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Booth CS, Song C, Howell ME, Rasquinha A, Saska A, Helikar R, Sikich SM, Couch BA, van Dijk K, Roston RL, Helikar T. Teaching Metabolism in Upper-Division Undergraduate Biochemistry Courses using Online Computational Systems and Dynamical Models Improves Student Performance. CBE LIFE SCIENCES EDUCATION 2021; 20:ar13. [PMID: 33635127 PMCID: PMC8108505 DOI: 10.1187/cbe.20-05-0105] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 05/30/2023]
Abstract
Understanding metabolic function requires knowledge of the dynamics, interdependence, and regulation of metabolic networks. However, multiple professional societies have recognized that most undergraduate biochemistry students acquire only a surface-level understanding of metabolism. We hypothesized that guiding students through interactive computer simulations of metabolic systems would increase their ability to recognize how individual interactions between components affect the behavior of a system under different conditions. The computer simulations were designed with an interactive activity (i.e., module) that used the predict-observe-explain model of instruction to guide students through a process in which they iteratively predict outcomes, test their predictions, modify the interactions of the system, and then retest the outcomes. We found that biochemistry students using modules performed better on metabolism questions compared with students who did not use the modules. The average learning gain was 8% with modules and 0% without modules, a small to medium effect size. We also confirmed that the modules did not create or reinforce a gender bias. Our modules provide instructors with a dynamic, systems-driven approach to help students learn about metabolic regulation and equip students with important cognitive skills, such as interpreting and analyzing simulation results, and technical skills, such as building and simulating computer-based models.
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Affiliation(s)
- Christine S. Booth
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | - Changsoo Song
- Social and Behavioral Sciences Research Consortium (SBSRC): Methodology and Evaluation Research Core Facility, University of Nebraska, Lincoln, NE 68583-0866
| | - Michelle E. Howell
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
- LCC International University, Klaipėda 92307, Lithuania
- School of Biological Sciences, University of Nebraska, Lincoln, NE 68588-0118
| | - Achilles Rasquinha
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | - Aleš Saska
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | - Resa Helikar
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | | | - Brian A. Couch
- School of Biological Sciences, University of Nebraska, Lincoln, NE 68588-0118
| | - Karin van Dijk
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | - Rebecca L. Roston
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
| | - Tomáš Helikar
- Department of Biochemistry, University of Nebraska, Lincoln, NE 68588-0664
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102
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Chumbley SD, Devaraj VS, Mattick K. An Approach to Economic Evaluation in Undergraduate Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:171-183. [PMID: 32745338 DOI: 10.1002/ase.2008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
Medical education research is becoming increasingly concerned with the value (defined as "educational outcomes per dollar spent") of different teaching approaches. However, the financial costs of various approaches to teaching anatomy are under-researched, making evidence-based comparisons of the value of different teaching approaches impossible. Therefore, the aims of this study were to report the cost of six popular anatomy teaching methods through a specific, yet generalizable approach, and to demonstrate a process in which these results can be used in conjunction with existing effectiveness data to undertake an economic evaluation. A cost analysis was conducted to report the direct and indirect costs of six anatomy teaching methods, using an established approach to cost-reporting. The financial information was then combined with previously published information about the effectiveness of these six teaching methods in increasing anatomy knowledge, thereby demonstrating how estimations of value can be made. Dissection was reported as the most expensive teaching approach and computer aided instruction/learning (CAI/L) was the least, based on an estimation of total cost per student per year and assuming a student cohort size of just over 1,000 (the United Kingdom average). The demonstrated approach to economic evaluation suggested computer aided instruction/learning as the approach that provided the most value, in terms of education outcomes per dollar spent. The study concludes by suggesting that future medical education research should incorporate substantially greater consideration of cost, in order to draw important conclusions about value for learners.
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Affiliation(s)
- Samuel D Chumbley
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Vikram S Devaraj
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Karen Mattick
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
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103
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Haji FA. Simulation in Neurosurgical Education During the COVID-19 Pandemic and Beyond. Can J Neurol Sci 2021; 48:152-154. [PMID: 33077011 PMCID: PMC8060615 DOI: 10.1017/cjn.2020.234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Faizal A. Haji
- Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, Queen’s University and Kingston Health Sciences Centre, Kingston, Ontario, Canada
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104
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Vining RD, Millard T. Educator's Learning Alignment Instrument (ELAI). THE JOURNAL OF CHIROPRACTIC EDUCATION 2021; 35:28-37. [PMID: 32348152 PMCID: PMC7958661 DOI: 10.7899/jce-19-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/27/2019] [Accepted: 08/27/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To report the development and initial testing of a questionnaire designed to assess the concept of learning alignment within chiropractic college courses. METHODS A 36-item questionnaire, Educator's Learning Alignment Instrument (ELAI), was created to evaluate how learning goals, course activities, and assessments align within a college course. Questionnaire development was informed by learning theories and tested using a 2-phased electronic survey mechanism among a chiropractic college faculty. Phase 1 included completing the ELAI for a currently implemented course. Phase 2 included questions about confidential reports generated from ELAI data. RESULTS Thirty-one of 46 (67%) respondents completed an ELAI. Twelve (38%) participated in phase 2. Twenty-one (68%) courses demonstrated consistent learning focus across goals, activities, and assessments. Aggregate data from early, middle, and late chiropractic program courses revealed progressive shifts toward higher-level learning. Eighty-seven percent of courses contained 1 or more individual learning areas with potentially misaligned goals, activities, or assessment. Ninety-seven percent of respondents completed ELAI questions within 20 minutes. Most (87%) phase 2 respondents noted the report accurately reflected the course. Sixty-seven percent of phase 2 respondents agreed that confidential reports provided useful information to inform course design. CONCLUSION The ELAI is a nonburdensome instrument that can facilitate faculty reflection on how aligned learning concepts are applied in a course and provide novel data to assess general learning focus within college courses and within programs. Results indicate ELAI questions can be revised to improve clarity. Additional research comparing ELAI responses from experts, peer educators, and students is recommended.
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105
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Frithioff A, Guldager MJ, Andersen SAW. Current Status of Handheld Otoscopy Training: A Systematic Review. Ann Otol Rhinol Laryngol 2021; 130:1190-1197. [PMID: 33629599 DOI: 10.1177/0003489421997289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Otoscopy is a frequently performed procedure and competency in this skill is important across many specialties. We aim to systematically review current medical educational evidence for training of handheld otoscopy skills. METHODS Following the PRISMA guideline, studies reporting on training and/or assessment of handheld otoscopy were identified searching the following databases: PubMed, Embase, OVID, the Cochrane Library, PloS Medicine, Directory of Open Access Journal (DOAJ), and Web of Science. Two reviewers extracted data on study design, training intervention, educational outcomes, and results. Quality of educational evidence was assessed along with classification according to Kirkpatrick's model of educational outcomes. RESULTS The searches yielded a total of 6064 studies with a final inclusion of 33 studies for the qualitative synthesis. Handheld otoscopy training could be divided into workshops, physical simulators, web-based training/e-learning, and smartphone-enabled otoscopy. Workshops were the most commonly described educational intervention and typically consisted of lectures, hands-on demonstrations, and training on peers. Almost all studies reported a favorable effect on either learner attitude, knowledge, or skills. The educational quality of the studies was reasonable but the educational outcomes were mostly evaluated on the lower Kirkpatrick levels with only a single study determining the effects of training on actual change in the learner behavior. CONCLUSION Overall, it seems that any systematic approach to training of handheld otoscopy is beneficial in training regardless of learner level, but the heterogeneity of the studies makes comparisons between studies difficult and the relative effect sizes of the interventions could not be determined.
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Affiliation(s)
- Andreas Frithioff
- Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark.,Copenhagen Academy for Medical Education and Simulation (CAMES), The Capital Region of Denmark, Copenhagen, Denmark
| | - Mads Juhl Guldager
- Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark
| | - Steven Arild Wuyts Andersen
- Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark.,Copenhagen Academy for Medical Education and Simulation (CAMES), The Capital Region of Denmark, Copenhagen, Denmark.,Department of Otorhinolaryngology, The Ohio State University, Columbus, OH, USA
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106
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Assessing competence in cochlear implant surgery using the newly developed Cochlear Implant Surgery Assessment Tool. Eur Arch Otorhinolaryngol 2021; 279:127-136. [PMID: 33604749 DOI: 10.1007/s00405-021-06632-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/20/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE To develop and gather validity evidence for a novel tool for assessment of cochlear implant (CI) surgery, including virtual reality CI surgery training. METHODS Prospective study gathering validity evidence according to Messick's framework. Four experts developed the CI Surgery Assessment Tool (CISAT). A total of 35 true novices (medical students), trained novices (residents) and CI surgeons performed two CI-procedures each in the Visible Ear Simulator, which were rated by three blinded experts. Classical test theory and generalizability theory were used for reliability analysis. RESULTS The CISAT significantly discriminated between the three groups (p < 0.001). The generalizability coefficient was 0.76 and most of the score variance (53.3%) was attributable to the participant and only 6.8% to the raters. When exploring a standard setting for CI surgery, the contrasting groups method suggested a pass/fail score of 36.0 points (out of 55), but since the trained novices performed above this, we propose using the mean CI surgeon performance score (45.3 points). CONCLUSION Validity evidence for simulation-based assessment of CI performance supports the CISAT. Together with the standard setting, the CISAT might be used to monitor progress in competency-based training of CI surgery and to determine when the trainee can advance to further training.
