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Grissa MH, Dhaoui R, Bel Haj Ali K, Sekma A, Toumia M, Sassi S, Sakly AK, Zorgati A, Bouraoui H, Ben Soltane H, Mezgar Z, Boukef R, Boubaker H, Bouida W, Beltaief K, Nouira S. Comparison of simulation and video-based training for acute asthma. BMC MEDICAL EDUCATION 2023; 23:873. [PMID: 37974223 PMCID: PMC10655321 DOI: 10.1186/s12909-023-04836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Emergency medicine is particularly well suited to simulation training. However, evidence for the efficacy of simulation-based medical training remains limited especially to manage high-risk cases such as acute asthma. OBJECTIVE The objective of our study was to compare the performance of high-fidelity simulation (HFS) and interactive video-case challenge-based training (IVC) for final-year medical students in the management of acute asthma. METHODS This was a prospective randomized controlled study conducted at the emergency department (ED) of Monastir University hospital ( Tunisia). 69 final-year medical students were randomized to HFS (n = 34) and IVC (n = 35) training on acute asthma topic. The study was conducted over a 1-week period. Efficacy of each teaching method was compared through the use of multiple-choice questionnaires (MCQ) before (pre-test), after (post-test) training and a simulation scenario test conducted 1 week later. The scenario was based on acute asthma management graded on predefined critical actions using two scores: the checklist clinical score (range 0 to 30), and the team skills score (range 0 to 16). Student satisfaction was also evaluated with the Likert 5 points scale. Two years after the post-test, both groups underwent a third MCQ testing to assess sustainability of knowledge. RESULTS There were no differences in age between groups. There was no statistically significant difference between the HFS and IVC groups pre-test scores (p = 0.07). Both groups demonstrated improvement in MCQ post-test from baseline after training session; the HFS MCQ post-test score increased significantly more than the IVC score (p < 0.001). The HFS group performed better than the IVC group on the acute asthma simulation scenario (p < 0.001). Mean checklist clinical score and mean team skills score were significantly higher in HFS group compared to IVC group (respectively 22.9 ± 4.8 and 11.5 ± 2.5 in HFS group vs 19.1 ± 3 and 8.4 ± 3.1 in IVC group) (p < 0.001). After 2 years, MCQ post-test scores decreased in both groups but the decrease was lower in HFS group compared to the IVC group. CONCLUSION High-fidelity simulation-based training was superior to interactive video-case challenge for teaching final year medical students,and led to more long-term knowledge retention in the management of simulated acute asthma patients. TRIAL REGISTRATION The study was registered at www. CLINICALTRIALS gov NCT02776358 on 18/05/2016.
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Affiliation(s)
- Mohamed Habib Grissa
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Randa Dhaoui
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Khaoula Bel Haj Ali
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Adel Sekma
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Maroua Toumia
- Emergency Department, Haj Ali Soua Regional Hospital of Ksar Hellal, Ksar Hellal, 5070, Tunisia
| | - Sarra Sassi
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Abdel Karim Sakly
- Orthopedic Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Asma Zorgati
- Emergency Department, Sahloul University Hospital, Sousse, 4000, Tunisia
| | - Hajer Bouraoui
- Pharmacology Department Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Houda Ben Soltane
- Emergency Department, Farhat Hached University Hospital, Sousse, 4000, Tunisia
| | - Zied Mezgar
- Emergency Department, Farhat Hached University Hospital, Sousse, 4000, Tunisia
| | - Riadh Boukef
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
- Emergency Department, Sahloul University Hospital, Sousse, 4000, Tunisia
| | - Hamdi Boubaker
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Wahid Bouida
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Kaouthar Beltaief
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia
| | - Semir Nouira
- Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia.
- Research Laboratory LR12SP18, University of Monastir, Monastir, 5000, Tunisia.
- Emergency Department and Laboratory Research (LR12SP18), Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia.
