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Cerles AA, Dinh NNL, MacMillan L, Kemp DC, Rush MA. Development of Novel Video-Based First Responder Opioid Hazard Refresher Training. New Solut 2021; 31:298-306. [PMID: 34382476 DOI: 10.1177/10482911211038336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
First responders encounter many hazards in the execution of their duties, and exposure to hazardous materials such as opioids is a primary safety concern. The ongoing opioid crisis in the United States continues to be a major public health issue, with overdose deaths from opioids reaching epidemic levels. Although responders frequently encounter opioids, available data on safety and risk are not always well-communicated, and we identified a need for refresher and just-in-time training products on this topic. In response, we created a training video series that is informative, concise, and visually appealing. The video series, available on YouTube, was tested with a small initial population, with findings suggesting key questions for a larger study focused on integration of the refresher training with existing programs to optimize retention and adoption of safety practices.
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The Impact of a Mobile Phone Application for Retention of Bleeding Control Skills. J Surg Res 2021; 267:669-677. [PMID: 34273797 DOI: 10.1016/j.jss.2021.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/19/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The American College of Surgeons Bleeding Control Course (B-Con) empowers bystanders with hemorrhage control skills to manage prehospital emergencies, but demonstrates poor skill retention. The point of care use of a free Stop the Bleed mobile phone application on the retention of hemorrhage control skills from the B-Con Course was explored. METHODS Convenience sample of college students previously trained in B-Con were randomized into mobile application (MA) or control groups. The use of a mobile application during a simulated emergency scenario with tourniquet and situational awareness skills was assessed. Wound packing skill retention without intervention was also assessed. Survey data allowed for comparison of participant perceptions of skills with actual performances. RESULTS MA (n = 30) was superior to control (n = 32) in correct tourniquet application (62.5% versus 30.0%; P = 0.01) with longer placement times (163 sec versus 95 sec; P < 0.001) and in calling 911 (31.3% versus 3.3%, P = 0.004). Participants maintain inflated perceptions of their skills, but generally feel underprepared for a future bleeding emergency. CONCLUSIONS Mobile apps improve tourniquet and situational awareness skills and may serve as potential aids to improve bystander hemorrhage control skills in real-time, but require further prospective investigation into its use.
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Muthomi N, Wachira LJ, Ooko WS. Knowledge in pre-hospital emergency and risk management among outdoor adventure practitioners in East Africa afro-alpine mountains. Afr J Emerg Med 2021; 11:87-92. [PMID: 33680726 PMCID: PMC7910172 DOI: 10.1016/j.afjem.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The enjoyment of nature and other benefits of outdoor activities happen amid inherent hazards. This calls for knowledge and competency in emergency and risk management. Practitioners in outdoor activities, such as mountaineering, thus need to be knowledgeable on how to manage risks and attend to emergencies in their practice. The study sought to establish the preparedness of East African mountaineering practitioners in prehospital emergency and risk management. It sought to establish their knowledge on prehospital emergency and risk management, based on their age, gender, level of education and refresher training. METHODS The study purposively sampled one hundred and thirty six (N = 136) outdoor adventure practitioners from the Afro-alpine mountain areas in East Africa. It was hypothesized that there would be no significant relationship between the outdoor practitioners' knowledge in prehospital emergency risk management and their age, gender, level of education, refresher training. Somers' d was used to test the hypotheses. RESULTS It was established that the knowledge scores of prehospital emergency and risk management for the mountaineering practitioners was low. It was also established that the knowledge scores of outdoor practitioners were not dependent on their age, gender, and work experience. However, there was a significant relationship between the outdoor adventure practitioners' knowledge scores and their highest level of education as well as refresher training. CONCLUSIONS The study concluded that there were gaps in the knowledge of prehospital risk management of the East African Afro-alpine mountaineering practitioners. It recommends frequent and regular training and re-certification among outdoor adventure practitioners in order to raise the knowledge in prehospital emergency risk management.