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107
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van Tetering AAC, Segers MHM, Ntuyo P, Namagambe I, van der Hout-van der Jagt MB, Byamugisha JK, Oei SG. Evaluating the Instructional Design and Effect on Knowledge, Teamwork, and Skills of Technology-Enhanced Simulation-Based Training in Obstetrics in Uganda: Stepped-Wedge Cluster Randomized Trial. JMIR MEDICAL EDUCATION 2021; 7:e17277. [PMID: 33544086 PMCID: PMC8081249 DOI: 10.2196/17277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/07/2020] [Accepted: 06/13/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Simulation-based training is a common strategy for improving the quality of facility-based maternity services and is often evaluated using Kirkpatrick's theoretical model. The results on the Kirkpatrick levels are closely related to the quality of the instructional design of a training program. The instructional design is generally defined as the "set of prescriptions for teaching methods to improve the quality of instruction with a goal of optimizing learning outcomes." OBJECTIVE The aim of this study is to evaluate the instructional design of a technology-enhanced simulation-based training in obstetrics, the reaction of participants, and the effect on knowledge, teamwork, and skills in a low-income country. METHODS A stepped-wedge cluster randomized trial was performed in a university hospital in Kampala, Uganda, with an annual delivery volume of over 31,000. In November 2014, a medical simulation center was installed with a full-body birthing simulator (Noelle S550, Gaumard Scientific), an interactive neonate (Simon S102 Newborn CPR Simulator, Gaumard Scientific), and an audio and video recording system. Twelve local obstetricians were trained and certified as medical simulation trainers. From 2014 to 2016, training was provided to 57 residents in groups of 6 to 9 students. Descriptive statistics were calculated for ten instructional design features of the training course measured by the 42-item ID-SIM (Instructional Design of a Simulation Improved by Monitoring). The Wilcoxon signed rank test was conducted to investigate the differences in scores on knowledge, the Clinical Teamwork Scale, and medical technical skills. RESULTS The mean scores on the ten instructional design features ranged from 54.9 (95% CI 48.5-61.3) to 84.3 (95% CI 80.9-87.6) out of 100. The highest mean score was given on the feature feedback and the lowest scores on repetitive practice and controlled environment. The overall score for the training day was 92.8 out of 100 (95% CI 89.5-96.1). Knowledge improved significantly, with a test score of 63.4% (95% CI 60.7-66.1) before and 78.9% (95% CI 76.8-81.1) after the training (P<.001). The overall score on the 10-point Clinical Teamwork Scale was 6.0 (95% CI 4.4-7.6) before and 5.9 (95% CI 4.5-7.2) after the training (P=.78). Medical technical skills were scored at 55.5% (95% CI 47.2-63.8) before and 65.6% (95% CI 56.5-74.7) after training (P=.08). CONCLUSIONS Most instructional design features of a technology-enhanced simulation-based training in obstetrics in a low-income country were scored high, although intervals were large. The overall score for the training day was high, and knowledge did improve after the training program, but no changes in teamwork and (most) medical technical skills were found. The lowest-scored instructional design features may be improved to achieve further learning aims. TRIAL REGISTRATION ISRCTN Registry ISRCTN98617255; http://www.isrctn.com/ISRCTN98617255. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12884-020-03050-3.
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Affiliation(s)
| | | | - Peter Ntuyo
- Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda
| | - Imelda Namagambe
- Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda
| | - M Beatrijs van der Hout-van der Jagt
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Josaphat K Byamugisha
- Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda
| | - S Guid Oei
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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108
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Terry A, Liu D, Divnic-Resnik T. The impact of an electronic guide on students' self-directed learning in simulation clinic. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:86-99. [PMID: 32777132 DOI: 10.1111/eje.12579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/23/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Simulation training on high-fidelity simulated models have been used to provide a safe and effective training platform for dental students to develop the skills necessary to treat patients. To surpass challenges of traditional pedagogies in simulation training and reinforce self-directed learning, a bespoke computer application, PerioPal, was designed to complement training of dental students in periodontal instrumentation. MATERIALS AND METHODS This study evaluated the impact of PerioPal on a cohort of 92 second-year dental students at an Australian University. During the first semester in 2019, they received traditional simulation periodontal instrumentation training (control semester). In the following semester, PerioPal was implemented as a technological teaching adjunct (intervention semester). Student perceptions of their learning experiences were gathered through a qualitative and quantitative questionnaire. Impact on student performance was evaluated through comparing periodontal instrumental assessment results in control and interventionsemesters. RESULTS With introduction of PerioPal, students perceived that the simulation clinic learning environment, better contributed to the speed at which they learnt new instrumentation as well as being able to self-pace their work. They commented that instructional videos and independent learning were most beneficial. Interestingly, students suggested that PerioPal aided their preparation for theoretical assessments more than their practical assessments. After introduction of PerioPal a minor improvement of average practical assessment marks was observed but could not be statistically confirmed as significant. CONCLUSION Although the computer-supported learning did not lead to improvement of the students' practical performance a positive effect on the student self-paced learning experience and engagement in simulated environment were observed.
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Affiliation(s)
- Andrew Terry
- Discipline of Restorative and Reconstructive Dentistry, Subject Area Periodontics, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Danny Liu
- DVC (Education) Portfolio, The University of Sydney, Sydney, NSW, Australia
| | - Tihana Divnic-Resnik
- Discipline of Restorative and Reconstructive Dentistry, Subject Area Periodontics, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
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Melnyk R, Campbell T, Holler T, Cameron K, Saba P, Witthaus MW, Joseph J, Ghazi A. See Like an Expert: Gaze-Augmented Training Enhances Skill Acquisition in a Virtual Reality Robotic Suturing Task. J Endourol 2021; 35:376-382. [PMID: 32967467 DOI: 10.1089/end.2020.0445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Introduction: The da Vinci Skills Simulator (DVSS) is an effective platform for robotic skills training. Novel training methods using expert gaze patterns to guide trainees have demonstrated superiority to traditional instruction. Portable head-mounted eye-trackers (HMET) offer the opportunity for eye tracking technology to enhance surgical robotic simulation training. Objective: To evaluate if training guided by expert gaze patterns can improve trainee performance over standard movement training techniques during robotic simulation. Methods: Medical students were recruited and randomized into gaze training (GT, n = 9) and movement training (MT, n = 8) groups. First, the participants reviewed an instructional video, with the GT group emulating expert gaze patterns and the MT group (n = 8) standard movement-based instruction. Training consisted of 10 repetitions of "Suture Sponge 3" on the DVSS while wearing HMET; the first three repetitions were followed by group-appropriate video coaching (gaze vs movement feedback), while the remaining repetitions were without feedback. Finally, two multitasking repetitions with a secondary bell-counting task were completed. Primary outcomes included DVSS scores during training and multitasking. Secondary outcomes included metrics collected from the HMET (gaze patterns and gaze entropy). Results: Total score, efficiency, and penalties improved significantly over the training in both groups; the GT group achieved higher scores on every attempt. Total scores in the GT group were higher than the MT group postvideo review (20.3 ± 21.8 vs 3.0 ± 6.2, p = 0.047), after coaching repetitions (61.8 ± 18.8 vs 30.1 ± 26.2, p = 0.01), and at the last training attempt (73.0 ± 16.5 vs 63.1 ± 17.4, p = 0.247). During multitasking, the GT group maintained higher total scores (75 ± 10.1 vs 63.3 ± 15.3, p = 0.01), efficiency (86.3 ± 7.4 vs 77.4 ± 11.2, p = 0.009), and superior secondary task performance (error: 6.3% ± 0.06 vs 10.7% ± 0.11, p = 0.20). Gaze entropy (cognitive-load indicator) and gaze pattern analysis showed similar trends. Conclusion: Gaze-augmented training leads to more efficient movements through adoption of expert gaze patterns that withstand additional stressors.
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Affiliation(s)
- Rachel Melnyk
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Timothy Campbell
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.,Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Tyler Holler
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Katherine Cameron
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Patrick Saba
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Michael W Witthaus
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.,Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jean Joseph
- Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Ahmed Ghazi
- Simulation Innovation Laboratory, Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.,Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
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Kraiger K, Ford JK. The Science of Workplace Instruction: Learning and Development Applied to Work. ANNUAL REVIEW OF ORGANIZATIONAL PSYCHOLOGY AND ORGANIZATIONAL BEHAVIOR 2021. [DOI: 10.1146/annurev-orgpsych-012420-060109] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Learning is the engagement in mental processes resulting in the acquisition and retention of knowledge, skills, and/or affect over time and applied when needed. Building on this definition, we integrate the science of training and the science of learning to propose a new science of workplace instruction, linking the design of instructional events to instructional outcomes such as transfer and job performance through the mediating effects of learner events and learning outcomes. We propose three foundational elements: the learner, instructional principles, and training delivery (methods and media). Understanding and applying instructional principles are the primary methods for enhancing training effectiveness; thus, we detail 15 empirically supported principles. We then discuss the erroneous pursuit of aptitude-by-treatment interactions under the guise of learner styles and age-specific instruction. Finally, we offer suggestions for future research that draw on the foundation of instructional principles to optimize self-directed learning and learning in synthetic learning environments.
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Affiliation(s)
- Kurt Kraiger
- Department of Management, University of Memphis, Memphis, Tennessee 38152, USA
| | - J. Kevin Ford
- Department of Psychology, Michigan State University, East Lansing, Michigan 48824, USA
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111
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Raison N, Harrison P, Abe T, Aydin A, Ahmed K, Dasgupta P. Procedural virtual reality simulation training for robotic surgery: a randomised controlled trial. Surg Endosc 2021; 35:6897-6902. [PMID: 33398587 PMCID: PMC8599326 DOI: 10.1007/s00464-020-08197-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022]
Abstract
Background Virtual reality (VR) training is widely used for surgical training, supported by comprehensive, high-quality validation. Technological advances have enabled the development of procedural-based VR training. This study assesses the effectiveness of procedural VR compared to basic skills VR in minimally invasive surgery. Methods 26 novice participants were randomised to either procedural VR (n = 13) or basic VR simulation (n = 13). Both cohorts completed a structured training programme. Simulator metric data were used to plot learning curves. All participants then performed parts of a robotic radical prostatectomy (RARP) on a fresh frozen cadaver. Performances were compared against a cohort of 9 control participants without any training experience. Performances were video recorded and assessed blindly using GEARS post hoc. Results Learning curve analysis demonstrated improvements in technical skill for both training modalities although procedural training was associated with greater training effects. Any VR training resulted in significantly higher GEARS scores than no training (GEARS score 11.3 ± 0.58 vs. 8.8 ± 2.9, p = 0.002). Procedural VR training was found to be more effective than both basic VR training and no training (GEARS 11.9 ± 2.9 vs. 10.7 ± 2.8 vs. 8.8 ± 1.4, respectively, p = 0.03). Conclusions This trial has shown that a structured programme of procedural VR simulation is effective for robotic training with technical skills successfully transferred to a clinical task in cadavers. Further work to evaluate the role of procedural-based VR for more advanced surgical skills training is required. Electronic supplementary material The online version of this article (10.1007/s00464-020-08197-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicholas Raison
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, Guy's Hospital, 5th Floor Tower Wing, London, SE1 9RT, UK.
