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Peng YC, Wu HS. The Efficacy of High-Fidelity Telesimulation in Preparing Nursing Students for Emergency and Critical Patient Care: A Prospective Study. J Nurs Res 2024; 32:00134372-990000000-00115. [PMID: 39360862 DOI: 10.1097/jnr.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND High-fidelity telesimulation can address the gap in nursing education caused by the pandemic by providing a simulated environment for students to practice skills that closely mimic real-life scenarios. PURPOSE This study was designed to determine the effect of a high-fidelity telesimulation teaching program on emergency and critical patient care-related knowledge, self-confidence, and critical thinking skills in nursing students. METHODS This randomized, single-blind controlled study was conducted on a sample of 84 nursing students who were evaluated using pretest and posttest measurements. The participants were randomized into a control group ( n = 43) and an experimental group ( n = 41). The control group received an in-person traditional teaching program, and the experimental group was taught using a high-fidelity telesimulation program. During the high-fidelity telesimulation, synchronous online tutorial learning and telesimulation were conducted every 100 and 300 minutes. The experimental group program included a lecture, simulation teaching videos, and demonstrations related to endotracheal intubation, 12-lead electrocardiography, protective clothing, and hybrid telesimulation learning. In each subgroup, the students executed a single high-fidelity telesimulation scenario in which they were assigned individual roles. The students in the other subgroups served as observers and engaged in the synchronous online debriefing. Teaching efficacy was evaluated using an objective structured clinical examination and a questionnaire designed for emergency and critical patient care. RESULTS In the experimental group, levels of knowledge and self-confidence as well as critical thinking skills related to emergency and critical patient care were significantly higher than in the control group ( p < .05). CONCLUSIONS High-fidelity telesimulation teaching is a feasible and reliable alternative to conventional in-person simulation for nursing students, particularly in situations where traditional clinical experiences are not possible.
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Affiliation(s)
- Yi-Chi Peng
- PhD, RN, Assistant Professor, Department of Nursing, Asia University, Taiwan
| | - Hua-Shan Wu
- PhD, RN, Distinguished Professor, Department of Nursing, Asia University, Taiwan
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Dudding CC, Zraick RI, Dudding SM. The Use of Simulation in Communication Sciences and Disorders: A Follow-Up Survey. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2399-2423. [PMID: 39225709 DOI: 10.1044/2024_ajslp-23-00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE This study investigates changes in the prevalence and practice of simulation in communication sciences and disorders (CSD) education. It is a follow-up to a 2015 survey on the same topic. Given the changes in program certification standards and the impact of the COVID-19 pandemic on clinical education programs across the United States, re-examination of simulation in CSD is warranted. METHOD An online questionnaire was developed to survey university programs accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association. University program directors and clinical directors received recruitment e-mails using QuestionPro, an online survey platform. The recruitment e-mail contained the purpose of the study and a link to the online questionnaire along with instructions to forward the survey to the appropriate designee. The consent form was then embedded in the questionnaire. RESULTS The results of this survey indicated changes in patterns and the use of simulation in clinical education for CSD. Results indicated an overall increase in the use of simulations, specifically in computer-based simulations. Distance simulation as a hybrid technology proved a major addition to clinical education programs during the COVID-19 pandemic. External and internal factors affecting the use of simulations in CSD were identified. CONCLUSIONS The use of simulation to supplement clinical education in CSD has evolved in recent years. These changes are likely due in part to changes in certification standards in the profession, an increase in awareness and training, and reliance on distance simulation during the COVID-19 pandemic.
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Affiliation(s)
- Carol C Dudding
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | | | - Samantha M Dudding
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
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Hrdy M, Faig W, Ren D, Lee B, Tay KY, Guttadauria B, Zaveri P, Lavoie M, Zhao X. A Comparison of Telesimulation Using the Virtual Resus Room and In Situ Simulation in Pediatric Emergency Medicine. Pediatr Emerg Care 2024:00006565-990000000-00515. [PMID: 39180191 DOI: 10.1097/pec.0000000000003256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
OBJECTIVES During the COVID-19 pandemic, there was a marked shift toward telesimulation in medical education. Limited studies exist comparing the effectiveness of online and offline simulation education. The goals of this study are to evaluate active learners' perceived effectiveness of telesimulation versus in situ simulation and to identify potential shortcomings of existing online teaching platforms. METHODS Through participant evaluations after a simulation, we compared telesimulation using the Virtual Resus Room (VRR) to in situ simulation in the domains of (1) self-efficacy, (2) fidelity, (3) educational value, and (4) teaching quality. Study subjects included medical and pharmacy residents and medical students completing their pediatric emergency medicine rotation at two children's hospitals as well as nurses, nurse practitioners, and physician assistants who were recently hired and orienting to their new roles in the emergency department. Learners used a modified Michigan Standard Simulation Experience Scale to evaluate either a telesimulation or in situ simulation case. Survey responses were compared using Wilcoxon rank sum tests with Bonferroni correction for multiple comparisons. RESULTS In overall assessment, in situ simulation was rated higher than telesimulation. There were significant differences noted related to perceived realism, utility in training device-related skills, and utility in training team-building skills. All P values were less than 0.0036. There were no significant differences between simulation types in perception of physical examination fidelity, instructor adequacy, or self-efficacy. CONCLUSIONS Telesimulation using the VRR is comparable to in situ simulation in learners' perception of improvement in self-efficacy and of teaching quality for pediatric emergency medicine topics. However, participants felt less able to practice tactile and communication skills virtually. Further innovation is needed to improve learners' experience with fidelity and educational value.
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Affiliation(s)
| | - Walter Faig
- Children's Hospital of Philadelphia, Philadelphia, PA
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Marshall J, Shiu C, Raatz M, Penman A, Beak K, Clarke S, Ward EC. Telesimulation for Training in Infant Feeding: A Randomized Controlled Trial. Dysphagia 2024:10.1007/s00455-024-10746-7. [PMID: 39133239 DOI: 10.1007/s00455-024-10746-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/31/2024] [Indexed: 08/13/2024]
Abstract
Simulation is an education modality known to support clinical skill development. Unfortunately, access to simulation has been challenging, both prior to and during the pandemic. Simulation via telepractice, i.e., "telesimulation", has emerged, but little is known about whether outcomes are comparable to in-person simulation. This study compared in-person versus telesimulation learner outcomes in an infant feeding scenario. The secondary aim was to compare outcomes between novice and experienced participants.This pragmatic randomized controlled trial included speech pathologists who could attend if randomized to the in-person modality. Block randomization matched participants with < 6 months' infant feeding experience to those with > 6 months experience (2:1 ratio) into telesimulation or in-person simulation. Measures of clinical reasoning, confidence/anxiety, and satisfaction were collected, pre-, post-, and 4-weeks post-simulation.Overall, 39 clinicians completed either in-person simulation (n = 17) or telesimulation training (n = 22), including 16 experienced and 23 novice learners. Both in-person and telesimulation groups achieved significant improvements across time in clinical reasoning, self-reported confidence, and anxiety. The extent of change in clinical reasoning, confidence and anxiety was comparable between the telesimulation and in-person simulation groups. Comparing by experience, novice-level participants reported significantly greater changes in confidence and anxiety than experienced participants. Satisfaction levels were high regardless of simulation modality or experience.Participants in telesimulation and in-person simulation achieved similar improvements in the primary outcome measure of clinical reasoning, had comparable improvements in self-perceived confidence and anxiety, and demonstrated high satisfaction levels. Telesimulation is a promising means to improve clinician access to simulation training in infant feeding.
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Affiliation(s)
- Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Charis Shiu
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Madeline Raatz
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Logan Hospital, Metro South Hospital and Health Service, Brisbane, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly Beak
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Sally Clarke
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia
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Minor KC, Bianco K, Mayo JA, Abir G, Judy AE, Lee HC, Leonard SA, Ayotte S, Hedli LC, Schaffer K, Sie L, Daniels K. Virtual simulation training for postpartum hemorrhage in low-to-moderate-volume hospitals in the US. AJOG GLOBAL REPORTS 2024; 4:100357. [PMID: 38975047 PMCID: PMC11227018 DOI: 10.1016/j.xagr.2024.100357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background Maternal mortality in the United States is rising and many deaths are preventable. Emergencies, such as postpartum hemorrhage, occur less frequently in non-teaching, rural, and urban low-birth volume hospitals. There is an urgent need for accessible, evidence-based, and sustainable inter-professional education that creates the opportunity for clinical teams to practice their response to rare, but potentially devastating events. Objective To assess the feasibility of virtual simulation training for the management of postpartum hemorrhage in low-to-moderate-volume delivery hospitals. Study design The study occurred between December 2021 and March 2022 within 8 non-academic hospitals in the United States with low-to-moderate-delivery volumes, randomized to one of two models: direct simulation training and train-the-trainer. In the direct simulation training model, simulation faculty conducted a virtual simulation training program with participants. In the train-the-trainer model, simulation faculty conducted virtual lessons with new simulation instructors on how to prepare and conduct a simulation course. Following this training, the instructors led their own simulation training program at their respective hospitals. The direct simulation training participants and students trained by new instructors from the train-the-trainer program were evaluated with a multiple-choice questionnaire on postpartum hemorrhage knowledge and a confidence and attitude survey at 3 timepoints: prior to, immediately after, and at 3 months post-training. Paired t-tests were performed to assess for changes in knowledge and confidence within teaching models across time points. ANOVA was performed to test cross-sectionally for differences in knowledge and confidence between teaching models at each time point. Results Direct simulation training participants (n=22) and students of the train-the-trainer instructors (n=18) included nurses, certified nurse midwives and attending physicians in obstetrics, family practice or anesthesiology. Mean pre-course knowledge and confidence scores were not statistically different between direct simulation participants and the students of the instructors from the train-the-trainer course (79%+/-13 versus 75%+/-14, respectively, P-value=.45). Within the direct simulation group, knowledge and confidence scores significantly improved from pre- to immediately post-training (knowledge score mean difference 9.81 [95% CI 3.23-16.40], P-value<.01; confidence score mean difference 13.64 [95% CI 6.79-20.48], P-value<.01), which were maintained 3-months post-training. Within the train-the-trainer group, knowledge and confidence scores immediate post-intervention were not significantly different compared with pre-course or 3-month post-course scores. Mean knowledge scores were significantly greater for the direct simulation group compared to the train-the-trainer group immediately post-training (89%+/-7 versus 74%+/-8, P-value<.01) and at 3-months (88%+/-7 versus 76%+/-12, P-value<.01). Comparisons between groups showed no difference in confidence and attitude scores at these timepoints. Both direct simulation participants and train-the-trainer instructors preferred virtual education, or a hybrid structure, over in-person education. Conclusion Virtual education for obstetric simulation training is feasible, acceptable, and effective. Utilizing a direct simulation model for postpartum hemorrhage management resulted in enhanced knowledge acquisition and retention compared to a train-the-trainer model.
