Practice emergency care safely in a clinical skills workshop

When acquiring the professional skills of a doctor, it is important to strike a balance between theoretical studies, on the one hand, and patient encounters and care, on the other. Simulation instruction is a good way of familiarising students with situations that cannot be practised with patients.

The simulated arrhythmia instruction in cardiology organised in the clinical skills workshop at Biomedicum (Skilla) creates emergency situations resembling real-life cases where students have the opportunity to treat, under the supervision of a senior doctor, a range of arrhythmia cases. In addition to actual patient care, this instruction involves other relevant elements, such as group communication, interaction with other medical and nursing staff, drug administration in emergency situations and consultation phone calls.

Problem-solving skills developed with the help of virtual patients

The coronavirus pandemic transferred some parts of traditional group teaching online. In the case of many forms of instruction (lectures, seminars and case-based learning), this is a beneficial transition. The creation of virtual patients is a new addition to digital teaching. In the future, cardiology will be taught in online classes, during which students solve and independently treat various virtual patient cases.

The ‘examination’ of patients on an interactive online platform includes almost every aspect associated with the interaction seen at regular appointments. Virtual patients can be asked about underlying conditions, medication and symptoms. In addition, relevant tests and investigations, such as laboratory tests, ECGs and imaging scans, can be ordered. Virtual patients can also be ‘examined’ by asking questions and receiving answers to them. In some cases, it is even possible to auscultate the patient's lungs or heart. These exercises make it possible to practise problem-solving in ordinary cases, which students will later encounter in their professional life when treating patients.

Skills develop also in examinations

Alongside instruction in the practical work of doctors, the assessment of these skills has been developed at the University of Helsinki. The Objective Structured Clinical Exam (OSCE) for graduating students has been continually maintained and developed.

In the examination, students complete brief assignments assessed by an invigilator. The assignments measure practical clinical skills and interaction with the patient.

The examination benefits both parties, as students value the feedback on their skills, while teachers receive direct feedback on areas where teaching needs to be further developed. Since OSCE is an examination, anxiety can easily affect student performance. However, failing one assignment is not a disaster, and individual assignments can be retaken at a later date. ‘FAIL’ stands for ‘First Attempt in Learning’. The fact that the association for students of medicine at the University of Helsinki (LKS) named the OSCE team the Teacher of the Year in 2019 speaks of the appreciation expressed by students.

Mika Laitinen, clinical instructor
Department of Internal Medicine