ILM FAN YANGILIKLARI KONFERENSIYASI
IYUN
ANDIJON,2025
278
IMPROVING CLINICAL DECISION-MAKING IN PEDIATRICS: EDUCATIONAL
OUTCOMES OF SIMULATION-BASED LEARNING FOR MEDICAL STUDENTS
Ergashzoda Khusniya Sharafidin kizi
Central Asian Medical University
E-mail: ergashzodaxusniya@gmail.com
https://orcid.org/0009-0001-6423-3642
Eminov Ravshanjon Ikromjon ugli
Department of Faculty and Hospital Surgery, FMIOPH, Fergana, Uzbekistan
Abstract:
Simulation-based learning in pediatric education enhances students’ clinical
reasoning, confidence, and non-technical skills through realistic, safe environments. This
review discusses its effectiveness in improving diagnostic decision-making and preparing
students for real-world pediatric care using virtual reality, high-fidelity, and low-fidelity
methods.
Keywords:
pediatrics, simulation, education, diagnostic, decision
Аннотация:
Обучение с использованием симуляций в педиатрии усиливает клиническое
мышление, уверенность и неформальные навыки студентов благодаря безопасной и
реалистичной среде. В статье рассматривается эффективность симуляционного обучения
в развитии диагностических навыков и подготовке студентов к клинической практике.
Ключевые слова:
педиатрия, симуляция, образование, диагностика, решение
Annotatsiya:
Pediatriyada simulyatsiyaga asoslangan o‘qitish talabalarning klinik tafakkurini,
ishonchini va no-texnik ko‘nikmalarini xavfsiz, real muhitda oshiradi. Ushbu maqola
simulyatsiya usullarining diagnostik qaror qabul qilishni rivojlantirishdagi samaradorligini
muhokama qiladi.
Kalit so‘zlar:
pediatriya, simulyatsiya, ta’lim, diagnostika, qaror
Introduction
Simulation-based learning has emerged as a pivotal tool in enhancing clinical decision-making
skills among medical students in pediatrics. This educational approach provides a risk-free
environment where students can practice and refine both technical and non-technical skills,
such as communication, situational awareness, and decision-making, which are crucial in
pediatric emergencies[2] [5]. The integration of simulation into medical curricula has shown
significant improvements in students' clinical skills, as evidenced by higher scores in Objective
Structured Clinical Examinations (OSCE) among those trained with simulation compared to
traditional methods[3]. High-fidelity simulations, in particular, offer immersive experiences
that allow students to engage in realistic patient scenarios, fostering critical thinking and
clinical reasoning[7]. Moreover, the use of innovative methods such as the Script Concordance
Test combined with simulation has been effective in developing clinical reasoning and non-
technical skills in pediatric residents, indicating the potential for broader application across
various specialties[2]. The incorporation of virtual reality (VR) simulations further enhances
learning by providing high-fidelity experiences that significantly improve students' knowledge
and procedural skills in pediatric emergencies[10]. These simulations not only boost students'
confidence and willingness to make clinical decisions but also translate well into real-world
clinical settings, as they mimic the complexities and dynamics of actual pediatric care
scenarios[8] [9]. The positive impact of simulation-based learning is also reflected in the
increased ability of students to manage acute clinical problems and lead teams effectively, as
they report reduced stress and improved teamwork skills over time[9]. Overall, simulation-
ILM FAN YANGILIKLARI KONFERENSIYASI
IYUN
ANDIJON,2025
279
based education in pediatrics is a valuable strategy that enhances clinical decision-making,
improves patient safety, and prepares medical students for the challenges of pediatric
care[1] [4] [6].
Read Less
Enhancing Knowledge and Clinical Reasoning
Simulation-based learning is highly effective in enhancing both theoretical knowledge and
clinical reasoning skills. Studies have shown that high-fidelity simulations, such as those using
virtual reality (VR), can significantly improve students' ability to diagnose and manage
pediatric emergencies. For instance, a study using VR simulations for newborn sepsis scenarios
demonstrated a marked increase in students' knowledge scores, from 7.80 ± 2.1 to 10.90 ± 1.2
points, highlighting the effectiveness of SBL in knowledge acquisition [1]. Similarly, another
study found that high-fidelity simulations outperformed case-based discussions in developing
clinical reasoning, communication, and leadership skills, with large effect sizes observed across
these domains [3].
The use of simulated patient cases software, such as the Diagnostic Clinical Reasoning
Program (DxR), has also been shown to enhance clinical competence. Students who used this
software during their pediatric clerkship performed significantly better in clinical examinations
compared to their peers who did not use the software, demonstrating the practical application of
SBL in improving clinical decision-making [4].
