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Elendu C, Amaechi DC, Okatta AU, Amaechi EC, Elendu TC, Ezeh CP, Elendu ID. The impact of simulation-based training in medical education: A review. Medicine (Baltimore) 2024; 103:e38813. [PMID: 38968472 PMCID: PMC11224887 DOI: 10.1097/md.0000000000038813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/13/2024] [Indexed: 07/07/2024] Open
Abstract
Simulation-based training (SBT) has emerged as a transformative approach in medical education, significantly enhancing healthcare professionals' learning experience and clinical competency. This article explores the impact of SBT, tracing its historical development and examining the various types of simulations utilized today, including high-fidelity mannequins, virtual reality environments, standardized patients, and hybrid simulations. These methods offer a safe and controlled environment for students to practice and hone technical and non-technical skills, ultimately improving patient safety and clinical outcomes. The benefits of SBT are manifold, including enhanced skill acquisition, error reduction, and the opportunity for repeated practice without risk to actual patients. Immediate feedback and structured debriefing further solidify learning, making Simulation an invaluable tool in medical education. However, the implementation of SBT is challenging. It requires substantial financial investment, specialized equipment, and trained faculty. Additionally, there are concerns about the realism of simulations and the transferability of skills to real-world clinical settings. Despite these challenges, numerous case studies and empirical research underscore the effectiveness of SBT compared to traditional methods. Looking ahead, advancements in technology, such as artificial intelligence and improved virtual reality applications, promise to enhance the efficacy and accessibility of simulation training. The integration of Simulation with other training modalities and its adoption in diverse global contexts highlight its potential to revolutionize medical education worldwide. This article affirms the crucial role of SBT in preparing the next generation of healthcare professionals and its ongoing evolution driven by technological innovations.
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Mulherkar R, Shah C, Bulat M, Thaker NG, Kamrava M, Beriwal S. Role of simulation-based training and assessment to improve brachytherapy competency among radiation oncology residents. Brachytherapy 2024; 23:489-495. [PMID: 38643045 DOI: 10.1016/j.brachy.2024.02.010] [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: 12/27/2023] [Revised: 02/13/2024] [Accepted: 02/29/2024] [Indexed: 04/22/2024]
Abstract
Simulation is a technique used in healthcare to replicate clinical scenarios and improve patient safety, efficacy, and efficiency. Simulation-based medical education facilitates training and assessment in healthcare without increasing risk to patients, supported by ample evidence from surgical/procedural specialties. Simulation in radiation oncology has been leveraged to an extent, with successful examples of both screen-based and hands-on simulators that have improved confidence and performance in trainees. In the current era, evidence substantiates a significant deficit in brachytherapy procedure education, with radiation oncology residents reporting low confidence in this procedural skill, largely attributable to insufficient caseloads at some centers. Simulation-based medical education can facilitate structured training and competency-based assessment in brachytherapy skills. This review discusses existing advances and future directions in brachytherapy simulation, using examples from simulation in surgical specialties.
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Affiliation(s)
- Ria Mulherkar
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Cancer Center, Cleveland, OH
| | - Mitchell Bulat
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Nikhil G Thaker
- Department of Radiation Oncology, Capital Health Medical Center, Pennington, NJ
| | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Sushil Beriwal
- Department of Radiation Oncology, AHN Cancer Institute, Pittsburgh, PA.
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Abdelrahman MM, Hashem R, Abo-Seif LMES. Promoting infant safe sleep practices among neonatal and paediatric nurses through simulation-based training program. J Pediatr Nurs 2024; 77:e474-e479. [PMID: 38777675 DOI: 10.1016/j.pedn.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE To evaluate the effect of a Simulation-based training (SBT) program on neonatal and paediatric nurses' knowledge regarding infant safe sleep practices. BACKGROUND Sudden infant death syndrome (SIDS) presents a major public health concern, preventable through the promotion of optimal safe sleep practices, particularly among neonatal and paediatric nurses. Despite its effectiveness in enhancing nurses' knowledge and clinical skills, SBT is not an adopted training method for nurses in Egypt. DESIGN AND METHODS A single-group pre- and post-test design involved 57 nurses from Neonatal Intensive Care Unit, Paediatric Intensive Care Unit, and Paediatric In-patient Unit. The study consisted of two stages. In the first stage, knowledge assessment to identify deficiencies. The second stage, researchers developed four SBT scenarios. Two of these scenarios were recorded for training purposes, while the other two were intended for nurses to actively participate in. Data were collected from May 2022 to January 2023. RESULTS A significant improvement in nurses' knowledge of infant safe sleep practices and SIDS prevention was observed (p = 0.000). Nurses expressed high satisfaction with the training program (mean score 45.035 ± 4.38). CONCLUSION This study provides evidence that simulation-based training is an effective approach to promoting safe infant sleep practices among neonatal and paediatric nurses. PRACTICE IMPLICATIONS Integrating SBT programs into nursing education can enhance nurses' knowledge and skills in infant-safe sleep practices, providing a realistic and interactive learning experience.
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Affiliation(s)
| | - Reham Hashem
- Paediatric Specialty Registrar, Hinchingbrooke Hospital, United Kingdom
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Huber L, Good R, Bone MF, Flood SM, Fredericks R, Overly F, Tofil NM, Wing R, Walsh K. A Modified Delphi Study for Curricular Content of Simulation-Based Medical Education for Pediatric Residency Programs. Acad Pediatr 2024; 24:856-865. [PMID: 38663801 DOI: 10.1016/j.acap.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE We sought to establish core knowledge topics and skills that are important to teach pediatric residents using simulation-based medical education (SBME). METHODS We conducted a modified Delphi process with experts in pediatric SBME. Content items were adapted from the American Board of Pediatrics certifying exam content and curricular components from pediatric entrustable professional activities (EPAs). In round 1, participants rated 158 items using a four-point Likert scale of importance to teach through simulation in pediatric residency. A priori, we defined consensus for item inclusion as ≥70% rated the item as extremely important and exclusion as ≥70% rated the item not important. Criteria for stopping the process included reaching consensus to include and/or exclude all items, with a maximum of three rounds. RESULTS A total of 59 participants, representing 46 programs and 25 states participated in the study. Response rates for the three rounds were 92%, 86% and 90%, respectively. The final list includes 112 curricular content items deemed by our experts as important to teach through simulation in pediatric residency. Seventeen procedures were included. Nine of the seventeen EPAs had at least one content item that experts considered important to teach through simulation as compared to other modalities. CONCLUSIONS Using consensus methodology, we identified the curricular items important to teach pediatric residents using SBME. Next steps are to design a simulation curriculum to encompass this content.
