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Kumar R, Kumar R. An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System. Indian J Crit Care Med 2024; 28:702-705. [PMID: 38994267 PMCID: PMC11234124 DOI: 10.5005/jp-journals-10071-24760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/19/2024] [Indexed: 07/13/2024] Open
Abstract
Background Suction-assisted laryngoscopy and airway decontamination (SALAD) is a new modality and training manikins are quite costly. Few modifications have been described with their pluses and minuses. We describe a low-cost simulator that replicates fluid contamination of the airway at various flow rates and allows the practice of SALAD in vitro. Materials and methods We modified a standard Laerdal airway management trainer with locally available equipment to simulate varying rates of continuous vomiting or hemorrhage into the airway during intubation. The effectiveness of our SALAD simulator was tested during an advanced airway workshop of the Airway Management Foundation (AMF). The workshop had a brief common presentation on the learning objective of the SALAD technique followed by a demonstration to small groups of 5-6 participants at one time with necessary instructions. This was followed by a hands-on practical learning session on the simulator. Results One hundred and five learners used the simulator including 15 faculties and 90 participants (48 on ICU and 42 on ENT workstations). At the end of the session, the workshop faculty and participants were asked to rate their level of confidence in managing similar situations in real practice on a four-point Likert scale. All 15 faculty members and 70 out of 90 participants felt very confident in managing similar situations in real practice. Fifteen participants felt fairly confident and 5 felt slightly confident. Conclusion In resource-limited settings, our low-cost SALAD simulator is a good educational tool for training airway managers in the skills of managing continuously and rapidly soiling airways. How to cite this article Kumar R, Kumar R. An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System. Indian J Crit Care Med 2024;28(7):702-705.
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Affiliation(s)
- Rajender Kumar
- Department of Critical Care, Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India
| | - Rakesh Kumar
- Department of Anesthesia and Critical Care, Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India
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Fiszer E, Shaylor R, Karol D, Rozeznic J, Kaplan G, Weiniger CF, Brzezinski Sinai Y. Development of a Low-Cost Medium-Fidelity On-Site Cardiothoracic Anesthesia Simulation Program. J Cardiothorac Vasc Anesth 2024; 38:1279-1281. [PMID: 38480089 DOI: 10.1053/j.jvca.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/02/2024] [Accepted: 02/14/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Elisheva Fiszer
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ruth Shaylor
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - Dana Karol
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Jonathan Rozeznic
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Gaby Kaplan
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Carolyn F Weiniger
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Yitzhak Brzezinski Sinai
- Division of Anesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
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Levy N, Saeed S, Gbagornah PF, Benavides-Zora D, Winterton D, Jackson CD, Sharkey A, Levy L, Neves S, Walsh DP, Matyal R. Implementation of Routine In Situ Simulation in Residency Curriculum Targeting Competency in Technical and Decision-Making Skills. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00297-0. [PMID: 38955619 DOI: 10.1053/j.jvca.2024.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/05/2024] [Accepted: 04/22/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE To describe the development and implementation of a comprehensive in situ simulation-based curriculum for anesthesia residents. DESIGN This is a prospective study. SETTING This study was conducted at a university hospital. PARTICIPANTS This single-center prospective study included all 53 anesthesia residents enrolled in the anesthesia residency program. INTERVENTIONS Introduction of a routine, high-fidelity, in situ simulation program that incorporates short sessions to train residents in the necessary skill sets and decision-making processes required in the operating room. MEASUREMENTS AND MAIN RESULTS Our team conducted 182 individual 15-minute simulation sessions over 3 months during regular working hours. All 53 residents in our program actively participated in the simulations. Most residents engaged in at least 3 sessions, with an average participation rate of 3.4 per resident (range, 1-6 sessions). Residents completed an online anonymous survey, with a response rate of 71.7% (38 of 53 residents) over the 3-month period. The survey aimed to assess their overall impression and perceived contribution of this project to their training. CONCLUSIONS Our proposed teaching method can bridge the gap in resident training and enhance their critical reasoning to manage diverse clinical situations they may not experience during their residency.
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Affiliation(s)
- Nadav Levy
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Shirin Saeed
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Peva F Gbagornah
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - David Benavides-Zora
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Dario Winterton
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Cullen D Jackson
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Lior Levy
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Sara Neves
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Daniel P Walsh
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215
| | - Robina Matyal
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215.
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Faisal H, Qamar F, Martinez S, Razmi S, Oviedo R, Masud F. Learning curve of ultrasound-guided surgeon-administered transversus abdominis plane (UGSA-TAP) block on a porcine model. Heliyon 2024; 10:e25006. [PMID: 38322832 PMCID: PMC10844114 DOI: 10.1016/j.heliyon.2024.e25006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Background Surgeons commonly perform ultrasound-guided Transversus Abdominis Plane blocks to manage acute pain following abdominal surgeries. There is no consensus on whether surgeons should undergo basic hands-on training to perform TAP blocks or if video-based learning is sufficient. We theorized that simulation-based learning is superior to video-based learning. In the present study, we present the analysis of technical skills of UGSA-TAP block performance on a live porcine model by general surgery trainees after undergoing video or simulation-based learning. Methods We performed a prospective, double-blinded, randomized study. Ten surgery residents and two surgery critical-care fellows (n = 12) without prior experience in performing the TAP block were recruited. The participants were randomized either into a video-based or simulation-based training group. After that, all participants performed a TAP block on a live anesthetized pig, which was recorded and scored by three blinded anesthesiologists. All participants completed a post-performance survey to assess their confidence in gaining competency in the UGSA-TAP block. Statistical analyses were performed to assess the differences between the two groups. P < 0.05 was considered statistically significant. Results All simulation-based learning participants successfully performed a survey scan, identified the three muscular layers of the abdominal wall, and identified the transversus abdominis plane compared to 50 %, 50 %, and 33 % video-based learning group participants for the respective parameters (p < 0.05). While some performance metrics showed no statistically significant differences between the groups, substantial effect sizes (Cohen's ℎ up to 1.07) highlighted notable differences in participants' performance. Both groups exhibited confidence in core competencies, with varied rates of satisfactory skill execution. Performance assessed using a global rating scale revealed a higher passing rate for the simulation group (83 % vs. 33 %). Participant feedback via the Likert scale reflected confidence post-training. Inter-rater reliability (0.83-1) confirmed the robustness of study evaluations. Conclusion The UGSA-TAP block curriculum should be introduced into the surgical residency programs with an emphasis on simulation-based learning to enhance the procedural skills of the trainees before transitioning to surgical patients.
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Affiliation(s)
- H. Faisal
- Clinical Surgery at Weill Cornell Medical College, USA
- Clinical Surgery at Houston Methodist Academic Institute, USA
- Clinical Medicine at Texas A&M University, Houston Methodist Hospital, Houston, TX, USA
| | - F. Qamar
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - S. Martinez
- Clinical Surgery at Texas A&M College of Medicine, Surgery Residency Program Director/Interim Chief of the Division of Acute Care Surgery, Houston Methodist Hospital, USA
| | - S.E. Razmi
- Texas A&M College of Medicine EnMed, Houston, TX, USA
| | - R.J. Oviedo
- Surgery, Weill Cornell Medical College, Cornell University, Texas A&M University College of Medicine, USA
| | - F. Masud
- Anesthesiology at Houston Methodist Academic Institute, Medical Director, Center for Critical Care, USA
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Yu H, Zhang C, He J, Xu J. Reflections on training and teaching modes for anesthesia monitoring nurses in China. Heliyon 2024; 10:e24540. [PMID: 38304766 PMCID: PMC10831792 DOI: 10.1016/j.heliyon.2024.e24540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
Objective The purpose of this scoping review was to map and identify studies describing the current state of research and teaching methods and evaluation systems for nurse anesthetists within China. Design A wide-ranging search of multiple databases and gray literature was performed according to JBI criteria, employing predefined selection criteria and following PRISMA guidelines. Methods This scoping review included studies published between 1988 and 2021 that explored the current state of clinical training and teaching methods for nurse anesthetists nationally and internationally. These articles were reviewed by four reviewers and content analysis was performed. Results Fifty-two articles were included in the review. The results suggest that both simulation teaching in nursing education and Kolb's experiential learning cycle theory improve nursing staff teamwork, develop critical thinking skills, and improve core nursing competencies. Conclusions High-fidelity simulation teaching based on Kolb's experiential learning cycle theory may be an effective teaching method to develop and improve the competence of nurse anesthesia monitors.
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Affiliation(s)
- Han Yu
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu City, China
| | - Cao Zhang
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu City, China
| | - Jiangqin He
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu City, China
| | - Jianhong Xu
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu City, China
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Parab SY, Ranganathan P, Shetmahajan M, Malde A. Role of simulation-based training in thoracic anaesthesia. Indian J Anaesth 2024; 68:58-64. [PMID: 38406334 PMCID: PMC10893814 DOI: 10.4103/ija.ija_1235_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/26/2023] [Accepted: 12/31/2023] [Indexed: 02/27/2024] Open
Abstract
Simulation-based training (SBT) aims to acquire technical and non-technical skills in a simulated fashion without harming the patient. Simulation helps the anaesthesiologist acquire procedural competence and non-technical abilities. In thoracic anaesthesia, various simulators are available with varying degrees of fidelity and costs. Apart from improving bronchoscopy-related skills, other potential applications of SBT include the practice of lung isolation in normal and difficult airway scenarios, troubleshooting complications during surgeries, and certification of the proficiency of anaesthesiologists. A pragmatic approach is required for choosing the simulator based on its availability, cost, and benefits. Although the literature supports SBT to improve procedural skills, retention of the skills and their translation into improving clinical outcomes remain largely unproven. Randomised, controlled studies targeting the effect of SBT on the improvement of clinical outcomes of patients are needed to prove their worth.
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Affiliation(s)
- Swapnil Y. Parab
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National University, Dr. E Borges Road, Parel, Mumbai, Maharashtra, India
| | - Priya Ranganathan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National University, Dr. E Borges Road, Parel, Mumbai, Maharashtra, India
| | - Madhavi Shetmahajan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National University, Dr. E Borges Road, Parel, Mumbai, Maharashtra, India
| | - Anila Malde
- Department of Anaesthesiology, Lokmanya Tilak Municipal General Hospital and Medical College, Sion, Mumbai, Maharashtra, India
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Nakatani R, Patel K, Chowdhury T. Simulation in Anesthesia for Perioperative Neuroscience: Present and Future. J Neurosurg Anesthesiol 2024; 36:4-10. [PMID: 37903630 DOI: 10.1097/ana.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/27/2023] [Indexed: 11/01/2023]
Abstract
The brain's sensitivity to fluctuations in physiological parameters demands precise control of anesthesia during neurosurgery, which, combined with the complex nature of neurosurgical procedures and potential for adverse outcomes, makes neuroanesthesia challenging. Neuroanesthesiologists, as perioperative physicians, work closely with neurosurgeons, neurologists, neurointensivists, and neuroradiologists to provide care for patients with complex neurological diseases, often dealing with life-threatening conditions such as traumatic brain injuries, brain tumors, cerebral aneurysms, and spinal cord injuries. The use of simulation to practice emergency scenarios may have potential for enhancing competency and skill acquisition amongst neuroanesthesiologists. Simulation models, including high-fidelity manikins, virtual reality, and computer-based simulations, can replicate physiological responses, anatomical structures, and complications associated with neurosurgical procedures. The use of high-fidelity simulation can act as a valuable complement to real-life clinical exposure and training in neuroanesthesia.
