Targeted Simulation Training in ICU Shared Decision-Making Boosts Confidence and Competence in Medical Students.

Abstract

IntroductionShared decision-making (SDM) is the standard of communication. Many providers receive little or no training in SDM. In our study, we implemented a training simulation aimed at boosting medical student confidence and competence in SDM.Methods, Study DesignProspective, non-randomized, observational pilot study.Study SettingSimulation center in large, urban, academic medical center.RecruitmentParticipants were recruited by electronic mail invitation. Participation was voluntary and paid.ConsentParticipants were consented for participation in the study, including video recording, prior to starting the study.ParticipantsParticipants were recruited from our medical school's second (M2), third (M3), and fourth (M4) year classes. Each participant completed two confidence surveys, two simulations, and a communication training session. Seven months later, participants were invited to complete a confidence survey and an assessment of attitudes.ResultsThirty seven participants completed the study: 17 M2 (46%), 9 M3 (24%) , and 11 M4 (30%). We observed an improvement in learner confidence in 8 of 8 communication domains (100%). Following training, statistically significant improvement in learner competence was measured in 7 of 8 domains (87.5%). Our retention rate was 59% (n = 22) at seven months, at which time confidence in nonverbal communication was significantly higher. Participants rated the simulation highly.ConclusionSimulation is effective at improving medical student communication skill and confidence. Students maintained their increased confidence for at least seven months. We recommend the implementation of targeted simulation training early in medical school to establish a standard for SDM and enhance student communication skill and confidence.