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Kitapcioglu D, Aksoy ME, Ozkan AE, Usseli T. Comparing Learning Outcomes of Machine-Guided Virtual Reality-Based Training With Educator-Guided Training in a Metaverse Environment: Randomized Controlled Trial. JMIR Serious Games 2024; 12:e58654. [PMID: 39110497 PMCID: PMC11339586 DOI: 10.2196/58654] [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: 03/22/2024] [Revised: 05/23/2024] [Accepted: 07/06/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Virtual reality (VR) modules are commonly used for health care training, such as adult advanced cardiac life support (ACLS), due to immersion and engagement. The metaverse differs from current VR serious gaming by enabling shared social connections, while current VR modules focus on computer-based content without social interaction. Educators in the metaverse can foster communication and collaboration during training sessions. OBJECTIVE This study aimed to compare learning outcomes of VR-based, machine-guided training with educator-guided, VR-based training in the metaverse environment. METHODS A total of 62 volunteered students from Acibadem Mehmet Ali Aydinlar University Vocational School for Anesthesiology were randomly divided into 2 groups of 31 participants each: one group received VR-based training with machine guidance (MG), and the other received VR-based training with educator guidance (EG) in the metaverse. The members of both groups undertook VR-based basic training for ACLS. Afterward, the MG group was trained with a VR-based advanced training module, which provides training with full MG, whereas the EG group attended the VR-based, educator-guided training in the metaverse. The primary outcome of the study was determined by the exam score of the VR-based training module. Descriptive statistics defined continuous variables such as VR exam scores and time spent on machine- or educator-guided training. The correlation between training time and VR exam scores was assessed with the Spearman rank correlation, and nonnormally distributed variables were compared using the Mann-Whitney U test. Statistical significance was set at P<.05, with analyses executed by MedCalc Statistical Software (version 12.7.7). RESULTS Comparing the VR test scores between the MG and EG groups revealed no statistically significant difference. The VR test scores for the EG group had a median of 86 (range 11-100). In contrast, the MG group scores had a median of 66 (range 13-100; P=.08). Regarding the correlation between the duration of machine-guided or educator-guided training and VR-based exam scores, for the MG group, =0.569 and P=.005 were obtained. For the EG group, this correlation was found to be =0.298 and P=.10. While this correlation is statistically significant for the MG group, it is not significant for the EG group. The post hoc power analysis (80%), considering the correlation between the time spent on training and exam scores, supported this finding. CONCLUSIONS The results of this study suggest that a well-designed, VR-based serious gaming module with MG could provide comparable learning outcomes to VR training in the metaverse with EG for adult ACLS training. Future research with a larger sample size could explore whether social interaction with educators in a metaverse environment offers added benefits for learners. TRIAL REGISTRATION ClinicalTrials.gov NCT06288087; https://clinicaltrials.gov/study/NCT06288087.
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Affiliation(s)
- Dilek Kitapcioglu
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mehmet Emin Aksoy
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
- Department of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Arun Ekin Ozkan
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tuba Usseli
- Vocational School for Anaesthesiology Technicians, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Sorensen D, Cristancho S, Soh M, Varpio L. Team Stress and Its Impact on Interprofessional Teams: A Narrative Review. TEACHING AND LEARNING IN MEDICINE 2024; 36:163-173. [PMID: 36625564 DOI: 10.1080/10401334.2022.2163400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Phenomenon: Interprofessional healthcare team (IHT) collaboration can produce powerful clinical benefits for patients; however, these benefits are difficult to harness when IHTs work in stressful contexts. Research about stress in healthcare typically examines stress as an individual psychological phenomenon, but stress is not only a person-centered experience. Team stress also affects the team's performance. Unfortunately, research into team stress is limited and scattered across many disciplines. We cannot prepare future healthcare professionals to work as part of IHTs in high-stress environments (e.g., emergency medicine, disaster response) unless we review how this dispersed literature is relevant to medical education. Approach: The authors conducted a narrative review of the literature on team stress experienced by interprofessional teams. The team searched five databases between 1 Jan 1990 and 16 August 2021 using the search terms: teams AND stress AND performance. Guided by four research questions, the authors reviewed and abstracted data from the 22 relevant manuscripts. Findings: Challenging problems, time pressure, life threats, environmental distractors, and communication issues are the stressors that the literature reports that teams faced. Teams reacted to team stress with engagement/cohesion and communication/coordination. Stressors impact team stress by either hindering or improving team performance. Critical thinking/decision-making, team behaviors, and time for task completion were the areas of performance affected by team stress. High-quality communication, non-technical skills training, and shared mental models were identified as performance safeguards for teams experiencing team stress. Insights: The review findings adjust current models explaining drivers of efficient and effective teams within the context of interprofessional teams. By understanding how team stress impacts teams, we can better prepare healthcare professionals to work in IHTs to meet the demands placed on them by the ever-increasing rate of high-stress medical situations.
