Can high fidelity human patient simulators help biomedical science students better understand complex concepts such as anticholinergic burden?

High-Fidelity Human simulators (HFHS) are life-like mannequins used extensively for teaching within the clinical setting. They offer an exciting method of learning compared to conventional passive approaches to learning (e.g. lectures) where students may have little opportunity to engage with the material. This pilot study investigated whether HFHS could be an effective educational tool within medical sciences teaching. It explored whether simulators could enable students to better understand complex concepts such as anticholinergic burden that involve a knowledge of both physiology and pharmacology. The SimMan 3G (Laerdal, Norway) HFHS was used to imitate responses observed in a patient experiencing anticholinergic burden due to inappropriate prescribing. Volunteers (n=28) were biomedical science undergraduates and teaching staff (n = 4). Before commencing, participants were given a scenario and revision sheet covering areas (Autonomic physiology, opioids and anticholinergic burden) relevant to the simulation/existing course material to assist them in their understanding and to help them ‘recap'. Multiple Choice Questions (MCQs) were given prior to and following the simulation. Participants also completed an anonymous questionnaire which asked them to grade aspects of the activity on a Likert scale. Participants scored significantly higher in MCQs (P = 0.0057, Wilcoxon matched pairs test) following the simulation compared to pre-simulation (Increase in mean score achieved from 9.3±1.4 to 13.2±1.1, n = 16 since not all students completed the questionnaires, error values represent standard error of mean). Participants found this novel experience an effective, highly engaging and realistic teaching tool. Themes identified from free text feedback indicated that duration of simulation, requirement for an introductory and debrief period, and the delivery style of the simulation leader were important to participants. Participants enjoyed the interactive nature of the simulation and being able to apply scientific concepts they had learnt in lectures to a ‘real-life' case scenario. Staff highlighted that simulation ‘brings to life' the material from classes and suggested ways to further integrate simulation into the current curriculum. Simulation is a novel teaching method that enables clinically-related students to critically think beyond the textbook/lecture theatre, by relating to and being able to visualise/conceptualise real physiology. To further test how participants respond to lectures vs simulation, separate groups - one group given lecture-based material and the other the simulation alone, independent of each other - would be required. It is hoped this will provide further evidence that simulation can be successfully applied outwith traditional clinical teaching activities.