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Affiliation(s)
| | - Krisha Patel
- Toronto Western Hospital, University of Toronto, Toronto
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Nagarajappa A, Kaur S. Simulation in contemporary medical education: Current practices and the way forward. Indian J Anaesth 2024; 68:17-23. [PMID: 38406335 PMCID: PMC10893808 DOI: 10.4103/ija.ija_1203_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 02/27/2024] Open
Abstract
Integration of theoretical knowledge and practical skills is critical for effective medical education. Simulation is crucial in bridging the gap to prepare medical professionals for high-quality patient care in a safe environment. Simulation-based teaching has become the standard practice in medical education, especially in postgraduate courses like Anaesthesia. However, undergraduate medical education and other doctoral courses are still nascent. In line with the current National Medical Commission guidelines, it is imperative to complement the existing curriculum with a simulation-based approach as early as the first year of medical school. This review focuses on the current practices related to simulation-based medical education during undergraduate and postgraduate courses, particularly on anaesthesiology. We aim to discuss different types of simulation, the advantages of integration, students' perspectives, and the role of simulation in assessment and feedback. Finally, recommendations for future advancements of simulation in medical education and the way forward will be laid.
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Affiliation(s)
- Abhishek Nagarajappa
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Burnett G, Goldhaber-Fiebert S. The role of simulation training in patients' safety in anaesthesia and perioperative medicine. BJA Educ 2024; 24:7-12. [PMID: 38495746 PMCID: PMC10941098 DOI: 10.1016/j.bjae.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- G.W. Burnett
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Corvetto MA, Altermatt FR, Belmar F, Escudero E. Health Care Simulation as a Training Tool for Epidemic Management: A Systematic Review. Simul Healthc 2023; 18:382-391. [PMID: 36881436 DOI: 10.1097/sih.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
SUMMARY STATEMENT The objective of this research was to identify and review studies that have evaluated the impact of simulation-based training on health care professionals during epidemics.All studies in health care simulation-based training published during the last 5 epidemics with a global impact (SARS-CoV, H1N1, MERS, Ebola, SARS-CoV-2; through July 2021) were selected from a systematic search of PUBMED, EMBASE, and key journals.The search strategy identified 274 studies; 148 met the inclusion criteria and were included. Most of the studies were developed in response to SARS-CoV-2 infection (n = 117, 79.1%), used a descriptive approach (n = 54, 36.5%), and were used to train technical skills (n = 82, 55.4%).This review demonstrates a growing interest in publications related to health care simulation and epidemics. Most of the literature is marked by limited study designs and outcome measurements, although there is a trend toward the use of more refined methodologies in the most recent publications. Further research should seek the best evidence-based instructional strategies to design training programs in preparation for future outbreaks.
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Affiliation(s)
- Marcia A Corvetto
- From the Department of Anesthesiology (M.A.C., F.R.A.), Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Experimental Surgery and Simulation Center (M.A.C., F.B.), Department of Digestive Surgery, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; and Comité Académico de Fundación Garrahan (E.E.), Buenos Aires, Argentina
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Khoo DW, Roscoe AJ, Hwang NC. Beyond the self: a novel framework to enhance non-technical team skills for anesthesiologists. Minerva Anestesiol 2023; 89:1115-1126. [PMID: 38019175 DOI: 10.23736/s0375-9393.23.16729-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Human factors and non-technical skills (NTS) have been identified as essential contributors to both the propagation and prevention of medical errors in the operating room. Despite extensive study and interventions to nurture and enhance NTS in anesthesiologists, gaps to effective team practice and patient safety remain. Furthermore, the link between added NTS training and clinically significant improved outcomes has not yet been demonstrated. We performed a narrative review to summarize the literature on existing systems and initiatives used to measure and nurture NTS in the clinical operating room setting. Controlled interventions performed to nurture NTS (N.=13) were identified and compared. We comment on the body of current evidence and highlight the achievements and limitations of interventions published thus far. We then propose a novel education and training framework to further develop and enhance non-technical skills in both individual anesthesiologists and operating room teams. We use the cardiac anesthesiology environment as a starting point to illustrate its use, with clinical examples. NTS is a key component of enhancing patient safety. Effective framing of its concepts is central to apply individual characteristics and skills in team environments in the OR and achieve tangible, beneficial patient outcomes.
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Affiliation(s)
- Deborah W Khoo
- Department of Anesthesiology, Singapore General Hospital, Singapore, Singapore -
| | - Andrew J Roscoe
- Department of Anesthesiology, Singapore General Hospital, Singapore, Singapore
- Department of Cardiothoracic Anesthesia, National Heart Center Singapore, Singapore, Singapore
| | - Nian C Hwang
- Department of Anesthesiology, Singapore General Hospital, Singapore, Singapore
- Department of Cardiothoracic Anesthesia, National Heart Center Singapore, Singapore, Singapore
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Grissa MH, Dhaoui R, Bel Haj Ali K, Sekma A, Toumia M, Sassi S, Sakly AK, Zorgati A, Bouraoui H, Ben Soltane H, Mezgar Z, Boukef R, Boubaker H, Bouida W, Beltaief K, Nouira S. Comparison of simulation and video-based training for acute asthma. BMC MEDICAL EDUCATION 2023; 23:873. [PMID: 37974223 PMCID: PMC10655321 DOI: 10.1186/s12909-023-04836-7] [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: 02/20/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Emergency medicine is particularly well suited to simulation training. However, evidence for the efficacy of simulation-based medical training remains limited especially to manage high-risk cases such as acute asthma. OBJECTIVE The objective of our study was to compare the performance of high-fidelity simulation (HFS) and interactive video-case challenge-based training (IVC) for final-year medical students in the management of acute asthma. METHODS This was a prospective randomized controlled study conducted at the emergency department (ED) of Monastir University hospital ( Tunisia). 69 final-year medical students were randomized to HFS (n = 34) and IVC (n = 35) training on acute asthma topic. The study was conducted over a 1-week period. Efficacy of each teaching method was compared through the use of multiple-choice questionnaires (MCQ) before (pre-test), after (post-test) training and a simulation scenario test conducted 1 week later. The scenario was based on acute asthma management graded on predefined critical actions using two scores: the checklist clinical score (range 0 to 30), and the team skills score (range 0 to 16). Student satisfaction was also evaluated with the Likert 5 points scale. Two years after the post-test, both groups underwent a third MCQ testing to assess sustainability of knowledge. RESULTS There were no differences in age between groups. There was no statistically significant difference between the HFS and IVC groups pre-test scores (p = 0.07). Both groups demonstrated improvement in MCQ post-test from baseline after training session; the HFS MCQ post-test score increased significantly more than the IVC score (p < 0.001). The HFS group performed better than the IVC group on the acute asthma simulation scenario (p < 0.001). Mean checklist clinical score and mean team skills score were significantly higher in HFS group compared to IVC group (respectively 22.9 ± 4.8 and 11.5 ± 2.5 in HFS group vs 19.1 ± 3 and 8.4 ± 3.1 in IVC group) (p < 0.001). After 2 years, MCQ post-test scores decreased in both groups but the decrease was lower in HFS group compared to the IVC group. CONCLUSION High-fidelity simulation-based training was superior to interactive video-case challenge for teaching final year medical students,and led to more long-term knowledge retention in the management of simulated acute asthma patients. TRIAL REGISTRATION The study was registered at www. CLINICALTRIALS gov NCT02776358 on 18/05/2016.
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Affiliation(s)
- Mohamed Habib Grissa
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Randa Dhaoui
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Khaoula Bel Haj Ali
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Adel Sekma
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Maroua Toumia
- Emergency Department, Haj Ali Soua Regional Hospital of Ksar Hellal, Ksar Hellal, 5070, Tunisia
| | - Sarra Sassi
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Abdel Karim Sakly
- Orthopedic Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Asma Zorgati
- Emergency Department, Sahloul University Hospital, Sousse, 4000, Tunisia
| | - Hajer Bouraoui
- Pharmacology Department Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Houda Ben Soltane
- Emergency Department, Farhat Hached University Hospital, Sousse, 4000, Tunisia
| | - Zied Mezgar
- Emergency Department, Farhat Hached University Hospital, Sousse, 4000, Tunisia
| | - Riadh Boukef
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
- Emergency Department, Sahloul University Hospital, Sousse, 4000, Tunisia
| | - Hamdi Boubaker
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Wahid Bouida
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Kaouthar Beltaief
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Semir Nouira
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia.
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia.
- Emergency Department and Laboratory Research (LR12SP18), Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia.
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Tayeb BO, Shubbak FA, Doais KS, Yamani AN, Dhaifallah DG, Alsayed EF, Addas MJ, Boker AM. Uses of simulation-based education for anesthesiology training, certification and recertification: A scoping review. J Taibah Univ Med Sci 2023; 18:1118-1123. [PMID: 37881638 PMCID: PMC10594003 DOI: 10.1016/j.jtumed.2023.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/03/2023] [Accepted: 03/30/2023] [Indexed: 10/27/2023] Open
Abstract
Objectives To conduct a comprehensive scoping review focusing on published anesthesiology-specific training based on simulation to assess up-to-date uses of simulation-based education in anesthesiology training. Our goal was to establish a solid ground for building standardized and accredited curricula for simulation-based education in the specialty of anesthesia in the near future. Methods We searched the PubMed, CINAHL and EMBASE databases on May 10, 2021 for relevant articles. We followed the five-stage scoping review methodology: identifying a research question, identifying relevant studies, study selection, charting the data, and synthesis of results. Results Our initial electronic search identified 5609 potential articles. After abstract screening and removing duplicates, 636 articles were evaluated in full text for inclusion or exclusion. Based on this strategy, 283 articles were included in this review. We mapped the current practice of simulation in training and certification across different anesthesiology subspecialties. Conclusions Significant effort has been placed into the use of simulation for training, certification, and recertification in anesthesiology. Future effort to develop simulation-based training that can be generalized to trainees in this specialty, similar to other fields such as aviation and space sciences, will enhance the standardization of training and hence patient safety.
