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Branditz LD, Kendle AP, Leung CG, San Miguel CE, Way DP, Panchal AR, Yee J. Bridging the procedures skill gap from medical school to residency: a simulation-based mastery learning curriculum. MEDICAL EDUCATION ONLINE 2024; 29:2412399. [PMID: 39370875 DOI: 10.1080/10872981.2024.2412399] [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: 10/06/2023] [Revised: 07/25/2024] [Accepted: 09/30/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND The transition from medical student to intern is a recognized educational gap. To help address this, the Association of American Medical Colleges developed the Core Entrustable Professional Activities for entering residency. As these metrics outline expectations for all graduating students regardless of specialty, the described procedural expectations are appropriately basic. However, in procedure-heavy specialties such as emergency medicine, the ability to perform advanced procedures continues to contribute to the disconnect between undergraduate and graduate medical education. To prepare our graduating students for their internship in emergency medicine, we developed a simulation-based mastery learning curriculum housed within a specialty-specific program. Our overall goal was to develop the students' procedural competency for central venous catheter placement and endotracheal intubation before graduation from medical school. METHODS Twenty-five students participated in a simulation-based mastery learning procedures curriculum for ultrasound-guided internal jugular central venous catheter placement and endotracheal intubation. Students underwent baseline assessment, deliberate practice, and post-test assessments. Both the baseline and post-test assessments used the same internally developed checklists with pre-established minimum passing scores. RESULTS Despite completing an emergency medicine rotation and a critical care rotation, none of the students met the competency standard during their baseline assessments. All twenty-five students demonstrated competency on both procedures by the end of the curriculum. A second post-test was required to demonstrate achievement of the central venous catheter and endotracheal intubation minimum passing scores by 16% and 28% of students, respectively. CONCLUSIONS Students demonstrated procedural competency for central venous catheter placement and endotracheal intubation by engaging in simulation-based mastery learning procedures curriculum as they completed their medical school training. With three instructional hours, students were able to achieve basic procedural competence for two common, high-risk procedures they will need to perform during emergency medicine residency training.
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Affiliation(s)
- Lauren D Branditz
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Andrew P Kendle
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Cynthia G Leung
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Christopher E San Miguel
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - David P Way
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ashish R Panchal
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jennifer Yee
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Sadeghi M, Nematollahi M, Farokhzadian J, Khoshnood Z, Eghbalian M. The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study. BMC Nurs 2023; 22:475. [PMID: 38093263 PMCID: PMC10717742 DOI: 10.1186/s12912-023-01442-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/09/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students. METHOD This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests. RESULTS The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05). CONCLUSION The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.
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Affiliation(s)
- Mohammad Sadeghi
- Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Monirsadat Nematollahi
- Nursing research center, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, 7616913555, Iran
| | - Jamileh Farokhzadian
- Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Khoshnood
- Nursing research center, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, 7616913555, Iran.
| | - Mostafa Eghbalian
- Endocrinology and metabolism research center, Institute of basic and clinical physiology sciences, Kerman University of Medical Science, Kerman, Iran
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Meyer A, Stosch C, Klatt AR, Streichert T. The impact of COVID-19 on medical students' practical skills and hygiene behavior regarding venipuncture: a case control study. BMC MEDICAL EDUCATION 2022; 22:558. [PMID: 35850715 PMCID: PMC9294821 DOI: 10.1186/s12909-022-03601-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite their importance to current and future patient care, medical students' hygiene behaviors and acquisition of practical skills have rarely been studied in previous observational study. Thus, the aim of this study was to investigate the potential impact of the COVID-19 pandemic on medical student's hygiene and practical skills. METHODS This case-control study assessed the effect of the COVID-19 pandemic on hygiene behavior by contrasting the practical skills and hygiene adherence of 371 medical students post the pandemic associated lockdown in March 2020 with that of 355 medical students prior to the SARS-CoV-2 outbreak. Students' skills were assessed using an objective structured clinical examination (OSCE). Their skills were then compared based on their results in hygienic venipuncture and the total OSCE score. RESULTS During the SARS-CoV-2 pandemic, medical students demonstrated an increased level of compliance regarding hand hygiene before (prior COVID-19: 83.7%; during COVID-19: 94.9%; p < 0.001) and after patient contact (prior COVID-19: 19.4%; during COVID-19: 57.2%; p = 0.000) as well as disinfecting the puncture site correctly (prior COVID-19: 83.4%; during COVID-19: 92.7%; p < 0.001). Prior to the pandemic, students were more proficient in practical skills, such as initial venipuncture (prior COVID-19: 47.6%; during COVID-19: 38%; p < 0.041), patient communication (prior COVID-19: 85.9%; during COVID-19: 74.1%; p < 0.001) and structuring their work process (prior COVID-19: 74.4%; during COVID-19: 67.4%; p < 0.024). CONCLUSION Overall, the COVID-19 pandemic sensitized medical students' attention and adherence to hygiene requirements, while simultaneously reducing the amount of practice opportunities, thus negatively affecting their practical skills. The latter development may have to be addressed by providing additional practice opportunities for students as soon as the pandemic situation allows.
