Standardized Patient Simulation as an Effective Tool for Teaching Gastrointestinal Bleeding to Preclinical Medical Students

Swapnil Patel,1 Allison R Leisgang,2 Brandon Rodgers,2 Emmanuelle Williams,2 Hadie Razjouyan2,3 1Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA; 2Division of Gastroenterology and Hepatology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA; 3Department of Public Health and Sciences, Penn State College of Medicine, Hershey, PA, USACorrespondence: Swapnil Patel, Department of Medicine, Penn State Health, 500 University Drive, Hershey, PA, 17033, USA, Email spatel95@gmail.comIntroduction: Medical simulations are a well-established educational tool, allowing students hands on practice before starting clinical practice. In this study, we created a medical simulation to guide preclinical first-year medical students through a gastrointestinal (GI) bleed patient encounter. Our objective was to evaluate the educational impact of simulation cases, particularly in the context of GI pre-clinical medical education.Methods: Students participated in a standardized patient (SP) simulation of a patient with abdominal discomfort and rectal bleeding suggestive of cirrhosis. Sixteen sessions with two SPs were facilitated by five GI attendings and fellows. Student teams performed history-taking, physical examination, differential diagnosis, and management of a dynamically evolving, critically ill patient. Following the simulation, facilitators led a debrief linking clinical findings to preclinical pathophysiology. Students completed post-simulation surveys assessing perceived skills and learning.Results: Seventy-seven students participated; 63 were included in analysis. Sixty-three percent were female. Students demonstrated significant improvement in perceived history and physical exam skills (pre: 3.23± 1.06 vs post: 4.21± 0.58, P< 0.01) and in developing differential diagnoses (pre: 3.02± 0.91 vs post: 4.13± 0.61, P< 0.01). Ninety-seven percent reported improved understanding of GI bleeding. Additionally, 83% preferred more simulation-based learning prior to clerkships, and 83% desired more GI-focused simulations during clerkship.Discussion: This simulation case proved to be an effective tool to enhance pre-clinical medical students’ abilities to understand and manage GI bleeding. The simulation allowed for the realistic practice of critical clinical skills while demonstrating to students the relevance of their pre-clinical learning. The perceived improvements observed in knowledge and confidence suggest that integrating simulation-based training early into the medical curriculum could improve the transition from theoretical learning to clinical practice. Future studies should evaluate long-term skill retention and impact on clinical performance.Keywords: medical simulation, gastrointestinal bleeding, preclinical medical education, standardized patient, clinical skills development