| | - Patrick Harrison
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, Guy's Hospital, 5th Floor Tower Wing, London, SE1 9RT, UK
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Abdullatif Aydin
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, Guy's Hospital, 5th Floor Tower Wing, London, SE1 9RT, UK
| | - Kamran Ahmed
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, Guy's Hospital, 5th Floor Tower Wing, London, SE1 9RT, UK
| | - Prokar Dasgupta
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, Guy's Hospital, 5th Floor Tower Wing, London, SE1 9RT, UK
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Schroedl CJ, Frogameni A, Barsuk JH, Cohen ER, Sivarajan L, Wayne DB. Impact of Simulation-based Mastery Learning on Resident Skill Managing Mechanical Ventilators. ATS Sch 2020; 2:34-48. [PMID: 33870322 PMCID: PMC8043263 DOI: 10.34197/ats-scholar.2020-0023oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Caring for patients requiring mechanical ventilation is complex, and residents may lack adequate skill for managing these patients. Simulation-based mastery learning (SBML) is an educational model that trains clinicians to a high standard and can reduce complications. The mastery learning model has not been applied to ventilator management. Objective: The purpose of this study was to determine whether SBML, as compared with traditional training, is an effective strategy for teaching residents the skills necessary to manage patients requiring mechanical ventilation. Methods: We developed an SBML curriculum and a 47-item skills checklist to test ventilator management for patients with normal, restricted, and obstructed lung physiology. A minimum passing standard (MPS) on the checklist was set using the Mastery Angoff method. Residents rotating through the medical intensive care unit in Academic Year 2017-2018 were assigned to SBML or traditional training based on their medical intensive care unit team. The SBML group was pretested on a ventilator simulator using the skills checklist. They then received a 1.5-hour session (45 min didactic and 45 min deliberate practice on the simulator with feedback). At rotation completion, they were posttested on the simulator using the checklist until the MPS was met. Both SBML-trained and traditionally trained groups received teaching during daily bedside rounds and twice weekly didactic lectures. At rotation completion, traditionally trained residents were tested using the same skills checklist on the simulator. We compared pretest and posttest performance among SBML-trained residents and end of the rotation test performances between the SBML-trained and traditionally trained residents. Results: The MPS was set at 87% on the checklist. Fifty-seven residents were assigned to the SBML-trained group and 49 were assigned to the traditionally trained group. Mean checklist scores for SBML-trained residents improved from 51.4% (standard deviation [SD] = 17.5%) at pretest to 86.1% (SD = 7.6%) at initial posttest and 92.5% (SD = 3.7%) at final (mastery) posttest (both P < 0.001). Forty-two percent of residents required more than one attempt at the posttest to meet or exceed the MPS. At rotation completion, the traditionally trained residents had a mean test score of 60.9% (SD = 13.3%). Conclusion: SBML is an effective strategy to train residents on mechanical ventilator management. An SBML curriculum may augment traditional training methods to further equip residents to safely manage ventilated patients.
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Affiliation(s)
- Clara J. Schroedl
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alexandra Frogameni
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeffrey H. Barsuk
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elaine R. Cohen
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lakshmi Sivarajan
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Diane B. Wayne
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Evaluation of 3 Cognitive Load Measures During Repeated Simulation Exercises for Novice Anesthesiology Residents. Simul Healthc 2020; 15:388-396. [PMID: 33269900 DOI: 10.1097/sih.0000000000000458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Maintaining an appropriate level of cognitive load during simulations is crucial to optimize learning. We evaluated 3 subjective measures of cognitive load in a simulated operating room (OR) context across multiple scenarios of varying complexity. METHODS This observational study of 25 first-year anesthesiology residents took place during a 5-day simulation "Boot Camp." Each day, participants completed 2 different high-fidelity scenarios in a fully equipped simulated OR. After each simulation, participants completed 3 cognitive load measures: the Paas scale, NASA Task Load Index (TLX), and Cognitive Load Component (CLC) questionnaire. Two-way repeated-measures and mixed-design analyses of variance, with the cognitive load measures and scenarios as independent factors, were used to determine the effect of using different measures to report cognitive load. RESULTS Cognitive load scores reported by all measures correlated significantly with one another (P < 0.01): TLX and Paas (r = 0.65); Paas and CLC (r = 0.63); and TLX and CLC (r = 0.61). The CLC subscale scores (intrinsic, extraneous, germane) also correlated significantly with composite TLX and Paas scores (P < 0.01). Scenarios and measures displayed significant interaction: F(10, 210) = 3.01, P = 0.001. Participants reported highest overall cognitive load using the Paas scale. CONCLUSIONS All cognitive load measures were sensitive to scenario variability and showed similar fluctuation patterns across the 10 scenarios. The findings suggest that cognitive load measures can help create benchmarks based on learner perceptions of cognitive burden for different simulation scenarios.
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Effects of a Simulation With Team-Based Learning on Knowledge, Team Performance, and Teamwork for Nursing Students. Comput Inform Nurs 2020; 38:367-372. [PMID: 32349024 DOI: 10.1097/cin.0000000000000628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Simulation and team-based learning are reported as useful strategies in nursing education. However, empirical evidence on the effects of participating in an integrated course of team-based learning and simulation is limited. The aim of this study was to identify the effects of a nursing simulation program with team-based learning on knowledge, team performance, and teamwork among Korean nursing students. A one-group pretest-posttest design was used. Fourth-year students (N = 229) participated in a 32-hour nursing simulation program with team-based learning. Each of the three sessions of the program involved a 3-hour task training with video-assisted learning and skills performance assessment, 1-hour team-based learning, and 4-hour simulation session with a high-fidelity simulator. In addition to the knowledge test and performance assessment, participants completed a self-administered questionnaire on teamwork. Participants achieved higher scores in the Group Readiness Assurance Test than they did in the Individual Readiness Assurance Test. The posttest scores on team performance and teamwork were significantly higher than their pretest scores. The simulation with team-based learning induced favorable effects on participants' knowledge, performance, and teamwork. A curricular integration of simulation program with team-based learning is consistent with achieving outcomes-based learning in nursing education.
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115
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Celi J, Fehlmann CA, Rutschmann OT, Pelieu-Lamps I, Fournier R, Nendaz M, Sarasin F, Rouyer F. Learning process of ultrasound-guided Ilio-fascial compartment block on a simulator: a feasibility study. Int J Emerg Med 2020; 13:57. [PMID: 33256593 PMCID: PMC7706061 DOI: 10.1186/s12245-020-00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/16/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promote EP to use this procedure. The goal of this study was to assess the feasibility of a training concept for non-anesthesiologists for the US-FICB on a simulator based on a validating learning path. METHOD This was a feasibility study. Emergency physicians and medical students received a 1-day training with a learning phase (theoretical and practical skills), followed by an assessment phase. The primary outcome at the assessment phase was the number of attempts before successfully completing the procedure. The secondary outcomes were the success rate at first attempt, the length of procedure (LOP), and the stability of the probe, corresponding to the visualization of the needle tip (and its tracking) throughout the procedure, evaluated on a Likert scale. RESULTS A total of 25 participants were included. The median number of attempts was 2.0 for emergency physicians and 2.5 for medical students, and this difference was not significant (p = 0.140). Seven participants (28%) succeeded at the first attempt of the procedure; the difference between emergency physicians and medical students was not significant (37% versus 21%; p = 0.409). The average LOP was 19.7 min with a significant difference between emergency physicians and medical students (p = 0.001). There was no significant difference regarding the stability of the probe between the two groups. CONCLUSION Our 1-day training for non-anesthesiologists with or without previous skills in ultrasound seems to be feasible for learning the US-FICB procedure on a simulator.
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Affiliation(s)
- Julien Celi
- Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland.
| | - Christophe A Fehlmann
- Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland
| | - Olivier T Rutschmann
- Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland
| | - Iris Pelieu-Lamps
- Anesthesiology Unit, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Roxane Fournier
- Anesthesiology Unit, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Mathieu Nendaz
- Unit of Development and Research in Medical Education, Faculty of Medicine, and Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - François Sarasin
- Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland
| | - Frédéric Rouyer
- Emergency Unit, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 2, CH-1205, Geneva, Switzerland
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Martin A, Cross S, Attoe C. The Use of in situ Simulation in Healthcare Education: Current Perspectives. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:893-903. [PMID: 33273877 PMCID: PMC7707431 DOI: 10.2147/amep.s188258] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/10/2020] [Indexed: 06/01/2023]
Abstract
In situ simulation is the practice of using simulated scenarios in a clinical environment itself rather than in training facilities to promote learning and improved clinical care. The use of in situ simulation has been increasingly used to train healthcare staff in dealing with emergencies, resuscitation and clinical skills. The aim of this study is to provide an overview of the themes, perspectives and approaches to in situ simulation for educational purposes with healthcare staff. The literature search included studies describing and evaluating in situ simulations with an educational component. We carried out a narrative synthesis and extracted data on the clinical setting, the simulation purpose, design, evaluation method and impact. In situ simulation has proved useful in a range of different specialties for skills improvement and team development. Simulation design ranges in terms of fidelity, duration and topic. No specific design has shown to be the most efficient. However, adopting a design that fits into the specific centers resources, educational needs and clinical demands is the most important consideration.