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Affiliation(s)
- Annika Meyer
- Faculty of medicine and university hospital, department of clinical chemistry, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Christoph Stosch
- Faculty of medicine and university hospital, Interprofessional Skills Lab and Simulation center (KISS), University of Cologne, Joseph-Stelzmann-Straße 9a, 50931, Cologne, Germany
| | - Andreas R Klatt
- Faculty of medicine and university hospital, department of clinical chemistry, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Thomas Streichert
- Faculty of medicine and university hospital, department of clinical chemistry, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Kowalski C, Boulesteix AL, Harendza S. Effective methods to enhance medical students' cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study. BMC MEDICAL EDUCATION 2022; 22:417. [PMID: 35650577 PMCID: PMC9158220 DOI: 10.1186/s12909-022-03495-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Guideline-based therapy of cardiac arrhythmias is important for many physicians from the beginning of their training. Practical training of the required skills to treat cardiac arrhythmias is useful for acquiring these skills but does not seem sufficient for skill retention. The aim of this study was to compare different retention methods for skills required to treat cardiac arrhythmias with respect to the performance of these skills in an assessment. METHODS Seventy-one final-year medical students participated in a newly designed workshop to train synchronized cardioversion (SC) and transcutaneous cardiac pacing (TCP) skills in 2020. All participants completed an objective structured clinical examination (OSCE 1) one week after the training. Afterwards, the participants were stratified and randomized into three groups. Nine weeks later, one group received a standard operating procedure (SOP) for the skills, one group participated in a second workshop (SW), and one group received no further intervention (control). Ten weeks after the first training, all groups participated in OSCE 2. RESULTS The average score of all students in OSCE 1 was 15.6 ± 0.8 points with no significant differences between the three groups. Students in the control group reached a significantly (p < 0.001) lower score in OSCE 2 (-2.0 points, CI: [-2.9;-1.1]) than in OSCE 1. Students in the SOP-group achieved on average the same result in OSCE 2 as in OSCE 1 (0 points, CI: [-0.63;+0.63]). Students who completed a second skills training (SW-group) scored not significantly higher in OSCE 2 compared to OSCE 1 (+0.4 points, CI: [-0.29;+1.12]). The OSCE 2 scores in groups SOP and SW were neither significantly different nor statistically equivalent. CONCLUSIONS Partial loss of SC and TCP skills acquired in a workshop can be prevented after 10 weeks by reading an SOP as well as by a second workshop one week before the second assessment. Refreshing practical skills with an SOP could provide an effective and inexpensive method for skills retention compared to repeating a training. Further studies need to show whether this effect also exists for other skills and how frequently an SOP should be re-read for appropriate long-term retention of complex skills.
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Affiliation(s)
- Christian Kowalski
- Department of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany
| | - Anne-Laure Boulesteix
- Department of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - Sigrid Harendza
- Department of Internal Medicine, University Medical, Center Hamburg-Eppendorf, Hamburg, Germany
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Meyer A, Schreiber J, Brinkmann J, Klatt AR, Stosch C, Streichert T. Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills. BMC MEDICAL EDUCATION 2021; 21:434. [PMID: 34404414 PMCID: PMC8369648 DOI: 10.1186/s12909-021-02868-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The American Association of Medical Colleges has defined peripheral intravenous cannulation as one of the eight practical skills that a medical student should possess upon graduation. Since following a standard hygiene protocol can reduce the rate of complications such as bloodstream infections, the medical student's compliance to hygienic standards is highly relevant. METHODS This unicentric longitudinal cohort study included 177 medical students undergoing OSCE 1 in the winter semesters 2016/2017 and 2017/2018 as well as OSCE 2 during the winter semesters 2018/2019 and 2019/2020 at the University of Cologne. Their performance in peripheral intravenous cannulation was rated by trained student supervisors using a scaled 13-item questionnaire and compared between OSCE 1 and OSCE 2. RESULTS Overall, a decline in the correct placement of peripheral intravenous catheters was observed among advanced medical students during OSCE 2 (mean total score: 6.27 ± 1.84) in comparison to their results in OSCE 1 (mean total score: 7.67 ± 1.7). During OSCE 2, the students were more negligent in regard to hygienic behavior, such as disinfection of the puncture site as well as hand disinfection before and after venipuncture. Their patients were also less likely to be informed about the procedure as compared to OSCE 1. CONCLUSIONS An unsatisfying performance in regard to peripheral intravenous cannulation was observed in medical students with hygiene compliance deteriorating between the third and fifth year of their study. Thus, we promote an extension of practical hygiene and stress management training in medical school to reduce complications associated with intravenous catheters, such as bloodstream infections.