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Affiliation(s)
- Nkatha Muthomi
- Department of Recreation and Sports Management, School of Hospitality, Tourism and Leisure Studies, Kenyatta University, Nairobi, Kenya
| | - Lucy-Joy Wachira
- Department of Physical Education, Exercise and Sport Science, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya
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Riccò M, Berrone M, Vezzosi L, Gualerzi G, Canal C, De Paolis G, Schallenberg G. Factors influencing the willingness to perform bystander cardiopulmonary resuscitation on the workplace: a study from North-Eastern Italy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020180. [PMID: 33525292 PMCID: PMC7927506 DOI: 10.23750/abm.v91i4.8593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/11/2019] [Indexed: 11/23/2022]
Abstract
Background: Early bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. However, few data are available regarding the willingness to perform CPR among First Aid Attendants on the Workplace (FAAWs) in Italy. The present study was performed in order to identify current attitudes of Italian FAAWs towards CPR. Methods: Between February and June 2017, FAAWs from the Autonomous Province of Trento were asked about their willingness to perform CPR through a structured questionnaire assessing their knowledge about CPR, and the reasons for hesitancy. A cumulative knowledge score (KS) was eventually calculated. Results: A total of 123 FAAWs (male 57.7%, mean age 45.2 years ± 10.1) completed the questionnaire. About 1/3 of participants (32.5%) had previously performed First Aid procedures. Overall, 77.2% exhibited willingness to perform CPR, and such attitude was more frequently reported by subjects younger than 40 years (29.5% vs. 10.7% in older subjects; p=0.045), perceiving First Aid training as useful (98.9% vs. 84.7%, p=0.002), and exhibiting a better knowledge of CPR (KS≥75%: 47.4% vs. 15.3%). The reasons for the unwillingness were inadequate knowledge and doubt regarding whether they could perform the techniques effectively. Eventually, KS was identified as the main predictor for willingness to perform CPR (OR 4.450, 95%CI 1.442-14.350). Conclusions: Willingness to perform CPR was seemingly high, and knowledge of CPR techniques was its main predictor. These findings emphasize the importance for an accurate CPR training, as well as for the surveillance of the quality of qualification courses.(www.actabiomedica.it)
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Mirco Berrone
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Luigi Vezzosi
- Azienda Socio Sanitaria Territoriale di Cremona, Direzione Medica Ospedale di Cremona.
| | - Giovanni Gualerzi
- School of Medicine and Surgery, Department of Medicine and Surgery, University of Parma, Parma (PR).
| | - Chiara Canal
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Giuseppe De Paolis
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Gert Schallenberg
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
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Chien CY, Fang SY, Tsai LH, Tsai SL, Chen CB, Seak CJ, Weng YM, Lin CC, Chien WC, Huang CH, Lin CY, Chaou CH, Liu PH, Tseng HJ, Chen JC, Peng SY, Cheng TH, Hsu KH, Ng CJ. Traditional versus blended CPR training program: A randomized controlled non-inferiority study. Sci Rep 2020; 10:10032. [PMID: 32572100 PMCID: PMC7308401 DOI: 10.1038/s41598-020-67193-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/03/2020] [Indexed: 11/09/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) training and its quality are critical in improving the survival rate of cardiac arrest. This randomized controlled study investigated the efficacy of a newly developed CPR training program for the public in a Taiwanese setting. A total of 832 adults were randomized to either a traditional or blended (18-minute e-learning plus 30-minute hands-on) compression-only CPR training program. The primary outcome was compression depth. Secondary outcomes included CPR knowledge test, practical test, quality of CPR performance, and skill retention. The mean compression depth was 5.21 cm and 5.24 cm in the blended and traditional groups, respectively. The mean difference in compression depth between groups was -0.04 (95% confidence interval -0.13 to infinity), demonstrating that the blended CPR training program was non-inferior to the traditional CPR training program in compression depth after initial training. Secondary outcome results were comparable between groups. Although the mean compression depth and rate were guideline-compliant, only half of the compressions were delivered with adequate depth and rate in both groups. CPR knowledge and skill retained similarly in both groups at 6 and 12 months after training. The blended CPR training program was non-inferior to the traditional CPR training program. However, there is still room for improvement in optimizing initial skill performance as well as skill retention. Clinical Trial Registration: NCT03586752; www.clinicaltrial.gov.
