The impact of a prehospital simulation on medical students' resourcefulness, personal growth initiative, and uncertainty tolerance.

Background: Emergency medicine (EM) physicians often practice in dynamic, high-stress, and uncertain settings with limited resources. Although simulation has been shown to enhance various aspects of student development, its impact on medical students' personal growth initiative, resourcefulness, and tolerance of uncertainty-crucial traits for managing future crises as emergency physicians-remain unclear. The purpose of this study, therefore, was to determine a high-fidelity prehospital simulation's impact on medical students' resourcefulness, personal growth, and tolerance of uncertainty.

Methods: We surveyed 107 fourth-year medical students before and after a multiday, high-fidelity prehospital simulation. The survey included items from the Intolerance of Uncertainty Scale-12 Item Form, the Personal Growth Initiative Scale, and the Resourcefulness Skills Scale. We compared students' pre- and post-simulation responses to investigate any change in their uncertainty intolerance, personal growth initiative, and resourcefulness following simulation participation.

Results: Students' scores significantly increased following the simulation for both resourcefulness ((106) = -6.89,  < 0.001,  = -0.67) and personal growth initiative ((106) = -6.22,  < 0.001,  = -0.60). Effect size calculations suggest that participating in the simulation had a medium to large effect on participants' resourcefulness and personal growth initiative. However, participants' tolerance of uncertainty scores prior to and following the simulation did not significantly differ ((106) = 1.66,  = 0.100,  = 0.16), indicating that the simulation had little effect on participants' tolerance of uncertainty.

Conclusions: Our results indicate that simulation is a promising educational tool for developing students' resourcefulness and personal growth initiative so they can navigate high-stress, low-resource environments. Follow-on research is needed to determine how to leverage simulation to enhance students' uncertainty tolerance in high-stress, low-resource environments.