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Ott T, Demare T, Möhrke J, Silber S, Schwab J, Reuter L, Westhphal R, Schmidtmann I, Dietz SO, Pirlich N, Ziebart A, Engelhard K. Does an instructional video as a stand-alone tool promote the acquisition of practical clinical skills? A randomised simulation research trial of skills acquisition and short-term retention. BMC MEDICAL EDUCATION 2024; 24:714. [PMID: 38956562 PMCID: PMC11221112 DOI: 10.1186/s12909-024-05714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND The effectiveness of instructional videos as a stand-alone tool for the acquisition of practical skills is yet unknown because instructional videos are usually didactically embedded. Therefore, we evaluated the acquisition of the skill of a humeral intraosseous access via video in comparison to that of a self-study with an additional retention test. METHODS After ethical approval, we conducted two consecutive studies. Both were designed as randomised controlled two-armed trials with last-year medical students as independent samples at our institutional simulation centre of a tertiary university hospital centre. In Study 1, we randomly assigned 78 participants to two groups: Vid-Self participants watched an instructional video as an intervention, followed by a test, and after seven days did a self-study as a control, followed by a test. Self-Vid ran through the trial in reverse order. In Study 2, we investigated the influence of the sequence of the two teaching methods on learning success in a new sample of 60 participants: Vid-Self watched an instructional video and directly afterward did the self-study followed by a test, whereas Self-Vid ran through that trial in reverse order. In Studies 1 and 2, the primary outcome was the score (worst score = 0, best score = 20) of the test after intervention and control. The secondary outcome in Study 1 was the change in score after seven days. RESULTS Study 1: The Vid-Self (Participants n = 42) was superior to the Self-Vid (n = 36) (mean score 14.8 vs. 7.7, p < 0.001). After seven days, Self-vid outperformed Vid-Self (mean score 15.9 vs. 12.5, p < 0.001). Study 2: The Vid-Self (n = 30) and Self-Vid (n = 30) scores did not significantly differ (mean 16.5 vs. mean 16.5, p = 0.97). CONCLUSION An instructional video as a stand-alone tool effectively promotes the acquisition of practical skills. The best results are yielded by a combination of an instructional video and self-study right after each other, irrespective of sequence. TRIAL REGISTRATIONS ClinicalTrials.gov: NCT05066204 (13/04/2021) (Study 1) and NCT04842357 (04/10/2021) (Study 2).
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Affiliation(s)
- Thomas Ott
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany.
| | - Tim Demare
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Julia Möhrke
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Saskia Silber
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Johannes Schwab
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Lukas Reuter
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Ruben Westhphal
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centerof the, Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, Mainz, 55131, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centerof the, Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, Mainz, 55131, Germany
| | - Sven-Oliver Dietz
- Department of Orthopaedics and Traumatology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Nina Pirlich
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Alexander Ziebart
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Kristin Engelhard
- Department of Anaesthesiology, University Medical Centerof the, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
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Feldman O, Nasrallah N, Bitterman Y, Shavit R, Marom D, Rapaport Z, Kabesa S, Benacon M, Shavit I. Pediatric Intraosseous Access Performed by Emergency Department Nurses Using Semiautomatic Devices: A Randomized Crossover Simulation Study. Pediatr Emerg Care 2021; 37:442-446. [PMID: 30256319 DOI: 10.1097/pec.0000000000001621] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND No study has examined the performance of emergency department (ED) nurses in establishing intraosseous access (IO) access. This study aimed to evaluate ED nurses' success rate in establishing pediatric IO access using semiautomatic devices. METHODS A randomized crossover simulation study was conducted. The success rates of ED nurses were compared with those of paramedics with similar years of experience. The study instruments were the new spring-loaded injector (NIO) and the battery power drill (EZ-IO). Uncooked piglets' bones were used as the study model. All attempts were filmed by a video camera. Successful placement was defined as the visualization of flow from the marrow cavity. Participants recorded their ranking of the "ease of use" of each device. RESULTS No differences in 1-attempt success rate was found between nurses and paramedics (27/34 [79.4%] vs 25/30 [83.3%], P = 0.68). Nurses and paramedics had similar success rates with the 2 semiautomatic IO devices (12/17 vs 12/15 with the spring-loaded injector, P = 0.69, and 15/17 vs 13/15 with the battery power drill, P = 0.9). The number of failed attempts and the causes for failure were equally distributed between nurses and paramedics. Median ease-of-use Likert-scale scores of the spring-loaded injector and the battery power drill were 4 (interquartile range [IQR] = 3-4) and 5 (IQR = 5-5) (P < 0.04) for the nurses and 5 (IQR = 4-5) and 5 (IQR = 4-5) (P = 0.44) for the paramedics, respectively. CONCLUSIONS Emergency department nurses and paramedics had a similarly high insertion success rates on a pediatric bone model. This pilot study suggests that ED nurses can successfully perform this procedure.
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Affiliation(s)
| | | | - Yuval Bitterman
- Pediatric Department, Ruth Children's Hospital, Rambam Health Care Campus, Haifa
| | - Roni Shavit
- Faculty of Life Sciences, Tel Aviv University, Tel Aviv
| | | | - Zofia Rapaport
- Advanced Nursing Education Center, Rambam Health Care Campus, Haifa
| | - Shauli Kabesa
- Advanced Nursing Education Center, Rambam Health Care Campus, Haifa
| | - Michael Benacon
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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Leutscher SA, Gerritse BM, van der Meer NJ, Schuitemaker FJ, Scohy TV. Need of intraosseous access in advanced life support in the in-hospital setting. Resuscitation 2017; 112:e7. [DOI: 10.1016/j.resuscitation.2016.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 11/21/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
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Krishnan M, Lester K, Johnson A, Bardeloza K, Edemekong P, Berim I. Bent Metal in a Bone: A Rare Complication of an Emergent Procedure or a Deficiency in Skill Set? Case Rep Crit Care 2016; 2016:4382481. [PMID: 28018682 PMCID: PMC5149611 DOI: 10.1155/2016/4382481] [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: 10/16/2016] [Revised: 10/27/2016] [Accepted: 10/30/2016] [Indexed: 12/04/2022] Open
Abstract
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus. Conventional bedside removal was impossible and required surgical intervention in operating room.
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Affiliation(s)
- Mridula Krishnan
- Department of Internal Medicine, CHI Creighton University Medical Center, Omaha, NE, USA
| | | | - Amber Johnson
- Creighton University School of Medicine, Omaha, NE, USA
| | - Kaye Bardeloza
- Department of Internal Medicine, CHI Creighton University Medical Center, Omaha, NE, USA
| | - Peter Edemekong
- Department of Family Medicine, CHI Creighton University Medical Center, Omaha, NE, USA
| | - Ilya Berim
- Department of Pulmonary and Critical Care, CHI Creighton University Medical Center, Omaha, NE, USA
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