Improving Acute Care Preparedness Amongst Medical Students: A Systematic Review.

Abstract

Evidence suggests that there is inadequate preparation for acute care within the undergraduate medical curriculum. Although previous attempts have been made to address this concern, a lack of formal evaluation of intervention effectiveness limits their utility. This review aimed to identify educational interventions seeking to prepare medical students for acute care and evaluate their effectiveness. MEDLINE, CENTRAL, Embase, Scopus and Web of Science were systematically searched. Primary research studies published between 2000 and 2020 and reporting changes in outcomes related to medical student preparation for acute care were included. Study outcomes were described as either highly effective, effective, ineffective, negative or variable. Study quality was appraised using the Medical Education Research Study Quality Instrument (MERSQI). Studies with an MERSQI score of ≥14 were classed as high-quality. Overall, 72 studies were included in this review. The majority were single-group pre- and post-test studies (n=39, 54.2%) and none measured changes in student behaviour or patient/healthcare outcomes. Courses, clerkships, and simulation were found to be the most effective interventions. All Clerkship studies measuring improvements in acute care skills were effective or highly effective. Mean MERSQI score was 12.4 (range=7.8-15.5, SD=1.7) and 18 studies (25%) were classed as high-quality. This review favours the use of clerkships, as well as courses and simulation. However, considerable heterogeneity and numerous study limitations prevent firm conclusions from being drawn. Future high-quality studies, especially those measuring behavioural changes and patient/healthcare outcomes, are subsequently needed. Reviews with a more focused area of research, those assessing long-term outcomes and cost-effectiveness, would additionally prove beneficial.