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Jeong HW, Moon SH. Enhancing ACLS training effects through video-assisted boosting methods: A comparative analysis of self-simulation and model simulation videos. Nurse Educ Pract 2024; 78:104010. [PMID: 38843687 DOI: 10.1016/j.nepr.2024.104010] [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: 12/27/2023] [Revised: 05/12/2024] [Accepted: 05/26/2024] [Indexed: 07/08/2024]
Abstract
AIMS To assess the impact of learner-participation and instructor-led simulation videos on nurses' CPR skills, focusing on iterative learning to boost proficiency in ACLS. BACKGROUND Advanced cardiac life support (ACLS) training is crucial for nurses, especially to improve cardiopulmonary resuscitation (CPR) proficiency, for which an effective training strategy is needed. DESIGN A quasi-experimental, pretest-posttest design was implemented to assess the impact of self-simulation and model simulation videos on sustaining CPR education. METHODS The research was carried out at a university hospital in Korea from August 2021 to July 2022. A total of 110 nurses were allocated into three groups based on the building of their workplace in the hospital. Each group watched training videos at 4-month intervals after the simulation training. The self-video group viewed simulations featuring their participation, while the model video group watched instructor-led simulations. A comparison group participated in the simulations without subsequent video boosting. RESULTS Both the self-video and model video groups exhibited significantly superior ACLS performance compatred with the comparison group at both four months (H = 70.33, p <.001) and eight months (H = 81.52, p <.001) following the intervention, with large effect sizes (self-video vs. comparison: d = 4.73 at four months, d = 12.54 at eight months; model video vs. comparison: d = 4.53 at four months, d = 11.01 at eight months). ACLS knowledge scores also significantly increased over time in both intervention groups (self-video: χ² = 22.09, p <.001; model video: χ² = 24.13, p <.001), but not in the comparison group (χ² = 3.75, p =.153). There were no significant differences among the groups in terms of CPR self-efficacy or stress at either time point. CONCLUSION Supplementary training using simulation videos is an effective method for maintaining and enhancing nurses' ACLS competency, offering a sustainable approach to repetitive CPR training. This study underscores the value of incorporating recorded simulation videos in clinical training, offering insights into efficient methods for continuous learning and CPR proficiency among nursing professionals.
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Affiliation(s)
- Hye Won Jeong
- Department of Nursing, Korea National University of Transportation, Jeungpyeong, South Korea.
| | - Sun-Hee Moon
- College of Nursing, Chonnam National University, Gwangju, South Korea.
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Agarwal A, Baitha U, Ranjan P, Swarnkar NK, Singh GP, Baidya DK, Garg R, Gupta N, Choudhury A, Kumar A, Roy A, Naik N, Khan MA, Wig N. Knowledge and Skills in Cardiopulmonary Resuscitation and Effect of Simulation Training on it among Healthcare Workers in a Tertiary Care Center in India. Indian J Crit Care Med 2024; 28:336-342. [PMID: 38585308 PMCID: PMC10998517 DOI: 10.5005/jp-journals-10071-24670] [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: 10/25/2023] [Accepted: 01/02/2024] [Indexed: 04/09/2024] Open
Abstract
Aim and background High-quality cardiopulmonary resuscitation (CPR) is associated with improved patient outcomes, but healthcare workers (HCWs) may be frequently undertrained. This study aimed to assess baseline knowledge and skills among HCWs about basic and advanced life support and the effect of simulation-based training on it. Methods It was a single-center prospective quasi-interventional study among resident doctors and nurses at a Tertiary Center in New Delhi, India. A questionnaire-based assessment was done to assess baseline knowledge. The participants then underwent simulation-based training followed by questionnaire-based knowledge assessment and skill assessment. A repeat questionnaire-based assessment was done 6 months post-training to assess knowledge retention. Results A total of 82 HCWs (54 doctors and 28 nurses) were enrolled. The participants scored 22.28 ± 6.06 out of 35 (63.65%) in the pre-training knowledge assessment, with low scores in post-cardiac arrest care, advanced life support, and defibrillation. After the training, there was a significant rise in scores to 28.32 ± 4.08 out of 35 (80.9%) (p < 0.01). The retention of knowledge at 6 months was 68.87% (p < 0.01). The participants scored 92.61 ± 4.75% marks in skill assessment with lower scores in chest compressions and team leadership roles. There was a positive correlation (r = 0.35) between knowledge and skills scores (p < 0.01). Conclusion There is a progressive decrease in baseline knowledge of HCWs with the further steps in the adult chain of survival. The simulation training program had a positive impact on the knowledge of HCWs. The training programs should focus on defibrillation, advanced life support, post-cardiac arrest care, and leadership roles. How to cite this article Agarwal A, Baitha U, Ranjan P, Swarnkar NK, Singh GP, Baidya DK, et al. Knowledge and Skills in Cardiopulmonary Resuscitation and Effect of Simulation Training on it among Healthcare Workers in a Tertiary Care Center in India. Indian J Crit Care Med 2024;28(4):336-342.
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Affiliation(s)
- Ayush Agarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Neeraj K Swarnkar
- Department of Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Gyaninder P Singh
- Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Dalim K Baidya
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Garg
- Department of Onco-Anaesthesiology and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesiology and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arindam Choudhury
- Department of Cardiac Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nitish Naik
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof Ahmed Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Lee SH, Riney LC, Merkt B, McDonough SD, Baker J, Boyd S, Zhang Y, Geis GL. Improving Pediatric Procedural Skills for EMS Clinicians: A Longitudinal Simulation-Based Curriculum with Novel, Remote, First-Person-View Video-Based Outcome Measurement. PREHOSP EMERG CARE 2024; 28:352-362. [PMID: 37751212 DOI: 10.1080/10903127.2023.2263555] [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: 05/24/2023] [Accepted: 09/21/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Emergency medical services (EMS) clinicians are expected to provide expert care to all patients, but face obstacles in maintaining skillsets required in the care of critically ill or injured children. The objectives of this study were to describe and assess the effectiveness of a pediatric-focused, simulation-based, procedural training program for EMS clinicians, delivered on-site by a pediatric simulation education team. We also describe a novel, remote, asynchronous performance outcome measurement system using first-person-view video review. METHODS This was a prospective study of simulation-based training and procedural outcomes. The study population involved EMS clinicians at three fire-based EMS agencies stratified as urban, suburban, and rural sites. The primary outcome was performance of intraosseous catheterization (IO), bag-valve-mask ventilation (BVM), and supraglottic device placement (SGD), measured across three time points. Secondary outcomes were identification of differences across EMS agencies and participant survey responses. RESULTS We obtained video data from 122 clinicians, totaling 561 videos, with survey response rates of 89.0-91.3%. Pre-intervention scores were high: least-square means (95% confident-intervals) 9.5 (8.9, 10.2) for IO; 9.6 (9.3, 9.9) for BVM; and 11.6 (10.9, 12.2) for SGD. There was significant improvement post-intervention: 11.5 (10.7, 12.3) for IO; 11.0 (10.7, 11.4) for BVM; and 13.6 (12.8, 14.4) for SGD. Improvement was maintained at follow-up after a median of 9.5 months: 10.5 (9.8, 11.2) for IO; 10.2 (9.9, 10.6) for BVM; and 12.4 (11.7, 13.1) for SGD. There were no statistical differences between sites. Of survey respondents, half had not cared for a critically ill or injured child in at least a year, the vast majority had not had hands-on pediatric training in over 6 months, and the majority felt that training should occur at least every 6 months. CONCLUSIONS Our pediatric-focused, simulation-based procedural training program was associated with improvement and maintenance of high-baseline procedural performance for EMS clinicians over the study period. Findings were consistent across sites. Remote assessment was feasible. Participant surveys emphasized a desire for more pediatric-focused training and highlighted the low frequency of clinical exposure to procedures potentially needed in the care of critically ill or injured pediatric patients.