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Affiliation(s)
- Derek Sorensen
- Center for Health Professions Education & Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Sayra Cristancho
- Department of Surgery and Faculty Education, Western University, London, Ontario, Canada
| | - Michael Soh
- Center for Health Professions Education & Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Lara Varpio
- Center for Health Professions Education & Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Dijkstra FS, de la Croix A, van Schuppen H, Meeter M, Renden PG. When routine becomes stressful: A qualitative study into resuscitation team members' perception of stress and performance. J Interprof Care 2024; 38:191-199. [PMID: 38129181 DOI: 10.1080/13561820.2023.2289507] [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: 11/10/2022] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Interprofessional teamwork is of high importance during stressful situations such as CPR. Stress can potentially influence team performance. This study explores the perception of stress and its stressors during performance under pressure, to be able to further adjust or develop training. Healthcare professionals, who are part of the resuscitation team in a large Dutch university medical center, discussed their experiences in homogeneous focus groups. Nine focus groups and one individual interview were conducted and analyzed thematically, in order to deepen our understanding of their experiences. Thematic analysis resulted in two scenarios, routine and stress and an analysis of accompanying team processes. Routine refers to a setting perceived as straightforward. Stress develops in the presence of a combination of stressors such as a lack of clarity in roles and a lack of knowledge on fellow team members. Participants reported that stress affects the team, specifically through an altering of communication, a decrease in situational awareness, and formation of subgroups. This may lead to a further increase in stress, and potentially result in a vicious cycle. Team processes in a stressful situation like CPR can be disrupted by different stressors, and might affect the team and their performance. Improved knowledge about the stressors and their effects might be used to design a training environment representative for the performance setting healthcare professionals work in. Further research on the impact of representative training with team-level stressors and the development of a "team brain" might be worthwhile.
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Affiliation(s)
- F S Dijkstra
- Academy of Health Sciences, Saxion University of Applied Sciences, Deventer, The Netherlands
- Educational and Family Studies, Faculty of Behavioural and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A de la Croix
- Amsterdam UMC location Vrije Universiteit Amsterdam, Research in Education, Amsterdam, The Netherlands
- LEARN! Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H van Schuppen
- Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - M Meeter
- Educational and Family Studies, Faculty of Behavioural and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- LEARN! Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - P G Renden
- Department of Nursing, Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, The Hague, the Netherlands
- Research Group Relational Care, Centre of Expertise Health Innovation, The Hague University of Applied Sciences, The Hague, the Netherlands
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Aksoy ME, Özkan AE, Kitapcioglu D, Usseli T. Comparing the Outcomes of Virtual Reality-Based Serious Gaming and Lecture-Based Training for Advanced Life Support Training: Randomized Controlled Trial. JMIR Serious Games 2023; 11:e46964. [PMID: 37768719 PMCID: PMC10570891 DOI: 10.2196/46964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/04/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Simulation-based Advanced Cardiac Life Support (ACLS) or Advanced Life Support (ALS) training for health care professionals is important worldwide for saving lives. Virtual reality (VR)-based serious gaming can be an alternative modality to be used as a part of simulation-based ALS training. OBJECTIVE The aim of this study is to investigate whether a VR-based ALS serious game module can replace classroom-based ALS lectures, the latter being part of existing conventional ALS training protocols in addition to skills training. METHODS Participants were students from Acibadem Mehmet Ali Aydinlar University's Vocational School for Anesthesiology (N=29) randomly divided into 2 groups with 15 (conventional training group) and 14 (VR-based training group) participants each. Participants in the conventional training group had to complete the pretest consisting of multiple-choice questions at the beginning of the study. Afterward, they took part in an interactive classroom-based ALS lecture. The next step involved skills training with task trainers to teach them compression skills. Following this, the conventional