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Affiliation(s)
- Kathleen C. Minor
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Obstetrics, Stanford University School of Medicine, Stanford, CA (Dr Minor, Dr Bianco, Mr Mayo, Dr Judy, and Dr Leonard)
| | - Katherine Bianco
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Obstetrics, Stanford University School of Medicine, Stanford, CA (Dr Minor, Dr Bianco, Mr Mayo, Dr Judy, and Dr Leonard)
| | - Jonathan A. Mayo
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Obstetrics, Stanford University School of Medicine, Stanford, CA (Dr Minor, Dr Bianco, Mr Mayo, Dr Judy, and Dr Leonard)
| | - Gillian Abir
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Obstetric Anesthesiology, Stanford University School of Medicine, Stanford, CA (Dr Abir)
| | - Amy E. Judy
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Obstetrics, Stanford University School of Medicine, Stanford, CA (Dr Minor, Dr Bianco, Mr Mayo, Dr Judy, and Dr Leonard)
| | - Henry C. Lee
- Department of Pediatrics, Division of Neonatology, University of California San Diego, La Jolla, CA (Dr Lee and Ms Schaffer)
| | - Stephanie A. Leonard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Obstetrics, Stanford University School of Medicine, Stanford, CA (Dr Minor, Dr Bianco, Mr Mayo, Dr Judy, and Dr Leonard)
| | - Stephany Ayotte
- Johnson Center for Pregnancy and Newborn Services, Lucile Packard Children's Hospital, Stanford, CA (Ms Ayotte)
| | - Laura C. Hedli
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA (Ms Hedli and Ms Sie)
| | - Kristen Schaffer
- Department of Pediatrics, Division of Neonatology, University of California San Diego, La Jolla, CA (Dr Lee and Ms Schaffer)
| | - Lillian Sie
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA (Ms Hedli and Ms Sie)
| | - Kay Daniels
- Department of Obstetrics and Gynecology, Stanford School of Medicine, Stanford, CA (Dr Daniels)
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Hamad NB, Folorunsho EF. Simulated Participants' Experiences and Challenges With Online and Face-to-Face Interactions During COVID-19: A Case Study in UAEU. Simul Healthc 2024; 19:235-242. [PMID: 37823744 DOI: 10.1097/sih.0000000000000752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Direct patient contact is essential when training health professionals for future patient-centered interactions. Simulated participants (SPs) play a critical role during training; however, limited information is available about their personal perspectives. This study explored SPs at the College of Medicine and Health Sciences experiences, adaptations, and preferences regarding online and face-to-face encounters. METHODS After ethical approval, a qualitative research study using structured in-depth interviews was conducted online with 16 SPs, applying critical incident narratives and storytelling. Interview data were transcribed and encoded using thematic framework analysis, after which member checking was conducted to increase credibility. RESULTS All SPs acknowledged the benefits of online delivery models during the pandemic, including the convenience of working from home, continued clinical skills training, and personal protection from COVID infection. Participants preferred face-to-face delivery over online encounters, except for one SP, who saw no difference. Challenges included technical issues, communication problems, and lack of realism. CONCLUSIONS Although these results cannot be generalized, all participants acknowledged the relevance of online portrayals during the pandemic. Most preferred face-to-face delivery models for improving role-playing and enhancing personal communication to achieve better patient outcomes, while one SP had no preference. The use of concurrent online and face-to-face methods may more effectively engage SPs in simulation-based education. Before restructuring programs, further research is needed, including a deeper exploration of students' and educators' perspectives.
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Affiliation(s)
- Nabtta Bashir Hamad
- From the Medical Education Department, CMHS-UAEU (N.B.H., E.F.F), United Arab Emirates
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Huber L, Good R, Bone MF, Flood SM, Fredericks R, Overly F, Tofil NM, Wing R, Walsh K. A Modified Delphi Study for Curricular Content of Simulation-Based Medical Education for Pediatric Residency Programs. Acad Pediatr 2024; 24:856-865. [PMID: 38663801 DOI: 10.1016/j.acap.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE We sought to establish core knowledge topics and skills that are important to teach pediatric residents using simulation-based medical education (SBME). METHODS We conducted a modified Delphi process with experts in pediatric SBME. Content items were adapted from the American Board of Pediatrics certifying exam content and curricular components from pediatric entrustable professional activities (EPAs). In round 1, participants rated 158 items using a four-point Likert scale of importance to teach through simulation in pediatric residency. A priori, we defined consensus for item inclusion as ≥70% rated the item as extremely important and exclusion as ≥70% rated the item not important. Criteria for stopping the process included reaching consensus to include and/or exclude all items, with a maximum of three rounds. RESULTS A total of 59 participants, representing 46 programs and 25 states participated in the study. Response rates for the three rounds were 92%, 86% and 90%, respectively. The final list includes 112 curricular content items deemed by our experts as important to teach through simulation in pediatric residency. Seventeen procedures were included. Nine of the seventeen EPAs had at least one content item that experts considered important to teach through simulation as compared to other modalities. CONCLUSIONS Using consensus methodology, we identified the curricular items important to teach pediatric residents using SBME. Next steps are to design a simulation curriculum to encompass this content.
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Affiliation(s)
- Lorel Huber
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo.
| | - Ryan Good
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Meredith F Bone
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Shannon M Flood
- University of Colorado (SM Flood), Pediatric Emergency Medicine, Aurora, Colo
| | - Ryan Fredericks
- Swedish Medical Center (R Fredericks), Pediatric Critical Care Medicine, Seattle, Wash
| | - Frank Overly
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Nancy M Tofil
- University of Alabama at Birmingham (NM Tofil), Pediatric Critical Care Medicine, Birmingham, Ala
| | - Robyn Wing
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Kathryn Walsh
- University of Colorado (K Walsh), Denver Health, Pediatric Critical Care Medicine, Denver Health Medical Center, Denver, Colo
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Roche AF, Moneley D, Lawler T, Boyle E, Gosi G, O'Callaghan A, Cahir C, O'Keeffe D, Condron CM. Remote feedback in endovascular simulation training: a mixed-methods study. Adv Simul (Lond) 2024; 9:24. [PMID: 38863034 PMCID: PMC11165733 DOI: 10.1186/s41077-024-00297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/02/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND There is an increasing need to increase simulation-based learning opportunities for vascular surgery residents in endovascular skills training. This study aims to explore the effectiveness of remote expert instructional feedback of endovascular simulation-based education, as a means of increasing training opportunities in this area for vascular surgery residents. METHODS A mixed-methods study design was adopted. Twelve vascular surgery residents from Ireland were tasked with completing two endovascular renal artery procedures: one with in-person expert feedback and the other with remote instruction. Participants ranged in experience levels from second year to final year of residency. Following the training activities, interviews and a questionnaire were employed to gather information on the usefulness of remote feedback. RESULTS There was no significant difference reported by participants using a post-event validated questionnaire between remote and in-person feedback. During the interviews, participants expressed mixed feelings about the presence of the educator while practicing, but they eventually saw no limiting factors to their practice when the trainer provided remote feedback. When receiving performance feedback remotely, clear communication and a shared knowledge of the task development are critical to success. CONCLUSIONS We believe these findings can inform the design and development of remote learning and assessment of endovascular skills training and ultimately provide increased opportunities for more skills practice for vascular surgical residents.
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Affiliation(s)
- Adam F Roche
- RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- RCSI SIM Centre for Simulation Education & Research, 26 York Street, Dublin 2, D02 P796, Ireland.
| | | | - Tim Lawler
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Emily Boyle
- Tallaght University Hospital, Dublin, Ireland
| | - Greg Gosi
- University Hospital Waterford, Waterford, Ireland
| | | | - Caitriona Cahir
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Dara O'Keeffe
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire M Condron
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Bajwa M, Ahmed R, Lababidi H, Morris M, Morton A, Mosher C, Wawersik D, Herx-Weaver A, Gross IT, Palaganas JC. Development of Distance Simulation Educator Guidelines in Healthcare: A Delphi Method Application. Simul Healthc 2024; 19:1-10. [PMID: 36598821 DOI: 10.1097/sih.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The abrupt disruption of in-person instruction in health care during the COVID-19 pandemic resulted in the rapid adoption of distance simulation as an immediate alternative to providing in-person simulation-based education. This massive instructional shift, combined with the lack of educator training in this domain, led to challenges for both learners and educators. This study aimed to disseminate the first set of competencies required of and unique to effective distance simulation educators. METHODS This was a multiphasic and iterative modified Delphi study validating the content of carefully and rigorously synthesized literature. Experts were invited from around the globe to participate in this study with mandatory attendance at an annual health care simulation conference to openly discuss the guidelines presented as competencies in this document. We divided each competency into "Basic" and "Advanced" levels, and agreement was sought for these levels individually. The experts provided their opinion by choosing the options of "Keep, Modify, or Delete." A free-marginal kappa of 0.60 was chosen a priori. RESULTS At the conclusion of the Delphi process, the number of competencies changed from 66 to 59, basic subcompetencies from 216 to 196, and advanced subcompetencies from 179 to 182. CONCLUSIONS This article provides the first set of consensus guidelines to distance simulation educators in health care, and paved the way for further research in distance simulation as a modality.
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Affiliation(s)
- Maria Bajwa
- From the MGH Institute of Health Professions (M.B., R.A., H.L., M.M., A.M., A.H., J.C.P.), Boston, MA; Indiana University School of Medicine (R.A.), Indianapolis, IN; King Fahad Medical City (H.L.), Riyadh, Saudi Arabia; Nova Southeastern University (M.M.), Ft. Lauderdale, FL; Alfaisal University, College of Medicine (C.M.), Riyadh, Saudi Arabia; Henry Ford College (D.W.), Dearborn, MI; Fitchburg State University (A.H.), Fitchburg, MA; UMass Chan Medical School (A.H.), Worcester, MA; Yale University School of Medicine (I.T.G.), New Haven, CT; and Harvard Medical School (J.C.P.), Boston, MA
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10
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Nakatani R, Patel K, Chowdhury T. Simulation in Anesthesia for Perioperative Neuroscience: Present and Future. J Neurosurg Anesthesiol 2024; 36:4-10. [PMID: 37903630 DOI: 10.1097/ana.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/27/2023] [Indexed: 11/01/2023]
Abstract
The brain's sensitivity to fluctuations in physiological parameters demands precise control of anesthesia during neurosurgery, which, combined with the complex nature of neurosurgical procedures and potential for adverse outcomes, makes neuroanesthesia challenging. Neuroanesthesiologists, as perioperative physicians, work closely with neurosurgeons, neurologists, neurointensivists, and neuroradiologists to provide care for patients with complex neurological diseases, often dealing with life-threatening conditions such as traumatic brain injuries, brain tumors, cerebral aneurysms, and spinal cord injuries. The use of simulation to practice emergency scenarios may have potential for enhancing competency and skill acquisition amongst neuroanesthesiologists. Simulation models, including high-fidelity manikins, virtual reality, and computer-based simulations, can replicate physiological responses, anatomical structures, and complications associated with neurosurgical procedures. The use of high-fidelity simulation can act as a valuable complement to real-life clinical exposure and training in neuroanesthesia.
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Affiliation(s)
| | - Krisha Patel
- Toronto Western Hospital, University of Toronto, Toronto
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11
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Khoury JA, Assani D, Vandette MP, Denis-LeBlanc M, Burnier I, Fotsing S. Medical Students' Perception of Telesimulation Training: A Qualitative Analysis. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241247371. [PMID: 38633450 PMCID: PMC11022672 DOI: 10.1177/23821205241247371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Over the past 2 decades, simulation-based learning has become an essential part of medical training. Simulated clinics have proven to be effective for training medical students. Even so, this learning method presents organizational and financial challenges that limit its dissemination to all medical students, especially since the COVID-19 pandemic. Simulated teleconsultation retains the advantages of interactive simulated clinics while offering concrete solutions to the challenges faced. The project aims to explore students' perspectives on simulated teleconsultation training compared to simulated clinics in person. METHODS Ten pre-clerkship students in the Faculty of Medicine at the University of Ottawa participated in interviews following in-person and teleconsultation simulated clinic sessions. The interview guide was developed based on previous work. The questions asked concerned experience with teleconsultation, interaction with the tutor and patient, practical or logistical obstacles, educational value and feasibility. The authors evaluated the results using a thematic analysis. RESULTS The interview analysis showed that the tutor feedback received during the simulated teleconsultation was comparable to that received after the in-person simulated clinic. Although most of the students enjoy teleconsultation, they raised the challenge of carrying out physical examinations and creating a personal connection with the tutor/patient. CONCLUSION Given the circumstances of the pandemic and students' comfort with technology, the new generation of medical students seems prepared to embrace teleconsultation. The themes identified in the analysis will enable the necessary adjustments to be made in order to optimize their teleconsultation training, an inextricable step in promoting the active offer of healthcare services.
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Affiliation(s)
- Jo-Ann Khoury
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Dourra Assani
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Manon Denis-LeBlanc
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
| | - Isabelle Burnier
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
| | - Salomon Fotsing
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
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Kishimoto N, Sanuki T, Liu Y, Tran SD, Seo K. Simulation training for medical emergencies of dental patients: A review of the dental literature. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:104-113. [PMID: 36937224 PMCID: PMC10017307 DOI: 10.1016/j.jdsr.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
In recent years, due to the aging of the population, the number of dental patients with comorbidities such as hypertension and diabetes has increased. Although it has been reported that these patients are increasingly developing medical emergencies during their dental treatments, many dental providers still do not possess the skills to manage medical emergencies appropriately. Simulation training is essential to improve this situation however, there is no report describing how to conduct an effective simulation in detail for dental office medical emergencies. The purpose of this review is to provide information on simulations that is effective and practical. The authors will highlight the key characteristics for providing effective simulation trainings, such as the selection of simulators, simulation locations, instructors, debriefings, methods for evaluating educational effectiveness, and the use of telesimulation as a method for simulation training due to the global COVID-19 pandemic. In addition, this review provides recommendations on tailoring an ideal simulation training course for those who wish to create one. The authors hope that this review will promote the spread of effective simulation training and in turn, contribute to improving the medical safety of dental patients.