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Affiliation(s)
- Sang Hoon Lee
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Lauren C Riney
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Brant Merkt
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Shawn D McDonough
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Jordan Baker
- Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Stephanie Boyd
- Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Yin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Gary L Geis
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
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Thekkan KR, Genna C, Ferro F, Cecchetti C, Dall'Oglio I, Tiozzo E, Raponi M, Gawronski O. Pediatric vital signs monitoring in hospital wards: Recognition systems and factors influencing nurses' attitudes and practices. J Pediatr Nurs 2023; 73:e602-e611. [PMID: 37977971 DOI: 10.1016/j.pedn.2023.10.041] [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: 07/26/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
AIMS To describe: 1) systems in place for recognition and response to deteriorating children in Italy, 2) attitudes and practices of registered nurses (RN) towards vital signs (VS) monitoring in pediatric wards, 3) the associations of nurses attitudes and pratices with nurses' and organizational characteristics. DESIGN AND METHODS A multicentre cross-sectional correlational study. Data were collected between January-May 2020 using: an adapted version of the 'Survey on Recognition and Response Systems in Australia', and the 'Ped-V Scale'. Descriptive and adjusted linear regression analysis was performed, accounting for clustering. RESULTS Ten Italian hospitals participated, 432 RNs responded to the Ped-V scale (response rate = 52%). Five (50%) hospitals had a VS policy in place, three hospitals (30%) had a Pediatric Early Warning System (PEWS), almost all hospitals had a system in place to respond to deteriorating children. Following multivariate regression analysis, having a PEWS was significantly associated with Ped-V scale 'Workload', 'Clinical competence', 'Standardization' dimensions; gender was associated with 'key indicators' and pediatric surgical ward with 'Clinical competence'. CONCLUSIONS The use of VS policies and PEWS was not consistent across hospitals caring for children in Italy. Nurses' attitudes and practices (i.e., perception of workload, and clinical competence) were significantly lower in hospitals with increased complexity of care/PEWS. Gender was significantly associated with knowledge scores. PRACTICE IMPLICATIONS System strategies to improve nurses' attitudes and practices towards VS monitoring and education are warranted to support effective behaviors towards VS monitoring, their interpretation, and appropriate communication to activate the efferent limb of the rapid response system.
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Affiliation(s)
- Kiara Ros Thekkan
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Catia Genna
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Federico Ferro
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Corrado Cecchetti
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Immacolata Dall'Oglio
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Orsola Gawronski
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
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Altabbaa G, Pidhorney C, Beran T, Kim J, Ledgerwood D, Cowan M, Paolucci EO. Personal protection equipment: Preliminary evidence of effectiveness from a three-phase simulation program. J Infect Prev 2023; 24:244-251. [PMID: 37969467 PMCID: PMC10638951 DOI: 10.1177/17571774231208118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/29/2023] [Indexed: 11/17/2023] Open
Abstract
Background Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE. Objective In this study, we developed a three-phase intervention to promote PPE proficiency. Methods Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists. Results Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, p < .001. Conclusions An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency.
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Affiliation(s)
- Ghazwan Altabbaa
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | | | - Tanya Beran
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Joseph Kim
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Donna Ledgerwood
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Michèle Cowan
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
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Larraga-García B, Monforte-Escobar F, Quintero Mínguez R, Quintana-Díaz M, Gutiérrez Á. Modified Needleman-Wunsch algorithm for trauma management performance evaluation. Int J Med Inform 2023; 177:105153. [PMID: 37490831 DOI: 10.1016/j.ijmedinf.2023.105153] [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: 02/27/2023] [Revised: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Trauma injuries are one of the leading causes of death in the world, representing approximately 8 % of all deaths. Therefore, trauma management training is of great importance and new training courses have arisen during the last decades. However, actual training courses do not typically analyze compliance with the protocols and guidelines available in the literature. Considering general trauma management guidelines such as the Advanced Trauma Life Support (ATLS) manual and the expertise of trauma specialists, a trauma management automated evaluation system has been designed in this paper. METHODS A modification to the Needleman-Wunsch (NW) algorithm is developed, including all relevant aspects of trauma management to automatically evaluate how a trauma intervention has been implemented according to trauma protocols. This allows to consider more information with respect to the order of the actions taken and the type of actions performed than current evaluation methods, such as checklists or videos recorded in simulation. A web-based trauma simulator is used so that it can be used at any setting with internet connection. Final-year medical students and first- and second-year residents performed an experimental test, where a trauma score is obtained with the modified NW algorithm. This automatic score relates to how similar the actions are to trauma protocols. RESULTS The results show the best combination of the scores used for the modified NW variables. This combination has an error, for the different case scenarios created, below 0.07 which verifies the values obtained. Additionally, trauma experts verified the results obtained showing a median difference of 0 between the protocol adherence evaluation using the algorithm and the one provided by the trauma experts. CONCLUSIONS The best set of score values to apply to the modified NW algorithm show that the modified NW algorithm provides a successful objective measurement with respect to the protocol compliance.
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Affiliation(s)
- Blanca Larraga-García
- Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Avenida Complutense, 30, 28040 Madrid, Spain.
| | | | | | - Manuel Quintana-Díaz
- Hospital La Paz Institute for Health Research, IdiPAZ, C. de Pedro Rico, 6, 28029 Madrid, Spain
| | - Álvaro Gutiérrez
- Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Avenida Complutense, 30, 28040 Madrid, Spain
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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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Choi S, Shim H, Lee JH. Efficiency analysis by training sequence of high-fidelity simulation-based neonatal resuscitation program (NRP). PLoS One 2023; 18:e0281515. [PMID: 36763618 PMCID: PMC9916567 DOI: 10.1371/journal.pone.0281515] [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: 12/08/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE This study was conducted to find a more effective education method in a neonatal resuscitation program (NRP) using a high-fidelity simulation that has recently shown positive results in terms of its effectiveness. STUDY DESIGN A single-blind prospective cohort study was performed. The high-fidelity simulation model was used in a formal NRP training course for trainees caring for neonatal patients. The trainees were divided into a group that conducted the scenario after the lecture (Group A) and a group that attended the lecture after the scenario (Group B) and they both took the test before, during, and after the training. RESULTS The increase in score after theory training was statistically significant in both groups, but the final score did not differ between the two groups. However, when compared by career, in Group A, trainees under 24 months tended to be more effective, and in Group B, trainees over 24 months tended to be more effective. CONCLUSION The difference in short-term memory of trainees according to the order of education identified by the test score was not prominent, but it was found that the degree of difference in test scores for the order of education tended to be different according to the career. It is thought that the effectiveness of the training might be increased by changing the education order according to the degree of experience of each trainee. More effective educational methods should be introduced by continuously developing lectures for repeated education of various trainees in the future.
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Affiliation(s)
- Seoheui Choi
- Department of Paediatrics, Ajou University School of Medicine, Suwon, South Korea
| | - Hoyeon Shim
- Department of Simulation Center, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea
| | - Jang H. Lee
- Department of Paediatrics, Ajou University School of Medicine, Suwon, South Korea
- * E-mail:
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Shikuku DN, Jebet J, Nandikove P, Tallam E, Ogoti E, Nyaga L, Mutsi H, Bashir I, Okoro D, Bar Zeev S, Ameh C. Improving midwifery educators' capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study. BMC MEDICAL EDUCATION 2022; 22:749. [PMID: 36316670 PMCID: PMC9623932 DOI: 10.1186/s12909-022-03827-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The objective of the study was to assess the capacity of university midwifery educators to deliver the updated competency-based curriculum after the capacity strengthening workshop in Kenya. METHODS The study used a quasi-experimental (pre-post) design. A four-day training to strengthen the capacity of educators to deliver emergency obstetrics and newborn care (EmONC) within the updated curriculum was conducted for 30 midwifery educators from 27 universities in Kenya. Before-after training assessments in knowledge, two EmONC skills and self-perceived confidence in using different teaching methodologies to deliver the competency-based curricula were conducted. Wilcoxon signed-rank test was used to compare the before-after knowledge and skills mean scores. McNemar test was used to compare differences in the proportion of educators' self-reported confidence in applying the different teaching pedagogies. P-values < 0.05 were considered statistically significant. FINDINGS Thirty educators (7 males and 23 females) participated, of whom only 11 (37%) had participated in a previous hands-on basic EmONC training - with 10 (91%) having had the training over two years beforehand. Performance mean scores increased significantly for knowledge (60.3% - 88. %), shoulder dystocia management (51.4 - 88.3%), newborn resuscitation (37.9 - 89.1%), and overall skill score (44.7 - 88.7%), p < 0.0001. The proportion of educators with confidence in using different stimulatory participatory teaching methods increased significantly for simulation (36.7 - 70%, p = 0.006), scenarios (53.3 - 80%, p = 0.039) and peer teaching and support (33.3 - 63.3%, p = 0.022). There was improvement in use of lecture method (80 - 90%, p = 0.289), small group discussions (73.3 - 86.7%, p = 0.344) and giving effective feedback (60 - 80%, p = 0.146), although this was not statistically significant. CONCLUSION Training improved midwifery educators' knowledge, skills and confidence to deliver the updated EmONC-enhanced curriculum. To ensure that midwifery educators maintain their competence, there is need for structured regular mentoring and continuous professional development. Besides, there is need to cascade the capacity strengthening to reach more midwifery educators for a competent midwifery workforce.
