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Jannot M, Attal JP, Marteleur VL, Le-Goff S, Colombier ML, Gouze H, Dursun E, Brun A, François P. Perceptions regarding the use of a three-dimensionally-printed manufactured educational simulator for periodontal treatment of intraosseous and interradicular lesions. J Dent Educ 2024; 88:1133-1143. [PMID: 38572587 DOI: 10.1002/jdd.13539] [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: 12/22/2023] [Revised: 02/17/2024] [Accepted: 03/17/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE/OBJECTIVES Treating intraosseous lesions (IOLs) and interradicular bone lesions (IRLs) is an extremely technical dental procedure in periodontics. Instrumentation of these lesions is often perceived as difficult by students and inexperienced dentists before they perform a certain number of procedures on patients in the clinic. The aim of this article is to evaluate a cost-effective three-dimensional (3D)-printed educational simulator for the periodontal treatment of IOLs/IRLs (including scaling, incisions and sutures). METHODS The simulators were first developed digitally, and then manufactured using printable resins and specific materials; finally, they were assembled using different bonding systems. To evaluate the simulators, assessments were gathered from two target populations: undergraduate students and periodontics experts. These individuals tested the simulator and completed a cross-sectional questionnaire based on a Likert scale with comparative and pedagogical items scored from one to five. The purpose of the questionnaire was to compare our simulator to clinical reality (i.e., operation on human jaws) and to an animal simulator (i.e., simulation of porcine jaws). The results are expressed as the mean and standard deviation and were statistically analyzed with the Wilcoxon signed-rank test. RESULTS Overall, the results were satisfactory for both groups of testers (4.70 and 4.61 out of five for students and experts, respectively, for global satisfaction). CONCLUSIONS The overall educational relevance of the simulator designed herein highlights the fact that 3D-printed educational simulators could enable efficient cognitive-functional learning for clinical IOL/IRL treatment.
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Affiliation(s)
- Marie Jannot
- Department of Dental Materials, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Jean-Pierre Attal
- Department of Dental Materials, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Vincent Le Marteleur
- Department of Dental Materials, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Stephane Le-Goff
- Department of Dental Materials, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Marie-Laure Colombier
- Division of Periodontology, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Helene Gouze
- Center for Research in Epidemiology and Population Health, CESP-INSERM, Université Paris Saclay, Villejuif, France
| | - Elisabeth Dursun
- Division of Pediatric Dentistry, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Adrian Brun
- Division of Periodontology, Faculty of Dental Surgery, Université Paris Cité, Paris, France
| | - Philippe François
- Department of Dental Materials, Faculty of Dental Surgery, Université Paris Cité, Paris, France
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Wiebe N, Hunt A, Taylor T. "Everything new is happening all at once": a qualitative study of early career obstetrician and gynaecologists' preparedness for independent practice. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:6-17. [PMID: 39114783 PMCID: PMC11302748 DOI: 10.36834/cmej.77329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Background The transition from residency training into practice is associated with increasing risks of litigation, burnout, and stress. Yet, we know very little about how best to prepare graduates for the full scope of independent practice, beyond ensuring clinical competence. Thus, we explored the transition to independent practice (TTP) experiences of recent Obstetrics and Gynaecology graduates to understand potential gaps in their perceived readiness for practice. Methods Using constructivist grounded theory, we conducted semi-structured interviews with 20 Obstetricians/Gynaecologists who graduated from nine Canadian residency programs within the last five years. Iterative data collection and analysis led to the development of key themes. Results Five key themes encompassed different practice gaps experienced by participants throughout their transition. These practice gaps fit into five competency domains: providing clinical care, such as managing unfamiliar low-risk ambulatory presentations; navigating logistics, such as triaging referrals; managing administration, such as hiring or firing support staff; reclaiming personhood, such as boundary-setting between work and home; and bearing ultimate responsibility, such as navigating patient complaints. Mitigating factors were found to widen or narrow the extent to which new graduates experienced a practice gap. There was a shared sense among participants that some practice gaps were impossible to resolve during training. Conclusions Existing practice gaps are multi-dimensional and perhaps not realistically addressed during residency. Instead, TTP mentorship and training opportunities must extend beyond residency to ensure that new graduates are equipped for the full breadth of independent practice.
