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Messing JA, Russell-Babin K, Baker D, D'Aoust R. Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence. J Trauma Nurs 2024; 31:129-135. [PMID: 38742719 DOI: 10.1097/jtn.0000000000000786] [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: 05/16/2024]
Abstract
BACKGROUND The care of patients undergoing low-volume, high-risk emergency procedures such as bedside laparotomy (BSL) remains a challenge for surgical trauma critical care nurses. OBJECTIVES This study evaluates simulation and microlearning on trauma nurse role ambiguity, knowledge, and confidence in caring for patients during emergency BSL. METHODS The study is a single-center, prospective pretest-posttest design conducted from September to November 2022 at a Level I trauma center in the Mid-Atlantic United States using simulation and microlearning to evaluate role clarity, knowledge, and confidence among surgical trauma intensive care unit (STICU) nurses. Participants, nurses from a voluntary convenience sample within a STICU, attended a simulation and received three weekly microlearning modules. Instruments measuring role ambiguity, knowledge, and confidence were administered before the simulation, after, and again at 30 days. RESULTS From the pretest to the initial posttest, the median (interquartile range [IQR]) Role Ambiguity scores increased by 1.0 (1.13) (p < .001), and at the 30-day posttest, improved by 1.33 (1.5) (p < .001). The median (IQR) knowledge scores at initial posttest improved by 4.0 (2.0) (p < .001) and at the 30-day posttest improved by 3.0 (1.75) (p< .001). The median (IQR) confidence scores at initial posttest increased by 0.08 (0.33) (p = .009) and at the 30-day posttest improved by 0.33 (0.54) (p = .01). CONCLUSIONS We found that simulation and microlearning improved trauma nurse role clarity, knowledge, and confidence in caring for patients undergoing emergency BSL.
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Affiliation(s)
- Jonathan A Messing
- Author Affiliations: Inova Health System (Drs Messing and Russell-Babin), Fairfax, Virginia; and School of Nursing, Johns Hopkins University (Drs Baker and D'Aoust), Baltimore, Maryland
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Almarhabi M, Cornish J, Raleigh M, Philippou J. Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia. NURSE EDUCATION TODAY 2024; 134:106092. [PMID: 38262185 DOI: 10.1016/j.nedt.2024.106092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care. OBJECTIVES To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions. DESIGN A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development. SETTINGS Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia. PARTICIPANTS Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated. METHODS Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis. FINDINGS Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement. CONCLUSION This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided. TWEETABLE ABSTRACT The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.
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Affiliation(s)
- Maha Almarhabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Jocelyn Cornish
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Mary Raleigh
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Julia Philippou
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
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Bartimote C, Hoskin AK, Fraser CL, Watson S. Globe trauma associated with falls at Australian tertiary centres. Emerg Med Australas 2024; 36:55-61. [PMID: 37620108 DOI: 10.1111/1742-6723.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Falls frequently cause globe and adnexal trauma, particularly in the elderly. The morbidity decreases confidence, independence and quality of life. We aimed to improve the understanding of fall-related globe and adnexal trauma and the involvement of ophthalmology at two tertiary trauma centres. METHODS A retrospective medical record review was conducted at Royal North Shore Hospital and Royal Prince Alfred Hospital of patients admitted with fall-related globe and/or adnexal trauma between January 2015 and December 2019. International Classification of Disease Tenth Revision codes were used to identify patients for inclusion. Medical records were reviewed to extract data on demographics, trauma, ocular examination and referrals to ophthalmology. RESULTS From January 2015 to December 2019, 346 patients, 186 were female (54%) and median age 76 years (interquartile range 24 years), were admitted to Royal North Shore Hospital and Royal Prince Alfred Hospital with fall-related globe and/or adnexal trauma. One hundred and twenty-five (36%) suffered globe trauma with 48 (14%) classified as severe. Patients over 65 years old had at least three risk factors contributing to falls. Alcohol and illicit substances were involved in 20% of falls and occurred predominantly in younger populations. There were significantly more patients with globe trauma if orbital/mid-facial fractures were present (55% vs 36%, P < 0.001). CONCLUSION Fall-related globe and adnexal trauma were more common in the elderly. Alcohol and illicit substances have a role in falls in younger populations. Thorough ocular assessment is required especially in mid-facial/orbital trauma to exclude globe trauma. Further, research is required to determine the effect of fall prevention strategies in preventing globe trauma.