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Affiliation(s)
- Duncan N Shikuku
- Liverpool School of Tropical Medicine (Kenya), P.O. Box 24672-00100, Nairobi, Kenya
- Liverpool School of Tropical Medicine (UK), L3 5QA Liverpool, UK
| | - Joyce Jebet
- University of Nairobi, P. O. Box 19676-00100, Nairobi, Kenya
| | - Peter Nandikove
- Masinde Muliro University of Science and Technology, P.O. Box 190-50100, Kakamega, Kenya
| | - Edna Tallam
- Nursing Council of Kenya, P.O. Box 20056-00200, Nairobi, Kenya
| | - Evans Ogoti
- Moi University, P.O. Box 4606 – 30100, Eldoret, Kenya
| | - Lucy Nyaga
- Liverpool School of Tropical Medicine (Kenya), P.O. Box 24672-00100, Nairobi, Kenya
| | - Hellen Mutsi
- Department of Family Health, Ministry of Health, P.O. Box 30016-00100, Nairobi, Kenya
| | - Issak Bashir
- Department of Family Health, Ministry of Health, P.O. Box 30016-00100, Nairobi, Kenya
| | - Dan Okoro
- United Nations Population Fund Kenya, P.O. Box 30218-00100, Nairobi, Kenya
| | - Sarah Bar Zeev
- Technical Division, United Nations Population Fund, 10158 New York, NY USA
| | - Charles Ameh
- Liverpool School of Tropical Medicine (UK), L3 5QA Liverpool, UK
- University of Nairobi, P. O. Box 19676-00100, Nairobi, Kenya
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A modern roadmap for the use of simulation in regional anesthesiology training. Curr Opin Anaesthesiol 2022; 35:654-659. [PMID: 35942715 DOI: 10.1097/aco.0000000000001179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW A variety of educational modalities are used to teach regional anesthesia. Simulation is an educational tool that facilitates hands-on learning in a well tolerated, reproducible environment, eliminating potential harm to patients during the process of learning. Available literature and expert consensus statements support customizing simulation programs according to the level of training and experience of the learners. RECENT FINDINGS Simulation is useful for learners of all levels of expertise, though the application and frequency of simulation must be adapted to meet the learners' objectives. SUMMARY This review presents recommendations for the use of simulation for residents, fellows, practicing anesthesiologists without formal training in regional anesthesia, and practicing anesthesiologists with regional anesthesia expertise. Passports and portfolio programs that include simulation can be used to verify training. Virtual applications of simulation are growing, expanding the scope of regional anesthesia simulation and increasing access to lower resource areas.
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Ffrench-O'Carroll R, Sunderani Z, Preston R, Mayer U, Albert A, Chau A. Enhancing knowledge, skills, and comfort in providing anesthesia assistance during obstetric general anesthesia for operating room nurses: a prospective observational study. Can J Anaesth 2022; 69:1220-1229. [PMID: 35750971 DOI: 10.1007/s12630-022-02277-2] [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: 12/15/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Due to a nationwide shortage of anesthesia assistants, operating room nurses are often recruited to assist with the induction of obstetric general anesthesia (GA). We developed and administered a training program and hypothesized there would be significant improvements in knowledge and skills in anesthesia assistance during obstetric GA by operating room nurses following training with adequate retention at six months. METHODS Following informed consent, all operating room nurses at our institution were invited to participate in the study. Baseline knowledge of participants was assessed using a 14-item multiple choice questionnaire (MCQ), and skills were assessed using a 12-item checklist scored by direct observation during simulated induction of GA. Next, a 20-min didactic lecture followed by a ten-minute hands-on skills station were delivered. Knowledge and skills were immediately reassessed after training, and again at six weeks and six months. The primary outcomes of this study were adequate knowledge and skills retention at six months, defined as achieving ≥ 80% in MCQ and ≥ 80% in skills checklist scores and analyzed using longitudinal mixed-effects linear regression. RESULTS A total of 34 nurses completed the study at six months. The mean MCQ score at baseline was 8.9 (95% confidence interval [CI], 8.5 to 9.4) out of 14. The mean skills checklist score was 5.5 (95% CI, 4.9 to 6.1) out of 12. The mean comfort scores for assisting elective and emergency Cesarean deliveries were 3.6 (95% CI, 3.2 to 3.9) and 3.1 (95% CI, 2.7 to 3.5) out of 5, respectively. There was a significant difference in the mean MCQ and skills checklist scores across the different study periods (overall P value < 0.001). Post hoc pairwise tests suggested that, compared with baseline, there were significantly higher mean MCQ scores at all time points after the training program at six weeks (11.9; 95% CI, 11.4 to 12.4; P < 0.001) and at six months (12.0; 95% CI, 11.5 to 12.4; P < 0.001). DISCUSSION The knowledge and skills of operating room nurses in providing anesthesia assistance during obstetric GA at our institution were low at baseline. Following a single 30-min in-house, anesthesiologist-led, structured training program, scores in both dimensions significantly improved. Although knowledge improvements were adequately retained for up to six months, skills improvements decayed rapidly, suggesting that sessions should be repeated at six-week intervals, at least initially.
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Affiliation(s)
| | - Zahid Sunderani
- Department of Anesthesia, Rockyview General Hospital, Calgary, AB, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB, Canada
| | - Roanne Preston
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
| | - Ulrike Mayer
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Arianne Albert
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Anthony Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada. .,Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
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12
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Hill ME, Aliaga SR, Foglia EE. Learning with digital recording and video review of delivery room resuscitation. Semin Fetal Neonatal Med 2022; 27:101396. [PMID: 36457212 DOI: 10.1016/j.siny.2022.101396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Digital recording and video review of delivery room resuscitations is a proven useful tool to evaluate neonatal resuscitation program (NRP) technical and non-technical skills. It is also valuable for research, quality improvement, and individual and group learning. Digital recording and video review programs are growing in number, and planning and implementation of digital recording requires careful thought. Consideration of technology requirements, policy implementation, and stakeholder involvement is essential to implement a successful digital recording and video review program. Video review can then be applied for individual and team-based learning. An approach to sustainability and on-going quality review of the program are key components critical to success.
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Affiliation(s)
- Morgan E Hill
- Division of Neonatology, Perinatal Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Sofia R Aliaga
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth E Foglia
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Lee KS, Natarajan B, Wong WX, Yousman W, Koester S, Nyotowidjojo I, Lee JZ, Kern KB, Acharya D, Fortuin D, Hung O, Voelker W, Indik JH. A randomized controlled trial of simulation training in teaching coronary angiographic views. BMC MEDICAL EDUCATION 2022; 22:644. [PMID: 36028807 PMCID: PMC9414435 DOI: 10.1186/s12909-022-03705-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Simulation technology has an established role in teaching technical skills to cardiology fellows, but its impact on teaching trainees to interpret coronary angiographic (CA) images has not been systematically studied. The aim of this randomized controlled study was to test whether structured simulation training, in addition to traditional methods would improve CA image interpretation skills in a heterogeneous group of medical trainees. METHODS We prospectively randomized a convenience sample of 105 subjects comprising of medical students (N = 20), residents (N = 68) and fellows (N = 17) from the University of Arizona. Subjects were randomized in a stratified fashion into a simulation training group which received simulation training in addition to didactic teaching (n = 53) and a control training group which received didactic teaching alone (n = 52). The change in pre and post-test score (delta score) was analyzed by a two-way ANOVA for education status and training arm. RESULTS Subjects improved in their post-test scores with a mean change of 4.6 ± 4.0 points. Subjects in the simulation training arm had a higher delta score compared to control (5.4 ± 4.2 versus 3.8 ± 3.7, p = 0.04), with greatest impact for residents (6.6 ± 4.0 versus 3.5 ± 3.4) with a p = 0.02 for interaction of training arm and education status. CONCLUSIONS Simulation training complements traditional methods to improve CA interpretation skill, with greatest impact on residents. This highlights the importance of incorporating high-fidelity simulation training early in cardiovascular fellowship curricula.