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Affiliation(s)
- Cheng-Yu Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Shao-Yu Fang
- Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Li-Heng Tsai
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Shang-Li Tsai
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Chen-Bin Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chen-June Seak
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Yi-Ming Weng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Chi-Chun Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Wei-Che Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Chien-Hsiung Huang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Cheng-Yu Lin
- Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Peng-Huei Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Hsiao-Jung Tseng
- Biostatistics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, 333, Taiwan
| | - Jih-Chang Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Shu-Yuan Peng
- Department of nursing, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Tsung-Hsuan Cheng
- Department of nursing, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Kuang-Hung Hsu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Laboratory for Epidemiology, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Urology, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
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Ruttenberg R, Raynor PC, Tobey S, Rice C. Perception of Impact of Frequent Short Training as an Enhancement of Annual Refresher Training. New Solut 2020; 30:102-110. [PMID: 32345123 DOI: 10.1177/1048291120920553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction of facilitated hands-on drills as often as monthly and the use of online modules prior to annual refresher training for emergency response teams were investigated through surveys and group discussions. This research explores how these drills are perceived by emergency response team members, emergency response team coordinators, instructors, and management at the company. Using these tools throughout the year, members of emergency response teams from automobile manufacturing facilities reported an increased ability to maintain their skill sets, build teamwork, and continually refresh and strengthen their ability to protect their fellow workers as well as plant operations and equipment. The results also document examples of how this innovative program that incorporates frequent training has led to workplace improvements.
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Affiliation(s)
- Ruth Ruttenberg
- President, Ruth Ruttenberg & Associates, Northfield, VT, USA
| | - Peter C Raynor
- University of Minnesota, School of Public Health, Minneapolis, MN, USA
| | - Scott Tobey
- President, ERS International, Plymouth, MI, USA
| | - Carol Rice
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
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Goralnick E, Chaudhary MA, McCarty JC, Caterson EJ, Goldberg SA, Herrera-Escobar JP, McDonald M, Lipsitz S, Haider AH. Effectiveness of Instructional Interventions for Hemorrhage Control Readiness for Laypersons in the Public Access and Tourniquet Training Study (PATTS): A Randomized Clinical Trial. JAMA Surg 2019; 153:791-799. [PMID: 29801156 DOI: 10.1001/jamasurg.2018.1099] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Several national initiatives have emerged to empower laypersons to act as immediate responders to reduce preventable deaths from uncontrolled bleeding. Point-of-care instructional interventions have been developed in response to the scalability challenges associated with in-person training. However, to our knowledge, their effectiveness for hemorrhage control has not been established. Objective To evaluate the effectiveness of different instructional point-of-care interventions and in-person training for hemorrhage control compared with no intervention and assess skill retention 3 to 9 months after hemorrhage control training. Design, Setting, and Participants This randomized clinical trial of 465 laypersons was conducted at a professional sports stadium in Massachusetts with capacity for 66 000 people and assessed correct tourniquet application by using different point-of-care interventions (audio kits and flashcards) and a Bleeding Control Basic (B-Con) course. Non-B-Con arms received B-Con training after initial testing (conducted from April 2017 to August 2017). Retesting for 303 participants (65%) was performed 3 to 9 months after training (October 2017 to January 2018) to evaluate B-Con retention. A logistic regression for demographic associations was performed for retention testing. Interventions Participants were randomized into 4 arms: instructional flashcards, audio kits with embedded flashcards, B-Con, and control. All participants received B-Con training to later assess retention. Main Outcomes and Measures Correct tourniquet application in a simulated scenario. Results Of the 465 participants, 189 (40.7%) were women and the mean (SD) age was 46.3 (16.1) years. For correct tourniquet application, B-Con (88% correct application [n = 122]; P < .001) was superior to control (n = 104 [16%]) while instructional flashcards (n = 117 [19.6%]) and audio kit (n = 122 [23%]) groups were not. More than half of participants in point-of-care arms did not use the educational prompts as intended. Of 303 participants (65%) who were assessed 3 to 9 months after undergoing B-Con training, 165 (54.5%) could correctly apply a tourniquet. Over this period, there was no further skill decay in the adjusted model that treated time as either linear (odds ratio [OR], 0.98; 95% CI, 0.95-1.03) or quadratic (OR, 1.00; 95% CI, 1.00-1.00). The only demographic that was associated with correct application at retention was age; adults aged 18 to 35 years (n = 58; OR, 2.39; 95% CI, 1.21-4.72) and aged 35 to 55 years (n = 107; OR, 1.77; 95% CI, 1.04-3.02) were more likely to be efficacious than those older than 55 years (n = 138). Conclusions and Relevance In-person hemorrhage control training for laypersons is currently the most efficacious means of enabling bystanders to act to control hemorrhage. Laypersons can successfully perform tourniquet application after undergoing a 1-hour course. However, only 54.5% retain this skill after 3 to 9 months, suggesting that investigating refresher training or improved point-of-care instructions is critical. Trial Registration ClinicalTrials.gov Identifier: NCT03479112.