training group was divided into Code Blue teams, each consisting of 5 participants for the simulation session. Two independent instructors evaluated video recordings in terms of technical and nontechnical skills. The score acquired from the manikin-based simulation session was considered the main performance indicator in this study to measure the learning outcome. A similar workflow was used for the VR-based training group, but this group was trained with the VR-based ALS serious game module instead of the theoretical lecture. The final stage of the study involved completing the posttest consisting of multiple-choice questions. A preference survey was conducted among the study participants. Mann-Whitney U and Wilcoxon signed-rank tests were used to analyze the 2 groups' performances in this study. RESULTS The improvement in posttest results compared with pretest results was significant in the conventional training group (P=.002). Hands-on technical scores of the conventional training group were higher than those of the VR-based training group during manikin-based simulation, but total scores, including those for technical and crisis resource management skills, acquired from the manikin-based simulation session did not reveal any significant difference between the 2 groups. The results of the VR preference survey revealed that the majority of the participants prefer VR-based serious game-based training instead of classroom lectures. CONCLUSIONS Although hands-on technical scores of the conventional training group during the manikin-based simulation session were higher than those of the VR-based training group, both groups' total performance scores, including those for technical and crisis resource management skills, did not differ significantly. The preference survey reveals that the majority of the participants would prefer a VR-based ALS serious gaming module instead of lecture-based training. Further studies are required to reveal the learning outcome of VR-based ALS serious gaming. TRIAL REGISTRATION ClinicalTrials.gov NCT05798910; https://clinicaltrials.gov/study/NCT05798910.
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Affiliation(s)
- Mehmet Emin Aksoy
- Department of Biomedical Device Technology, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Arun Ekin Özkan
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Dilek Kitapcioglu
- Department of Medical Education, Medical Faculty, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tuba Usseli
- Vocational School for Anaesthesiology Technicians, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Lorenzini G, Zamboni A, Gelati L, Di Martino A, Pellacani A, Barbieri N, Baraldi M. Emergency team competencies: scoping review for the development of a tool to support the briefing and debriefing activities of emergency healthcare providers. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE (ONLINE) 2023; 3:24. [PMID: 37507807 PMCID: PMC10386683 DOI: 10.1186/s44158-023-00109-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Globally, at least one adverse event occurs in 10% of patients using emergency, inpatient, outpatient, surgical and primary care services. Particularly in emergency health care, this problem is exacerbated by additional variables such as patient criticality, high-risk diagnostic and therapeutic interventions and varying levels of healthcare provider training. In relation to the last point, briefing and debriefing activities during an emergency reinforce staff training and support them in managing work resources, planning interventions and improving future performance. The aim of the scoping review is to explore the state of the art in human factors applied to emergency situations and to develop a new tool to support healthcare professionals in conducting evidence-based briefings and debriefings. This review was developed using a search strategy based on the Arksey and O'Malley's six-step framework for scoping reviews. The literature analysed and the data identified, which are heterogeneous due to different study methodologies, objectives and types of interventions, suggest that human factors applied to emergency situations are still under-researched. At the end of the data extraction, analysis process, authors' reviews, discussion rounds and comparison with the multidisciplinary team of healthcare providers, 42 behaviours, 33 elements and 8 domains were considered relevant and included in the Emergency Team Comptencies (ETC) briefing and debriefing tool, ranked in order of priority as follows: communication, decision-making, clinical skills, situational awareness, leadership, task management, collaboration and stress and fatigue management. Further research is needed to investigate human factors applied to emergency situations and to generate new evidence to improve clinical practice and reduce the risk of error. In the near future, further studies will be conducted by the authors to test the validity of the Emergency Team Competencies tool in objectively measuring the performance of professionals and multidisciplinary teams.