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Affiliation(s)
- Baraa O. Tayeb
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
- Clinical Skills and Simulation Centre, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Firas A. Shubbak
- Anesthesiology and Perioperative Medicine Administration Department, Faculty of Medicine, King Fahad Medical City, Riyadh, KSA
| | - Khaled S. Doais
- Anesthesiology and Perioperative Medicine Administration Department, Faculty of Medicine, King Fahad Medical City, Riyadh, KSA
| | - Ahad N. Yamani
- Department of Surgery, Anesthesiology Section, Faculty of Medicine, King Abdulaziz University, Rabigh, KSA
| | - Daniah G. Dhaifallah
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
| | - Eyad F. Alsayed
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
| | - Malik J. Addas
- Internship Department, King Abdulaziz University Hospital, Jeddah, KSA
| | - Abdulaziz M. Boker
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
- Clinical Skills and Simulation Centre, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
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14
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Buléon C, Minehart RD, Rudolph JW, Blanié A, Lilot M, Picard J, Plaud B, Pottecher J, Benhamou D. Strategy to Develop a Common Simulation Training Program: Illustration with Anesthesia and Intensive Care Residency in France. TEACHING AND LEARNING IN MEDICINE 2023; 35:537-549. [PMID: 36251797 DOI: 10.1080/10401334.2022.2127730] [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: 01/27/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed programs. Defining the current baseline of what is available and feasible is a crucial first step. This paper uses anesthesia and intensive care (AIC) in France as a case study in how to document this baseline. Approach: An IRB-approved, online anonymous closed survey was submitted to AIC residency program directors and AIC simulation program directors in France from January to February 2021. The researcher-developed survey consisted of 65 questions across five sections: centers' characteristics, curricular characteristics, courses' characteristics, instructors' characteristics, and simulation perceptions and perspectives. Findings: The participation rate was 31/31 (100%) with 29 centers affiliated with a university hospital. All centers had AIC simulation activities. Resident training was structured in 94% of centers. Simulation uses were training (100%), research and development (61%), procedural or organizational testing (42%), and summative assessment (13%). Interprofessional full-scale simulation training existed in 90% of centers. Procedural training on simulators prior to clinical patients' care was performed "always" in 16%, "most often" in 45%, "sometimes" in 29% and "rarely" or "not" in 10% of centers. Simulated patients were used in 61% of centers. Main themes were identified for procedural skills, full-scale and simulated patient simulation training. Simulation activity was perceived as increasing in 68% of centers. Centers expressed a desire to participate in developing and using a national common AIC simulation program. Insights: Based on our findings in AIC, we demonstrated a baseline description of nationwide simulation activities. We now have a clearer perspective on a decentralized approach in which individual institutions or regional consortia conduct simulation for a discipline in a relatively homogeneous way, suggesting the feasibility for national guidelines. This approach provides useful clues for AIC and other disciplines to develop a comprehensive and meaningful program matching existing expectations and closing the identified gaps.
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Affiliation(s)
- Clément Buléon
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
- Medical School, University of Caen Normandy, Caen, France
- Center for Medical Simulation, Boston, MA, USA
| | - Rebecca D Minehart
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Antonia Blanié
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Marc Lilot
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Edouard Herriot University Hospital, HCL, Lyon, France
| | - Julien Picard
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Grenoble University Hospital, Grenoble, France
| | - Benoît Plaud
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Saint-Louis University Hospital, APHP, Paris, France
| | - Julien Pottecher
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Dan Benhamou
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
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15
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Fernandes NL, Lilaonitkul M, Subedi A, Owen MD. Global obstetric anaesthesia: bridging the gap in maternal health care inequities through partnership in education. Int J Obstet Anesth 2023; 55:103646. [PMID: 37211512 DOI: 10.1016/j.ijoa.2023.103646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/20/2023] [Indexed: 05/23/2023]
Abstract
Maternal mortality rates are unacceptably high globally. Low- and middle-income countries (LMICs) face challenges of an inadequate anaesthesia workforce, under-resourced healthcare systems and sub-optimal access to labour and delivery care, all of which negatively impact maternal and neonatal outcomes. In order to effect the changes in surgical-obstetric-anaesthesia workforce numbers advocated by the Lancet Commission on Global Surgery to support the UN sustainable development goals, mass training and upskilling of both physician and non-physician anaesthetists is imperative. The implementation of outreach programmes and partnerships across organisations and countries has already been shown to improve the provision of safe care to mothers and their babies, and these efforts should be continued. Short subspecialty courses and simulation training are two cornerstones of modern obstetric anaesthesia training in poorly resourced environments. This review discusses the challenges to accessing quality maternal healthcare in LMICs and the use of education, outreach, partnership and research to protect the most vulnerable women from coming to harm in the peripartum period.
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Affiliation(s)
- N L Fernandes
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
| | - M Lilaonitkul
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - A Subedi
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - M D Owen
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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16
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Stephens GC, Wilson AB, Lazarus MD. In Reply to Hancock and Mattick. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:870-871. [PMID: 37146231 DOI: 10.1097/acm.0000000000005233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Georgina C Stephens
- Senior lecturer, Centre for Human Anatomy Education, Monash University, Melbourne, Australia; ; ORCID: https://orcid.org/0000-0001-9695-7592
| | - Adam B Wilson
- Associate professor, Department of Anatomy and Cell Biology, Rush University, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-1221-5602
| | - Michelle D Lazarus
- Associate professor and director, Centre for Human Anatomy Education, and curriculum integration lead, Monash Centre for Scholarship in Health Education, Monash University, Melbourne, Australia; ORCID: https://orcid.org/0000-0003-0996-4386
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17
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Su Y, Zeng Y. Simulation based training versus non-simulation based training in anesthesiology: A meta-analysis of randomized controlled trials. Heliyon 2023; 9:e18249. [PMID: 37576292 PMCID: PMC10412876 DOI: 10.1016/j.heliyon.2023.e18249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Background Simulation based training (SBT) has become an important tool in medical education, yet a comprehensive review of its effect in anesthesiology is currently lacking. This study was aimed to compare the effect of SBT versus non-simulation based training (NSBT) in anesthesia education. Methods Data were derived from PubMed, Ovid (EMBASE and MEDLINE), China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) from database inception up to June 2022. We included published randomized controlled trials (RCTs) that assessed the impact of Simulation-Based Training (SBT) on anesthesiology training and compared it to Non-Simulation-Based Training (NSBT). Results 25 eligible studies were included, with a total sample size of 1621 medical students. SBT was associated with improved theoretical scores [mean difference (MD):5.28, 95%CI 3.06 to 7.49, P < 0.01] and skill scores (MD: 7.63, 95% CI 5.7 to 9.57, P < 0.01) in comparison with NSBT. And SBT significantly improved teaching effects, including success rate, analytic skill in clinical setting, learning interest, learn efficiency and satisfaction survey. Also, a dramatic promotion was observed in the evaluation of non-technical ability consisting of cooperative ability, problem solving ability and situational awareness after trainees with SBT. Conclusions Simulation-based training is an effective method for improving theoretical scores, skill scores, teaching effects and non-technical ability. Yet, further good-quality RCTs are required to confirm these changes translate to improved patient outcomes. Furthermore, it is important to carefully consider the cost-benefit effect to conduct simulation-based in anesthesiology education.
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Affiliation(s)
- Yi Su
- Department of Algology, The People's Hospital of Dujiangyan, No 622 Baolian Road, Dujiangyan, Sichuan, 611830, China
| | - Yi Zeng
- Department of Algology, The People's Hospital of Dujiangyan, No 622 Baolian Road, Dujiangyan, Sichuan, 611830, China
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18
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Wibowo G, Anggrahini DW, Rismawanti RI, Fatimah VAN, Hakim A, Hidayah RN, Gharini PPR. 3D-Printing-Based Fluoroscopic Coronary Angiography Simulator Improves Learning Capability Among Cardiology Trainees. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:763-771. [PMID: 37465375 PMCID: PMC10351594 DOI: 10.2147/amep.s407629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023]
Abstract
Aim One of the essential competencies of cardiology trainees is the ability to perform coronary angiography with good projection. Purpose This study is a research and development study aimed at testing the effectiveness of 3D-printing-based fluoroscopic coronary angiography simulator as a learning medium for diagnostic coronary angiogram. Methods Thirty-four cardiology trainees randomly were divided into two groups. Both groups took a pretest before the intervention. The first group (group A) studied using conventional learning media and underwent the first post-test. Afterward, they switched to a 3D-printing-based fluoroscopic coronary angiography simulator and underwent a second post-test. The second group (group B) studied using a 3D-printing-based fluoroscopic coronary angiography simulator, underwent the first post-test, switched to the conventional learning media, and underwent a second post-test. Results The delta between the post-test I and the pretest of group B was 8.53, higher than the delta between the post-test I and the pretest of group A (5.21) with a significant difference (p = 0.003). In group A, the delta between post-test II and pretest was 9.65, higher than the delta between post-test I and pretest (5.21) with a significant difference (p < 0.001). Conclusion 3D-printing-based fluoroscopic coronary angiography simulator is effective as a learning medium for coronary angiogram diagnostics.
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Affiliation(s)
- Ganda Wibowo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Integrated Cardiovascular Center, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Dyah Wulan Anggrahini
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Integrated Cardiovascular Center, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rochmi Isnaini Rismawanti
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Vita Arfiana Nurul Fatimah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alhadi Hakim
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rachmadya Nur Hidayah
- Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Putrika Prastuti Ratna Gharini
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Integrated Cardiovascular Center, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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19
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Risner V, Huang B, McCullagh K, Benefield T, Lee YZ. The Development and Application of a Cost-Effective Cervical Spine Phantom for Use in Fluoroscopically Guided Lateral C1-C2 Spinal Puncture Training. AJNR Am J Neuroradiol 2023; 44:873-878. [PMID: 37321858 PMCID: PMC10337607 DOI: 10.3174/ajnr.a7908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND PURPOSE Lateral C1-C2 spinal punctures are uncommon procedures performed by radiologists for access to CSF and contrast injection when a lumbar approach is contraindicated and an alternate method of access becomes necessary. There are limited opportunities to learn and practice the technique. We aimed to develop and assess the efficacy of a low-cost, reusable cervical spine phantom for training in fluoroscopically guided lateral C1-C2 spinal puncture. MATERIALS AND METHODS The phantom was constructed with a cervical spine model, an outer tube representing the thecal sac, an inner balloon representing the spinal cord, and polyalginate to replicate soft tissue. The total cost of materials was approximately US $70. Workshops were led by neuroradiology faculty experienced in the procedure using the model under fluoroscopy. Survey questions were assessed on a 5-point Likert scale. Participants were given pre- and postsurveys assessing comfort, confidence, and knowledge of steps. RESULTS Twenty-one trainees underwent training sessions. There was significant improvement in comfort level (Δ: 2.00, SD: 1.00, P value < .001); confidence (Δ: 1.52 points, SD: 0.87, P value < .001); and knowledge (Δ: 2.19, SD: 0.93, P value < .001). Eighty-one percent of participants found the model "very helpful" (5/5 on Likert scale), and all participants were "very likely" to recommend this workshop to others. CONCLUSIONS This cervical phantom model is affordable and replicable and demonstrates training utility to prepare residents for performing lateral C1-C2 spinal puncture. This is a rare procedure, so the use of a phantom model before patient encounters is invaluable to resident education and training.