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Affiliation(s)
- Eric Goralnick
- Brigham and Women's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Muhammad A Chaudhary
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Justin C McCarty
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Edward J Caterson
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts.,Brigham and Women's Hospital, Division of Plastic Surgery, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Scott A Goldberg
- Brigham and Women's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Juan P Herrera-Escobar
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Meghan McDonald
- Brigham and Women's Hospital, Division of Trauma, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Stuart Lipsitz
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Adil H Haider
- Brigham and Women's Hospital, Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, Massachusetts.,Deputy Editor
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8
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Riggs M, Franklin R, Saylany L. Cardiopulmonary resuscitation (CPR) psychomotor skills of laypeople, as affected by training interventions, number of times trained and retention testing intervals: A dataset derived from a systematic review. Data Brief 2019; 25:104236. [PMID: 31497626 PMCID: PMC6718818 DOI: 10.1016/j.dib.2019.104236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022] Open
Abstract
This article is a companion to a systematic review, entitled, Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: a systematic review (Riggs et al., 2019). The data tables described in this article summarise the impact that specific training interventions, number of times trained, and retention testing intervals have on laypeople's CPR psychomotor skills, as reported by peer-reviewed journal articles. The psychomotor skills included are: compression rate, compression depth, duration of interruptions to compressions, chest recoil, hand placement, proportion of adequate or 'correct' compressions, ventilation volume, compression-to-ventilation ratio, duty cycle and overall skills. The data tables described in this article are available as a supplementary file to this article.
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Aliyari S, Pishgooie AH, Abdi A, Mazhari MS, Nazari MR. Comparing two teaching methods based on concept map and lecture on the level of learning in basic life support. Nurse Educ Pract 2019; 38:40-44. [PMID: 31176242 DOI: 10.1016/j.nepr.2019.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 04/16/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022]
Abstract
Education and training about Basic Life Support is necessary for different medical groups such as nurses. Different teaching methods have been developed to preserve essential medical information, knowledge and skills. The purpose of the study was to determine the effect of concept map-based and lecture-based teaching methods on the level of nursing students' learning in Basic Life Support. This quasi-experimental study was conducted in 2015 on 57 nursing students from a nursing school in Tehran. Students were selected by census and then divided into lecture (n = 29) and concept map groups (n = 28) by random allocation. The effect of education on knowledge (before, immediately after, one week after and one month after session) and practice (before and immediately after session) was studied. No significant differences were found between the mean scores of knowledge and practice before intervention (P > 0.05). After intervention the mean scores of knowledge were not statistically significant between the two groups (P > 0.05) but mean scores of practice were significantly higher in the concept map group (P = 0.03). In achieving skill and practice goals, it seems that the concept map-based teaching method was more effective than the lecture method.
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Affiliation(s)
- Shahla Aliyari
- AJA University of Medical Sciences, Faculty of Nursing, Maternal Newborn Health Department, Nursing School of AJA, End of Kaj Ave., Infront of Bahar Shiraz Ave., Shariati St., Tehran, Iran.
| | - Amir Hosein Pishgooie
- AJA University of Medical Sciences, Faculty of Nursing, Department of Medical-Surgical Nursing, Nursing School of AJA, End of Kaj Ave., Infront of Bahar Shiraz Ave., Shariati St., Tehran, Iran.
| | - Azadeh Abdi
- AJA University of Medical Sciences, Faculty of Nursing, Nursing School of AJA, End of Kaj Ave., Infront of Bahar Shiraz Ave., Shariati St., Tehran, Iran.
| | - Marjan Seyed Mazhari
- AJA University of Medical Sciences, Faculty of Nursing, Department of Medical-Surgical Nursing, Nursing School of AJA, End of Kaj Ave., Infront of Bahar Shiraz Ave., Shariati St., Tehran, Iran.
| | - Mohammad Reza Nazari
- AJA University of Medical Sciences, Faculty of Nursing, Nursing School of AJA, End of Kaj Ave., Infront of Bahar Shiraz Ave., Shariati St., Tehran, Iran.