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Affiliation(s)
- Nicole Wiebe
- Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Andrea Hunt
- Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
- Department of Obstetrics and Gynaecology, Guelph General Hospital, Ontario, Canada
| | - Taryn Taylor
- Department of Obstetrics and Gynaecology, London Health Sciences Centre, Ontario, Canada
- The Centre for Education Research and Innovation, Schulich School of Medicine & Dentistry, Ontario, Canada
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Pollard J, Tombs M. Teaching Undergraduate Medical Students Non-Technical Skills: An Evaluation Study of a Simulated Ward Experience. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:485-494. [PMID: 35592356 PMCID: PMC9113035 DOI: 10.2147/amep.s344301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/08/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Research suggests that medical students in the UK report a need to be better prepared for the non-technical skills required for the role of a junior doctor. A Simulated Ward Experience was developed in an attempt to address this need. The purpose of this study was (1) to evaluate the effectiveness of the Simulated Ward Experiences by examining students' reactions regarding the quality of teaching and (2) to examine the main drivers of learning and the extent to which students felt it helped them prepare for their future training. METHODS A mixed method evaluation study was conducted using a questionnaire and focus groups. Final year students who participated in the Simulated Ward Experience were invited to contribute to the evaluation, out of which 25 completed the questionnaire and 13 took part in focus group interviews. Data analysis were conducted by means of descriptive statistics for questionnaire data and thematic analysis of focus group transcripts. RESULTS The median Likert scores for quality of teaching Non-Technical Skills were either very good or excellent, demonstrating that students were highly satisfied with the way in which these were taught. Qualitative data provided further insights into the aspects of the intervention that promoted learning, and these were categorised into four themes, including realism of the simulation; relevance for the role and responsibilities of the Foundation Year 1 Doctor (including Non-Technical Skills); learning from and with others; and supportive learning environment. CONCLUSION This evaluation study provides further evidence of the value of learning in a simulated setting, particularly when it is closely aligned to the real clinical context and creates opportunities to practice skills that are perceived to be relevant by the learner. Study limitations are recognised and suggestions for further studies are provided.
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Affiliation(s)
- Jennifer Pollard
- Highland Medical Education Centre, University of Aberdeen, Inverness, UK
| | - Michal Tombs
- Centre for Medical Education, Cardiff University, Cardiff, UK
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Hayashi M, Nishiya K, Kaneko K. Transition from undergraduates to residents: A SWOT analysis of the expectations and concerns of Japanese medical graduates during the COVID-19 pandemic. PLoS One 2022; 17:e0266284. [PMID: 35353865 PMCID: PMC8967019 DOI: 10.1371/journal.pone.0266284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/17/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Interruptions in undergraduate clinical clerkship during the COVID-19 pandemic have reduced the confidence and preparedness of residents beginning their postgraduate training. We explore the thoughts of new residents about this transition and reflect on the support needed. Methods An exploratory qualitative case study was conducted with 51 residents. All had experienced interruptions in clinical training due to the pandemic and had just started their postgraduate training. Qualitative data were collected through 6 focus groups and 12 individual follow-up interviews. A thematic analysis was undertaken, and the data were categorised using a Strengths, Weaknesses, Opportunities, and Threats (SWOT) framework. Results Graduates beginning their residency were aware of their professionalism and independence during the transition. They also faced the predicament of needing close supervision while their supervisors managed pandemic conditions. Residents emphasised the importance of developing relationships with colleagues and supervisors during the transition to residency and wanted direct observation and detailed feedback from their supervisors during procedures. Conclusions The experiences of residents were not uniformly negative. In fact, some had developed a positive mindset when entering the clinical field. Medical faculty members reflecting on interactions with new residents and planning future clinical internships could benefit from placing a high value on building relationships among residents, who may expect direct observation and detailed feedback from their supervisors.
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Affiliation(s)
- Mikio Hayashi
- Center for Medical Education, Kansai Medical University, Osaka, Japan
- * E-mail:
| | - Katsumi Nishiya
- Center for Medical Education, Kansai Medical University, Osaka, Japan
| | - Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Osaka, Japan
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McAleer P, Tallentire VR, Stirling SA, Edgar S, Tiernan J. Postgraduate medical procedural skills: attainment of curricular competencies using enhanced simulation-based mastery learning at a novel national boot camp. Clin Med (Lond) 2022; 22:125-130. [PMID: 35304373 PMCID: PMC8966818 DOI: 10.7861/clinmed.2021-0578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A new UK medical postgraduate curriculum prompted the creation of a novel national medical postgraduate 'boot camp'. An enhanced simulation-based mastery learning (SBML) methodology was created to deliver procedural skills teaching within this national boot camp. This study aimed to explore the impact of SBML in a UK medical boot camp. METHODS One-hundred and two Scottish medical trainees attended a 3-day boot camp starting in August 2019. The novel enhanced SBML pathway entailed online pre-learning resources, deliberate practice, and simulation assessment and feedback. Data were gathered via pre- and post-boot camp questionnaires and assessment checklists. RESULTS The vast majority of learners achieved the required standard of performance. Learners reported increased skill confidence levels, including skills not performed at the boot camp. CONCLUSION An enhanced SBML methodology in a boot camp model enabled streamlined, standardised procedural skill teaching to a national cohort of junior doctors. Training curricular competencies were achieved alongside increased skill confidence.
