J.M. Ray is instructor, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut; ORCID: https://orcid.org/0000-0003-3410-1507 .
A.H. Wong is assistant professor, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut; ORCID: https://orcid.org/0000-0001-7471-1647 .
Acad Med. 2021 Oct 1;96(10):1431-1435. doi: 10.1097/ACM.0000000000004129.
In March 2020, the novel coronavirus 2019 (COVID-19) became a global pandemic. Medical schools around the United States faced difficult decisions, temporarily suspending hospital-based clerkship rotations for medical students due to potential shortages of personal protective equipment and a need to social distance. This decision created a need for innovative, virtual learning opportunities to support undergraduate medical education.
Educators at Yale School of Medicine developed a novel medical student curriculum converting high-fidelity, mannequin-based simulation into a fully online virtual telesimulation format. By using a virtual videoconferencing platform to deliver remote telesimulation as an immersive educational experience for widely dispersed students, this novel technology retains the experiential strengths of simulation-based learning while complying with needs for social distancing during the pandemic. The curriculum comprises simulated clinical scenarios that include live patient actors; facilitator interactions; and real-time assessment of vital signs, labs, and imaging. Each 90-minute session includes 2 sets of simulation scenarios and faculty-led teledebriefs. A team of 3 students performs the first scenario, while an additional team of 3 students observes. Teams reverse roles for the second scenario.
The 6-week virtual telesimulation elective enrolled the maximum 48 medical students and covered core clinical clerkship content areas. Communication patterns within the virtual telesimulation format required more deliberate turn-taking than normal conversation. Using the chat function within the videoconferencing platform allowed teams to complete simultaneous tasks. A nurse confederate provided cues not available in the virtual telesimulation format.
Rapid dissemination of this program, including online webinars and live demonstration sessions with student volunteers, supports the development of similar programs at other universities. Evaluation and process improvement efforts include planned qualitative evaluation of this new format to further understand and refine the learning experience. Future work is needed to evaluate clinical skill development in this educational modality.
2020 年 3 月，新型冠状病毒 2019（COVID-19）成为全球大流行。美国各地的医学院面临着艰难的决策，由于个人防护设备短缺和需要保持社交距离，暂时暂停了医学生的医院实习轮转。这一决定需要创新的、虚拟的学习机会来支持本科医学教育。
耶鲁大学医学院的教育工作者开发了一种新的医学生课程，将高保真、基于模型的模拟转换为完全在线的虚拟远程模拟格式。通过使用虚拟视频会议平台为广泛分散的学生提供远程远程模拟沉浸式教育体验，这项新技术保留了基于模拟学习的体验优势，同时满足了大流行期间保持社交距离的需求。该课程包括模拟临床场景，包括现场患者演员、主持人互动以及实时评估生命体征、实验室和影像学。每 90 分钟的课程包括 2 组模拟场景和由教师主导的远程简报。一组 3 名学生进行第一个场景，而另外一组 3 名学生进行观察。两组学生交换角色进行第二个场景。
为期 6 周的虚拟远程模拟选修课程最多招收了 48 名医学生，涵盖了核心临床实习课程内容领域。虚拟远程模拟格式中的沟通模式比正常对话需要更刻意的轮流发言。使用视频会议平台的聊天功能允许团队同时完成任务。一名护士助理提供了虚拟远程模拟格式中无法提供的提示。
该计划的快速传播，包括在线网络研讨会和学生志愿者的现场演示会议，支持了其他大学类似计划的发展。评估和流程改进工作包括对这种新格式的计划进行定性评估，以进一步了解和完善学习体验。未来需要评估这种教育模式的临床技能发展。
