Testing the efficiency of emergency intörnship of 6th year medical students with simulation application

Objective: This study aimed to evaluate the clinical knowledge and skills gained by final-year medical students during their emergency medicine internship and to objectively measure the impact of the internship on students' clinical competencies. Methods: A total of 86 intern doctors who completed their emergency medicine internship at the Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine in 2024 were included in the study. The research was conducted in a prospective and observational design. The clinical performances of the students were evaluated at two different time points before and after the internship using structured case scenarios on a screen-based virtual patient simulation platform (Full Code). Each participant's case management performance was scored based on components such as anamnesis, physical examination, diagnosis, intervention, stabilization, communication, and case management duration. Results: A statistically significant increase was observed in overall performance scores following the internship (from 69.2 ± 20.5 to 83.4 ± 11.2; p < 0.001). Significant improvements were recorded in physical examination (71.1 ± 27.9 → 79.0 ± 24.9), diagnostic accuracy (65.1 ± 27.1 → 71.2 ± 23.9), intervention (27.7 ± 33.3 → 42.7 ± 39.4), stabilization (67.5 ± 31.2 → 77.1 ± 27.9), and communication skills (60.4 ± 44.5 → 67.1 ± 44.0) (all p < 0.001). Case management time decreased significantly from 399 ± 120 seconds to 335 ± 106 seconds (p < 0.001). In system-based subgroup analyses, significant increases in overall performance scores were observed across all clinical categories: from 60.2 ± 18.5 to 78.7 ± 12.2 in cardiac emergencies; 73.9 ± 18.6 to 84.4 ± 10.4 in pulmonary emergencies; 71.2 ± 20.9 to 86.7 ± 6.04 in abdominal emergencies; 71.4 ± 14.2 to 80.2 ± 9.59 in central nervous system emergencies; 72.7 ± 23.7 to 87.5 ± 9.38 in medical emergencies; and 65.9 ± 22.7 to 82.7 ± 14.8 in other types of emergencies (all p < 0.001). Conclusion: The findings demonstrated that the emergency medicine internship significantly enhanced the clinical competencies of final-year medical students and contributed meaningfully to their preparedness for post-graduation clinical practice. Notable improvements were observed in physical examination, diagnostic reasoning, decision-making regarding interventions, stabilization procedures, communication, and time management in case resolution. These results indicate that the emergency medicine internship plays a critical role in developing students' clinical decision making, procedural application, and case management skills.