Case-based simulation scenarios in cardiology

Mohsin Faysal Butt,1 Kabir Matwala,2 Rakin Rownak Choudhury1  1Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; 2Department of Medicine, Imperial College London, London SW7 2AZ, UK We read with interest the study by Bilello et al,1 which assessed the utility of a cardiac case-based simulation scenario to investigate the physical examination performance of fourth-year medical students. As medical students, mannequins have granted us useful practical skills, but we recognize that they do not command the same feeling of dread nor the adrenaline surge that comes with managing a real-life cardiac arrest. This is a unique study design, and we respect the authors’ description of its limitations, but for the educator who wishes to utilize mannequins in a similar investigation, we propose slight alterations to the study protocol. Authors’ reply Leslie A Bilello,1 Nicole M Dubosh,1 Jason J Lewis,1 Matthew M Hall,1 Jonathan Fisher,2 Edward A Ullman,1 1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; 2Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, USA  We appreciate the Letter to the Editor from Butt et al regarding our study and recent publication entitled, “Fourth-year medical students do not perform a focused physical examination during a case-based simulation scenario.” This study sought to assess the physical examination performance of medical students in the simulation laboratory during a high-acuity cardiac case that later evolved into a cardiac arrest.  View the original paper by Bilello and colleagues. &nbsp