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Affiliation(s)
- Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Corresponding author at: Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Younan Liu
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Kenji Seo
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Tang E, Daniel R, Wintraub L, Nelms MW, Heslop C, Cho DD, Otremba M. Delivering Point-of-Care ultrasound teaching using a video conferencing technique. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:118-121. [PMID: 38226301 PMCID: PMC10787862 DOI: 10.36834/cmej.76285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Point-of-care ultrasound (POCUS) has usually been taught using a hands-on, in-person approach. We present a novel approach to delivering POCUS virtually using a dual image videoconferencing technique. We outline an easily implementable approach and summarize medical students' experience and feedback. This form of delivery has potential to improve instructional delivery in resource restricted settings or during pandemic restrictions where a hands-on approach may not be possible.
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Affiliation(s)
- Evan Tang
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Ryan Daniel
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Lauren Wintraub
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Matthew W Nelms
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Claire Heslop
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Ontario, Canada
| | - Dennis Dane Cho
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Ontario, Canada
| | - Mirek Otremba
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
- Department of Medicine, Royal Jubilee Hospital, British Columbia, Canada
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Fang JL, Umoren RA. Telesimulation for neonatal resuscitation training. Semin Perinatol 2023; 47:151827. [PMID: 37743211 DOI: 10.1016/j.semperi.2023.151827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Telesimulation uses telecommunication and simulation to educate and assess remote learners, obviating the need for instructors or learners to travel off site. Telesimulation increases access to and convenience of simulation-based education for sites that do not have formal simulation centers, including rural/remote areas. Telesimulation is feasible, improves knowledge and skills, and is favorably received by learners and instructors. In general, telesimulation has been shown to be effective for neonatal resuscitation training, even in low- and middle-income countries. Post telesimulation debriefing, termed teledebriefing, requires many of the skills of in-person debriefing, and teledebriefing can optimize learning by exposing learners to content experts in geographically distant sites or from specialties not available locally. When implementing telesimulation for neonatal resuscitation training, key considerations include program design, telecommunication platform, pre-telesimulation preparation, and teledebriefing. Additional research is needed to identify whether lessons learned during telesimulation translate to clinical practice and impact patient outcomes.
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Affiliation(s)
- Jennifer L Fang
- Division of Neonatal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Rachel A Umoren
- Division of Neonatology, University of Washington, Seattle, WA, USA
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15
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Want DR, Cieslowski BJ. Telepresence: An Innovative Teaching Modality to Enrich Simulation and Remote Learning. Nurs Educ Perspect 2023; 44:378-379. [PMID: 36730934 DOI: 10.1097/01.nep.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT The COVID-19 pandemic magnified the need for simulation and necessitated a radical change in how educators execute simulation-based learning (SBL), highlighting new and emerging technologies. Student evaluations noted a lack of realism with screen-based and telesimulations, and faculty reported students' decreased engagement. This project enhanced SBL using robot telepresence to provide an immersive and interactive environment. Student comments supported the positive experience, expressing greater engagement and indicating that the experience closely mirrored clinical practice. Telepresence removes barriers to distance learning, augments the potential of SBL, and broadens the understanding of how to deliver engaging SBL experiences to remote learners.
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Affiliation(s)
- David R Want
- About the Authors David R. Want, DNP, FNP-C, RN, CHSE, is clinical assistant professor, Conway School of Nursing, Catholic University of America, Washington, DC. Bethany J. Cieslowski, DNP, CHSE, RN, is associate professor and VR and simulation coordinator, George Mason University School of Nursing, Fairfax, Virginia. For more information, contact Dr. Want at
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16
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Marshall J, Raatz M, Ward EC, Penman A, Beak K, Moore M, Hill AE. Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study. Dysphagia 2023; 38:1308-1322. [PMID: 36692653 PMCID: PMC9872075 DOI: 10.1007/s00455-023-10556-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
Simulation enables learners to practice new skills in a supportive environment. Largely driven by the COVID-19 pandemic, simulation via telepractice, i.e., telesimulation, has emerged. Viable delivery of telesimulation requires consideration of the adaptations needed to conduct simulation via telepractice. The aim of this study was to design and pilot test the feasibility of using telesimulation to provide training in infant feeding management. An iterative process was used across four phases: (1) simulation design, (2) telesimulation adaptations, (3) user testing, feedback, and modifications, and (4) user testing of modified simulation, feedback, and final modifications. During Phases 1 and 2, team members worked together to design and test telepractice adaptations for a simulation experience. During Phases 3 and 4, the telesimulation was pilot tested with a group of speech pathologists, with feedback sought via open-ended survey questions and/or an optional focus group. Manifest content analysis was used to interpret user feedback. In Phase 2, several adaptations were explored to optimize telesimulation delivery and engagement, including Zoom® functions (e.g., 'spotlighting,' digital backgrounds) and supplementary video/auditory files. There were 11 participants across Phases 3 and 4. Specific feedback centered around simulation preparation and structure, session practicalities, supports for realism, Zoom® functions, group dynamics, participants' experiences, and future enhancements. An overall list of recommendations for telesimulation was generated. Telesimulation for feeding management was considered feasible and participant feedback was favorable. Further research is required to investigate if the learner outcomes of telesimulation are comparable to in-person simulation for infant feeding management.
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Affiliation(s)
- Jeanne Marshall
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Madeline Raatz
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Speech Pathology Department, Logan Hospital, Metro South Hospital and Health Service, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly Beak
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Madison Moore
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Mileder LP, Bereiter M, Schwaberger B, Wegscheider T. Telesimulation for the Training of Medical Students in Neonatal Resuscitation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1502. [PMID: 37761463 PMCID: PMC10527675 DOI: 10.3390/children10091502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
Background: Telesimulation may be an alternative to face-to-face simulation-based training. Therefore, we investigated the effect of a single telesimulation training in inexperienced providers. Methods: First-year medical students were recruited for this prospective observational study. Participants received a low-fidelity mannequin and medical equipment for training purposes. The one-hour telesimulation session was delivered by an experienced trainer and broadcast via a video conference tool, covering all elements of the neonatal resuscitation algorithm. After the telesimulation training, each student underwent a standardized simulated scenario at our Clinical Skills Center. Performance was video-recorded and evaluated by a single neonatologist, using a composite score (maximum: 10 points). Pre- and post-training knowledge was assessed using a 20-question questionnaire. Results: Seven telesimulation sessions were held, with a total of 25 students participating. The median performance score was 6 (5-8). The median time until the first effective ventilation breath was 30.0 s (24.5-41.0) and the median number of effective ventilation breaths out of the first five ventilation attempts was 5 (4-5). Neonatal resuscitation knowledge scores increased significantly. Conclusions: Following a one-hour telesimulation session, students were able to perform most of the initial steps of the neonatal resuscitation algorithm effectively while demonstrating notable mask ventilation skills.
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Affiliation(s)
- Lukas P. Mileder
- Clinical Skills Center, Medical University of Graz, 8010 Graz, Austria
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria
| | - Michael Bereiter
- Clinical Skills Center, Medical University of Graz, 8010 Graz, Austria
| | - Bernhard Schwaberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria
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18
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Park JO, Lee-Jayaram J, Sato E, Eto Y, Kahili-Heede M, Hirayama K, Berg BW. A scoping review of remote facilitation during simulation-based healthcare education. BMC MEDICAL EDUCATION 2023; 23:592. [PMID: 37605196 PMCID: PMC10464104 DOI: 10.1186/s12909-023-04551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Remote facilitation is a synchronous distance education method where instructors facilitate a lesson, in real-time, in physically separate conditions. In this scoping review, we aimed to describe types of remote facilitation used in a healthcare simulation, the influences on learner outcomes, and related factors. METHODS We accessed PubMed, EMBASE, CINAHL, ERIC, and Web of Science using our search strategies. Five reviewers performed the review using the Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews (PRISMA-ScR) framework, and the Johanna Briggs Institute (JBI) guidelines. RESULTS We included a total of 29 articles presenting 28 simulation studies. The most common tool was videoconferencing (n = 26, 89.7%). Knowledge improvement was the most frequently measured outcome. There was no significant difference in learning outcomes between the two teaching modes. There were differences in learners' preferences and satisfaction with remote facilitators before and after COVID-19. CONCLUSIONS Our scoping review indicates that remote facilitation has been widely accepted in many healthcare professions using various types of simulation modalities. Remote facilitation can be used to overcome logistical problems of synchronous multi-location education, and to improve learner knowledge, skills, and confidence measured by instructor evaluation or self-assessment.
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Affiliation(s)
- Ju Ok Park
- Department of Emergency Medicine, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea.
| | - Jannet Lee-Jayaram
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Eri Sato
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Yuka Eto
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Melissa Kahili-Heede
- Health Science Library, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu Hawaii, USA
| | - Krystal Hirayama
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Benjamin W Berg
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
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19
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Yasser NBM, Tan AJQ, Harder N, Ashokka B, Chua WL, Liaw SY. Telesimulation in healthcare education: A scoping review. NURSE EDUCATION TODAY 2023; 126:105805. [PMID: 37062239 DOI: 10.1016/j.nedt.2023.105805] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To provide a comprehensive overview on the utilization and effectiveness of telesimulation in healthcare education. DESIGN A scoping review. DATA SOURCES A search of five databases including PubMed, Web of Science, Cochrane, EMBASE and ProQuest was conducted between 2000 and 2022. REVIEW METHODS Arksey and O' Malley's scoping review framework was utilised. Data were narratively synthesised. RESULTS 29 articles were included. More than half of the publications on telesimulation were borne out of need during the COVID-19 pandemic. Innovation reports were the most prevalent publications followed by descriptive studies. Telesimulation was applied for the delivery of diverse learning content including patient care management, procedural skills and team training. A variety of videoconferencing software and simulation modalities have been used for telesimulation. Telesimulation was generally well-received, despite its technical challenges. Learning effectiveness of telesimulation was evident in quasi-experimental studies. CONCLUSION Telesimulation has been gaining acceptance as a distance-based simulation education modality. It will continue to evolve and potentially blend with in-person simulation. More rigorous research is warranted to evaluate learning outcomes and establish best practices in telesimulation.
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Affiliation(s)
| | - Apphia J Q Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Nicole Harder
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Balakrishnan Ashokka
- Department of Anaesthesia, National University Hospital, Singapore; Centre for Medical Education, CenMED, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Irfanullah EA, Chandra A, Solaiman RH, Siems C, Chethan S, Belani K, Harmon J. Simulation Training in a Lower Middle-Income Country: Supporting a New Center and Developing Low-Cost Models for Critical Skill Acquisition. Cureus 2023; 15:e40950. [PMID: 37503495 PMCID: PMC10368800 DOI: 10.7759/cureus.40950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION There is a demand for surgical simulation training to be made accessible in low-resource countries. We conducted a pilot workshop at a new state-of-the-art simulation center and evaluated two novel low-cost surgical simulation models in a lower middle-income country (LMIC). METHODS A hands-on workshop to train local educators about simulation training was held at a new simulation center. Participant surveys were analyzed following the "training-the-trainer" workshop. Low-cost, hybrid-fidelity pericardiocentesis and thoracic cavity simulation training models were created using locally available materials. These models recreated the pertinent anatomy at a cost under 20 US dollars each. The models were used to train 109 postgraduate anesthesiology trainees during two hands-on medical education workshops. Participant surveys were collected and analyzed. RESULTS Of the local educators who participated in the "training-the-trainer" workshop, 65% "agreed" and 35% "strongly agreed" with the claim that the simulations better prepared the trainees to teach the clinical scenarios. Additionally, 65% of local educators "agreed" and 35% "strongly agreed" that the simulations prepared them to navigate interprofessional care in those scenarios. The low-cost pericardiocentesis simulation was ranked as "good" or "outstanding" by 100% of survey respondents. The low-cost thoracostomy simulation was ranked as "good" or "outstanding" by 64% of survey respondents. Both the pericardiocentesis and thoracostomy simulators were valued for their low-cost design, the recreation of essential anatomy, and immersive design elements. CONCLUSION Our team successfully implemented novel simulators for skill training in an LMIC by working in close collaboration with local experts, with the advancement of local simulation instruction practices. Collaboration is key to increasing access to surgical simulations, particularly in low- to middle-income countries.