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Affiliation(s)
| | - Victoria R Tallentire
- NHS Education for Scotland, Edinburgh, UK and consultant in acute medicine, NHS Lothian, Edinburgh, UK
| | | | - Simon Edgar
- NHS Lothian, Edinburgh, UK and consultant anaesthetist, NHS Lothian, Edinburgh, UK
| | - James Tiernan
- NHS Lothian, Edinburgh, UK and a consultant in respiratory medicine, NHS Lothian, Edinburgh, UK
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A systematic review of methodological principles and delivery of surgical simulation bootcamps. Am J Surg 2021; 223:1079-1087. [PMID: 34865734 DOI: 10.1016/j.amjsurg.2021.10.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/27/2021] [Accepted: 10/31/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The growth of "bootcamp style" simulation training in surgical practice has been exponential over the last decade. Developing and delivering a surgical bootcamp requires a significant investment. This systematic review aims to identify the key components that allow for a successful and rewarding surgical bootcamp course to be implemented that can be applied to all surgical specialities. METHODS To understand the surgical bootcamp principles and delivery mechanisms, we searched peer-reviewed, English language studies published between 2000 and 21. RESULTS From 137 articles, 14 studies with a Medical Education Research Quality Instrument Score of >11.5 were included. Most studies followed the core components; delivery at transition (12), mapping syllabus (13), multimodality delivery (14), and deliberate practice with formative feedback (12) apart from 1:1 training by only 2 studies. CONCLUSIONS Our review suggests that Surgical bootcamp can be an extremely useful education tool for trainees if 5 pillars of a boot camp are respected.
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Pal S, Benson R, Duvall P, Taylor-Jones V. Do innovative immersive virtual reality simulation videos have a role to play in teaching non-technical skills and increasing preparedness for clinical placements for medical students? MEDEDPUBLISH 2021; 9:164. [PMID: 37583646 PMCID: PMC10423946 DOI: 10.15694/mep.2020.000164.2] [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: 08/17/2023] Open
Abstract
This article was migrated. The article was marked as recommended. BACKGROUND Teaching non-technical skills (NTS) is an important part of the undergraduate medical curriculum. Resource intensive high-fidelity simulation has an established role in this. Alternative methods of delivering large scale simulation-based education should be considered to help further improve NTS and preparedness for clinical placements of medical students. Emerging technologies such as immersive virtual reality (VR) may have a role in this. AIM To assess if a VR simulation-based teaching programme enhances understanding of NTS and preparedness for clinical placements in medical students at the University of Liverpool. METHODS A VR simulation-based teaching programme, consisting of 4 sessions of lecture-based simulation and a hi-fidelity simulation session was delivered to 3 rd year medical students. The lecture-based sessions used pre-recorded, immersive clinical scenarios developed by the School of Medicine, with a focus on NTS. The hi-fidelity simulation session was delivered by local hospital trusts. A survey was sent to all students to assess their understanding of key NTS: decision making, task prioritisation and delegation and how the clinical environment works. Preparedness for clinical placement and confidence in the clinical environment was also assessed. A focus group further explored how students felt towards these NTS, with subsequent thematic analysis. Results: 101/281 students responded to the survey reporting a greater understanding in all NTS assessed. Students also described feeling better prepared for clinical placements. The focus group reported the programme provided a 'safe space' for learning alongside increasing understanding of role modelling and self-awareness. Discussion: Utilising emerging technology alongside hi-fidelity simulation increased students' exposure to the clinical environment and enabled exploration of NTS by students. Additional work with larger focus groups will be required to further validate our results. Whilst restrictions are limiting clinical exposure due to the COVID-19 pandemic, we propose that VR simulation-based teaching programmes could provide an alternativeeducational tool.