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Affiliation(s)
- Kwan S Lee
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Balaji Natarajan
- University of California Riverside School of Medicine, Riverside, CA, USA
| | - Wei X Wong
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Wina Yousman
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Stefan Koester
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Iwan Nyotowidjojo
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | | | - Karl B Kern
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Deepak Acharya
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | | | - Olivia Hung
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | | | - Julia H Indik
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA.
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Schwindt EM, Stockenhuber R, Kainz T, Stumptner N, Henkel M, Hefler L, Schwindt JC. Neonatal simulation training decreases the incidence of chest compressions in term newborns. Resuscitation 2022; 178:109-115. [PMID: 35700883 DOI: 10.1016/j.resuscitation.2022.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/25/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
AIM OF THE STUDY To determine the effectiveness of a multidimensional neonatal simulation-based medical education training programme on direct and indirect patient outcome parameters. METHODS This was a retrospective analytical study with a historical control group in a level II neonatal care unit (1,700 births per year). A multidimensional interdisciplinary training programme on neonatal resuscitation was implemented in 2015; pre-training (2012-2014) and post-training (2015-2019) eras were compared in terms of mortality (direct outcome) and the received intervention level immediately after birth (indirect outcome). Intervention levels were defined as follows: A) short-term non-invasive ventilation, B) prolonged non-invasive ventilation (>5 inflation breaths), C) chest compressions. RESULTS Of 13,950 neonates born during the study period, 826 full-term newborns received one of the three intervention levels for adaptation after birth. A total of 284 (34.4%) patients received short-term non-invasive ventilation (A), 477 (57.8%) had prolonged ventilation (B), and 65 (7.9%) chest compressions (C), respectively. Comparing the pre- and post-training eras, there was no significant reduction in mortality, and no significant changes were found in groups A or B. However, the risk for chest compressions (group C) decreased significantly from 0.91% in the pre-training era to 0.20% in the post-training era (p < 0.001). CONCLUSION Although there was no significant effect on neonatal mortality, regular interdisciplinary simulation training decreased the number of administered chest compressions immediately after birth. Further studies are needed to test indirect outcome-related parameters, such as frequency of chest compressions as a measure of effectiveness and impact of medical training.
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Affiliation(s)
- Eva M Schwindt
- Medical University Vienna, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Waehringerguertel 18-20, 1090 Vienna, Austria; STAR - SIMCharacters Training and Research, Lehargasse 1, 1090 Vienna, Austria; Neonatal Working Group, Austrian Resuscitation Council, Villefortgasse 22, 8010 Graz, Austria
| | | | - Theresa Kainz
- Medical University Vienna, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Waehringerguertel 18-20, 1090 Vienna, Austria
| | - Nicola Stumptner
- Department of Paediatrics and Adolescent Medicine, Hospital Barmherzige Schwestern Linz, Seilerstaette 4, 4010 Linz, Austria
| | - Martin Henkel
- Department of Paediatrics and Adolescent Medicine, Hospital Barmherzige Schwestern Linz, Seilerstaette 4, 4010 Linz, Austria
| | - Lukas Hefler
- Department of Obstetrics and Gynecology, Konventhospital Barmherzige Brueder and Ordensklinikum Linz, Seilerstaette 2-4, 4010 Linz, Austria
| | - Jens C Schwindt
- STAR - SIMCharacters Training and Research, Lehargasse 1, 1090 Vienna, Austria; Neonatal Working Group, Austrian Resuscitation Council, Villefortgasse 22, 8010 Graz, Austria
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Manrique I, Calvo C, Carrillo A, Sebastián V, Manrique G, López-Herce J. Evaluation of Pediatric Immediate Life Support Courses by the Students. CHILDREN 2022; 9:children9020229. [PMID: 35204949 PMCID: PMC8870246 DOI: 10.3390/children9020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/05/2022] [Accepted: 02/06/2022] [Indexed: 11/24/2022]
Abstract
A retrospective analysis was performed of 1637 questionnaires among students of immediate pediatric life support (IPLS) courses. All theory and practice classes and organization and methods received an average score higher than 8.5 except for the schedule and time devoted to developing contents. All parameters evaluating instructors’ skills received a score higher than 9. Participants requested more time to practice and for course adaptation to their specific professionals needs. IPLS courses are highly valued by students. The duration of IPLS practice sessions should be increased and the course should be adapted to the specific professional needs of participants.
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Affiliation(s)
- Ignacio Manrique
- Instituto Valenciano de Pediatría, 46004 Valencia, Spain;
- Spanish Paediatric and Neonatal Resuscitation Group, 28029 Madrid, Spain; (C.C.); (A.C.); (V.S.)
| | - Custodio Calvo
- Spanish Paediatric and Neonatal Resuscitation Group, 28029 Madrid, Spain; (C.C.); (A.C.); (V.S.)
| | - Angel Carrillo
- Spanish Paediatric and Neonatal Resuscitation Group, 28029 Madrid, Spain; (C.C.); (A.C.); (V.S.)
| | - Valero Sebastián
- Spanish Paediatric and Neonatal Resuscitation Group, 28029 Madrid, Spain; (C.C.); (A.C.); (V.S.)
- Centro de Salud Fuente de San Luis, 46013 Valencia, Spain
| | - Gema Manrique
- Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón de Madrid, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, 28007 Madrid, Spain;
- Departamento de Salud Pública y Maternoinfantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jesús López-Herce
- Spanish Paediatric and Neonatal Resuscitation Group, 28029 Madrid, Spain; (C.C.); (A.C.); (V.S.)
- Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón de Madrid, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, 28007 Madrid, Spain;
- Departamento de Salud Pública y Maternoinfantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (RedSAMID), RETICS Financiada por el PN I+D+I 2008–2011, ISCIII—Subdirección General de Evaluación y Fomento de la Investigación y el Fondo Europeo de Desarrollo Regional (FEDER), ref. RD12/0026, 28007 Madrid, Spain
- Correspondence:
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16
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Sand K, Guldal AU, Myklebust TÅ, Hoff DAL, Juvkam PC, Hole T. Cardiopulmonary resuscitation retention training for hospital nurses by a self-learner skill station or the traditional instructor led course: A randomised controlled trial. Resusc Plus 2021; 7:100157. [PMID: 34467255 PMCID: PMC8384897 DOI: 10.1016/j.resplu.2021.100157] [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: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 10/26/2022] Open
Abstract
Introduction Intrahospital cardiac arrest has a steep mortality and high-quality cardiopulmonary resuscitation (CPR) is essential for favourable outcome. Instructor led (IL) CPR training is resource demanding and instructor free, feedback providing CPR skill stations (SS) could provide a means to enable the needed frequent retraining. The main objective of this study was to test the hypothesis that there was no difference between IL and SS training. Methods A total of 129 hospital nurses were randomised to CPR retraining in three groups; skill station with retraining at 2 months (SS-R), skill station without retraining (SS) and instructor led training (IL). Participants were tested at baseline, 2 and 8 months. The skill station groups were combined (c-SS) for analysis at baseline and 2 months when comparing to IL. Results Baseline characteristics for the three groups differed significantly, however c-SS and IL groups performed equally at baseline and testing at 2 months. At 8 months the SS group performed 71% correct ventilations compared to 54% in the IL group (p = 0.04), but CPR quality was otherwise equal. Longitudinal analysis showed SS-R performed 3.4 mm deeper compressions at final evaluation compared to baseline (p = 0.02) and 2.8 mm deeper compared to 2-month test (p = 0.02). No effects of retraining at 2 months could be detected at final comparison of SS-R and SS groups. Conclusion CPR training using a skill station led to equal performance at 2 and 8 months compared to instructor led training. Feedback-providing skill stations could be a feasible tool for required frequent retraining.