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Affiliation(s)
- Lorel Huber
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo.
| | - Ryan Good
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Meredith F Bone
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Shannon M Flood
- University of Colorado (SM Flood), Pediatric Emergency Medicine, Aurora, Colo
| | - Ryan Fredericks
- Swedish Medical Center (R Fredericks), Pediatric Critical Care Medicine, Seattle, Wash
| | - Frank Overly
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Nancy M Tofil
- University of Alabama at Birmingham (NM Tofil), Pediatric Critical Care Medicine, Birmingham, Ala
| | - Robyn Wing
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Kathryn Walsh
- University of Colorado (K Walsh), Denver Health, Pediatric Critical Care Medicine, Denver Health Medical Center, Denver, Colo
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Azher S, Mills A, He J, Hyjazie T, Tokuno J, Quaiattini A, Harley JM. Findings Favor Haptics Feedback in Virtual Simulation Surgical Education: An Updated Systematic and Scoping Review. Surg Innov 2024; 31:331-341. [PMID: 38486132 PMCID: PMC11047018 DOI: 10.1177/15533506241238263] [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] [Indexed: 04/28/2024]
Abstract
BACKGROUND Virtual simulations (VSs) enhance clinical competencies and skills. However, a previous systematic review of 9 RCT studies highlighted a paucity of literature on the effects of haptic feedback in surgical VSs. An updated systematic and scoping review was conducted to encompass more studies and a broader range of study methodologies. METHODS A systematic literature search was conducted on July 31, 2023, in MEDLINE, Embase, and Cochrane. English language studies comparing haptic vs non-haptic conditions and using VSs were included. Studies were evaluated and reported using PRISMA-ScR guidelines. RESULTS Out of 2782 initial studies, 51 were included in the review. Most studies used RCT (21) or crossover (23) methodologies with medical residents, students, and attending physicians. Most used post-intervention metrics, while some used pre- and post-intervention metrics. Overall, 34 performance results from studies favored haptics, 3 favored non-haptics, and the rest showed mixed or equal results. CONCLUSION This updated review highlights the diverse application of haptic technology in surgical VSs. Haptics generally enhances performance, complements traditional teaching methods, and offers personalized learning with adequate simulator validation. However, a sparsity of orienting to the simulator, pre-/post-study designs, and small sample sizes poses concerns with the validity of the results. We underscore the urgent need for standardized protocols, large-scale studies, and nuanced understanding of haptic feedback integration. We also accentuate the significance of simulator validation, personalized learning potential, and the need for researcher, educator, and manufacturer collaboration. This review is a guidepost for navigating the complexities and advancements in haptic-enhanced surgical VSs.
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Affiliation(s)
- Sayed Azher
- Department of Surgery, McGill University, Montreal, QC, Canada
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Aralia Mills
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Jinzhi He
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Taliah Hyjazie
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Junko Tokuno
- Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andrea Quaiattini
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Jason M. Harley
- Department of Surgery, McGill University, Montreal, QC, Canada
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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Deuchler S, Dail YA, Berger T, Sneyers A, Koch F, Buedel C, Ackermann H, Flockerzi E, Seitz B. Simulator-Based Versus Traditional Training of Fundus Biomicroscopy for Medical Students: A Prospective Randomized Trial. Ophthalmol Ther 2024; 13:1601-1617. [PMID: 38615132 PMCID: PMC11109054 DOI: 10.1007/s40123-024-00944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/25/2024] [Indexed: 04/15/2024] Open
Abstract
INTRODUCTION Simulation training is an important component of medical education. In former studies, diagnostic simulation training for direct and indirect funduscopy was already proven to be an effective training method. In this prospective controlled trial, we investigated the effect of simulator-based fundus biomicroscopy training. METHODS After completing a 1-week ophthalmology clerkship, medical students at Saarland University Medical Center (n = 30) were block-randomized into two groups: The traditional group received supervised training examining the fundus of classmates using a slit lamp; the simulator group was trained using the Slit Lamp Simulator. All participants had to pass an Objective Structured Clinical Examination (OSCE); two masked ophthalmological faculty trainers graded the students' skills when examining patient's fundus using a slit lamp. A subjective assessment form and post-assessment surveys were obtained. Data were described using median (interquartile range [IQR]). RESULTS Twenty-five students (n = 14 in the simulator group, n = 11 in the traditional group) (n = 11) were eligible for statistical analysis. Interrater reliability was verified as significant for the overall score as well as for all subtasks (≤ 0.002) except subtask 1 (p = 0.12). The overall performance of medical students in the fundus biomicroscopy OSCE was statistically ranked significantly higher in the simulator group (27.0 [5.25]/28.0 [3.0] vs. 20.0 [7.5]/16.0 [10.0]) by both observers with an interrater reliability of IRR < 0.001 and a significance level of p = 0.003 for observer 1 and p < 0.001 for observer 2. For all subtasks, the scores given to students trained using the simulator were consistently higher than those given to students trained traditionally. The students' post-assessment forms confirmed these results. Students could learn the practical backgrounds of fundus biomicroscopy (p = 0.04), the identification (p < 0.001), and localization (p < 0.001) of pathologies significantly better with the simulator. CONCLUSIONS Traditional supervised methods are well complemented by simulation training. Our data indicate that the simulator helps with first patient contacts and enhances students' capacity to examine the fundus biomicroscopically.
