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Farquharson B, Cortegiani A, Lauridsen KG, Yeung J, Greif R, Nabecker S. Teaching team competencies within resuscitation training: A systematic review. Resusc Plus 2024; 19:100687. [PMID: 39006135 PMCID: PMC11239706 DOI: 10.1016/j.resplu.2024.100687] [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: 05/07/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 07/16/2024] Open
Abstract
Objectives To evaluate the effectiveness of life support training with specific emphasis on team competencies on clinical and educational outcomes. Methods This systematic review was prospectively registered (PROSPERO CRD42023473154) and followed the PICOST (population, intervention, comparison, outcome, study design, timeframe) format. All randomized controlled trials and non-randomized studies evaluating learners undertaking life support training with specific emphasis on team competencies in any setting (actual and simulated resuscitations) were included. Unpublished studies were excluded. Medline, Embase and Cochrane databases as well as trial registries were searched from inception to August 2023 (updated January 18, 2024). Two researchers performed title and abstract screening, full-text screening, data extraction, assessment of risk of bias (using RoB2 and ROBINS-I) and certainty of evidence (using GRADE). PRISMA reporting checklist was used to report the results. No funding was obtained to perform this systematic review. Results The literature search identified 5470 manuscripts. After the removal of 2073 duplicates, reviewing the remaining articles' titles and abstracts yielded 31 articles for full-text review. Of these, 17 studies were finally included. The studies involved the following training levels: basic life support, adult advanced life support, paediatric and neonatal resuscitations. Most studies (n = 16) evaluated outcomes in simulated, and only one study in actual resuscitations. Studies included in all training contexts showed either neutrality and/or benefits of life support training with specific emphasis on team competencies. Team competencies training improved CPR skill performance and CPR quality. Specific team competencies that improved included leadership, communication, decision-making and task management. No undesirable effects were observed. Meta-analysis was not possible due to significant methodological heterogeneity. Sub-group analysis was impossible due to lack of data. Risk of bias assessment ranged from some concerns to serious. Overall certainty of evidence was rated as low to very low due to risk of bias and imprecision. Conclusion This systematic review identified very low and low certainty evidence, almost entirely derived from simulation studies. The studies and their findings were heterogenous but suggest that teaching team competencies can improve resuscitation skills performance and CPR quality, as well as improve team competencies, specifically leadership, communication, decision-making, and task management. Further research is required to understand optimal configuration of team competencies training interventions and to understand the effect on clinical outcomes and cost-effectiveness.
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Affiliation(s)
- Barbara Farquharson
- Faculty of Health Sciences & Sport, University of Stirling, Stirling, United Kingdom
| | - Andrea Cortegiani
- Department of Precision Medicine in Medical Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency. University Hospital Policlinico ’Paolo Giaccone’, Palermo, Italy
| | - Kasper G. Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Denmark
- Department of Anesthesiology and Intensive Care, Randers Regional Hospital, Denmark
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Robert Greif
- Department of Surgical Science, University of Torino, Torino, Italy
- University of Bern, Bern, Switzerland
| | - Sabine Nabecker
- Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, Canada
| | - Education Implementation Team Task Force of the International Liaison Committee on Resuscitation ILCOR1
- Faculty of Health Sciences & Sport, University of Stirling, Stirling, United Kingdom
- Department of Precision Medicine in Medical Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency. University Hospital Policlinico ’Paolo Giaccone’, Palermo, Italy
- Research Center for Emergency Medicine, Aarhus University Hospital, Denmark
- Department of Anesthesiology and Intensive Care, Randers Regional Hospital, Denmark
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, USA
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Surgical Science, University of Torino, Torino, Italy
- University of Bern, Bern, Switzerland
- Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, Canada
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Kneafsey R, Moore A, Palmer S, Szczepura A, Hooper G, Leech C, Turner C, Khan A, Pawar B, Rodrigues Amorim Adegboye A. Tailored leadership training in emergency medicine: qualitative exploration of the impact of the EMLeaders programme on consultants and trainees in England. Emerg Med J 2024; 41:543-550. [PMID: 39009425 DOI: 10.1136/emermed-2023-213868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Emergency medicine (EM) consultants are expected to provide leadership to facilitate optimal clinical results, effective teamwork and learning. To foster leadership skills, the Emergency Medicine Leadership Programme (EMLeaders) was launched in 2018 by the Royal College of Emergency Medicine (RCEM), Health Education England and National Health Service England. A mixed-methods evaluation of EMLeaders was commissioned to assess the impact at the strategic, team and individual levels. This paper reports the qualitative evaluation component. METHODS Qualitative data collected from 2021 to 2022 were drawn from an online survey of RCEM members in England, which included four open questions about leadership training. At the end of the survey, participants were asked to share contact details if willing to undertake an in-depth qualitative interview. Interviews explored perceptions of the programme and impact of curriculum design and delivery. Data were analysed thematically against the Kirkpatrick framework, providing in-depth understanding. RESULTS There were 417 survey respondents, of whom 177 had participated in EMLeaders. Semistructured interviews were completed with 13 EM consultants, 13 trainees and 1 specialty and associate specialist doctor. EMLeaders was highly valued by EM consultants and trainees, particularly group interaction, expert facilitation and face-to-face practical scenario work. Consultant data yielded the themes: we believe in it; EM relevance is key; on a leadership journey; shaping better leaders; and a broken system. Challenges were identified in building engagement within a pressured workplace system and embedding workplace role modelling. Trainees identified behavioural shift in themselves following the programme but wanted more face-to-face discussions with senior colleagues. Key trainee themes included value in being together, storytelling in leadership, headspace for the leadership lens and survival in a state of collapse. CONCLUSION The development of leadership skills in EM is considered important. The EMLeaders programme can support leadership learning but further embedding is needed.
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Affiliation(s)
- Rosie Kneafsey
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Amanda Moore
- Department of Primary Care and Population Health, University College London, London, UK
| | - Shea Palmer
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Ala Szczepura
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Gareth Hooper
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Caroline Leech
- Emergency Department, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Chris Turner
- Emergency Department, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Aanika Khan
- Royal Borough of Kensington and Chelsea, London, UK
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Hanke LI, Vradelis L, Boedecker C, Griesinger J, Demare T, Lindemann NR, Huettl F, Chheang V, Saalfeld P, Wachter N, Wollstädter J, Spranz M, Lang H, Hansen C, Huber T. Immersive virtual reality for interdisciplinary trauma management - initial evaluation of a training tool prototype. BMC MEDICAL EDUCATION 2024; 24:769. [PMID: 39026193 PMCID: PMC11264734 DOI: 10.1186/s12909-024-05764-w] [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: 04/01/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Emergency care of critically ill patients in the trauma room is an integral part of interdisciplinary work in hospitals. Live threatening injuries require swift diagnosis, prioritization, and treatment; thus, different medical specialties need to work together closely for optimal patient care. Training is essential to facilitate smooth performance. This study presents a training tool for familiarization with trauma room algorithms in immersive virtual reality (VR), and a first qualitative assessment. MATERIALS AND METHODS An interdisciplinary team conceptualized two scenarios and filmed these in the trauma room of the University Medical Center Mainz, Germany in 3D-360°. This video content was used to create an immersive VR experience. Participants of the Department of Anesthesiology were included in the study, questionnaires were obtained and eye movement was recorded. RESULTS 31 volunteers participated in the study, of which 10 (32,2%) had completed specialist training in anesthesiology. Participants reported a high rate of immersion (immersion(mean) = 6 out of 7) and low Visually Induced Motion Sickness (VIMS(mean) = 1,74 out of 20). Participants agreed that VR is a useful tool for medical education (mean = 1,26; 1 very useful, 7 not useful at all). Residents felt significantly more secure in the matter after training (p < 0,05), specialist showed no significant difference. DISCUSSION This study presents a novel tool for familiarization with trauma room procedures, which is especially helpful for less experienced residents. Training in VR was well accepted and may be a solution to enhance training in times of low resources for in person training.
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Affiliation(s)
- Laura Isabel Hanke
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Lukas Vradelis
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Christian Boedecker
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Jan Griesinger
- Department of Anesthesiology, University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany
| | - Tim Demare
- Department of Anesthesiology, University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany
| | - Nicola Raphaele Lindemann
- Department of Anesthesiology, University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany
| | - Florentine Huettl
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Vuthea Chheang
- Virtual and Augmented Reality Group, Faculty of Computer Science, Otto-von-Guericke-University, Magdeburg, Germany
| | - Patrick Saalfeld
- Virtual and Augmented Reality Group, Faculty of Computer Science, Otto-von-Guericke-University, Magdeburg, Germany
| | - Nicolas Wachter
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Jochen Wollstädter
- Department of Orthopedics and Trauma Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany
| | - Marike Spranz
- Department of Diagnostic and Interventional Radiology, University Medical Center Johannes Gutenberg-University, Mainz, Germany
| | - Hauke Lang
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Christian Hansen
- Virtual and Augmented Reality Group, Faculty of Computer Science, Otto-von-Guericke-University, Magdeburg, Germany
| | - Tobias Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Johannes Gutenberg-University, Mainz Langenbeckstraße 1, 55131, Mainz, Germany.