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Affiliation(s)
- V Risner
- From the Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - B Huang
- From the Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - K McCullagh
- From the Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - T Benefield
- From the Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Y Z Lee
- From the Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
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20
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Patel SJ, Notarianni AP, Martin AK, Tsai A, Pulton DA, Linganna R, Patel PA, Waldron NH, Nimma SR, Bodmer NJ, Kothari P, Jackson E, Gupta RG, Roberts ML, Feinman JW. The Year in Graduate Medical Education: Selected Highlights From 2022. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00275-6. [PMID: 37210326 DOI: 10.1053/j.jvca.2023.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Saumil J Patel
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Andrew P Notarianni
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Archer Kilbourne Martin
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Albert Tsai
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Danielle A Pulton
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Regina Linganna
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Prakash A Patel
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Nathan H Waldron
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Sindhuja R Nimma
- Division of Regional Anesthesiology and Acute Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Natalie J Bodmer
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Perin Kothari
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ethan Jackson
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ragini G Gupta
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Monique L Roberts
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Jared W Feinman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA.
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21
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Finstad AS, Aase I, Bjørshol CA, Ballangrud R. In situ simulation-based team training and its significance for transfer of learning to clinical practice-A qualitative focus group interview study of anaesthesia personnel. BMC MEDICAL EDUCATION 2023; 23:208. [PMID: 37013537 PMCID: PMC10071610 DOI: 10.1186/s12909-023-04201-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Anaesthesia personnel are an integral part of an interprofessional operating room-team; hence, team-based training in non-technical skills (NTS) are important in preventing adverse events. Quite a few studies have been done on interprofessional in situ simulation-based team training (SBTT). However, research on anaesthesia personnel's experiences and the significance for transfer of learning to clinical practice is limited. The aim of this study is to explore anaesthesia personnel's experience from interprofessional in situ SBTT in NTS and its significance for transfer of learning to clinical practice. METHODS Follow-up focus group interviews with anaesthesia personnel, who had taken part in interprofessional in situ SBTT were conducted. A qualitative inductive content analysis was performed. RESULTS Anaesthesia personnel experienced that interprofessional in situ SBTT motivated transfer of learning and provided the opportunity to be aware of own practice regarding NTS and teamwork. One main category, 'interprofessional in situ SBTT as a contributor to enhance anaesthesia practice' and three generic categories, 'interprofessional in situ SBTT motivates learning and improves NTS', 'realism in SBTT is important for learning outcome', and 'SBTT increases the awareness of teamwork' illustrated their experiences. CONCLUSIONS Participants in the interprofessional in situ SBTT gained experiences in coping with emotions and demanding situations, which could be significant for transfer of learning essential for clinical practice. Herein communication and decision-making were highlighted as important learning objectives. Furthermore, participants emphasized the importance of realism and fidelity and debriefing in the learning design.
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Affiliation(s)
- Anne Strand Finstad
- Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Ingunn Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Conrad Arnfinn Bjørshol
- The Regional Centre for Emergency Medical Research and Development (RAKOS), Stavanger University Hospital, Stavanger, Norway
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Randi Ballangrud
- Department of Health Science, Norwegian University of Science and Technology, Gjøvik, Norway
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22
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Zhang C. A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4487. [PMID: 36901496 PMCID: PMC10002261 DOI: 10.3390/ijerph20054487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.
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Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Sunlight South Road 1, Beijing 102488, China
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23
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Golicnik A, Berden J, Goslar T, Gorjup V. High fidelity ECMO simulation: a reality check with reality-use of simulation in ECMO teaching program. J Artif Organs 2023; 26:36-44. [PMID: 35575949 DOI: 10.1007/s10047-022-01336-1] [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: 03/17/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
Simulation based learning is becoming a crucial part in ECMO education. Simulation can provide a safe but also very realistic learning experience depending on simulation fidelity. In our institution we developed a simulation based ECMO training program that incorporates low- and high-fidelity simulation. Aim of this study was to evaluate effectiveness of low- and high-fidelity simulation teaching strategies in ECMO novices. We conducted four consecutive ECMO training courses that included fifty-one ECMO novices. We describe ECMO training execution and evaluate training effectiveness and perception by structured pre- and post-training questionnaires analysis. Results of our study show extremely high satisfaction rate with simulation training (4.9 ± 0.3, Lickert 5 point scale). High-fidelity simulation was perceived as very realistic and as such represents an important tool in learning immersion and experience. However, participants reported significant decline from their expectations with regard to structured approach to troubleshooting (4.7 ± 0.5 vs 4.3 ± 0.7, p = 0.02) and efficiency improvement (4.7 ± 0.5 vs 4.3 ± 0.6, p = 0.002) after high-fidelity simulation. There was also a significant decline from their expectation on self-confidence improvement (4.7 ± 0.5 vs 4.2 ± 0.7, p = 0.001). Our results therefore show, that complex high-fidelity simulation should probably be used with caution in novice participants, not to discourage them from further learning.
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Affiliation(s)
- Alenka Golicnik
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.
| | - Jernej Berden
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.
| | - Tomaz Goslar
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Vojka Gorjup
- Department for Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia
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24
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Laurens LM, Bañeras J, Biarnés A, Nuñez S. [Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2023; 70:77-82. [PMID: 34840352 PMCID: PMC8610838 DOI: 10.1016/j.redar.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The restrictions to stop COVID-19 pandemic have had a negative impact in simulation. However, it is imperative to develop new strategies that facilitate healthcare education. OBJECTIVE To describe a simulation in healthcare based on the learning of non-technical skills and performed under the restrictions of COVID-19 pandemic. METHODS Quasi-experimental study of an educational activity performed through simulation with Anaesthesiology residents in November 2020. Twelve residents participated in 2 consecutive days. A questionnaire was filled related to the performance of non-technical skills that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the non-technical skills results obtained between the 2 days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. RESULTS The global performance of the teams improved when comparing first and second day (79.5 vs. 88.6%, P < .01). Leadership was the worst section rated, however, was the one that showed the best improvement (70 vs. 87.5%, P < .01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. CONCLUSION Clinical simulation can be done in the context of COVID-19 pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.
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Affiliation(s)
- L M Laurens
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron Hospital Universitari, Barcelona, España
| | - J Bañeras
- Servicio de Cardiología, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Direcció de Docència, Vall d'Hebron Hospital Universitari, Barcelona, España
| | - A Biarnés
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Vall d'Hebron Hospital Universitari, Barcelona, España
| | - S Nuñez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Vall d'Hebron Hospital Universitari, Barcelona, España
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25
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Laurens LM, Bañeras J, Biarnés A, Nuñez S. Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2023; 70:77-82. [PMID: 36813026 PMCID: PMC9940464 DOI: 10.1016/j.redare.2021.08.001] [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: 05/19/2021] [Accepted: 08/01/2021] [Indexed: 02/22/2023]
Abstract
BACKGROUND The restrictions to stop COVID-19 pandemic have had a negative impact in simulation, however, it is imperative to develop new strategies that facilitate healthcare education. OBJECTIVE To describe a simulation in healthcare based on the learning of Non-Technical Skills (NTS) and performed under the restrictions of COVID-19 Pandemic. METHODS Quasi-experimental study of an educational activity performed through simulation with anaesthesiology residents in November 2020. Twelve residents participated in two consecutive days. A questionnaire was filled related to the performance of NTS that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the NTS results obtained between the two days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. RESULTS The global performance of the teams improved when comparing first and second day (79.5% vs 88.6%, p<0.01). Leadership was the worst section rated, however, was the one that showed the best improvement (70% vs 87.5%, p<0.01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. CONCLUSION Clinical simulation can be done in the context of COVID-19 Pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.
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Affiliation(s)
- L M Laurens
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - J Bañeras
- Servicio de Cardiología, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Direcció de Docència, Vall d'Hebron Hospital Universitari, Barcelona, Spain.
| | - A Biarnés
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - S Nuñez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Vall d'Hebron centre Simulació Clínica Avançada (VH_Centre de Simulació Clínica Avançada), Vall d'Hebron Hospital Universitari, Barcelona, Spain
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26
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de’Angelis N, Marchegiani F, Schena CA, Khan J, Agnoletti V, Ansaloni L, Barría Rodríguez AG, Bianchi PP, Biffl W, Bravi F, Ceccarelli G, Ceresoli M, Chiara O, Chirica M, Cobianchi L, Coccolini F, Coimbra R, Cotsoglou C, D’Hondt M, Damaskos D, De Simone B, Di Saverio S, Diana M, Espin‐Basany E, Fichtner‐Feigl S, Fugazzola P, Gavriilidis P, Gronnier C, Kashuk J, Kirkpatrick AW, Ammendola M, Kouwenhoven EA, Laurent A, Leppaniemi A, Lesurtel M, Memeo R, Milone M, Moore E, Pararas N, Peitzmann A, Pessaux P, Picetti E, Pikoulis M, Pisano M, Ris F, Robison T, Sartelli M, Shelat VG, Spinoglio G, Sugrue M, Tan E, Van Eetvelde E, Kluger Y, Weber D, Catena F. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper. World J Emerg Surg 2023; 18:11. [PMID: 36707879 PMCID: PMC9883976 DOI: 10.1186/s13017-023-00476-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. METHODS This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. RESULTS Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. CONCLUSIONS Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.