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Affiliation(s)
- Eesha A Irfanullah
- Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
| | - Abhishek Chandra
- Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
| | - Rafat H Solaiman
- Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
| | - Chesney Siems
- Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
| | | | - Kumar Belani
- Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, USA
| | - James Harmon
- Department of Surgery, University of Minnesota Medical School, Minneapolis, USA
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Ramadan K, Chaiton K, Burke J, Labrakos D, Maeda A, Okrainec A. Virtual fundamentals of laparoscopic surgery (FLS) boot-camp using telesimulation: an educational solution during the covid-19 pandemic. Surg Endosc 2023; 37:3926-3933. [PMID: 37067595 PMCID: PMC10108785 DOI: 10.1007/s00464-023-09995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/23/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND The Fundamentals of Laparoscopic Surgery (FLS) is an internationally recognized educational and certification program designed to teach the knowledge and skills required for basic laparoscopic surgery. Previously, our institution has organized an FLS boot-camp to teach PGY1 residents the FLS manual skills. During the COVID-19 pandemic, in-person sessions were not possible. The purpose of this study was to utilize telesimulation as an education solution for teaching FLS technical skills to PGY1 residents during the COVID-19 pandemic. METHODS A virtual FLS program was established. A complete, easily portable FLS kit was distributed to participants and instructors to set up an FLS box and connect remotely using telesimulation. The program was delivered by three senior residents using the Zoom™ platform. Participants were split into groups of 3-4 individuals, each receiving three 1-h sessions. Sessions were structured with initial demonstration of tasks followed by individual coaching of participants in 'break-out' rooms. The official FLS exam was administered in-person on the 4th week. Pre- and post-course surveys were administered to participants gauging self-reported proficiency with FLS tasks and overall course feedback. Anonymized FLS exam results were collected. RESULTS A total of 14 residents participated, and 11 responded to the survey. Participants reported that their overall FLS skills proficiency significantly improved on a 5-point likert scale from 1.5 ± 0.5 pre-course to 4.0 ± 0.5 post-course (mean ± SD). Participants unanimously stated that having the FLS box at home was valuable and enabled them to practice more. On the FLS exam, 13 of 14 participants passed the manual skills component. CONCLUSIONS We developed a telesimulation hands-on FLS course as an alternative to in-person training. The course was practical and effective and was preferred to traditional methods by participants. With ever-expanding technological solutions, virtual telesimulation education is an attractive and underutilized tool, not only in the setting of COVID-19, but also more broadly across current educational programs.
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Affiliation(s)
- Khaled Ramadan
- Department of Surgery, Faculty of Medicine, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada
| | - Karen Chaiton
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada
| | - Jaime Burke
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Dimitra Labrakos
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada
| | - Azusa Maeda
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Allan Okrainec
- Department of Surgery, Faculty of Medicine, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada.
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada.
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada.
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22
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Falcioni AG, Yang HC, de Mattos E Silva E, Maricic MA, Ruvinsky S, Bailez MM. Comparative effectiveness of telesimulation versus standard simulation for pediatric Minimally Invasive Surgery (MIS) essential skills training. J Pediatr Surg 2023; 58:669-674. [PMID: 36658075 PMCID: PMC9773740 DOI: 10.1016/j.jpedsurg.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Proctored on site simulation-based surgical education has been integrated in our residents curricula since 2012. Due to COVID-19 pandemic and social distance protocols, we developed a Tele-assisted Essential Skills Training Module (T-ESTM). The aim of this study is to evaluate comparative effectiveness between Telesimulation (T) versus Standard Simulation (S) for minimally invasive surgery (MIS) essential skills training. METHODS ESTM includes academic lectures, tutorials for ergonomics and 7 hands-on tasks scheduled into 2 sessions of 3 hours. Initial and final assessment scoring (adapted from GOALS) as well as timing for 3 of the tasks were registered. Telesimulation (T) group accessed the content online and completed their Hands-On practice through a digital communication platform. Standard Simulation (S) group attended conferences and Hands-On practice at the simulation center. Both groups were proctored by the same educators with summative and formative feedback and debriefing. Data was analyzed with the R-studio software program. RESULTS Each group had 20 participants with a mean age of 28 ± 5 years. 67.5% were surgeons in training, 47.5% had performed low complexity procedures and 40% had previous experience with simulation training. We observed a significant improvement in scoring and time reduction for all assessed tasks in S and T groups (p < 0.001), with no statistically significant differences when comparing both groups. Similar performance could be achieved with both strategies. CONCLUSION Telesimulation is a reproducible and effective educational tool for remote MIS essential skills training, and should be considered as an alternative to on-site simulation programs. LEVEL OF EVIDENCE Level II. TYPE OF STUDY Clinical Research.
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Affiliation(s)
| | - Hsien Chen Yang
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
| | | | | | - Silvina Ruvinsky
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
| | - Maria Marcela Bailez
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
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23
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Meyer EG, Cozza KL, West JC, Hamaoka D. The Effectiveness of Online Experiential Learning in a Psychiatry Clerkship. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:181-186. [PMID: 36808570 PMCID: PMC9937738 DOI: 10.1007/s40596-023-01755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The Uniformed Services University of the Health Sciences 5-week psychiatry clerkship educates about 180 students a year at sites around the USA. In 2017, weekly in-person experiential learning sessions were implemented for local students and resulted in improved performance in several end-of-clerkship Objective Structured Clinical Examination (OSCE) skills as compared to distant learners who did not receive these sessions. The difference in performance (~ 10%) highlighted a need to provide comparable training for distant learners. Providing in-person, repeated simulated experiential training at multiple distant sites was not practical, requiring development of a novel online approach. METHODS Students at all four distant sites over 2 years (n = 180) participated in five weekly synchronous online experiential learning sessions, while local students (n = 180) received five weekly in-person experiential learning sessions. Tele-simulation used the same curriculum, centralized faculty, and standardized patients as the in-person iterations. Overall end-of-clerkship OSCE performance was compared for learners receiving online versus in-person experiential learning for non-inferiority. Specific skills were compared to receiving no experiential learning. RESULTS Overall OSCE performance was non-inferior for students who received synchronous online as compared to in-person experiential learning. Performance on each skill other than communication improved significantly when comparing students who received online versus no experiential learning (p < 0.05). CONCLUSIONS The use of weekly online experiential learning to enhance clinical skills is comparable to in-person efforts. Virtual, simulated, synchronous experiential learning provides a feasible and scalable platform for training complex clinical skills to clerkship students, a critical capability given the impact the pandemic has had on clinical training.
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Affiliation(s)
- Eric G Meyer
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Kelly L Cozza
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - James C West
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Derrick Hamaoka
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Gross IT, Clapper TC, Ramachandra G, Thomas A, Ades A, Walsh B, Kreuzer F, Elkin R, Wagner M, Whitfill T, Chang TP, Duff JP, Deutsch ES, Loellgen RM, Palaganas JC, Fayyaz J, Kessler D, Calhoun AW. Setting an Agenda: Results of a Consensus Process on Research Directions in Distance Simulation. Simul Healthc 2023; 18:100-107. [PMID: 36989108 DOI: 10.1097/sih.0000000000000663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic forced rapid implementation and refinement of distance simulation methodologies in which participants and/or facilitators are not physically colocated. A review of the distance simulation literature showed that heterogeneity in many areas (including nomenclature, methodology, and outcomes) limited the ability to identify best practice. In April 2020, the Healthcare Distance Simulation Collaboration was formed with the goal of addressing these issues. The aim of this study was to identify future research priorities in the field of distance simulation using data derived from this summit. METHODS This study analyzed textual data gathered during the consensus process conducted at the inaugural Healthcare Distance Simulation Summit to explore participant perceptions of the most pressing research questions regarding distance simulation. Participants discussed education and patient safety standards, simulation facilitators and barriers, and research priorities. Data were qualitatively analyzed using an explicitly constructivist thematic analysis approach, resulting in the creation of a theoretical framework. RESULTS Our sample included 302 participants who represented 29 countries. We identified 42 codes clustered within 4 themes concerning key areas in which further research into distance simulation is needed: (1) safety and acceptability, (2) educational/foundational considerations, (3) impact, and (4) areas of ongoing exploration. Within each theme, pertinent research questions were identified and categorized. CONCLUSIONS Distance simulation presents several challenges and opportunities. Research around best practices, including educational foundation and psychological safety, are especially important as is the need to determine outcomes and long-term effects of this emerging field.
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Affiliation(s)
- Isabel T Gross
- From the Department of Pediatrics (I.T.G., T.W.), Section of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT; Weill Cornell Medicine NewYork-Presbyterian Simulation Center (T.C.C.), Weill Cornell Medical College, New York, NY; Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad, India; Division of Pediatric Emergency Medicine (A.T.), Department of Pediatrics, Seattle Children's Hospital, Seattle, WA; Division of Neonatology (A.A.), Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Division of Pediatric Emergency Medicine (B.W.), Department of Pediatrics, Boston University School of Medicine, Boston, MA; Faculty of Medicine (F.K.), Ludwig-Maximilians-University Munich, Munich, Germany; Department of Emergency Medicine (R.E., D.K.), Columbia University Vagelos College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY; Division of Neonatology (M.W.), Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Department of Emergency Medicine (T.W.), Yale University School of Medicine, New Haven, CT; Division of Emergency Medicine (T.P.C.), Department of Medical Education, Children's Hospital Los Angeles & Keck School of Medicine at University of Southern California, Los Angeles, CA; Division of Pediatric Critical Care Medicine (J.P.D.), Department of Pediatrics, University of Alberta, Edmonton, Canada; Department of Anesthesiology and Critical Care Medicine (E.S.D.), Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatric Emergency Medicine (R.M.L.), Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Anesthesia, Critical Care, and Pain Medicine (J.C.P.), Harvard Medical School, Boston, MA; Department of Pediatric Emergency Medicine (J.F.), The Hospital for Sick Children, Toronto, Canada; and Department of Pediatrics (A.W.C.), University of Louisville and Norton Children's Hospital, Louisville, KY
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Hildreth AF, Maggio LA, Iteen A, Wojahn AL, Cook DA, Battista A. Technology-enhanced simulation in emergency medicine: Updated systematic review and meta-analysis 1991-2021. AEM EDUCATION AND TRAINING 2023; 7:e10848. [PMID: 36936085 PMCID: PMC10014971 DOI: 10.1002/aet2.10848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/14/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
Background Over the past decade, the use of technology-enhanced simulation in emergency medicine (EM) education has grown, yet we still lack a clear understanding of its effectiveness. This systematic review aims to identify and synthesize studies evaluating the comparative effectiveness of technology-enhanced simulation in EM. Methods We searched MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, Web of Science, and Scopus to identify EM simulation research that compares technology-enhanced simulation with other instructional modalities. Two reviewers screened articles for inclusion and abstracted information on learners, clinical topics, instructional design features, outcomes, cost, and study quality. Standardized mean difference (SMD) effect sizes were pooled using random effects. Results We identified 60 studies, enrolling at least 5279 learners. Of these, 23 compared technology-enhanced simulation with another instructional modality (e.g., living humans, lecture, small group), and 37 compared two forms of technology-enhanced simulation. Compared to lecture or small groups, we found simulation to have nonsignificant differences for time skills (SMD 0.33, 95% confidence interval [CI] -0.23 to 0.89, n = 3), but a large, significant effect for non-time skills (SMD 0.82, 95% CI 0.18 to 1.46, n = 8). Comparison of alternative types of technology-enhanced simulation found favorable associations with skills acquisition, of moderate magnitude, for computer-assisted guidance (compared to no computer-assisted guidance), for time skills (SMD 0.50, 95% CI -1.66 to 2.65, n = 2) and non-time skills (SMD 0.57, 95% CI 0.33 to 0.80, n = 6), and for more task repetitions (time skills SMD 1.01, 95% CI 0.16 to 1.86, n = 2) and active participation (compared to observation) for time skills (SMD 0.85, 95% CI 0.25 to 1.45, n = 2) and non-time skills (SMD 0.33 95% CI 0.08 to 0.58, n = 3). Conclusions Technology-enhanced simulation is effective for EM learners for skills acquisition. Features such as computer-assisted guidance, repetition, and active learning are associated with greater effectiveness.