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Sanguanwit P, Kulrotwichit T, Tienpratarn W, Athinartrattanapong N, Trainarongsakul T, Angkoontassaneeyarat C. Effect of mini-course training in communication and teamwork on non-technical skills score in emergency residents: a prospective experimental study. BMC MEDICAL EDUCATION 2023; 23:529. [PMID: 37491254 PMCID: PMC10369795 DOI: 10.1186/s12909-023-04507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Non-technical skill (NTS) teaching is a recent development in medical education that should be applied in medical education, especially in medical specialties that involve critically ill patients, resuscitation, and management, to promote patient safety and improve quality of care. Our study aimed to compare the effects of mini-course training in NTS versus usual practice among emergency residents. METHODS In this prospective (non-randomized) experimental study, emergency residents in the 2021-2022 academic year at Ramathibodi Hospital, a tertiary care university hospital, were included as participants. They were categorized into groups depending on whether they underwent a two-hour mini-course training on NTS (intervention group) or usual practice (control group). Each participant was assigned a mean NTS score obtained by averaging their scores on communication and teamwork skills given by two independent staff. The outcome was the NTS score before and after intervention at 2 weeks and 16 weeks. RESULTS A total of 41 emergency residents were enrolled, with 31 participants in the intervention group and 10 in the control group. The primary outcome, mean total NTS score after 2 weeks and 16 weeks, was shown to be significantly better in intervention groups than control groups (25.85 ± 2.06 vs. 22.30 ± 2.23; P < 0.01, 28.29 ± 2.20 vs. 23.85 ± 2.33; P < 0.01) although the mean total NTS score did not differ between the groups in pre-intervention period. In addition, each week the NTS score of each group increased 0.15 points (95% CI: 0.01-0.28, P = 0.03), although the intervention group showed greater increases than the control (0.24 points) after adjustment for time (95% CI: 0.08-0.39, P < 0.01). CONCLUSION Emergency residents who took an NTS mini-course showed improved mean NTS scores in communication and teamwork skills versus controls 2 weeks and 16 weeks after the training. Attention should be paid to implementing NTS in the curricula for training emergency residents. TRIAL REGISTRATION This trial was retrospectively registered in the Thai Clinical Trial Registry on 29/11/2022. The TCTR identification number is TCTR20221129006.
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Affiliation(s)
- Pitsucha Sanguanwit
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand
| | - Thanet Kulrotwichit
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand
| | - Welawat Tienpratarn
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand.
| | - Natsinee Athinartrattanapong
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand
| | - Thavinee Trainarongsakul
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand
| | - Chuenruthai Angkoontassaneeyarat
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand
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Neutel E, Kuhn S, Driscoll P, Gwinnutt C, Moreira Z, Veloso A, Manso MC, Carneiro A. Does participation in the European Trauma Course lead to new behaviours and organisational change? A Portuguese experience. BMC MEDICAL EDUCATION 2023; 23:415. [PMID: 37280631 DOI: 10.1186/s12909-023-04322-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 05/03/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Medical educational courses can be successful from an immediate feedback perspective but not lead to new behaviour or organisational changes in the workplace. The aim of this study was to assess the self-perceived impact of the European Trauma Course (ETC) on Reanima trainees' behaviour and organisational change. METHODS A 40-item questionnaire based on Holton's evaluation model was used to evaluate the candidate's perceptions. The results were analysed with descriptive and inferential statistical analysis using nonparametric tests with α = 0.05. RESULTS Out of 295 participants, 126 responded to the survey. Of these, 94% affirmed that the ETC modified their approach to trauma patients, and 71.4% described a change in their behaviour. Postcourse responders changed their behaviour in their initial approach to trauma care in the nontechnical skills of communication, prioritisation and teamwork. Being an ETC instructor strongly influenced the acquisition of new material, and this group was able to implement changes in attitudes. Individuals with no previous trauma course experience identified lack of self-efficacy as a significant obstacle to introducing new work-based learning. In contrast, responders with ATLS training noted a lack of ETC colleagues as the main impediment for moving from conceptualisation to experimentation in the workplace. CONCLUSIONS Participation in the ETC led to behavioural changes in the workplace. However, the ability to influence others and bring about wider organisational changes was more difficult to achieve. Major factors were the status of the person, their experience and self-efficacy. National organisational impact was obtained, which went far beyond our aspirations in acknowledging change in individual daily practice. Future research studies will include the effect of implementing the ETC methodology on the outcome of trauma patients.