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Affiliation(s)
- Nicola de’Angelis
- grid.508487.60000 0004 7885 7602Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, Paris, France ,grid.410511.00000 0001 2149 7878Faculty of Medicine, University of Paris Est, UPEC, Créteil, France
| | - Francesco Marchegiani
- grid.508487.60000 0004 7885 7602Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, Paris, France
| | - Carlo Alberto Schena
- grid.508487.60000 0004 7885 7602Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, Paris, France
| | - Jim Khan
- grid.4701.20000 0001 0728 6636Department of Colorectal Surgery, Queen Alexandra Hospital, University of Portsmouth, Southwick Hill Road, Cosham, Portsmouth, UK
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Intensive Care Unit, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- grid.419425.f0000 0004 1760 3027Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | | | - Paolo Pietro Bianchi
- grid.4708.b0000 0004 1757 2822Division of General and Robotic Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Walter Biffl
- grid.415402.60000 0004 0449 3295Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Francesca Bravi
- grid.415207.50000 0004 1760 3756Healthcare Administration, Santa Maria Delle Croci Hospital, Ravenna, Italy
| | - Graziano Ceccarelli
- General Surgery, San Giovanni Battista Hospital, USL Umbria 2, Foligno, Italy
| | - Marco Ceresoli
- grid.7563.70000 0001 2174 1754General and Emergency Surgery, School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy
| | - Osvaldo Chiara
- grid.4708.b0000 0004 1757 2822General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano, Milan, Italy
| | - Mircea Chirica
- grid.450307.50000 0001 0944 2786Department of Digestive Surgery and Liver Transplantation, Michallon Hospital, Grenoble University, Grenoble, France
| | - Lorenzo Cobianchi
- grid.419425.f0000 0004 1760 3027Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Department, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- grid.488519.90000 0004 5946 0028Riverside University Health System Medical Center, Riverside, CA USA
| | | | - Mathieu D’Hondt
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium
| | - Dimitris Damaskos
- grid.418716.d0000 0001 0709 1919Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Belinda De Simone
- Department of General and Metabolic Surgery, Poissy and Saint‐Germain‐en‐Laye Hospitals, Poissy, France
| | - Salomone Di Saverio
- Unit of General Surgery, San Benedetto del Tronto Hospital, av5 Asur Marche, San Benedetto del Tronto, Italy
| | - Michele Diana
- grid.11843.3f0000 0001 2157 9291Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, Strasbourg, France ,grid.420397.b0000 0000 9635 7370IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Eloy Espin‐Basany
- grid.7080.f0000 0001 2296 0625Department of General Surgery, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Stefan Fichtner‐Feigl
- grid.7708.80000 0000 9428 7911Department of General and Visceral Surgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Paola Fugazzola
- grid.419425.f0000 0004 1760 3027Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paschalis Gavriilidis
- grid.15628.380000 0004 0393 1193Department of HBP Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX UK
| | - Caroline Gronnier
- grid.42399.350000 0004 0593 7118Eso-Gastric Surgery Unit, Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, Pessac, France
| | - Jeffry Kashuk
- grid.12136.370000 0004 1937 0546Department of Surgery, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrew W. Kirkpatrick
- grid.414959.40000 0004 0469 2139Department of General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Michele Ammendola
- grid.411489.10000 0001 2168 2547Digestive Surgery Unit, Health of Science Department, “Magna Graecia” University Medical School, “Mater Domini” Hospital, Catanzaro, Italy
| | - Ewout A. Kouwenhoven
- grid.417370.60000 0004 0502 0983Department of Surgery, Hospital Group Twente ZGT, Almelo, Netherlands
| | - Alexis Laurent
- grid.410511.00000 0001 2149 7878Faculty of Medicine, University of Paris Est, UPEC, Créteil, France ,grid.412116.10000 0004 1799 3934Unit of HPB and Service of General Surgery, Henri Mondor University Hospital, Creteil, France
| | - Ari Leppaniemi
- grid.7737.40000 0004 0410 2071Department of Gastrointestinal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mickaël Lesurtel
- grid.508487.60000 0004 7885 7602Department of HPB Surgery and Liver Transplantation, AP-HP Beaujon Hospital, University of Paris Cité, Clichy, France
| | - Riccardo Memeo
- grid.415844.80000 0004 1759 7181Unit of Hepato‐Pancreato‐Biliary Surgery, General Regional Hospital “F. Miulli”, Acquaviva delle Fonti, Bari, Italy
| | - Marco Milone
- grid.4691.a0000 0001 0790 385XDepartment of Clinical Medicine and Surgery, Federico II” University of Naples, Naples, Italy
| | - Ernest Moore
- grid.241116.10000000107903411Ernest E Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO USA
| | - Nikolaos Pararas
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Andrew Peitzmann
- grid.21925.3d0000 0004 1936 9000University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Patrick Pessaux
- grid.11843.3f0000 0001 2157 9291Visceral and Digestive Surgery, Nouvel Hôpital Civil, University of Strasbourg, Strasbourg, France ,grid.480511.9Institute for Image‐Guided Surgery, IHU Strasbourg, Strasbourg, France ,Institute of Viral and Liver Disease, INSERM U1110, Strasbourg, France
| | - Edoardo Picetti
- grid.411482.aDepartment of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Parma, Parma, Italy
| | - Manos Pikoulis
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Michele Pisano
- 1St General Surgery Unit, Department of Emergency, ASST Papa Giovanni Hospital Bergamo, Bergamo, Italy
| | - Frederic Ris
- grid.150338.c0000 0001 0721 9812Division of Digestive Surgery, University Hospitals of Geneva and Medical School, Geneva, Switzerland
| | - Tyler Robison
- grid.5288.70000 0000 9758 5690Minimally Invasive Surgery Fellow, Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR USA
| | | | - Vishal G. Shelat
- grid.240988.f0000 0001 0298 8161Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Giuseppe Spinoglio
- grid.420397.b0000 0000 9635 7370IRCAD Faculty Member Robotic and Colorectal Surgery‐ IRCAD, Strasbourg, France
| | - Michael Sugrue
- grid.415900.90000 0004 0617 6488Department of Surgery, Letterkenny University Hospital, Donegal, Ireland
| | - Edward Tan
- grid.10417.330000 0004 0444 9382Department of Surgery, Trauma Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ellen Van Eetvelde
- grid.411326.30000 0004 0626 3362Department of Digestive Surgery, UZ, Brussels, Belgium
| | - Yoram Kluger
- Department of General Surgery, Rambam Healthcare Campus, Haifa, Israel
| | - Dieter Weber
- grid.416195.e0000 0004 0453 3875Department of Trauma Surgery, Royal Perth Hospital, Perth, Australia
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Department of General and Emergency Surgery, Bufalini Hospital‐Level 1 Trauma Center, Cesena, Italy
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Nishida K, Watanabe F, Kojima T. Efficacy of in-situ simulation training using evaluation checklists for sudden oxygen supply failure during general anesthesia: A preliminary report. Saudi J Anaesth 2023; 17:1-6. [PMID: 37032690 PMCID: PMC10077802 DOI: 10.4103/sja.sja_541_22] [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: 07/23/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Sudden oxygen supply failure (OSF) is a life-threatening consequence that may be triggered by natural disasters. Anesthesiologists are required to manage OSF promptly in such catastrophic situations. However, the current evidence regarding the efficacy of anesthesia training for sudden OSF is insufficient. This preliminary study aimed to introduce our in-situ simulation training utilizing evaluation checklists for a sudden OSF situation during general anesthesia and to evaluate the efficacy of the training program for anesthesia providers. Methods This is a preliminary single-center, prospective study. We developed an OSF simulation scenario utilizing evaluation checklists with key actions to manage OSF. The training session comprised four components: orientation, benchmark evaluation (pre-test) according to the checklists, a short didactic lecture, and post-lecture evaluation (post-test). The scenario comprised two steps wherein the participants were supposed to utilize different oxygen supply sources immediately after OSF (Step 1) and minimize the amount of oxygen consumption (Step 2). Results Fifteen anesthesia providers were enrolled. The score for all anesthesia providers in the post-test was significantly higher than that in the pre-test (median 8 [IQR: 8, 8], 3 [IQR: 3, 4], P < 0.001, respectively). The successful performance rates of all anesthesia providers in one key action of all the four in Step 1 and four of all the six in Step 2 were significantly higher in the post-test than in the pre-test. Conclusions Our in-situ training method utilizing evaluation checklists for a sudden OSF situation improved overall performance of anesthesia providers.
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Affiliation(s)
- Keisuke Nishida
- Department of Anesthesiology, Aichi Children's Healthy and Medical Center, Obu-City, Aichi, Japan
| | - Fumio Watanabe
- Department of Anesthesiology, Aichi Children's Healthy and Medical Center, Obu-City, Aichi, Japan
| | - Taiki Kojima
- Department of Anesthesiology, Aichi Children's Healthy and Medical Center, Obu-City, Aichi, Japan
- Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
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Ffrench-O'Carroll R, Sunderani Z, Preston R, Mayer U, Albert A, Chau A. Enhancing knowledge, skills, and comfort in providing anesthesia assistance during obstetric general anesthesia for operating room nurses: a prospective observational study. Can J Anaesth 2022; 69:1220-1229. [PMID: 35750971 DOI: 10.1007/s12630-022-02277-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Due to a nationwide shortage of anesthesia assistants, operating room nurses are often recruited to assist with the induction of obstetric general anesthesia (GA). We developed and administered a training program and hypothesized there would be significant improvements in knowledge and skills in anesthesia assistance during obstetric GA by operating room nurses following training with adequate retention at six months. METHODS Following informed consent, all operating room nurses at our institution were invited to participate in the study. Baseline knowledge of participants was assessed using a 14-item multiple choice questionnaire (MCQ), and skills were assessed using a 12-item checklist scored by direct observation during simulated induction of GA. Next, a 20-min didactic lecture followed by a ten-minute hands-on skills station were delivered. Knowledge and skills were immediately reassessed after training, and again at six weeks and six months. The primary outcomes of this study were adequate knowledge and skills retention at six months, defined as achieving ≥ 80% in MCQ and ≥ 80% in skills checklist scores and analyzed using longitudinal mixed-effects linear regression. RESULTS A total of 34 nurses completed the study at six months. The mean MCQ score at baseline was 8.9 (95% confidence interval [CI], 8.5 to 9.4) out of 14. The mean skills checklist score was 5.5 (95% CI, 4.9 to 6.1) out of 12. The mean comfort scores for assisting elective and emergency Cesarean deliveries were 3.6 (95% CI, 3.2 to 3.9) and 3.1 (95% CI, 2.7 to 3.5) out of 5, respectively. There was a significant difference in the mean MCQ and skills checklist scores across the different study periods (overall P value < 0.001). Post hoc pairwise tests suggested that, compared with baseline, there were significantly higher mean MCQ scores at all time points after the training program at six weeks (11.9; 95% CI, 11.4 to 12.4; P < 0.001) and at six months (12.0; 95% CI, 11.5 to 12.4; P < 0.001). DISCUSSION The knowledge and skills of operating room nurses in providing anesthesia assistance during obstetric GA at our institution were low at baseline. Following a single 30-min in-house, anesthesiologist-led, structured training program, scores in both dimensions significantly improved. Although knowledge improvements were adequately retained for up to six months, skills improvements decayed rapidly, suggesting that sessions should be repeated at six-week intervals, at least initially.
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Affiliation(s)
| | - Zahid Sunderani
- Department of Anesthesia, Rockyview General Hospital, Calgary, AB, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB, Canada
| | - Roanne Preston
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
| | - Ulrike Mayer
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Arianne Albert
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Anthony Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada. .,Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
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Clark JA. Education in the Pediatric Intensive Care Unit. Pediatr Clin North Am 2022; 69:621-631. [PMID: 35667765 DOI: 10.1016/j.pcl.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article addresses the latest data and ideas related to education in the pediatric intensive care unit, including traditional education methods with newer and technology-based methods. A review of adult learning theory is included with discussions regarding medical decision making and error prevention, bedside teaching, medical simulation, and electronic methods of education.