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Padley J, Boyd S, Jones A, Walters L. Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates. Health Sci Rep 2021; 4:e270. [PMID: 33855193 PMCID: PMC8025846 DOI: 10.1002/hsr2.270] [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: 11/25/2020] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 01/01/2023] Open
Abstract
CONTEXT Work readiness is often described in terms of the clinical competence medical graduates bring to day 1 of internship. Despite being increasingly viewed as a key graduate outcome, work readiness has remained poorly defined. OBJECTIVE This narrative review draws on the international literature to explore how different research methods provide differing insight into what constitutes work readiness of medical graduates. From this, we explored contributory factors and developed a conceptual framework to better understand work readiness. METHODS Databases were searched using the terms including "ready," "readiness," "preparedness," "medical graduates," "intern," and "junior doctor." Information was summarized using a textual description template that included information on study setting, participants, methodologies, limitations, and key result areas (including measures/themes and study conclusions). Consensus discussions between authors led to the naming and understanding of the key themes. RESULTS Seventy studies were included in the review. Study participants included final-year medical students (n = 20), junior doctors early in internship (n = 24), and junior doctors late in internship or postgraduate year 2 and above (n = 23). Most studies explored work readiness through the retrospective self-report of the students and/or junior doctor participants. Quantitative research methods elaborated on key skills-based competencies, whereas qualitative research methods provided insight into key contextual and individual characteristics that contributed to preparedness. CONCLUSIONS Different research methods provided insight into competencies, as well as individual and contextual aspects, associated with preparedness for practice. The transition from university to clinical practice is significant and requires personal capability and confidence, as well as a supportive training context. Enabling students to engage authentically in clinical environments enhanced preparedness by promoting understanding of role and responsibility. Individual resilience is important, but contextual factors, including provision of adequate support and feedback, can enhance or subtract from feeling prepared. We propose a novel conceptual framework for better understanding work readiness.
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Affiliation(s)
- James Padley
- Discipline of Rural and Remote Health, College of Medicine & Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Sarah Boyd
- Discipline of Rural and Remote Health, College of Medicine & Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Alison Jones
- College of Medicine & Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Lucie Walters
- Discipline of Rural and Remote Health, College of Medicine & Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
- Adelaide Rural Clinical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
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Walsh SM, Costello M, Murphy E, Lowery A, Reid McDermott B, Byrne D. Practical tips for introducing high-fidelity simulation to undergraduates at a large scale: learning from our experience. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:452-453. [DOI: 10.1136/bmjstel-2021-000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 11/04/2022]
Abstract
The letter provides practical tips for developing, implementing and scaling an effective simulation‑based education programme at a large scale for undergraduate medical students. Using time-lapsed scenarios and the pause-discuss method of debrief are some of the useful tips that are discussed further in the letter.
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Pollard J, Jeffreys D, Irvine D, Thomas I. Twelve Tips for running in-situ simulation during a Coronavirus pandemic. MEDEDPUBLISH 2021; 10:15. [PMID: 38486520 PMCID: PMC10939556 DOI: 10.15694/mep.2021.000015.1] [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] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. The arrival of the coronavirus pandemic has caused massive disruption to medical education, with universities having to close and adopt new ways of teaching, ensuring social distancing as standard. Final year medical students from the University of Aberdeen graduated early and stepped up to start working as 'Foundation interim Year 1 doctors' (FiY1). With their final months of medical school and end of year examinations cancelled, we felt that an in-situ ward simulation would help them make that transition by giving them an opportunity to act up in a safe environment. Here we share our tips for designing and implementing an in-situ simulation aimed at junior doctors in the early stages of their training. We conclude by reflecting on what we have learnt and how we plan to take this method of simulation forward into future practice, once the pandemic is over.
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Bobel MC, Branson CF, Chipman JG, Campbell AR, Brunsvold ME. "Who wants me to do what?" varied expectations from key stakeholder groups in the surgical intensive care unit creates a challenging learning environment. Am J Surg 2020; 221:394-400. [PMID: 33303187 DOI: 10.1016/j.amjsurg.2020.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/30/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Surgical intensive care units (SICU) require complex care from a multi-disciplinary team. Frequent changes in team members can lead to shifting expectations for junior general surgical trainees, which creates a challenging working and learning environment. We aim to identify expectations of junior surgery trainee's medical knowledge and technical/non-technical skills at the start of their SICU rotation. We hypothesize that expectations will not be consistent across SICU stakeholder groups. METHODS Twenty-eight individual semi-structured interviews were conducted with six SICU stakeholder groups at a medium-sized academic hospital. Expectations were identified from interview transcripts. Frequency counts were analyzed. RESULTS Forty-one expectations were identified. 4 expectations were identified by a majority of interviewees. Most expectations were identified by 7 or fewer interviewees. 23 (53%) expectations were shared by at least one stakeholder group. 2 (8%) expectations were shared by all groups. CONCLUSIONS SICU stakeholder groups identified ten medical knowledge, ten technical skill, and three non-technical skill expectations. Yet, few expectations were shared among the groups. Thus, SICU stakeholder groups have disparate expectations for surgery trainees in our SICU.