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Steinbach TC, Jennerich AL, Çoruh B. Effective Behaviors of Leaders During Clinical Emergencies: A Qualitative Study of Followers' Perspectives. Chest 2024:S0012-3692(24)00685-8. [PMID: 38838955 DOI: 10.1016/j.chest.2024.05.011] [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: 01/18/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND To manage a clinical emergency effectively, physicians need well-developed leadership skills, yet limited structured leadership training is available for critical care trainees. To develop an effective curriculum, leadership competencies first must be defined. RESEARCH QUESTION During clinical emergencies, what leadership behaviors do followers value? STUDY DESIGN AND METHODS We conducted qualitative interviews with members of multidisciplinary critical care teams at a large academic health system, with participants including resident physicians, nurses, and respiratory therapists (N = 15). Thematic analysis was used to categorize leadership behaviors that followers perceived to be effective. RESULTS We identified three themes related to leadership during clinical emergencies: control, collaboration, and common understanding. Participants described behaviors they believed resulted in both effective and ineffective leadership. For effective leaders, control, the most dominant theme, included behaviors that clearly established roles for the leader and followers, allowing the leader to guide care during a clinical emergency. Collaboration referenced the ability of a leader to maintain a collegial environment. Finally, common understanding reflected a leader's ability to manage communication in a way that fostered a shared mental model across team members. INTERPRETATION During clinical emergencies, followers value leaders who assert themselves while also maintaining positive team interaction and encouraging an organized flow of information. Our findings provide a potential framework to develop a leadership curriculum for critical care trainees.
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Affiliation(s)
- Trevor C Steinbach
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Ann L Jennerich
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA
| | - Başak Çoruh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA
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Jurd C, Barr J. Leadership factors for cardiopulmonary resuscitation for clinicians in-hospital; behaviours, skills and strategies: A systematic review and synthesis without meta-analysis. J Clin Nurs 2024. [PMID: 38757400 DOI: 10.1111/jocn.17215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/11/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
AIM To identify leadership factors for clinicians during in-hospital cardiopulmonary resuscitation. DESIGN Systematic review with synthesis without meta-analysis. METHODS The review was guided by SWiM, assessed for quality using CASP and reported with PRISMA. DATA SOURCES Cochrane, EMBASE, PubMed, Medline, Scopus and CINAHL (years of 2013-2023) and a manual reference list search of all included studies. RESULTS A total of 60 papers were identified with three major themes of useful resuscitation leadership; 'social skills', 'cognitive skills and behaviour' and 'leadership development skills' were identified. Main factors included delegating effectively, while being situationally aware of team members' ability and progress during resuscitation, and being empathetic and supportive, yet 'controlling the room' using a hands-off style. Shared decision-making to reduce cognitive load for one leader was shown to improve effective teamwork. Findings were limited by heterogeneity of studies and inconsistently applied tools to measure leadership. CONCLUSION Traditional authoritarian leadership styles are not wanted by team members with preference for shared leadership and collaboration. Balancing this with the need for team members to see leaders in 'control of the room' brings new challenges for leaders and trainers of resuscitation. IMPLICATIONS FOR NURSING PROFESSION All clinicians need effective leadership skills for cardiopulmonary resuscitation in-hospital. Nurses provide first response and ongoing leadership for cardiopulmonary resuscitation. Nurses typically display suitable skills that align with useful resuscitation leader factors. IMPACT What were the main findings? Collaboration rather than an authoritarian approach to leadership is preferred by team members. Nurses are suitable to 'control the room'. Restricting resuscitation team size will manage disruptive behaviour of team members. TRIAL REGISTRATION PROSPERO Registration: CRD42022385630. PATIENT OF PUBLIC CONTRIBUTION No patient of public contribution.
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Affiliation(s)
- Catherine Jurd
- Darling Downs Hospital and Health Service, Kingaroy Hospital, Kingaroy, Queensland, Australia
- Charles Darwin University, Casuarine, Brinkin, Northern Territory, Australia
| | - Jennieffer Barr
- Charles Darwin University, Casuarine, Brinkin, Northern Territory, Australia
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Varghese A, Kumar H, Kathrotia R, Uniyal M, Rao S. High-Fidelity, Indigenously Prepared, Low-Cost Moulage as a Valid Simulation Tool to Improve Trauma Education. Cureus 2024; 16:e57451. [PMID: 38566779 PMCID: PMC10986642 DOI: 10.7759/cureus.57451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/04/2024] Open
Abstract
Background Simulation-based trauma education facilitates repeated practice in a controlled and safer environment for the learner without any risk to the patient's well-being. Moulage contributes to the perception of reality during training using standardized patients. However, the high cost of commercial moulage items is often prohibitive for regular use. This study aimed to assess the effectiveness of indigenously prepared, low-cost moulage as a valid simulation tool to improve trauma education, explore possible replacements of commercial moulage products, and determine their merits and demerits. Methodology Readily available economic items were used to make low-cost moulage on the simulated patients to replicate trauma victims. A cross-sectional design used a pre-validated Modified Moulage Authenticity Rating Scale to collect data from 61 participants of Advanced Trauma Life Support and Advanced Trauma Care for Nurses courses to analyze the effectiveness and fidelity of moulage. Results In total, 54 (89%) participants scored the low-cost moulage to provide high fidelity effectively. The majority of respondents graded the authenticity of moulage as good. Overall, 46 (75%) participants felt moulage injuries were quite realistic. All agreed that the moulage-based simulation offered a good teaching-learning alternative to assess and manage trauma victims. Further, 45 (73%) participants felt they were in an actual clinical situation, and 58 (95%) stated it could help them in their clinical practice. Conclusions Indigenously prepared, low-cost moulage is a feasible and cost-effective means to enhance fidelity in simulation-based trauma education. It can also be a possible replacement for commercial moulage. Further research is needed to rigorously evaluate the effectiveness of indigenously prepared, cost-effective moulage in trauma education to enhance patient care outcomes. This technique can also be easily translated into other simulation-based medical education domains.
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Affiliation(s)
- Arun Varghese
- College of Nursing, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Hemanth Kumar
- Advanced Center of Medical Simulation and Skills, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Rajesh Kathrotia
- Physiology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Madhur Uniyal
- Trauma and Critical Care, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shalinee Rao
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Colman N, Wiltrakis SM, Holmes S, Hwu R, Iyer S, Goodwin N, Mathai C, Gillespie S, Hebbar KB. A comparison of rapid cycle deliberate practice and traditional reflective debriefing on interprofessional team performance. BMC MEDICAL EDUCATION 2024; 24:122. [PMID: 38326900 PMCID: PMC10848365 DOI: 10.1186/s12909-024-05101-1] [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: 08/15/2023] [Accepted: 01/27/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND In simulation-based education, debriefing is necessary to promote knowledge acquisition and skill application. Rapid Cycle Deliberate Practice (RCDP) and Traditional Reflective Debriefing (TRD) are based in learning theories of deliberate practice and reflective learning, respectively. In this study, we compared the effectiveness of TRD versus RCDP on acquisition of conceptual knowledge and teamwork skills among interdisciplinary learners in the pediatric emergency department. METHODS One hundred sixty-four learners including emergency department attending physicians, fellows, nurses, medical technicians, paramedics, and respiratory therapists, participated in 28 in-situ simulation workshops over 2 months. Groups were quasi-randomized to receive RCDP or TRD debriefing. Learners completed a multiple-choice test to assess teamwork knowledge. The TEAM Assessment Tool assessed team performance before and after debriefing. Primary outcomes were teamwork knowledge and team performance. RESULTS Average pre-intervention baseline knowledge assessment scores were high in both groups (TRD mean 90.5 (SD 12.7), RCDP mean 88.7 (SD 15.5). Post-test scores showed small improvements in both groups (TRD mean 93.2 (SD 12.2), RCDP mean 89.9 (SD 13.8), as indicated by effect sizes (ES = 0.21 and 0.09, for TRD and RCDP, respectively). Assessment of team performance demonstrated a significant improvement in mean scores from pre-assessment to post-assessment for all TEAM Assessment skills in both TRD and RCDP arms, based on p-values (all p < 0.01) and effect sizes (all ES > 0.8). While pre-post improvements in TEAM scores were generally higher in the RCDP group based on effect sizes, analysis did not indicate either debriefing approach as meaningfully improved over the other. CONCLUSIONS Our study did not demonstrate that either TRD versus RCDP was meaningfully better in teamwork knowledge acquisition or improving skill application and performance. As such, we propose Reflective Deliberate Practice as a framework for future study to allow learners to reflect on learning and practice in action.