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Affiliation(s)
- Christopher Bartimote
- Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Annette K Hoskin
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Ophthalmology, The University of Western Australia, Perth, Western Australia, Australia
- Department of Ophthalmology, Lions Eye Institute, Perth, Western Australia, Australia
| | - Clare L Fraser
- Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Watson
- Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Bartimote C, Hoskin AK, Fraser CL, Watson S. Globe and adnexal trauma at Australian trauma centres. Injury 2024; 55:110976. [PMID: 37563048 DOI: 10.1016/j.injury.2023.110976] [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: 02/23/2023] [Revised: 07/05/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION In multisystem trauma, the assessment and management of globe and adnexal trauma is often complex. Ophthalmology input may assist managing such patients. To understand the role of ophthalmology in tertiary trauma centres we report on the management of globe and adnexal trauma at two tertiary trauma centres in Sydney, Australia. METHOD A retrospective case series was completed at Royal North Shore Hospital (RNSH) and Royal Prince Alfred Hospital (RPAH) on patients admitted between January 2015 and December 2019. International Classification of Disease, Tenth Revision codes, diagnostic and procedural coding data were used to identify patients admitted with globe and/or adnexal trauma. Data extracted from medical records included demographics, mechanism of injury, ocular examination and specialist ophthalmic referral. RESULTS Over 5-years, 773 patients, average age of 53.2years and 62% male, were admitted to RNSH and RPAH with globe and/or adnexal trauma. Most patients (83%) first presented to RNSH or RPAH. The most common mechanism of injury was falls (45%) followed by burns (13%). Two-hundred and thirty-five patients had multisystem trauma, of these patients, 121 (51%) suffered globe trauma with 49 (21%) classified as severe. Three patients were not diagnosed initially due to delayed ophthalmology referral. CONCLUSION Falls followed by burns were common causes of globe and adnexal trauma in Sydney, Australia. The presence of orbital/mid-facial injury may indicate a patient has globe trauma. In multisystem trauma, globe trauma may be diagnosed late or not identified. Ophthalmology review has an important role in diagnosing and managing globe trauma in multisystem trauma.
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Affiliation(s)
- C Bartimote
- Department of Ophthalmology, The Sydney and Sydney Eye Hospital, Sydney, NSW, Australia; Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales Australia.
| | - A K Hoskin
- Department of Ophthalmology, University of Western Australia, Nedlands, Western Australia, Australia; Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales Australia; Lions Eye Institute, Nedlands, Western Australia, Australia
| | - C L Fraser
- Department of Ophthalmology, The Sydney and Sydney Eye Hospital, Sydney, NSW, Australia; Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales Australia
| | - S Watson
- Department of Ophthalmology, The Sydney and Sydney Eye Hospital, Sydney, NSW, Australia; Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales Australia
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Knutsson S, Axelsson J, Lindqvist G. An application of the caritative caring approach – nursing students’ experiences of practising caring and uncaring encounters by simulation at a clinical training centre. Int J Qual Stud Health Well-being 2022; 17:2100610. [PMID: 35822434 PMCID: PMC9291673 DOI: 10.1080/17482631.2022.2100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Purpose Nurses’ lack of competence to be caring affects patients’ health and patients describe a desire for more individual and compassionate care. Nursing education tends, however, to focus less on the caring approach in nursing practice and more on developing knowledge in psychomotor skills. The aim of this study was to describe nursing students’ experiences of simulating caring and uncaring encounters founded on the caritative perspective at a Clinical Training Centre (CTC). Method A qualitative, inductive approach using a qualitative latent content analysis. Written reflections of 49 students were analysed. Findings By intertwining reflection with acting and observation, the students experienced that they achieved an open mind and gained an understanding of how important it was to treat the patient based on a caring approach. To act, first uncaring and thereafter caring, gave them an awakening. The students were touched and an overwhelming feeling of suddenly understanding human uniqueness and vulnerability appeared. Conclusions To simulate caritative caring and uncaring encounters at the CTC enhanced students’ knowledge and understanding about caring and strengthened their prerequisites to acquire a caritative ontological basic view and attitude which in the long run may lead to an increased feeling of patient well-being in the encounter.
