Training residents to lead emergency teams: A qualitative review of barriers, challenges and learning goals

Implementing Oncology Pharmacy Boot Camp for Advanced Pharmacy Practice Experience Students at a Regional Conference in Saudi Arabia

Background Upon graduation, pharmacy students are expected to possess a diverse array of knowledge, skills, and attitudes. A subject-specific boot camp may support bridging the gap between the information and skills gained during clerkships, courses required for pharmacy school after graduation, and skills needed for the job market, as well as the gap between pharmacy school and residency. This research aimed to determine whether an integrated boot camp increased Advanced Pharmacy Practice Experience (APPE) student self-confidence and enhanced students' knowledge in oncology pharmacy. Method APPE students who attended the annual meeting of the Saudi Oncology Pharmacy Assembly (SOPA)/International Society of Oncology Pharmacy Practitioners (ISOPP) Regional Conference 2021 were voluntarily enrolled in a three-hour oncology-focused boot camp consisting of interactive lectures. Pre- and post-intervention examinations were used to evaluate student learning outcomes and their experience feedback. Result Of 118 students who attended the boot camp, 80 students who met the criteria were included in the study. The pre- and post-intervention examinations were completed by the 80 APPE students. The pre-intervention test results (mean: 66%, standard deviation (SD): 16%) increased by 21.5% after the boot camp (mean: 87.5%, SD: 12%, p = 0.001). Students scored better on each of the 10 test questions, with nine questions demonstrating a statistically significant result. Conclusion The results of this research showed that interns who participated in an oncology boot camp had a higher level of knowledge and confidence in applying key oncology concepts. Interns were satisfied with the chance to engage in the activity, and they agreed to adding boot camps to future conferences would be valuable. This research shows that it is possible to hold a transitional boot camp during conferences to better prepare students for their fields of study and increase their participation in oncology conferences.

Gender Differences in Anxiety, Attitudes, and Fear among Nursing Undergraduates Coping with CPR Training with PPE Kit for COVID

BACKGROUND

The aim of this study was to examine the attitudes, fears, and anxiety level of nursing students faced with a critical clinical simulation (cardiopulmonary reanimation) with and without personal protective equipment (PPE).

METHODS

A pilot before-after study as conducted from 21 to 25 June 2021, with 24 students registered in the nursing degree of the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM) in the city of Talavera de la Reina (Toledo, Spain). From 520 possible participants, only 24 were selected according to the exclusion and inclusion criteria. The STAI Manual for the State-Trait Anxiety Inventory, a self-evaluation questionnaire, was used to study trait STAI (basal anxiety), trait STAI before CPR, state STAI after CPR, total STAI before CPR, and total STAI after CPR as the main variables. A t-test was used to study the STAI variables according to sex and the physiological values related to the anxiety level of participants. An ANOVA statistical test was used to perform a data analysis of the STAI variables.

RESULTS

A total of 54.2% of participants (IC 95% 35.1-72.1) suffered from global anxiety before the cardiopulmonary reanimation maneuvers (CPR). The results of the STAI before CPR maneuvers showed significant differences according to gender in state anxiety (p = 0.04), with a higher level of anxiety in women (22.38 ± 7.69 vs. 15.82 ± 7.18).

CONCLUSIONS

This study demonstrates different levels of anxiety in terms of gender suffered by nursing students in high-pressure environments, such as a CPR situation.

Harnessing power of simulation training effectiveness with Kirkpatrick model in emergency surgical airway procedures

Objectives

Training effectiveness indicates how good a program has met pre-set training objectives or organizational goals for the best benefit of healthcare professionals and service users in the community. The study aimed to evaluate training effectiveness following implementation of new training curriculum of emergency surgical airway procedures (Cricothyroidotomy) organized by the Queen Elizabeth Hospital.

Design

This training evaluation relied on observational descriptive study design. Timed task on Cricothyroidotomy procedures and standardized post-training questionnaire were applied to assess the first 3 levels of Kirkpatrick's model: (Level-1) Reaction by training satisfaction; (Level-2) Learning by acquisition of knowledge and skills assessment passing rate; (Level-3) Behavior by personal strengths.

Setting

This program was operated in the Multi-Disciplinary Simulation and Skills Centre, a hospital-based high-fidelity simulation training center accredited by the Society for Simulation in Healthcare.

Participants

The study recruited 80 trauma service providers, including 35 general surgeons, 15 emergency physicians, 10 anesthesiologists or intensivists, 6 neurosurgeons, 4 orthopedic surgeons, and 10 emergency nurses from five trauma centers under the Hospital Authority. All underwent the Advanced Trauma Life Support training in advance.

Results

Compared with reference score from previous training sessions, the result of program using new training curriculum and simulator demonstrated significant training satisfaction of participants (Level-1), and high level of assertiveness, mental preparedness, self-efficacy, and internal locus of control and responsibility (p < .01, for all in Level-3). All participants (N = 80) completed entire Cricothyroidotomy procedure in 2 min without technical errors (Assessment passing rate = 100%) (Level-2).

Conclusions

Under Kirkpatrick model, simulation training in Cricothyroidotomy procedure using new curriculum and simulators has been proven to be useful for healthcare professionals involved in trauma service management. The result suggests that application of a state-of-the-art training tools to advanced surgical skills training could improve training satisfaction, knowledge and skills acquisition, and personal strengths transferable to clinical practice.