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Affiliation(s)
- Nora Colman
- Department of Pediatrics, Division of Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Susan M Wiltrakis
- Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis, 1 Children's Place, St. Louis, MO, 63110, USA.
| | - Sherita Holmes
- Department of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Ruth Hwu
- Department of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Srikant Iyer
- Department of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | | | - Claire Mathai
- Children's Healthcare of Atlanta, Atlanta, GA, 30329, USA
| | - Scott Gillespie
- Scott Gillespie: Department of Pediatrics, Pediatrics Biostatistics Core, Emory University School of Medicine, Atlanta, GA, USA
| | - Kiran B Hebbar
- Department of Pediatrics, Division of Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
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Subramaniam T, Aznal SSS, Ikram MA. Evolution of Clinical Simulation Training and Pandemic-Led Acceleration: The International Medical University (IMU), Malaysia Journey. MEDICAL SCIENCE EDUCATOR 2024; 34:201-208. [PMID: 38510413 PMCID: PMC10948633 DOI: 10.1007/s40670-023-01916-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 03/22/2024]
Abstract
In many universities, simulation-based learning has finally been inducted as a member of 'the accepted teaching modality community'. This paper is to share the challenges and successes in the journey towards the inclusion of simulation-based learning in the medical curriculum at the authors' university which saw a steep surge during the COVID-19 pandemic. Our teaching and learning that was heavily traditional based went through a dramatic change to adapt to the new norm when the actual environment and patients became out of reach. We followed five factors (5 Fs) that significantly influenced the successful change: fast, force, fellowship, flexibility, and favourable reception.
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Affiliation(s)
- Thiruselvi Subramaniam
- Department of Anaesthesia & Critical Care, International Medical University, Seremban, Negeri Sembilan 70300 Malaysia
| | - Sharifah Sulaiha Syed Aznal
- Department of Obstetrics & Gynaecology. International Medical University, Seremban, Negeri Sembilan 70300 Malaysia
| | - Mohammad Arshad Ikram
- Department of Orthopaedics, International Medical University, 70300 Seremban, Negeri Sembilan Malaysia
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Yartseva MO, Khomiak OV, Avramenko IV. Crisis-ready educational skills of life support in newborns and adults' scenarios: the impact of simulation-based training on student proficiency. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1033-1038. [PMID: 39008594 DOI: 10.36740/wlek202405124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
OBJECTIVE Aim: To assess the impact of multidisciplinary simulation training on the educational outcomes of medical students in the emergency care of adults and newborns and implement changes in the curriculum to master simulation scenarios more. PATIENTS AND METHODS Materials and Methods: To assess the differences in learning outcomes between medical students who study the same curriculum without simulation interventions and those who undergo multidisciplinary emergency care simulation training. A quasi-experimental approach was used to assign students to the Intervention Group or the Control Group. RESULTS Results: According to individual criteria, the lowest scores in both groups were obtained for the stages that required the greatest accuracy and correct technique. After the appropriate cycle of initiation, the results in both groups improved significantly, but the results of students from the first group were significantly higher than those of students from the second group. Despite the absence of a significant difference in the average overall score for the skills, students in the first group significantly improved the accuracy and correctness of the criteria that assess the technical aspects of performance, while students in the second group mainly improved the quality of the descriptive and communicative parts of the practical skill. CONCLUSION Conclusions: We believe that reallocating curricular time to additional hours dedicated to simulation scenarios will better prepare aspiring healthcare professionals for the demanding and dynamic nature of their career, as we continue to increase our understanding of the potential of simulation-based education.
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Affiliation(s)
- Mariia O Yartseva
- POLISH BRANCH (KMU POLISH CAMPUS) OF PRIVATE HIGHER EDUCATION ESTABLISHMENT "KYIV MEDICAL UNIVERSITY", BYTOM, POLAND
| | - Olena V Khomiak
- POLISH BRANCH (KMU POLISH CAMPUS) OF PRIVATE HIGHER EDUCATION ESTABLISHMENT "KYIV MEDICAL UNIVERSITY", BYTOM, POLAND
| | - Iryna V Avramenko
- POLISH BRANCH (KMU POLISH CAMPUS) OF PRIVATE HIGHER EDUCATION ESTABLISHMENT "KYIV MEDICAL UNIVERSITY", BYTOM, POLAND
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Muehlberg J, Tipold A, Heppelmann M, Wissing S. Simulator-Assisted Training of Abomasal Surgery-A Pilot Study Using Blended Learning and Face-to-Face Teaching. Animals (Basel) 2023; 13:3822. [PMID: 38136859 PMCID: PMC10740769 DOI: 10.3390/ani13243822] [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: 10/11/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Two stimulators were developed, one simplified and one realistic, in the present study for learning abomasal surgery for veterinary students. The simulators were tested in a pilot study: The upcoming blended learning format was compared with traditional face-to-face teaching. A total of 21 5th-year students participated in the study. While one group learned the surgical technique in traditional face-to-face simulator training, the second group completed interactive video training asynchronously. Afterwards, skills were examined in person. The results showed that the different groups did not lead to different performance results. Participation in the study increased self-assessment of skills by an average of about 7 of 36 points, as well as the learning success and motivation of students in both groups. The simulators developed were well liked by the students and rated as appropriate by 12 practicing bovine veterinarians. The pilot study indicates that blended learning could be a suitable alternative to traditional face-to-face teaching. This should be followed by further research to support the use of blended learning in the veterinary education of clinical skills.
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Affiliation(s)
- Julia Muehlberg
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Andrea Tipold
- Clinic for Small Animals, Neurology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
| | - Maike Heppelmann
- Clinic for Cattle, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Sandra Wissing
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
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Kelly S, Garner J, Treadway V, Sadera G. Knowledge mobilization in critical care and the evolving communication role of nurses. Nurs Crit Care 2023; 28:913-922. [PMID: 35794068 DOI: 10.1111/nicc.12821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The importance of appropriate communication skills within a health care setting rests upon the need for effective information sharing. When successful, this provides a supportive working environment for staff and has a positive impact on patient care and outcomes. AIMS The purpose of this study was to explore how knowledge/evidence is acquired, shared, and applied in the Critical Care (CC) environment for staff and patients/family members. STUDY DESIGN A qualitative approach was used, consisting of semi-structured interviews and focus groups. Data analysis was conducted using an iterative thematic approach. RESULTS Data collected prior to the COVID-19 pandemic from United Kingdom (UK) critical care workers (N = 46), patients, and family members (N = 21) identified four communication roles performed by the nursing staff: team member; diplomat; translator and friend. CONCLUSIONS It was evident that without suitable training and support, the stresses and demands placed upon the nurses could lead to disenfranchisement and burnout. RELEVANCE TO CLINICAL PRACTICE These findings are relevant and timely given the impact of the pandemic, highlighting the need for accessible and alternate communication strategies to support nurses by reducing stress, moral distress and increasing psychological safety. Improved communication can provide tailored information for staff and patients/family improving the CC experience for all.
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Affiliation(s)
- Sioban Kelly
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Jayne Garner
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Victoria Treadway
- Library and Knowledge Service, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, UK
- NHS England, Leeds, UK
| | - Girendra Sadera
- Department of Critical Care and Anaesthesia, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, UK
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12
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Bijok B, Jaulin F, Picard J, Michelet D, Fuzier R, Arzalier-Daret S, Basquin C, Blanié A, Chauveau L, Cros J, Delmas V, Dupanloup D, Gauss T, Hamada S, Le Guen Y, Lopes T, Robinson N, Vacher A, Valot C, Pasquier P, Blet A. Guidelines on human factors in critical situations 2023. Anaesth Crit Care Pain Med 2023; 42:101262. [PMID: 37290697 DOI: 10.1016/j.accpm.2023.101262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To provide guidelines to define the place of human factors in the management of critical situations in anaesthesia and critical care. DESIGN A committee of nineteen experts from the SFAR and GFHS learned societies was set up. A policy of declaration of links of interest was applied and respected throughout the guideline-producing process. Likewise, the committee did not benefit from any funding from a company marketing a health product (drug or medical device). The committee followed the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based. METHODS We aimed to formulate recommendations according to the GRADE® methodology for four different fields: 1/ communication, 2/ organisation, 3/ working environment and 4/ training. Each question was formulated according to the PICO format (Patients, Intervention, Comparison, Outcome). The literature review and recommendations were formulated according to the GRADE® methodology. RESULTS The experts' synthesis work and application of the GRADE® method resulted in 21 recommendations. Since the GRADE® method could not be applied in its entirety to all the questions, the guidelines used the SFAR "Recommendations for Professional Practice" A means of secured communication (RPP) format and the recommendations were formulated as expert opinions. CONCLUSION Based on strong agreement between experts, we were able to produce 21 recommendations to guide human factors in critical situations.