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Affiliation(s)
- Kristoffer Sand
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Dag Arne Lihaug Hoff
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Per Christian Juvkam
- Clinic of Emergency Medicine and Prehospital Care, St. Olav's University Hospital, Trondheim, Norway
| | - Torstein Hole
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
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17
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Smith AW, Elliott JO, Gable BD. Simulation Improves Internal Medicine Resident Confidence With Defibrillation, Cardioversion, and Transcutaneous Pacemaker Use. Cureus 2021; 13:e16648. [PMID: 34458046 PMCID: PMC8384576 DOI: 10.7759/cureus.16648] [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: 04/26/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction While many graduate medical education programs require residents to be certified in advanced cardiac life support, this does not cover all aspects of cardiac stabilization in patients with a pulse. Residents are often on the front lines of providing care to patients with life-threatening dysrhythmias. Our residents expressed a lack of confidence in their ability to provide this care. Methods A convenience sample of internal medicine, preliminary medicine, and transitional year residents from our large community-based tertiary care hospital participated in our survey and training. We utilized a pre-post survey method of our residents’ confidence in domains that are critical to caring for patients requiring cardiac resuscitation and stabilization. Our pre-post survey was a modified Likert scale. Our training consisted of a 1-hour faculty-led hands-on training session focused on these critical domains in our hospital’s simulation suites. Follow-up survey data were collected immediately after the training and at six and 11 months after the training using mean confidence across all five domains as the study variable. Results Resident mean confidence in the five domains (placing leads and pads, manipulating defibrillator controls, performing defibrillation, performing synchronized cardioversion, and performing transcutaneous pacemaker use) increased immediately after our training compared to before the training (p<0.001). This increase in confidence from before the training was sustained at six and 11 months after the training (p=0.001 and p=0.002, respectively). Confidence was lower at six and 11 months than immediately after training (p=0.01 and p=0.004, respectively). Conclusion Our project showed that simulation-based training was effective in improving our trainee’s confidence in providing care to patients with life-threatening dysrhythmias. As with previous studies in simulation, confidence degradation was seen over time and likely mirrors skill degradation in these low-frequency encounters. As such, future aims include identification of ideal time intervals between training.
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Affiliation(s)
| | - John O Elliott
- Medical Education, OhioHealth Research Institute, Columbus, USA
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18
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Vrachnis N, Cohen-Overbeek TE. ISUOG ultrasound training in Oman: evaluating participant long-term retention and effect of repetitive practical courses on ultrasound knowledge and skills. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:175-177. [PMID: 33760291 DOI: 10.1002/uog.23632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Affiliation(s)
- N Vrachnis
- Third Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Attikon Hospital, Athens, Greece
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - T E Cohen-Overbeek
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetal Medicine, Erasmus MC-Sophia Children's Hospital University Medical Center Rotterdam, Rotterdam, The Netherlands
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19
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Arrogante O, Ríos-Díaz J, Carrión-García L, Samith S, González-Romero GM, Caperos JM. Deliberate practice in resuscitation training using a feedback device, and the effects of the physical characteristics of the rescuer on the acquisition and retention of cardiopulmonary resuscitation skills: Randomized clinical trial. Int Emerg Nurs 2021; 58:101037. [PMID: 34332453 DOI: 10.1016/j.ienj.2021.101037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) skills decline rapidly and rescuers' physical characteristics could impact on their performance. Our aim was to analyse the effects of deliberate practice using a feedback device (FD) on the CPR performance of nursing students prior to, immediately after, and three months after training, considering their physical characteristics. METHOD Sixty nursing students participated in this randomized clinical trial (control group n = 28; training group n = 32). Their physical characteristics (weight, height, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)% index, handgrip strength, and CPR position strength) were measured before starting the trial. The training group followed a CPR training programme based on deliberate practice, providing feedback on their performance using an FD. All participants were evaluated during two-minute CPR compression/ventilation cycles. RESULTS The training group showed an improved ability to perform chest compressions (F(2, 115.2) = 13.3; p < .001; ω2p = 0.17) and ventilations (F(2, 115.3) = 102.1; p < .001; ω2p = 0.63), improving their overall quality of CPR (F(2, 115.2) = 40.1; p < .001; ω2p = 0.40). The physical characteristics of the participants did not affect CPR performance in any study phase. CONCLUSIONS A structured training programme based on deliberate practice using an FD had a positive effect on the acquisition of CPR skills by participants, while their physical characteristics had no impact on performance.
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Affiliation(s)
- Oscar Arrogante
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - José Ríos-Díaz
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Laura Carrión-García
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Sabrina Samith
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Gracia María González-Romero
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - José Manuel Caperos
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain; UNINPSI, Dpto. de Psicología, Universidad Pontificia Comillas, Madrid, Spain.
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20
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Battaglini D, Ionescu Maddalena A, Caporusso RR, Garofalo E, Bruni A, Bocci MG, Cingolani E, Giarratano A, Petrini F. Acquisition of skills in Critical Emergency Medicine: an experimental study on the SIAARTI Academy CREM experience. Minerva Anestesiol 2021; 87:1174-1182. [PMID: 34170097 DOI: 10.23736/s0375-9393.21.15427-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In 2019 the SIAARTI developed a seven-days course for residents, focused on critical emergency medicine (CREM) in a hostile environment, that grounds on simulation-based education and training with hands-on simulation, high-fidelity simulators and part-task trainers. This project aimed to evaluate the efficacy of this course in comparison to traditional learning programs in term of technical (TS) and non-technical (NTS) skills. We assessed the improvement in TS and NTS over time, and the ability to involve trainees in corporate activities. METHODS Three-hundred and twenty-seven trainees completed the study. Trainees were allocated into 3 groups: those who joined the SIAARTI-Academy-CREM course and received a study kit (SAKit, n=124), those who received only a study kit (Kit, n=108), and Control (n=95). Eighty-five tests were administered to investigate skills at 3 timepoints: T0=baseline, T1=post-training/kit, and T2=4-months later. RESULTS TS differed among groups (p<0.0001), with the highest points in the SA-Kit group at T1 (post-hoc comparison, p<0.0001 vs Kit; p<0.0001 vs Control), and T2 (post-hoc comparison, p<0.0001 vs Kit; p<0.0001 vs Control). NTS differed among groups (p=0.0406), with the highest points in the SA-Kit group at T1 (post-hoc comparison, p=0.0337 vs Kit; p=0.0416 vs Control), and T2 (post-hoc comparison, p=0.0073 vs Kit; p=0.3308 vs Control). SA-Kit group significantly improved TS (p<0.0001) and NTS (p=0.0006) over time. Involvement in corporate activities of SAkit was significantly higher than Kit and Control (p=0.0012). CONCLUSIONS SA-Kit improvement in TS and NTS was higher than Kit and Control and was maintained over time. Participation in this course implemented participation in corporate activities among attendees.