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Affiliation(s)
- Anastasia Martin
- Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Sean Cross
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| | - Chris Attoe
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
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117
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Vestbøstad M, Karlgren K, Olsen NR. Research on simulation in radiography education: a scoping review protocol. Syst Rev 2020; 9:263. [PMID: 33220713 PMCID: PMC7680590 DOI: 10.1186/s13643-020-01531-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Today, there are fewer opportunities for health care students and staff for skills training through direct patient contact. The World Health Organization therefore recommends learning about patient safety through hands-on experience and simulation. Simulation has the potential to improve skills through training in a controlled environment, and simulation has a positive effect on knowledge and skills, and even patient-related outcomes. Reviews addressing the use of simulation across the different radiography specialties are lacking. Further knowledge on simulation in radiography education is needed to inform curriculum design and future research. The purpose of this scoping review is to explore, map, and summarize the extent, range, and nature of published research on simulation in radiography education. METHODS We will follow the methodological framework for scoping reviews originally described by Arksey and O'Malley. We will search the MEDLINE, Embase, Epistemonikos, The Cochrane Library, ERIC, Scopus, and sources of grey literature. A comprehensive search strategy for Ovid MEDLINE was developed in collaboration with a research librarian. An example of a full electronic search from the Ovid MEDLINE (1641 articles records, January 9, 2020) is provided and will be used to adapt the search strategy to each database. Two independent review authors will screen all abstracts and titles, and full-text publications during a second stage. Next, they will extract data from each included study using a data extraction form informed by the aim of the study. A narrative account of all studies included will be presented. We will present a simple numerical analysis related to the extent, nature, and distribution of studies, and we will use content analysis to map the different simulation interventions and learning design elements reported. Any type of simulation intervention within all types of radiography specializations will be included. Our search strategy is not limited by language or date of publication. DISCUSSION An overview of publications on simulation in radiography education across all radiography specialties will help to inform future research and will be useful for stakeholders within radiography education using simulation, both in the academic and clinical settings. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (OSF). Submitted on October 18, 2020.
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Affiliation(s)
- Mona Vestbøstad
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | - Klas Karlgren
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
- The Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
- The Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Nina Rydland Olsen
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
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Cook DA, Oh SY, Pusic MV. Accuracy of Physicians' Electrocardiogram Interpretations: A Systematic Review and Meta-analysis. JAMA Intern Med 2020; 180:1461-1471. [PMID: 32986084 PMCID: PMC7522782 DOI: 10.1001/jamainternmed.2020.3989] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE The electrocardiogram (ECG) is the most common cardiovascular diagnostic test. Physicians' skill in ECG interpretation is incompletely understood. OBJECTIVES To identify and summarize published research on the accuracy of physicians' ECG interpretations. DATA SOURCES A search of PubMed/MEDLINE, Embase, Cochrane CENTRAL (Central Register of Controlled Trials), PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), ERIC (Education Resources Information Center), and Web of Science was conducted for articles published from database inception to February 21, 2020. STUDY SELECTION Of 1138 articles initially identified, 78 studies that assessed the accuracy of physicians' or medical students' ECG interpretations in a test setting were selected. DATA EXTRACTION AND SYNTHESIS Data on study purpose, participants, assessment features, and outcomes were abstracted, and methodological quality was appraised with the Medical Education Research Study Quality Instrument. Results were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES Accuracy of ECG interpretation. RESULTS Of 1138 studies initially identified, 78 assessed the accuracy of ECG interpretation. Across all training levels, the median accuracy was 54% (interquartile range [IQR], 40%-66%; n = 62 studies) on pretraining assessments and 67% (IQR, 55%-77%; n = 47 studies) on posttraining assessments. Accuracy varied widely across studies. The pooled accuracy for pretraining assessments was 42.0% (95% CI, 34.3%-49.6%; n = 24 studies; I2 = 99%) for medical students, 55.8% (95% CI, 48.1%-63.6%; n = 37 studies; I2 = 96%) for residents, 68.5% (95% CI, 57.6%-79.5%; n = 10 studies; I2 = 86%) for practicing physicians, and 74.9% (95% CI, 63.2%-86.7%; n = 8 studies; I2 = 22%) for cardiologists. CONCLUSIONS AND RELEVANCE Physicians at all training levels had deficiencies in ECG interpretation, even after educational interventions. Improved education across the practice continuum appears warranted. Wide variation in outcomes could reflect real differences in training or skill or differences in assessment design.
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Affiliation(s)
- David A Cook
- Office of Applied Scholarship and Education Science and Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - So-Young Oh
- Institute for Innovations in Medical Education, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Martin V Pusic
- Department of Emergency Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
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119
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Simulation Research Rubric: Further Analysis of Published Simulation Studies and Future Implications. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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120
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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121
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Ferguson J, Astbury J, Willis S, Silverthorne J, Schafheutle E. Implementing, embedding and sustaining simulation-based education: What helps, what hinders. MEDICAL EDUCATION 2020; 54:915-924. [PMID: 32306437 DOI: 10.1111/medu.14182] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/30/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Although there is much evidence to support the use of simulation-based education (SBE) in undergraduate education of health care professionals, less attention has been paid to how SBE, viewed as a complex intervention, is implemented and becomes embedded and sustained. This paper aims to explore factors that inhibited or promoted SBE becoming normal practice in undergraduate health care professional programmes. METHODS Participants involved in the organisation, design and delivery of SBE in the north of England were recruited purposefully from higher education institutions (HEI) and National Health Service (NHS) Trusts through local networks for qualitative telephone interviews. Transcripts were analysed inductively using a hybrid approach involving simultaneous inductive open coding and deductive coding using normalisation process theory (NPT) as a theoretical lens. FINDINGS A total of 12 NHS staff from 11 trusts and seven individuals from four HEIs were interviewed. There was considerable variation in the approach taken to implementation across organisations, which resulted in varying degrees of embeddedness. Implementation was challenged or enabled by organisational leadership, professional buy-in and the development and maturity of the strategic approach. Variation in understanding of the scope and pedagogical aims of SBE led to inequity between professions and organisations in investment and participation, as well as design and delivery of SBE. CONCLUSIONS Given the complexity of SBE, best practice in implementation should be considered fundamental to the successful delivery of SBE. The findings provide an explanation of how contextual factors can support or hinder implementation to maximise potential benefits and learning outcomes; this understanding can be used to better inform development of SBE strategies and highlight potential factors needed to navigate contextual barriers so that learning outcomes can be maximised.
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Affiliation(s)
- Jane Ferguson
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jayne Astbury
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Sarah Willis
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Ellen Schafheutle
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
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Robinson T, Santorino D, Dube M, Twine M, Najjuma JN, Cherop M, Kyakwera C, Brenner J, Singhal N, Bajunirwe F, Wishart I, Lin Y, Lorentzen H, Lutnæs DE, Cheng A. Sim for Life: Foundations-A Simulation Educator Training Course to Improve Debriefing Quality in a Low Resource Setting: A Pilot Study. Simul Healthc 2020; 15:326-334. [PMID: 33003188 DOI: 10.1097/sih.0000000000000445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Despite the importance of debriefing, little is known about the effectiveness of training programs designed to teach debriefing skills. In this study, we evaluated the effectiveness of a faculty development program for new simulation educators at Mbarara University of Science and Technology in Uganda, Africa. METHODS Healthcare professionals were recruited to attend a 2-day simulation educator faculty development course (Sim for Life: Foundations), covering principles of scenario design, scenario execution, prebriefing, and debriefing. Debriefing strategies were contextualized to local culture and focused on debriefing structure, conversational strategies, and learner centeredness. A debriefing worksheet was used to support debriefing practice. Trained simulation educators taught simulation sessions for 12 months. Debriefings were videotaped before and after initial training and before and after 1-day refresher training at 12 months. The quality of debriefing was measured at each time point using the Objective Structured Assessment of Debriefing (OSAD) tool by trained, calibrated, and blinded raters. RESULTS A total of 13 participants were recruited to the study. The mean (95% confidence interval) OSAD scores pretraining, posttraining, and at 12 months before and after refresher were 18.2 (14.3-22.1), 26.7 (22.8-30.6), 25.5 (21.2-29.9), and 27.0 (22.4-31.6), respectively. There was a significant improvement from pretraining to posttraining (P < 0.001), with no significant decay from posttraining to 12 months (P = 0.54). There was no significant difference in OSAD scores pre- versus post-refresher training at 12 months (P = 0.49). CONCLUSIONS The Sim for Life Foundations program significantly improves debriefing skills with retention of debriefing skills at 12 months.
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Affiliation(s)
- Traci Robinson
- From the Department of Pediatrics (J.B., N.S., A.C.), Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada, Global Health Unit (T.R.), University of Calgary, Calgary, Alberta, Canada; Mbarara University of Science and Technology (D.S., M.T., J.N.N., M.C., C.K., F.B.), Mbarara, Uganda; eSIM Provincial Program (M.D.), Alberta Health Services; Department of Emergency Medicine (I.W.), University of Calgary; KidSIM Simulation Program (Y.L.), Alberta Children's Hospital, Calgary, Alberta, Canada; Operations Training, Oceaneering (H.L.), Sandnes; Formerly of: SAFER (D.E.L.); and The Norwegian Healthcare Investigation Board (D.E.L.), Stavanger, Norway
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Radkowitsch A, Fischer MR, Schmidmaier R, Fischer F. Learning to diagnose collaboratively: validating a simulation for medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc51. [PMID: 32984510 PMCID: PMC7499460 DOI: 10.3205/zma001344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 04/24/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Physicians with different professional backgrounds often diagnose a patients' problem collaboratively. In this article, we first introduce a process model for collaborative diagnosing (CDR model), describe the development of a simulation used to empirically examine the facilitation of collaborative diagnostic reasoning. Based on a contemporary validity framework [1], we further suggest indicators for validity and collect initial evidence with respect to the scoring, generalization, extrapolation, and implication inferences to assess the validity of the simulation when used to assess effects of learning interventions. Method: In a quasi-experimental study, we assessed objectivity and reliability of the simulation and compared medical students with low and advanced prior knowledge to practitioners with high prior knowledge with respect to their diagnostic accuracy, diagnostic efficiency, information sharing skills, and their intrinsic cognitive load. Additionally, we obtained authenticity ratings from practitioners with high prior knowledge. Results: The results yielded satisfying initial evidence for the validity of the scoring and the extrapolation inferences as ratings are objective, and the simulation and the collaborative process is perceived as rather authentic. Additionally, participants on different levels of prior knowledge differ with respect to their diagnostic accuracy, diagnostic efficiency, information sharing skills, and their reported intrinsic cognitive load. With one exception (information sharing skills), the generalization inference seems to be valid as well. Conclusions: We conclude that collecting validity evidence for the simulation was an important step towards a better interpretation of the simulation. We found that the simulation is an authentic and valid representation of the chosen collaborative situation and that the collected validity evidence offers sufficient evidence for an initial validation of the simulation. Nevertheless, the validation process highlighted some important gaps that need further consideration. We further conclude that applying a validation model to the context of empirical research is promising and encourage other researchers to follow the example.