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Affiliation(s)
- Benjamin Bijok
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France; Pôle de l'Urgence, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France.
| | - François Jaulin
- Président du Groupe Facteurs Humains en Santé, France; Directeur Général et Cofondateur Patient Safety Database, France; Directeur Général et Cofondateur Safe Team Academy, France.
| | - Julien Picard
- Pôle Anesthésie-Réanimation, Réanimation Chirurgicale Polyvalente - CHU Grenoble Alpes, Grenoble, France; Centre d'Evaluation et Simulation Alpes Recherche (CESAR) - ThEMAS, TIMC, UMR, CNRS 5525, Université Grenoble Alpes, Grenoble, France; Comité Analyse et Maîtrise du Risque (CAMR) de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Daphné Michelet
- Département d'Anesthésie-Réanimation du CHU de Reims, France; Laboratoire Cognition, Santé, Société - Université Reims-Champagne Ardenne, France
| | - Régis Fuzier
- Unité d'Anesthésiologie, Institut Claudius Regaud. IUCT-Oncopole de Toulouse, France
| | - Ségolène Arzalier-Daret
- Département d'Anesthésie-Réanimation, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000 Caen, France; Comité Vie Professionnelle-Santé au Travail (CVP-ST) de la Société Française d'Anesthésie-Réanimation (SFAR), France
| | - Cédric Basquin
- Département Anesthésie-Réanimation, CHU de Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France; CHP Saint-Grégoire, Groupe Vivalto-Santé, 6 Bd de la Boutière CS 56816, 35760 Saint-Grégoire, France
| | - Antonia Blanié
- Département d'Anesthésie-Réanimation Médecine Périopératoire, CHU Bicêtre, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France; Laboratoire de Formation par la Simulation et l'Image en Médecine et en Santé (LabForSIMS) - Faculté de Médecine Paris Saclay - UR CIAMS - Université Paris Saclay, France
| | - Lucille Chauveau
- Service des Urgences, SMUR et EVASAN, Centre Hospitalier de la Polynésie Française, France; Maison des Sciences de l'Homme du Pacifique, C9FV+855, Puna'auia, Polynésie Française, France
| | - Jérôme Cros
- Service d'Anesthésie et Réanimation, Polyclinique de Limoges Site Emailleurs Colombier, 1 Rue Victor-Schoelcher, 87038 Limoges Cedex 1, France; Membre Co-Fondateur Groupe Facteurs Humains en Santé, France
| | - Véronique Delmas
- Service d'Accueil des Urgences, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France; CAp'Sim, Centre d'Apprentissage par la Simulation, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France
| | - Danièle Dupanloup
- IADE, Cadre de Bloc, CHU de Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France; Comité IADE de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Tobias Gauss
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU Grenoble Alpes, Grenoble, France
| | - Sophie Hamada
- Université Paris Cité, APHP, Hôpital Européen Georges Pompidou, Service d'Anesthésie Réanimation, F-75015, Paris, France; CESP, INSERM U 10-18, Université Paris-Saclay, France
| | - Yann Le Guen
- Pôle Anesthésie-Réanimation, CHU Grenoble Alpes, Grenoble, France
| | - Thomas Lopes
- Service d'Anesthésie-Réanimation, Hôpital Privé de Versailles, 78000 Versailles, France
| | | | - Anthony Vacher
- Unité Recherche et Expertise Aéromédicales, Institut de Recherche Biomédicale des Armées, Brétigny Sur Orge, France
| | | | - Pierre Pasquier
- 1ère Chefferie du Service de Santé, Villacoublay, France; Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Percy, Clamart, France; École du Val-de-Grâce, Paris, France
| | - Alice Blet
- Lyon University Hospital, Department of Anaesthesiology and Critical Care, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Cancer Research Center of Lyon, Lyon, France
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Dopelt K, Shevach I, Vardimon OE, Czabanowska K, De Nooijer J, Otok R, Leighton L, Bashkin O, Duplaga M, Levine H, MacLeod F, Malowany M, Okenwa-Emegwa L, Zelber-Sagi S, Davidovitch N, Barach P. Simulation as a key training method for inculcating public health leadership skills: a mixed methods study. Front Public Health 2023; 11:1202598. [PMID: 37483956 PMCID: PMC10359821 DOI: 10.3389/fpubh.2023.1202598] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Background Successful management of public health challenges requires developing and nurturing leadership competencies. We aimed to evaluate the effectiveness of training simulations to assess public health leadership and decision-making competencies during emergencies as an effective learning and training method. Methods We examined the effects of two simulation scenarios on public health school students in terms of their experience (compared to face-to-face learning) and new skills acquired for dealing with similar emergent situations in the future. A mixed-methods design included developing a validated and pre-tested questionnaire with open-and closed-ended questions that examined the simulation impact and the degree of student satisfaction with the conditions in which it was conducted. Semi-structured in-depth interviews were conducted with the students after going through the simulations. The questionnaire results were evaluated using descriptive analytics. The interviews were analyzed using thematic analyses. All data were collected during June 2022. Results The questionnaire results indicate that students strengthened their interpersonal communication skills and learned about the importance of listening to the opinions of others before formulating their positions. Four themes emerged from 16 in-depth interviews, according to Kolb's experimental learning cycle. Students emphasized the effectiveness of experiential learning versus traditional classroom learning. The simulation scenarios were felt to realistically convey critical issues regarding leadership, decision-making, and teamwork challenges. They effectively conveyed the importance of building a culture of conducting substantive and respectful discussions. Conclusion Simulation is a powerful pedagogical training tool for public health leadership competencies. Simulations were seen to be advantageous over face-to-face learning in imparting a range of leadership skills and hands-on practice. We recommend integrating simulations in all public health leadership training programs.
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Affiliation(s)
- Keren Dopelt
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Itamar Shevach
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ofek Eliad Vardimon
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Jascha De Nooijer
- Department of Health Promotion, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Robert Otok
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Lore Leighton
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Hagai Levine
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat-Gan, Israel
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel
| | - Fiona MacLeod
- School of Public Health, University College Cork, Cork, Ireland
| | - Maureen Malowany
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel
| | - Leah Okenwa-Emegwa
- Department of Health Sciences, The Swedish Red Cross University (SRCU), Huddinge, Sweden
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat-Gan, Israel
| | - Paul Barach
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- Interdisciplinary Research Institute for Health Law and Science, Sigmund Freud University Vienna, Vienna, Austria
- Department of Surgery, Imperial College School of Medicine, London, United Kingdom
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14
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Rodriguez-Ruiz E, Marcos-Alonso S, Campelo-Izquierdo M, Estany-Gestal A, Rodríguez-Núñez A. Are ICU nurses able to achieve their ventilation goals when bagging a patient? A pilot study. Med Intensiva 2023; 47:298-300. [PMID: 36202745 DOI: 10.1016/j.medine.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/16/2022] [Indexed: 04/29/2023]
Affiliation(s)
- E Rodriguez-Ruiz
- Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain; Simulation, Life Support & Intensive Care Research Unit of Santiago de Compostela (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - S Marcos-Alonso
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain; Pediatrician. Galician Public Health System (SERGAS), A Coruña, Spain
| | - M Campelo-Izquierdo
- Division of Nursing, Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain
| | - A Estany-Gestal
- Epidemiology and Clinical Research Unit, Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
| | - A Rodríguez-Núñez
- Simulation, Life Support & Intensive Care Research Unit of Santiago de Compostela (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain; Paediatric Intensive Care Unit, Department of Pediatrics, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain
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15
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Trauma Quality Improvement and Team Education: How Can We Better Optimize Our Training? CURRENT SURGERY REPORTS 2023. [DOI: 10.1007/s40137-023-00351-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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16
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Strategic Educational Expansion of Trauma Simulation Initiative via a Plan-Do-Study-Act Ramp. West J Emerg Med 2023; 24:76-78. [PMID: 36735012 PMCID: PMC9897251 DOI: 10.5811/westjem.2022.12.57735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/29/2022] [Indexed: 01/28/2023] Open
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Lodemann T, Akçalı E, Fernandez R. Process Modeling of ABCDE Primary Survey in Trauma Resuscitations: A Crucial First Step for Agent-Based Simulation Modeling of Complex Team-Based Clinical Processes. Simul Healthc 2022; 17:425-432. [PMID: 34934025 PMCID: PMC9273801 DOI: 10.1097/sih.0000000000000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Trauma teams are ad hoc, multidisciplinary teams that perform complex patient care and medical decision making under dynamic conditions. The ability to measure and thus understand trauma team processes is still limited. Agent-based simulation modeling (ABSM) can be used to investigate complex relationships and performance within a trauma team. However, the foundational work to support such efforts is lacking. The goal of this work is to develop a comprehensive process model for the primary survey in trauma that can support ABSM. METHODS A process model for the primary survey of patients with blunt traumatic injuries was developed using Advanced Trauma Life Support guidelines and peer-reviewed publications. This model was then validated using video recordings of 25 trauma resuscitations in a level 1 trauma center. The assessment and treatment pathway followed in each video were mapped against the defined pathway in the process model. Deviations were noted when resuscitations performance did not follow the defined pathway. RESULTS Overall the process model contains 106 tasks and 78 decision points across all domains, with the largest number appearing in the circulation domain, followed by airway and breathing. A total of 34 deviations were observed across all 25 videos, and a maximum of 3 deviations were observed per video. CONCLUSIONS Overall, our data offered validity support for the blunt trauma primary survey process model. This process model was an important first step for the use of ABSM for the support of trauma care operations and team-based processes.
