Abstracts

Rationale: Status epilepticus (SE) is a common neurologic emergency and it is estimated that there are about 200,000 episodes of status epilepticus in the United States annually. SE has a high mortality risk of around 22%. With the acuteness of the situation and necessity to act fast and accurately, it can be frightening for the new learners. Using Hi-fidelity mannequins for simulation of SE ensures no harm during the training but definitely helps improve the skills of the trainees which we wanted to show with our two year data collection and analysis. Methods: We used the 3 phased learning for the 3rd year Medical students in the Neurology clerkship. In academic year 2011, 20 sessions were conducted with 72 students and in academic year 2012, 24 sessions were conducted with 90 students. Students were initially provided with the Continuum article for self study (Phase 1) and then they worked in groups of 3-4 for the management of Hi-Fidelity mannequins with SE (Phase 2). The students filled a Post-Simulation questionnaire with 10 multiple choice questions (MCQs). Debriefing was done by the clerkship director (Phase 3). Students also filled a post-simulation survey. Results: Post simulation questionnaire: The students performed excellent with scoring above 91% regarding definition of SE, refractory SE, loading dosage of fosphenytoin and lorazepam. More than 70% students answered questions about mechanism of seizure induction; securing ABC's and blood glucose measurement, goal of treatment (85%), alternative IV and non IV treatments correctly. Roughly 50% of students were aware that Myoclonic SE has highest mortality rates. Evaluation of the exercise by students: About 95% of the students agreed that the simulation will help them manage real life patients better along with better understanding of health care practices; also they felt that this way of learning is better than the regular didactic session and they will be able to remember the management protocol better. Students have rated the characteristics of Realism, Quality, Organization and Duration of simulation provided as good or excellent in 90% cases. 50% of the students rated the overall experience as Excellent, 20% as Good and 30% as Adequate. Faculty observation: The groups performed Airway support, Oxygen initiation, Vitals, History, Labs, IV fluids, thiamine and glucose injection, EEG, Lorazepam, Fosphenytoin, Intubation and phenobarbital injection in 90-100% of the cases correctly. The data collected in year 2011 and 2012 were almost consistent, showing some improvement in some regards in 2012. Conclusions: We have been doing Status Epilepticus simulation at University of Missouri, Columbia in Neurology Clerkship for 3rd year medical students for the past 2 years. The survey shows that more than 90% students' feels that this way of learning is better than the classroom teaching and helps them remember the management protocol too.