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Affiliation(s)
- Svenja Deuchler
- Augenzentrum Frankfurt, Georg-Baumgarten-Straße 3, 60549, Frankfurt am Main, Germany.
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany.
| | - Yaser Abu Dail
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany
| | - Albéric Sneyers
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany
| | - Frank Koch
- Augenzentrum Frankfurt, Georg-Baumgarten-Straße 3, 60549, Frankfurt am Main, Germany
| | - Claudia Buedel
- Augenzentrum Frankfurt, Georg-Baumgarten-Straße 3, 60549, Frankfurt am Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Elias Flockerzi
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, 66424, Homburg, Saar, Germany
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Ainsworth J, Perumal S, Pillai S. The use of Simulated Observations in Medical Simulation and its effect on perceived realism: A pilot project. MEDEDPUBLISH 2024; 13:66. [PMID: 38845813 PMCID: PMC11153985 DOI: 10.12688/mep.19719.2] [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] [Accepted: 06/06/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Simulation is an effective teaching method with increasing growth and recognition and refers to the artificial representation of a real-life scenario. The aim of this study was to compare simulation with and without the use of a simulated observations monitor and to investigate differences in students' impression of realism, engagement, learning, and enjoyment. Methods Simulation sessions were delivered to second and third-year Swansea University Medical Students, and a total of 15 students were included. Students carried out 2-3 scenarios each with and without the use of a simulated observations monitor. Data collection was conducted via student surveys and a joint interview. Results All students had an increased sense of realism with the use of the simulated observations monitor, feeling a closer resemblance to what would be experienced in clinical practice. They felt this improved their learning, making them more prepared for the real-life scenario. The monitor was more dynamic, responding to their interventions, helping them maintain focus and engagement throughout. A key theme was the reduction of interruptions or deviations from the scenario to communicate with the examiner or ask for observations. The visual and audible affects provided additional stimuli, adding to the realistic nature of the simulation. Discussion Simulation has been shown to be a useful education tool, but there is less evidence to support the use of higher fidelity over lower fidelity simulation. The terms are often used inconsistently, and many factors affect the students' perceived sense of realism. This study shows that the addition of a simple device such as the simulated observations monitor can produce a higher level of fidelity, particularly in terms of the stimuli provided and student perceptions of realism, which may be effective in improving engagement with the simulation, learning, and aid recall when presented with similar scenarios in a real-life situation.
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Cole R, Shen C, Shumaker J, Matthews KJ, Brown ZL, Cuestas J, Rudinsky SL. The impact of simulation-based training on medical students' whole blood transfusion abilities. Transfusion 2024. [PMID: 38783709 DOI: 10.1111/trf.17906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Whole blood transfusion has been found to increase the likelihood of patient survival within both military and civilian medicine contexts. However, no whole blood transfusion training curriculum currently exists within undergraduate or graduate medical education in the United States. The purpose of our study was to: (1) determine the impact of simulation-based training on medical students' abilities to conduct whole blood transfusions; and (2) determine the impact of simulation-based training on medical students' confidence in conducting whole blood transfusions. STUDY DESIGN AND METHODS We assessed 157 third-year military medical students' ability to conduct whole blood transfusion before and after Operation Gunpowder, a 2-day high-fidelity prolonged casualty care simulation. We conducted a paired samples t-test to compare the students' pre- and post-simulation performance scores as well as self-reported confidence and stress ratings. RESULTS There was a significant difference in students' scores at the beginning of the course (M = 20.469, SD 6.40675) compared to their scores at the end of the course (M = 30.361, SD = 2.10053); t(155) = -18.833, p < .001. The effect size for this analysis (d = 6.56) was large. There was a significant difference (p < .001) between the pre- and post-ratings for all self-reported confidence and stress survey items. DISCUSSION Our results suggest that simulation-based training is an effective means of training medical students to conduct whole blood transfusiontraining in a limited resource simulated environment where blood inventories may be limited.
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Affiliation(s)
- Rebekah Cole
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Department of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Cynthia Shen
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jonathan Shumaker
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kevin J Matthews
- Enlisted to Medical Degree Preparatory Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Zachery L Brown
- Enlisted to Medical Degree Preparatory Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Joshua Cuestas
- Enlisted to Medical Degree Preparatory Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Sherri L Rudinsky
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Arai Y, Ohta K, Yoshino G, Okanishi T, Maegaki Y. The Impact of Simulation-Based Training on Self-Efficacy in Sedation for Pediatric Magnetic Resonance Imaging. Yonago Acta Med 2024; 67:108-113. [PMID: 38803588 PMCID: PMC11128076 DOI: 10.33160/yam.2024.05.002] [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: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 05/29/2024]
Abstract
Background In Japan, approximately 35% of facilities experience sedation-related complications for pediatric magnetic resonance imaging (MRI), including severe complications such as respiratory and cardiac arrests. In the medical education field, simulation improves not only the quality of real emergency response but also health care workers' self-efficacy. Individuals with high self-efficacy are better prepared at handling diverse conditions. However, there is no research examining the impact of sedation simulation for pediatric MRI on the self-efficacy of health care workers. This study aimed to retrospectively investigate the impact of sedation simulation for pediatric MRI on the self-efficacy of health care workers in sedation. Methods The study was conducted on August 18, 2023, and enrolled pediatricians, nurses, and radiological technologists. The impact of sedation simulation for pediatric MRI on the participants was analyzed using confidence scale scores and part of the Pediatric Resuscitation and Escalation of Care Self-Efficacy Scale (PRSES), before and after sedation simulation for pediatric MRI. Results Eighteen participants (six pediatricians, six nurses, and six radiological technologists) were included in this study. Regarding confidence scale scores, a significant improvement was observed in the overall group (P = 0.002) and among the nurses (P = 0.0036). Regarding the item 'When confronted with a clinically deteriorating child, I know how to ask for assistance' of PRSES, a significant improvement was observed in the overall group (P = 0.0035) and among the radiological technologists (P = 0.048). Conclusion There's a potential for sedation simulation for pediatric MRI to increase the self-efficacy of health care workers in MRI sedation. Our findings suggest that this training has a valuable role in preparing health care workers to practice sedation for pediatric MRI.