Building Confidence in Clinical Decision-Making
One of the most significant benefits of SBL is its ability to build confidence in medical students.
A study evaluating the impact of in situ simulation training found that 100% of participants
reported increased confidence in managing acutely unwell children, with many also noting
improvements in their knowledge and awareness of non-technical skills such as communication
and teamwork [13]. Another study using high-fidelity simulations reported that students who
participated in these sessions were more likely to accept the presence of family members during
emergencies, further indicating the positive impact of SBL on confidence and real-world
application [16].
The immersive nature of SBL also plays a crucial role in confidence building. A pilot study
using VR simulations for pediatric emergencies found that students' perceived level of
competence increased significantly after participating in the sessions, from a median of 2 to 4
on a 5-point Likert scale [7]. This increase in confidence is likely due to the realistic and
engaging nature of SBL, which allows students to practice high-stakes scenarios without the
risks associated with real patient care.
Developing Non-Technical Skills
In addition to clinical knowledge and confidence, SBL is particularly effective in developing
non-technical skills such as communication, leadership, and situational awareness. A mixed-
methods study evaluating the effectiveness of simulation-based training for interprofessional
teams found significant improvements in team communication, decision-making, and
leadership skills, with scores increasing from 3.16 ± 1.20 to 7.61 ± 1.0 for communication and
from 3.50 ± 1.54 to 7.16 ± 1.42 for decision-making [2].
The importance of non-technical skills in pediatric care is further emphasized by a study that
highlighted the value of role allocation and debriefing in simulation sessions. Students
particularly appreciated the opportunity to communicate with simulated parents, which was
identified as a key area for improvement in their learning outcomes [12]. These findings
underscore the holistic approach of SBL in preparing medical students for the complexities of
real-world clinical practice.
Table:
Comparison of simulation methods and their effectiveness
Simulation Method
Effectiveness
Citation
ILM FAN YANGILIKLARI KONFERENSIYASI
IYUN
ANDIJON,2025
280
Virtual
Reality
(VR)
Simulations
Significant improvement in knowledge and
clinical reasoning skills
[1] [6]
High-Fidelity Simulations
Enhanced
clinical
reasoning,
communication, and leadership skills
[3] [16]
Simulated Patient Software Improved
clinical
competence
and
performance in examinations
[4]
In Situ Simulations
Increased
confidence
in
managing
emergencies and improving non-technical
skills
[13]
Mixed
Reality
(MR)
Simulations
Enhanced engagement and immersive
learning experiences
[10]
Low-Fidelity Simulations
Effective in improving clinical skills and
confidence
[12]
This table highlights the effectiveness of various simulation methods in improving clinical
decision-making skills in pediatric education, supported by relevant citations from the research
papers.
The Role of Technology in Simulation-Based Learning
Advancements in technology have significantly enhanced the effectiveness of SBL in pediatric
education. Virtual reality (VR) and high-fidelity simulations have become increasingly popular
due to their ability to create immersive and realistic learning environments. A study comparing
VR simulations with case-based discussions found that students in the VR group reported
higher levels of satisfaction and engagement, with many describing the experience as more
realistic and useful for their professional development [6].
The use of web-based simulated patient cases, such as the DxR software, has also been shown
to enhance clinical skills in a virtual hospital setting. Students who used this software during
their pediatric clerkship performed significantly better in clinical examinations, with particular
improvements in their ability to assess and manage pediatric patients [4]. These findings
highlight the potential of technology to complement traditional teaching methods and provide
students with a more engaging and effective learning experience.
Feedback and Debriefing in Simulation-Based Learning
Feedback and debriefing are essential components of SBL, allowing students to reflect on their
performance and identify areas for improvement. A study evaluating the impact of simulation-
based training on crisis resource management skills found that participants highly valued the
structured debriefs, which provided individualized feedback and helped consolidate their
learning [2]. Similarly, a study on high-fidelity simulations emphasized the importance of
expert facilitation during debriefing sessions, with students appreciating the guidance provided
by clinicians [1].
The use of video-recorded consultations and multisource feedback has also been explored in
pediatric education. A study comparing student, educator, and simulated parent ratings of
medical student consultations found that feedback from multiple sources helped identify areas
of weakness and improved student self-appraisal [8]. These findings suggest that the integration
of feedback mechanisms in SBL can enhance the learning experience and improve clinical
decision-making skills.