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Affiliation(s)
- Amy F. Hildreth
- Walter Reed National Military Medical CenterBethesdaMarylandUSA
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Lauren A. Maggio
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Alex Iteen
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
- 3rd Medical Battalion, 3rd Marine Logistics GroupOkinawaJapan
| | - Amanda L. Wojahn
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
- Naval Medical Center San DiegoSan DiegoCaliforniaUSA
| | - David A. Cook
- Office of Applied Scholarship and Education ScienceMayo Clinic College of Medicine and ScienceRochesterMinnesotaUSA
| | - Alexis Battista
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
- The Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMarylandUSA
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Mille F, Romer A, Choudhury TA, Zurca AD, Peddy SB, Widmeier K, Hamburger M, Shankar V. Development and Optimization of a Remote Pediatric Cardiac Critical Care Bootcamp Using Telesimulation. J Pediatr Intensive Care 2023. [DOI: 10.1055/s-0043-1767736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
AbstractWe developed a novel cardiac critical care bootcamp consisting of didactic, small group, and simulation sessions. The bootcamp was remote due to the COVID-19 pandemic and included telesimulation. We aimed to assess learners' reactions to the bootcamp and their perception of telesimulation. Paired anonymous surveys were administered before and after participation. Surveys assessed participants' comfort in independently managing cardiac critical care scenarios, perceptions of telesimulation, barriers to its effectiveness, and specific feedback on course components. Forty-three fellows from 10 institutions joined the bootcamp over 2 years. Thirty-eight pre- and 28 postcourse surveys were completed. The course was rated good or excellent by all respondents, and 27/28 rated the material as appropriate to their level of training. Based on feedback from 2020, the electrophysiology sessions were converted to a small group format in 2021; positive assessment of these sessions improved from 65 to 90–100%. The telesimulations were highly rated, with 83–94% of participants in 2020 and 90–100% in 2021 rating them as good or excellent. Participants' views on telesimulation improved following the course, with 78% (14/18) post- versus 50% preparticipation agreeing that telesimulation is an effective educational tool (p = 0.06) and 56% (10/18) post- versus 67% (12/18) pre-rating telesimulation as less effective than in person simulation (p = 0.04). Identified limitations of telesimulation were limited active participation, lack of realism, impaired flow of conversation, and audiovisual and technical concerns. Telesimulation is feasible in cardiac critical care education and was an acceptable alternative to in person simulation for course participants.
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Raatz M, Marshall J, Ward EC, Dickinson C, Frederiksen N, Reilly C, Fernando S. Understanding Training Needs in Pediatric Feeding for Allied Health Professionals: An Australian Perspective. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:452-468. [PMID: 36692930 DOI: 10.1044/2022_ajslp-22-00232] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Clinician experience and confidence can negatively impact pediatric feeding service availability, but limited research has investigated what training allied health professionals (AHPs) need to increase these factors. This study developed and distributed a survey investigating Australian AHPs' self-reported confidence and anxiousness, training needs, factors impacting training access, and training preferences. METHOD This study was conducted over two phases. Phase 1 involved development and refinement of the survey, and Phase 2 involved distribution to Australian AHPs. Questions pertained to general demographics, feeding experience, feeding confidence and skills perception, and training needs. The questions were composed of multiple-choice, Likert scale, and short-response options. RESULTS Overall, 198 complete responses were received. Participants reported significantly lower confidence and higher anxiousness working with infants compared to older children (p < .01). Increased frequency of service provision predicted higher self-reported confidence and lower anxiousness (p < .01). Practical training opportunities including case discussion, videos, and clinical feedback were preferred. Access facilitators were online, on-demand training; however, respondents reported preferring hands-on training opportunities. Common barriers included cost, time, competing professional development priorities, and distance/travel. CONCLUSIONS Findings have highlighted that recency and frequency of practice impact self-reported confidence and anxiousness, and that AHPs self-report lowest confidence and highest anxiety working with infants compared to older age groups. Overall, the findings highlight the need for flexible, practical, and remotely accessible training opportunities, as well as the need for access to regular clinical supervision and a pediatric feeding caseload.
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Affiliation(s)
- Madeline Raatz
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Corrine Dickinson
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Nadine Frederiksen
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Claire Reilly
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Shenali Fernando
- Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
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Nomura O, Sunohara M, Watanabe I, Itoh T. Evaluating Emotional Outcomes of Medical Students in Pediatric Emergency Medicine Telesimulation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010169. [PMID: 36670719 PMCID: PMC9856926 DOI: 10.3390/children10010169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/17/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While medical trainees' perceived emotions have been acknowledged as a critical outcome of the in-person simulation-based training, the impact of telesimulation on trainees' emotions has been unexamined. We conducted an educational team-based simulation study with a pediatric case of septic shock. Seventeen and twenty-four medical students participated in the telesimulation training and in-person simulation training, respectively. The institutional pandemic social restrictions at the time of each training session determined the participant assignment to either the telesimulation training or in-person simulation training. All participants responded to the Japanese version of the Medical Emotion Scale, which includes 20 items rated on a five-point Likert-type scale before, during, and after the simulation sessions. The measured emotions were categized into four emotion groups according to two dimensions: positive or negative and activating or deactivating emotions. The one-way analysis of variance between the telesimulation and in-person simulation training revealed no significant differences in the emotions perceived by the participants before, during, and after the simulation training sessions. The perceived emotions of medical students were comparable between the telesimulation and in-person simulation training. Further longitudinal studies with larger samples and multiple variables are needed to generalize the effectiveness of telesimulation.
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Affiliation(s)
- Osamu Nomura
- Department of Health Sciences Education, Hirosaki University, Hirosaki 036-8562, Japan
- Centre for Community-Based Health Professions Education, Hirosaki University, Hirosaki 036-8562, Japan
- Department of Emergency and Disaster Medicine, Hirosaki University, Hirosaki 036-8562, Japan
- Correspondence:
| | - Momoka Sunohara
- Department of Psychology, Concordia University, Montreal, QC H3G 1M8, Canada
| | - Ichiro Watanabe
- Tokyo Metropolitan Children’s Medical Center, Division of Pediatric Critical Care Medicine, Tokyo 183-8561, Japan
| | - Taichi Itoh
- Department of Emergency Medicine, University of Michigan, Ann Abor, MI 48109, USA
- Department of Medical Education, University of Illinois at Chicago, Chicago, IL 60612, USA
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Gerstenberger JP, Hayes L, Chow CJ, Raaum S. Medical Student Experiential Learning in Telesimulation. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231216067. [PMID: 38025030 PMCID: PMC10664437 DOI: 10.1177/23821205231216067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Telesimulation utilizes telecommunication technology to engage learners in simulation while in different physical locations. Despite this potential advantage, understanding of the student experience and assessment of student learning in telesimulation activities is limited. This study evaluates medical student emotional experience and self-identified learning in telesimulation through the Kolb experiential learning framework and qualitative analysis. METHODS Fourth-year medical students enrolled in the Spencer Fox Eccles School of Medicine at the University of Utah participated in 3 telesimulation activities as part of a required internal medicine course. Students were surveyed regarding their satisfaction with the activity (N = 114) and responded to questions about their emotional experience and self-identified areas of learning. Free-text responses were analyzed using qualitative content analysis to identify themes until thematic saturation (N = 66). RESULTS Students were highly satisfied with telesimulation, with greater than 90% of students expressing a positive view of simulation realism, debrief quality, and group size. Themes of anxiety and uncertainty, confidence versus incompetence, team dynamics, fun, and difficult patient interaction were identified regarding the emotional experience. Themes of communication and teamwork, managing emotions, information gathering, differential diagnosis, resource reference, executing treatment, and medical knowledge were identified regarding student-identified learning. CONCLUSION In this analysis of medical student experiences with telesimulation, we found students have rich emotional, cognitive, and behavioral experiences and self-identify learning across a variety of domains. Our findings support further study of telesimulation for medical student learning and demonstrate how assessment of outcomes via Kolb framework, using the learner's reflective observation and self-identified learning, may help better define learning outcomes from simulation.
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Affiliation(s)
- John P. Gerstenberger
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lara Hayes
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Candace J. Chow
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sonja Raaum
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
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Rusli KDB, Lau ST, Tan JZ, Liaw SY. Academic-Practice Collaboration Using Virtual Telesimulation to Support Students' Clinical Practice. Nurse Educ 2023; 48:E6-E10. [PMID: 35926138 DOI: 10.1097/nne.0000000000001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Collaboration between academic institutions and clinical practice plays an important role in supporting students' learning in clinical practice. A virtual telesimulation was incorporated to provide academic-practice collaboration between academic educators and nurse preceptors to support students' clinical education. PURPOSE The purpose was to evaluate the experiences of nursing students and academic educators on the perceived impact of virtual telesimulation in clinical education. METHODS A descriptive qualitative study using focus group discussions was conducted. RESULTS Four themes emerged: "coming together to know one another" for rapport building, "learning from different perspectives" to foster clinical learning and practice, "application of learning strategy" to stimulate case-based discussion, and "reaching out to more preceptors" to optimize its impact in clinical practice. CONCLUSIONS Academic-practice collaboration using virtual telesimulation enabled students and academic educators to build rapport with clinical preceptors and learn from other practices, which in turn enhanced students' clinical learning experiences.
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Affiliation(s)
- Khairul Dzakirin Bin Rusli
- PhD Candidate & Research Assistant (Khairul), Associate Professor (Siew Tiang), Research Assistant (Jian Zhi), and Associate Professor (Sok Ying), Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Bloom AD, Aliotta RE, Mihas A, Peterson DT, Robinett DA, White ML. Tele-Simulated Instruction and Learner Perceptions of Fiberoptic Intubation and Nasopharyngoscopy: A Pilot Study. West J Emerg Med 2022; 24:104-109. [PMID: 36602496 PMCID: PMC9897257 DOI: 10.5811/westjem.2022.11.58053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023] Open
Affiliation(s)
- Andrew D. Bloom
- University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama
| | - Rachel E. Aliotta
- University of Alabama at Birmingham, Department of Orthopaedic Surgery, Birmingham, Alabama
| | - Alexander Mihas
- University of Alabama at Birmingham, Department of Orthopaedic Surgery, Birmingham, Alabama
| | - Dawn Taylor Peterson
- University of Alabama at Birmingham, Department of Medical Education, Birmingham, Alabama
| | - Derek A. Robinett
- University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama
| | - Marjorie Lee White
- University of Alabama at Birmingham, Department of Pediatrics, Birmingham, Alabama
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Löllgen RM, Berger-Estilita J, Rössler LA, Mileder LP. Avatar and distance simulation as a learning tool - virtual simulation technology as a facilitator or barrier? A questionnaire-based study on behalf of Netzwerk Kindersimulation e.V. Front Pediatr 2022; 10:853243. [PMID: 36389370 PMCID: PMC9644191 DOI: 10.3389/fped.2022.853243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Virtual simulation modalities have been implemented widely since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic restrictions in March 2020, as educators face persistent restrictions to face-to-face education of medical students and healthcare professionals.There is paucity of published data regarding the benefits and barriers of distance and avatar simulation training modalities. Methods Following a 2-day virtual pediatric simulation competition facilitated by Netzwerk Kindersimulation e.V., using remote human avatars and distance simulation, we conducted a multicenter survey to explore the advantages and challenges of avatar and distance simulation among participants. We used a modified Delphi approach to draft and develop the 32-item online questionnaire with 7-point Likert-like scales (7 being the highest rating). Results Twenty participants answered our questionnaire. Respondents indicated both a high overall satisfaction (median of 5.0 [Q25-Q75: 4.0-6.0] ) for avatar and distance simulation 6.0 (5.0-6.0), respectively, as well as a high achieved psychological safety with both simulation types (5.0 [4.0-6.0] vs. 5.0 [4.0-6.0]). The most frequently reported profits of avatar and distance simulation included the elimination of travel distances, associated lower costs, less time spent attending the education activity, and effective communication and leadership training, especially with avatar simulation. Most often named challenges were technical problems, limited reception of non-verbal cues and a spatial distance from the team/educator. Discussion Based on the results of this pilot study, avatar and distance simulation can be employed successfully and appear to be good supplements to face-to-face simulation. Other studies are warranted to further explore the effectiveness of various types of virtual simulation compared to conventional presential simulation. We suggest using avatar-based simulation for targeted communication and leadership skills training and the application of distance simulation to bring simulation experts virtually to remote places where educator resources are lacking.