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Affiliation(s)
- Yuto Arai
- Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Kento Ohta
- Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Go Yoshino
- Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Tohru Okanishi
- Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Kadom N, Peterson RB. Streaming Success: Harnessing Social Media for Dynamic Radiology Education. Curr Probl Diagn Radiol 2024; 53:335-340. [PMID: 38508977 DOI: 10.1067/j.cpradiol.2024.03.006] [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: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
Social media are increasingly used as tools in radiologists education. This article describes features that aid with the selection of SM platforms, and how to emulate educator roles in the digital world. In addition, we summarize best practices regarding curating and delivering stellar content, building a SM brand, and rules of professionalism when using SM in radiology education.
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Affiliation(s)
- Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Children's Healthcare of Atlanta- Egleston Campus, Atlanta, GA, USA.
| | - Ryan B Peterson
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Yang SH, Chen CY, Liu WL, Liu HW, Chao KY. Development of a Cost-Effective 3D-Printed Airway Suction Simulator for Respiratory Therapy Students. Respir Care 2024; 69:549-556. [PMID: 38167213 PMCID: PMC11147610 DOI: 10.4187/respcare.11277] [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: 01/05/2024]
Abstract
BACKGROUND Three-dimensional (3D)-printed models are cost-effective and can be customized by trainers. This study designed a 3D-printed airway suction simulator for use by respiratory therapy (RT) students. The objective was to demonstrate the cost-effectiveness and application of 3D-printed models in respiratory care training, aiming to enhance the educational experience for RT students. METHODS This study developed a 3D-printed airway suction simulator that was cost-effective. A randomized controlled trial was conducted involving RT students to compare effectiveness in a 3D-model group and a control group. Skill assessments and written examinations were used to evaluate the participants' knowledge and skills. RESULTS A total of 38 second-year RT students were randomly assigned to either the 3D-model group (n = 19) or the control group (n = 19). One participant in the 3D-model group was lost to follow-up during the planned direct observation of procedural skills (DOPS) assessment and satisfaction questionnaire completion. The posttest written examination scores were significantly higher in the 3D-model group than in the control group (100% vs 80%, P = .02). The scores from the DOPS and satisfaction questionnaire were comparable in the 2 groups. CONCLUSIONS This study demonstrated that 3D printing can be used to create a safe and cost-effective airway suction simulator for use by RT students, with potential to enhance training methods. Further research is necessary.
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Affiliation(s)
- Shih-Hsing Yang
- Department of Respiratory Therapy, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; and Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chao-Yu Chen
- Department of Respiratory Therapy, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; and Department of Life Science, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wei-Lun Liu
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; and Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hsia-Wei Liu
- Department of Life Science, Fu Jen Catholic University, New Taipei City, Taiwan; and Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ke-Yun Chao
- Department of Respiratory Therapy, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; School of Physical Therapy, Graduate Institute of Rehabilitation Sciences, Chang Gung University, Taoyuan, Taiwan; and Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, Taiwan.
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Epuitai J, Adongo PR, Oboth P, Apili F, Kumakech E, Owusu-Sekyere S, Wandabwa JN. "We are actually being involved in management of the patient": A qualitative exploration of experiences of students and faculty regarding the use of clinical simulation in Busitema University and Lira University. RESEARCH SQUARE 2024:rs.3.rs-4242598. [PMID: 38699328 PMCID: PMC11065065 DOI: 10.21203/rs.3.rs-4242598/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Introduction Experiences regarding the use of simulation in low-resource settings like Uganda where it has not taken root have not been explored. The purpose of the study was to explore the experiences of students, clinical staff, and faculty regarding the use of clinical simulation in teaching undergraduate students. Materials and methods The study was conducted at Busitema and Lira Universities in Uganda. We conducted 20 in-depth interviews with the faculty staff and 10 focused group discussions with undergraduate Nursing, Midwifery, Medical and Anesthesia students. The study obtained ethical clearance from the Busitema University Research and Ethics Committee (BUFHS-2023-78) and Uganda National Council of Science and Technology (HS3027ES). Thematic analysis was used to analyze the data. Results Four themes emerged from the data. Simulation was seen to be about improvising and (return) demonstration. Concerns of realism were expressed including notions that simulation was not real, that simulation felt real and the extreme end that simulation tends to present the ideal setting. Perceived benefits of simulation include room for mistakes and immediate feedback, enhanced confidence and self-efficacy, enhanced acquisition of soft and clinical skills, prepares students for clinical placement, convenient and accessible. Concerns were expressed related to whether skills in clinical simulation would translate to clinical competence in the clinical setting. Conclusion Students perceived simulation to be beneficial. However, concerns about realism and transferability of skills to clinical settings were noted. Clarifying preconceived notions against the use of clinical simulation will enhance its utilization in educational settings where simulation is not readily embraced.
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Eklics K, Csongor A, Hambuch A, Fekete JD. Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:301-312. [PMID: 38618523 PMCID: PMC11016270 DOI: 10.2147/amep.s438102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.