Curriculum Design and Implementation
The design and implementation of SBL curricula are critical to their success. A study
evaluating a simulation-based pediatric clinical skills curriculum found that students who
participated in the program showed significant improvements in their clinical performance
during clerkship, with effect sizes ranging from small to medium across 16 evaluation
components [15]. Another study highlighting the importance of integrating simulation into the
ILM FAN YANGILIKLARI KONFERENSIYASI
IYUN
ANDIJON,2025
281
undergraduate curriculum found that students who participated in simulation sessions during
their pediatric placement reported higher levels of confidence and competence in managing
acutely unwell children [14].
The inclusion of mini-tutorials and focused group discussions in simulation courses has also
been shown to enhance learning outcomes. A study evaluating an immersive simulation-based
educational intervention found that students highly valued the incorporation of mini-tutorials,
which provided additional technical and pathophysiological insights into each clinical
scenario [5]. These findings suggest that a well-structured and comprehensive SBL curriculum
can significantly enhance the clinical decision-making skills of medical students.
Considerations and Challenges
While SBL offers numerous benefits, there are several considerations and challenges to its
implementation. The cost and resource requirements for high-fidelity simulations can be a
barrier for many institutions, particularly in low-resource settings. However, studies have
shown that even low-fidelity simulations can be effective in improving clinical skills and
confidence, suggesting that SBL can be adapted to different resource environments [12].
Another challenge is the need for standardized evaluation methods to assess the transferability
of skills from simulation to real-world clinical settings. A systematic review of pediatric
simulation-based education highlighted the lack of validated clinical skills evaluation methods,
emphasizing the need for further research in this area [9]. Additionally, the assumption that
younger students can navigate VR hardware with ease should not be taken for granted, as some
studies have reported lower ease-of-use ratings for VR simulations [7].
Future Directions
The future of SBL in pediatric education is promising, with ongoing advancements in
technology and curriculum design. The integration of virtual, augmented, and mixed reality
into SBL is expected to further enhance the learning experience, offering more immersive and
engaging environments for medical students [10]. Additionally, the development of more
comprehensive clinical skills evaluation methods will be crucial to assessing the long-term
impact of SBL on clinical decision-making and patient outcomes.
In conclusion, simulation-based learning is a powerful tool for improving clinical decision-
making in pediatrics. By enhancing knowledge, building confidence, developing non-technical
skills, and providing realistic learning environments, SBL prepares medical students for the
challenges of real-world clinical practice. As technology continues to evolve and curricula are
refined, the potential of SBL to transform pediatric education is immense.
Conclusion
Simulation-based learning stands out as a transformative educational strategy in pediatric
training, enabling students to bridge the gap between theory and clinical application. Through
structured, immersive experiences—ranging from virtual reality to bedside simulations—
medical students acquire not only critical decision-making skills but also the confidence and
communication abilities essential for managing pediatric patients in high-stakes environments.
Furthermore, the integration of feedback and debriefing mechanisms ensures that learning is
reflective and adaptive, promoting deeper understanding and retention. By fostering both
technical and non-technical competencies, simulation reinforces the core principles of safe,
patient-centered pediatric care.
References
:
1.
Тешабоев, А. М., Юлчиева, С. Т., Расулов, У. М., Борецкая, А. С., & Расулов, Ф. Х.
ИЗУЧЕНИЕ ИММУНОГЕНЕЗА И ГЕМОПОЭЗА У ЖИВОТНЫХ С ТИ-ПОМ
АЦЕТИЛИРОВАНИЯ И ПУТИ ИХ КОРРЕКЦИИ С ОЧИЩЕННЫМ КОМПЛЕКСОМ
ДЕТОКСИОМЫ.
ILM FAN YANGILIKLARI KONFERENSIYASI
IYUN
ANDIJON,2025
282
2.
Расулов, Ф., Тожалиевна, М., Рузибаева, Ё., & Борецкая, А. (2024). Исследование
стабильной формы коронавируса и ее устойчивости к изменчивости.
Профилактическая
медицина и здоровье
,
3
(3), 20-26.
3.
Расулов, Ф. Х., Борецкая, А. С., Маматкулова, М. Т., & Рузибаева, Ё. Р. (2024).
INFLUENCE AND STUDY OF MEDICINAL PLANTS OF UZBEKISTAN ON THE
IMMUNE SYSTEM.
Web of Medicine: Journal of Medicine, Practice and Nursing
,
2
(12),
118-124.
4.
Икромова, Н., & Эминов, Р. (2025). Развитие речи и языка у дошкольников: роль
родительского взаимодействия.
in Library
,
1
(2), 28-32.
