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Calé R. "Observe, simulate, execute and mentor": A contemporary approach to learning in Interventional Cardiology. Rev Port Cardiol 2024; 43:397-398. [PMID: 38759914 DOI: 10.1016/j.repc.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Affiliation(s)
- Rita Calé
- Hospital Garcia de Orta, Almada, Portugal.
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Noamen A, Ben Amara A, Lajmi M, Hajlaoui N, Fehri W. Simulation versus theoretical learning for the transradial approach: a randomized controlled trial in interventional cardiology. LA TUNISIE MEDICALE 2023; 101:47-53. [PMID: 37682260 PMCID: PMC11099928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Simulation-based education (SE) in interventional cardiology improves knowledge acquisition and mastery of procedures including the conventional radial access (CRA). AIM To evaluate the contribution of SE in CRA compared with theoretical learning alone. METHODS This is a prospective randomized controlled study including cardiology residents and patients with normal radial pulses. Experienced residents as well as patients with contraindications to CRA, requiring urgent intervention, or with hemodynamic instability were not included. Missing the teaching sessions was the exclusion criteria. Residents were randomized into two groups: simulation versus control. They attended a theory lecture explaining CRA and were evaluated Only the simulation group attended an SE session with measurement of heart rate (HR) and stress level. A real application was then performed with measurement of HR and stress level. The primary outcome was success puncture rate. RESULTS The success of the puncture was similar between the two groups (p=0.651). In the practical application, the stress level was significantly different before the procedure but similar after the end of the procedure. The stress level varied significantly within the same group before and after the procedure The simulation group was significantly less tachycardic both before and during the procedure with a significant difference between the two groups (p <10-3). CONCLUSION This study demonstrated the interest of SE in novice residents for CRA as a complement to theoretical learning upstream of the real-life procedure.
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Affiliation(s)
- Aymen Noamen
- Hôpital militaire principal d'instruction de Tunis / Université Tunis El Manar / faculté de médecine de Tunis
| | - Ahmed Ben Amara
- Hôpital militaire principal d'instruction de Tunis / Université Tunis El Manar / faculté de médecine de Tunis
| | - Mokhles Lajmi
- Hôpital militaire principal d'instruction de Tunis / Université Tunis El Manar / faculté de médecine de Tunis
| | - Nadhem Hajlaoui
- Hôpital militaire principal d'instruction de Tunis / Université Tunis El Manar / faculté de médecine de Tunis
| | - Wafa Fehri
- Hôpital militaire principal d'instruction de Tunis / Université Tunis El Manar / faculté de médecine de Tunis
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3
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Vandermolen S, Ricci F, Chahal CAA, Capelli C, Barakat K, Fedorowski A, Westwood M, Patel RS, Petersen SE, Gallina S, Pugliese F, Khanji MY. 'The Digital Cardiologist': How Technology Is Changing the Paradigm of Cardiology Training. Curr Probl Cardiol 2022; 47:101394. [PMID: 36100095 DOI: 10.1016/j.cpcardiol.2022.101394] [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] [Received: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
In the same way that the practice of cardiology has evolved over the years, so too has the way cardiology fellows in training (FITs) are trained. Propelled by recent advances in technology-catalyzed by COVID-19-and the requirement to adapt age-old methods of both teaching and health care delivery, many aspects, or 'domains', of learning have changed. These include the environments in which FITs work (outpatient clinics, 'on-call' inpatient service) and procedures in which they need clinical competency. Further advances in virtual reality are also changing the way FITs learn and interact. The proliferation of technology into the cardiology curriculum has led to some describing the need for FITs to develop into 'digital cardiologists', namely those who comfortably use digital tools to aid clinical practice, teaching, and training whilst, at the same time, retain the ability for human analysis and nuanced assessment so important to patient-centred training and clinical care.
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Affiliation(s)
- Sebastian Vandermolen
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, EC1A 7BE, UK
| | - Fabrizio Ricci
- Institute of Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University, Chieti, Italy; Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 - 205 02, Malmö, Sweden; Casa di Cura Villa Serena, Città Sant'Angelo, Pescara, Italy
| | - C Anwar A Chahal
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; Center for Inherited Cardiovascular Diseases, WellSpan Health, Lancaster, PA; Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Claudio Capelli
- Institute of Cardiovascular Science, University College London (London, UK)
| | - Khalid Barakat
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 - 205 02, Malmö, Sweden; Department of Cardiology, Karolinska University Hospital, and Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mark Westwood
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, EC1A 7BE, UK
| | - Riyaz S Patel
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; Institute of Cardiovascular Science, University College London (London, UK)
| | - Steffen E Petersen
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, EC1A 7BE, UK
| | - Sabina Gallina
- Institute of Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University, Chieti, Italy
| | - Francesca Pugliese
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, EC1A 7BE, UK
| | - Mohammed Y Khanji
- Barts Heart Centre, Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK; NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, EC1A 7BE, UK; Newham University Hospital. Glen Road, Plaistow, Barts Health NHS Trust. London, UK.