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Affiliation(s)
- Kata Eklics
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Csongor
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Anikó Hambuch
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Diana Fekete
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
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Marsh-Armstrong B, Pacheco F, Dameff C, Tully J. Design and Pilot Study of a High-Fidelity Medical Simulation of a Hospital-Wide Cybersecurity Attack. RESEARCH SQUARE 2024:rs.3.rs-3959502. [PMID: 38645079 PMCID: PMC11030511 DOI: 10.21203/rs.3.rs-3959502/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Cybersecurity incidents affecting hospitals have grown in prevalence and consequence over the last two decades, increasing the importance of cybersecurity preparedness and response training to minimize clinical disruptions. This work describes the development, execution, and post-exercise assessment of a novel simulation scenario consisting of four interlocking intensive care unit (ICU) patient scenarios. This simulation was designed to demonstrate the management of acute pathologies without access to conventional treatment methods during a cybersecurity incident in order to raise clinician awareness of the increasing incidence and patient safety implications of such events. Methods The simulation was developed by a multidisciplinary team of physicians, simulation experts, and medical education experts at UCSD School of Medicine. The simulation involves the treatment of four patients, respectively experiencing postoperative hemorrhage, end stage renal disease, diabetic ketoacidosis, and hypoxic respiratory failure, all without access to networked medical resources. The simulation was first executed as part of the proceedings of CyberMed Summit, a healthcare cybersecurity conference in La Jolla, California, on November 19th, 2022. Following the simulation, a debrief session was held with the learner in front of conference attendees, with additional questioning and discussion prompted by attendee input. Results Though limited to a single subject by the pilot-study nature of this research, the physician learner successfully identified the acute etiologies and managed the patients' acute decompensations while lacking access to the hospital's electronic medical records (EMRs), laboratory results, imaging, and communication systems. Review of footage of the event and post-experience interviews yielded numerous insights on the specific physician-focused challenges and possible solutions to a hospital-infrastructure-crippling cyber attack. Conclusion Healthcare cybersecurity incidents are known to result in significant disruption of clinical activities and can be viewed through a patient-safety oriented perspective. Simulation training may be a particularly effective method for raising clinician awareness of and preparedness for these events, though further research is required.
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Gu Y, Tenenbein M, Korz L, Busse JW, Chiu M. Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey. Can J Anaesth 2024:10.1007/s12630-024-02720-6. [PMID: 38453798 DOI: 10.1007/s12630-024-02720-6] [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: 03/26/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs. METHODS We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology from October 2019 to January 2020. The survey consisted of questions pertaining to the characteristics of the simulation centres, their faculty, learners, curriculum, and assessment processes. RESULTS All 17 residency training programs participated in the survey and reported large variability in the number and formal training of simulation faculty and in content delivery. Five programs (29%) did not provide faculty recognition for curriculum design and running simulation sessions. Most programs offered one to four simulation sessions per academic year for each year of residency. All programs offered mannequin-based and part-task trainers for teaching technical and nontechnical skills. Fourteen programs (82%) offered interprofessional and interdisciplinary simulation sessions, and ten programs (59%) did not include in situ simulation training. Commonly reported barriers to faculty involvement were lack of protected time (12 programs, 71%), lack of financial compensation (ten programs, 59%), and lack of appreciation for SBME (seven programs, 41%). CONCLUSION Large variability exists in the delivery of SBME in Canadian anesthesiology residency simulation programs, in part because of differences in financial/human resources and educational content. Future studies should explore whether training and patient outcomes differ between SBME programs and, if so, whether additional standardization is warranted.
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Affiliation(s)
- Yuqi Gu
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, ON, K1H 8L6, Canada.
| | - Marshall Tenenbein
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Linda Korz
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Jason W Busse
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Michelle Chiu
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Ashraf M, Ismahel H, Shah D, Middleton EES, Gardee A, Chaudhary A, Salloum LA, Evans V, Nelson-Hughes M, Cheng Y, Goonewardena E, Ball E, Minnis M, Anyaegbunam GK, Salim O, Bashir ABBA, Hay S, Ismahel N, Ismahel S, Mackenzie I, Wang W, Shew W, Wynne S, Doherty J, Hassan S, Brown J, Bhattathiri P, Davidson A, Alakandy L. Shaping Perceptions and Inspiring Future Neurosurgeons: The Value of a Hands-On Simulated Aneurysm Clipping Workshops at a Student-Organized Neurosurgical Conference. Asian J Neurosurg 2024; 19:26-36. [PMID: 38751389 PMCID: PMC11093635 DOI: 10.1055/s-0043-1778634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Objective Early exposure to niche specialities, like neurosurgery, is essential to inform decisions about future training in these specialities. This study assesses the impact of a hands-on simulated aneurysm clipping workshop on medical students' and junior doctors' perceptions of neurosurgery at a student-organized neurosurgical conference. Methods Ninety-six delegates were sampled from a hands-on workshop involving hydrogel three-dimensional printed aneurysms clipping using surgical microscopes. Consultant neurosurgeons facilitated the workshop. Changes in delegates' perceptions of neurosurgery were collected using Likert scale and free-text responses postconference. Results Postworkshop, 82% of participants reported a positive impact on their perception of neurosurgery. Thematic analysis revealed that delegates valued the hands-on experience, exposure to microsurgery, and interactions with consultant neurosurgeons. Thirty-six of the 96 delegates (37.5%) expressed that the workshop dispelled preconceived fears surrounding neurosurgery and improved understanding of a neurosurgeon's day-to-day tasks. Several delegates initially apprehensive about neurosurgery were now considering it as a career. Conclusion Hands-on simulated workshops can effectively influence medical students' and junior doctors' perceptions of neurosurgery, providing valuable exposure to the specialty. By providing a valuable and immersive introduction to the specialty, these workshops can help to dispel misconceptions, fears, and apprehensions associated with neurosurgery, allowing them to consider the specialty to a greater degree than before. This study of a one-time workshop cannot effectively establish its long-term impact on said perceptions, however.
