1. By Dr. Ellie Nash Combined Paediatric Problem-based learning and Human Patient Simulation for Undergraduate Medical Students At Lancashire Simulation Centre and Royal Preston Hospital

2. Overview Background Proposal Method Outcomes Future work

3. Background PBL and Simulation are widely used in Undergraduate Medical Education, – but as separate entities. Learning is enhanced when students are provided with the opportunity to apply their theoretical learning into a real life context 1 Merging these two teaching modalities together could positively enhance the students learning experience. 1. Liaw, S.Y., Chen, F.G., Klainin, P., Brammer, J., O’Brien, A., & Samarasekera, D.D. (2010). Developing clinical competency in crisis event management: An integrated simulated problem-based learning activity. Advances in Health Sciences Education, 15(3), 403-413.

4. Study proposal A small-scale study was developed to qualitatively compare Fourth Year Medical Students learning experiences from pure PBL to PBL-simulation combined, for their Paediatric placements Ethical approval was sort and advised that it was not required

5. Method Three of the six paediatric PBL scenarios were suitable to be adapted into simulation scenarios: – Neonatal shock; – Bronchiolitis; – Febrile convulsion As part of the closing of a PBL case each week, the students were given a simulation related to the PBL case. The students faced a high-fidelity simulated infant and a simulated parent (actor).

6. Simulation learning objectives An appropriate ABCDE assessment and management of an unwell infant; Communicating with a parent during an emergency situation; Obtaining a relevant history from the parent under time constraints Appropriate handover of the patient to a senior colleague; Development of non-technical skills, including team-working, leadership and situational awareness.

7. Obtaining feedback Turning-Point questionnaires pre and post every simulation session; Focus groups at the end of the rotation.

8. Results The HPS-PBL sessions have been positively received from the students Turning-point feedback: – students’ developed non-technical skills; – more confident at talking to parents when a child is unwell Both would not have been possible with pure PBL

11. Focus group feedback HPS consolidated and reinforced students’ theoretical learning from PBL; Gaps in knowledge base become apparent during HPS that may not be revealed during PBL discussions; HPS motivated students to learn their PBL work; Students’ confidence in their clinical placement increased, especially with assessing children on the Paediatric Assessment Unit.

12. Outcomes The combining of these teaching modalities has improved the medical education the students receive. This consequently will improve their abilities as future clinicians and positively impact future patient care.

13. Future work The combined PBL-HPS sessions are now a permanent and popular feature of the Paediatric PBL at Royal Preston Hospital. The aim is to extend the combined sessions to the other placements for the Third and Fourth Year Medical Students. However, it is time, tutor and resource intensive in comparison to normal PBL sessions, which is a limiting factor in expanding these sessions.

14. Thank you