In SBL as a reliable means to assess

In this study
the percentage scores on most of the items were all in favor of SBL. The reported
average satisfaction rate was 65 out of 100. The results were comparable with
the study by Joseph et al who reported overall positive perception of medical
students.10 The result showed that the use of simulation modality
improved students’ clinical skills in term of knowledge, critical thinking,
reasoning and self-confidence. A similar study confirmed the effective use of simulation in teaching
and learning medicine.8

Furthermore, to
the satisfaction with SBL we aimed to measure the other components of SBL which
were the equipment, facilities and instructors. Students showed general
agreement on type, number and quality of the equipment provided by the college.
Tutors’ and instructors’ briefing and feedback were highly criticized by the
students and were considered adequately unsatisfying among majority of the
students.  

However, students’
responses on the downsides of the SBL were aimed towards the lack of time to
use the equipment and the availability of the labs and insufficient numbers of
tutors to give fair time for each student. These concerns agreed with another
survey concluded among clerkship directors in emergency medicine on SBL.Ref The survey results emphases were based on lack of
instructors’ time to teach, financial resources and number of students.
Similarly, another study found SBL
as a reliable means to assess learners’ skills by providing constructive
feedback which was negatively perceived by most study participants. 11

In addition to
the general satisfaction rates we analyzed the differences in between levels of
the students in college and among genders. This study observed a significant
increase in the scores based on the level of the students in college. The
reason would be the experience and practice on simulated patients in different level
of study might be a reason of this significant difference. There were a
significance differences between the gender in the domains of process,
equipment and feedback. Reference

Even though, few students who gave unfavorable
feedback, the qualitative analysis in this study, acknowledged the benefits of
simulation teaching in practice. The shared benefits summarized as; confidence
building, improved communication skill, families and use of reasoning skills
while dealing with the real patient.

The group
of participants raised attention to two things. Firstly, simulation center had
a critical role in teaching clinical skills need to be advanced.  Secondly, how initiative and involvement of
leadership is important to facilitate this modality in medical education. The
findings were consistent with a study done on nursing students argued on
the critical role of stakeholders in enhancing the clinical learning experience
to students.12

It is known fact that debriefing is
crucial aspect of SBL to increase skills and improve reflective practice.13 The result presented a
deficiency in the aspects of faculty development and lack of debriefing skills.
The result emphasize on the importance of training sessions and curriculum
reform by developing experiential learning approach in teaching.

Study
limitations.

Some
limitations that prevented the generalization were small number of participants
from one institution but it suggest the need to include sample from other
colleges of the region. Secondly, there was no control group for comparison to
see the contribution of other modalities on students learning.

The findings despite
certain limitation will guide the stakeholders on how students’ learning needs should
be addressed. This recognition is important in planning, implementation and
evaluation of SBL in medical education.

Conclusion and
recommendations

SBL in this
study generally recognized as useful and effective way of learning skills. The current integration between
clinical teaching methods and simulation is still at its start, and there is
vast potential for further association. It would be important for educational leaders in the institution to understand
that all the stakeholders have a significant role in teaching the clinical
knowledge and skills to medical students. There is a need to communicate
benefits of simulation with faculty members and students and to review the
current strategic goals of the use of
simulation to include this approach in medical curricula. Further studies to
explore the current and future implications of simulation in clinical learning
are required.