1. Title of the Change Project
Student ID.
MSc in Healthcare Management,
Institute of Leadership, Royal College of Surgeons in Ireland
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The Implementation and Evaluation of Clinical Skills Teaching using Advanced Mannequin Simulators .
S. A. Naqi, C.M. Condron, A. Salih, F. Ayoub , M. Quirke. ADK Hill.
Department of Surgery , Royal College of Surgeons in Ireland .
Abstract
This change project involved the implementation and evaluation of a pilot simulation teaching session of peripheral arterial examination to second year medical students. Medical students were divided into two groups, one taught peripheral arterial examination on a manikin and another group was taught on simulated patients. Both groups were assessed by using OSCE s with real patients. Feedback was obtained from students in a focused group discussion. The initiative was driven by the challenges posed by decreasing availability of real patients for teaching clinical skills to medical students during their undergraduate training and by a need to meet the demand of providing students with highest quality in teaching physical examination skills. The HSE Change model (2008) was used to guide the change process which began in September 2014 and was completed in march Evaluation of the change process was achieved using Stufflebeam’s (2007)1 Context, Input, Process and Product (CIPP) evaluation model. Positive feedback from the staff and students were considered as an important factor in completing change project successfully by the change leader. Results of clinical OSCE revealed that computerised manikin simulators are as effective as simulated patients for teaching physical examination skills. Further implementation of this change project needs integration of clinical skills teaching on advanced manikin simulators into curriculum along with simulated patient tutorials.
1 Stufflebeam, D. L., & Shinkfield, A. J. (2007). Evaluation theory, models, and applications (Vol. 3). Jossey-Bass.

2. Organisational Impact
The Implementation and Evaluation of Clinical Skills Teaching using Advanced Mannequin Simulators .
S. A. Naqi, C.M. Condron, A. Salih, F. Ayoub , M. Quirke. ADK Hill.
Department of Surgery , Royal College of Surgeons in Ireland .
Introduction & Background
Methodology
Evaluation
The HSE Change Model (2008) provided the framework for the change process. The tutorials were delivered in March 2015 to volunteer students (n=21). The evaluation process was undertaken using Stufflebeam’s (2007)1 Context, Input, Process and Product (CIPP) model. Focus groups were conducted to gain input from students in further developing the tutorials.
Figure 2: The Health Service Executive (HSE) Model 2
There was no statistical difference between students who were taught peripheral arterial examination on simulated patients(SP) and students taught on the mannequin simulator. In the knowledge component the SimMan 3G group had a mean score of while the SP group had mean score of (P = 0.57) In skill component the SimMan 3G group had a mean score of 19.3 while the SP group had mean score of 16.( p = 0.14)
This change project designed and delivered two different modality simulated tutorials to second year medical students using computer mannequins or simulated patients. The students were facilitated in small groups of 11 and 9 and the groups were taught by faculty from the department of surgery. Students were assessed by OSCE by two independent examiners following the tutorials.
Figure 1: The SimMan 3G
Organisational Impact
RCSI wants to promote patient and population health through innovative teaching and learning methods and aims to achieve this goal by developing and delivering advanced clinical simulation education at undergraduate level. Our pilot project demonstrated that simulation technology is educationally effective and complements medical education in real patient setting. Stake holder analysis allowed selection of people in organisation which are influential and continued communication with these people engendered their commitment for simulation teaching of clinical skills.
Figure 3: RCSI Students exam a SimMan
Aims & Objectives
Our aim was to implement and evaluate the use of mannequin simulators and simulated patients for teaching clinical skills to undergraduate medical students at RCSI. The specific objectives were of teaching were that students will:
Be able to locate and palpate peripheral arterial pulses in the lower limbs.
Be able detect presence or absence of peripheral arterial pulses in the lower limbs.
Be able to detect the rhythm of an arterial pulse.
Be able to make a provisional diagnosis.
Demonstrate transfer of skills to real patients, evaluated by Objective Structured Clinical Exam (OSCE).
Conclusion
References
Clinical skills teaching on mannequin simulators in combination with simulated patients can be effective in preparing medical students to meet the required standards.
1 Stufflebeam, D. L., & Shinkfield, A. J. (2007). Evaluation theory, models, and applications (Vol. 3). Jossey-Bass.
2 HSE (2008). Improving Our Services; A User Guide to Managing Change in the Health Service Executive. Dublin: Organisation Development and Design.