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Katiyar V, Sadhwani N, Sharma R, Tandon V, Raheja A, Goda R, Ganeshkumar A, Mishra S, Garg K, Prada F, Kale SS. A High-Fidelity Agar-Based Phantom for Ultrasonography-Guided Brain Biopsy Simulation: A Novel Training Prototype with Visual Feedback. World Neurosurg 2022; 167:e333-e343. [PMID: 35961586 DOI: 10.1016/j.wneu.2022.08.014] [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: 05/19/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE A novel agar-based phantom was developed and assessed for ultrasonography (USG)-guided brain biopsy training. The phantom provides visual cues combined with sonologic cues, allowing multimodal training. Impact of multimodal training is evaluated through pretraining and posttraining trials. METHODS Twenty-five participants were divided based on experience with USG-based procedures into familiar (≥3 procedures performed in the past) (n = 14) and unfamiliar (<3 procedures performed) (n = 11). Agar phantoms with an opaque top and transparent middle layer were constructed in transparent glass bowls, each having 12 embedded targets. Participants underwent 2 supervised trials of USG-guided biopsy with aluminum foil covering the glass bowls, eliminating visual cues. Between 2 trials, participants underwent unsupervised self-training on a phantom without foil cover, providing visual cues. Performance was measured through insonation efficiency (EfI), biopsy efficiency (EfB), efficiency score (Ef), error score (Er), and performance score (PS). Scores were compared between and within the 2 groups before and after training. Impact of the self-training session on subjective comfort levels with the procedure was assessed through feedback forms. RESULTS Familiars had better pretraining EfB, Ef, Er, and PS (P < 0.001) compared with unfamiliars. After training, both performed similarly on all metrics. After training, familiars improved only in EfI (P = 0.001), with the unfamiliars showing significance in all metrics except EfI. CONCLUSIONS Simulation and phantom-based models can never supplant training through supervised skill application in vivo but our model supplements training by enabling technical skill acquisition, especially for beginners in USG-guided brain biopsy.
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Affiliation(s)
- Varidh Katiyar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Nidhisha Sadhwani
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ravi Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Revanth Goda
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Akshay Ganeshkumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Francesco Prada
- Ultrasound NeuroImaging and Therapy (UNIT) Laboratory, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Errichetti A, Eckles R, Beto J, Gross GA, Lorion AE. The Use of Patient Simulations to Teach and Assess Clinical Competencies in Colleges of Podiatric Medicine: A Survey of US Podiatric Medical Schools. J Am Podiatr Med Assoc 2022; 112:20-077. [PMID: 35482588 DOI: 10.7547/20-077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Human and mechanical simulations are used to teach and assess clinical competencies in medical education. In 2014, the National Board of Podiatric Medical Examiners implemented the Clinical Skills Patient Encounter, an examination using standardized patients. Similar clinical skills examinations already existed as part of medical and osteopathic licensure examinations. The purpose of this study was to assess the use of simulation-based education in the nine colleges of podiatric medicine in the United States to inform podiatric clinical faculty and other stakeholders about current trends within the podiatric education system. In 2019, the Clinical Skills Patient Encounter committee of the National Board of Podiatric Medical Examiners developed a survey and contacted each podiatric school to voluntarily participate. The mailed survey instrument gathered information on patient simulation modalities, years used, clinical content application, simulation program administration, facilities and equipment available, and the role of simulation educators. All nine schools participated anonymously. The survey showed that simulation modalities were used in all of the schools during the first 3 years, although there was considerable variance in their use.
