Whole task simulation in surgical training: A hybrid method of teaching undergraduate medical students

Abstract

Background: The current Competency-Based Medical Education (CBME) curriculum practiced in India accentuates that medical graduates must demonstrate competency in safely diagnosing, investigating, and managing clinical presentations across both community and secondary care settings. Therefore, there is a need for more hybrid teaching methods that simulate real situations. This approach will help newly qualified doctors gain confidence and prepare them for the future. We used the whole task simulation method to teach them one of the most common surgical problems i.e., breast cancer along with communication skills, professionalism, Interprofessional teamwork, asepsis, and safe surgery practices. Methods: The study enrolled 20 final-year MBBS students through purposeful sampling. Following classroom-based teaching on a Breast case, a simulated scenario was given, based on SECO (The Safe and Effective Clinical Outcome) design, and was modified with the addition of a simulated operating room setup. History taking, examination, ordering investigations and interpreting them, pre-operative counseling and consent and operation theatre scenario was done using standardized patient and mannequins. Pre- and post-simulation survey was conducted. Quantitative data were collected through Google Forms to assess their conceptual knowledge and qualitative data by Focused group discussions. Results: Students preferred a shift to this hybrid method of learning in a simulated environment over classical classroom-based teaching. They all felt that getting involved in a real-life situation helps in understanding surgical management better. They also understood the concept of teamwork and effective communication. "I feel it’s the best way to learn clinical medicine. No amount of literature could ever replace the knowledge we get from being in the scenario", was one of the responses given by the participants. Conclusion: Integration of surgical simulated clinics along with the operation room (OR) set up into the undergraduate curriculum could facilitate the acquisition of clinical skills actively and interactively. Such a hybrid method of teaching is an effective tool for teaching communication skills, professionalism, interprofessional teamwork along clinical skills.