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Affiliation(s)
- Jeff A Clark
- Pediatric Critical Care Medicine, Ascension St. John Children's Hospital, 22101 Moross Road, Detroit, MI 48236, USA.
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30
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Simulation-based education and training in anaesthesia during residency in Europe: where are we now?: A survey conducted by the European Society of Anaesthesiology and Intensive Care Simulation Committee. Ugeskr Laeger 2022; 39:558-561. [PMID: 35608878 DOI: 10.1097/fja.0000000000001667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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European simulation-based education and training in anaesthesiology and intensive care: still a long way to go? Eur J Anaesthesiol 2022; 39:487-488. [PMID: 35608875 DOI: 10.1097/eja.0000000000001687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Walshe N, Condon C, Gonzales RA, Burke E, Chianáin LN, Thamanam N, Smart A, Jordaan G, Regan PO. Cultural Simulations, Authenticity, Focus, and Outcomes: A Systematic Review of the Healthcare Literature. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Savoldelli GL, Østergaard D. Simulation-based education and training in anaesthesia during residency in Europe: where are we now?: A survey conducted by the European Society of Anaesthesiology and Intensive Care Simulation Committee. Eur J Anaesthesiol 2022; 39:558-561. [PMID: 35190515 DOI: 10.1097/eja.0000000000001667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Georges L Savoldelli
- From the Division of Anaesthesia, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals (GLS), The Unit of Development and Research in Medical Education (UDREM), Geneva University Hospitals and Faculty of Medicine University of Geneva, Geneva, Switzerland (GLS), the Copenhagen Academy for Medical Education and Simulation, Copenhagen University Hospital, Herlev (DØ) and the Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (DØ)
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Abildgren L, Lebahn-Hadidi M, Mogensen CB, Toft P, Nielsen AB, Frandsen TF, Steffensen SV, Hounsgaard L. The effectiveness of improving healthcare teams' human factor skills using simulation-based training: a systematic review. Adv Simul (Lond) 2022; 7:12. [PMID: 35526061 PMCID: PMC9077986 DOI: 10.1186/s41077-022-00207-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/05/2022] [Indexed: 01/08/2023] Open
Abstract
Background Simulation-based training used to train healthcare teams’ skills and improve clinical practice has evolved in recent decades. While it is evident that technical skills training is beneficial, the potential of human factor training has not been described to the same extent. Research on human factor training has been limited to marginal and acute care scenarios and often to validate instruments. This systematic review aimed to investigate the effectiveness of simulation-based training in improving in-hospital qualified healthcare teams’ human factor skills. Method A review protocol outlining the study was registered in PROSPERO. Using the PRISMA guidelines, the systematic search was conducted on September 28th, 2021, in eight major scientific databases. Three independent reviewers assessed title and abstract screening; full texts were evaluated by one reviewer. Content analysis was used to evaluate the evidence from the included studies. Results The search yielded 19,767 studies, of which 72 were included. The included studies were published between 2004 and 2021 and covered research from seven different in-hospital medical specialisms. Studies applied a wide range of assessment tools, which made it challenging to compare the effectiveness of human factor skills training across studies. The content analysis identified evidence for the effectiveness. Four recurring themes were identified: (1) Training human factor skills in qualified healthcare teams; (2) assessment of human factor skills; (3) combined teaching methods, and (4) retention and transfer of human factor skills. Unfortunately, the human factor skills assessments are variable in the literature, affecting the power of the result. Conclusion Simulation-based training is a successful learning tool to improve qualified healthcare teams’ human factor skills. Human factor skills are not innate and appear to be trainable similar to technical skills, based on the findings of this review. Moreover, research on retention and transfer is insufficient. Further, research on the retention and transfer of human factor skills from simulation-based training to clinical practice is essential to gain knowledge of the effect on patient safety. Supplementary Information The online version contains supplementary material available at 10.1186/s41077-022-00207-2.
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Affiliation(s)
- Lotte Abildgren
- Anesthesiology and Intensive Care Unit, Odense University Hospital, Odense, Denmark. .,OPEN, Open Patient data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark. .,Emergency Research Unit, Hospital Sønderjylland, University Hospital of Southern Denmark, Odense, Denmark.
| | - Malte Lebahn-Hadidi
- Emergency Research Unit, Hospital Sønderjylland, University Hospital of Southern Denmark, Odense, Denmark.,Centre for Human Interactivity, Department of Language and Communication, University of Southern Denmark, Odense, Denmark
| | - Christian Backer Mogensen
- Emergency Research Unit, Hospital Sønderjylland, University Hospital of Southern Denmark, Odense, Denmark
| | - Palle Toft
- Anesthesiology and Intensive Care Unit, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anders Bo Nielsen
- OPEN, Open Patient data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,SimC, Regional Center for Technical Simulation, Region of Southern Denmark, Odense, Denmark
| | - Tove Faber Frandsen
- Department of Design and Communication, University of Southern Denmark, Kolding, Denmark
| | - Sune Vork Steffensen
- Centre for Human Interactivity, Department of Language and Communication, University of Southern Denmark, Odense, Denmark.,Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark.,Center for Ecolinguistics, South China Agricultural University, Guangzhou, People's Republic of China.,College of International Studies, Southwest University, Chongqing, People's Republic of China
| | - Lise Hounsgaard
- OPEN, Open Patient data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Institute of Nursing & Health Science, Ilisimartusarfik, University of Greenland, Nuuk, Greenland.,Center for Mental Health Nursing and Health Research (CPS), Mental Health Services, Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
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Al Shabeeb RQ, Lee E, El Shatanofy M, Mulcahy CF, Sherman ML, Heinz ER, Yamane DP. Impact of COVID-19 specific simulation training in improving intubators' level of comfort during intubations of COVID-19 patients - Results from a USA national survey. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022; 43:17-22. [PMID: 38620697 PMCID: PMC8784652 DOI: 10.1016/j.tacc.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022]
Abstract
Background Tracheal intubation is a hazardous aerosolizing procedure with a potential risk of spreading SAR-CoV-2 between patients and physicians. Aim The purpose of this study was to explore the impact of COVID-19 specific simulation training in improving provider level of comfort during the intubation of COVID-19 patients. Methods In this cross-sectional national study, an electronic survey was disseminated using a snowball sample approach to intubators from 55 hospitals across the United States. The survey assessed providers' comfort of intubating and fear of contracting the virus during COVID-19 intubations. Results A total of 329 surveys from 55 hospitals were analyzed. Of 329 providers, 111 providers (33.7%) reported participating in simulation training. Of those, 86 (77.5%) reported that the simulation training helped reduce their fear of intubating COVID-19 patients. Providers in the simulation training group also reported a higher level of comfort level with intubating both general patients (median [range] no-simulation training group 9 [3-10], simulation training group 9 [6-10]; p = 0.015) and COVID-19 patients (no-ST 8 [1-10], ST group 9 [4-10]; p < 0.0005) than providers in the no-simulation training group. Conclusions Our study suggests that COVID-19 specific intubation simulation training promotes provider comfort. Simulation training may be implemented as part of airway management training during the current and novel pandemic situations.
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Affiliation(s)
- Reem Qabas Al Shabeeb
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Esther Lee
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Western University of Health Sciences, Pomona, CA, USA
| | - Muhammad El Shatanofy
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Collin F Mulcahy
- Division of Otolaryngology - Head & Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Marian L Sherman
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Eric R Heinz
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - David P Yamane
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Noyes JA, Carbonneau KJ, Matthew SM. Comparative Effectiveness of Training with Simulators Versus Traditional Instruction in Veterinary Education: Meta-Analysis and Systematic Review. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:25-38. [PMID: 33891532 DOI: 10.3138/jvme-2020-0026] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
One of the greatest challenges in veterinary education is adequately preparing students with the clinical skills they need to be successful health care providers. Integration of simulators, devices used to represent real world phenomena under test conditions, into the veterinary curriculum can help address challenges to clinical instruction. The use of simulators in veterinary education is increasing; however, their effectiveness remains unclear. This meta-analysis seeks to synthesize the evidence for simulator training in veterinary education to provide a consensus of effect, guide the integration of simulators into the curriculum, and direct the development of future simulation-based research in veterinary medicine. A systematic search identified 416 potential manuscripts from which 60 articles were included after application of inclusion criteria. Information was extracted from 71 independent experiments. The overall weighted mean effect size for simulator training was g = 0.49 for the random-effects model. The outcome measures of knowledge, time, process, and product all produced statistically significant mean effect sizes favoring simulation (d = 0.41, 0.35, 0.70, 0.53, respectively). A moderator analysis revealed that study characteristics and instructional design features moderated the effectiveness of simulator training. Overall, the results indicate that simulator training in veterinary education can be effective for knowledge and clinical skill outcomes.
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Kurdi M, Kundra P, Mehrotra S, Jahan N, Kiran S, Vadhanan P. Newer teaching-learning methods and assessment modules in anaesthesia education. Indian J Anaesth 2022; 66:47-57. [PMID: 35309022 PMCID: PMC8929315 DOI: 10.4103/ija.ija_1103_21] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 11/06/2022] Open
Abstract
The National Medical Commission in its recent guidelines has stated that postgraduate training in anaesthesiology should have clear objectives and be competency based. This means that the existing teaching–learning (TL) methods need a major face-lift. E-learning and blended learning including learning management systems, virtual classrooms, app-based learning, flipped classroom, podcasts, webinars, web-based collaborative education, reflective feedback, problem-based discussions and mentorship are some newer TL methods that can be adopted. Simulation can help teach technical and non-technical skills such as leadership, teamwork and communication. In line with TL methods, newer assessment methods have to be applied to revolutionise postgraduate anaesthesia education. Formative assessment and assessment of clinical skills are important and to do this, workplace-based assessment methods such as mini-clinical evaluation exercise, direct observation of procedural skills, multisource feedback, logbook and E-portfolio can be applied. Objective structured clinical examination, simulation-based assessment and E-assessment are other useful evaluation methods.