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Affiliation(s)
- Tobias Lodemann
- Department of Industrial & Systems Engineering, College of Engineering, University of Florida, Gainesville, FL
| | - Elif Akçalı
- Department of Industrial & Systems Engineering, College of Engineering, University of Florida, Gainesville, FL
| | - Rosemarie Fernandez
- Center for Experiential Learning and Simulation and Department of Emergency Medicine, University of Florida, Gainesville, FL
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18
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Yau AA, Cortez P, Auguste BL. The Physician Leader: Teaching Leadership in Medicine. Adv Chronic Kidney Dis 2022; 29:539-545. [PMID: 36371119 DOI: 10.1053/j.ackd.2022.08.002] [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: 03/03/2022] [Revised: 07/21/2022] [Accepted: 08/25/2022] [Indexed: 11/11/2022]
Abstract
An integral part of a physician's practice includes being a leader, especially as there is a strong need for skilled leaders to advocate and navigate patient-centered and organizational outcomes. Nephrologists undertake multiple leadership roles, but dedicated leadership training is lacking in medical and postgraduate education. Given the growing need for physician leaders, practitioners in nephrology and beyond must become better equipped in understanding the role of leadership skills in medical practice. Nephrology and the medical community as a whole should focus on intentional and dedicated leadership in medical education training to better groom physicians for leadership roles. In this paper, we define and discuss the components and styles of leadership. We further propose cognitive models that allow one to apply leadership theory in common practice.
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Affiliation(s)
- Amy A Yau
- Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, OH.
| | | | - Bourne L Auguste
- Division of Nephrology, University of Toronto, Toronto, ON, Canada; Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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19
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Cassidy DJ, Jogerst K, Coe T, Monette D, Sell N, Eurboonyanum C, Hamdi I, Sampson M, Petrusa E, Stearns D, Gee DW, Chyn A, Saillant N, Takayesu JK. Simulation versus reality: what can interprofessional simulation teach us about team dynamics in the trauma bay? GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 1:56. [PMID: 38013715 PMCID: PMC9614190 DOI: 10.1007/s44186-022-00063-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/08/2022]
Abstract
Purpose Surgical consultation and the joint management of trauma patients is a common scenario in the emergency department. The goal of this study was to utilize interprofessional trauma team training to understand the role of simulation and its impact on the overall culture of trauma-related care. Methods Interdisciplinary trauma simulation scenarios were completed by 12 groups of emergency medicine residents, general surgery residents, and emergency medicine nurses across two academic years. Following each simulation, a debriefing session was held to reflect on the scenario, focusing on team interactions. Debriefing sessions were audio-recorded, transcribed, deidentified, and independently, inductively coded by two members of the research team. Using the constant comparative method, a codebook was developed and refined until interrater reliability was confirmed with a kappa of > 0.9. Codes were organized into higher level themes. Results There were 72 participants, including 23 general surgery residents, 19 emergency medicine residents, and 30 emergency medicine nurses. 214 primary codes were collapsed into 29 coding categories, with 6 emerging themes. Pre-trauma bay impact describes how interactions prior to the trauma scenario can impact how team members communicate, trust one another, and ultimately care for the patient. Role and team identity explores the importance of one knowing their individual role in the trauma bay and how it impacts overall team identity. Resource allocation describes the balance of having appropriate resources to efficiently care for patients while not negatively impacting crowd control or role identity. Impact of the simulation experience highlights the impact of the lower stakes simulation scenario on learning and reflection as well as concerns with simulation fidelity. Trauma leader traits and actions outlines inherent traits and learned actions of trauma leaders that impact how the trauma scenario unfolds. Interprofessional team performance describes the overall performance of the trauma team, including but not limited to the type of communication used, teamwork behaviors, and transition of care of the patient. Conclusions Interdisciplinary trauma simulations and structured debriefing sessions provide insights into team dynamics and interprofessional relationships. Simulations and debriefing sessions can promote understanding, respect, and familiarity of team members' roles; recognition of key characteristics of high functioning leaders and teams; and discovery of conflict mitigating strategies for future interdisciplinary team improvement. Simulation sessions allow implementation of quality improvement measures and communication and leadership strategy practice in a safe, collaborative learning environment. The lessons learned from these sessions can encourage participants to reexamine how they interact and function as a team within the real-life trauma bay.
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Affiliation(s)
| | - Kristen Jogerst
- Department of Surgery, Mayo Clinic Hospital, Phoenix, AZ USA
| | - Taylor Coe
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Derek Monette
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA USA
| | - Naomi Sell
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | | | - Isra Hamdi
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Michael Sampson
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Dana Stearns
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA USA
| | - Denise W. Gee
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Angela Chyn
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA USA
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, MA USA
| | - James K. Takayesu
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA USA
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Silva JAM, Mininel VA, Fernandes Agreli H, Peduzzi M, Harrison R, Xyrichis A. Collective leadership to improve professional practice, healthcare outcomes and staff well-being. Cochrane Database Syst Rev 2022; 10:CD013850. [PMID: 36214207 PMCID: PMC9549469 DOI: 10.1002/14651858.cd013850.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Collective leadership is strongly advocated by international stakeholders as a key approach for health service delivery, as a response to increasingly complex forms of organisation defined by rapid changes in health technology, professionalisation and growing specialisation. Inadequate leadership weakens health systems and can contribute to adverse events, including refusal to prioritise and implement safety recommendations consistently, and resistance to addressing staff burnout. Globally, increases in life expectancy and the number of people living with multiple long-term conditions contribute to greater complexity of healthcare systems. Such a complex environment requires the contribution and leadership of multiple professionals sharing viewpoints and knowledge. OBJECTIVES: To assess the effects of collective leadership for healthcare providers on professional practice, healthcare outcomes and staff well-being, when compared with usual centralised leadership approaches. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and two trials registers on 5 January 2021. We also searched grey literature, checked references for additional citations and contacted study authors to identify additional studies. We did not apply any limits on language. SELECTION CRITERIA Two groups of two authors independently reviewed, screened and selected studies for inclusion; the principal author was part of both groups to ensure consistency. We included randomised controlled trials (RCTs) that compared collective leadership interventions with usual centralised leadership or no intervention. DATA COLLECTION AND ANALYSIS Three groups of two authors independently extracted data from the included studies and evaluated study quality; the principal author took part in all groups. We followed standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS We identified three randomised trials for inclusion in our synthesis. All studies were conducted in acute care inpatient settings; the country settings were Canada, Iran and the USA. A total of 955 participants were included across all the studies. There was considerable variation in participants, interventions and measures for quantifying outcomes. We were only able to complete a meta-analysis for one outcome (leadership) and completed a narrative synthesis for other outcomes. We judged all studies as having an unclear risk of bias overall. Collective leadership interventions probably improve leadership (3 RCTs, 955 participants). Collective leadership may improve team performance (1 RCT, 164 participants). We are uncertain about the effect of collective leadership on clinical performance (1 RCT, 60 participants). We are uncertain about the intervention effect on healthcare outcomes, including health status (inpatient mortality) (1 RCT, 60 participants). Collective leadership may slightly improve staff well-being by reducing work-related stress (1 RCT, 164 participants). We identified no direct evidence concerning burnout and psychological symptoms. We are uncertain of the intervention effects on unintended consequences, specifically on staff absence (1 RCT, 60 participants). AUTHORS' CONCLUSIONS: Collective leadership involves multiple professionals sharing viewpoints and knowledge with the potential to influence positively the quality of care and staff well-being. Our confidence in the effects of collective leadership interventions on professional practice, healthcare outcomes and staff well-being is moderate in leadership outcomes, low in team performance and work-related stress, and very low for clinical performance, inpatient mortality and staff absence outcomes. The evidence was of moderate, low and very low certainty due to risk of bias and imprecision, meaning future evidence may change our interpretation of the results. There is a need for more high-quality studies in this area, with consistent reporting of leadership, team performance, clinical performance, health status and staff well-being outcomes.