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Affiliation(s)
- Elizabete Neutel
- Department of Anaesthesiology, Intensive Care Medicine and Emergency, Porto University Hospital: Centro Hospitalar Universitário de Santo António (CHUd SA), Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
| | - Sebastian Kuhn
- Institute of Digital Medicine, Philipps-University Marburg and University Hospital of Giessen and Marburg, Marburg, Germany
| | - Peter Driscoll
- Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Carl Gwinnutt
- Resuscitation Council UK, Tavistock Square, London, WC1H 9HR, UK
| | - Zélia Moreira
- Department of Anaesthesiology, Intensive Care Medicine and Emergency, Porto University Hospital: Centro Hospitalar Universitário de Santo António (CHUd SA), Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - Ana Veloso
- CICS. NOVA. UMinho; School of Psychology, University of Minho, 4704-553, Braga, Portugal
| | - Maria Conceição Manso
- Faculty of Health Sciences, FP-I3ID/FP-BHS, University Fernando Pessoa, 4200-150, Porto, Portugal
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Lin Y, Savage T, Gravel G, Davidson J, Tofil N, Duff J, Cheng A. Who is the real team leader? Comparing leadership performance of the team leader and CPR Coach during simulated cardiac arrest. Resusc Plus 2023; 14:100400. [PMID: 37265710 PMCID: PMC10230253 DOI: 10.1016/j.resplu.2023.100400] [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: 06/03/2023] Open
Abstract
Purpose To describe the leadership performance of team leaders and CPR Coaches, and to determine if there is a correlation between leadership scores and CPR performance during management of simulated pediatric cardiac arrest events. Methods This is a secondary analysis of data from a prior randomized controlled trial. We observed the performance of both team leaders and CPR coaches during the management of an 18-minute simulated cardiac arrest scenario which was run for 20 resuscitation teams comprised of CPR-certified professionals from four pediatric tertiary care centers. CPR Coaches were responsible for providing real-time verbal feedback of CPR performance to compressors. Two raters were trained to use the Behavioral Assessment Tool (BAT) to assess leadership performance of the team leader and CPR Coach. BAT scores of team leaders and CPR coaches were compared and linked with objective CPR performance. Results There was no significant difference between the BAT scores of team leaders and CPR coaches (median score 27/40 vs 28.8/40, p = 0.16). Higher BAT scores of team leaders were significantly associated with higher percentage of excellent CPR (r = 0.52, p = 0.02), while higher BAT scores of CPR coaches were significantly associated with higher chest compression fraction (r = 0.48, p = 0.03). Conclusions Both team leaders and CPR coaches have similarly high leadership performance during the management of simulated cardiac arrest. Leadership behaviors were associated with quality of CPR performance.Clinical Trial Registration: Registration ID: NCT02539238; https://www.clinicaltrials.gov.
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Affiliation(s)
- Yiqun Lin
- Jennifer Davidson RN, KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, Canada
| | - Tyson Savage
- Department of Emergency Medicine, University of Calgary, Canada
| | - Genevieve Gravel
- Department of Emergency Medicine, Laval University, Quebec City, Canada
| | - Jennifer Davidson
- Jennifer Davidson RN, KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, Canada
| | - Nancy Tofil
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jonathan Duff
- Department of Pediatrics, Faculty of Medicine and Dentristry, University of Alberta, Edmonton, Canada
| | - Adam Cheng
- Department of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, Canada
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Leal-Costa C, Carrasco-Guirao JJ, Adánez-Martínez MG, Díaz-Agea JL, Ramos-Morcillo AJ, Ruzafa-Martínez M, Suarez-Cortes M, Jiménez-Ruiz I. Development and psychometric testing of the non-technical skills scale in medical and surgical hospital units for nursing students. Nurse Educ Pract 2023; 67:103559. [PMID: 36682321 DOI: 10.1016/j.nepr.2023.103559] [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: 04/22/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students. BACKGROUND In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units. DESIGN An instrumental study design was employed. METHODS Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale. RESULTS The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained. CONCLUSION The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy.
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Affiliation(s)
- César Leal-Costa
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 El Palmar, Murcia, Spain.
| | | | | | - José Luis Díaz-Agea
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 El Palmar, Murcia, Spain.
| | | | - María Ruzafa-Martínez
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 El Palmar, Murcia, Spain.
| | - María Suarez-Cortes
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 El Palmar, Murcia, Spain.
| | - Ismael Jiménez-Ruiz
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 El Palmar, Murcia, Spain.