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Affiliation(s)
- Mohammad Ashraf
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Hassan Ismahel
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Devansh Shah
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Ameerah Gardee
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Attika Chaudhary
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Laulwa Al Salloum
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Vivienne Evans
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Meaghan Nelson-Hughes
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Yihui Cheng
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Eranga Goonewardena
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Emma Ball
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Meghan Minnis
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Omar Salim
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Sophie Hay
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Nadeen Ismahel
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Sophia Ismahel
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | | | | | - Wenmiao Shew
- Organlike Limited, Scotland, United Kingdom
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Simon Wynne
- Carl Zeiss UK Ltd, Cambridge, United Kingdom
| | - John Doherty
- Aesculap Division, B. Braun Medical Ltd, Sheffield, United Kingdom
| | - Samih Hassan
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Jennifer Brown
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Parameswaran Bhattathiri
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Amy Davidson
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Likhith Alakandy
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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Hutton D, Ashraf M, Sescu D, Ismahel H, Hepburn K, Lumsden E, Wright P, Chai C, Helley M, McSorley N, Mohamed B, Abdulrahman M, Page B, Porter R, Bodkin P, Okasha M. Dundee Annual Neurosurgery Skills Event (DANSE)-Improving the Availability and Affordability of Neurosurgical Skills Workshops for Medical Students. Asian J Neurosurg 2024; 19:63-72. [PMID: 38751396 PMCID: PMC11093633 DOI: 10.1055/s-0044-1785481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Background Neurosurgery can be a daunting career choice for medical students, with preparation for trainee application often being inaccessible and expensive. This article describes a student-led neurosurgical skills event supported by local neurosurgery faculty members. Such event was designed to offer a means to bridge this gap by providing an opportunity to practice neurosurgical techniques in simulation, and learn about what a career in neurosurgery involves. Methods Pre- and postskills laboratory surveys were used to ascertain the baseline confidence and knowledge of common neurosurgical techniques, as well as to what both the application to neurosurgery and the typical workload of a neurosurgeon involves. The conference offered six neurosurgical workshops as well as three lectures to provide practical and theoretical learning opportunities. The session included introduction to the candidates and faculty, identification of learning objectives, and career discussion. Postcourse feedback also was also used to assess learning outcomes. Results Eighteen students attended the event. Postskills event, students were significantly more likely to understand the principles behind all of the relevant neurosurgical skills included on the day. Additionally, students were more likely to understand what a career in neurosurgery involves, and how to approach applying for a training number. Respondents enjoyed the workshops, valued hands-on experience and interactions with consultants, found it affordable, and would recommend to their peers. Conclusions For medical students interested in a career in neurosurgery, opportunities to learn relevant techniques and skills are often expensive and difficult to come across. Here, we highlight affordable methods of simulation to result in significant student satisfaction. Additionally, providing ample opportunity to practice different neurosurgical techniques under almost 1:1 level tutoring enables significant increases in students' confidence and understanding of different neurosurgical concepts. We greatly encourage other medical student groups to develop their own hands-on simulation events to attract medical students to a surgical field often considered daunting and inaccessible, and address gaps in the medical school curriculum.
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Affiliation(s)
- Dana Hutton
- The Royal Victoria Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Mohammed Ashraf
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Queen Elizabeth University Hospital Glasgow, United Kingdom
| | - Daniel Sescu
- School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Hassan Ismahel
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Queen Elizabeth University Hospital Glasgow, United Kingdom
| | - Katie Hepburn
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Emma Lumsden
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Poppy Wright
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Carmen Chai
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Michael Helley
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Nathan McSorley
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Belal Mohamed
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Mohammed Abdulrahman
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Beverley Page
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Roslyn Porter
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Peter Bodkin
- Department of Neurosurgery, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland
| | - Mohamed Okasha
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
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Aljuwaiser S, Abdel-Fattah AR, Brown C, Kane L, Cooper J, Mostafa A. Evaluating the effects of simulation training on stroke thrombolysis: a systematic review and meta-analysis. Adv Simul (Lond) 2024; 9:11. [PMID: 38424568 PMCID: PMC10905914 DOI: 10.1186/s41077-024-00283-6] [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: 11/01/2023] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Ischaemic strokes are medical emergencies, and reperfusion treatment, most commonly intravenous thrombolysis, is time-critical. Thrombolysis administration relies on well-organised pathways of care with highly skilled and efficient clinicians. Simulation training is a widespread teaching modality, but results from studies on the impact of this intervention have yet to be synthesised. This systematic review and meta-analysis aimed to synthesise the evidence and provide a recommendation regarding the effects of simulation training for healthcare professionals on door-to-needle time in the emergency thrombolysis of patients with ischaemic stroke. METHODS Seven electronic databases were systematically searched (last updated 12th July 2023) for eligible full-text articles and conference abstracts. Results were screened for relevance by two independent reviewers. The primary outcome was door-to-needle time for recombinant tissue plasminogen activator administration in emergency patients with ischaemic stroke. The secondary outcomes were learner-centred, improvements in knowledge and communication, self-perceived usefulness of training, and feeling 'safe' in thrombolysis-related decision-making. Data were extracted, risk of study bias assessed, and analysis was performed using RevMan™ software (Web version 5.6.0, The Cochrane Collaboration). The quality of the evidence was assessed using the Medical Education Research Study Quality Instrument. RESULTS Eleven studies were included in the meta-analysis and nineteen in the qualitative synthesis (n = 20,189 total patients). There were statistically significant effects of simulation training in reducing door-to-needle time; mean difference of 15 min [95% confidence intervals (CI) 8 to 21 min]; in improving healthcare professionals' acute stroke care knowledge; risk ratio (RR) 0.42 (95% CI 0.30 to 0.60); and in feeling 'safe' in thrombolysis-related decision-making; RR 0.46 (95% CI 0.36 to 0.59). Furthermore, simulation training improved healthcare professionals' communication and was self-perceived as useful training. CONCLUSION This meta-analysis showed that simulation training improves door-to-needle times for the delivery of thrombolysis in ischaemic stroke. However, results should be interpreted with caution due to the heterogeneity of the included studies.