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Rineau E, Collard A, Jean L, Guérin S, Maunoury L, Martin L, Lasocki S, Léger M. Cognitive Aid for Anesthetic Preparation in An Emergency Situation: A Simulation-Based Study. Healthcare (Basel) 2021; 9:1646. [PMID: 34946372 PMCID: PMC8700863 DOI: 10.3390/healthcare9121646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 01/28/2023] Open
Abstract
When anesthesia checklists and preparations are performed urgently, omissions may occur and be deleterious to the patient. The aim of this study was to evaluate in simulation the interest of a cognitive aid to effectively prepare an anesthetic room for an emergency. In a prospective single-center simulation-based study, 32 anesthesia residents had to prepare an anesthetic room in an emergency scenario, without cognitive aid in the first phase. Three months later (phase 2), they were randomly assigned to receive a cognitive aid (aid group) or no additional aid (control) and were involved in the same scenario. The primary outcome was the validation rate of each essential item in the first 5 min in phase 2. Eight items were significantly more frequently completed in the first 5 min in the aid group in phase 2 (vs. phase 1), compared with two only in the control group. However, there were no significant differences in the overall number of completed items between the two groups, as both groups completed significantly more items in phase 2, either in the first 5 min (19 (14-23) vs. 13 (9-15) in phase 1 for all residents, p < 0.001) or without time limit. Preparation times were reduced in phase 2 in both groups. In conclusion, the use of a cognitive aid allowed anesthesia residents to complete some safety items of a simulated urgent anesthesia preparation more frequently. In addition, despite daily clinical experience, a single simulation session improved anesthesia preparation and reduced the preparation time with or without cognitive aid.
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Affiliation(s)
- Emmanuel Rineau
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Anna Collard
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Lorine Jean
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Sarah Guérin
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Louise Maunoury
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Ludovic Martin
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Dermatology, University Hospital of Angers, 49100 Angers, France
| | - Sigismond Lasocki
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
| | - Maxime Léger
- All’Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France; (A.C.); (L.J.); (S.G.); (L.M.); (L.M.); (S.L.); (M.L.)
- Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France
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Jujo S, Nakahira A, Kataoka Y, Banno M, Tsujimoto Y, Tsujimoto H, Oikawa S, Matsui H, Berg BW. Transesophageal Echocardiography Simulator Training: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Simul Healthc 2021; 16:341-352. [PMID: 33428355 DOI: 10.1097/sih.0000000000000537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY STATEMENT We aimed to assess the learning effects of novice transesophageal echocardiography (TEE) simulator training and to identify gaps in existing studies. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the learning effects of novice TEE training with versus without simulators, searching published articles and proceedings in 6 major databases in June 2019. We included 9 RCTs (268 participants). Compared with nonsimulator training, TEE simulator training resulted in higher skill and knowledge posttraining test scores with large effect sizes (standardized mean difference = 0.81 for skill, 1.61 for knowledge; low-certainty evidence) and higher training satisfaction with a small effect size (standardized mean difference = 0.36; very low-certainty evidence). No RCTs reported training budget or patient outcomes. Additional well-designed studies with low risk of bias and large sample sizes are needed to provide reliable and robust findings and develop more effective TEE simulation-based training curricula.
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Affiliation(s)
- Satoshi Jujo
- From the SimTiki Simulation Center (S.J., A.N., B.W.B.), John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI; Department of Anesthesiology (S.J., H.M.), Kameda General Hospital, Chiba; Department of Critical Care Medicine (A.N.), Nara Prefecture General Medical Center, Nara; Department of Respiratory Medicine (Y.K.) and Hospital Care Research Unit (Y.K., H.T.), Hyogo Prefectural Amagasaki General Medical Center, Hyogo; Department of Psychiatry (M.B.), Seichiryo Hospital; Department of Psychiatry (M.B.), Nagoya University Graduate School of Medicine, Aichi; Department of Nephrology and Dialysis (Y.T.), Kyoritsu Hospital, Hyogo; and Department of Healthcare Epidemiology (Y.T.), School of Public Health in the Graduate School of Medicine, and Medical Education Center (S.O.), Graduate School of Medicine, Kyoto University, Kyoto, Japan
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An Innovative Biological Model for Ultrasound-Guided Central Venous Access Simulation. Simul Healthc 2021; 16:362-366. [PMID: 33196608 DOI: 10.1097/sih.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Simulation training is an increasingly used method to train medical students in the use of ultrasound guidance for vascular access positioning. Although very efficient for basic training, commercial simulators for vascular access do not reproduce real-life conditions. We developed a biological training model, using porcine liver, and compared it with an existing commercial model. METHODS Whole porcine livers were used by perfusing the portal vein system after inferior vena cava clamping. Thirty-three practitioners accustomed to ultrasound-guided procedure were enrolled to perform an ultrasound-guided vascular procedure on both biological and commercial models. Procedure duration was recorded and 10-point scales were used to compare the 2 models regarding image quality, procedure feeling, and similarity with the real-life procedure. RESULTS Participants reported a better image quality with the biological model (8.8 ± 1 vs. 7.7 ± 2, P = 0.007) as well as a significant difference in the procedure feeling (8.0 ± 1 vs. 6.9 ± 1.9, P = 0.002). Real-life likeness was significantly better for the biological model (8.4 ± 1.1 vs. 4.5 ± 6, P < 0.0001). Procedure duration was almost 3 times longer using the biological model than the commercial model (209.6 ± 189.0 vs. 59.8 ± 50.1, P < 0.0001). CONCLUSIONS This study validates our biological model of porcine's liver as an interesting training model, allowing closer real-life perception than its commercial counterpart. This model could complement and enhance simulation learning.
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Finstad AS, Ballangrud R, Aase I, Wisborg T, Romundstad LG, Bjørshol CA. Is simulation-based team training performed by personnel in accordance with the INACSL Standards of Best Practice: Simulation SM?-a qualitative interview study. Adv Simul (Lond) 2021; 6:33. [PMID: 34565483 PMCID: PMC8474884 DOI: 10.1186/s41077-021-00186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anesthesia personnel was among the first to implement simulation and team training including non-technical skills (NTS) in the field of healthcare. Within anesthesia practice, NTS are critically important in preventing harmful undesirable events. To our best knowledge, there has been little documentation of the extent to which anesthesia personnel uses recommended frameworks like the Standards of Best Practice: SimulationSM to guide simulation and thereby optimize learning. The aim of our study was to explore how anesthesia personnel in Norway conduct simulation-based team training (SBTT) with respect to outcomes and objectives, facilitation, debriefing, and participant evaluation. METHODS Individual qualitative interviews with healthcare professionals, with experience and responsible for SBTT in anesthesia, from 51 Norwegian public hospitals were conducted from August 2016 to October 2017. A qualitative deductive content analysis was performed. RESULTS The use of objectives and educated facilitators was common. All participants participated in debriefings, and almost all conducted evaluations, mainly formative. Preparedness, structure, and time available were pointed out as issues affecting SBTT. CONCLUSIONS Anesthesia personnel's SBTT in this study met the International Nursing Association for Clinical Simulation and Learning (INACSL) Standard of Best Practice: SimulationSM framework to a certain extent with regard to objectives, facilitators' education and skills, debriefing, and participant evaluation.
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Affiliation(s)
- Anne Strand Finstad
- Department of Nurse Anesthetists, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Randi Ballangrud
- Department of Health Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Teknologivegen 22, 2815, Gjøvik, Norway
| | - Ingunn Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Torben Wisborg
- Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromsø - the Arctic University of Norway, Tromsø, Norway
- Norwegian National Advisory Unit on Trauma, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Hammerfest Hospital, Department of Anaesthesiology and Intensive Care, Finnmark Health Trust, Hammerfest, Norway
| | - Luis Georg Romundstad
- Department of Anaesthesia, Oslo University Hospital, Rikshospitalet, N-0424, Oslo, Norway
| | - Conrad Arnfinn Bjørshol
- The Regional Centre for Emergency Medical Research and Development (RAKOS), Stavanger University Hospital, Stavanger, Norway
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Kabi A, Dhar M, Arora P, Bhardwaj BB, Chowdhury N, Rao S. Effectiveness of a Simulation-Based Training Program in Improving the Preparedness of Health Care Workers Involved in the Airway Management of COVID-19 Patients. Cureus 2021; 13:e17323. [PMID: 34557368 PMCID: PMC8450013 DOI: 10.7759/cureus.17323] [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] [Accepted: 08/20/2021] [Indexed: 11/05/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has currently emerged as a global threat and a significant public health issue. The role of simulation-based training (SBT) during such a pandemic becomes more relevant for teaching a team approach and building capacity especially when there is a threat to health care workers due to aerosol generation and there is a huge demand for manpower during the pandemic. Objective To assess the effectiveness of a simulation-based training program in improving knowledge and concept of teamwork of health care workers involved in airway management of suspected or confirmed COVID-19 patients. Methods After institutional review committee approval, a prospective analytical study was conducted in the department of medical education on participants from various specialties undergoing COVID-19 airway training. The purpose of the study was to assess team dynamics during simulation scenarios and compare test scores at baseline, immediately post-training, and seven days post-training (using online forms). Scores were compared using the Friedman test followed by post-hoc testing. Sub-group comparison was done using an unpaired t-test. Results Median scores were significantly higher in the immediate post-training test and seven days post-training test (online) compared to baseline pretest scores in the overall participant group and in individual sub-groups. There was no significant difference in immediate versus seven-day post-training test scores overall and in all subgroups. In the sub-group comparisons, median improvement in score was significantly better in the non-anesthesia group and in the resident group. It was observed that team performance in terms of role clarity, closed-loop communication, and idea acceptance improved substantially during the subsequent scenarios. Conclusion Simulation-based training was effective in improving knowledge and team dynamics amongst health care workers regarding airway management in COVID-19 patients, with retention of up to one week. Similar future research can be planned for the affective and psychomotor domains.
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Affiliation(s)
- Ankita Kabi
- Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | - Mridul Dhar
- Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Poonam Arora
- Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | - Bharat B Bhardwaj
- Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | | | - Shalinee Rao
- Pathology, Advanced Center of Continuous Professional Development, All India Institute of Medical Sciences, Rishikesh, IND
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Schmutz JB. Institutionalizing an interprofessional simulation education program: an organizational case study using a model of strategic change. J Interprof Care 2021; 36:402-412. [PMID: 34459330 DOI: 10.1080/13561820.2021.1951189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Initiatives to implement interprofessional simulation education programs (ISEP) often fail due to lack of support, resources from management or proper integration into the organization system. This paper aims to identify factors that ensure the successful implementation of an ISEP. Further, the study explores the potential effects an ISEP can have on organizational processes and culture. The case study describes the implementation process of an ISEP in a non-academic community hospital using interviews, participative observations and archival data over six years. A thematic approach has been used to analyze the data guided by Kotter's 8-step model for organizational change. Strategies for a successful implementation of an ISEP include: 1) make a case for interprofessional simulation-based education (SBE), 2) search for healthcare champions, 3) define where the ISEP will lead the organization, 4) spread the word about interprofessional SBE, 5) ensure that structures, skills and supervisors align with the change effort, 6) win over smaller entities, 7) enable peer feedback and create more change, 8) institutionalize the ISEP. Indicators of how the ISEP impacted hospital culture are presented and discussed. ISEPs - if implemented effectively - provide powerful opportunities to span boundaries between professional groups, foster interprofessional collaboration, and eventually improve patient care.
