An integrated simulation-based early clinical exposure module in cardiovascular physiology

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Objectives: A good conceptual understanding of physiology is very important to build a strong foundation for medical students. It is a daunting job for teachers to emphasise the clinical relevance of basic science subjects as exposure to patients invariably starts after these subjects have been taught. With the introduction of early clinical exposure in the newly revised Indian undergraduate medical curriculum, this problem can be addressed to a certain extent. We developed an integrated simulation module for teaching cardiovascular physiology to pre-clinical students as a part of early clinical exposure. Materials and Methods: We included 145 medical students of a Private Medical College of a Deemed to be University in Mangalore, Karnataka, India. The teaching module covered the topics of cardiovascular physiology such as functional anatomy, cardiac cycle, normal electrocardiogram (ECG), arrhythmia, arterial pulse examination, heart sounds and hands-on cardiovascular examination using a variety of simulators. The assessment was done by pre-test and post-test. A retro-pre questionnaire was used to assess their self-perceived knowledge gain and level of clinical skills. Feedback on overall experience was collected from the participants. Results: The student feedback showed that learning experience was life-like (98.6%), effective, innovative and enjoyable (99.3%) and making the overall experience of learning easier (95.2%). It also improved participation, communication (93.8%), clinical skills and a better understanding of patient care (99.3%). The results of the retro- pre questionnaire to assess their self-perceived knowledge gain (95%) and level of clinical skills (96%) were highly satisfactory. The assessment of knowledge domain showed 100% of the students achieved pass percentage (>50%) with significant difference among pre- and post-test scores. Faculty (100%) opined that simulation-based teaching resulted in effected learning. Conclusions: The use of simulation-based teaching in cardiovascular physiology as part of early clinical exposure leads to enhanced learning and clinical application. This will stimulate interest in subject and promote better learning.