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Affiliation(s)
- Ruth M Löllgen
- Pediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- Netzwerk Kindersimulation e.V., Tübingen, Germany
| | - Joana Berger-Estilita
- Netzwerk Kindersimulation e.V., Tübingen, Germany
- Institute for Medical Education, University of Bern, Bern, Switzerland
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine of Porto, Porto, Portugal
| | - Lisa A Rössler
- Netzwerk Kindersimulation e.V., Tübingen, Germany
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lukas P Mileder
- Netzwerk Kindersimulation e.V., Tübingen, Germany
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Kiriyama K, Poudel S, Kurashima Y, Watanabe Y, Murakami Y, Miyazaki K, Kawarada Y, Hirano S. Development of a systematic telesimulation curriculum for laparoscopic inguinal hernia repair. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 1:52. [PMID: 38013710 PMCID: PMC9582386 DOI: 10.1007/s44186-022-00059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/12/2022] [Accepted: 10/09/2022] [Indexed: 12/04/2022]
Abstract
Purpose Telesimulation, whereby learners telecommunicate and use simulator resources to receive education at an off-site location, has been used to educate surgical trainees about how to perform basic surgical procedures. However, it has not yet been used for advanced surgical procedures. We aimed to develop a telesimulation curriculum to teach a common laparoscopic procedure called transabdominal preperitoneal (TAPP) repair and to explore the feasibility of its use. Methods Learning objectives were created to develop a telesimulation curriculum that included didactic telelecture and telesimulation training. Pre-tests and post-tests to assess the didactic materials were developed and assessed among surgeons with various experiences. We assessed the feasibility of the telelecture and telesimulation separately. Pre-tests, post-tests, and questionnaires were used to assess the telelectures. We created a TAPP repair telesimulation system and checked for problems during training. Trainees were assessed to determine their skill improvement using previously published assessment tools and questionnaires. Results A didactic telelecture was developed based on the learning objectives using an expert consensus and pilot-tested among five participants. After the lecture, their test scores improved and they expressed positive opinions about the usefulness of telelectures. The TAPP repair telesimulation training was pilot-tested among three trainees. No technical problems occurred during training. All trainees improved their skills after the telesimulation training and agreed that the training was useful for learning the TAPP repair procedure. Conclusions We systematically developed a telesimulation curriculum for the TAPP repair procedure and demonstrated its feasibility among learners.
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Affiliation(s)
- Kotoe Kiriyama
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
- Department of Surgery and Gastroenterological Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
| | - Yusuke Watanabe
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yoshihiro Murakami
- Department of Surgery and Gastroenterological Surgery, Asahikawa City Hospital, Asahikawa, Japan
| | | | - Yo Kawarada
- Department of Surgery and Gastroenterological Surgery, Tonan Hospital, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
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Fouhy F, Sheehy B, Hannon MJ, Sweeney AM, Kennedy MP. Remote Simulation Training in the COVID-19 Era: A Novel Approach to Ultrasound-guided Diagnostic Thoracentesis. J Bronchology Interv Pulmonol 2022; 29:e60-e63. [PMID: 35822742 DOI: 10.1097/lbr.0000000000000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Fergal Fouhy
- Department of Medicine, Bantry General Hospital, Bantry
| | - Brian Sheehy
- Department of Medicine, Bantry General Hospital, Bantry
| | - Mark J Hannon
- Department of Medicine, Bantry General Hospital, Bantry
| | - Anne M Sweeney
- Department of Respiratory Medicine, Cork University Hospital
| | - Marcus P Kennedy
- Department of Respiratory Medicine, Cork University Hospital
- ASSERT Centre
- College of Medicine and Health, University College Cork, Cork, Ireland
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Olvera-Cortés HE, Hernández-Gutiérrez LS, Scherer-Castanedo E, Ramírez-Arias JD, Argueta Muñoz FD, Gutiérrez-Barreto SE. Who Can Debriefing Assessment for Simulation in Healthcare? Different Perspectives on Teledebriefing Assessments. Simul Healthc 2022; 17:308-312. [PMID: 35136006 DOI: 10.1097/sih.0000000000000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Virtual debriefing is a cardinal element to achieve the effectiveness of telesimulation. There are different instruments to assess face-to-face debriefing to determine the degree of effectiveness of debriefing; Debriefing Assessment for Simulation in Healthcare (DASH) instrument is one of them. This study aims to describe and compare the evaluation of raters, instructors, and students during a virtual debriefing using the DASH. METHODS A cross-sectional study was performed evaluating the virtual debriefing of 30 instructors after a heart failure telesimulation scenario. The evaluation was conducted by 30 instructors, 338 undergraduate students in the seventh semester, and 7 simulation raters. The 3 versions of the DASH instrument in Spanish were applied, respectively. RESULTS Two comparisons were made, student versus instructor and rater versus instructor. Cronbach α was 0.97 for each version. The averages of the results on the DASH instrument were: 6.61 (3.34-7.0), 5.95 (4.65-7.0), and 4.84 (2.68-6.02) for student, rater, and instructor versions, respectively. The size effect between student and debriefer perspectives was 0.42. In contrast, the size effect between instructor and rater was 0.72. All differences were significant. CONCLUSIONS There are different rates between the persons who use the DASH. In this study, from the perspective of the instructor and rater, the difference was 1 point with a wide range, in contrast with the difference between instructor and student, which is relatively minor. It is necessary to consider the perspectives of experts in the subject to achieve a virtual debriefing of high quality and improve a debriefing by using the DASH.
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Affiliation(s)
- Hugo E Olvera-Cortés
- From the Department of Integration of Medical Sciences, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Chuisano SA, Anderson OS, Weirauch K, Roper R, Phillips J, McCabe C, Sadovnikova A. An Application of Kane's Validity Framework to Evaluate Formative and Summative Assessment Instruments for Telesimulations in Clinical Lactation. Simul Healthc 2022; 17:313-321. [PMID: 35322800 DOI: 10.1097/sih.0000000000000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Health professional learners have limited exposure to breastfeeding patients from diverse backgrounds in clinical rotations. Instead, simulation-based training is used for lactation skills training. There are no validated or standardized simulations and assessment rubrics for lactation. In this pilot, breastfeeding telesimulations with standardized patients (SPs) wearing a high-fidelity breast model matching their skin tone were developed. The validity of Formative and Summative Assessment Rubrics (FAR, SAR) were assessed following Kane's validity framework. The objective was to provide initial evidence for the validity of the FAR and SAR as constructs of competence in lactation support at the entry to practice or practice level. METHODS Three breastfeeding case scenarios, FAR, and SAR were developed and evaluated with clinical lactation specialists (evaluators, n = 17) and SPs. The FAR was used in practice telesimulations where SPs' (n = 14) performance and telesimulation feasibility were assessed. The FAR was updated in preparation for a pilot study where medical students (n = 13) completed the 3 telesimulations. In the pilot, the updated FAR was used by SPs (n = 6) to assess medical students' performance of clinical skills. After the pilot, rubrics were updated after focus groups with SPs and discussions with evaluators. Evaluators (n = 3) graded students' posttelesimulation documentations using the SAR. Cronbach ɑ level and the intraclass correlation coefficient were assessed iteratively to collect evidence for the scoring, generalizability, and extrapolation of the FAR and SAR according to Kane's framework. RESULTS The FAR and SAR were found to have acceptable internal consistency and moderate to high interrater reliability (intraclass correlation coefficient, 0.55-0.94), which provided evidence for scoring and generalizability of the instruments. Evaluators agreed that SPs' performances were realistic (5.6/6), and SPs' feedback was organized (5.5/6) and helpful (5.6/6), which provided evidence for extrapolation. CONCLUSIONS Initial evidence for validity of scoring, generalization, and extrapolation FAR and SAR (according to Kane's framework) in assessing health professional learner's performance of clinical lactation skills has been presented. These results from a pilot study suggest that the FAR and SAR are reliable instruments for assessing learners' clinical performance in a breastfeeding-focused telesimulation where the SP wears a high-fidelity breast model matching their skin tone. Additional studies will be required to collect evidence according to all 4 categories of Kane's framework for the validity of the FAR and SAR.
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Affiliation(s)
- Samantha A Chuisano
- From LiquidGoldConcept, Inc. (S.A.C., A.S.), Ypsilanti; Department of Nutritional Sciences (O.S.A., C.M.), University of Michigan School of Public Health, Ann Arbor, MI; Sparrow-MSU Family Medicine Residency Program (K.W., R.R.), Lansing, MI; Department of Family Medicine (J.P.), College of Human Medicine, Michigan State University, East Lansing, MI; and Physician Scientist Training Program (A.S.), University of California, Davis, Davis, CA
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Thomas AA, Montgomery EE, Abulebda K, Whitfill T, Chapman J, Leung J, Fayyaz J, Auerbach M. The feasibility of a pediatric distance learning curriculum for emergency department nurses during the COVID-19 pandemic: An Improving Pediatric Acute Care Through Simulation (ImPACTS) collaboration. J Emerg Nurs 2022. [PMCID: PMC9458703 DOI: 10.1016/j.jen.2022.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction To develop and evaluate the feasibility and effectiveness of a longitudinal pediatric distance learning curriculum for general emergency nurses, facilitated by nurse educators, with central support through the Improving Acute Care Through Simulation collaborative. Methods Kern’s 6-step curriculum development framework was used with pediatric status epilepticus aimed at maintaining physical distancing, resulting in a 12-week curriculum bookended by 1-hour telesimulations, with weekly 30-minute online asynchronous distance learning. Recruited nurse educators recruited a minimum of 2 local nurses. Nurse educators facilitated the intervention, completed implementation surveys, and engaged with other educators with the Improving Pediatric Acute Care through Simulation project coordinator. Feasibility data included nurse educator project engagement and curriculum engagement by nurses with each activity. Efficacy data were collected through satisfaction surveys, pre-post knowledge surveys, and pre-post telesimulation performance checklists. Results Thirteen of 17 pediatric nurse educators recruited staff to complete both telesimulations, and 38 of 110 enrolled nurses completed pre-post knowledge surveys. Knowledge scores improved from a median of 70 of 100 (interquartile range: 66-78) to 88 (interquartile range: 79-94) (P = .018), and telesimulation performance improved from a median of 60 of 100 (interquartile range: 45-60) to 100 (interquartile range: 85-100) (P = .016). Feedback included a shortened intervention and including physician participants. Discussion A longitudinal pediatric distance learning curriculum for emergency nurses collaboratively developed and implemented by nurse educators and Improving Pediatric Acute Care through Simulation was feasible for nurse educators to implement, led to modest engagement in all activities by nurses, and resulted in improvement in nurses’ knowledge and skills. Future directions include shortening intervention time and broadening interprofessional scope.