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Affiliation(s)
| | | | | | - Marina Peduzzi
- Professional Orientation Department, University of Sao Paulo, Sao Paulo, Brazil
| | - Reema Harrison
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Olenick J, Dishop C. Clarifying dynamics for organizational research and interventions: A diversity example. ORGANIZATIONAL PSYCHOLOGY REVIEW 2022. [DOI: 10.1177/20413866221112427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interventions backfire for many reasons, one being that the dynamics governing a system are not well-understood. To better explain organizational phenomena, and to intervene in ways that yield desired consequences, an appreciation of the core insights from dynamics may be necessary to include into a researcher's toolkit. Although substantial buzz surrounds the term dynamics in organizational science, conceptual missteps are present in the literature, ultimately limiting its application. We provide a coherent description of what dynamics encompasses by (1) advancing a definition and of dynamics and comparing it to other longitudinal concepts, (2) proposing theoretical principles to help researchers apply dynamics concepts to their own research, and (3) demonstrating how dynamics may refine our ability to explain organizational phenomena and devise practical implications. Plain Language Summary Organizational researchers and practitioners are faced with many complex issues and understanding how they unfold over time is difficult. Those difficulties often lead to unexpected results when we try to address those issues. Viewing organizations from a more dynamic lens can shed light on how phenomena evolve over time as governed by the iterative application of mathematical rules. Illumination of dynamics can assist with better targeting interventions and understanding their potential effects. A dynamics lens also emphasizes continuing needs to improve research methods, such as collecting longitudinal data and engaging in computational modeling. To illustrate these points, we discuss how diversity interventions in organizations may be better understood once dynamics are applied. For example, organizations wishing to improve the diversity of their work forces must focus both on why underrepresented groups enter the organization and why they might leave. Focus on only one or the other is unlikely to generate the desired effect. Once identifying the drivers of both entering and leaving and how those factors might reinforce each other, interventions to improve diversity might be better targeted.
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Affiliation(s)
- Jeffrey Olenick
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Christopher Dishop
- Tepper School of Business, Carnegie Mellon University, Pittsburgh, PA, USA
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Davies AJ, Shepherd I, Leigh E. Enhancing leadership training in health services - an evidence-based practice-oriented approach. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 35766369 DOI: 10.1108/lhs-04-2022-0040] [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: 11/17/2022]
Abstract
PURPOSE Globally, private and public organisations invest ever increasing amounts of money, time and effort to develop leadership capabilities in current and future leaders. Whilst such investment results in benefits for some, the full value of developmental strategies on offer is not always realised. Challenges inhibiting achievement of full value include struggling to identify learning programs that best fit with the organisational structure, culture, mission and vision and difficulties in maximising engagement of personnel at multiple levels of the management structure. DESIGN/METHODOLOGY/APPROACH The purpose of this study is to introduce a pathway for health services to develop and embed simulation-based educational strategies that provide targeted learning for leaders and teams. Aligning this approach to leadership development through presentation of case studies in which the model has been applied illustrates the pathway for application in the health-care sector. FINDINGS The findings of the approach to leadership development are presented through the presentation of a case study illustrating application of the ADELIS model to simulation-based learning. PRACTICAL IMPLICATIONS The ADELIS model, outlined in this study, provides a guide for creating customised and flexible learning designs that apply simulation-based learning, enabling organisations to develop and provide leadership training for individuals, units and teams that is appropriately fit for purpose. ORIGINALITY/VALUE The key contribution to health-care leadership development offered in this study is the rationale for using simulation-based learning accompanied by a model and pathway for creating such a pedagogical approach, which embraces the reality of workplace circumstances.
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Affiliation(s)
| | - Irwyn Shepherd
- Virtual and Augmented Reality Services (VARS) Unit, Monash University, Melbourne, Australia
| | - Elyssebeth Leigh
- Department of Education, University of Technology Sydney City Campus, Broadway, Australia
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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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Hansen M, Harrod T, Bahr N, Schoonover A, Adams K, Kornegay J, Stenson A, Ng V, Plitt J, Cooper D, Scott N, Chinai S, Johnson J, Conlon LW, Salva C, Caretta-Weyer H, Huynh T, Jones D, Jorda K, Lo J, Mayersak R, Paré E, Hughes K, Ahmed R, Patel S, Tsao S, Wang E, Ogburn T, Guise JM. The Effects of Leadership Curricula With and Without Implicit Bias Training on Graduate Medical Education: A Multicenter Randomized Trial. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:696-703. [PMID: 34966032 DOI: 10.1097/acm.0000000000004573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine whether a brief leadership curriculum including high-fidelity simulation can improve leadership skills among resident physicians. METHOD This was a double-blind, randomized controlled trial among obstetrics-gynecology and emergency medicine (EM) residents across 5 academic medical centers from different geographic areas of the United States, 2015-2017. Participants were assigned to 1 of 3 study arms: the Leadership Education Advanced During Simulation (LEADS) curriculum, a shortened Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum, or as active controls (no leadership curriculum). Active controls were recruited from a separate site and not randomized to limit any unintentional introduction of materials from leadership curricula. The LEADS curriculum was developed in partnership with the Council on Resident Education in Obstetrics and Gynecology and Council of Residency Directors in Emergency Medicine as a novel way to provide a leadership toolkit. Both LEADS and the abbreviated TeamSTEPPS were designed as six 10-minute interactive web-based modules.The primary outcome of interest was the leadership performance score from the validated Clinical Teamwork Scale instrument measured during standardized high-fidelity simulation scenarios. Secondary outcomes were 9 key components of leadership from the detailed leadership evaluation measured on 5-point Likert scales. Both outcomes were rated by a blinded clinical video reviewer. RESULTS One hundred ten obstetrics-gynecology and EM residents participated in this 2-year trial. Participants in both LEADS and TeamSTEPPS had statistically significant improvement in leadership scores from "average" to "good" ranges both immediately and at the 6-month follow-up, while controls remained unchanged in the "average" category throughout the study. There were no differences between LEADS and TeamSTEPPS curricula with respect to the primary outcome. CONCLUSIONS Residents who participated in a brief structured leadership training intervention had improved leadership skills that were maintained at 6-month follow-up.
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Affiliation(s)
- Matt Hansen
- M. Hansen is associate professor of emergency medicine and pediatrics, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Tabria Harrod
- T. Harrod is senior research associate, Department of Obstetrics and Gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Nathan Bahr
- N. Bahr is senior research associate, Department of Obstetrics and Gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Amanda Schoonover
- A. Schoonover is senior research assistant, Department of Obstetrics and Gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Karen Adams
- K. Adams is professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Josh Kornegay
- J. Kornegay is associate professor of emergency medicine, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Amy Stenson
- A. Stenson is associate professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Vivienne Ng
- V. Ng is assistant professor of emergency medicine, The University of Arizona College of Medicine, Tucson, Arizona
| | - Jennifer Plitt
- J. Plitt is assistant clinical professor of emergency medicine, The University of Arizona College of Medicine, Tucson, Arizona
| | - Dylan Cooper
- D. Cooper is professor of clinical emergency medicine, Indiana University School of Medicine, Bloomington, Indiana
| | - Nicole Scott
- N. Scott is assistant professor of clinical obstetrics and gynecology, Indiana University School of Medicine, Bloomington, Indiana
| | - Sneha Chinai
- S. Chinai is assistant professor of emergency medicine, University of Massachusetts Chan Medical School, Boston, Massachusetts
| | - Julia Johnson
- J. Johnson is professor of obstetrics and gynecology, University of Massachusetts Chan Medical School, Boston, Massachusetts
| | - Lauren Weinberger Conlon
- L.W. Conlon is assistant professor of emergency medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Catherine Salva
- C. Salva is associate professor of clinical obstetrics and gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Holly Caretta-Weyer
- H. Caretta-Weyer is assistant director, Emergency Medicine Residency Program, Stanford University School of Medicine, Stanford, California
| | - Trang Huynh
- T. Huynh is associate professor of pediatrics, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - David Jones
- D. Jones is associate professor of emergency medicine, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Katherine Jorda
- K. Jorda is assistant professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Jamie Lo
- J. Lo is assistant professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Ryanne Mayersak
- R. Mayersak is assistant professor of emergency medicine, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Emmanuelle Paré
- E. Paré is associate professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
| | - Kate Hughes
- K. Hughes is assistant professor of emergency medicine, The University of Arizona College of Medicine, Tucson, Arizona
| | - Rami Ahmed
- R. Ahmed is professor of emergency medicine, Indiana University School of Medicine, Bloomington, Indiana
| | - Soha Patel
- S. Patel is assistant professor of obstetrics and gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Suzana Tsao
- S. Tsao is associate professor of emergency medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Eileen Wang
- E. Wang is professor of obstetrics and gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tony Ogburn
- T. Ogburn is professor and chair of obstetrics and gynecology, University of Texas Rio Grande Valley School of Medicine, Edinburgh, Texas
| | - Jeanne-Marie Guise
- J.-M. Guise is professor of obstetrics and gynecology, Oregon Health & Science University School of Medicine, Portland, Oregon
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Maarseveen OECV, Ham WHW, Huijsmans RLN, Leenen LPH. The pace of a trauma resuscitation: experience matters. Eur J Trauma Emerg Surg 2022; 48:2503-2510. [PMID: 35141771 PMCID: PMC9192480 DOI: 10.1007/s00068-021-01838-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022]
Abstract
Purpose Resuscitation quality and pace depend on effective team coordination, which can be facilitated by adequate leadership. Our primary aim was to assess the influence of trauma team leader experience on resuscitation pace. Second, we investigated the influence of injury severity on resuscitation pace. Methods The trauma team leaders were identified (Staff trauma surgeon vs Fellow trauma surgeon) and classified from video analysis during a 1-week period. Resuscitations were assessed for time to the treatment plan, total resuscitation time, and procedure time. Furthermore, patient and resuscitation characteristics were assessed and compared: age, gender, Injury Severity Score, Glasgow Coma Scale < 9, and the number (and duration) of surgical procedures during initial resuscitation. Correlations between total resuscitation time, Injury Severity Score, and time to treatment plan were calculated. Results After adjustment for the time needed for procedures, the time to treatment plan and total resuscitation time was significantly shorter in resuscitations led by a Staff trauma surgeon compared to a Fellow trauma surgeon (median 648 s (IQR 472–813) vs 852 s (IQR 694–1256); p 0.01 resp. median 1280 s (IQR 979–1494) vs 1535 s (IQR 1247–1864), p 0.04). Surgical procedures were only performed during resuscitations led by Staff trauma surgeons (4 thorax drains, 1 endotracheal intubation, 1 closed fracture reduction). Moreover, a significant negative correlation (r: – 0.698, p < 0.01) between Injury Severity Score and resuscitation time was found. Conclusion Experienced trauma team leaders may positively influence the pace of the resuscitation. Moreover, we found that the resuscitation pace increases when the patient is more severely injured.