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Baudou E, Guilbeau-Frugier C, Tack I, Muscari F, Claudet I, Mas E, Taillefer A, Breinig S, Bréhin C. Clinical decision-making training using the Script Concordance Test and simulation: A pilot study for pediatric residents. Arch Pediatr 2023:S0929-693X(23)00056-8. [PMID: 37147153 DOI: 10.1016/j.arcped.2023.03.007] [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: 12/22/2021] [Revised: 12/06/2022] [Accepted: 03/25/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Each year, new pediatric residents begin their shifts in the pediatric emergency room. While technical skills are often acquired during workshops, non-technical skills such as communication, professionalism, situational awareness, or decision-making are rarely tested. Simulation enables non-technical skills to be developed in situations frequently encountered in pediatric emergencies. Adopting an innovative approach, we combined two pedagogical methods: the Script Concordance Test (SCT) and simulation to improve clinical reasoning and non-technical skills of first-year pediatric residents in dealing with clinical situations involving febrile seizures. The aim of this work is to report the feasibility of such a combined training. METHODS The first-year pediatric residents participated in a training session on how to manage a child attending the emergency department with a febrile seizure. At the beginning of the session, the trainees had to complete the SCT (seven clinical situations) and then participated in three simulation scenarios. Student satisfaction was assessed by means of a questionnaire at the end of the session. RESULTS In this pilot study, 20 residents participated in the training. The SCT scores for the first-year pediatric residents were lower and more widely distributed than those of the experts with better concordance for diagnostic items compared to investigation or treatment items. All were satisfied with the teaching methods employed. Further sessions on additional topics relating to the management of pediatric emergency cases were requested. CONCLUSION Although limited by the small size of our study, this combination of teaching methods was possible and seemed promising for the development of non-technical skills of pediatric residents. These methods are in line with the changes being made to the third cycle of medical studies in France and can be adapted to other situations and other specialties.
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Affiliation(s)
- E Baudou
- Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | | | - I Tack
- Explorations Fonctionnelles Physiologiques, Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | - F Muscari
- Unité de Chirurgie Digestive, CHU de Toulouse, Toulouse, France
| | - I Claudet
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - E Mas
- Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, F-31300, IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France
| | - A Taillefer
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - S Breinig
- Unité de Réanimation Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - C Bréhin
- Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
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An alternative educational method: Computer-based simulation program for advanced cardiac life support education. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.825921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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de Silva D, Singh C, Muraro A, Worm M, Alviani C, Cardona V, DunnGlvin A, Garvey LH, Riggioni C, Angier E, Arasi S, Bellou A, Beyer K, Bijlhout D, Bilo MB, Brockow K, Fernandez‐Rivas M, Halken S, Jensen B, Khaleva E, Michaelis LJ, Oude Elberink H, Regent L, Sanchez A, Vlieg‐Boerstra B, Roberts G. Diagnosing, managing and preventing anaphylaxis: Systematic review. Allergy 2021; 76:1493-1506. [PMID: 32880997 DOI: 10.1111/all.14580] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/13/2020] [Accepted: 08/15/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. METHODS We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. RESULTS It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. CONCLUSIONS Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
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Affiliation(s)
| | | | - Antonella Muraro
- Department of Women and Child Health Food Allergy Referral Centre Veneto Region Padua General University Hospital Padua Italy
| | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Germany
| | - Cherry Alviani
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
| | - Victoria Cardona
- Department of Internal Medicine, Allergy Section Hospital Vall d’Hebron Barcelona Spain
- ARADyAL Research Network Cáceres Spain
| | - Audrey DunnGlvin
- University College Cork Cork UK
- Sechnov University Moscow Moscow Russia
| | - Lene Heise Garvey
- Department of Dermatology and Allergy Allergy Clinic Gentofte Hospital Hellerup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Carmen Riggioni
- Paediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Deu and Sant Joan de Deu Research Foundation Barcelona Spain
| | - Elizabeth Angier
- Primary Care and Population Sciences University of Southampton Southampton UK
| | - Stefania Arasi
- Predictive and Preventive Medicine Research Unit, Multifactorial and Systemic Diseases Research Area Bambino Gesù Hospital IRCCS Rome Italy