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Malmgren A, Biswanger K, Lundqvist A, Zaoutis T. Education, decision support, feedback and a minor reward: a novel antimicrobial Stewardship intervention in a Swedish paediatric emergency setting. Infect Dis (Lond) 2019; 51:559-569. [PMID: 31088317 DOI: 10.1080/23744235.2019.1606933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Sweden enjoys a favourable situation with regard to antimicrobial resistance. However, healthcare costs are expected to increase exponentially, along with increased morbidity and mortality, due to the emergence of resistant bacterial strains. Our aim was to design an antimicrobial stewardship programme suitable for Scandinavian settings. Methods: A quasi-experimental pre-post study was conducted in a Swedish paediatric emergency department, evaluating adherence to national guidelines for acute otitis media and acute tonsillitis. The programme consisted of educational outreach, decision support, feedback, and a minor reward upon reaching a pre-defined adherence rate. Results: The largest impact, significant for both diagnoses, was on the practice of refraining from antibiotic use when recommended. The other variables evaluated showed no significant improvement for either condition; however, in most cases, pre-interventional adherence was already high. Conclusions: This relatively easily implementable ASP intervention showed a significant effect on correctly refraining from the use of antibiotics. Previous interventions in Scandinavia either failed to accomplish this or have been more logistically difficult. The combination of education, decision support, email-based feedback and a minor reward, offers an alternative. Future research will be needed to assess whether the result is sustainable, as well as to identify additional barriers to the judicious use of antibiotics not addressed in this study.
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Affiliation(s)
- Annika Malmgren
- a Department of Pediatric Medicine , Queen Silvia Children's Hospital , Gothenburg , Sweden
| | - Karin Biswanger
- b Department of Pediatric Medicine , Södra Älvsborg Hospital , Borås , Sweden
| | - Anders Lundqvist
- c Department of Infectious Diseases , Södra Älvsborg Hospital , Borås , Sweden
| | - Theoklis Zaoutis
- d Division of Infectious Diseases and the Center for Pediatric Clinical Effectiveness , Children's Hospital of Philadelphia , Philadelphia , PA , USA
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11
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Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation 2019; 138:259-272. [PMID: 30928504 DOI: 10.1016/j.resuscitation.2019.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. METHODS Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts. RESULTS Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills. CONCLUSION All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.
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Carleton RN, Afifi TO, Turner S, Taillieu T, Vaughan AD, Anderson GS, Ricciardelli R, MacPhee RS, Cramm HA, Czarnuch S, Hozempa K, Camp RD. Mental health training, attitudes toward support, and screening positive for mental disorders. Cogn Behav Ther 2019; 49:55-73. [PMID: 30794073 DOI: 10.1080/16506073.2019.1575900] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Public Safety Personnel (PSP; e.g. correctional workers, dispatchers, firefighters, paramedics, police) are frequently exposed to potentially traumatic events (PTEs). Several mental health training program categories (e.g. critical incident stress management (CISM), debriefing, peer support, psychoeducation, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures, often using cognitive behavioral therapy model content, but with limited effectiveness research. The current study assessed PSP perceptions of access to professional (i.e. physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e. spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants included 4,020 currently serving PSP participants. Data were analyzed using cross-tabulations and logistic regressions. Most PSP reported access to professional and non-professional support; nevertheless, most would first access a spouse (74%) and many would never, or only as a last resort, access professional support (43-60%) or PSP leaders (67%). Participation in any mental health training category was associated with lower (p < .01) rates for some, but not all, mental disorders, with no robust differences across categories. Revisions to training programs may improve willingness to access professional support; in the interim, training and support for PSP spouses and leaders may also be beneficial.
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Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Tracie O Afifi
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Sarah Turner
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Tamara Taillieu
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Adam D Vaughan
- School of Criminal Justice, College of Applied Arts, Texas State University, San Marcos, TX, USA
| | - Gregory S Anderson
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, New Westminster, BC, Canada
| | | | - Renée S MacPhee
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Heidi A Cramm
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Stephen Czarnuch
- Department of Electrical and Computer Engineering, Faculty of Engineering and Applied Science / Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Kadie Hozempa
- Collaborative Centre for Justice and Safety, University of Regina, Regina, SK, Canada
| | - Ronald D Camp
- Hill / Levene Schools of Business, Faculty of Business Administration, University of Regina, Regina, SK, Canada
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Vale S, Netting MJ, Ford LS, Tyquin B, McWilliam V, Campbell DE. Anaphylaxis management in Australian schools: Review of guidelines and adrenaline autoinjector use. J Paediatr Child Health 2019; 55:143-151. [PMID: 30523652 DOI: 10.1111/jpc.14307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
Abstract
Food allergy and anaphylaxis is increasing in Australian children, and anaphylaxis is relatively common in Australian schools. This review aims to provide an overview of current policies and practices for anaphylaxis management in Australian schools, including approaches to risk mitigation and anaphylaxis training. We reviewed literature related to anaphylaxis training in the school setting published between 2010 and 2018. Current anaphylaxis policies/guidelines were obtained from Australian education and health departments, and reports of suspected anaphylaxis and adrenaline autoinjector (AAI) use for 2016-2017 were obtained from education departments where available. Our review of policies/guidelines across Australian jurisdictions indicates inconsistent approaches to anaphylaxis management training. Almost half of Australian school anaphylaxis events required a general-use AAI, administered to students not identified as at risk of anaphylaxis. Development of clear, evidence-based, consistent guidelines related to anaphylaxis management and training in the school setting is imperative to minimise risk.
