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European Journal of Pediatrics

, Volume 177, Issue 2, pp 211–219 | Cite as

Fixed versus variable practice for teaching medical students the management of pediatric asthma exacerbations using simulation

  • David DrummondEmail author
  • Jennifer Truchot
  • Eleonora Fabbro
  • Pierre-François Ceccaldi
  • Patrick Plaisance
  • Antoine Tesnière
  • Alice Hadchouel
Original Article

Abstract

Simulation-based trainings represent an interesting approach to teach medical students the management of pediatric asthma exacerbations (PAEs). In this study, we compared two pedagogical approaches, training students once on three different scenarios of PAEs versus training students three times on the same scenario of PAE. Eighty-five third-year medical students, novice learners for the management of PAEs, were randomized and trained. Students were assessed twice, 1 week and 4 months after the training, on a scenario of PAE new to both groups and on scenarios used during the training. The main outcome was the performance score on the new scenario of PAE at 1 week, assessed on a checklist custom-designed for the study. All students progressed rapidly and acquired excellent skills. One week after the training, there was no difference between the two groups on all the scenarios tested, including the new scenario of PAE (median performance score (IQR) of 8.3 (7.4–10.0) in the variation group versus 8.0 (6.0–10.0) in the repetition group (p = 0.16)). Four months later, the performance of the two groups remained similar.

Conclusion : Varying practice with different scenarios was equivalent to repetitive practice on the same scenario for novice learners, with both methods leading to transfer and long-term retention of the skills acquired during the training.

What is known:

• Simulation-based trainings represent an interesting approach to teach medical students the management of pediatric asthma exacerbations.

• It is unclear whether students would benefit more from repetitive practice on the same scenario of asthma exacerbation or from practice on different scenarios in terms of transfer of skills.

What is new:

• An individual 30-min training on the management of pediatric asthma exacerbations using simulation allows transfer and long-term retention of the skills acquired.

• Varying practice with different scenarios is equivalent to repetitive practice on the same scenario in terms of transfer of skills.

Keywords

Asthma exacerbation Medical education Variability of practice Simulation training 

Abbreviations

CPP

Comité de protection des personnes

MCQ

Multiple-choice questionnaire

PAE

Pediatric asthma exacerbation

SABA

Short-acting beta-agonist

SBT

Simulation-based training

Notes

Acknowledgments

The authors would like to thank Guillaume Escouboué for his technical assistance throughout the study, and Sylviane Frédéric and Emeline d’Angelo for their help in the management of the simulation rooms.

Authors’ contributions

David Drummond conceptualized the study, participated in data collection, carried out the initial analyses, drafted the initial manuscript, and approved the final manuscript as submitted;

Jennifer Truchot participated in data collection, revised the manuscript critically, and approved the final manuscript as submitted.

Eleonora Fabbro contributed to the design of the study, participated in data collection, revised the manuscript critically, and approved the final manuscript as submitted;

Pierre-François Ceccaldi participated in the conception of the study, revised the manuscript critically, and approved the final manuscript as submitted.

Patrick Plaisance participated in the conception of the study, revised the manuscript critically, and approved the final manuscript as submitted.

Antoine Tesnière participated in the conception of the study, revised the manuscript critically, and approved the final manuscript as submitted.

Alice Hadchouel participated in the conception of the study, carried out the analysis with David Drummond, revised the manuscript critically, and approved the final manuscript as submitted.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

431_2017_3054_MOESM1_ESM.docx (63 kb)
ESM 1 (DOCX 63 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Ilumens Simulation DepartmentParisFrance
  2. 2.Pediatric PulmonologyNecker-Enfants Malades Hospital, AP-HPParisFrance
  3. 3.Emergency DepartmentLariboisiere Hospital, AP-HPParisFrance
  4. 4.Department of Obstetrics and Gynecology, Beaujon, AP-HPClichy and Paris Diderot UniversityParisFrance
  5. 5.Risks in Pregnancy, Universitary Hospital DepartementParis Descartes UniversityParisFrance
  6. 6.Surgical Intensive Care Unit, Cochin HospitalAssistance Publique-Hôpitaux de Paris, AP-HPParisFrance

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