5.
Икромова, Н., & Эминов, Р. (2025). Влияние эмоционального интеллекта и уровня
тревожности на развитие речи и социальную адаптацию детей дошкольного возраста.
in
Library
,
1
(2), 15-19.
6.
Икромова, Н. М. (2024). Научно-Теоретические Основы Социальной Адаптации
Старшего Дошкольника На Основе Речевого Развития.
Miasto Przyszłości
,
54
, 385-387.
7.
Борецкая, А. С., Расулов, Ф. Х., Рузалиев, К. Н., & Хасанов, Н. Ф. У. (2024).
ИММУНОГЕНЕЗ
И
МИКРОФЛОРА
КИШЕЧНИКА
ПРИ
ПАТОЛОГИИ
СМЕШАННОЙ
ЭТИОЛОГИИ
И
ПУТИ
ИХ
КОРРЕКЦИИ.
Science
and
innovation
,
3
(Special Issue 45), 276-281.
8.
Борецкая, А. С. (2022). СОСТОЯНИЕ ОБРАЗОВАНИЯ И ПЕДАГОГИЧЕСКОЙ
МЫСЛИ В ЭПОХУ БЕРУНИ.
Academic research in educational sciences
, (3), 125-127.
9.
Бобохонова, М. М., & Дехконбоева, К. А. (2021). НАЦИОНАЛЬНАЯ МОДЕЛЬ
ОХРАНЫ ЗДОРОВЬЯ МАТЕРИ И РЕБЕНКА В УЗБЕКИСТАНЕ:" ЗДОРОВАЯ МАТЬ-
ЗДОРОВЫЙ РЕБЕНОК".
Экономика и социум
, (10 (89)), 540-543.
10.
Raqiboyevna, G. M., & Abdulhay, M. (2025, May). MORPHOLOGICAL AND
CLINICAL INDICATIONS OF COMPLICATIONS OF CARDIOVASCULAR DISEASE
ARCUS SENILIS. In
International Conference on Multidisciplinary Sciences and Educational
Practices
(pp. 182-184).
11.
Raqiboyevna, G. M., & Abdulhay, M. (2025). PREVENTION OF COMPLICATIONS
OF CARDIOVASCULAR DISEASES BY ORGANIZING MORPHOLOGICAL AND
CLINICAL INDICATORS OF ARCUS SENILIS.
Modern education and development
,
26
(4),
201-204.
12.
Mo’Minjonovna,
B.
M.,
&
O’G’Li,
M.
A.
R.
(2024).
STUDY
AND
ANALYSIS
OF
THE
PHARMACOLOGICAL
PROPERTIES
OF
MEDICINAL
PLANTS,
WHICH
ARE
CARDIAC
GLYCOSIDES
USED
IN
CLINICAL
PRACTICE.
Eurasian
Journal
of
Medical
and
Natural
Sciences
,
4
(1-1),
80-83.
13.
Ikromova,
N.
(2024,
October).
AMIGDALIN
HOSILALARI
SINTEZI
ISTIQBOLLARI.
In
CONFERENCE
ON
THE
ROLE
AND
IMPORTANCE
OF
SCIENCE
IN
THE
MODERN
WORLD
(Vol.
1,
No.
8,
pp.
164-166).
14.
Ikromova,
N.
(2024).
TABIIY
SIANOGLIKOZID-AMIGDALINNING
KIMYOVIY
XOSSALARI
VA
AMALIY
AHAMIYATI.
Universal
xalqaro
ilmiy
jurnal
,
1
(6),
26-29.
15.
Ganiyeva
M.
R.
CLINICAL
AND
MORPHOFUNCTIONAL
CHANGES
IN
THE
RETINA
IN
HIGH
MYOPIA
IN
COMBINATION
WITH
AGE-RELATED
MACULAR
DEGENERATION
OF
DIFFERENT
STAGES
//International
Conference
on
Modern
Science
and
Scientific
Studies.
–
2024.
–
С.
141-142.
16.
Boboxonova, M. (2025). COMBATING EARLY MENOPAUSE: MODERN
MEDICAL APPROACHES AND NATURAL TREATMENT METHODS. International
Journal of Artificial Intelligence, 1(4), 56-59.
17.
Adhamjon o'g, A. A. Z., & Mo'minjonovna, M. B. (2025, May). CLINICAL
PHARMACOLOGY OF ANTI-INFLAMMATORY DRUGS. In CONFERENCE OF
MODERN SCIENCE & PEDAGOGY (Vol. 1, No. 2, pp. 88-91).
16.