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Affiliation(s)
- Sandra Vale
- National Allergy Strategy, Sydney, New South Wales, Australia.,Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia
| | - Merryn J Netting
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Healthy Mothers Babies and Children's Theme, South Australian Health Medical Research Institute, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,Nutrition Department, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Lara S Ford
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Briony Tyquin
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
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Flett KB, Bousvaros A, Carpenter J, Millrinen CE, Martin P, Sandora TJ. Reducing Redundant Anaerobic Therapy Through Spaced Education and Antimicrobial Stewardship Interventions. J Pediatric Infect Dis Soc 2018; 7:317-322. [PMID: 29165636 DOI: 10.1093/jpids/pix090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Decreasing the use of redundant anaerobic therapy is a key target for antimicrobial stewardship. Education techniques that optimize knowledge retention could be an important component of reducing these regimens. METHODS We implemented a quality improvement project that incorporated spaced education to reduce the use of redundant anaerobic therapy. The initial interventions (November through December 2015) included education in a hospital-wide newsletter and review of redundant anaerobic regimens by the antimicrobial stewardship program. A spaced education module was then developed with the gastroenterology (GI) service, which had a relatively high rate of redundant anaerobic therapy use. Ten questions with teaching points were delivered to GI physicians at spaced intervals over 2 to 4 weeks (February through March 2016). Knowledge scores were compared at initial and final question presentation using generalized estimating equations. Interrupted time-series analysis was used to compare the rates of redundant-metronidazole-days per 1000 patient-days among patients in the patients admitted to the GI service and those in the non-GI group before and after the intervention. RESULTS Of 66 GI physicians, 56 (85%) participated in the spaced education activity. After the intervention, their knowledge scores on all the questions improved, and their mean knowledge score increased from 57% to 86% (P < .001). Nearly all (91%) of the participants were very or generally satisfied with the activity. In the GI group, the rate of redundant-metronidazole-days decreased from 26.2 to 13.0 per 1000 patient-days (relative risk [RR], 0.45 [95% confidence interval (CI), 0.27-0.73]; P = .001). This rate in the non-GI group also decreased from 5.47 to 2.18 per 1000 patient-days (RR, 0.47 [95% CI, 0.36-0.60]; P < .001) after our interventions. CONCLUSIONS Spaced education is an effective approach for teaching antimicrobial stewardship topics. Focused provider education was associated with a sustained reduction in the use of redundant anaerobic therapy.
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Affiliation(s)
- Kelly B Flett
- Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.,Infection Prevention and Control and Antimicrobial Stewardship, Boston Children's Hospital, Massachusetts
| | - Athos Bousvaros
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Massachusetts
| | - Jane Carpenter
- Infection Prevention and Control and Antimicrobial Stewardship, Boston Children's Hospital, Massachusetts
| | - Carly E Millrinen
- Program for Patient Safety and Quality, Boston Children's Hospital, Massachusetts
| | - Patricia Martin
- Department of Quality and Safety, Carney Hospital, Boston, Massachusetts
| | - Thomas J Sandora
- Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.,Infection Prevention and Control and Antimicrobial Stewardship, Boston Children's Hospital, Massachusetts
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Carleton RN, Korol S, Mason JE, Hozempa K, Anderson GS, Jones NA, Dobson KS, Szeto A, Bailey S. A longitudinal assessment of the road to mental readiness training among municipal police. Cogn Behav Ther 2018; 47:508-528. [PMID: 29912631 DOI: 10.1080/16506073.2018.1475504] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Police agencies increasingly implement training programs to protect mental health. The Road to Mental Readiness (R2MR) program was designed by the Canadian military to increase mental health resilience. A version of R2MR was adapted for municipal police by the Mental Health Commission of Canada (MHCC). The current research was designed to assess the R2MR program, as adapted and delivered by the MHCC, in a municipal police sample. Participants were 147 Canadian police agency employees (57% women) who received a single R2MR training session. Participants completed pre- and post-training self-report questionnaires, and follow-ups at 6 and 12 months. The questionnaires assessed mental health symptoms, work engagement, resiliency, mental health knowledge, and stigma. Multilevel modeling analyses assessed for within-participant changes over time. The results were consistent with other single session interventions; specifically, there were no significant changes in mental health symptoms, resilience, or work engagement (p > .05). There were small, but significant (p < .05), reductions in stigma at post-training that may facilitate help-seeking among police; relatedly, in open-ended response fields, participants commonly described the training as helpful for changing attitudes and improving communication. More engagement with the material may produce larger, sustained gains, but more published research is critically needed.
