virtual hospital setting in order to assess delegates’ team-based performance on tasks related to patient handovers (prioritisation, team allocation).Methods: A total of 41 clinical year medical students were split into 3 cohorts, each of which included 3 groups of 4 or 5 people. The groups consisted of a structured mix of educational and cultural backgrounds of students to achieve homogeneity. Each performing group received the handover for 5 patients in the virtual hospital and had to identify and deal with the acutely unwell ones within 15 minutes. We used TEAMTM tool to assess team-based performances.Results: The mean handover performance was 5.44/10 ± 2.24 which was the lowest across any performance marker. The overall global performance across any team was 6.64/10 ± 2.11. The first rotating team’s global performance for each cycle was 6.44/10 ± 2.01, for the second 7.89/10 ± 2.09 and for the third 6.78/10 ± 1.64 (p = 0.099 between groups).Conclusion: This is one of the first reported, high-fidelity, globally reproducible SBL settings to assess the capacity of students to work as part of a multinational team, highlighting several aspects that need to be addressed during undergraduate studies. Medical schools should consider similar efforts with the aim to incorporate assessment frameworks for individual performances of students as part of a team, which can be a stepping-stone for enhancing safety in clinical practice.Keywords: virtual on-call, simulation based learning, team-based assessment, high fidelity simulation, handover