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Affiliation(s)
- Matthew C Bobel
- University of Minnesota, Department of Surgery, 420 Delaware Street SE, Mayo Mail Code 195, Minneapolis, MN, 55455, USA.
| | - Carolina Fernandez Branson
- University of Minnesota, Department of Surgery, 420 Delaware Street SE, Mayo Mail Code 195, Minneapolis, MN, 55455, USA
| | - Jeffrey G Chipman
- University of Minnesota, Department of Surgery, 420 Delaware Street SE, Mayo Mail Code 195, Minneapolis, MN, 55455, USA
| | - Andre R Campbell
- University of California-San Francisco, Department of Surgery, San Francisco, Campus Box 0807, CA, 94143-0807, USA
| | - Melissa E Brunsvold
- University of Minnesota, Department of Surgery, 420 Delaware Street SE, Mayo Mail Code 195, Minneapolis, MN, 55455, USA
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Walker KG, Blackhall VI, Hogg ME, Watson AJM. Eight Years of Scottish Surgical Boot Camps: How We Do It Now. JOURNAL OF SURGICAL EDUCATION 2020; 77:235-241. [PMID: 31889694 DOI: 10.1016/j.jsurg.2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/16/2019] [Accepted: 11/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Scottish Surgical Boot Camps are the induction course for new start Core Surgical Trainees (Residents) in Scotland. The aim is to capitalise on trainees' receptiveness at a time of transition, and to give them a safe and "flying start." At their inception, these were the first such courses in the UK to integrate technical and non-technical skills training. As well as knowledge and skills, trainees have learned norms and expectations of a community of professional practice. METHODS Over 9 consecutive years of delivery and quality improvement, faculty have learned much about the safe use of simulation, as an adjuvant training modality for a range of competences required in the operating room, the clinic/office, the wards and other clinical domains. CONCLUSION In this paper we describe the development and content of the course, discuss the importance of the whole "activity system," and present some evaluation data. We give tips for success, such as using simulations of escalating complexity, and the power of seemingly incidental Learning Outcomes.
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Affiliation(s)
- Kenneth G Walker
- Highland Medical Education Centre, Centre for Health Science, Raigmore Hospital, Inverness, Scotland, United Kingdom.
| | - Vivienne I Blackhall
- Highland Medical Education Centre, Centre for Health Science, Raigmore Hospital, Inverness, Scotland, United Kingdom
| | - Morag E Hogg
- Highland Medical Education Centre, Centre for Health Science, Raigmore Hospital, Inverness, Scotland, United Kingdom
| | - Angus J M Watson
- Highland Medical Education Centre, Centre for Health Science, Raigmore Hospital, Inverness, Scotland, United Kingdom
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Duffy CC, Nawoor-Quinn Z, Burlacu CL. "Rapid sequence induction"-an anaesthesiology boot camp. Ir J Med Sci 2019; 189:1047-1051. [PMID: 31828507 DOI: 10.1007/s11845-019-02146-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/15/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The novice anaesthesiology trainee must rapidly assimilate the cognitive, technical and non-technical skills necessary to competently respond to critical events in their new role. Providing trainees with the safe and controlled environment of high-fidelity patient simulation is one method to compensate for gaps in trainee experience, offering the potential for effective training. An anaesthesiology boot camp was set up to increase the knowledge, clinical, technical and non-technical competencies of the novice trainee, creating a framework for their future learning and practice. Anaesthetic nurses also attended to incorporated teamwork and collaboration into the boot camp. METHODS Seven novice anaesthesiology trainees and 3 anaesthetic nurses attended 3 4-h boot camp sessions. The boot camp consisted of the following: (1) interactive didactic lectures; (2) task-trainer technical skills teaching; and, (3) high-fidelity simulations. Pre- and post-course evaluation forms including a multiple-choice-questions (MCQ) assessing knowledge were completed. RESULTS Nine participants fully completed the boot camp. There was a significant increase in post-MCQ score (p = 0.001). Feedback from participants included "well organised", "helpful" and "structured approach" with all participants agreeing or strongly agreeing that it was relevant training for their practice. DISCUSSION We have created the first Irish anaesthesiology boot camp, demonstrating the important role that simulation has in enhancing medical education. Our results showed both knowledge attainment and participant satisfaction in this method of learning. Anaesthesiology boot camps are the ideal method to provide novice trainees with a framework for their initial introduction into anaesthesia.