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Affiliation(s)
- Oscar E C van Maarseveen
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Wietske H W Ham
- Emergency Department, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Institute of Nursing Studies, University of Applied Science, Heidelberglaan 7, 3584 CS, Utrecht, The Netherlands
| | - Roel L N Huijsmans
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Luke P H Leenen
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Al Ani A, Riad Z, Ahmed H, Aboughosiba H, Abuhussein N, Abdulhakim H, Kabeer N, Ibrahim M, Atasi A, Banday V, Makki M, Tamer A, Qassem N. Trauma team training: A key to success. HAMDAN MEDICAL JOURNAL 2022. [DOI: 10.4103/hmj.hmj_40_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Evans JC, Evans MB, Slack M, Peddle M, Lingard L. Examining non-technical skills for ad hoc resuscitation teams: a scoping review and taxonomy of team-related concepts. Scand J Trauma Resusc Emerg Med 2021; 29:167. [PMID: 34863278 PMCID: PMC8642998 DOI: 10.1186/s13049-021-00980-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022] Open
Abstract
Background Non-technical skills (NTS) concepts from high-risk industries such as aviation have been enthusiastically applied to medical teams for decades. Yet it remains unclear whether—and how—these concepts impact resuscitation team performance. In the context of ad hoc teams in prehospital, emergency department, and trauma domains, even less is known about their relevance and impact. Methods This scoping review, guided by PRISMA-ScR and Arksey & O’Malley’s framework, included a systematic search across five databases, followed by article selection and extracting and synthesizing data. Articles were eligible for inclusion if they pertained to NTS for resuscitation teams performing in prehospital, emergency department, or trauma settings. Articles were subjected to descriptive analysis, coherence analysis, and citation network analysis. Results Sixty-one articles were included. Descriptive analysis identified fourteen unique non-technical skills. Coherence analysis revealed inconsistencies in both definition and measurement of various NTS constructs, while citation network analysis suggests parallel, disconnected scholarly conversations that foster discordance in their operationalization across domains. To reconcile these inconsistencies, we offer a taxonomy of non-technical skills for ad hoc resuscitation teams. Conclusion This scoping review presents a vigorous investigation into the literature pertaining to how NTS influence optimal resuscitation performance for ad hoc prehospital, emergency department, and trauma teams. Our proposed taxonomy offers a coherent foundation and shared vocabulary for future research and education efforts. Finally, we identify important limitations regarding the traditional measurement of NTS, which constrain our understanding of how and why these concepts support optimal performance in team resuscitation. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00980-5.
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Affiliation(s)
- J Colin Evans
- Division of Emergency Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - M Blair Evans
- Department of Psychology, Western University, London, ON, Canada
| | - Meagan Slack
- Middlesex-London Paramedic Service, London, ON, Canada
| | - Michael Peddle
- Division of Emergency Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lorelei Lingard
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Singas E, Quintero LD, Dhar S, Tsegaye A, Finuf K, Pekmezaris R, Weitzen MS, Mayo PH. Training Pulmonary Critical Care Medicine Fellows in Thoracentesis Using a Head-Mounted Video Camera. ATS Sch 2021; 2:632-641. [PMID: 35079742 PMCID: PMC8749010 DOI: 10.34197/ats-scholar.2021-0052in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Determination of competence to perform procedures during pulmonary critical care medicine fellowship training has traditionally been based on subjective faculty opinion and numerical requirements. OBJECTIVE To describe an objective means of assessing competence of fellows to perform thoracentesis using a head-mounted video camera with offline scoring of the thoracentesis performed on an actual patient. METHODS To test competence in performance of thoracentesis after a multimodality training program, a total of eight first-year fellows performed a thoracentesis on an actual patient while recording the procedure with a lightweight head-mounted video camera in 2017 and 2018. The recordings were scored offline by two faculty members using a 30-point checklist. The percentage agreement between scorers was measured, as was the opinion of the fellows and the scorers on the testing process. If a fellow failed completion of all checklist items, they were provided with further training and retested to assure competence. As part of their training, fellows reviewed the video record of their procedures. RESULTS Eight first-year fellows were tested, of whom seven successfully completed key checklist items as determined by the video scorers. One failing fellow passed after further training and testing. The percentage agreement between the scorers was high, and fellows indicated that the video device was useful for training. CONCLUSION This study supports the use of video-based testing for assessment of competence and for training in performance of thoracentesis by fellows.
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Affiliation(s)
- Effie Singas
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | | | - Sean Dhar
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Adey Tsegaye
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Kayla Finuf
- Division of Health Services Research, Center for Health Innovations and Outcomes Research, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, New Hyde Park, New York
| | - Renee Pekmezaris
- Division of Health Services Research, Center for Health Innovations and Outcomes Research, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, New Hyde Park, New York
| | - Maya S. Weitzen
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Paul H. Mayo
- Division of Pulmonary, Critical Care and Sleep Medicine, and
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Rosenman ED, Misisco A, Olenick J, Brolliar SM, Chipman AK, Vrablik MC, Chao GT, Kozlowski SWJ, Grand JA, Fernandez R. Does team leader gender matter? A Bayesian reconciliation of leadership and patient care during trauma resuscitations. J Am Coll Emerg Physicians Open 2021; 2:e12348. [PMID: 33532754 PMCID: PMC7823088 DOI: 10.1002/emp2.12348] [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: 10/25/2020] [Revised: 11/24/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians. METHODS We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma activation criteria. Two video-recorded observations for each participant were coded for team leadership quality and patient care by 2 sets of raters. Raters were balanced with regard to gender and were blinded to study hypotheses. We used Bayesian regression to determine whether our data supported gender-based advantages in team leadership. RESULTS A total of 60 participants and 120 video recorded observations were included. The modal relationship between gender and team leadership (β = 0.94, 95% highest density interval [HDI], -.68 to 2.52) and gender and patient care (β = 2.42, 95% HDI, -2.03 to 6.78) revealed a weak positive effect for female leaders on both outcomes. Gender-based advantages to team leadership and clinical care were not conclusively supported or refuted, with the exception of rejecting a strong male advantage to team leadership. CONCLUSIONS We prospectively measured team leadership and clinical care during patient care. Our findings do not support differences in trauma resuscitation team leadership or clinical care based on the gender of the team leader.
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Affiliation(s)
| | - Anthony Misisco
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Jeffrey Olenick
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
- Department of PsychologyOld Dominion UniversityNorfolkVirginia
| | - Sarah M. Brolliar
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Anne K. Chipman
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Marie C. Vrablik
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Georgia T. Chao
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
- Department of PsychologyUniversity of South FloridaTampaFlorida
| | - Steve W. J. Kozlowski
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
- Department of PsychologyUniversity of South FloridaTampaFlorida
| | - James A. Grand
- Department of PsychologyUniversity of MarylandCollege ParkMarylandUSA
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Kelley MN, Mercurio L, Tsao HS, Toomey V, Carillo M, Brown L, Wing R. Excellence in Communication and Emergency Leadership (ExCEL): Pediatric Primary and Secondary Survey in Trauma Workshop for Residents. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11079. [PMID: 33501375 PMCID: PMC7821439 DOI: 10.15766/mep_2374-8265.11079] [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: 05/11/2020] [Accepted: 10/06/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Unintentional traumatic injury remains the leading cause of pediatric death in the United States. There is wide variation in the assessment and management of pediatric trauma patients in emergency departments. Resident education on trauma evaluation and management is lacking. This workshop focused on developing resident familiarity with the primary and secondary trauma survey in pediatric patients. METHODS This hands-on workshop utilized patient-actors and low-fidelity simulators to instruct learners on the initial assessment of trauma patients during the primary and secondary trauma surveys. It was designed for residents across all levels of training who care for pediatric trauma patients (including pediatrics, medicine-pediatrics, emergency medicine, and family medicine) and adapted for different session durations and learner group sizes. RESULTS Eighteen residents participated in this workshop at two separate institutions. Participants strongly agreed that the workshop was relevant and effective in teaching the initial primary and secondary trauma survey assessment of pediatric trauma patients. Residents also reported high levels of confidence in performing a primary and secondary trauma survey after participation in the workshop. DISCUSSION This workshop provided residents with instruction and practice in performing the primary and secondary trauma survey for injured pediatric patients. Additional instruction is needed on assigning Glasgow Coma Scale and AVPU (alert, voice, pain, unresponsive) scores to injured patients. The structure and time line of this curriculum can be adapted to the needs of an individual institution's program and the number of workshop participants.