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Affiliation(s)
- Susanne Knutsson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Johanna Axelsson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Gunilla Lindqvist
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Oliveira TMN, Moreira ACMG, Martins EAP. simulação da reanimação cardiopulmonar e o conhecimento de socorristas. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.39427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: comparar o conhecimento de socorristas antes e depois da capacitação de reanimação cardiopulmonar com o método da simulação realística. Método: estudo quase-experimental realizado com 41 socorristas do Suporte Básico de Vida que contemplam 8 bases da 18° Regional de Saúde do Paraná. Os socorristas responderam ao Instrumento para Avaliação da capacitação em Ressuscitação Cardiopulmonar aplicado antes e depois da simulação realística. Resultados: obteve-se diferença estatisticamente significativa (p < 0,02) em 6 das 10 questões, as quais abordaram: a sequência das manobras de reanimação cardiopulmonar; a carga elétrica do desfibrilador externo automático; a posição, a profundidade e a velocidade das compressões torácicas; a relação compressão/ventilação; e o manuseio do desfibrilador externo automático. Já em outras duas questões — reconhecimento da parada cardiorrespiratória e dispositivo de ventilação com pressão positiva — não houve mudança quanto à alternativa de resposta. Encontraram-se 60% de acertos das questões quando avaliado o conhecimento prévio e 90% de acertos após as fases da simulação realística. Conclusão: os socorristas não atingiram com totalidade o questionário de pré-teste; entretanto, após a estratégia da simulação realística, houve um aumento significativo desse conhecimento. Esses resultados demonstraram melhoria no conhecimento cognitivo dos socorristas após simulação, o que foi comprovado pelo aumento de conhecimento expresso no pós-teste. Essa metodologia também pode ser aplicada com sucesso a essa categoria profissional.
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Rutherford-Hemming T, Herrington A, Newsome L. The Use of Simulation-Based Education With New Graduate Nurses in Emergency Department and Acute Care Settings: A Scoping Review. J Contin Educ Nurs 2022; 53:301-306. [PMID: 35858147 DOI: 10.3928/00220124-20220603-05] [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: 11/20/2022]
Abstract
Background The literature questions if newly graduated nurses are truly ready to practice at the bedside. Simulation has been shown to bridge the gap between theory and practice. The purpose of this study was to investigate what is known about the use of simulation education with novice graduate nurses in critical care settings in the hospital. Method A scoping review was conducted using the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Articles published in English between 2015 and September 2021 that focused on simulation education with novice graduate nurses in a critical care setting were included. Results The review yielded six articles. Conclusion The literature is scant on the use of simulation in critical care areas with novice graduate nurses. Additional inquiry is needed related to the role of learners, cost, timing, setting, and educational practices. More studies with stronger research designs and valid and reliable measurement instruments are also needed. Finally, there is a need to better understand the effects of simulation on novice nurse graduates' knowledge and skills as well as patient outcomes. [J Contin Educ Nurs. 2022;53(7):301-306.].
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Serou N, Sahota LM, Husband AK, Forrest SP, Slight RD, Slight SP. Learning from safety incidents in high-reliability organizations: a systematic review of learning tools that could be adapted and used in healthcare. Int J Qual Health Care 2021; 33:mzab046. [PMID: 33729493 PMCID: PMC8271183 DOI: 10.1093/intqhc/mzab046] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/26/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE A high-reliability organization (HRO) is an organization that has sustained almost error-free performance, despite operating in hazardous conditions where the consequences of errors could be catastrophic. A number of tools and initiatives have been used within HROs to learn from safety incidents, some of which have the potential to be adapted and used in healthcare. We conducted a systematic review to identify any learning tools deemed to be effective that could be adapted and used by multidisciplinary teams in healthcare following a patient safety incident. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses for Protocols reporting guidelines and was registered with the PROSPERO (CRD42017071528). A search of databases was carried out in January 2021, from the date of their commencement. We conducted a search on electronic databases such as Web of Science, Science Direct, MEDLINE in Process Jan 1950-present, EMBASE Jan 1974-present, CINAHL 1982-present, PsycINFO 1967-present, Scopus and Google Scholar. We also searched the grey literature including reports from government agencies, relevant doctoral dissertations and conference proceedings. A customized data extraction form was used to capture pertinent information from included studies and Critical Appraisal Skills Programme tool to appraise on their quality. RESULTS A total of 5921 articles were identified, with 964 duplicate articles removed and 4932 excluded at the title (4055), abstract (510) and full-text (367) stages. Twenty-five articles were included in the review. Learning tools identified included debriefing, simulation, crew resource management and reporting systems to disseminate safety messages. Debriefing involved deconstructing incidents using reflective questions, whilst simulation training involved asking staff to relive the event again by performing the task(s) in a role-play scenario. Crew resource management is a set of training procedures that focus on communication, leadership and decision-making. Sophisticated incident-reporting systems provide valuable information on hazards and were widely recommended as a way of disseminating key safety messages following safety incidents. These learning tools were found to have a positive impact on learning if conducted soon after the incident with efficient facilitation. CONCLUSION Healthcare organizations should find ways to adapt to the learning tools or initiatives used in HROs following safety incidents. It is challenging to recommend any specific one as all learning tools have shown considerable promise. However, the way these tools or initiatives are implemented is critical, and so further work is needed to explore how to successfully embed them into healthcare organizations so that everyone at every level of the organization embraces them.