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Affiliation(s)
- Annika Meyer
- Department of clinical chemistry, University of Cologne, Faculty of medicine and university hospital, Kerpener Str. 62, 50937, Cologne, Germany.
- Interprofessional Skills Lab and Simulation center (KISS), University of Cologne, faculty of medicine and university hospital, Joseph-Stelzmann-Straße 9a, 50931, Cologne, Germany.
| | - Jakob Schreiber
- Interprofessional Skills Lab and Simulation center (KISS), University of Cologne, faculty of medicine and university hospital, Joseph-Stelzmann-Straße 9a, 50931, Cologne, Germany
| | - Julian Brinkmann
- Interprofessional Skills Lab and Simulation center (KISS), University of Cologne, faculty of medicine and university hospital, Joseph-Stelzmann-Straße 9a, 50931, Cologne, Germany
| | - Andreas R Klatt
- Department of clinical chemistry, University of Cologne, Faculty of medicine and university hospital, Kerpener Str. 62, 50937, Cologne, Germany
| | - Christoph Stosch
- Interprofessional Skills Lab and Simulation center (KISS), University of Cologne, faculty of medicine and university hospital, Joseph-Stelzmann-Straße 9a, 50931, Cologne, Germany
| | - Thomas Streichert
- Department of clinical chemistry, University of Cologne, Faculty of medicine and university hospital, Kerpener Str. 62, 50937, Cologne, Germany
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Häske D, Beckers SK, Hofmann M, Lefering R, Grützner PA, Stöckle U, Papathanassiou V, Münzberg M. Subjective safety and self-confidence in prehospital trauma care and learning progress after trauma-courses: part of the prospective longitudinal mixed-methods EPPTC-trial. Scand J Trauma Resusc Emerg Med 2017; 25:79. [PMID: 28806988 PMCID: PMC5557465 DOI: 10.1186/s13049-017-0426-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims ultimately affects the routine and skills and underlines the importance of effective training. Standardized courses, like PHTLS, are established for health care professionals to improve the prehospital care of trauma patients. The aim of the study was to investigate the subjective safety in prehospital trauma care and learning progress by paramedics in a longitudinal analysis. METHODS This was a prospective intervention trial and part of the mixed-method longitudinal EPPTC-trial, evaluating subjective and objective changes among participants and real patient care as a result of PHTLS courses. Participants were evaluated with pre/post questionnaires as well as one year after the course. RESULTS We included 236 datasets. In the pre/post comparison, an increased performance could be observed in nearly all cases. The result shows that the expectations of the participants of the course were fully met even after one year (p = 0.002). The subjective safety in trauma care is significantly better even one year after the course (p < 0.001). Regression analysis showed that (ABCDE)-structure is decisive (p = 0.036) as well as safety in rare and common skills (both p < 0.001). Most skills are also rated better after one year. Knowledge and specific safety are assessed as worse after one year. CONCLUSION The courses meet the expectations of the participants and increase the subjective safety in the prehospital care of trauma patients. ABCDE-structure and safety in skills are crucial. In the short term, both safety in skills and knowledge can be increased, but the courses do not have the power to maintain knowledge and specific subjective safety issues over a year. TRIAL REGISTRATION German Clinical Trials Register, ID DRKS00004713 , registered 14. February 2014.
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Affiliation(s)
- David Häske
- Faculty of Medicine, Eberhard Karls University Tübingen, 72076 Tuebingen, Germany
| | - Stefan K. Beckers
- Department of Anesthesiology, University Hospital RWTH, Aachen, 52074 Aachen, Germany
- Emergency Medical Service, Fire Department, City of Aachen, 52057 Aachen, Germany
| | - Marzellus Hofmann
- Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine, University of Witten/Herdecke, 51109 Cologne, Germany
| | - Paul A. Grützner
- Department of Trauma Surgery and Orthopedics, BG Hospital Ludwigshafen, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, D-67071 Ludwigshafen, Germany
| | - Ulrich Stöckle
- Department of Traumatology and Reconstructive Surgery, BG Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Vassilios Papathanassiou
- Institute of Medical Psychology, University Hospital of the Saarland and Medical Faculty of the University of Saarland, /Saar, 66421 Homburg, Germany
| | - Matthias Münzberg
- Department of Trauma Surgery and Orthopedics, BG Hospital Ludwigshafen, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, D-67071 Ludwigshafen, Germany
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