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Falcioni AG, Yang HC, Maricic MA, Rodriguez SP, Bailez MM. Effectiveness of telesimulation for pediatric minimally invasive surgery essential skills training. J Pediatr Surg 2022; 57:1092-1098. [PMID: 35241279 PMCID: PMC8806401 DOI: 10.1016/j.jpedsurg.2022.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND In the context of the COVID-19 pandemic and social distancing rules, access to in-person training activities had temporarily been interrupted, speeding up the implementation of telesimulation for minimally invasive surgery (MIS) essential skills training (T-ESTM, Telesimulation - Essential Skills Training Module) in our center. The aim of this study was to explore the effectiveness of T-ESTM. METHODS T-ESTM was scheduled into 2 sessions of 3 h through the Zoom® virtual meeting platform. The academic lectures, the tutorials for box-trainer set-up and 7 performance tasks were accessed through an online campus previous to the remote encounter for personalized guidance and debriefing. Initial (pre-telementoring) and final (post 6-hour telementoring) assessment scoring as well as timing for Task 2 (circle-cutting pattern), 3 (extracorporeal Roeder knot) and 5 (intracorporeal Square knot) were registered. RESULTS 61 participants were recruited. The mean age was 31±5 years. 65% were surgical residents. 48% performed low complexity procedures. 52% had previous experience with simulation training. In Task 2, there was a 21% improvement in the final score obtained, as well as a significant decrease in time of 33%; in Task 3, there was an increase of 39% in the scoring and a decrease of 49% in the timing; and in Task 5, participants improved their technique a 30% and decreased the performance time a 47%. All the differences were statistically significant. DISCUSSION Our data support T-ESTM as a reproducible and effective educational tool for remote MIS essential skills hands-on training. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Alejandra Georgina Falcioni
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina.
| | - Hsien Chen Yang
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
| | - Maximiliano Alejo Maricic
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
| | | | - Maria Marcela Bailez
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
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Thyagarajan S, Ramachandra G, Jamalpuri V, Calhoun AW, Nadkarni V, Deutsch ES. Simulathon 2020: Integrating Simulation Period Prevalence Methodology Into the COVID-19 Disaster Management Cycle in India. Simul Healthc 2022; 17:183-191. [PMID: 34405824 PMCID: PMC9169606 DOI: 10.1097/sih.0000000000000601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
SUMMARY STATEMENT The disaster management cycle is an accepted model that encompasses preparation for and recovery from large-scale disasters. Over the past decade, India's Pediatric Simulation Training and Research Society has developed a national-scale simulation delivery platform, termed the Simulathon , with a period prevalence methodology that integrates with core aspects of this model. As an exemplar of the effectiveness of this approach, we describe the development, implementation, and outcomes of the 2020 Simulathon, conducted from April 20 to May 20 in response to the nascent COVID-19 pandemic disaster. We conclude by discussing how aspects of the COVID-19 Simulathon enabled us to address key aspects of the disaster management cycle, as well as challenges that we encountered. We present a roadmap by which other simulation programs in low- and middle-income countries could enact a similar process.
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Affiliation(s)
- Sujatha Thyagarajan
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Geethanjali Ramachandra
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Vijayanand Jamalpuri
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Aaron W. Calhoun
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Vinay Nadkarni
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Ellen S. Deutsch
- From the Aster RV Hospital (S.T.), Bangalore; PediSTARS (S.T.); Department of Pediatric Intensive Care (G.R.), Krishna Institute of Medical Science, Secunderabad; Pediatric Simulation Training and Research Society (G.R.); Rainbow Children's Hospital (V.J.), Hyderabad, India; Department of Pediatrics (A.W.C.), Norton Children's Hospital, University of Louisville, Louisville, KC; and Departments of Anesthesiology (V.N., E.S.D.), Critical Care (V.N.), and Pediatrics (V.N.), Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Cruz-Panesso I, Perron R, Chabot V, Gauthier F, Demers MM, Trottier R, Soulières F, Juste L, Gharavi S, MacDonald N, Richard A, Boivin A, Deligne B, Bouillon K, Drolet P. A practical guide for translating in-person simulation curriculum to telesimulation. Adv Simul (Lond) 2022; 7:14. [PMID: 35551653 PMCID: PMC9096760 DOI: 10.1186/s41077-022-00210-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 04/15/2022] [Indexed: 11/22/2022] Open
Abstract
This article provides a road map, along with recommendations, for the adoption and implementation of telesimulation at a large scale. We provide tools for translating an in-presence simulation curriculum into a telesimulation curriculum using a combination off-the-shelf telecommunication platform. We also describe the roles and tasks that emerged within the simulation team when planning and delivering a telesimulation curriculum.
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Affiliation(s)
- Ilian Cruz-Panesso
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Roger Perron
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Valérie Chabot
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Frédérique Gauthier
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Marie-Michèle Demers
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Roxane Trottier
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Francis Soulières
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Laetitia Juste
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Shiva Gharavi
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | | | - Amélie Richard
- Undergraduate Medical Studies, Université de Montréal, Montreal, Canada
| | - Audrey Boivin
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Benoit Deligne
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
| | - Karine Bouillon
- Undergraduate Medical Studies, Université de Montréal, Montreal, Canada
| | - Pierre Drolet
- Center for learning of clinical attitudes and skills (CAAHC, Centre d’Apprentissage des Attitudes et Habilités Cliniques), Université de Montréal – Campus de Montréal, Montreal, Canada
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Brandão CFS, Vaccarezza GF, Albanese RP, Fernandes GCVR, Cecilio-Fernandes D. Application of telesimulation in a medical undergraduate course during the SARS-CoV-2 pandemic: a quantitative and retrospective study. SAO PAULO MED J 2022; 140:509-513. [PMID: 35507998 PMCID: PMC9671257 DOI: 10.1590/1516-3180.2021.0108.r2.22112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 09/16/2021] [Accepted: 11/22/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Because of the social isolation and distancing measures that were imposed to stop the spread of coronavirus disease 19 (COVID-19), new ways of teaching were implemented. OBJECTIVES To describe the implementation of telesimulation and seek to assess students' perceptions regarding telesimulation. DESIGN AND SETTING Retrospective quantitative study conducted within the hospital simulation at a private medical school in São Paulo, Brazil. METHODS After telesimulation training, students answered a questionnaire that provided an overall assessment of this activity, self-assessment and assessments of the facilitators and infrastructure provided by the University. RESULTS Among the students, 50% reported that the activity was below expectations and 45% reported that it was in line with their expectations. The strong points of the activity were the clinical cases, workload and teachers. The main challenge was students' difficulty in reflecting on their learning and the infrastructure. CONCLUSIONS Since students have less experience and fewer clinical encounters than residents or professionals, they also face more difficulty. Although telesimulation may have provided a valid alternative to replace simulation training during the COVID-19 pandemic, more face-to-face activities should be offered to students, when possible.
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Affiliation(s)
- Carolina Felipe Soares Brandão
- BSc, DVM, MSc, PhD. Professor, Hospital Simulation, Medicine Program, Universidade Cidade de São Paulo (UNICID), São Paulo (SP), Brazil.
| | - Gabriela Furst Vaccarezza
- DDS, MSc. Professor, Medicine Program, Universidade Municipal de São Caetano do Sul (USCS), São Caetano do Sul (SP), Brazil.
| | - Regina Pose Albanese
- MSc. Professor, Medicine Program, Universidade Municipal de São Caetano do Sul (USCS), São Caetano do Sul (SP), Brazil.
| | | | - Dario Cecilio-Fernandes
- MSc, PhD. Researcher, Department of Medical Psychology and Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Chua WL, Ooi SL, Chan GWH, Lau TC, Liaw SY. The Effect of a Sepsis Interprofessional Education Using Virtual Patient Telesimulation on Sepsis Team Care in Clinical Practice: Mixed Methods Study. J Med Internet Res 2022; 24:e35058. [PMID: 35436237 PMCID: PMC9062715 DOI: 10.2196/35058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/21/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Improving interprofessional communication and collaboration is necessary to facilitate the early identification and treatment of patients with sepsis. Preparing undergraduate medical and nursing students for the knowledge and skills required to assess, escalate, and manage patients with sepsis is crucial for their entry into clinical practice. However, the COVID-19 pandemic and social distancing measures have created the need for interactive distance learning to support collaborative learning. OBJECTIVE This study aimed to evaluate the effect of sepsis interprofessional education on medical and nursing students' sepsis knowledge, team communication skills, and skill use in clinical practice. METHODS A mixed methods design using a 1-group pretest-posttest design and focus group discussions was used. This study involved 415 undergraduate medical and nursing students from a university in Singapore. After a baseline evaluation of the participants' sepsis knowledge and team communication skills, they underwent didactic e-learning followed by virtual telesimulation on early recognition and management of sepsis and team communication strategies. The participants' sepsis knowledge and team communication skills were evaluated immediately and 2 months after the telesimulation. In total, 4 focus group discussions were conducted using a purposive sample of 18 medical and nursing students to explore their transfer of learning to clinical practice. RESULTS Compared with the baseline scores, both the medical and nursing students demonstrated a significant improvement in sepsis knowledge (P<.001) and team communication skills (P<.001) in immediate posttest scores. At the 2-month follow-up, the nursing students continued to have statistically significantly higher sepsis knowledge (P<.001) and communication scores (P<.001) than the pretest scores, whereas the medical students had no significant changes in test scores between the 2-month follow-up and pretest time points (P=.99). A total of three themes emerged from the qualitative findings: greater understanding of each other's roles, application of mental models in clinical practice, and theory-practice gaps. The sepsis interprofessional education-particularly the use of virtual telesimulation-fostered participants' understanding and appreciation of each other's interprofessional roles when caring for patients with sepsis. Despite noting some incongruities with the real-world clinical practice and not encountering many sepsis scenarios in clinical settings, participants shared the application of mental models using interprofessional communication strategies and the patient assessment framework in their daily clinical practice. CONCLUSIONS Although the study did not show long-term knowledge retention, the use of virtual telesimulation played a critical role in facilitating the application of mental models for learning transfer and therefore could serve as a promising education modality for sepsis training. For a greater clinical effect, future studies could complement virtual telesimulation with a mannequin-based simulation and provide more evidence on the long-term retention of sepsis knowledge and clinical skills performance.
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Affiliation(s)
- Wei Ling Chua
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Sim Leng Ooi
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Gene Wai Han Chan
- Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tang Ching Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Rheumatology, Department of Medicine, National University Health System, Singapore, Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
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Mosher C, Mukhtar F, Alnaami N, Akkielah YA, Alsharif J, Khan T, Taskiran HC, Zafar M. Donning and Doffing of Personal Protective Equipment: Perceived Effectiveness of Virtual Simulation Training to Decrease COVID-19 Transmission and Contraction. Cureus 2022; 14:e22943. [PMID: 35411270 PMCID: PMC8987117 DOI: 10.7759/cureus.22943] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction The COVID-19 pandemic exposed gaps in the knowledge of correct donning and doffing of personal protective equipment (PPE) among healthcare workers, causing hospitals to ramp up training. However, social distancing measures forced most institutions and workplaces to shift to remote operations, allowing only essential personnel onsite. Virtual simulation is a growing trend in healthcare simulation education, even more so in this pandemic era. Yet, we have found no evidence of the perceived effectiveness of virtual simulation for training healthcare providers in the proper donning and doffing of PPE. This study aims to determine learner perceptions of the effectiveness of a virtual simulation PPE training module. Methods To address this gap, we used a virtual simulation training module in an online format to determine the perceived efficacy of this method of instruction with the contribution of a variety of healthcare providers and trainees, including physicians, surgeons, pharmacists, dentists, and nurses. Results We found a statistically significant difference in the confidence level of observing best practices of donning and doffing PPE before and after the training sessions. We also found that participants believe virtual simulation can be an effective educational tool for clinical skills. Conclusions This paper presents an international, guideline-based virtual simulation training module that can serve to educate, train, and assess healthcare workers in the proper sequence and technique of donning (putting on), doffing (removing), and disposing of PPE without contaminating themselves or others.
