Simulation-based education in an emergency medicine clerkship in Qatar: impact on academic performance and student perceptions

Simulation-based medical education (SBME) is increasingly used in emergency medicine (EM) training to enhance clinical skills and decision-making. However, its impact on undergraduate clerkship performance and student perceptions in the Middle Eastern context remains underexplored. This study aimed to evaluate whether the integration of high-fidelity simulation into a medical student EM clerkship in Qatar improves academic outcomes and enhances student satisfaction with the learning experience. Two clerkship students cohorts were compared: 63 students in a lecture-based education (LBE) group in 2022 and 67 students in an SBME group in 2024. Multiple-choice question (MCQ) and objective structured clinical examination (OSCE) scores were analyzed using independent sample t-tests. Demographic variables (age, gender) were collected, and qualitative feedback from the SBME group was analyzed using descriptive content analysis. There were no statistically significant differences in academic performance between the lecture-based education (LBE) and simulation-based medical education (SBME) cohorts. The mean MCQ score was 29.2 (SD = 4.1) for the LBE group and 28.8 (SD = 4.3) for the SBME group (p = 0.588), with no meaningful difference (mean difference = +0.4, 95% CI: [-1.08, 1.84], Cohen’s d = +0.10). OSCE scores were also comparable, with the LBE group scoring a mean of 24.8 (SD = 1.8) and the SBME group 25.2 (SD = 1.7) (p = 0.192; mean difference = -0.4, 95% CI: [-1.01, +0.21], Cohen’s d = -0.23). Demographic characteristics were also similar between groups, with a mean age of approximately 23 years and around 70% of participants being female. Thematic analysis of feedback revealed three dominant themes: (1) Enhanced clinical preparedness and confidence – students felt better prepared for real emergencies after simulation practice; (2) Active learning and realism – the lifelike scenarios and hands-on approach helped bridge theory to practice in a safe environment; (3) Positive engagement and recommendations – students found simulation highly engaging and recommended increasing its use. One student wrote, “The simulations were the most valuable part of the rotation, boosting my confidence in handling acute cases.” Minor challenges noted included initial anxiety during simulations and scheduling constraints, but overall perceptions were overwhelmingly positive. While SBME in the emergency medicine clerkship did not lead to statistically significant improvements in exam performance, it was highly valued by students and associated with enhanced confidence, clinical preparedness, and engagement. These results support the continued integration of SBME into EM clerkship as a complementary approach to traditional teaching. Future studies with larger sample sizes and extended follow-up are warranted to evaluate the long-term impact and broader applicability of simulation-based medical education.