Simulation Game Versus Multiple Choice Questionnaire to Assess the Clinical Competence of Medical Students: Prospective Sequential Trial

BACKGROUND: The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied. OBJECTIVE: The objective of this study was to assess whether an SG better reflects the clinical competence of medical students than a multiple choice questionnaire (MCQ). METHODS: Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities: high-fidelity simulation (HFS), considered the gold standard for the evaluation of clinical competence, the SG Effic’Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities and the MCQ and HFS modalities. Student satisfaction was also evaluated. RESULTS: Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (P=.04). Students reported significantly higher satisfaction with the SG (P<.01) than with the MCQ modality. CONCLUSIONS: The SG Effic’Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Because SGs allow the assessment of more dimensions of clinical competence than MCQs, they are particularly appropriate for the assessment of medical students on situations involving symptom recognition, prioritization of decisions, and technical skills. TRIAL REGISTRATION: ClinicalTrials.gov NCT03884114; https://clinicaltrials.gov/ct2/show/NCT03884114