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Affiliation(s)
- Caoimhe C Duffy
- Department of Anaesthesiology, Intensive Care and Pain Medicine, St. Vincent's University Hospital (SVUH), Elm Park, Dublin 4, Ireland.
- College of Anaesthesiologists Simulation Training Programme (CAST), College of Anaesthesiology of Ireland, Merrion Square North, Dublin 2, Ireland.
| | - Zeenat Nawoor-Quinn
- Department of Anaesthesiology, Intensive Care and Pain Medicine, St. Vincent's University Hospital (SVUH), Elm Park, Dublin 4, Ireland
- College of Anaesthesiologists Simulation Training Programme (CAST), College of Anaesthesiology of Ireland, Merrion Square North, Dublin 2, Ireland
| | - Crina L Burlacu
- Department of Anaesthesiology, Intensive Care and Pain Medicine, St. Vincent's University Hospital (SVUH), Elm Park, Dublin 4, Ireland
- College of Anaesthesiologists Simulation Training Programme (CAST), College of Anaesthesiology of Ireland, Merrion Square North, Dublin 2, Ireland
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Buist N, Webster CS. Simulation Training to Improve the Ability of First-Year Doctors to Assess and Manage Deteriorating Patients: a Systematic Review and Meta-analysis. MEDICAL SCIENCE EDUCATOR 2019; 29:749-761. [PMID: 34457539 PMCID: PMC8368756 DOI: 10.1007/s40670-019-00755-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many simulation courses now exist which aim to prepare first-year doctors for the task of assessing and managing potentially deteriorating patients. Despite the substantial resources required, the degree to which participants benefit from such courses, and which aspects of the simulation training are optimal for learning, remains unclear. A systematic literature search was undertaken across seven electronic databases. Inclusion criteria were that the intervention must be a simulation of a deteriorating patient scenario that would likely be experienced by first-year doctors, and that participants being first-year doctors or in their final year of medical school. Studies reporting quantitative benefits of simulation on participants' knowledge and simulator performance underwent meta-analyses. The search returned 1444 articles, of which 48 met inclusion criteria. All studies showed a benefit of simulation training, but outcomes were largely limited to self-rated or objective tests of knowledge, or simulator performance. The meta-analysis demonstrated that simulation improved participant performance by 16% as assessed by structured observation of a simulated scenario, and participant knowledge by 7% as assessed by written assessments. A mixed-methods analysis found conflicting evidence about which aspects of simulation were optimal for learning. The results of the review indicate that simulation is an important tool to improve first-year doctors' confidence, knowledge and simulator performance with regard to assessment and management of a potentially deteriorating patient. Future research should now seek to clarify the extent to which these improvements translate into clinical practice, and which aspects of simulation are best suited to achieve this.