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Affiliation(s)
- Anika Radkowitsch
- Ludwig-Maximilians-Universität München, Munich Center of the Learning Sciences, München, Germany
- Ludwig-Maximilians-Universität München, Lehrstuhl für Empirische Pädagogik, Department Psychologie, München, Germany
| | - Martin R. Fischer
- Ludwig-Maximilians-Universität München, Munich Center of the Learning Sciences, München, Germany
- Ludwig-Maximilians-Universität München, LMU Klinikum, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
| | - Ralf Schmidmaier
- Ludwig-Maximilians-Universität München, Munich Center of the Learning Sciences, München, Germany
- Ludwig-Maximilians-Universität München, LMU Klinikum, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Frank Fischer
- Ludwig-Maximilians-Universität München, Munich Center of the Learning Sciences, München, Germany
- Ludwig-Maximilians-Universität München, Lehrstuhl für Empirische Pädagogik, Department Psychologie, München, Germany
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Evaluation of a 3-Dimensional-Printed Head Simulation Technique for Teaching Flexible Nasopharyngoscopy to Radiation Oncology Residents. Int J Radiat Oncol Biol Phys 2020; 109:317-323. [PMID: 32891794 PMCID: PMC7471799 DOI: 10.1016/j.ijrobp.2020.08.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 12/25/2022]
Abstract
Purpose Simulation-based medical education is an effective tool for medical teaching, but simulation-based medical education deployment in radiation oncology (RO) is limited. Flexible nasopharyngoscopy (FNP), an essential skill for RO residents, requires practice that typically occurs on volunteer patients, introducing the potential for stress and discomfort. We sought to develop a high-fidelity simulator and intervention that provides RO residents the opportunity to develop FNP skills in a low-pressure environment. Methods and Materials Computed tomography images were used to create an anatomically accurate 3-dimensional–printed model of the head and neck region. An intervention incorporating didactic instruction, multimedia content, and FNP practice on the model was designed and administered to RO residents attending the Anatomy and Radiology Contouring Bootcamp. Participants completed pre- and postintervention evaluations of the training session and model fidelity, and self-assessments of FNP skill and confidence performing FNP. Participants were video recorded performing FNP pre- and postintervention. Videos were scored by a blinded observer on a predefined rubric. Changes in scores were evaluated using the Wilcoxon signed-rank test. Results Twenty-four participants from 17 institutions and 4 countries completed the intervention, 50% were women, and most were senior residents. Postintervention, FNP confidence and FNP performance improved significantly (mean ± standard deviation on a 10-point scale: 1.8 ± 1.8, P < .001; 2.2 ± 2.0, P < .001, respectively). Participants felt the model was helpful (mean ± standard deviation on a 5-point scale: 4.2 ± 0.6), anatomically correct (4.1 ± 0.9), and aided in spatial comprehension (4.3 ± 0.8). Overall satisfaction for the intervention was high (4.3 ± 0.8). Participants strongly agreed the intervention should be integrated into RO training programs (4.3 ± 0.8). Conclusions A 3-dimensional–printed model and associated intervention were effective at improving FNP performance and the teaching method was rated highly by participants. RO residents may benefit from broader dissemination of this technique to improve trainee performance.
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van Tetering AAC, Fransen AF, van der Hout-van der Jagt MB, Oei SG. The use of a stronger instructional design by implementing repetitive practice in simulation-based obstetric team training: trainees’ satisfaction. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:284-288. [DOI: 10.1136/bmjstel-2019-000434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 11/03/2022]
Abstract
ObjectiveThis study compares satisfaction levels from multiprofessional obstetric care teams about simulation-based obstetric team training courses with and without the instructional design feature repetitive practice.MethodsThe present study is part of a multicentre cluster-randomised controlled trial (TOSTI trial) that investigated the effectiveness of a 1 day, multiprofessional, simulation-based obstetric team training. The initial training group received a training which was designed based on best practice. After 1 year, the control group received a training course in which the instructional design was changed by providing repetitive practice. All participants were asked to fill in a 29-item evaluation form with seven questions about baseline characteristics and 22 questions about training features. The questions about training features could be rated on a scale of 1 to 5. Finally, all participants were asked to rate the total training day on a scale of 1–10.ResultsThe best practice group consisted of 471 trainees and the repetitive practice group of 549, including gynaecologists, residents, midwives and nurses. The best practice group rated the total training day significantly higher than the repetitive practice group (mean 8.8, SD 0.6 and mean 8.7, SD 0.6; p<0.003, Cohen’s d=0.19). Several training features were also scored higher in the best practice group.ConclusionThis study showed that obstetric healthcare professionals rated a simulation-based obstetric team training course, with and without repetition of scenarios, both high. The training without the repetitive elements gained higher scores for the total training dayand several, and several training features were scored higher. The difference between the mean scores and the effect sizes for the training features were small. This implies that repetitive practice can be integrated in simulation-based team training to optimise learning effects, with small effects on trainees satisfaction.
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Buijs-Spanjers KR, Harmsen A, Hegge HH, Spook JE, de Rooij SE, Jaarsma DADC. The influence of a serious game's narrative on students' attitudes and learning experiences regarding delirium: an interview study. BMC MEDICAL EDUCATION 2020; 20:289. [PMID: 32873285 PMCID: PMC7465326 DOI: 10.1186/s12909-020-02210-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/25/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Delirium is a neuropsychiatric syndrome that affects patients' attention and awareness as a result of a physical condition. In recent years, persistent gaps in delirium education have led to suboptimal delirium care. Still, little is known about what are the most important aspects of effective delirium education. Serious games are both entertainment and an interactive, safe learning environment where players can experiment and create new knowledge. They have the potential to contribute to improved delirium education. We used a video-based serious games' narrative to explore aspects essential to enhance students' attitudes and learning experiences regarding delirium. METHODS We created a semi-structured interview guide and interviewed seven nursing and nine medical students about their attitudes and learning experiences, after they had played the game. A qualitative descriptive design and inductive content analysis with constant comparison were used. RESULTS The patient's and nurse's perspective, interactivity to experiment, realistic views on care options, and feedback on care actions were important for enhancing students' attitudes and learning experiences regarding delirium. Students felt these aspects encouraged them to get actively involved in and experiment with the study material, which in turn led to enhanced reflection on delirium care and education. Our findings highlight the importance of a more patient-oriented focus to delirium education to drive attitudinal change. Students' learning experiences were further enhanced through their affective responses provoked by the perspectives, interactivity, realism, and feedback. CONCLUSIONS Students considered the characters' perspectives, interactivity, realism, and feedback important aspects of the game to enhance their attitudes towards delirious patients and enrich their learning experiences. A patient-oriented narrative provides a clinically relevant experience in which reflection plays an important role. The serious game also serves as medium to actively experiment with care solutions to create better understanding of how healthcare professionals can influence a delirious patient's experience.
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Affiliation(s)
- Kiki R Buijs-Spanjers
- Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, HPC: AA43, Groningen, 9700 RB, The Netherlands.
- Center for Education Development and Research in Health Professions, LEARN, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Anne Harmsen
- Strategic Communication Group, Wageningen University, Wageningen, The Netherlands
| | - Harianne H Hegge
- Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, HPC: AA43, Groningen, 9700 RB, The Netherlands
- Center for Education Development and Research in Health Professions, LEARN, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jorinde E Spook
- Strategic Communication Group, Wageningen University, Wageningen, The Netherlands
| | - Sophia E de Rooij
- Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, HPC: AA43, Groningen, 9700 RB, The Netherlands
- Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands
| | - Debbie A D C Jaarsma
- Center for Education Development and Research in Health Professions, LEARN, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Mackenzie CF, Elster EA, Bowyer MW, Sevdalis N. Scoping Evidence Review on Training and Skills Assessment for Open Emergency Surgery. JOURNAL OF SURGICAL EDUCATION 2020; 77:1211-1226. [PMID: 32224033 DOI: 10.1016/j.jsurg.2020.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Scope evidence on technical performance metrics for open emergency surgery. Identify surgical performance metrics and procedures used in trauma training courses. DESIGN Structured literature searches of electronic databases were conducted from January 2010 to December 2019 to identify systematic reviews of tools to measure surgical skills employed in vascular or trauma surgery evaluation and training. SETTING AND PARTICIPANTS Faculty of Shock Trauma Anesthesiology Research Center, University of Maryland School of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland and Implementation Science, King's College, London. RESULTS The evidence from 21 systematic reviews including over 54,000 subjects enrolled into over 840 eligible studies, identified that the Objective Structured Assessment of Technical Skill was used for elective surgery not for emergency trauma and vascular control surgery procedures. The Individual Procedure Score (IPS), used to evaluate emergency trauma procedures performed before and after training, distinguished performance of residents from experts and practicing surgeons. IPS predicted surgeons who make critical errors and need remediation interventions. No metrics showed Kirkpatrick's Level 4 evidence of technical skills training benefit to emergency surgery outcomes. CONCLUSIONS Expert benchmarks, errors, complication rates, task completion time, task-specific checklists, global rating scales, Objective Structured Assessment of Technical Skills, and IPS were found to identify surgeons, at all levels of seniority, who are in need of remediation of technical skills for open surgical hemorrhage control. Large-scale, multicenter studies are needed to evaluate any benefit of trauma technical skills training on patient outcomes.
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Affiliation(s)
| | - Eric A Elster
- The Uniformed Services University of Health Sciences and the Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Mark W Bowyer
- The Uniformed Services University of Health Sciences and the Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Nick Sevdalis
- Center for Implementation Science, King's College, London, United Kingdom
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Developing facilitator competence in scenario-based medical simulation: Presentation and evaluation of a train the trainer course in Bergen, Norway. Nurse Educ Pract 2020; 47:102840. [DOI: 10.1016/j.nepr.2020.102840] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/07/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022]
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Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. MEDICAL EDUCATION 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
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Salem S, Cooper J, Schneider J, Croft H, Munro I. Student Acceptance of Using Augmented Reality Applications for Learning in Pharmacy: A Pilot Study. PHARMACY 2020; 8:pharmacy8030122. [PMID: 32708150 PMCID: PMC7560130 DOI: 10.3390/pharmacy8030122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 12/30/2022] Open
Abstract
Creating engaging learning experiences that are easy to use and support the different learning requirements of university students is challenging. However, improvements in simulation technologies, such as augmented reality (AR) and virtual reality (VR), are making such changes possible. The aim of this study is to use a mobile-based AR technology to develop an interactive learning module about contraceptive devices and medicines and to measure its acceptability and usability by undergraduate pharmacy students. The learning module comprising AR images of contraceptive medicines, case studies relating to their use and a series of directed questions was completed by 33 pharmacy students. Students answered a survey to collect information about the usability and acceptability of AR for learning. The results show that the majority of students reported that AR is a useful resource for learning about medicines compared to more traditional methods, such as didactic lectures and tutorials. Students indicated that the AR application was easy to use and improved their knowledge of medicines. These findings suggest that AR technology is a useful tool to create engaging and easy to use learning experiences for university students.
