Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study(Springer, 2024) Kodikara, K.; Seneviratne, T.; Premaratna, R.;Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Seventeen clusters of second-year medical students were randomly assigned to either IG or CG. The IG trained on venipuncture in the skills laboratory, receiving instruction after modified Payton’s Four Step Method. Following the training, students of both IG and CG underwent bedside learning for one month. Afterward, students of both groups performed venipuncture on actual patients in a clinical setting. An independent, blinded assessor scored students’ performance using the Integrated Procedural Protocol Instrument (IPPI) and a checklist. Patients assessed students’ performance with the Communication Assessment Tool (CAT). Eight and nine clusters were randomized to the intervention and control groups, respectively. IG completed significantly more single steps of the procedure correctly (IG: 19.36 ± 3.87 for checklist items; CG: 15.57 ± 4.95; p < 0.001). IG also scored significantly better on IPPI ratings (median: IG: 27 (12) vs. CG: 21 (8); p < 0.001). Rated by patients, students’ communication skills did not significantly differ between the two groups. Simulation-based venipuncture training enabled students to perform the procedure on actual patients with a higher technical accuracy than students who learned venipuncture at the bedside. Students were able to transfer the skills acquired through venipuncture training at the skill laboratory to the bedside.Item Intermediate fidelity simulation to educate emergency management skills(Penerbit Universiti Sains Malaysia, 2020) Kodikara, K.G.; Karunaratne, W.C.D.; Chandratilake, M.N.Medical students learn clinical skills related to the management of emergencies during their clerkships, mainly via peripheral participation and observation. Simulation-based training is identified as an adjunct to clinical practice enabling students to learn clinical skills in a safe environment. Nevertheless, simulation-based training is still underutilised in many countries in the developing world. The purpose of this study was to explore the value of simulation-based learning using an intermediate fidelity simulator to train medical undergraduates on the management of medical emergencies. A pilot group of 80 fourth year medical students attended four simulation-based clinical skills sessions. The students completed a self-administered evaluation, which included both open and close-ended questions postsimulation. Descriptive statistics were employed to analyse the responses to close-ended questions, and the responses to open-ended questions were analysed for recurring themes. All participating students responded to the evaluation. Students rated the simulation-based learning experience with high positivity. The self-competency of 74 (92.5%) students had increased following the sessions. The sessions have provided a “safe” learning environment to all students, and 70 (87.5%) felt it helped apply theory into practice. Thirty-three (41.2%) noted the simulation session as an important learning tool for practising clinical skills. Thirty-one (38.5%) wished to participate in more sessions, and 39 (48.7%) felt that simulation should be introduced to the curriculum from the first-year. Students have recognised intermediate fidelity simulators as a valuable learning tool to train on the management of clinical emergencies and should be integrated into undergraduate medical curricula.Item Medical student’s experiences of training on simulated and real patients in education: A qualitative exploration(Penerbit Universiti Sains Malaysia, 2023) Kodikara, K.; Senaviratne, T.; Premaratna, R.Patient interaction is a key learning experience in undergraduate medical education. An actual or simulated/standardised patient (SP) can be used for this purpose. Although both real patients and SPs have inherent advantages and disadvantages, the value of SPs, as opposed to real patients, is recognised as an important area warranting research. The objective of this study was to explore the students’ perception of using real patients and SPs in their education. Six focus group interviews were conducted using medical undergraduates in the third, fourth, and fifth (final) year batches of the Faculty of Medicine, University of Kelaniya, Sri Lanka, from July to October 2020. The interviews were thematically analysed. All the participants considered real patient encounters more authentic than SP encounters. The students identified many strengths of SP interactions. SP encounters enabled them to prepare for real patient encounters. In particular, the participants appreciated the opportunity to practice communication skills with SPs. Students valued the feedback provided by SPs. The students identified real patient encounters enabled learning physical examination skills and procedural skills. Interestingly, most identified real patient encounters as more instructive, and some students identified that “the nervousness and anxiety” associated with real patient encounters helps improve selfconfidence. Students identified specific strengths and weaknesses in both real patient encounters and SP encounters. Participants appreciated SP encounters explicitly for learning communication skills and preparing for real patient encounters. Real patient encounters were valued for learning and improving clinical skills. The findings of the study support harnessing these specific strengths of each encounter and, thus, incorporating both in undergraduate medical education.Item Best practices of basic life support training in undergraduate medical education: A guide to medical teachers.(Penerbit Universiti Sains Malaysia, 2022) Kodikara, K.G.Basic life support (BLS) is an essential clinical skill that needs to be mastered by graduating medical officers as potential first responders in clinical settings. Inadequate resuscitation skills of healthcare professionals in BLS have been identified as contributing to poor prognosis in cardiac arrest victims. Thus, BLS training has been incorporated into undergraduate medical curricula using various instructional methods to equip their graduates with BLS skills. Despite such training, medical students and junior doctors were found to be under-competent in delivering BLS primarily due to different methods of instruction utilised in BLS training as opposed to simulation-based training, which is identified as the gold standard in BLS training. It is recommended that simulation-based BLS training be conducted, giving more weight to the skill component, in small groups of 3–10 students, complemented by yearly refresher courses and just-in-time training. This article aims to build awareness and inform medical teachers and programme directors on the current best practices of BLS training in undergraduate medical education.Item Simulation(College of Medical Educations., 2020) Kodikara, K.; Karunathilake, I.No abstract available