The impact of SimMan on resident training in emergency skills

A novel 3D-printed educational model for the training of laparoscopic bile duct Exploration:a pilot study for beginning trainees

Background

Laparoscopic common bile duct exploration (LCBDE) is a minimally invasive procedure for the removal of bile duct stones that is often performed by experienced hepatobiliary surgeons; beginners do not easily master this approach.

Aim

To investigate the effectiveness and practicality of a three-dimensional printed (3DP) anatomical model based on radiographic images in the training of LCBDE techniques and formulate standardized educational workflows.

Methods

Colored LCBDE training models were produced using 3DP technology. Twenty standardized training trainees were randomly divided into two groups: a 3DP model training group and a traditional laparoscopic simulation training group. Both groups received the same number of teaching hours. After a 4-weeks training course, the trainees' subjective and objective progress in basic knowledge and manipulations were evaluated and compared.

Results

Compared with traditional laparoscopic simulation, 3DP model simulation training is of great significance in improving trainers' understanding of surgical procedures and cooperation during the operation. Trainees with 3DP models training demonstrated a significant improvement in their understanding of the key points of surgery (χ2 = 6.139, p = 0.013) and skills scores, especially in core procedural steps operation. More importantly, the trainees showed higher levels of satisfaction and self-confidence while assisting in the surgery.

Conclusion

With the development of 3DP models, improvements in the learning effect for theoretical understanding and practical skills were significant. The present study is the initial educational experience with 3DP models to facilitate the operational capabilities of the trainees for LCBDE.

Exploration of cardiopulmonary resuscitation teamwork training for maternal cardiac arrest using the SimMan intelligent simulation platform: A simulation teaching study

Background and Aims

Maternal cardiac arrest is the most urgent clinical event in obstetrics and can lead to serious consequences, such as maternal or fetal death. Therefore, the training of team cardiopulmonary resuscitation (CPR) skills for obstetricians is essential. The aim of this study was to investigate the effect of applying intelligent simulation to CPR in maternal cardiac arrest teamwork training for obstetricians.

Methods

Twenty-four obstetricians who participated in the "Maternal First Aid Workshop," organized by our hospital in 2018, were selected as training participants. The SimMan intelligent comprehensive patient simulator was used to train the CPR team collaboration with first-aid skills. Each team participating in the training was assessed before and after the training using a questionnaire survey.

Results

The evaluation of the results after the training showed that all four teams were qualified and that the timing of the cesarean section was 100% correct. The mean score, team collaboration score, and chest compression fraction were significantly higher than before training. Teamwork CPR assessment time, interruption time of chest compressions, and artificial airway establishment time were significantly shorter than before training. The questionnaire survey showed that 95.8% of the physicians reported that the training was rewarding and helpful to their clinical work, and 100% of the physicians believed that obstetricians require similar training.

Conclusion

Using the SimMan intelligent comprehensive patient simulator to train obstetricians for CPR of maternal cardiac arrest teamwork first-aid skills can significantly improve the training effect, clinical first-aid skills, and teamwork awareness.

Virtual-reality-enhanced mannequin to train emergency physicians to examine dizzy patients using the HINTS method

Introduction

Acute vertigo is a frequent chief complaint in the emergency departments, and its efficient management requires thorough training. The HINTS protocol is a valid method to screen patients in the emergency room, but its application in routine is hindered by the lack of training. This study aimed to evaluate the training of emergency physicians for the HINTS method based on a mannequin-based virtual reality simulator (MBVRS).

Methods

We conducted a monocenter, prospective, longitudinal, and randomized cohort study in an Emergency Department at a regional university hospital. We included 34 emergency physicians randomized into two equal groups matched by age and professional experience. The control group attended a theoretical lesson with video demonstrations and the test group received a simulation-based training in addition to the lecture.

Results

We showed that the test group had a higher diagnosis performance for the HINTS method compared to the control group as evaluated by the simulator at 1 month (89% sensitivity versus 45, and 100% specificity versus 86% respectively, p < 001, Fisher's exact test). Evaluation at 6 months showed a similar advantage to the test group.

Discussion

The MBVRS is a useful pedagogic tool for the HINTS protocol in the emergency department. The advantage of a unique training session can be measured up to 6 months after the lesson.

A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues

Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.

Method for Teaching Life-Saving Combat First-Aid Skills With live-actor Patients Using a Wearable Training Apparatus

INTRODUCTION

Training combat personnel in combat first-aid skills has faced many challenges over time, such as the need to combine tactics with medicine and to overcome combat personnel's lack of medical background knowledge. Therefore, many simulation methods are currently being developed, each of which has its advantages and disadvantages. In this study, a combined simulation method involving live-actor patients using a wearable training apparatus was developed, and the effects of this method were observed.

MATERIALS AND METHODS

Focusing on the major causes of preventable deaths among victims killed in action, wearable training apparatuses simulating massive hemorrhage, airway obstruction, and tension pneumothorax were designed and produced. Methods of simulating these three injury types using live-actor patients with these training apparatuses were developed, and medical teachers evaluated the simulation effects. The live-actor patients were incorporated into a tactical scenario to train and test nonmedical and medical students in year 3, respectively. High-fidelity simulator-based training and traditional training without simulation served as the control. A post-training survey using a 7-point Likert scale evaluated the trainees' feelings toward these training approaches.

RESULTS

Three types of training apparatuses were developed to simulate three life-threatening injuries, and the simulation effects of the live-actor patients using these apparatuses were highly recognized by medical teachers. Both live-actor patients and high-fidelity simulator-based training improved performance significantly more than traditional training. However, the improvement due to training with live-actor patients was greater than that due to high-fidelity simulator-based training for nonmedical students, whereas there was no difference between these two simulation methods for medical students. A post-training survey revealed that all the trainees were confident in practicing first-aid skills after training, and they all agreed that live-actor patients could combine tactical situations with first aid better than high-fidelity simulators. The nonmedical students strongly agreed that live-actor patients were more helpful in the training of injury evaluation than high-fidelity simulators.

CONCLUSIONS

The method using wearable training apparatus-based live-actor patients was satisfying and effective for teaching life-saving combat first-aid skills, especially for nonmedical students.

Undergraduate nursing students' participation in pre-hospital first aid practice with ambulances in China: A qualitative study

OBJECTIVES

The aim of this study is to understand the feelings and experiences of nursing undergraduates who participate in pre-hospital first aid and to explore the training programme of pre-hospital first aid for nursing undergraduates. The main objective is to provide a reference for the reform of pre-hospital first aid teaching in undergraduate colleges.

METHODS

Semi-structured interviews were conducted with 16 nursing undergraduates who had participated in pre-hospital first aid in an ambulance from a teaching hospital in Hunan, China. The interview data were transcribed, and Colaizzi's seven-step method was used for subject analysis.

RESULTS

The experiences of undergraduate nursing interns can be summarized into five themes: helplessness and fear of death, uncertainty of unknown events, satisfaction with self-improvement, need for professional competence, and the perception of a gap in pre-hospital emergency resources.

CONCLUSIONS

Nursing colleges and teaching hospitals should pay attention to death education and pre-hospital first aid training. Teachers should be able to apply situational teaching methods to pre-hospital first-aid teaching and should focus on cultivating the comprehensive abilities of nursing students. At the same time, schools and teaching hospitals should also strengthen the cultivation of professional identity during pre-hospital first aid practice to reduce the rate of nursing personnel turnover. It's very important to supplement and retain professional nurses for the pre-hospital first aid.