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Mileder LP, Schüttengruber G, Prattes J, Wegscheider T. Simulation-based training and assessment of mobile pre-hospital SARS-CoV-2 diagnostic teams in Styria, Austria. Medicine (Baltimore) 2020; 99:e21081. [PMID: 32702851 PMCID: PMC7373634 DOI: 10.1097/md.0000000000021081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The World Health Organization has declared coronavirus disease 2019 (COVID-19) a pandemic. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the diagnostic gold standard of COVID-19. We have developed a simulation-based training program for mobile prehospital diagnostic teams in the province of Styria, Austria, and performed a prospective observational study on its applicability and effectivity.The 1-day curriculum uses theoretical instruction, technical skills training, and simulator-based algorithm training to teach and train prehospital patient identification and communication, donning the personal protective equipment, collection of naso-/oropharyngeal swabs for SARS-CoV-2 polymerase chain reaction testing, doffing the personal protective equipment, and sample logistics. Trainings were conducted at the SIM CAMPUS simulation hospital, Eisenerz, using high-fidelity patient simulation. To ensure achievement of predefined learning outcomes, participants had to undergo a final simulator-based objective structured clinical examination.In March 2020, 45 emergency medical assistants and 1 physician of the Austrian Red Cross participated on a voluntary basis. Forty-five of the 46 participants (97.8%) completed the curriculum successfully, with mean objective structured clinical examination ratings of 98.6%.Using several proven educational concepts, we have successfully drafted and implemented a training program for mobile prehospital SARS-CoV-2 diagnostic teams. Based on simulation-based objective structured examinations, it has prepared participants effectively for preclinical duties.
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Affiliation(s)
- Lukas P. Mileder
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz
- Clinical Skills Center, Medical University of Graz
| | | | - Jürgen Prattes
- Department of Internal Medicine, Medical University of Graz
| | - Thomas Wegscheider
- Clinical Skills Center, Medical University of Graz
- Division of Special Anesthesiology, Pain and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz
- SIM CAMPUS GmbH, Center for Emergency, Crisis and Disaster Simulation and Disaster Diplomacy, Eisenerz, Austria
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High fidelity simulation evaluation studies in nursing education: A review of the literature. Nurse Educ Pract 2020; 46:102818. [DOI: 10.1016/j.nepr.2020.102818] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 11/23/2022]
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Roth M, Daas L, MacKenzie CR, Balasiu A, Stachon T, Neumann I, Steindor F, Seitz B, Geerling G. Development and Assessment of a Simulator for in Vivo Confocal Microscopy in Fungal and Acanthamoeba Keratitis. Curr Eye Res 2020; 45:1484-1489. [PMID: 32434387 DOI: 10.1080/02713683.2020.1772830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE In vivo confocal microscopy (IVCM) is a non-invasive imaging technique that allows morphological analysis as a diagnostic approach of the cornea in real time, thus providing a suspected diagnosis of fungal or amoebic keratitis immediately, whereas culture or PCR require several days or even weeks. Since these infections are rare, it is difficult for ophthalmologists to gain the experience necessary to differentiate infection from normal findings or artefacts. The purpose of this project was to establish a simulator, on which physicians could practice as well as acquiring a database of IVCM images of fungal or amoebic keratitis and respective analyses. PATIENTS AND METHODS An IVCM simulator was set up with cadaver human corneas, infected with either acanthamoeba, candida or aspergillus. Twenty-one ophthalmologists were trained in IVC microscopy first in a Dry Lab, then practically on the simulator. For evaluation, the participants were asked to fill out a standardized questionnaire, with a pre- and post-course self-assessment. RESULTS The self-assessed theoretical and practical skills in differentiating infectious from non-infectious keratitis in IVCM significantly increased (p = 0.0001, p = 0.0002, respectively). The barrier to use this technique decreased (p = 0.0474). CONCLUSION A very simple protocol based on a model of ex vivo corneal mycotic and amoebic infections can be used to train novices in the structured approach and diagnostic use of IVCM for corneal infections.
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Affiliation(s)
- M Roth
- Department of Ophthalmology, Heinrich-Heine University Düsseldorf , Düsseldorf, Germany
| | - L Daas
- Department of Ophthalmology, Saarland University Medical Center UKS , Homburg, Germany
| | - C R MacKenzie
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine University , Düsseldorf, Germany
| | - A Balasiu
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine University , Düsseldorf, Germany
| | - T Stachon
- Department of Ophthalmology, Saarland University Medical Center UKS , Homburg, Germany
| | - I Neumann
- Department of Ophthalmology, Heinrich-Heine University Düsseldorf , Düsseldorf, Germany
| | - F Steindor
- Department of Ophthalmology, Heinrich-Heine University Düsseldorf , Düsseldorf, Germany
| | - B Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS , Homburg, Germany
| | - G Geerling
- Department of Ophthalmology, Heinrich-Heine University Düsseldorf , Düsseldorf, Germany
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Kardong-Edgren S, Oermann MH, Rizzolo MA. Emerging Theories Influencing the Teaching of Clinical Nursing Skills. J Contin Educ Nurs 2020; 50:257-262. [PMID: 31136668 DOI: 10.3928/00220124-20190516-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 01/08/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recognition is increasing that many psychomotor skills essential for safe nursing practice are not being retained. New theories and methods are emerging that, when applied in an organized pedagogical model, could influence initial learning and the retention of critical psychomotor skills. METHOD This article explains and applies emerging educational theories and concepts relevant to skills teaching in nursing. RESULTS Theories and concepts on cognitive load, deliberate practice, mastery learning, overlearning, spaced learning, and skill decay are integrated to provide a framework for teaching skills in nursing. An example is included of using this framework for skills instruction and practice. CONCLUSION This framework may improve the nurse educator's ability to prepare learners to perform skills safely in both the skills laboratory and patient care settings and to retain skills. [J Contin Educ Nurs. 2019;50(6):257-262.].
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Astbury J, Ferguson J, Silverthorne J, Willis S, Schafheutle E. High-fidelity simulation-based education in pre-registration healthcare programmes: a systematic review of reviews to inform collaborative and interprofessional best practice. J Interprof Care 2020; 35:622-632. [PMID: 32530344 DOI: 10.1080/13561820.2020.1762551] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Simulation-based education (SBE) is recognized as an effective interprofessional teaching and learning method. Whilst there is a large volume of research evidence concerning elements of SBE there is a lack of clarity concerning foundational principles of best practice. This is important for educators wishing to utilize high-quality SBE to deliver interprofessional education. The aim of this review is to synthesize review evidence of SBE best practice in a broad range of pre-registration healthcare programs and contextualize findings in light of relevant educational theory. A systematic search of PubMed, Scopus, Medline/Ovid, British Nursing Index, and the Cochrane Library databases was undertaken in February 2020. Data extraction and quality evaluation were undertaken by two authors. Fifteen reviews were included. In addition to identifying barriers and enablers to implementation, three interdependent themes regarding SBE best practice were found: curriculum level integration and planning (curriculum level integration, the opportunity for deliberate repeated practice, distribution, and sequencing); simulation design and delivery (clearly defined learning outcomes and benchmarks, pre-brief, multiple learning strategies, interactivity and individualized learning, feedback, and debrief); and resources (facilitator competency, controlled environments). These themes broadly align with the social constructivist theory of experiential learning whereby structured opportunities to learn via concrete experience, reflective observation, abstract conceptualization, and active experimentation are provided through effective planning, design, and delivery of SBE. Interdependencies suggest that integration of SBE at curriculum-level enables planning and implementation of best practice principles which are associated with effective learning, which also inform and facilitate the availability of adequate simulation resources.
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Affiliation(s)
- Jayne Astbury
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jane Ferguson
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | | | - Sarah Willis
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Ellen Schafheutle
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
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Brydges R, Campbell DM, Beavers L, Khodadoust N, Iantomasi P, Sampson K, Goffi A, Caparica Santos FN, Petrosoniak A. Lessons learned in preparing for and responding to the early stages of the COVID-19 pandemic: one simulation's program experience adapting to the new normal. Adv Simul (Lond) 2020; 5:8. [PMID: 32514385 PMCID: PMC7267752 DOI: 10.1186/s41077-020-00128-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/19/2020] [Indexed: 12/22/2022] Open
Abstract
Use of simulation to ensure an organization is ready for significant events, like COVID-19 pandemic, has shifted from a "backburner" training tool to a "first choice" strategy for ensuring individual, team, and system readiness. In this report, we summarize our simulation program's response during the COVID-19 pandemic, including the associated challenges and lessons learned. We also reflect on anticipated changes within our program as we adapt to a "new normal" following this pandemic. We intend for this report to function as a guide for other simulation programs to consult as this COVID-19 crisis continues to unfold, and during future challenges within global healthcare systems. We argue that this pandemic has cemented simulation programs as fundamental for any healthcare organization interested in ensuring its workforce can adapt in times of crisis. With the right team and set of partners, we believe that sustained investments in a simulation program will amplify into immeasurable impacts across a healthcare system.
