Evaluation of a simulation-based pediatric clinical skills curriculum for medical students

INTRODUCTION: Simulation-based education is expensive and requires greater resources than traditional methods, yet there is limited evidence to justify such expenditures for medical student education. METHODS: We describe the implementation and evaluation of a simulation-based curriculum delivered to medical students during a pediatric clerkship. This prospective mixed-methods study evaluated a 5-day long simulation-based clinical skills curriculum (PRE-Clerkship EDucational Exercises [PRECEDE]) at the Johns Hopkins University School of Medicine. Two hundred medical students participated in PRECEDE during a 2-year period and were compared with 236 students who had not. Outcomes were assessed across 3 levels of Kirkpatrick's framework for evaluation. The 4-level model consists of reaction, learning, behavior, and results criteria. Secondary outcomes measured changes in assessment scores across 16 student performance domains during clerkship, changes in performance on the National Board of Medical Examiners subject examination in pediatrics, and student assessments of the curriculum. RESULTS: Improvements were noted across 3 levels of the Kirkpatrick's model. Student performance evaluations were significantly higher across all 16 evaluation components, with effect sizes ranging from small to medium (Cohen's d, 0.23-0.44). Students scored significantly higher on the National Board of Medical Examiners pediatric shelf examination (80 vs. 77, P < 0.001). Ninety-seven percent of the medical students agreed that their skills increased and that the time lost to real clinical experiences was a worthwhile trade-off for this curriculum CONCLUSIONS: The implementation of a simulation-based curriculum within a pediatrics clerkship resulted in higher knowledge scores and led to improvements in medical student clinical performance during the clerkship.