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Tham AC, Himdi L, Nguyen LH, Frenkiel S, Tewfik MA. Conducting an Endoscopic Sinus Surgery Dissection Course via Telesimulation: An Initial Experience. OTO Open 2022; 6:2473974X221083981. [PMID: 35274075 PMCID: PMC8902190 DOI: 10.1177/2473974x221083981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Medical education has been severely disrupted by the COVID-19 pandemic, with many
in-person educational activities transitioned to distance learning. To overcome this
challenge, we utilized telesimulation to conduct an endoscopic sinus surgery (ESS)
dissection course. Our objectives were to evaluate the effectiveness and acceptability
of telesimulation as an alternative to in-person dissection courses for resident
training. Study Design Cross-sectional study. Setting Academic medical centers. Methods The course, consisting of lectures and hands-on dissection, was conducted entirely over
the Zoom platform. The participants were allocated outpatient clinic rooms at 2
hospitals, while the instructors supervised remotely. We utilized the camera systems in
the clinics and 3-dimensional–printed sinus models for the dissection. Laptops with
cameras were used to capture the endoscopic image and the dissector. We evaluated the
effectiveness of telesimulation, the surgical skills of the participants, and the course
by way of pre- and posttest and a questionnaire. Results A total of 8 participants and 7 instructors participated in the study. Telesimulation
was found to be effective in helping participants gain knowledge and skills in ESS. All
participants improved on their pretest scores (31.5% vs 73.4%, P =
.003) and felt more comfortable with ESS postcourse (1.9 vs 3.2, P =
.008). Participants and instructors opined that telesimulation is an acceptable
alternative to in-person dissection courses. Conclusion Telesimulation is an effective, acceptable, and viable alternative to in-person
dissection courses. It also has the advantage of overcoming temporal and geographic
constraints to surgical training in residency.
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Affiliation(s)
- Alex C. Tham
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada
| | - Lamiae Himdi
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada
| | - Lily H.P. Nguyen
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada
- Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Saul Frenkiel
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada
| | - Marc Antoine Tewfik
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada
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Herrera-Aliaga E, Estrada LD. Trends and Innovations of Simulation for Twenty First Century Medical Education. Front Public Health 2022; 10:619769. [PMID: 35309206 PMCID: PMC8929194 DOI: 10.3389/fpubh.2022.619769] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
In the last two decades there has been an enormous growth in the use of clinical simulation. This teaching-learning methodology is currently the main tool used in the training of healthcare professionals. Clinical simulation is in tune with new paradigms in education and is consistent with educational theories that support the use of experiential learning. It promotes the development of psychomotor skills and strengthens executive functions. This pedagogical approach can be applied in many healthcare topics and is particularly relevant in the context of restricted access to clinical settings. This is particularly relevant considering the current crisis caused by the COVID-19 pandemic, or when trying to reduce the frequency of accidents attributed to errors in clinical practice. This mini-review provides an overview of the current literature on healthcare simulation methods, as well as prospects for education and public health benefits. A literature search was conducted in order to find the most current trends and state of the art in medical education simulation. Presently, there are many areas of application for this methodology and new areas are constantly being explored. It is concluded that medical education simulation has a solid theoretical basis and wide application in the training of health professionals at present. In addition, it is consolidated as an unavoidable methodology both in undergraduate curricula and in continuing medical education. A promising scenario for medical education simulation is envisaged in the future, hand in hand with the development of technological advances.
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Affiliation(s)
| | - Lisbell D. Estrada
- Faculty of Health Sciences, Universidad Bernardo O'Higgins, Santiago, Chile
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Major S, Krage R, Lazarovici M. SimUniversity at a distance: a descriptive account of a team-based remote simulation competition for health professions students. Adv Simul (Lond) 2022; 7:6. [PMID: 35135625 PMCID: PMC8822656 DOI: 10.1186/s41077-021-00199-5] [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: 06/10/2021] [Accepted: 12/24/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND SimUniversity competition is an innovative Society in Europe for Simulation Applied to Medicine (SESAM) initiative which has existed since 2014, with the aim of creating opportunities for undergraduate healthcare students to take part in a formative educational experience on an international platform. The main educational focus is on promoting non-technical skills such as leadership, situation awareness, decision making, communication, and assertiveness, but also clinical reasoning within a team. In preparation for the 2021 virtual conference, the team designed a new methodology to meet the same mission, and yet be offered remotely. MAIN TEXT In this article, we describe the way in which we transformed the SimUniversity competition activity from face to face to a remote simulation. We relied on Zoom as the main communication technology to enable the distance component and followed the key elements of pre-briefing, simulation, and debriefing with the students being onsite together in one location and the faculty and simulator technologists in distant locations. Thirty-eight medical and nursing students formed 8 teams from 7 different countries. Two participating teams were based in Germany and one in Italy, Belgium, the Netherlands, Romania, Portugal, and Syria. Each team consisted of between 4 and 5 members and was self-selected to consist of either medical students alone or medical and nursing students together. The SimUniversity faculty team was composed of 5 physician educators, one nurse educator, one paramedic simulation technologist, and one industry simulation technologist. The faculty members facilitated each simulation synchronously in Zoom, while being based in different geographical locations within Europe (Germany, Switzerland, and the Netherlands) and the Middle East (Qatar and Lebanon). CONCLUSION We conclude that assuming there is access to adequate internet connectivity and minimal technical setup, conducting a remote simulation with virtual debriefing is achievable in supporting team-based learning, particularly when learners and/or faculty members are in distant locations. While the authors do not recommend this method to be superior to a face-to-face experience, we propose this model to be an alternative method to consider when educators are faced with imposed restrictions such as what we faced during the COVID-19 pandemic. We discuss lessons learned and highlight other potential benefits that this method may provide, to consider even when the restrictions are lifted.
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Affiliation(s)
- Stella Major
- Present Address: Division of Medical Education, Weill Cornell Medicine- Qatar,
| | - Ralf Krage
- Department of Anesthesiology and Intensive Medicine, KJF Klinik St. Elisabeth, Neuburg, Germany
| | - Marc Lazarovici
- University Hospital Munich, Institute for Emergency Medicine and Management in Medicine – INM, Munich, Germany
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Maloney CE, Burns R, Hartford E, von Saint Andre-von Arnim A, Foohey S, Kailemia M, Reel B, Thomas A. International Pediatric Emergency Medicine and Critical Care Fellow Education: Utilizing Virtual Resuscitation Simulation in Settings With Differing Resources. Cureus 2022; 14:e21991. [PMID: 35282505 PMCID: PMC8906565 DOI: 10.7759/cureus.21991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/05/2022] [Indexed: 11/23/2022] Open
Abstract
Pediatric Emergency and Critical Care-Kenya (PECC-Kenya) is an international collaboration between the University of Nairobi and the University of Washington (UW) supporting a combined fellowship program in pediatric emergency medicine (PEM) and pediatric critical care medicine (PCCM) in Kenya. Typically, PEM/PCCM faculty from UW travel to Kenya to support in-person simulation, which was cancelled due to COVID-19 travel restrictions. This presented a need for alternative modalities to continue simulation-based education. This technical report describes the use of virtual simulation for pediatric emergency and critical care fellow education on the management of hypovolemic and septic shock, utilizing international guidelines and being based on resource availability.
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Levine M, Singh M, Restivo A, Petti A, Kulkarni M. Recommendations for Optimizing Virtual Simulation: A Trial and Error Process From the COVID-19 Pandemic. J Grad Med Educ 2022; 14:18-21. [PMID: 35222814 PMCID: PMC8848875 DOI: 10.4300/jgme-d-21-00515.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Michael Levine
- Michael Levine, MD, is Emergency Medicine Resident, Albert Einstein College of Medicine
| | - Maninder Singh
- Maninder Singh, MD, is Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine, and Director of Healthcare Simulation, Jacobi Medical Center
| | - Andrew Restivo
- Andrew Restivo, MD, is Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine
| | - Alexander Petti
- Alexander Petti, MD, is Critical Care Fellow, Albert Einstein College of Medicine
| | - Miriam Kulkarni
- Miriam Kulkarni, MD, is Associate Professor of Emergency Medicine, Lake Erie College of Osteopathic Medicine
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Bilgic E, Okrainec A, Valanci S, Di Palma A, Fecso A, Kaneva P, Masino C, Watanabe Y, Vassiliou MC, Feldman LS, Fried GM. Development of a simulation curriculum to teach and assess advanced laparoscopic suturing skills using telesimulation: a feasibility study. Surg Endosc 2022; 36:5483-5490. [PMID: 34997338 PMCID: PMC8741533 DOI: 10.1007/s00464-021-08880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
Background Telesimulation helps overcome limitations in time and local expertise by eliminating the need for the learner and educator to be physically co-located, especially important during COVID-19. We investigated whether teaching advanced laparoscopic suturing (ALS) through telesimulation is feasible, effective, and leads to improved suturing in the operating room (OR). Methods In this prospective feasibility study, three previously developed 3D-printed ALS tasks were used: needle handling (NH), suturing under tension (UT), and continuous suturing (CS). General surgery residents (PGY4-5) underwent 1-month of telesimulation training, during which an expert educator at one site remotely trained residents at the other site over 2–3 teaching sessions. Trainees were assessed in the three tasks and in the OR at three time points: baseline(A1), control period(A2), and post-intervention(A3) and completed questionnaires regarding educational value and usability of telesimulation. Paired t-test was used to compare scores between the three assessment points. Results Six residents were included. Scores for UT improved significantly post-intervention A3(568 ± 60) when compared to baseline A1(416 ± 133) (p < 0.019). Similarly, scores for CS improved significantly post-intervention A3(756 ± 113) vs. baseline A1(539 ± 211) (p < 0.02). For intraoperative assessments, scores improved significantly post-intervention A3(21 ± 3) when compared to both A1(17 ± 4) (p < 0.018) and A2(18 ± 4) (p < 0.0008). All residents agreed that tasks were relevant to practice, helped improve technical competence, and adequately measured suturing skill. All residents found telesimulation easy to use, had strong educational value, and want the system to be incorporated into their training. Conclusion The use of telesimulation for remotely training residents using ALS tasks was feasible and effective. Residents found value in training using the tasks and telesimulation system, and improved ALS skills in the OR. As the pandemic has caused a major structural shift in resident education, telesimulation can be an effective alternative to on-site simulation programs. Future research should focus on how telesimulation can be effectively incorporated into training programs.
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Affiliation(s)
- Elif Bilgic
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, QC, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada
- Department of Surgery, McGill University, 1650 Cedar Ave, #L9.303, Montreal, QC, H3G 1A4, Canada
| | - Allan Okrainec
- Division of General Surgery, University Health Network, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Temerty Advanced Surgical Education and Simulation Centre, University Health Network, Toronto, ON, Canada
| | - Sofia Valanci
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada
| | - Adam Di Palma
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Andras Fecso
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Pepa Kaneva
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada
| | - Caterina Masino
- Temerty Advanced Surgical Education and Simulation Centre, University Health Network, Toronto, ON, Canada
| | - Yusuke Watanabe
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Melina C Vassiliou
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada
- Department of Surgery, McGill University, 1650 Cedar Ave, #L9.303, Montreal, QC, H3G 1A4, Canada
| | - Liane S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada
- Department of Surgery, McGill University, 1650 Cedar Ave, #L9.303, Montreal, QC, H3G 1A4, Canada
| | - Gerald M Fried
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, QC, Canada.
- Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, Canada.
- Department of Surgery, McGill University, 1650 Cedar Ave, #L9.303, Montreal, QC, H3G 1A4, Canada.
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Costa RRDO, Araújo MSD, Medeiros SMD, Mata ANDS, Almeida RGDS, Mazzo A. Análise conceitual e aplicabilidade de telessimulação no ensino em saúde: Revisão de escopo. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0457pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo analisar o conceito de telessimulação e sua aplicabilidade no contexto do ensino em saúde. Método trata-se de uma análise conceitual, realizada através de uma scoping review realizada em maio de 2021, nas seguintes bases de dados: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online e Google Scholar, mediante o uso do descritor “telessimulação” e suas respectivas traduções para inglês e espanhol. Para análise dos estudos, avaliaram-se os atributos, antecedentes e consequentes do conceito. Resultados a telessimulação é definida como uma ramificação da simulação clínica que se caracteriza pela promoção/viabilização de práticas educativas no ensino em saúde, realizadas remotamente, síncrona, através de videochamada. Tem como objetivo facilitar o contato entre instrutores e participantes em situações de necessidade de distanciamento social, acesso dificultado por razões econômicas, como a escassez de recursos humanos e materiais, e/ou geograficamente distantes, com a intenção de desenvolver e aperfeiçoar competências e habilidades pertinentes as profissões da saúde. Conclusão e implicações para a prática a telessimulação representa uma nova oportunidade na formação em saúde, ao ampliar as possibilidades de ensino e romper barreiras que vão desde as geográficas até as econômicas.
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