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Affiliation(s)
- Ryan Brydges
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Douglas M. Campbell
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Lindsay Beavers
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Nazanin Khodadoust
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Paula Iantomasi
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Kristen Sampson
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Alberto Goffi
- Department of Medicine, Division of Critical Care Medicine, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Filipe N. Caparica Santos
- Department of Anesthesia, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | - Andrew Petrosoniak
- Unity Health Toronto – Simulation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Department of Emergency Medicine, St. Michael’s Hospital, Toronto, Canada
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138
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Lee M, Kim S, Kang K, Kim S. Comparing the learning effects of debriefing modalities for the care of premature infants. Nurs Health Sci 2020; 22:243-253. [DOI: 10.1111/nhs.12662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/14/2019] [Accepted: 10/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Myung‐Nam Lee
- Department of NursingKangwon National University Samcheok Korea
| | | | | | - Sunghee Kim
- Red Cross College of NursingChung‐Ang University Seoul Korea
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139
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Design and validation of a low-cost, high-fidelity model for robotic pyeloplasty simulation training. J Pediatr Urol 2020; 16:332-339. [PMID: 32173325 DOI: 10.1016/j.jpurol.2020.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/01/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION/BACKGROUND Owing to restrictions in operative experiences, urology residents can no longer solely rely on 'hands-on' operative time to master their surgical skills by the end of residency. Simulation training could help residents master basic surgical skills and steps of a procedure to maximize time in the operative room. However, simulators can be expensive or tedious to set up, limiting the availability to residents and training programs. OBJECTIVE The authors sought to develop and validate an inexpensive, high-fidelity training model for robotic pyeloplasty. STUDY DESIGN Pyeloplasty models were created using Dragon Skin® FX-Pro tissue-mimicking silicone cast over 3-dimensional molds. Urology faculty and trainees completed a demographic questionnaire. The participants viewed a brief instructional video and then independently performed robotic dismembered pyeloplasty on the model. Acceptability and content validity were evaluated via post-task evaluation of the model. Construct validity was evaluated by comparing procedure completion time, the Global Evaluative Assessment of Robotic Skills (GEARS) score, blinded subjective physical evaluation of repair quality (1-10 scale), and flow rate between experts and novices. RESULTS In total, 5 urology faculty, 6 fellows, and 14 residents participated. The median robotic console experience among faculty, fellows, and residents was 8 years (interquartile range [IQR] = 6-11), 3.5 years (IQR = 2-4 years), and 0 years (IQR = 0-0.5 years), respectively. The median procedure completion time was 29 min (IQR = 26-40 min), and the median flow rate was 1.11 mL/s (IQR = 0-1.34 mL/s). All faculty had flow rates >1.25 mL/s and procedure times <30 min compared with 2 of 6 fellows and none of the residents (P < 0.001). All faculty, half of the fellows, and none of the residents achieved a GEARS score ≥20, with a median resident score of 12.5 (IQR = 8-13) (P < 0.001). For repair quality, all faculty scored ≥9 (out of 10), all fellows scored ≥8, and the median score among residents was 6 (IQR = 2-6) (P < 0.001). The material cost was $1.32/model, and the average production time was 0.12 person-hours/model. DISCUSSION AND CONCLUSION This low-cost pyeloplasty model exhibits acceptability and content validity. Construct validity is supported by significant correlation between participant expertise and simulator performance across multiple assessment domains. The model has excellent potential to be used as a training tool in urology and allows for repetitive practice of pyeloplasty skills before live cases.
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140
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Monteiro S, Sibbald M. Aha! Taking on the myth that simulation-derived surprise enhances learning. MEDICAL EDUCATION 2020; 54:510-516. [PMID: 32096233 DOI: 10.1111/medu.14141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This paper aims to discuss the recurring education-related issue of the high-fidelity simulation myth. In the current instantiation, educators erroneously believe that trainees benefit from authentic uncertainty and surprise in simulation-based training. METHODS We explore the origins of this myth within the experiential learning and social constructivism theories and propose an evidence-based solution of transparent and guided instruction in simulation. RESULTS Constructivist theories highlight meaning making as the benefit of inquiry and discovery learning strategies. Inappropriate translation of this epistemology into an element of curriculum design creates unfortunate unintended consequences. CONCLUSIONS We propose that the translation of constructivist theories of learning within simulation-based education has resulted in a pervasive myth, which decrees that scenarios must introduce realistic tension or surprises to encourage exploration and insightful problem solving. We argue that this myth is masquerading as experiential learning. In this narrative review, we interpret our experiences and observations of simulation-based education through our expertise in education science and curriculum design. We offer anecdotal evidence along with a review of selected literature to establish the presence of this previously undetected myth.
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Affiliation(s)
- Sandra Monteiro
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Matthew Sibbald
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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141
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Frenken MWE, de Wit-Zuurendonk LD, Easter SR, Goossens SMTA, Oei SG. Simulation-based training of vaginal twin delivery for experienced gynaecologists: Useful or not? Eur J Obstet Gynecol Reprod Biol 2020; 251:89-97. [PMID: 32485519 DOI: 10.1016/j.ejogrb.2020.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE It is important to train clinicians to maintain and optimise maternal and neonatal outcomes after vaginal twin delivery. Simulation-based training provides opportunities for training in a realistic way without harming patients. The aim of this study is to evaluate the effect of simulation-based training concerning twin vaginal delivery on knowledge and comfort of obstetrician-gynaecologists. STUDY DESIGN Obstetrician-gynaecologists participated in a twin vaginal delivery simulation between March 2018 and May 2019. Simulation-based training consisted of standardized patient interviews, didactic sessions and three different simulation-based scenarios: internal podalic version and breech extraction, assisted vaginal delivery and vaginal breech delivery with problems of aftercoming head. Pre- and posttraining, participants were asked to fill out questionnaires exploring knowledge concerning vertex-vertex twin deliveries and vertex-nonvertex twin deliveries, level of comfort performing various obstetric manoeuvres and counselling on mode of delivery for women pregnant with twins. Our primary outcome of interest was a change in knowledge or comfort surrounding vaginal twin delivery after completion of the simulation-based training. RESULTS The estimated median number of vaginal twin deliveries performed by the participating thirty-four obstetrician-gynaecologists was 50 (IQR 20-100). Significant improvements were seen in knowledge regarding twin deliveries with vertex-nonvertex presentation (p < 0.01). In two of three questions regarding twin delivery with vertex-vertex presentation significant improvements were seen as well (p < 0.01). Before training, 40.6% of participants felt comfortable to perform internal podalic version compared to 91.2% afterwards (p < 0.01). Comfort with breech extraction increased from 69.7% to 97.1% pre- and posttraining, respectively (p < 0.01). Before training only 55.9% would strongly counsel patients towards vaginal twin delivery as opposed to 73.5% after training (p = 0.07). CONCLUSIONS Simulation-based training results in beneficial effects on knowledge and comfort concerning vaginal twin deliveries for obstetrician-gynaecologists. This training suggested a potential impact on provider practice with a more favourable attitude towards twin vaginal birth.
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Affiliation(s)
- Maria W E Frenken
- Department of Obstetrics and Gynaecology, Máxima MC, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands; Eindhoven MedTech Innovation Centre (e/MTIC), Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.
| | - Laura D de Wit-Zuurendonk
- Department of Obstetrics and Gynaecology, Máxima MC, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands; Eindhoven MedTech Innovation Centre (e/MTIC), Eindhoven, The Netherlands
| | - Sarah Rae Easter
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, United States
| | - Simone M T A Goossens
- Department of Obstetrics and Gynaecology, Máxima MC, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands; Eindhoven MedTech Innovation Centre (e/MTIC), Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of Obstetrics and Gynaecology, Máxima MC, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands; Eindhoven MedTech Innovation Centre (e/MTIC), Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
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Abstract
INTRODUCTION Physicians' management of hazardous material (HAZMAT) incidents requires personal protective equipment (PPE) utilization to ensure the safety of victims, facilities, and providers; therefore, providing effective and accessible training in its use is crucial. While an emphasis has been placed on the importance of PPE, there is debate about the most effective training methods. Circumstances may not allow for a traditional in-person demonstration; an accessible video training may provide a useful alternative. HYPOTHESIS Video training of Emergency Medicine (EM) residents in the donning and doffing of Level C PPE is more effective than in-person training. NULL HYPOTHESIS Video training of EM residents in the donning and doffing of Level C PPE is equally effective compared with in-person training. METHODS A randomized, controlled pilot trial was performed with 20 EM residents as part of their annual Emergency Preparedness training. Residents were divided into four groups, with Group 1 and Group 2 viewing a demonstration video developed by the Emergency Preparedness Team (EPT) and Group 3 and Group 4 receiving the standard in-person demonstration training by an EPT member. The groups then separately performed a donning and doffing simulation while blinded evaluators assessed critical tasks utilizing a prepared evaluation tool. At the drill's conclusion, all participants also completed a self-evaluation survey about their subjective interpretations of their respective trainings. RESULTS Both video and in-person training modalities showed significant overall improvement in participants' confidence in doffing and donning PPE equipment (P <.05). However, no statistically significant difference was found in the number of failed critical tasks in donning or doffing between the training modalities (P >.05). Based on these results, the null hypothesis cannot be rejected. However, these results were limited by the small sample size and the study was not sufficiently powered to show a difference between training modalities. CONCLUSION In this pilot study, video and in-person training were equally effective in training for donning and doffing Level C PPE, with similar error rates in both modalities. Further research into this subject with an appropriately powered study is warranted to determine whether this equivalence persists using a larger sample size.
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Abstract
OBJECTIVE The aim of this study was to assess national pediatric/neonatal specialty transport teams' composition and training requirements to determine if any current standardization exists. METHODS This was a survey of the transport teams listed with the American Academy of Pediatrics via SurveyMonkey. RESULTS While most of the teams maintain internal criteria for team competency and training, there is large variation across team compositions. The vast majority of the teams have a nurse-led team with the addition of another nurse, medic, and/or respiratory therapist regardless of mode of transport. Many of the teams report adjusting team composition based on acuity. Fewer than 15% of teams have a physician as a standard team member. More than 80% required a minimum number of supervised intubations prior to independent practice; however, the number varied largely from as little as 3 to as many as 30. Eighty-eight percent of the teams report using simulation as part of their education program, but again there were marked differences between teams as to how it was used. CONCLUSIONS There is tremendous variability nationally among pediatric/neonatal transport teams regarding training requirements, certifications, and team composition. The lack of standardization regarding team member qualifications or maintenance of competency among specialized transport teams should be looked at more closely, and evidence-based guidelines may help lead to further improved outcomes in the care of critically ill pediatric patients in the prehospital setting.