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Affiliation(s)
- Sameera Aljuwaiser
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | | | - Craig Brown
- Emergency Medicine, NHS Grampian, Aberdeen, Scotland
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Leia Kane
- Emergency Medicine, NHS Grampian, Aberdeen, Scotland
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Jamie Cooper
- Emergency Medicine, NHS Grampian, Aberdeen, Scotland
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Alyaa Mostafa
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
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Leruste S, Baelen F, Doray B, Maillard T, Marimoutou C, Spodenkiewicz M. Obstacles and facilitators to preventing fetal alcohol spectrum disorder: a qualitative study with general practitioners. Front Med (Lausanne) 2024; 11:1280349. [PMID: 38487023 PMCID: PMC10939062 DOI: 10.3389/fmed.2024.1280349] [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: 08/20/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
Background Fetal Alcohol Spectrum Disorders are the leading cause of non-genetic intellectual disability. The damage caused, although completely preventable, is irreversible and requires lifelong support. General Practitioners have an important role in the prevention of Fetal Alcohol Spectrum Disorders. However, evidence suggests that General Practitioners do not monitor systematically alcohol consumption among pregnant women. Objectives The aim of this study was to understand the barriers and motivations of General Practitioners in the prevention of Fetal Alcohol Spectrum Disorders on Reunion Island. Methods A qualitative research study was conducted by conducting semi-structured individual interviews with general practitioners. Participants were selected by random or snowball sampling. General practitioners who worked only in unscheduled care services were excluded from this study. After the interviews were transcribed, a verbatim analysis was performed according to the principles of grounded theory. Results Twenty interviews were conducted by two researchers between November and December 2020. General practitioners expressed discomfort in addressing alcohol consumption and excessive drinking in women. They had inaccurate theoretical knowledge and a lack of practical experience with Fetal Alcohol Spectrum Disorders. They also showed little knowledge of the Fetal Alcohol Spectrum Disorders care pathway available on Reunion Island. Both patients and general practitioners expressed discomfort when discussing women's alcohol consumption. Conflicting government policies were highlighted as alcohol promotion campaigns overshadowed Fetal Alcohol Spectrum Disorders prevention initiatives. Conclusion General practitioners should be open and non-judgmental in their interactions with women and couples, with a focus on early detection and short-term intervention. General practitioners should be better educated about Fetal Alcohol Spectrum Disorders and have a clearer understanding of the Fetal Alcohol Spectrum Disorders care pathway.
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Affiliation(s)
- Sébastien Leruste
- Université de La Réunion—UFR Santé Site de l'IES, CHU de La Réunion, Saint-Pierre, France
- INSERM CIC-EC 1410, CHU of Réunion Island, Saint-Pierre, France
| | - François Baelen
- Université de La Réunion—UFR Santé Site de l'IES, CHU de La Réunion, Saint-Pierre, France
| | - Bérénice Doray
- Université de La Réunion—UFR Santé Site de l'IES, CHU de La Réunion, Saint-Pierre, France
- INSERM CIC-EC 1410, CHU of Réunion Island, Saint-Pierre, France
- Laboratoire EPI (Etudes pharmaco-immunologiques), UFR Santé, Université de La Réunion, CHU (Centre Hospitalier Universitaire) de La Réunion, Saint-Denis, France
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, Saint-Denis, France
- TSAF (Troubles du Spectre de l’Alcoolisation Foetale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, Saint-Pierre, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest Occitanie Réunion, Site Constitutif de La Réunion, Saint-Denis, France
| | | | - Catherine Marimoutou
- Université de La Réunion—UFR Santé Site de l'IES, CHU de La Réunion, Saint-Pierre, France
- INSERM CIC-EC 1410, CHU of Réunion Island, Saint-Pierre, France
| | - Michel Spodenkiewicz
- Université de La Réunion—UFR Santé Site de l'IES, CHU de La Réunion, Saint-Pierre, France
- INSERM CIC-EC 1410, CHU of Réunion Island, Saint-Pierre, France
- Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada
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Pérez-Cruz JC, Macías-Duvignau MA, Reyes-Soto G, Gasca-González OO, Baldoncini M, Miranda-Solís F, Delgado-Reyes L, Ovalles C, Catillo-Rangel C, Goncharov E, Nurmukhametov R, Lawton MT, Montemurro N, Encarnacion Ramirez MDJ. Latex vascular injection as method for enhanced neurosurgical training and skills. Front Surg 2024; 11:1366190. [PMID: 38464665 PMCID: PMC10920354 DOI: 10.3389/fsurg.2024.1366190] [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] [Received: 01/05/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024] Open
Abstract
Background Tridimensional medical knowledge of human anatomy is a key step in the undergraduate and postgraduate medical education, especially in surgical fields. Training simulation before real surgical procedures is necessary to develop clinical competences and to minimize surgical complications. Methods Latex injection of vascular system in brain and in head-neck segment is made after washing out of the vascular system and fixation of the specimen before and after latex injection. Results Using this latex injection technique, the vascular system of 90% of brains and 80% of head-neck segments are well-perfused. Latex-injected vessels maintain real appearance compared to silicone, and more flexible vessels compared to resins. Besides, latex makes possible a better perfusion of small vessels. Conclusions Latex vascular injection technique of the brain and head-neck segment is a simulation model for neurosurgical training based on real experiencing to improve surgical skills and surgical results.