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Nabecker S, Huwendiek S, Seidl C, Hana A, Theiler L, Greif R. Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial. Front Cardiovasc Med 2022; 9:840114. [PMID: 35911508 PMCID: PMC9335945 DOI: 10.3389/fcvm.2022.840114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
AimHuman factors are essential for high-quality resuscitation team collaboration and are, therefore, taught in international advanced life support courses, but their assessment differs widely. In Europe, the summative life support course assessment tests mainly adhere to guidelines but few human factors. This randomized controlled simulation trial investigated instructors’ and course participants’ perceptions of human factors assessment after two different summative assessments.MethodsAll 5th/6th-year medical students who attended 19 advanced life support courses according to the 2015 European Resuscitation Council guidelines during one study year were invited to participate. Each course was randomized to either: (1) Simulated team assessment (one instructor simulates a team, and the assessed person leads this “team” through a cardiac-arrest scenario test); (2) Real team assessment (4 students form a team, one of them is assessed as the team leader; team members are not assessed and act only on team leader’s commands). After the summative assessments, instructors, and students rated the tests’ ability to assess human factors using a visual analog scale (VAS, 0 = no agreement, 10 = total agreement).ResultsA total of 227 students participated in the 1-day Immediate Life Support courses, 196 students in the 2-day Advanced Life Support courses, additionally 54 instructors were included. Instructors judged all human factors significantly better in real team assessments; students rated leadership and situational awareness comparable between both assessments. Assessment pass rates were comparable between groups.ConclusionSummative assessment in real teams was perceived significantly better to assess human factors. These results might influence current summative assessment practices in advanced life support courses.
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Affiliation(s)
- Sabine Nabecker
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, ON, Canada
- ERC Research NET, Niel, Belgium
- Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland
- *Correspondence: Sabine Nabecker,
| | - Sören Huwendiek
- Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland
| | - Christian Seidl
- EMS Rescue Service of the Canton Basel-Stadt, Basel, Switzerland
| | - Anisa Hana
- Department of Intensive Care Medicine, Laurentius Hospital, Roermond, Netherlands
| | - Lorenz Theiler
- Department of Anesthesia, Kantonsspital Aarau, Aarau, Switzerland
| | - Robert Greif
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
- ERC Research NET, Niel, Belgium
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Moll-Khosrawi P, Zöllner C, Cencin N, Schulte-Uentrop L. Flipped learning enhances non-technical skill performance in simulation-based education: a randomised controlled trial. BMC MEDICAL EDUCATION 2021; 21:353. [PMID: 34158030 PMCID: PMC8220780 DOI: 10.1186/s12909-021-02766-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many efforts of the past years aimed to build a safer health care system and hereby, non-technical skills (NTS) have been recognised to be responsible for over 70 % of preventable medical mishaps. In order to counteract those mishaps, several simulation-based trainings have been implemented in health care education to convey NTS. Still, the best and effective way to foster NTS in simulation-based training is not known. Due to the importance of NTS, this gap in knowledge needs to be filled. A possible approach to convey NTS effectively during simulation-based medical education (SBME), might be the use of the flipped learning approach. The benefits of flipped learning regarding the improvement of human factors (NTS), have not been investigated yet. Therefore, the authors introduced flipped learning as an experimental intervention into their SBME emergency trainings and aimed to analyse, whether flipped learning improved students´ NTS performance compared to lecture-based learning (LBL). METHODS In a randomized controlled trial, 3rd year medical students participated in a SBME training and then received either a further SBME training with integrated flipped learning on NTS (intervention), or a further SBME training and an accompanying lecture on NTS (control). NTS performance was assessed on three skill dimensions with a validated behavioural marker system. RESULTS The authors analysed NTS performance of 102 students, prior and after their allocation to each teaching method. The baseline NTS performance of both groups did not differ, whereas the intervention group enhanced significantly on all three skill dimensions (t (44) = 5.63, p < .001; t (44) = 4.47, p < .001; t (44) = 4.94, p < .001). CONCLUSION The integration of flipped learning into SBME yields a significant improvement of NTS performance and therefore medical educators should consider the application of flipped learning to convey complex human factors and skills.
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Affiliation(s)
- Parisa Moll-Khosrawi
- Department of Anaesthesiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Christian Zöllner
- Department of Anaesthesiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Nadine Cencin
- Department of Anaesthesiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Leonie Schulte-Uentrop
- Department of Anaesthesiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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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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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: 147] [Impact Index Per Article: 49.0] [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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