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Affiliation(s)
- R Nicholas Carleton
- a Anxiety and Illness Behaviour Laboratory, Department of Psychology , University of Regina , Regina , Canada
| | - Stephanie Korol
- a Anxiety and Illness Behaviour Laboratory, Department of Psychology , University of Regina , Regina , Canada
| | - Julia E Mason
- a Anxiety and Illness Behaviour Laboratory, Department of Psychology , University of Regina , Regina , Canada
| | - Kadie Hozempa
- a Anxiety and Illness Behaviour Laboratory, Department of Psychology , University of Regina , Regina , Canada
| | | | - Nicholas A Jones
- c Department of Justice Studies , University of Regina , Regina , Canada
| | - Keith S Dobson
- d Department of Psychology , University of Calgary , Calgary , Canada
| | - Andrew Szeto
- d Department of Psychology , University of Calgary , Calgary , Canada
| | - Suzanne Bailey
- e SSO Social Work & MH Trg, CF Health Services Group HQ , Canadian Armed Forces , Ottawa , Canada
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March JA, Kiemeney MJ, De Guzman J, Ferguson JD. Retention of cricothyrotomy skills by paramedics using a wire guided technique. Am J Emerg Med 2018; 37:407-410. [PMID: 29891124 DOI: 10.1016/j.ajem.2018.05.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Cricothyrotomy may be necessary for airway management when a patient's airway cannot be maintained through standard techniques such as oral airway placement, blind insertion airway device, or endotracheal intubation. Wire-guided cricothyrotomy is one of many techniques used to perform a cricothyrotomy. Although there is some controversy over which cricothyrotomy technique is superior, there is no published data regarding long term retention rates. The purpose of this study is to determine whether ground based paramedics can be taught and are able to retain the skills necessary to successfully perform a wire-guided cricothyrotomy. METHODS This retrospective study was performed in a suburban county with a population of 160,000 with 23,000 EMS calls per year. Participants were ground-based paramedics who were taught wire-guided cricothyrotomy as part of a standardized paramedic educational update program. After viewing an instructional video, the paramedics were shown each the steps of the procedure on a simulation model, using a low fidelity task trainer previously developed to train emergency medicine residents. Using a 16 step procedural checklist, participants were allowed open-ended practice using the task trainer. Critical steps in the checklist were marked in bold lettering indicating automatic failure. Each paramedic was then individually supervised performing a minimum of 5 successful simulations. Retention was assessed using the same 16 step checklist 6 to 12 weeks following the initial training. RESULTS A total of 55 paramedics completed both the initial training and reassessment during the time period studied. During the initial training phase 100% (55 of 55) of the paramedics were successful in performing all 16 steps of the wire-guided cricothyrotomy. During the retention phase, 87.3% (48 of 55) of paramedics retained the skills necessary to successfully perform the wire-guided cricothyrotomy. On the 16 step checklist, most steps were performed successfully by all the paramedics or missed by only 1 of the 55 paramedics. The step involving removal of the needle prior to advancing the airway device over the guide wire was missed by 34.5% (19 of 55) of the participants. This was not an automatic failure since most participants immediately self-corrected and completed the procedure successfully. CONCLUSION Paramedics can be taught and can retain the skills necessary to successfully perform a wire-guided cricothyrotomy on a simulator. Future research is necessary to determine if paramedics can successfully transfer these skills to real patients.