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Affiliation(s)
- Mariann Nocera Kelley
- Assistant Professor, Departments of Pediatrics and Emergency Medicine/Traumatology, Division of Pediatric Emergency Medicine, University of Connecticut School of Medicine and Connecticut Children's; Director of Simulation Education, University of Connecticut School of Medicine
| | - Laura Mercurio
- Fellow, Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital
| | - Hoi See Tsao
- Fellow, Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital
| | - Vanessa Toomey
- Clinical Fellow, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School and Boston Children's Hospital
| | - Marie Carillo
- Fellow, Department of Cardiology, Children's National Hospital
| | - Linda Brown
- Associate Professor, Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Vice Chair of Pediatric Emergency Medicine, Hasbro Children's Hospital; Director, Lifespan Medical Simulation Center
| | - Robyn Wing
- Assistant Professor, Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Director of Pediatric Simulation, Lifespan Medical Simulation Center
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Brown KM, Hunt EA, Duval-Arnould J, Shilkofski NA, Budhathoki C, Ruddy T, Perretta JS, Keslin AN, Stella A, Slattery JM, Nelson-McMillian K. Pediatric Critical Care Simulation Curriculum: Training Nurse Practitioners to Lead in the Management of Critically Ill Children. J Pediatr Health Care 2020; 34:584-590. [PMID: 32883581 DOI: 10.1016/j.pedhc.2020.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Acute care pediatric nurse practitioners have become frontline providers in the critical care environment and are expected to provide leadership in acutely critical situations. We describe a 2-day, high-fidelity, simulation-based curriculum focused on training the pediatric nurse practitioners for leadership in critical care scenarios. METHOD This prospective pre-post interventional study used simulation-based pedagogy. Knowledge tests, time-to-task, and a follow-up survey were used to determine the effectiveness of the training. RESULTS Participants (n = 23) improved their knowledge scores by 27% (pretest: 35.2% [standard deviation = 12.1%]; posttest: 62.2% [standard deviation = 13.8%], p < .001). In addition, time-to-task for resuscitation variables improved significantly. At 3 months, 100% of the participants who responded either agreed (15.4%) or strongly agreed (84.6%) that the boot camp prepared them to lead in a critical emergency. DISCUSSION Simulation-based training is an effective strategy for educating critical care pediatric nurse practitioners and improves their ability to manage pediatric emergencies rapidly, which can be lifesaving.
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Wilson S, Rixon A, Hartanto S, White P, Judkins S. Review article: Systematic literature review of leadership in emergency departments. Emerg Med Australas 2020; 32:935-952. [PMID: 33089650 DOI: 10.1111/1742-6723.13658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 01/04/2023]
Abstract
Emergency medicine (EM) is a discipline with complex leadership demands. However, studies of EM physician leadership and ED leadership are in their infancy. As such, there is a lack of clarity about the forms, antecedents, enablers, barriers and consequences of EM physician leadership. A systematic review of the scientific literature was conducted to reveal the different conceptualisations of EM physician leadership, the activities involved in the practice of leadership, and the knowledge and skills of effective ED leaders. Seven databases were systematically searched for peer-reviewed empirical studies on the topic of EM physicians carrying out a manager or leadership role in an ED setting. Finally, 26 articles were included, and their findings were synthesised and analysed narratively. Two conceptualisations of EM physician leadership were found, reflecting clinical leadership and medical leadership, respectively. Clinical leadership is performed by all EM physicians, often informally, within their daily clinical practice, whereas medical leadership is performed by EM physicians who work at the management level within a hospital, in addition to or instead of their clinical practice. The focus of EM physician leadership and ED leadership research is team leadership, with much less attention given to wider organisation leadership. Consistent with the focus on team leadership, clinical knowledge and skill in orchestrating teams, especially trauma and resuscitation teams, emerged as the most important factors underpinning leadership effectiveness. Future research and training should make better use of existing leadership theory and research designs to illuminate the forms, dynamics, antecedents, moderators and consequences of EM physician leadership.
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Affiliation(s)
- Samuel Wilson
- Department of Management and Marketing, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Andrew Rixon
- Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Stephanie Hartanto
- Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Peter White
- Australasian College for Emergency Medicine, Melbourne, Victoria, Australia
| | - Simon Judkins
- Australasian College for Emergency Medicine, Melbourne, Victoria, Australia
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Kilpatrick K, Paquette L, Jabbour M, Tchouaket E, Fernandez N, Al Hakim G, Landry V, Gauthier N, Beaulieu MD, Dubois CA. Systematic review of the characteristics of brief team interventions to clarify roles and improve functioning in healthcare teams. PLoS One 2020; 15:e0234416. [PMID: 32520943 PMCID: PMC7286504 DOI: 10.1371/journal.pone.0234416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/25/2020] [Indexed: 11/18/2022] Open
Abstract
AIM Describe brief (less than half a day) interventions aimed at improving healthcare team functioning. METHODS A systematic review on brief team interventions aimed at role clarification and team functioning (PROSPERO Registration Number: CRD42018088922). Experimental or quasi-experimental studies were included. Database searches included CINAHL, Medline, EMBASE, PUBMED, Cochrane, RCT Registry-1990 to April 2020 and grey literature. Articles were screened independently by teams of two reviewers. Risk of bias was assessed. Data from the retained articles were extracted by one reviewer and checked by a second reviewer independently. A narrative synthesis was undertaken. RESULTS Searches yielded 1928 unique records. Final sample contained twenty papers describing 19 studies, published between 2009 and 2020. Studies described brief training interventions conducted in acute care in-patient settings and included a total of 6338 participants. Participants' socio-demographic information was not routinely reported. Studies met between two to six of the eight risk of bias criteria. Interventions included simulations for technical skills, structured communications and speaking up for non-technical skills and debriefing. Debriefing sessions generally lasted between five to 10 minutes. Debriefing sessions reflected key content areas but it was not always possible to determine the influence of the debriefing session on participants' learning because of the limited information reported. DISCUSSION Interest in short team interventions is recent. Single two-hour sessions appear to improve technical skills. Three to four 30- to 60-minute training sessions spread out over several weeks with structured facilitation and debriefing appear to improve non-technical skills. Monthly meetings appear to sustain change over time. CONCLUSION Short team interventions show promise to improve team functioning. Effectiveness of interventions in primary care and the inclusion of patients and families needs to be examined. Primary care teams are structured differently than teams in acute care and they may have different priorities.
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Affiliation(s)
- Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine, McGill University, Montréal, Québec, Canada
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL-HMR), Montréal, Québec, Canada
| | - Lysane Paquette
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Mira Jabbour
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL-HMR), Montréal, Québec, Canada
| | - Eric Tchouaket
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Nicolas Fernandez
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Grace Al Hakim
- Clinical and Professional Development Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Véronique Landry
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Nathalie Gauthier
- Nursing and Physical Health Directorate, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Québec, Canada
| | | | - Carl-Ardy Dubois
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
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Nurczyk K, Perez AJ, Murty NS, Patti MG. A Novel University of North Carolina Laparoscopic Ventral Hernia Repair Simulator. J Laparoendosc Adv Surg Tech A 2020; 30:608-611. [PMID: 31928496 DOI: 10.1089/lap.2019.0770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Simulation plays an important role in surgical training. We developed a simulator for laparoscopic ventral hernia repair (LVHR) surgery based on porcine tissue, characterized by low cost and high reality. Methods: Our LVHR model is based on porcine tissue mounted in a human mannequin. The anterior abdominal wall is constructed to allow laparoscopic training. Training sessions are conducted in a simulated operating room environment. Results: During preliminary tests, the LVHR simulator was found to be highly realistic in terms of tissue feedback, instrumentation usage, and performing the key steps of the LVHR procedure. The model was evaluated as a very useful tool for residents' training allowing to gain laparoscopic skills, learn the key steps of LVHR, and practice team work. Conclusions: Our simulator, based on porcine tissue mounted in a mannequin, offers a very realistic and cost-effective model for simulating LVHR surgery.
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Affiliation(s)
- Kamil Nurczyk
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Multidisciplinary Simulation Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,2nd Department of General and Gastrointestinal Surgery, and Surgical Oncology of Alimentary Tract, Medical University of Lublin, Lublin, Poland
| | - Arielle J Perez
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,University of North Carolina Health Care Hernia Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neal S Murty
- Multidisciplinary Simulation Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marco G Patti
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Multidisciplinary Simulation Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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