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Affiliation(s)
- Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy - .,Department of Medicine, University of Barcelona, Barcelona, Spain -
| | - Alessandra Ionescu Maddalena
- UOC Anestesia e Rianimazione, Polo Ospedaliero Balcolle ASL, Viterbo, Italy.,Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Istituto di Anestesiologia e Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del sacro Cuore, Rome, Italy
| | - Roberta R Caporusso
- Sezione anestesia e rianimazione, Dipartimento di Scienze mediche e chirurgiche, Università degli Studi di Foggia, Foggia, Italy
| | - Eugenio Garofalo
- Department of Medical and Surgical Sciences, Mater Domini University Hospital, Catanzaro, Italy
| | - Andrea Bruni
- Department of Medical and Surgical Sciences, Mater Domini University Hospital, Catanzaro, Italy
| | - Maria Grazia Bocci
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Istituto di Anestesiologia e Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del sacro Cuore, Rome, Italy
| | - Emiliano Cingolani
- Dipartimento di Emergenza Accettazione e delle Chirurgie specialistiche, UOSD Shock e Trauma, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Antonino Giarratano
- Section of Anaesthesia, Analgesia, Intensive Care and Emergency, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - Flavia Petrini
- Department of Anesthesia, Perioperative Medicine, Pain Therapy, RRS and Critical Care Area - DEA ASL2 Abruzzo, Chieti University Hospital, Chieti, Italy
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Greif R, Lockey A, Breckwoldt J, Carmona F, Conaghan P, Kuzovlev A, Pflanzl-Knizacek L, Sari F, Shammet S, Scapigliati A, Turner N, Yeung J, Monsieurs KG. [Education for resuscitation]. Notf Rett Med 2021; 24:750-772. [PMID: 34093075 PMCID: PMC8170459 DOI: 10.1007/s10049-021-00890-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/22/2022]
Abstract
Diese Leitlinien des European Resuscitation Council basieren auf dem internationalen wissenschaftlichen Konsens 2020 zur kardiopulmonalen Reanimation mit Behandlungsempfehlungen (International Liaison Committee on Resuscitation 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations [ILCOR] 2020 CoSTR). Dieser Abschnitt bietet Bürgern und Angehörigen der Gesundheitsberufe Anleitungen zum Lehren und Lernen der Kenntnisse, der Fertigkeiten und der Einstellungen zur Reanimation mit dem Ziel, das Überleben von Patienten nach Kreislaufstillstand zu verbessern.
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Affiliation(s)
- Robert Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Schweiz.,School of Medicine, Sigmund Freud University Vienna, Wien, Österreich
| | - Andrew Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, Großbritannien
| | - Jan Breckwoldt
- Institute of Anesthesiology, University Hospital Zurich, Zürich, Schweiz
| | | | - Patricia Conaghan
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, Großbritannien
| | - Artem Kuzovlev
- Negovsky Research Institute of General Reanimatology of the Federal research and clinical center of intensive care medicine and Rehabilitology, Moskau, Russland
| | - Lucas Pflanzl-Knizacek
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Ferenc Sari
- Emergency Department, Skellefteå Hospital, Skellefteå, Schweden
| | | | - Andrea Scapigliati
- Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rom, Italien
| | - Nigel Turner
- Department of Pediatric Anesthesia, Division of Vital Functions, Wilhelmina Children's Hospital at the University Medical Center, Utrecht, Niederlande
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, Großbritannien
| | - Koenraad G Monsieurs
- Emergency Department, Antwerp University Hospital and University of Antwerp, Edegem, Belgien
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22
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Theoretical knowledge and skill retention 3 and 6 months after a European Newborn Life Support provider course. Am J Emerg Med 2021; 49:83-88. [PMID: 34089968 DOI: 10.1016/j.ajem.2021.05.048] [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: 03/19/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The European Resuscitation Council Newborn Life Support Course (ERC- NLS) aims at training healthcare professionals, involved in perinatal care, in order to intervene efficiently and promptly to assist transition or resuscitate neonates who require help at birth. However, limited data exists for the retention of the theoretical knowledge and practical skills provided by the course. This study aims to evaluate the degree of knowledge and skill retention 3 and 6 months after the ERC-NLS provider course. METHODS This is a prospective study. Theoretical knowledge was evaluated using the ERC-approved NLS written test (50 True/False questions). Evaluation of technical skills included performance, on an Advanced Life Support neonatal maniquin (LAERDAL), of airway management, ventilation and support of circulation (21 detailed skills). The effect of certain factors on theoretical skill retention was also evaluated. RESULTS One hundred and sixteen (n = 116) participants were initially recruited in the study (12 males and 104 females). Theoretical knowledge was evaluated in 113 participants (3 participants missed follow-up appointments) and technical skills in 80 participants. The mean score for theoretical knowledge was 86.24% ± 5.3, 80.88% ± 7.43 and 80.04% ± 7.04 at baseline, at 3 and 6 months, respectively. This difference was significant among the three time points (baseline vs 3 months: p < 0.001; baseline vs 6 months: p < 0.001; 3 month's vs 6 months: p = 0.034). Although gender did not have an effect, doctors and participants of higher education yielded higher score of success. Regarding technical skills, 9 skills showed a continuous decline of performance from baseline to 6 months, while no difference existed for 12 skills. CONCLUSIONS Healthcare professionals after the NLS provider course retain satisfactory levels of theoretical knowledge and technical skills even at 6 months post-training, although, there is a decline compared to baseline. Further research is needed in order to establish the proper time and type of refreshment course in order to improve outcomes.
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23
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Greif R, Lockey A, Breckwoldt J, Carmona F, Conaghan P, Kuzovlev A, Pflanzl-Knizacek L, Sari F, Shammet S, Scapigliati A, Turner N, Yeung J, Monsieurs KG. European Resuscitation Council Guidelines 2021: Education for resuscitation. Resuscitation 2021; 161:388-407. [PMID: 33773831 DOI: 10.1016/j.resuscitation.2021.02.016] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
These European Resuscitation Council education guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidance to citizens and healthcare professionals with regard to teaching and learning the knowledge, skills and attitudes of resuscitation with the ultimate aim of improving patient survival after cardiac arrest.
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Affiliation(s)
- Robert Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland; School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.
| | - Andrew Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, UK
| | - Jan Breckwoldt
- Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Patricia Conaghan
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Artem Kuzovlev
- Negovsky Research Institute of General Reanimatology of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Lucas Pflanzl-Knizacek
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Ferenc Sari
- Emergency Department, Skellefteå Hospital, Sweden
| | | | - Andrea Scapigliati
- Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Nigel Turner
- Department of Pediatric Anesthesia, Division of Vital Functions, Wilhelmina Children's Hospital at the University Medical Center, Utrecht, The Netherlands
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Koenraad G Monsieurs
- Emergency Department, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
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24
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Yao F, Subramaniam M, Satghare P, Zhang Y, Seow E. A resuscitation course designed for a psychiatric hospital. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:261-263. [PMID: 33855324 DOI: 10.47102/annals-acadmedsg.2020427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Fengyuan Yao
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore
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Lockey A, Conaghan P, Bland A, Astin F. Educational theory and its application to advanced life support courses: a narrative review. Resusc Plus 2020; 5:100053. [PMID: 34223327 PMCID: PMC8244342 DOI: 10.1016/j.resplu.2020.100053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/27/2020] [Accepted: 11/11/2020] [Indexed: 11/30/2022] Open
Abstract
The knowledge, skills and attitudes taught on Advanced Life Support (ALS) courses are an important learning requirement for healthcare professionals who are involved with the care of acutely unwell patients. It is essential that the course design and delivery is appropriately planned to ensure that it optimises the learning opportunities for all learners. This paper offers a narrative review of how the application of educational theory has positively influenced the evolution of ALS courses since their inception in the late twentieth century. By embracing and understanding the relevant educational theories, the ALS course design has transformed from a predominantly lecture-based and behaviourist approach, to a more participative and social constructivist approach to learning. In addition, the advent of smarter technology and the challenges posed by the COVID-19 pandemic have facilitated a more connectivist approach to learning. It can therefore be demonstrated that the ALS course is influenced by a combination of theoretical approaches and provides a diverse framework of teaching and learning strategies that cater for many individual learning styles. Any further evolution and development of the course should be based upon contemporary educational theory to ensure that it remains fit for purpose.