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Affiliation(s)
- Jan B Schmutz
- Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
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Khundam C, Sukkriang N, Noël F. No difference in learning outcomes and usability between using controllers and hand tracking during a virtual reality endotracheal intubation training for medical students in Thailand. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2021; 18:22. [PMID: 34403577 PMCID: PMC8616725 DOI: 10.3352/jeehp.2021.18.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE We developed a virtual reality (VR) endotracheal intubation training that applied 2 interaction modalities (hand-tracking or controllers). It aimed to investigate the differences in usability between using hand tracking and controllers during the VR intervention for intubation training for medical students from February 2021 to March 2021 in Thailand. METHODS Forty-five participants were divided into 3 groups: video only, video with VR controller training, and video with VR hand tracking training. Pre-test, post-test, and practice scores were used to assess learning outcomes. The System Usability Scale (SUS) and User Satisfaction Evaluation Questionnaire (USEQ) questionnaires were used to evaluate the differences between the VR groups. The sample comprised 45 medical students (undergraduate) who were taking part in clinical training at Walailak University in Thailand. RESULTS The overall learning outcomes of both VR groups were better than those of the video group. The post-test scores (P=0.581) and practice scores (P=0.168) of both VR groups were not significantly different. Similarly, no significant between-group differences were found in the SUS scores (P=0.588) or in any aspects of the USEQ scores. CONCLUSION VR enhanced medical training. Interactions using hand tracking or controllers were not significantly different in terms of the outcomes measured in this study. The results and interviews provided a better understanding of support learning and training, which will be further improved and developed to create a self-learning VR medical training system in the future.
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Affiliation(s)
- Chaowanan Khundam
- Informatics Innovative Center of Excellence (IICE), School of Informatics, Walailak University, Nakhon Si Thammarat, Thailand
| | - Naparat Sukkriang
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Frédéric Noël
- Institute of Engineering, Université Grenoble Alpes, Grenoble, France
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Bialka S, Copik M, Ubych A, Marciniak R, Smereka J, Szarpak L, Misiolek H. Effect of high-fidelity simulation on alpha-amylase activity and concentrations of secretory immunoglobulin class A, cortisol, and testosterone among medical students. Endocrine 2021; 73:431-438. [PMID: 33821392 PMCID: PMC8263411 DOI: 10.1007/s12020-021-02696-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/11/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE High-fidelity simulation calls heavily upon cognitive capacities and generates stress and anxiety. The objective of this prospective, observational study was to evaluate the degree of stress in medical students by measuring hormone levels during critical care classes. METHODS Overall, 55 students (senior years of medical faculty) of both sexes were divided into 5-person teams. Demographic data and information on diagnosed diseases, stimulants used, and previous experience in the field of medical simulation were collected with a personal questionnaire. Before starting the scenario (T0), after the end of the scenario (T1), and 120 min thereafter (T2), stress level was measured. For this purpose, systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate and blood oxygen saturation were evaluated. In addition, saliva was collected to determine alpha-amylase activity and the concentrations of secretory immunoglobulin class A, cortisol, and testosterone. RESULTS Among hemodynamic parameters, systolic and mean blood pressure and heart rate were significantly higher in T1 than in T0 and T2 time points (p < 0.05). Cortisol concentration was higher at T2 compared with T0 and T1. Alpha-amylase activity was highest at T1. Secretory immunoglobulin class A concentration was highest at T0, followed by T1 and then T2. These differences were not statistically significant. Testosterone concentration showed significantly higher values at T2 compared with T0 and T1 (p < 0.05). The analysis of team leaders vs. other members revealed significantly lower cortisol and alpha-amylase values in leaders (p < 0.05). CONCLUSIONS High-fidelity simulation is a useful education method in medical subjects, especially in cases where a mistake could produce serious or irreversible consequences. It can increase stress hormone concentrations and thus can be assumed effective as a learning aid even in senior-year students of medical faculty.
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Affiliation(s)
- Szymon Bialka
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Maja Copik
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Ubych
- Center of Didactics and Medical Simulation, Medical University of Silesia, Katowice, Poland
| | - Radosław Marciniak
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jacek Smereka
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | | | - Hanna Misiolek
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Masoomi R, Shariati M, Labaf A, Mirzazadeh A. Transfer of learning from simulated setting to the clinical setting: identifying instructional design features. Med J Islam Repub Iran 2021; 35:90. [PMID: 34291014 PMCID: PMC8285558 DOI: 10.47176/mjiri.35.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Transfer of learning (ToL) is the endpoint of simulation-based training (SBT). It is affected by numerous factors, which can be classified into 3 categories: learner characteristics, work environment, and training design. The first 2 have been identified to some extent in previous research. In this study, the aim was to identify the instructional design (ID) features affecting the ToL in SBT. Methods: This qualitative study was conducted in 2 phases. Phase 1 covers thematic analysis of comparative studies in the field of SBT. A systematic search was performed on 6 databases of Ovid MEDLINE, EMBASE, PsycINFO, CENTRAL, Scopus, and Web of Science, and the references of related systematic reviews were also checked. In phase 2, semi-structured interviews were conducted with key informants (instructors and learners) and analyzed using directed content analysis. The results of the 2 phases were combined, and finally ID features of SBT were identified and categorized. Results: In the first phase, 121 comparative studies were reviewed and in the second phase, 17 key informants were interviewed. After combining the results of the phases, the ID features affecting the ToL in SBT were classified into 3 broad categories and 15 subcategories as follows: (1) presimulation: preparation, briefing, and teaching cognitive base; (2) underlying theories: deliberate practice, mastery learning, and proficiency-based training; (3) and methods and techniques: distributed practice, variability, increasing complexity, opportunity for practice, repetitive practice, active learning, feedback/debriefing, simulator type, and simulator fidelity. Conclusion: Although learning is transferred from the simulated setting to the clinical setting, this process is not automatic and straightforward. Numerous factors affect this transfer. The results of this research can be used in designing and evaluating the SBT programs.
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Affiliation(s)
- Rasoul Masoomi
- Department of Medical Education, Tehran University of medical Sciences, Tehran, Iran
| | - Mohammad Shariati
- Department of Community Medicine, Tehran University of medical Sciences, Tehran, Iran
| | - Ali Labaf
- Department of Emergency Medicine, Tehran University of medical Sciences, Tehran, Iran
| | - Azim Mirzazadeh
- Department of Internal Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
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Noyes JA, Keegan RD, Carbonneau KJ, Lepiz ML, Rankin DC, Matthew SM. Evaluating a Multimodal Clinical Anesthesia Course Integrated Into an Existing Veterinary Curriculum. Simul Healthc 2021; 16:177-184. [PMID: 32956211 DOI: 10.1097/sih.0000000000000502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study evaluated a multimodal, simulation-based course in veterinary anesthesia integrated into an existing veterinary curriculum. METHODS A simulation-based, multimodal training course in clinical anesthesia was evaluated using outcomes from multiple levels of the Kirkpatrick Model of Training Evaluation. Cognitive and affective outcomes were evaluated before and after instruction. Head-mounted cameras were used to record clinical performance during students' first live patient anesthesia experience in the curriculum. RESULTS Pretest-posttest analysis of cognitive and affective outcomes for course participants revealed significant increases in knowledge and self-efficacy. Course participants received higher ratings on clinical task performance and professional skills (ie, communication and collaboration) compared with a matched control group when evaluated by blinded, external raters using a standardized rubric. CONCLUSIONS These findings indicate that implementing a multimodal anesthesia simulation-based course directly into the curriculum can enhance cognitive and affective outcomes and prepare students for subsequent anesthesia-related patient care experiences.
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Affiliation(s)
- Julie A Noyes
- From the College of Veterinary Medicine (J.A.N., R.D.K., S.M.M.), and College of Education (J.A.N., K.J.C.), Washington State University, Pullman, DC; College of Veterinary Medicine (M.L.L.), Texas A&M University, College Station, TX; and College of Veterinary Medicine (D.C.R.), Kansas State University, Manhattan, KS
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General anesthesia for emergency cesarean delivery: simulation-based evaluation of residents. Braz J Anesthesiol 2021; 71:254-258. [PMID: 33940059 PMCID: PMC9373071 DOI: 10.1016/j.bjane.2021.02.059] [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: 01/15/2020] [Revised: 02/01/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Decreased rates of General Anesthesia (GA) for Cesarean Section (C-section) create a learning problem for anesthesia trainees. In this context, training the management of GA for C-section using simulation techniques allows a safe environment for exposure, learning, performance improvement, and capability retention. Objective Analyze anesthesia residents’ performance regarding a simulated clinical case of GA for emergency C-section and identify specific deficits in skill acquisition. Methods Between 2015 and 2018, we evaluated the performance of 25 anesthesiology residents challenged by a simulated clinical case of GA for emergency C-section after the conclusion of the obstetric anesthesia rotation. Each resident performed the clinical case once followed by the assessment of their performance. Final scores were given according to the completion rate of 14-tasks, going from 0% to 100%. Two study groups were considered according to residency year for subsequent comparison of results (Group 1, second and third residency years and Group 2, fourth and fifth residency years). Results and discussion Mean score was 64.29% ± 13.62. Comparatively, Group 1 obtained a higher score than Group 2 (70.63% ± 14.02 vs. 60.27% ± 11.94), although with no statistically significant difference (p = 0.063). The tasks most frequently accomplished were opioid administration (100%), rapid sequence technique (100%), pre-oxygenation (92%), gastric content aspiration prophylaxis (84%), and previous clinical history (84%). Conversely, the tasks less frequently accomplished were confirming presence of pediatrician (64%), oxytocin administration (56%), PONV prophylaxis (56%), and preoperative airway assessment (48%). Conclusion The performance of the residents observed in this study was comparable to results previously published. The final score did not depend on the residency year.
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Lorusso R, Whitman G, Milojevic M, Raffa G, McMullan DM, Boeken U, Haft J, Bermudez CA, Shah AS, D'Alessandro DA. 2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-cardiotomy Extracorporeal Life Support in Adult Patients. ASAIO J 2021; 67:e1-e43. [PMID: 33021558 DOI: 10.1097/mat.0000000000001301] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training.
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Affiliation(s)
- Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Heart & Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Glenn Whitman
- Cardiovascular Surgery Intensive Care Unit, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Milan Milojevic
- Department of Anaesthesiology and Critical Care Medicine, Dedinje Cardiovascular Institute, Belgrade, Serbia.,Department of Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia.,Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Giuseppe Raffa
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - David M McMullan
- Department of Cardiac Surgery, Seattle Children Hospital, Seattle, WA, USA
| | - Udo Boeken
- Department of Cardiac Surgery, Heinrich Heine University, Dusseldorf, Germany
| | - Jonathan Haft
- Section of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Christian A Bermudez
- Department of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ashish S Shah
- Department of Cardio-Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David A D'Alessandro
- Department of Cardio-Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
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Gisriel C, Dalley CB, Walker A. Supplementing Pharmacologic Didactic Lectures with High Fidelity Simulation: A Pilot Study. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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