Medical Students' Confidence After "CardioSim": A Low-Fidelity, Peer Role-Play Simulation

Introduction: Plans to increase medical student numbers will increase costs and potentially reduce clinical exposure. Simulation can be utilised to fill that gap. Low-fidelity simulation with peer role-play (PRP) provides reduced costs and standardisation of experience compared to high-fidelity or simulated patient RP simulation. This study aimed to assess changes in confidence in common graduate-level skills following a low-fidelity PRP scenario. Methods: Forty-three fourth-year medical students were divided into groups of three and five students. A Likert-scale questionnaire was completed at the start of the session. During the simulation, they had the opportunity to be the doctor and the patient and observe the remaining scenarios. Finally, the same questionnaire was answered. Results: All students gained confidence in at least two aspects. All students were confident in history taking and ST-elevation myocardial infarction (STEMI) management at the end of the session. The biggest improvement in overall confidence was in the management of non-ST-elevation myocardial infarction (NSTEMI) (62.8%) and Situation-Background-Assessment-Recommendation (SBAR) handover (60.5%). Six students improved their confidence by at least one ranking in every question, and one student improved their confidence by three rankings in four questions. SBAR handover and management of pneumothorax had the biggest improvements. Conclusion: Low-fidelity RP simulation allows the development of confidence in technical and nontechnical skills. Given increasing student numbers and increasing medical education costs, it can be utilised effectively as part of a simulation syllabus that helps prepare students for clinical practice. Areas of further research include focus groups, knowledge tests and comparisons to other forms of simulation.