Enhancing Neurology Clerkship Education: Assessing the Impact of Simulation-based Training on Medical Students’ Clinical Neurological Skills and Confidence
Amit Kandel1, Ashley Alex2, Osman Farooq3, Aya Ouf3, Katlyn Roginsky3, Jule Deren4, Alexus Ludwig5, Leanne Ottoni3, Ilana Selli3, Kathleen Sellick6, Wentao Mi7, Subhana Asjad8, Elizabeth Rosen3, Zaheerud Cheema9, Aaron Taylor3, Melissa Rayhill10, Daniel Sirica3, Robert Glover11, Karen Zinnerstrom3, Connor Grabowski3, John M Hourihane3, Gil Wolfe12, Thomas Covey3
1Neurology, University At Buffalo, 2University of Buffalo, 3University at Buffalo, 4UB Neurology, 5university at Buffalo, 6Georgetown University, 7UT Southwestern, 8University of Michigan, 9BSWhealth, 10UBMD Neurology/University At Buffalo SUNY, 11UBMD Neurology, 12Univ. At Buffalo, SUNY
Objective:
To assess the utility of simulation-based education in neurology clerkship.
Background:
Multiple studies have identified neurology pedagogy as more complex, with students often feeling less comfortable with neurological localization. Simulation-based education provides a learner-focused and experiential teaching model that could overcome such challenges.
Design/Methods:
This survey study assessed the learning experience of University at Buffalo/SUNY medical students exposed to simulation-based neurology training. Students engaged in two sessions: the first focused on best practices in adult and child neurological examinations and procedures, including simulated lumbar puncture. The second session included simulated case scenarios using high-fidelity manikins and standardized patients. Students completed three surveys: a pre-simulation survey (PS-0), a post-simulation survey on the same day (PS-1), and a follow-up post-simulation survey on or after 30 days (PS-2). The survey assessed the student comfort with neurological examinations and case management using a 1-5 Likert scale, where a higher score indicated greater confidence. Survey results were analyzed to evaluate the impact of simulation training on student perceptions.
Results:
112 medical students completed PS-0, 90 completed PS-1, and 63 completed PS-2. A total of 79 students completed both PS-0 and PS-1, and 39 students completed the survey at all three time points. Composite confidence scores were obtained for each participant across 15 survey questions. The average PS-0 rating was 2.66, which increased to 3.91 at PS-1 and 4.09 at PS-2, representing a statistically significant improvement in confidence rating across time points (P <.001). Similar effects were observed in parallel analyses performed for the PS-0 to PS-1 comparison only and for the analyses examining each survey question individually (P<.001 for all analyses).
Conclusions:
Medical student’s confidence in neurological examination and procedural skills significantly increased after simulation teaching, with a positive impact persisting to the end of the neurology clerkship or beyond.