| | | | - Kirsten Beyer
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charite Universitatsmedizin Berlin Berlin Germany
| | - Diola Bijlhout
- Association for Teacher Education in Europe (ATEE) Brussels Belgium
| | - M. Beatrice Bilo
- Allergy Unit Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy
- Department of Internal Medicine University Hospital of Ancona Ancona Italy
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
| | - Montserrat Fernandez‐Rivas
- Allergy Department Hospital Clinico San Carlos Facultad Medicina Universidad ComplutenseIdISSCARADyAL Madrid Spain
| | - Susanne Halken
- Hans Christian Andersen Children’s HospitalOdense University Hospital Odense Denmark
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Ekaterina Khaleva
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
| | - Louise J. Michaelis
- Paediatric Allergy Research Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - Hanneke Oude Elberink
- Department of Allergology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD Groningen The Netherlands
| | | | - Angel Sanchez
- AEPNAA Spanish Association for People with Food and Latex Allergy Madrid Spain
| | - Berber Vlieg‐Boerstra
- Department of Paediatrics OLVG Amsterdam The Netherlands
- Department of Nutrition & Dietetics Hanze University of Applied Sciences Groningen The Netherlands
| | - Graham Roberts
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- The David Hide Asthma and Allergy Research CentreSt Mary’s HospitalIsle of Wight UK
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Tawfik MMR, Fayed AA, Dawood AF, Al Mussaed E, Ibrahim GH. Simulation-Based Learning Versus Didactic Lecture in Teaching Bronchial Asthma for Undergraduate Medical Students: a Step Toward Improvement of Clinical Competencies. MEDICAL SCIENCE EDUCATOR 2020; 30:1061-1068. [PMID: 34457768 PMCID: PMC8368256 DOI: 10.1007/s40670-020-01014-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND Simulation-based learning (SBL), an effective teaching strategy, is still questionable on whether it can be an alternative to didactic lectures in medical education. Our study aimed to evaluate the effectiveness of SBL versus traditional lectures in retention of knowledge. METHODS A randomized controlled trial was conducted among medical students who were divided in two groups (36 students each). Each group received the same information about diagnosis and management of bronchial asthma, but with a different teaching method: didactic lecture or simulation. Knowledge level was tested before, immediately after the teaching sessions and 3 months later using multiple-choice questions. Student's satisfaction was evaluated using feedback questionnaire. RESULTS The simulation group scored higher than the lecture group in the post-test and the late test. However, these differences were not significant. Additionally, students' satisfaction scores were significantly higher in the simulation group than in the lecture group (p < 0.01). Students ranked simulation significantly better regarding motivation (71.9%), comfort (59.4%), understanding (59.4%), and effective communication (59.4%) (p < 0.01). CONCLUSION Simulation is as effective as lecture in retention of medical knowledge. Nonetheless, students agree that it is more satisfactory and interesting. SBL integration in medical programs is recommended to overcome obstacles in clinical training.
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Affiliation(s)
- Marwa M. R. Tawfik
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
- Hepatobiliary Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amel A. Fayed
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Amal F. Dawood
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Eman Al Mussaed
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Gehan H. Ibrahim
- Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Suez Canal University, Ismailia, 41511 Egypt
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The Effectiveness of Medical Simulation in Teaching Medical Students Critical Care Medicine: A Systematic Review and Meta-Analysis. Simul Healthc 2018; 12:104-116. [PMID: 28704288 DOI: 10.1097/sih.0000000000000189] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STATEMENT We aimed to assess effectiveness of simulation for teaching medical students critical care medicine and to assess which simulation methods were most useful. We searched AMED, EMBASE, MEDLINE, Education Resources Information Centre, British Education Index, Australian Education Index, and bibliographies and citations, in July 2013. Randomized controlled trials comparing effectiveness of simulation with another educational intervention, or no teaching, for teaching medical students critical care medicine were included. Assessments for inclusion, quality, and data extraction were duplicated and results were synthesized using meta-analysis.We included 22 randomized control trials (n = 1325). Fifteen studies comparing simulation with other teaching found simulation to be more effective [standardized mean difference (SMD) = 0.84; 95% confidence interval (CI) = 0.43 to 1.24; P < 0.001; I = 89%]. High-fidelity simulation was more effective than low-fidelity simulation, and subgrouping supported high-fidelity simulation being more effective than other methods. Simulation improved skill acquisition (SMD = 1.01; 95% CI = 0.49 to 1.53) but was no better than other teaching in knowledge acquisition (SMD = 0.41; 95% CI = -0.09 to 0.91).