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Affiliation(s)
| | | | - Andrew Bland
- University of Huddersfield, Centre for Applied Research in Health, UK
| | - Felicity Astin
- Calderdale & Huddersfield NHS Trust, Halifax, UK.,University of Huddersfield, Centre for Applied Research in Health, UK
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26
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Mitchell M, Newall F, Sokol J, Heywood M, Williams K. Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital. Adv Simul (Lond) 2020; 5:21. [PMID: 32817808 PMCID: PMC7425032 DOI: 10.1186/s41077-020-00139-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/22/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND An increasing number of incidents involving aggressive behaviour in acute care hospitals are being witnessed worldwide. Acute care hospital staff are often not trained or confident in managing aggression. Competent management of clinical aggression is important to maintain staff and patient safety. Training programmes for acute care staff are infrequently described in the literature and rarely reported for paediatric staff. Simulation training allows practice of skills without patient risk and may be more effective than traditional teaching formats for aggression management. AIM AND DESIGN The aim of this proof of concept study was to develop a simulation-based education session on aggression management for acute care paediatric staff based on best practice principles, to evaluate the acceptability of this training programme and to gain an understanding of the impact of the training on participants' perceived confidence in managing clinical aggression. Two separate simulation exercises were delivered as a 2-h component of a hospital management of clinical aggression (MOCA) training day. Participants completed a written survey immediately prior to, at completion of the simulation-based group training, and at 3-6 months following the simulation training. FINDINGS Nine training days were conducted in 2017 for nursing, medical, allied health, education and security staff with a total of 146 participants (83% were acute care nurses). Two thirds (68%) of participants had experienced clinical aggression as part of their routine work, with 51% overall reporting a lack of confidence managing these patients. Immediately following the simulation training, 80% of all participants reported feeling more confident in managing clinical aggression, 47% reported a 1-point increase in confidence, whilst 33% of participants reported a 2- or 3-point increase. At 3-6 months post-training, 66% of respondents (N = 44) reported continued confidence in managing aggression with 100% of participants stating they would recommend simulation training to colleagues. CONCLUSIONS Simulation training is an acceptable method of training and shows promise to improve staff-perceived confidence for managing behavioural emergencies in acute paediatric health care settings. In addition, there were potential enduring positive impacts at 3 months after the study. Whilst resource and time intensive, further research assessing the benefits of utilising simulation training in this setting is warranted in order to minimise staff burn-out and improve outcomes for these very vulnerable patients.
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Affiliation(s)
- Marijke Mitchell
- Neurodevelopment & Disability, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
| | - Fiona Newall
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Nursing, The University of Melbourne, 50 Flemington Road, Parkville, Victoria 3052 Australia
- Nursing Research, Nursing Education, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Jennifer Sokol
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- The RCH Simulation Program, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Melissa Heywood
- The RCH Simulation Program, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Katrina Williams
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Paediatrics, Education and Research, Monash Children’s Hospital, Monash University, 246 Clayton Road, Clayton, Victoria, 3168 Australia
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Michelet D, Barre J, Truchot J, Piot MA, Cabon P, Tesniere A. Effect of Computer Debriefing on Acquisition and Retention of Learning After Screen-Based Simulation of Neonatal Resuscitation: Randomized Controlled Trial. JMIR Serious Games 2020; 8:e18633. [PMID: 32780021 PMCID: PMC7448187 DOI: 10.2196/18633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/21/2020] [Accepted: 05/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Debriefing is key in a simulation learning process. Objective This study focuses on the impact of computer debriefing on learning acquisition and retention after a screen-based simulation training on neonatal resuscitation designed for midwifery students. Methods Midwifery students participated in 2 screen-based simulation sessions, separated by 2 months, session 1 and session 2. They were randomized in 2 groups. Participants of the debriefing group underwent a computer debriefing focusing on technical skills and nontechnical skills at the end of each scenario, while the control group received no debriefing. In session 1, students participated in 2 scenarios of screen-based simulation on neonatal resuscitation. During session 2, the students participated in a third scenario. The 3 scenarios had an increasing level of difficulty, with the first representing the baseline level. Assessments included a knowledge questionnaire on neonatal resuscitation, a self-efficacy rating, and expert evaluation of technical skills as per the Neonatal Resuscitation Performance Evaluation (NRPE) score and of nontechnical skills as per the Anaesthetists’ Non-Technical Skills (ANTS) system. We compared the results of the groups using the Mann-Whitney U test. Results A total of 28 midwifery students participated in the study. The participants from the debriefing group reached higher ANTS scores than those from the control group during session 1 (13.25 vs 9; U=47.5; P=.02). Their scores remained higher, without statistical difference during session 2 (10 vs 7.75; P=.08). The debriefing group had higher self-efficacy ratings at session 2 (3 vs 2; U=52; P=.02). When comparing the knowledge questionnaires, the significant baseline difference (13 for debriefing group vs 14.5 for control group, P=.05) disappeared at the end of session 1 and in session 2. No difference was found for the assessment of technical skills between the groups or between sessions. Conclusions Computer debriefing seems to improve nontechnical skills, self-efficacy, and knowledge when compared to the absence of debriefing during a screen-based simulation. This study confirms the importance of debriefing after screen-based simulation. Trial Registration ClinicalTrials.gov NCT03844009; https://clinicaltrials.gov/ct2/show/NCT03844009
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Affiliation(s)
- Daphne Michelet
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France.,Department of Anesthesia and Intensive Care, American Memorial Hospital, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Jessy Barre
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France
| | - Jennifer Truchot
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France.,Emergency Department, Lariboisière University Hospital, Paris, France
| | - Marie-Aude Piot
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France.,Psychiatry Department, Monsouris Mutualiste Institute, Paris, France
| | - Philippe Cabon
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France.,Laboratoire Adaptation Travail Individu, Université de Paris, Boulogne-Billancourt, France
| | - Antoine Tesniere
- Ilumens Platform of Simulation in Healthcare, Université de Paris, Paris, France.,Department of Anesthesia and Intensive Care, Georges Pompidou European Hospital, Paris, France
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Güsgen C, Anger F, Hauer T, Willms A, Buhr HJ, Germer CT, Schwab R, Lock JF. [Advanced training of general and visceral surgeons in life-saving emergency surgery : Results of a survey among participants of a surgery course]. Chirurg 2020; 91:1044-1052. [PMID: 32313966 PMCID: PMC7716888 DOI: 10.1007/s00104-020-01170-2] [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] [Indexed: 12/03/2022]
Abstract
Hintergrund Die geringe Anzahl operativ zu versorgender Körperhöhlenverletzungen erfordert ein Umdenken in der chirurgischen Aus- und Weiterbildung. Ein entsprechendes Kursformat wird seit 2014 über die DGAV angeboten. Um Berechtigung, Bedarf, Nutzen und Erfolg eines solchen Kursformates zu erheben, erfolgte eine Evaluation durch die bisherigen Kursteilnehmer. Material und Methoden Kursevaluation und zusätzliche Onlinebefragung der bisherigen Kursteilnehmer hinsichtlich Alter, Geschlecht, Ausbildungsstand, Fachrichtung, Versorgungsstufe des Krankenhauses, notfallchirurgischer Erfahrungen, der Häufigkeit chirurgischer Notfallversorgungen, Teilnahme an anderen Kursformaten, Erfahrungen nach der Kursteilnahme, Einschätzung der aktuellen Fort- und Weiterbildungssituation und Finanzierung solcher Kurse. Ergebnisse Insgesamt 142 Kursteilnehmer evaluierten ihre Kursteilnahme, zusätzlich beantworteten 83 den Onlinefragebogen. Über 90 % berichteten von einem nachhaltigen positiven Einfluss des Kurses auf ihr notfallchirurgisches Handeln. Mehr als die Hälfte konnte von konkreten Notfallsituationen berichten, die sie aufgrund der Kursteilnahme besser bewältigen konnten. In der Notfallversorgung erfahrene Chirurgen bewerteten den eigenen Lernerfolg durch die Kursteilnahme signifikant häufiger positiv als ihre weniger erfahrenen Kollegen. Keinen Einfluss auf den Lernerfolg hatten eine Ober- oder Chefarztposition, die Versorgungsstufe des Krankenhauses, das Alter oder Geschlecht der Teilnehmer. Die Mehrheit der antwortenden Chirurgen befürwortet die Integration eines solchen Kursformates in die chirurgische Weiterbildung und fordert hierzu eine finanzielle Unterstützung. Schlussfolgerung Kursformate, in denen notfallchirurgische Strategien und Fähigkeiten vermittelt werden, sind etabliert und werden sehr positiv evaluiert. Die Fort- und Weiterbildung in notfallchirurgischen Fähigkeiten und Kenntnissen liegt im gesellschaftlichen Interesse und zumindest anteilig auch in ihrer Verantwortung.