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144
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Dieckmann P, Torgeirsen K, Qvindesland SA, Thomas L, Bushell V, Langli Ersdal H. The use of simulation to prepare and improve responses to infectious disease outbreaks like COVID-19: practical tips and resources from Norway, Denmark, and the UK. Adv Simul (Lond) 2020; 5:3. [PMID: 32308988 PMCID: PMC7160610 DOI: 10.1186/s41077-020-00121-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
In this paper, we describe the potential of simulation to improve hospital responses to the COVID-19 crisis. We provide tools which can be used to analyse the current needs of the situation, explain how simulation can help to improve responses to the crisis, what the key issues are with integrating simulation into organisations, and what to focus on when conducting simulations. We provide an overview of helpful resources and a collection of scenarios and support for centre-based and in situ simulations.
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Affiliation(s)
- Peter Dieckmann
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, Opg. 1 - 25th floor, DK-2730 Herlev, Capital Region of Denmark Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Kjetil Torgeirsen
- Stavanger Acute Medicine Foundation for Education and Research (SAFER), Stavanger, Norway
| | - Sigrun Anna Qvindesland
- Stavanger Acute Medicine Foundation for Education and Research (SAFER), Stavanger, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Libby Thomas
- Emergency Department, Kings College Hospital NHS Foundation Trust, London, UK
- The Blizard Institute, Queen Mary University, London, UK
| | - Verity Bushell
- Postgraduate Medical and Dental Education Department, Kings College London, Denmark Hill, London, UK
| | - Hege Langli Ersdal
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
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145
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Decentralized Virtual Reality Training of Mastoidectomy Improves Cadaver Dissection Performance: A Prospective, Controlled Cohort Study. Otol Neurotol 2020; 41:476-481. [DOI: 10.1097/mao.0000000000002541] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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146
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Nayahangan LJ, Konge L, Møller-Skuldbøl IM, Kolster D, Paltved C, Sørensen JL. A Nationwide Needs Assessment to Identify and Prioritize Technical Procedures for Simulation in Obstetrics and Gynaecology: A Delphi Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:409-419. [PMID: 31859204 DOI: 10.1016/j.jogc.2019.08.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aims of the study were to identify and prioritize technical procedures that should be developed and integrated in a simulation-based curriculum for obstetrics and gynaecology residents. METHODS The Delphi method was used, consisting of three rounds of survey questionnaires. Key leaders across Denmark were invited to participate. In Delphi round 1, the participants individually identified technical procedures that newly authorized specialists should be able to perform. These procedures were sent to round 2 to be explored for need for simulation-based training by estimating frequency of procedures, number of doctors, potential patient risk and/or discomfort, and feasibility of simulation. Round 3 consisted of elimination and prioritization of remaining procedures (Canadian Task Force Classification III). RESULTS A total of 165 key leaders were invited. Response rates were 61%, 50%, and 53%, respectively. Identified procedures in Round 1 were as follows: gynaecology (n = 51), obstetrics (n = 40), and general procedures (n = 10). A needs assessment formula was used to calculate needs for training on the basis of the answers in round 2 and produce a preliminary prioritized list that was sent to round 3 for final exploration. Round 3 consisted of elimination and final prioritization, where gynaecology (n = 17) prioritized basic laparoscopy, vaginal ultrasound, and laparoscopy with salpingostomy and salpingectomy; obstetrics procedures (n = 16) prioritized basic resuscitation of newborn, vacuum extraction, and management of shoulder dystocia; and one general procedure (basic adult resuscitation) was included. CONCLUSION A needs assessment using the Delphi method produced a prioritized list of technical procedures suitable for simulation. This can guide the development of simulation-based training programs.
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Affiliation(s)
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Dorthe Kolster
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Charlotte Paltved
- MidtSim - Centre for Human Resources, Central Region of Denmark and Aarhus University, Aarhus, Denmark
| | - Jette Led Sørensen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Juliane Marie Center for Children, Women, and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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147
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Abstract
INTRODUCTION The quality of healthcare simulation learning relies heavily on effective debriefers. Traditional methods of faculty development in debriefing lack a structured approach to achieve expertise via graduated and reflective practice. METHODS The Simulation Learning, Education and Research Network (SimLEARN) developed DebriefLive, a virtual teaching environment, bringing together faculty and participant debriefers from across the Veterans Health Administration. Recorded simulation sessions were viewed followed by the opportunity for participant debriefers to debrief virtual learners. Participant debriefers were then provided structured and objective debriefings of the debriefings with the added opportunity for immediate practice. Program evaluation data for the pilot sessions were collected via electronic survey including a mix of Likert scale questions as well as short answer responses. RESULTS On a 7-point Likert scale, participant debriefers (n = 15) rated the content as effective (mean = 6.67, SD = 0.47) and appropriate to their level (mean = 6.47, SD = 0.47). The technology of video-based scenarios (mean = 6.6, SD = 0.61), followed by avatar-based debriefing sessions (mean = 6.6, SD = 0.8), was felt to be accurate and appropriate. All participants would agree or strongly agree with recommending this training program to colleagues. CONCLUSIONS Simulation instructors and fellows across the spectrum of the Veterans Health Administration found the innovative computer-based faculty development program DebriefLive acceptable as well as effective in increasing self-efficacy in debriefing. DebriefLive is an innovative and potentially disruptive tool, combining best practices in simulation theory and virtual technologies, for the training and assessment of debriefers.
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148
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Elison DM, McConnaughey S, Freeman RV, Sheehan FH. Focused cardiac ultrasound training in medical students: Using an independent, simulator-based curriculum to objectively measure skill acquisition and learning curve. Echocardiography 2020; 37:491-496. [PMID: 32212401 DOI: 10.1111/echo.14641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Using simulators built and validated at the University of Washington (UW), the study sought to test whether medical students can learn the basic skills of focused cardiac ultrasound (FoCUS) from an individually paced, simulator-based curriculum, how skills improve, and the rate at which these skills are acquired. METHODS The curriculum presented didactic material interspersed with hands-on practice. Psychomotor skill was measured by the angle error of the acquired image view plane relative to the correct image view plane. The rate of learning was assessed at baseline, after 7 practice cases, and after 10 cases. To assess the rate of learning, the same case was repeatedly presented at all three tests. To assess students' ability to apply their learning, a previously unseen post-test was included. RESULTS A total of 41 students completed the course. Average angle error improved from 43° ± 24 pretraining to 23° ± 16 post-training, with most students falling within one SD of the view angle acquired by sonographers. Regarding learning curve, or the rate of skill acquisition, an angle error of 43 ± 24° (pre) changed to 22 ± 14° (interim test, P < .0001 vs. pretest) and remained at that level for the post-test evaluation on both the repeated case (23 ± 16°) and the new case (26 ± 18°). CONCLUSIONS This study describes the learning curve and technical skill acquisition in FoCUS. A simulator-based curriculum improved medical student's skills in an objective and quantifiable manner. The individually paced curriculum allowed for independent knowledge and skill attainment, without facilitator oversight.
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Affiliation(s)
- David M Elison
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
| | - Shannon McConnaughey
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
| | - Rosario V Freeman
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
| | - Florence H Sheehan
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
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149
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Tekian A, Harden RM, Cook DA, Steinert Y, Hunt D, Norcini J. Managing the tension: From innovation to application in health professions education. MEDICAL TEACHER 2020; 42:333-339. [PMID: 31726877 DOI: 10.1080/0142159x.2019.1687871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Innovations in education are essential for solving problems and introducing new ways of thinking. However, implementation of these innovations must take several factors into consideration, including the context, the environment, the stakeholders, the technology needed, the cost, the pace of implementation, appropriateness, and available resources. When these factors are not balanced and considered, tensions arise. This paper describes tensions in five major educational domains, namely curriculum, instruction, assessment, accreditation/regulation, and faculty development. For each of these domains, the typical problems are described, and solutions are presented to manage the tension.
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Affiliation(s)
- Ara Tekian
- Department of Medical Education, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Ronald M Harden
- Association for Medical Education in Europe (AMEE), Dundee, Scotland
| | - David A Cook
- Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Yvonne Steinert
- Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Daniel Hunt
- Liaison Committee Medical Education, Association of American Medical Colleges, Washington, DC, USA
| | - John Norcini
- Foundation for Advancement of International Medical Education and Research, Philadelphia, PA, USA
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150
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Rosario J, Lebowitz D, Webb AL, Ganti L, Vera A, Macintosh T, Walker A, Rubero J. Assembly Line Education: A Novel Educational Technique for Today's Learners. Cureus 2020; 12:e7065. [PMID: 32226667 PMCID: PMC7089632 DOI: 10.7759/cureus.7065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Education is undergoing a transformation. The traditional passive lectures are failing to capture and inspire the new generation of learners who value more active and collaborative learning techniques. Objective We sought to create a novel educational technique to integrate into our curriculum that would be more personalized, employ more active learning and collaboration, and allow for an effective assessment of resident strengths and weaknesses. Discussion We created a monthly assembly line education academic half-day that evolved to replace one of the typical in-classroom didactics each month. Faculty run small-group simulation rooms, procedure workshops, competitive ultrasound, and wellness stations through which residents and medical students rotate. Conclusion This novel education technique resulted in a more personalized approach that increased resident interest, sparked the creation of a very popular MedEd-Simulation elective, and allowed the faculty to gain a better sense of resident strengths and deficiencies.
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Affiliation(s)
- Javier Rosario
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - David Lebowitz
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Amanda L Webb
- Emergency Medicine, University of Central Florida College of Medicine/Hospital Corporation of America Graduate Medical Education Consortium of Greater Orlando, Orlando, USA
| | - Latha Ganti
- Emergency Medicine, Envision Physician Services, Orlando, USA.,Emergency Medicine, University of Central Florida College of Medicine/Hospital Corporation of America Graduate Medical Education Consortium of Greater Orlando, Orlando, USA.,Emergency Medicine, Polk County Fire Rescue, Bartow, USA
| | - Ariel Vera
- Emergency Medicine, University of Central Florida College of Medicine/Hospital Corporation of America Graduate Medical Education Consortium of Greater Orlando, Kissimmee, USA.,Emergency Medicine, Osceola Regional Medical Center, Kissimmee, USA
| | - Tracy Macintosh
- Emergency Medicine, Osceola Regional Medical Center, Kissimmee, USA
| | - Ayanna Walker
- Emergency Medicine, University of Central Florida College of Medicine/Hospital Corporation of America Graduate Medical Education Consortium of Greater Orlando, Orlando, USA.,Emergency Medicine, Osceola Regional Medical Center, Orlando, USA
| | - Jose Rubero
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
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