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Affiliation(s)
| | - Robert Eckles
- †New York College of Podiatric Medicine, New York, NY
| | - Judith Beto
- ‡Academy of Nutrition and Dietetics, Chicago, IL
| | - Gretta A Gross
- *National Board of Osteopathic Medical Examiners, Conshohocken, PA
| | - Amy E Lorion
- *National Board of Osteopathic Medical Examiners, Conshohocken, PA
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Chong JH, Chahal CAA, Gupta A, Ricci F, Westwood M, Pugliese F, Petersen SE, Khanji MY. COVID-19 and the Digitalisation of Cardiovascular Training and Education-A Review of Guiding Themes for Equitable and Effective Post-graduate Telelearning. Front Cardiovasc Med 2021; 8:666119. [PMID: 34277728 PMCID: PMC8283504 DOI: 10.3389/fcvm.2021.666119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has had an unprecedented impact leading to novel adaptations in post-graduate medical education for cardiovascular and general internal medicine. Whilst the results of initial community COVID-19 vaccination are awaited, continuation of multimodality teaching and training that incorporates telelearning will have enduring benefit to post-graduate education and will place educational establishments in good stead to nimbly respond in future pandemic-related public health emergencies. With the rise in innovative virtual learning solutions, medical educators will have to leverage technology to develop electronic educational materials and virtual courses that facilitate adult learning. Technology-enabled virtual learning is thus a timely progression of hybrid classroom initiatives that are already adopted to varying degrees, with a need for faculty to serve as subject matter experts, to host and moderate online discussions, and to provide feedback and overall mentorship. As an extension from existing efforts, simulation-based teaching (SBT) and learning and the use of mixed reality technology should also form a greater core in the cardiovascular medicine curriculum. We highlight five foundational themes for building a successful e-learning model in cardiovascular and general post-graduate medical training: (1) digital solutions and associated infrastructure; (2) equity in access; (3) participant engagement; (4) diversity and inclusion; and (5) patient confidentiality and governance framework. With digitalisation impacting our everyday lives and now how we teach and train in medicine, these five guiding principles provide a cognitive scaffold for careful consideration of the required ecosystem in which cardiovascular and general post-graduate medical education can effectively operate. With due consideration of various e-learning options and associated infrastructure needs; and adoption of strategies for participant engagement under sound and just governance, virtual training in medicine can be effective, inclusive and equitable through the COVID-19 era and beyond.
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Affiliation(s)
- Jun Hua Chong
- National Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Sciences Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - C Anwar A Chahal
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States.,Department of Cardiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Ajay Gupta
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, United Kingdom
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging, and Clinical Sciences, Institute of Advanced Biomedical Technologies, "G.d'Annunzio" University, Chieti, Italy.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Casa di Cura Villa Serena, Pescara, Italy
| | - Mark Westwood
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
| | - Francesca Pugliese
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, United Kingdom
| | - Steffen E Petersen
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, United Kingdom
| | - Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, United Kingdom.,Department of Cardiology, Newham University Hospital and Barts Heart Centre, Barts Health National Health Service Trust, London, United Kingdom
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Affiliation(s)
- Alexandra Moss
- Department of Cardiology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Victoria M Stoll
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,Department of Cardiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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Qurash MT, Yaacob NY, Azuan N, Khaleel YS, Zakaria R. Special Ultrasound Phantom for Interventional Training: Construction, Advantages, and Application. J Med Ultrasound 2019; 26:210-214. [PMID: 30662153 PMCID: PMC6314090 DOI: 10.4103/jmu.jmu_40_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 03/09/2018] [Indexed: 12/03/2022] Open
Abstract
Interventional radiology procedures are becoming more challenging over time; thus, there is a need for excellent and reliable training methods. Training on live patients is neither safe nor an ethical solution. Alternatives are many and varied, but the most popular is ultrasound guided simulators. This report shows how a simple, homemade, low-cost phantom material, and construction modules can provide several advantages over ordinary gelatin phantoms. A new layering technique and target synthesis are described for the biopsy phantom, including tips on decreasing the needle pass artifact as well as controlling the mixture echogenicity.
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Affiliation(s)
- Musaad Taha Qurash
- Department of Radiology, UKM Medical Center, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, Malaysia
| | - Nur Yazmin Yaacob
- Department of Radiology, UKM Medical Center, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, Malaysia
| | - Nik Azuan
- Department of Radiology, UKM Medical Center, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, Malaysia
| | - Yasir Sabah Khaleel
- Department of Radiology, UKM Medical Center, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, Malaysia
| | - Rozman Zakaria
- Department of Radiology, UKM Medical Center, Hospital Canselor Tuanku Mukhriz, Kuala Lumpur, Malaysia
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