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Affiliation(s)
- C Güsgen
- Klinik für Allgemein- Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland
| | - F Anger
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - T Hauer
- Klinik für Allgemein- und Viszeralchirurgie, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - A Willms
- Klinik für Allgemein- Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland
| | - H J Buhr
- Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Berlin, Deutschland
| | - C-T Germer
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - R Schwab
- Klinik für Allgemein- Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland
| | - J F Lock
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland.
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Katz D, Shah R, Kim E, Park C, Shah A, Levine A, Burnett G. Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study. J Med Internet Res 2020; 22:e17425. [PMID: 32163038 PMCID: PMC7099400 DOI: 10.2196/17425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/18/2020] [Accepted: 01/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. OBJECTIVE This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. METHODS This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. RESULTS A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. CONCLUSIONS Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.
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Affiliation(s)
- Daniel Katz
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ronak Shah
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Elizabeth Kim
- City University of New York City Medical School, New York, NY, United States
| | - Chang Park
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anjan Shah
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Adam Levine
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Garrett Burnett
- Department of Anesthesiology, Pain, & Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Adegoke O, Danso-Bamfo S, Sheehy M, Tarimo V, Burke TF, Garg LF. A condom uterine balloon device among referral facilities in Dar Es Salaam: an assessment of perceptions, barriers and facilitators one year after implementation. BMC Pregnancy Childbirth 2020; 20:34. [PMID: 31931785 PMCID: PMC6958625 DOI: 10.1186/s12884-020-2721-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum hemorrhage (PPH) is the leading cause of maternal death in Tanzania. The Every Second Matters for Mothers and Babies- Uterine Balloon Tamponade (ESM-UBT) device was developed to address this problem in women with atonic uterus. The objective of this study was to understand the barriers and facilitators to optimal use of the device, in Dar es Salaam Tanzania 1 year after implementation. METHODS Semi-structured interviews of skilled-birth attendants were conducted between May and July 2017. Interviews were recorded, coded and analyzed for emergent themes. RESULTS Among the participants, overall there was a positive perception of the ESM-UBT device. More than half of participants reported the device was readily available and more than 1/3 described ease and success with initial use. Barriers included fear and lack of refresher training. Finally, participants expressed a need for training and device availability at peripheral hospitals. CONCLUSION The implementation and progression to optimal use of the ESM-UBT device in Tanzania is quite complex. Ease of use and the prospect of saving a life/preserving fertility strongly promoted use while fear and lack of high-level buy-in hindered utilization of the device. A thorough understanding and investigation of these facilitators and barriers are required to increase uptake of the ESM-UBT device.
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Affiliation(s)
- Oluwakemi Adegoke
- Department of Emergency Medicine, Division of Global Health Innovation, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA. .,Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sandra Danso-Bamfo
- Department of Emergency Medicine, Division of Global Health Innovation, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA
| | - Margaret Sheehy
- Department of Emergency Medicine, Division of Global Health Innovation, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Thomas F Burke
- Department of Emergency Medicine, Division of Global Health Innovation, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lorraine F Garg
- Department of Emergency Medicine, Division of Global Health Innovation, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA
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Vrachnis N, Papageorghiou AT, Bilardo CM, Abuhamad A, Tabor A, Cohen-Overbeek TE, Xilakis E, Mates F, Johnson SP, Hyett J. International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) - the propagation of knowledge in ultrasound for the improvement of OB/GYN care worldwide: experience of basic ultrasound training in Oman. BMC MEDICAL EDUCATION 2019; 19:434. [PMID: 31752883 PMCID: PMC6873715 DOI: 10.1186/s12909-019-1866-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study is to evaluate effectiveness of a new ISUOG (International Society of Ultrasound in Obstetrics and Gynecology) Outreach Teaching and Training Program delivered in Muscat, Oman. METHODS Quantitative assessments to evaluate knowledge and practical skills were administered before and after an ultrasound course for sonologists attending the ISUOG Outreach Course, which took place in November, 2017, in Oman. Trainees were selected from each region of the country following a national vetting process conducted by the Oman Ministry of Health. Twenty-eight of the participants were included in the analysis. Pre- and post-training practical and theoretical scores were evaluated and compared. RESULTS Participants achieved statistically significant improvements, on average by 47% (p < 0.001), in both theoretical knowledge and practical skills. Specifically, the mean score in the theoretical knowledge test significantly increased from 55.6% (± 14.0%) to 81.6% (± 8.2%), while in the practical test, the mean score increased from 44.6% (± 19.5%) to 65.7% (± 23.0%) (p < 0.001). Performance was improved post-course among 27/28 participants (96.4%) in the theoretical test (range: 14 to 200%) and among 24/28 (85.7%) trainees in the practical skills test (range: 5 to 217%). CONCLUSION Application of the ISUOG Basic Training Curriculum and Outreach Teaching and Training Course improved the theoretical knowledge and practical skills of local health personnel. Long-term re-evaluation is, however, considered imperative to ascertain and ensure knowledge retention.
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Affiliation(s)
- Nikolaos Vrachnis
- National and Kapodistrian University of Athens, Health Sciences School, Medical School, 124B Vasilissis Sophias Ave, 115 26, Athens, Greece.
- St George's NHS Foundation Trust Teaching Hospitals, St George's Medical School, University of London, London, UK.
| | - Aris T Papageorghiou
- St George's NHS Foundation Trust Teaching Hospitals, St George's Medical School, University of London, London, UK
| | - Caterina M Bilardo
- Department of Obstetrics and Prenatal Diagnosis Amsterdam University Medical Centres, Amsterdam and University Medical Centre Groningen, University van Groningen, Groningen, The Netherlands
| | - Alfred Abuhamad
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Ann Tabor
- Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Titia E Cohen-Overbeek
- Department of Obstetrics & Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | | | - Jon Hyett
- RPA Women and Babies, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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Balian S, McGovern SK, Abella BS, Blewer AL, Leary M. Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers. Heliyon 2019; 5:e02205. [PMID: 31406943 PMCID: PMC6684477 DOI: 10.1016/j.heliyon.2019.e02205] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/08/2019] [Accepted: 07/30/2019] [Indexed: 10/31/2022] Open
Abstract
AIM OF THE STUDY Augmented reality (AR) has the potential to offer a novel approach to CPR training that supplements conventional training methods with gamification and a more interactive learning experience. This is done through computer-generated imagery superimposed on users' view of the real environment to simulate interactive training scenarios. We sought to test the feasibility of an AR CPR training system (CPReality) for health care providers (HCPs). METHODS In this feasibility trial, a CPR training manikin was integrated with a commercial AR device (Microsoft HoloLens) to provide participants with real-time audio-visual feedback via a holographic overlay of blood flow to vital organs dependent on CC quality. In this system, higher quality CC visually improved virtual blood circulation. HCPs performed a 2-minute cycle of hands-only CPR using only the AR system, and CC parameters were recorded. Descriptive data on participants' demographics, CC quality, and satisfaction with the training environment were reported using quantitative and qualitative analysis. RESULTS Between 10/2018-11/2018, we enrolled a convenience sample of 51 HCPs. The median age of participants was 31 years (IQR 27-41), 71% (36/51) were female, and 67% (34/51) were registered nurses. CC rates (mean 126 ± 12.9 cpm), depths (median 53 mm, IQR 46-58), and percent with complete recoil (median 80%, IQR 12-100) were consistent with guideline recommendations for good quality CPR. Participants were predominantly satisfied with the system, with 82% perceiving the experience as realistic, 98% recognizing the visualizations as helpful for training, and 94% willing to use the application in future CPR training. CONCLUSIONS As AR is increasingly applied in the healthcare setting, integration in CPR training offers a novel and promising educational approach. In this convenience sample of trained HCPs, high quality CC delivery was feasible using the AR CPR training system which was received favorably by most participants.
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Affiliation(s)
- Steve Balian
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shaun K. McGovern
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin S. Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Audrey L. Blewer
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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