Abstract
Clinical simulation is a teaching strategy that replicates medical situations in controlled environments. The COVID-19 pandemic created disruptions for healthcare simulation centers. As a response, the Universidad Anáhuac designed online clinical simulation practices and assessments. The pre-intervention survey showed skeptical medical students (59.15%) to continue this learning format. The intervention included neurology, cardiology, and gynecology topics supported by five faculty members and staff. Instruments were examination checklists to evaluate the clinical competence based on a 100 score and the Debriefing Assessment for Simulation in Healthcare (DASH) with a 1 (extremely ineffective) to 7 (extremely effective) score. Students received individual training by Zoom, including simulation practices, debriefing, and assessment. Even though it seemed impossible to address clinical skills by distance, simulation practices continued with online resources. Collaborative participation between faculty, students, and staff facilitated learning during the COVID-19 conditions.
TopIntroduction
In November 2019, the Chinese government alerted the world about a new virus called SARS-Cov-2 that originated in the province of Wuhan, affecting the population by COVID-19 disease. With its virulence capacity, uncertain evolution, and high mortality rates, the world's governments implemented immediate epidemiological strategies to stop the spread and collapse of the world's health care systems. Therefore, in Mexico, in March 2020, the federal government began with protocols to reduce all non-essential activities and events with crowds of people, causing the suspension of many jobs and schools at all educational levels.
In medical schools, hospital rotations were suspended to prevent health risks. As a result, approximately 150 students interrupted the last semesters of their medical program, where most of the clinical competence is acquired or reinforced. In addition, the lockdown impacted the closing of several facilities transforming face-to-face education into screens with emergency remote education. Besides the hospital settings, clinical simulation sessions were also canceled, removing opportunities for medical learning. The unusual circumstances led to the project to experiment with innovative approaches considering distance learning as part of the social responsibility of the university and the medical school.
The purpose of the chapter is to describe an intervention project at the School of Medicine of the Universidad Anáhuac (Querétaro campus), to introduce Online Clinical Simulation to address the continuity of the academic medical program.
The objectives of the chapter are:
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Readiness for online simulation practices: Provide evidence of students' skepticism to apply online simulation practices and assessment.
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Framework for online simulation practices: Describe a conceptual framework to implement online simulation practices for the topics of neurology, cardiology, and gynecology.
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Assessment instruments: Introduce instruments to assess online simulation practices for clinical competence and debriefing as part of the educational intervention.
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Discussion and recommendations: Explain and contrast results of the clinical competence for the intervention applying online clinical simulation.
The authors of the present chapter invite leaders, faculty members, students, and staff to learn from the presented methods and experiences to reproduce online-based simulation activities in their contexts.
Key Terms in this Chapter
Online Learning: Is an educational approach that requires the Internet to address learning content.
Telesimulation: Is a process by which telecommunication and simulation resources provide education, training, or assessment to learners at an off-site location.
Distance Learning: Is a method to study remotely from the educational setting, either online or offline.
Online Clinical Simulation: Is a guided teaching strategy that replicates health care situations with home props to learn without risks.
Clinical Simulation: Is a teaching strategy that replicates medical situations in controlled environments, promoting learning without risks.
Patient-Centered Learning: Patient-centered learning (PCL) refers to patient care as a person who collaborates with the health team to decide every clinical intervention, considering integral quality healthcare services aligned with patient preferences in every phase of clinical care: patient knowledge, diagnosis, intervention, and monitoring/follow up.