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Sagalowsky ST, Wynter SA, Auerbach M, Pusic MV, Kessler DO. Simulation-Based Procedural Skills Training in Pediatric Emergency Medicine. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2016. [DOI: 10.1016/j.cpem.2016.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Solymos O, O'Kelly P, Walshe CM. Pilot study comparing simulation-based and didactic lecture-based critical care teaching for final-year medical students. BMC Anesthesiol 2015; 15:153. [PMID: 26490826 PMCID: PMC4617911 DOI: 10.1186/s12871-015-0109-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/17/2015] [Indexed: 12/29/2022] Open
Abstract
Background Simulation-based medical education has rapidly evolved over the past two decades, despite this, there are few published reports of its use in critical care teaching. We hypothesised that simulation-based teaching of a critical care topic to final-year medical students is superior to lecture-based teaching. Methods Thirty-nine final-year medical students were randomly assigned to either simulation-based or lecture-based teaching in the chosen critical care topic. The study was conducted over a 6-week period. Efficacy of each teaching method was compared through use of multiple choice questionnaires (MCQ) - baseline, post-teaching and 2 week follow-up. Student satisfaction was evaluated by means of a questionnaire. Feasibility and resource requirements were documented by teachers. Results Eighteen students were randomised to simulation-based, and 21 to lecture-based teaching. There were no differences in age and gender between groups (p > 0.05). Simulation proved more resource intensive requiring specialised equipment, two instructors, and increased duration of teaching sessions (126.7 min (SD = 4.71) vs 68.3 min (SD = 2.36)). Students ranked simulation-based teaching higher with regard to enjoyment (p = 0.0044), interest (p = 0.0068), relevance to taught subject (p = 0.0313), ease of understanding (p = 0.0476) and accessibility to posing questions (p = 0.001). Both groups demonstrated improvement in post-teaching MCQ from baseline (p = 0.0002), with greater improvement seen among the simulation group (p = 0.0387), however, baseline scores were higher among the lecture group. The results of the 2-week follow-up MCQ and post-teaching MCQ were not statistically significant when each modality were compared. Discussion Simulation was perceived as more enjoyable by students. Although there was a greater improvement in post-teaching MCQ among the simulator group, baseline scores were higher among lecture group which limits interpretation of efficacy. Simulation is more resource intensive, as demonstrated by increased duration and personnel required, and this may have affected our results. Conclusions The current pilot may be of use in informing future studies in this area.
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Affiliation(s)
- Orsolya Solymos
- Department of Anaesthesia and Critical Care Medicine, Royal College of Surgeons in Ireland, Smurfit Building, Beaumont Hospital, Dublin, Ireland.
| | - Patrick O'Kelly
- Department of Nephrology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
| | - Criona M Walshe
- Department of Anaesthesia and Critical Care Medicine, Royal College of Surgeons in Ireland, Smurfit Building, Beaumont Hospital, Dublin, Ireland.
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Effect of Screen-Based Computer Simulation on Knowledge and Skill in Nursing Students’ Learning of Preoperative and Postoperative Care Management. Comput Inform Nurs 2012; 30:196-203. [DOI: 10.1097/ncn.0b013e3182419134] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Biese KJ, Moro-Sutherland D, Furberg RD, Downing B, Glickman L, Murphy A, Jackson CL, Snyder G, Hobgood C. Using screen-based simulation to improve performance during pediatric resuscitation. Acad Emerg Med 2009; 16 Suppl 2:S71-5. [PMID: 20053216 DOI: 10.1111/j.1553-2712.2009.00590.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the ability of a screen-based simulation-training program to improve emergency medicine and pediatric resident performance in critical pediatric resuscitation knowledge, confidence, and skills. METHODS A pre-post, interventional design was used. Three measures of performance were created and assessed before and after intervention: a written pre-course knowledge examination, a self-efficacy confidence score, and a skills-based high-fidelity simulation code scenario. For the high-fidelity skills assessment, independent physician raters recorded and reviewed subject performance. The intervention consisted of eight screen-based pediatric resuscitation scenarios that subjects had 4 weeks to complete. Upon completion of the scenarios, all three measures were repeated. For the confidence assessment, summary pre- and post-test summary confidence scores were compared using a t-test, and for the skills assessment, pre-scores were compared with post-test measures for each individual using McNemar's chi-square test for paired samples. RESULTS Twenty-six of 35 (71.3%) enrolled subjects completed the institutional review board-approved study. Increases were observed in written test scores, confidence, and some critical interventions in high-fidelity simulation. The mean improvement in cumulative confidence scores for all residents was 10.1 (SD +/-4.9; range 0-19; p < 0.001), with no resident feeling less confident after the intervention. Although overall performance in simulated codes did not change significantly, with average scores of 6.65 (+/-1.76) to 7.04 (+/-1.37) out of 9 possible points (p = 0.58), improvement was seen in the administering of appropriate amounts of IV fluids (59-89%, p = 0.03). CONCLUSIONS In this study, improvements in resident knowledge, confidence, and performance of certain skills in simulated pediatric cardiac arrest scenarios suggest that screen-based simulations may be an effective way to enhance resuscitation skills of pediatric providers. These results should be confirmed using a randomized design with an appropriate control group.
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Affiliation(s)
- Kevin J Biese
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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