Multi-Institutional Physician Assistant Student Perception of Simulated Emergency Room Cases

Abstract

Introduction: During clinical experiences, physician assistant (PA) students are required to participate in the management of multiple patients simultaneously. One method of preparing students for clinical experiences is through the use of simulation. Simulation allows development of decision-making and teamwork skills. 1,2 A previous study of nursing students in a multiple-patient simulation demonstrated improved student readiness to care for multiple patients. 2 The present study evaluated the effect of using simulation on PA student comfort with managing multiple patients in an emergency room setting.

Methods: Four PA programs participated in this quasi-experimental pretest-posttest design. Four simulation days were held, each with 4 standardized cases. Half of the students acted as standardized patients, while the remainder of the students managed patients in small groups. Surveys were administered before and after the emergency medicine course. Descriptive statistics and statistical analysis for significance were performed using Excel and SPSS.

Results: Posttest results indicated significant improvement in student confidence in emergency scenarios, ability to perform a focused medical history, ability to choose and interpret laboratory values, time management, prioritizing patients in a simulated environment, and selecting appropriate treatment. Students reported satisfaction with the experience, feedback, and debriefing. Participation in these simulations increased student interest in pursuing a position in emergency medicine upon graduation.

Discussion: In clinical rotations, PA students are expected to manage multiple patients with a variety of conditions. In this study, students were initially uncomfortable managing multiple patients. Student comfort increased after a simulation experience. Increased opportunities for students to select appropriate diagnostics and treatment may increase their overall comfort in management of patients during rotations.