Targeted Simulation Training in ICU Shared Decision-Making Boosts Confidence and Competence in Medical Students

Abstract

Introduction

Shared decision-making (SDM) is the standard of communication. Many providers receive little or no training in SDM. In our study, we implemented a training simulation aimed at boosting medical student confidence and competence in SDM.

Methods, Study Design

Prospective, non-randomized, observational pilot study.

Study Setting

Simulation center in large, urban, academic medical center.

Recruitment

Participants were recruited by electronic mail invitation. Participation was voluntary and paid.

Consent

Participants were consented for participation in the study, including video recording, prior to starting the study.

Participants

Participants were recruited from our medical school’s second (M2), third (M3), and fourth (M4) year classes. Each participant completed two confidence surveys, two simulations, and a communication training session. Seven months later, participants were invited to complete a confidence survey and an assessment of attitudes.

Results

Thirty seven participants completed the study: 17 M2 (46%), 9 M3 (24%) , and 11 M4 (30%). We observed an improvement in learner confidence in 8 of 8 communication domains (100%). Following training, statistically significant improvement in learner competence was measured in 7 of 8 domains (87.5%). Our retention rate was 59% (n = 22) at seven months, at which time confidence in nonverbal communication was significantly higher. Participants rated the simulation highly.

Conclusion

Simulation is effective at improving medical student communication skill and confidence. Students maintained their increased confidence for at least seven months. We recommend the implementation of targeted simulation training early in medical school to establish a standard for SDM and enhance student communication skill and confidence.