1. WORKSHOP How to integrate basic clinical skills and simulation adjuncts in an undergraduate pre-clerkship medical curriculum?
Dr. Muhammad Zafar
MBBS, MPhil, PhD
Associate Professor of Anatomy/Skill Lab
Director of Clinical Skills Program
Dr. Nasir Ali Afsar
MBBS, MPhil, PhD, MERC
Senior Lecturer of Pharmacology

2. What is simulation?
Artificial representation of a real-world process to achieve educational goals via experiential learning.
A training and feedback method in which learners practice tasks and processes in life-like circumstances using models or virtual reality, with feedback from observers, peers, actor-patients, or video cameras to assist improvement in skills.
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CSC 2016 Dubai

3. Definitions
Simulation Lab. Is a laboratory that contains simulators and is used for simulation for teaching, training, evaluation and feedback purposes
Simulation area: An area in a simulation lab that simulates certain medical setups like OT, ER etc.
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CSC 2016 Dubai

4. Definitions
Standardized Patient (SP): Real people portray patients with scripted or outlined responses to the healthcare provider’s questions or physical examination.
Mannequin or a manikin: A model of the body, usually with moveable or removable members or parts.
Partial task simulator: Simple & low fidelity simulators.
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CSC 2016 Dubai

5. Definitions
Feedback: The return of some of the out put of a system as input so as to exert some control in the process.
Facilitator: A person who facilitates the conduction of a process of teaching or training for learning purpose.
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CSC 2016 Dubai

6. Basic Clinical Skills
Any purposely selected and integrated set of individually skillful acts that are pertinent to each patient encounter.
Examples:
Communication skills
Clinical history
Mental and physical examination
Initiating clinical tests
Undertaking diagnostic procedures and therapeutic interventions.
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CSC 2016 Dubai

7. Simulation Adjuncts Standardized patients (SPs)
3D or static Anatomy Models
Written Scenarios
Human Cadavers
Animal Models
Computer based simulations
Audio-simulations
Video-based simulations
Virtual reality simulation
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CSC 2016 Dubai

8. Why use Simulators?
The reasons behind the increased use for patient simulation are many and include:
Standardization and replication of the skills
Limited availability of patients
Patient safety
Improved realism of simulation devices
The growth of medical knowledge
Changes in medical education
New demands on student availability
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CSC 2016 Dubai

9. Simulator’s Fidelity
Means: how true to life the teaching/evaluating experience must be to accomplish its objectives.
Low-fidelity simulators: focused on single skills to practice in isolation.
Medium-fidelity simulators: more realistic representation but lack sufficient cues for the learner to be fully immersed in the situation.
High-fidelity simulators: allow full immersion in the experience and respond to treatment interventions.
Yaeger et al. (2004)
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CSC 2016 Dubai

10. Limitations of Simulation
Many areas of human anatomy and physiology are yet to be realized for simulation. Such as, the feel of the skin, skin color, and skin temperature
The simulation is constrained by the degree it can mimic reality. Such as, the fast-paced, high- stress environment of a critical care unit is difficult to simulate. As a result, there is no assurance that the learner will make a smooth transition of knowledge from the simulated situation to the actual clinical environment.
High cost to establish and maintain a simulation facility.
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CSC 2016 Dubai

11. Our Experience at Alfaisal University
Medical Curriculum: hybrid, 5-year curriculum for both genders
Our strength: Clinical Skills Courses as an important strategy to train medical students from Year-1.
Year 1-2
Basic
Year 2-3
Preclinical
Year 4-5
Clinical
Medicine, Pediatrics, Surgery, Eye, ENT, OBGYN, Electives,
Focused History taking and Physical Examination
Pathology, Microbiology, Pharmacology, Family and Community Medicine,
History taking, Physical Exam, selected procedures
Anatomy, Physiology, Biochemistry, Community Medicine, Communication Skills
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CSC 2016 Dubai

12. Typical Week
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CSC 2016 Dubai

13. Typical Organization of a CS Session
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CSC 2016 Dubai

14. Students’ Feedback Theme Percentage Sample quote
Hands-on practice in the course
30% (90)
“The course gave us the chance to practice and by the hospital visits, we got the chance to break our fear of practicing on real patients”
The organization of the course
26% (76)
“The subjects we are taking are similar to what we're learning in the blocks which thus makes it easier for us to grasp the concepts”
Clinical Skills acquired from the course
13% (40)
“It improved our clinical skills required in the clinical sessions.”
A table from a publication in press (Medical Teacher). A Combined Approach of Clinical Skills Training utilizing Near-Peers, In-Campus Faculty and Clinicians: An Innovative Integrated Model.
24-Feb-2016
CSC 2016 Dubai

15. WORKSHOP: How to integrate basic clinical skills and simulation adjuncts in an undergraduate pre-clerkship medical curriculum?
Thank You
Dr. Muhammad Zafar
MBBS, MPhil, PhD
Associate Professor of Anatomy/Skill Lab
Director of Clinical Skills Program
Dr. Nasir Ali Afsar
MBBS, MPhil, PhD, MERC
Senior Lecturer of Pharmacology

16. Weekly Time table Template
Days
Sunday
14/9/2014
Monday
15/9/2014
Tuesday
16/9/2014
Wednesday
17/9/2014
Thursday
18/9/2014
Time
Male
Female am am am pm pm
3 – 3.50 pm pm
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CSC 2016 Dubai

17. Integrated Schedule Example
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CSC 2016 Dubai