Through her previous career as a nurse, Danica Friesen (IMP Class of 2026) spent a lot of time working in clinical environments. When she entered medical school, however, she realized that many of her classmates didn’t have that same level of exposure. She also heard from fellow classmates and upper years how challenging the transition from lecture hall to bedside could be, especially in the context of limited or no previous medical experience.
Danica began to question if there was a way to ease that transition. She wondered if increasing the amount of time first- and second-year medical students spent in clinic could be the key, as well as about how that could be done. So, she decided to use her FLEX time on a research project that could help answer those questions.
“I’m passionate about understanding why we do what we do and figuring out how we can help make things better,” she says.
Danica speculated an answer may be found through the IMP Simulation (SIM) Club, an extracurricular group she had joined in first year and led as co-chair with Lyndon Rebello (IMP Class of 2026) in her second year. The student-run club, which is based out of the Centre for Interprofessional Clinical Simulation Learning (CICSL) at Victoria’s Royal Jubilee Hospital, offers members the opportunity to practice what they’re learning in class using high-fidelity mannequins in an imitation clinical environment.
Based on her own experiences with the group and with previous simulation-based education as a nurse, Danica felt that SIM learning could provide the clinical exposure pre-clerkship students needed. She wanted to know if other students in the club felt the same, so under the supervision of the IMP’s Year 3 Simulation Lead Dr. Barbara Lelj Garolla Di Bard, she worked together with Lyndon to develop a study to explore and quantify their perspectives.
Danica created surveys asking participants about how SIM-based medical education impacts their confidence in clinical decision-making, communication, and clinical skills compared to traditional teaching methods alone. These surveys were distributed both before and after a series of simulations.
Importantly, the simulations focused on topics that the students had recently covered in class. “Simulation should not come out of the blue,” explains Dr. Lelj Garolla Di Bard. While SIMs allow students to safely experience the pressure of a clinical environment, taking part in one without knowing the theory behind it can cause a different kind of stress that doesn’t support learning. “Simulation needs to be done around things you are learning so you can reapply your knowledge at the level that is appropriate for you.”
In total, 67 surveys were analyzed (35 pre-simulation and 32 post-simulation). The pre-simulation responses indicated participants felt a low level of confidence in all the areas listed in the survey. The post-simulation ratings, on the other hand, showed that they felt a significant increase in their confidence across all domains. Students also reported afterward that they perceived simulation as more effective than traditional didactic learning alone in preparing them for clinical practice.
Dr. Lelj Garolla Di Bard notes that as the study participants were already members of the IMP SIM club, there was a good chance they were going to view SIM learning positively. Still, she thinks Danica’s findings are worth noting and could be the jumping off point for additional research. “I think simulation is a great way to learn medicine, and people recognize it.” Some people are better at learning by doing, she says, and some people remember information more effectively when learning under pressure.
Lannie Sullivan (IMP Class of 2028), who now runs the IMP SIM club with Vincent Michaud (IMP Class of 2028), adds that this kind of learning experience isn’t just about getting hands-on practice. It also teaches students how to leverage the power of a team, use closed-loop communication techniques, and self-regulate in high-stress environments.
After peer review, Danica published her results in Cureus Journal of Medical Science. She and Dr. Lelj Garolla Di Bard hope the study shows the value of SIM-based medical education and possibly leads to more support for it at the club – and even the curricular – level.
Danica’s study suggests that increased access to SIM learning could help more students feel prepared for the transition into clinical environments during Year 3 clerkship. “Ultimately, I view incorporating simulation is a form of advocacy both for learners and for patients,” she says. “We know there is significant evidence showing that SIM improves knowledge retention and helps learners apply theory more effectively in real clinical scenarios. So, incorporating SIM earlier in medical education has the potential to improve both medical education and, by extension, patient care and safety.”