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Affiliation(s)
- Naresh Serou
- School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, Tyne and Wear NE1 7RU, UK
- Operating Theatres, Singleton Hospital, Swansea Bay University Health Board, Swansea SA2 8QA, Wales, UK
- Swansea Medical School, Swansea University, Swansea SA2 8QA , Wales, UK
| | - Lauren M Sahota
- School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, Tyne and Wear NE1 7RU, UK
| | - Andy K Husband
- School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, Tyne and Wear NE1 7RU, UK
| | - Simon P Forrest
- Department of Sociology, Durham University, Durham DH1 1SZ, UK
| | - Robert D Slight
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, Tyne and Wear NE1 7RU, UK
- Department of Pharmacy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Rd, High Heaton, Newcastle upon Tyne, Tyne and Wear NE7 7DN, UK
| | - Sarah P Slight
- School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, Tyne and Wear NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, Tyne and Wear NE1 7RU, UK
- Department of Pharmacy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Rd, High Heaton, Newcastle upon Tyne, Tyne and Wear NE7 7DN, UK
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Gholami M, Changaee F, Karami K, Shahsavaripour Z, Veiskaramian A, Birjandi M. Effects of multiepisode case-based learning (CBL) on problem-solving ability and learning motivation of nursing students in an emergency care course. J Prof Nurs 2021; 37:612-619. [PMID: 34016321 DOI: 10.1016/j.profnurs.2021.02.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Meeting the learning needs and developing the thinking skills of nursing students in caring for injured patients with complex, emergency, and unpredictable conditions is essential. PURPOSE The present study aimed to compare the effects of case-based learning (CBL) with multi-episode case studies and lecture-based learning (LBL) on the perceived problem-solving ability and learning motivation of undergraduate nursing students in an emergency care course. METHODS This study was conducted with a quasi-experimental, within-subjects, pretest-posttest design. Forty-three third-year undergraduate nursing students (as a single cohort) enrolled in the fall semester were selected using convenience sampling. The theoretical course of emergency nursing was taught to them using the LBL method (control group) during the first six weeks of the semester and then using the CBL method (intervention group) during the second six weeks of the semester through multi-episode cases in five steps. Outcomes including perceived problem-solving ability and learning motivation were measured using the Problem-Solving Inventory (PSI) and the Instructional Materials Motivation Scale (IMMS). RESULTS There was a significant difference (P < 0.001) between the changes in the total mean score of perceived problem-solving ability and its subscales on the three measurement points, i.e. before lectures (pre-test), after lectures (mid-term test) and after CBL (final test). There was a significant difference between the LBL and CBL groups in terms of the students' total learning motivation score (t = 16.91, P = 0.000) and all its subscales after the CBL intervention. CONCLUSION The study suggests that the CBL method applied through multi-episode cases is an effective approach to improving the perceived problem-solving ability and learning motivation of nursing students.
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Affiliation(s)
- Mohammad Gholami
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Farahnaz Changaee
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Kimia Karami
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Pediatric Nursing, Educational Development Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Shahsavaripour
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Atefeh Veiskaramian
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Birjandi
- Department of Biostatistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Abelsson A, Gustafsson M, Petersèn C, Knutsson S. Physical stress triggers in simulated emergency care situations. Nurs Open 2021; 8:156-162. [PMID: 33318823 PMCID: PMC7729522 DOI: 10.1002/nop2.614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/15/2020] [Accepted: 08/06/2020] [Indexed: 01/10/2023] Open
Abstract
Aim To practise emergency care situations during the education can be stressful. The aim of this study is to identify factors that cause stress in simulated emergency care. Design A descriptive observational study. Methods Video recordings (N = 26) subjected to observation with written field notes in turn subjected to interpretive qualitative content analysis. Results To assess the patient's condition and decide what measures to take trigger stress reactions. If the students failed to connect the correct and relevant information in the conversation with the physician, the students showed signs of stress. Also, to calculate medication dosages stress the students.