ACGME competencies

Practice Based Learning and Improvement.

Homeowner perceptions and responses to buffelgrass invasion risk in the Tucson, Arizona Wildland-Urban Interface

In this study, we aimed to analyze homeowners' level of awareness and perceived risk about buffelgrass invasion in the Tucson, Arizona Wildland-Urban Interface (WUI), as well as the factors influencing their participation in buffelgrass control and fire risk mitigation efforts. Data for the study were generated through the administration of an online survey among 117 members of Home Owner Associations (HOAs) in the Tucson WUI. The results showed that the overwhelming majority of respondents were aware of buffelgrass, but their knowledge about buffelgrass control mechanisms appeared to be limited. Respondents also more frequently expressed concern about the risks posed by buffelgrass invasion to general targets, such as the Sonoran Desert ecosystem, native plants and wildlife than risks to their private property and neighborhoods. The results also showed that the level of involvement in HOAs, and leadership in HOAs had significant positive effects on homeowners' participation in buffelgrass control efforts. Homeowners' duration of residence also had a significant negative effect on participation in buffelgrass control efforts, suggesting that newcomers may be more involved than long-term residents. Similarly, the number of months respondents spent in Tucson per year had a negative effect on the number of hours spent on buffelgrass control efforts. Respondents' perceived risk about buffelgrass invasion also had a positive effect on the hours spent on buffelgrass control as well as their level of involvement in fire risk mitigation efforts. These results highlight the importance of local institutions and community heterogeneity in social responses to threats in WUI communities. Policies aimed at building the resilience of WUI communities need to account for their complexity as coupled social-ecological systems.

Do Rescuers' Physiological Responses and Anxiety Influence Quality Resuscitation under Extreme Temperatures?

Teaching and training cardiopulmonary resuscitation (CPR) through simulation is a priority in Health Sciences degrees. Although CPR is taught as a simulation, it can still be stressful for the trainees since it resembles a real-life circumstance. The aim of this study was to assess the physiological effects and anxiety levels of health sciences undergraduates when faced with CPR process in different temperatures (room temperature, extremely cold, or extremely warm). This was a descriptive cross-sectional before–after study conducted during the 2018/2019 academic year with 59 students registered in the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM). State Trait Anxiety Inventory (STAI) questionnaires were distributed among the students before and after the CPR simulation. We found greater level of situational anxiety in undergraduates faced with extreme adverse temperature scenarios (extreme heat and cold), especially in conditions of extreme heat compared to controlled environment (at room temperature). We discovered differences regarding sex, in which men scored 6.4 ± 5.55 points (STAI after CPR score) and women scored 10.4 ± 7.89 points (STAI after CPR score). Furthermore, there was less lactate in blood, before and during the event in individuals with anxiety. In addition, beginning in Minute 7, we observed a remarkable decrease (but not significant) in the performance of rescuers with anxiety. Programs targeted at promoting coping mechanisms to reduce anxiety before a critical clinic situation should be implemented in academic training.

Multi-Specialty Boot Camp: Enhancing Student Confidence in Residency Preparation

BACKGROUND

A "boot camp" or senior preparatory course can help to bridge the gap between knowledge and skills attained in required clerkships and residency expectations. An under-researched area is in interventions across specialties and with student confidence as the outcome.

OBJECTIVE

A multi-specialty school-wide boot camp for 4th year medical students was evaluated with a curriculum that focused on specialty milestones and entrustable professional activities and the importance of student confidence as an outcome.

METHODS

A school-wide "boot camp" was developed to help 4th year students become ready for their matched specialty. Faculty resources were pooled to teach students from multiple specialties' common milestone topics. Surveys were collected from 3 academic years (2014-2015 to 2016-2017): pre-boot camp (Pre), immediately post-boot camp (Post 1), and 3 months after starting residency (Post 2). Dependent t-tests were employed to determine pre-post differences.

RESULTS

Over the 3-year study period, 185 students participated in boot camp, 162 (87.6%) completed the first 2 surveys, and 75 (40.5%) students provided data at all 3 points in time. With more robust findings between Pre and Post 1, students improved their confidence level in communicating with families and most specialty skills, and students felt more prepared to be an intern as a result of the boot camp.

CONCLUSIONS

The robust increase in student confidence suggested that a multi-specialty, school-wide approach to a capstone curriculum should be considered by medical schools, which will not only benefit students but faculty as well. Future research should examine student competence in achieving specialty skills.

Midwifery leadership in maternity emergencies: a video analysis

Maternity emergencies require effective leadership due to their time-critical high stakes nature, and like many emergency teams are recommended to have a singular leader. Midwives possess many of the skills required for leadership, but the extent to which they contribute to leadership in emergencies is unknown. In this video analysis study of 16 interprofessional teams responding to a simulated post-partum hemorrhage, a functional view of leadership was applied to determine midwifery contribution to leadership. The number and type of leadership utterances by team members during an emergency response was assessed, and midwifery and doctor leadership utterances compared. Midwives contributed just over 40% of all leadership utterances, indicating the occurrence of interprofessional shared leadership, despite the recommendation for a singular leadership. While the number of leadership utterances per scenario was similar for midwives and doctors, midwives contributed less to utterances of a clinical nature compared to doctors but a similar amount of non-clinical leadership. Further exploration of the factors which influence midwifery leadership in emergencies and the impact it may have on patient care is warranted.