Clinical simulation in the Argentine context: student perception and educational challenges

Authors

  • D'arcy Walter Palacios Baldoceda Universidad Abierta Interamericana, Facultad de Medicina y Ciencias de la Salud Carrera de Medicina. Buenos Aires, Argentina Author https://orcid.org/0009-0002-6314-3984

DOI:

https://doi.org/10.56294/shp202356

Keywords:

Clinical simulation, Medical education, Patient safety, University education, Educational evaluation

Abstract

The research addressed the use of clinical simulation as an educational strategy for medical students at the Universidad Abierta Interamericana (UAI), in an Argentine context characterized by structural challenges in health and education. Since the reports of the Institute of Medicine (IOM) in 1999 and 2001, simulation has been promoted as a key tool for reducing medical errors and improving the quality of care. This descriptive cross-sectional study set out to identify areas for improvement in the implementation of clinical simulation, through surveys conducted with final-year students who had completed their rotating internship by March 2024.
The results showed an overall positive assessment of clinical simulation, highlighting its effectiveness for skills development and its realism. However, opportunities for improvement were also identified. Fifty-one percent of the students pointed out deficiencies in curricular integration and in the measurement of results. In addition, 61% expressed the need for more time to master competencies, and 47% negatively evaluated team training. Instructor training and the educational context were rated as acceptable but perfectible.
It was concluded that, although clinical simulation has been a valued training tool at the UAI, its impact could be optimized through structural adjustments in curriculum design, teacher training and the duration of internships. In the current Argentinean context, where educational inequalities are palpable, simulation is presented as a strategic resource for training competent doctors committed to patient safety.

References

1. Stefl M. To Err is Human: Building a Safer Health System in 1999. Front Health Serv Manag. 2001 Feb;18:1–2.

2. Simulación en Educación Médica [Internet]. [citado 2024 jun 3]. Disponible en: https://www.elsevier.es/es-revista-investigacion-educacion-medica-343-pdf-S2007505714727334

3. Ziv A, Ben-David S, Ziv M. Simulation based medical education: an opportunity to learn from errors. Med Teach. 2005 May;27(3):193–9.

4. Gutiérrez LH, Núñez AVB, Cárdenas CD, Cortés HEO, Gabriela A, Sánchez O, et al. La seguridad del paciente y la simulación clínica.

5. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century [Internet]. Washington (DC): National Academies Press (US); 2001 [citado 2024 jun 3]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK222274/

6. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-Based Medical Education: An Ethical Imperative. Simul Healthc. 2006;1(4):252–6.

7. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003–2009. Med Educ. 2010 Jan;44(1):50–63.

8. Rudolph JW, Simon R, Raemer DB, Eppich WJ. Debriefing as Formative Assessment: Closing Performance Gaps in Medical Education. Acad Emerg Med. 2008 Nov;15(11):1010–6.

9. Fitch MT. Using high-fidelity emergency simulation with large groups of preclinical medical students in a basic science course. Med Teach. 2007 Mar;29(2–3):261–3.

10. Graber MA, Wyatt C, Kasparek L, Xu Y. Does simulator training for medical students change patient opinions and attitudes toward medical student procedures in the emergency department? Acad Emerg Med. 2005 Jul;12(7):635–9.

11. Waring MJ, Arrowsmith J, Leach AR, Leeson PD, Mandrell S, Owen RM, et al. An analysis of the attrition of drug candidates from four major pharmaceutical companies. Nat Rev Drug Discov. 2015 Jul;14(7):475–86.

12. Cook DA, Hamstra SJ, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Med Teach. 2013 Jan;35(1):e867–98.

13. McGaghie WC, Draycott TJ, Dunn WF, Lopez CM, Stefanidis D. Evaluating the Impact of Simulation on Translational Patient Outcomes. Simul Healthc. 2011 Aug;6(7):S42–7.

14. Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005 Jan;27(1):10–28.

15. Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In Situ Simulation in Continuing Education for the Health Care Professions: A Systematic Review. J Contin Educ Health Prof. 2012;32(4):243–54.

16. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. Revisiting ‘A critical review of simulation-based medical education research: 2003-2009’. Med Educ. 2016 Oct;50(10):986–91.

17. Okuda Y, Bryson EO, DeMaria S, Jacobson L, Quinones J, Shen B, et al. The Utility of Simulation in Medical Education: What Is the Evidence? Mt Sinai J Med. 2009 Aug;76(4):330–43.

18. Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ. 2012 Jul;46(7):636–47.

19. Kneebone RL, Scott W, Darzi A, Horrocks M. Simulation and clinical practice: strengthening the relationship. Med Educ. 2004 Oct;38(10):1095–102.

20. Roizen MF. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. Yearb Anesthesiol Pain Manag. 2012 Jan;2012:414–5.

21. Riancho J, Maestre JM, del Moral I, Riancho JA. Simulación clínica de alto realismo: una experiencia en el pregrado. Educ Med. 2012 Jun;15(2):109–15.

22. Hunt EA, Shilkofski NA, Stavroudis TA, Nelson KL. Simulation: Translation to Improved Team Performance. Anesthesiol Clin. 2007 Jun 1;25(2):301–19.

23. Allan CK, Thiagarajan RR, Beke D, Imprescia A, Kappus LJ, Garden A, et al. Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams. J Thorac Cardiovasc Surg. 2010 Sep;140(3):646–52.

24. Britt RC, Reed SF, Britt LD. Central Line Simulation: A New Training Algorithm. Am Surg. 2007 Jul 1;73(7):680–2.

25. Grudziak J, Herndon B, Dancel RD, Arora H, Tignanelli CJ, Phillips MR, et al. Standardized, Interdepartmental, Simulation-Based Central Line Insertion Course Closes an Educational Gap and Improves Intern Comfort with the Procedure. Am Surg. 2017 Jun 1;83(6):536–40. .

Published

2023-12-31

Issue

Section

Short communications

How to Cite

1.
Palacios Baldoceda DW. Clinical simulation in the Argentine context: student perception and educational challenges. South Health and Policy [Internet]. 2023 Dec. 31 [cited 2025 Sep. 28];2:56. Available from: https://shp.ageditor.ar/index.php/shp/article/view/56