Introducing early-phase medical students to clinical paediatrics using simulation and a flipped-classroom

Aim Both simulation and the flipped-classroom improve learning outcomes in medical education, with evidence emerging that they are effective in combination ('flipped-simulation'). Previous studies evaluating simulation in paediatrics have assessed efficacy for senior students. This study aimed to assess whether using flipped-simulation in early-phase medical student education would show similar benefits. Methods A flipped-simulation session was introduced into the earliest phase of the University of New South Wales Sydney's undergraduate medical program. A pre-test-post-test study design was used to assess short-term knowledge gains with an eight-item quiz administered before and after students attended the session. A retrospective cohort design was used to assess long-term knowledge retention, with student scores from a 10-item quiz administered at the second-phase paediatric course orientation, compared between a group that completed the flipped-simulation course and a group that attended an alternative play-based session. Additional survey data regarding student satisfaction were gathered. Results Students demonstrated short-term knowledge gains: mean test scores improved from the pre-test to post-test (3.4 +/- 1.5 vs. 6.0 +/- 1.3, P < 0.001). Students attending the flipped-simulation course retained knowledge more effectively in the longer term: mean test scores of students who completed the flipped-simulation session were significantly higher than those who attended the alternative play-based session (4.4 +/- 1.9 vs. 3.4 +/- 1.8, P < 0.001). Survey data demonstrated high student confidence in practical skills. Conclusion Combining simulation and the flipped-classroom is effective for early-phase medical students, with improved knowledge over the short and long term, and high student satisfaction.