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Affiliation(s)
- Nicholas Buist
- Department of Emergency Medicine, Whangarei Hospital, Northland District Health Board, Maunu Rd, Private Bag 9742, Whangarei, 0110 New Zealand
| | - Craig S. Webster
- Centre for Medical and Health Sciences Education and Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
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Somasundram K, Spence H, Colquhoun AJ, Mcilhenny C, Biyani CS, Jain S. Simulation in urology to train non-technical skills in ward rounds. BJU Int 2018; 122:705-712. [PMID: 29777617 DOI: 10.1111/bju.14402] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To report our experience of an exercise designed to train newly appointed urology trainees in non-technical skills on ward rounds as a part of a simulation 'boot camp', through a qualitative analysis of participant feedback on the utility of this method of training. PATIENTS AND METHODS The simulations took place in a high-fidelity simulated ward bay. Forty-eight doctors with formal urology training ranging between 2 and 60 months (mean 19.1 ± 11.6 months) took part. Thirty-one participants were on a formal urology specialty training pathway. The remaining participants were core (pre-specialty) surgical trainees. The entry requirement was that participants must be junior-level urologists, ideally at the beginning of specialty training. Participants individually led a simulated ward round, which was devised using actors to play patients and a simulated 'switchboard' for telephone conversations. Distractions were introduced deliberately for participants to manage an emergent urology-related scenario. 'Freeze-frames' were used to 'pause' the ward round, whereby observing consultants provided feedback on performance. After the simulated exercises, a whole-group structured debriefing took place. Non-Technical Skills for Surgeons (NOTSS) scores were generated for participants by seven consultant urologists. Participants completed a two-part feedback form. Part one involved nine questions scored on a Likert scale, and part two required free-text responses. RESULTS The mean (±sd) itemized NOTSS scores for situational awareness, decision-making, communication and teamwork, and leadership were 3.01 (±0.15), 2.95 (±0.16), 3.05 (±0.19), and 2.98 (±0.15), respectively. From the thematic analysis, participants commented positively on the number of scenarios per participant, the use of actors as patients and real staff, and the use of freeze-frames for immediate feedback. Residents also provided suggestions for distractions to be considered in the future. CONCLUSIONS This simulated ward round was generally well received by participants, and the obtained feedback provides an insight into how this can be adapted to maximize the benefits for new specialty residents. The mean NOTSS scores indicated that non-technical skills performances could be improved. This supports our rationale to train non-technical skills in a safe environment to bolster career transition into positions of greater decision-making autonomy.
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Pritchard SA, Blackstock FC, Keating JL, Nestel D. The pillars of well-constructed simulated patient programs: A qualitative study with experienced educators. MEDICAL TEACHER 2017; 39:1159-1167. [PMID: 28845722 DOI: 10.1080/0142159x.2017.1369015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The inclusion of simulated patients (SPs) in health professional education is growing internationally. However, there is limited evidence for best practice in SP methodology. This study investigated how experienced SP educators support SPs in providing SP-based education for health professional students. METHODS Experienced SP educators were identified via relevant professional associations, peer-reviewed publications, and peer referral. Semi-structured individual interviews were conducted via telephone. Data were analyzed independently by three researchers using principles of inductive thematic analysis. RESULTS Four themes were identified that represent the key structural components of SP programs considered by educators seeking to optimize learning for health professional students in SP programs: managing SPs by operationalizing an effective program, selecting SPs by rigorously screening for suitability, preparing SPs by educating for a specific scenario, and directing SPs by leading safe and meaningful interactions. Within these components, subthemes were described, with considerable variation in approaches. CONCLUSIONS Key structural components to SP programs were consistently described by experienced SP educators who operationalize them. A framework has been proposed to assist educators in designing high-quality SP programs that support SPs and learners. Future research is required to evaluate and refine this framework and other evidence-based resources for SP educators.
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Affiliation(s)
- Shane A Pritchard
- a Department of Physiotherapy , Monash University , Frankston , VIC , Australia
| | - Felicity C Blackstock
- b Physiotherapy, School of Science and Health , Western Sydney University , Campbelltown , NSW , Australia
- c College of Science, Health and Engineering , La Trobe University , Bundoora , VIC , Australia
| | - Jennifer L Keating
- a Department of Physiotherapy , Monash University , Frankston , VIC , Australia
| | - Debra Nestel
- d Monash Institute for Health and Clinical Education (MIHCE) , Monash University , Clayton , VIC , Australia
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Kehoe A, Illing J. Early clinical exposure requires facilitated access to support learning. MEDICAL EDUCATION 2017; 51:989-991. [PMID: 28901648 DOI: 10.1111/medu.13404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Kalet A, Zabar S, Szyld D, Yavner SD, Song H, Nick MW, Ng G, Pusic MV, Denicola C, Blum C, Eliasz KL, Nicholson J, Riles TS. A simulated "Night-onCall" to assess and address the readiness-for-internship of transitioning medical students. Adv Simul (Lond) 2017; 2:13. [PMID: 29450014 PMCID: PMC5806245 DOI: 10.1186/s41077-017-0046-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/24/2017] [Indexed: 11/10/2022] Open
Abstract
Transitioning medical students are anxious about their readiness-for-internship, as are their residency program directors and teaching hospital leadership responsible for care quality and patient safety. A readiness-for-internship assessment program could contribute to ensuring optimal quality and safety and be a key element in implementing competency-based, time-variable medical education. In this paper, we describe the development of the Night-onCall program (NOC), a 4-h readiness-for-internship multi-instructional method simulation event. NOC was designed and implemented over the course of 3 years to provide an authentic "night on call" experience for near graduating students and build measurements of students' readiness for this transition framed by the Association of American Medical College's Core Entrustable Professional Activities for Entering Residency. The NOC is a product of a program of research focused on questions related to enabling individualized pathways through medical training. The lessons learned and modifications made to create a feasible, acceptable, flexible, and educationally rich NOC are shared to inform the discussion about transition to residency curriculum and best practices regarding educational handoffs from undergraduate to graduate education.