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Affiliation(s)
- J A March
- Department of Emergency Medicine, Division of EMS, East Carolina University Brody School of Medicine, Greenville, NC, United States.
| | - M J Kiemeney
- Department of Emergency Medicine, Division of EMS, East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - J De Guzman
- Department of Emergency Medicine, Division of EMS, East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - J D Ferguson
- Department of Emergency Medicine, Division of EMS, East Carolina University Brody School of Medicine, Greenville, NC, United States
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Spaced education in medical residents: An electronic intervention to improve competency and retention of medical knowledge. PLoS One 2017; 12:e0181418. [PMID: 28759606 PMCID: PMC5536283 DOI: 10.1371/journal.pone.0181418] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 06/30/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spaced education is a novel method that improves medical education through online repetition of core principles often paired with multiple-choice questions. This model is a proven teaching tool for medical students, but its effect on resident learning is less established. We hypothesized that repetition of key clinical concepts in a "Clinical Pearls" format would improve knowledge retention in medical residents. METHODS This study investigated spaced education with particular emphasis on using a novel, email-based reinforcement program, and a randomized, self-matched design, in which residents were quizzed on medical knowledge that was either reinforced or not with electronically-administered spaced education. Both reinforced and non-reinforced knowledge was later tested with four quizzes. RESULTS Overall, respondents incorrectly answered 395 of 1008 questions (0.39; 95% CI, 0.36-0.42). Incorrect response rates varied by quiz (range 0.34-0.49; p = 0.02), but not significantly by post-graduate year (PGY1 0.44, PGY2 0.33, PGY3 0.38; p = 0.08). Although there was no evidence of benefit among residents (RR = 1.01; 95% CI, 0.83-1.22; p = 0.95), we observed a significantly lower risk of incorrect responses to reinforced material among interns (RR = 0.83, 95% CI, 0.70-0.99, p = 0.04). CONCLUSIONS Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents. However, among interns, repetition of the Clinical Pearls was associated with significantly higher test scores, perhaps reflecting their greater attendance at didactic sessions and engagement with Clinical Pearls. Although the study was limited by a low response rate, we employed test and control questions within the same quiz, limiting the potential for selection bias. Further work is needed to determine the optimal spacing and content load of Clinical Pearls to maximize retention amongst medical residents. This particular protocol of spaced education, however, was unique and readily reproducible suggesting its potential efficacy for intern education within a large residency program.
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Abstract
When conducting usability validation testing, representative users must use the device in the expected conditions of use in the field. There is usually a period of time—days or weeks—between the point in time a user is trained, and the moment they use the device for the first time. For this reason, the FDA acknowledges the need for “training decay” as part of usability validation testing, but manufacturers face challenges simulating real-time decays. In response to challenges associated with lags of days or weeks between training and usability validation testing, medical device manufacturers typically simulate shortened training decay periods. This paper discusses the theory behind the shapes of various training decay curves and the variables that drive differences between training decay curves. The author proposes to use a task-based approach for defining training decay curves in usability validation studies and sets out generalized training decay curves at a high level. Future research could reveal detailed and generalizable training decay curves. Identifying generalizable training decay curves could standardize the usability testing required for medical devices, and ultimately improve use error identification while avoiding an undue toll on manufacturer resources.
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Pavord DC, Birnbaum S, Bocuzzi D, deBoer S, Freedman DJ, Schell M, Sutlief S. A report from the AAPM Subcommittee on Guidelines for Competency Evaluation for Clinical Medical Physicists in Radiation Oncology. J Appl Clin Med Phys 2016; 17:3-14. [PMID: 27455473 PMCID: PMC5690041 DOI: 10.1120/jacmp.v17i4.5804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 11/23/2022] Open
Abstract
The goal of this report is to provide a framework from which an institution can develop a competency and credentialing program. It is not intended to be adopted as written, but rather as a list of suggestions from which the institution develops their program. A clear distinction should be made between the initial evaluation of the competency of new staff (credentialing) and the ongoing verification of the competency of existing staff. Furthermore, whenever new technologies are imple-mented, the entire staff would be subject to the credentialing process. Competencies involve the ongoing verification of the performance of a procedure according to the established policies and procedures at a facility. This can be done by audits of work product, direct observation of performance, self-evaluation, or testing. PACS number(s): 87.10.-e, 87.90.+y
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Secourisme sur le lieu de travail dans le monde : revue systématique de la littérature. ARCH MAL PROF ENVIRO 2015. [DOI: 10.1016/j.admp.2015.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Teaching basic fiberoptic intubation skills in a simulator: initial learning and skills decay. J Anesth 2015; 30:12-9. [DOI: 10.1007/s00540-015-2091-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
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Effectiveness of simplified 15-min refresher BLS training program: A randomized controlled trial. Resuscitation 2015; 90:56-60. [DOI: 10.1016/j.resuscitation.2015.02.015] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 12/14/2014] [Accepted: 02/16/2015] [Indexed: 11/20/2022]
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