Practicing pediatric medicine on the real thing: program lets medical students interact with kids and families

It’s one thing to use a stethoscope on a pint-sized manikin. It’s another to use one on a real live toddler. A program at Dalhousie University allows second-year medical students to examine children in a simulated clinical setting so students can get a proper example of what pediatrics is really like. The Parent Tot program is one of several run by the Centre for Collaborative Clinical Learning and Research at Dalhousie University. Between 25 and 50 families participate in the program each year. The families are given a script before attending the session, and are paid for their time at $20 an hour. But unlike adult simulated or standardized patients, the children are sometimes too young to follow the script. “This program falls somewhere between our simulated patient program and our volunteer patient program because we can somewhat simulate the parents/guardians, although they're coming with a lot of their own volunteered information and history, but children are coming just as themselves,” said Emily Armstrong, co-coordinator of the program and a simulated patient educator, in a Dalhousie University press release. “We don't dictate what happens and that's where we prep the learners.” Medical students appreciate the chance to work with children because they behave differently than manikins, said Dominique Salh, a third-year medical student at Dalhousie University. “Children have busy minds, are energetic, and require our full attention to keep them engaged during a clinical exam,” Salh said in a Dalhousie University press release. “For example, there is a difference between listening to the heart sounds of a manikin, versus listening to the heart sounds of a tot who likes to wiggle around in their parent's arms or on the exam table.” Read: QUIZ: Vascular anomalies in childhood Second-year medical students must complete four simulated appointments with a parent or guardian and their child while being supervised by a pediatrician. The children must be of various ages and with differing complaints so medical students can practice obtaining histories and completing exams before going on to their clerkship year. Salh and her classmates had to complete part of the program virtually due to the COVID-19 pandemic—giving them a chance to gain experience in that sphere—but they were invited back to carry out in in-person sessions in April. Shaylor Austin and their four children have been part of the program since 2015 and have been involved in 78 faculty of medicine sessions. This translates into 400 medical student encounters. Austin said that the program has helped the children, aged three to eight years old, become comfortable in medical settings. “When we started, it really felt like an incredibly important and valuable thing to do,” Austin said in a Dalhousie University press release. “As parents we can recognize how hard it can be to interact with kids without experience. When you add the complications that arise in a medical environment it’s something you really want to prepare people for as much as possible and so we’re happy to help with that however we can.” Read: Safe to take? New UofT program to provide info on exposures to medicines in pregnancy and lactation Other medical schools have simulated or standardized patient programs that involve children, including Memorial University of Newfoundland. A 2019 survey of pre-clerkship pediatric training programs in Canadian medical schools indicated that 13 Canadian medical schools give students access to simulated sessions with a parent or guardian and child. Only four medical schools were able to provide medical students with one-on-one interactions. Few students are exposed to a range of ages, with only five schools using a parent or guardian and an infant. The survey was published in Pediatrics and Child Health in 2019. Dalhousie University’s Parent Tot program has been running for 15 years. Canada’s first standardized patient program was established by Dr. Howard Barrows at McMaster University in 1971. Read: Can school-aged children accurately self-collect nasal swabs for SARS-CoV-2 tests?

Practicing pediatric medicine on the real thing: program lets medical students interact with kids and families

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