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Affiliation(s)
- Adina Kalet
- New York Simulation Center for the Health Sciences, New York, New York USA
- Institute for Innovations in Medical Education, NYU School of Medicine, New York, USA
- Program for Medical Education and Technology (PMET), NYU School of Medicine, New York, USA
- Department of Surgery, NYU School of Medicine, New York, USA
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York, New York USA
- Research on Medical Education Outcomes (ROMEO) Unit, Program for Medical Education Innovation and Research (PrMEIR), NYU School of Medicine, OBV CD-401, 462 1st Avenue, New York, New York 10016 USA
| | - Sondra Zabar
- Institute for Innovations in Medical Education, NYU School of Medicine, New York, USA
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York, New York USA
- Research on Medical Education Outcomes (ROMEO) Unit, Program for Medical Education Innovation and Research (PrMEIR), NYU School of Medicine, OBV CD-401, 462 1st Avenue, New York, New York 10016 USA
| | - Demian Szyld
- Department of Emergency Medicine, Center for Medical Simulation, Institute for Medical Simulation, Harvard Medical School, Boston, MA USA
| | - Steven D Yavner
- Department of Journalism, Central Connecticut State University, New Britain, CT USA
| | - Hyuksoon Song
- Department of Education, Georgian Court University, Lakewood, NJ USA
| | - Michael W Nick
- Program for Medical Education and Technology (PMET), NYU School of Medicine, New York, USA
| | - Grace Ng
- New York Simulation Center for the Health Sciences, New York, New York USA
| | - Martin V Pusic
- Department of Emergency Medicine, NYU School of Medicine, New York, New York USA
- Institute for Innovations in Medical Education, NYU School of Medicine, New York, USA
| | - Christine Denicola
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York, New York USA
- Research on Medical Education Outcomes (ROMEO) Unit, Program for Medical Education Innovation and Research (PrMEIR), NYU School of Medicine, OBV CD-401, 462 1st Avenue, New York, New York 10016 USA
| | - Cary Blum
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York, New York USA
| | - Kinga L Eliasz
- Program for Medical Education and Technology (PMET), NYU School of Medicine, New York, USA
| | - Joey Nicholson
- Health Science Library, NYU School of Medicine, New York, New York USA
| | - Thomas S Riles
- New York Simulation Center for the Health Sciences, New York, New York USA
- Institute for Innovations in Medical Education, NYU School of Medicine, New York, USA
- Program for Medical Education and Technology (PMET), NYU School of Medicine, New York, USA
- Department of Surgery, NYU School of Medicine, New York, USA
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Wass V, Mole TB. Contextually balanced medical education: realigning with global health care delivery. MEDICAL EDUCATION 2017; 51:773-775. [PMID: 28699289 DOI: 10.1111/medu.13360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Brown C, Thomas I. Twelve tips for conducting successful multiple patient encounter simulations (simultaneous simulations). MEDICAL TEACHER 2017; 39:660-664. [PMID: 28598737 DOI: 10.1080/0142159x.2017.1288864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Multiple patient encounter simulations (MPES), whereby learners are exposed to a number of simulated patients simultaneously, are gaining popularity as a method to address curricular gaps. Whilst this approach offers a host of benefits to educators and learners in ways single patient encounter simulations cannot, it also has significant challenges with regards to its implementation. We describe twelve tips for conducting successful MPES, divided into pre-, intra- and post-simulation considerations. By adhering to these twelve tips, educators can plan successful, fiscally responsible, well-organized, structured sessions for all learners (active and observing) that will achieve the learning outcomes desired using this advanced method of simulation.
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Affiliation(s)
- Craig Brown
- a Institute of Education for Medical and Dental Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen , Aberdeen , UK
| | - Ian Thomas
- a Institute of Education for Medical and Dental Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen , Aberdeen , UK
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Brown CW. Multiple patient encounter simulations in emergency medicine. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2016; 2:129-130. [DOI: 10.1136/bmjstel-2016-000145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2016] [Indexed: 11/04/2022]
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