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Affiliation(s)
- Anna Abelsson
- Department of Nursing ScienceSchool of Health SciencesJönköping UniversityJönköpingSweden
| | - Marcus Gustafsson
- Department of Nursing ScienceSchool of Health SciencesJönköping UniversityJönköpingSweden
| | - Christina Petersèn
- Department of Nursing ScienceSchool of Health SciencesJönköping UniversityJönköpingSweden
| | - Susanne Knutsson
- Department of Nursing ScienceSchool of Health SciencesJönköping UniversityJönköpingSweden
- Department of Health and Caring SciencesFaculty of Health and Life SciencesLinnaeus UniversityVäxjöSweden
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Drost-de Klerck AM, Olgers TJ, van de Meeberg EK, Schonrock-Adema J, Ter Maaten JC. Use of simulation training to teach the ABCDE primary assessment: an observational study in a Dutch University Hospital with a 3-4 months follow-up. BMJ Open 2020; 10:e032023. [PMID: 32636280 PMCID: PMC7342483 DOI: 10.1136/bmjopen-2019-032023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate short-term and long-term effectiveness of simulation training to acquire a structured Airway Breathing Circulation Disability Exposure (ABCDE) approach for medical emergencies; and to examine which skills were learnt and maintained best. DESIGN An observational study with a 3-4 months follow-up. SETTING Skills center of the University Medical Center Groningen. PARTICIPANTS Thirty voluntary participants (21 females and 9 males; 27±2.77 years) of a simulation-based course. INTERVENTION A 2-day ABCDE-teaching course for residents and non-residents. The course encompasses 24 simulations in which participants perform primary assessments of acute ill patients. Video recordings were taken of each participant performing a primary assessment, before (T1), directly after (T2) and 3-4 months after the intervention (T3). MAIN OUTCOME MEASURES Physicians' performance in the ABCDE primary assessment at T1, T2 and T3. Two observers scored the primary assessments, blinded to measurement moment, using an assessment form to evaluate the performance with regard to skills essential for a structured ABCDE approach. The Friedman and Wilcoxon signed-rank test were used to compare physicians' performances on the subsequent measurement moments. RESULTS The mean ranks on the total primary assessment at T1, T2 and T3 were 1.14, 2.62 and 2.24, respectively, and were significantly different, (p<0.001).The mean ranks on the total primary assessment directly after the course (T2 vs T1 p<0.001) and 3-4 months after the course (T3 vs T1 p<0.001) were significantly better than before the course. Certain skills deteriorated during the follow-up. Strikingly, most skills that decrease over time are Crew Resources Management (CRM) skills. CONCLUSION A course using simulation training is an effective educational tool to teach physicians the ABCDE primary assessment. Certain CRM skills decrease over time, so we recommend organising refresher courses, simulation team training or another kind of simulation training with a focus on CRM skills.
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Affiliation(s)
| | - Tycho J Olgers
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Johanna Schonrock-Adema
- Institute for Medical Education, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan C Ter Maaten
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
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Abelsson A, Lundberg L. Simulation as a means to develop firefighters as emergency care professionals. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 25:650-657. [PMID: 30362390 DOI: 10.1080/10803548.2018.1541122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective. The aim of this study was to evaluate the simulated emergency care performed by firefighters and their perception of simulation as an educational method. Methods. This study had a mixed method with both a quantitative and a qualitative approach. Data were collected by simulation assessment, a questionnaire and written comments. Descriptive analysis was conducted on the quantitative data whereas a qualitative content analysis was conducted on the qualitative data. Finally, a contingent analysis was used where a synthesis configured both the quantitative and the qualitative results into a narrative result. Results. The cognitive workload that firefighters face during simulated emergency care is crucial for learning. In this study, the severity and complexity of the scenarios provided were higher than expected by the firefighters. Clearly stated conditions for the simulation and constructive feedback were considered positive for learning. Patient actors induced realism in the scenario, increasing the experience of stress, in comparison to a manikin. Conclusion. Simulation in a realistic on-scene environment increases firefighters' cognitive ability to critically analyze problems and manage emergency care. Simulation of emergency care developed the firefighters as professionals.
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Affiliation(s)
- Anna Abelsson
- a School of Health Sciences, Jönköping University , Sweden
| | - Lars Lundberg
- b Swedish Armed Forces Centre for Defence Medicine , Sweden.,c PreHospen - Centre for Prehospital Research, University of Borås , Sweden
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