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Affiliation(s)
- Julio C. Pérez-Cruz
- Laboratorio de Técnicas Anatómicas y Material Didactico, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mario A. Macías-Duvignau
- Laboratorio de Técnicas Anatómicas y Material Didactico, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Oscar O. Gasca-González
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Departamento de Anatomía, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico
| | - Matias Baldoncini
- Laboratory of Microsurgical Neuroanatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Franklin Miranda-Solís
- Laboratorio de Neuroanatomía, Centro de Investigación de Anatomía y Fisiología Alto Andina, Universidad Andina del Cusco, Cusco, Peru
| | - Luis Delgado-Reyes
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carlos Ovalles
- Department of Neurosurgery, General Hospital, Durango, Mexico
| | - Carlos Catillo-Rangel
- Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico
| | - Evgeniy Goncharov
- Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russia
| | - Renat Nurmukhametov
- Neurological Surgery, Peoples Friendship University of Russia, Moscow, Russia
| | - Michael T. Lawton
- Department of Neurosurgery, St. Joseph’s Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy
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Faghihi A, Naderi Z, Keshtkar MM, Nikrouz L, Bijani M. A comparison between the effects of simulation of basic CPR training and workshops on firefighters' knowledge and skills: experimental study. BMC MEDICAL EDUCATION 2024; 24:178. [PMID: 38395870 PMCID: PMC10893681 DOI: 10.1186/s12909-024-05165-z] [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: 09/12/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND One of the most common causes of death worldwide is cardiopulmonary arrest. Firefighters are among the first responders at the scenes of accidents and can, therefore, play a key part in performing basic cardiopulmonary resuscitation (CPR) for victims who need it. The present study was conducted to compare the effects of simulation training against workshops on the CPR knowledge and skills of firefighters in the south of Iran. METHODS This experimental (Interventional) study was conducted on 60 firefighters of south of Fars province, Iran. The study was undertaken from March to July 2023. Through random allocation, the participants were divided into two groups: simulation-based training (30 members) and traditional workshop training (30 members). The participants' CPR knowledge and practical skills were measured before, immediately after, and three months after intervention. RESULTS The findings of the study revealed a statistically significant difference between the pretest and posttest CPR knowledge and skill mean scores of the simulation groups as compared to the workshop group (p < 0.001). As measured three months after the intervention, the firefighters' knowledge and skill mean scores were still significantly different from their pretest mean scores (p < 0.001); however, they had declined, which can be attributed to the fact that the study population did not frequently exercise CPR. CONCLUSION Based on the findings of the study, even though both methods of education were effective on enhancing the firefighters' CPR knowledge and skill, simulation training had a far greater impact than training in workshops. In view of the decline in the participants' knowledge and skill scores over time, it is recommended that short simulation training courses on CPR should be repeated on a regular basis.
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Affiliation(s)
- Amir Faghihi
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Zeinab Naderi
- Department of Medical Surgical Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | | | - Leila Nikrouz
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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O'Toole M, Doyle A, Collins N, Sullivan C, Mulhall C, Condron C, Doherty E, Eppich W. 'They mirror what they see': A constructivist grounded theory study of simulation culture in four professional domains in Ireland. MEDICAL TEACHER 2024:1-8. [PMID: 38340311 DOI: 10.1080/0142159x.2024.2311863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE In simulation-based education (SBE), educators integrate their professional experiences to prepare learners for real world practice and may embed unproductive stereotypical biases. Although learning culture influences educational practices, the interactions between professional culture and SBE remain less clear. This study explores how professional learning culture informs simulation practices in healthcare, law, teacher training and paramedicine. METHODS Using constructivist grounded theory, we interviewed 19 educators about their experiences in designing and delivering simulation-based communication training. Data collection and analysis occurred iteratively via constant comparison, memo-writing and reflexive analytical discussions to identify themes and explore their relationships. RESULTS Varied conceptualizations and enactments of SBE contributed to distinct professional learning cultures. We identified a unique 'simulation culture' in each profession, which reflected a hyper-real representation of professional practice shaped by three interrelated elements: purpose and rationale for SBE, professional values and beliefs, and educational customs and techniques. Dynamic simulation cultures created tensions that may help or hinder learning for later interprofessional practice. CONCLUSION The concept of simulation culture enhances our understanding of SBE. Simulation educators must be mindful of their uni-professional learning culture and its impacts. Sharing knowledge about simulation practices across professional boundaries may enhance interprofessional education and learners' professional practice.
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Affiliation(s)
- Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrea Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Naoise Collins
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Visual and Human Computing, Dundalk Institute of Technology, Dundalk, Ireland
| | - Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Condron
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Eva Doherty
- Department of Surgical Affairs, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Dahes S, Damerval M, Bataillard T, Lepiller Q, Nerich V. Knowledge and perceptions of French community pharmacists and pharmacy students about the papillomavirus vaccine. Infect Dis Now 2024; 54:104796. [PMID: 37804919 DOI: 10.1016/j.idnow.2023.104796] [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: 05/02/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION In a French context of low vaccination coverage for human papillomavirus (HPV) disease, we conducted a study on pharmacy students and community pharmacists to assess their self-reported knowledge about HPV infection and vaccination and their perceptions of vaccination. MATERIAL AND METHODS A prospective volunteered-based study was conducted in the French Franche-Comté region based on a questionnaire targeting pharmacy students (from the 2nd to 6th years) and community pharmacists. RESULTS All in all, 220 students and 55 pharmacists completed a questionnaire. Fewer than a third knew which HPV genotypes are considered to be high-risk (p-value = 0.11) and were aware of the diversified nature of HPV-induced cancers (p-value = 0.02). Their overall level of general knowledge about vaccination was estimated to be good by 62% of students and 85% of pharmacists (p-value = 10-3). More than 75% of students and pharmacists considered that HPV vaccination has a positive benefit-risk balance (p-value = 0.44) but that its low coverage is due to non-confirmed adverse events that were suggested in the past (p-value = 0.60). Pharmacists had a better perception of the safety of HPV vaccination (84% versus 64%, p-value = 6·10-3). More than 50% of students and pharmacists agreed with mandatory HPV vaccination for girls and boys (11-14 years). CONCLUSION This study allowed us to assess the knowledge of students and community pharmacists and their more or less favorable perceptions of HPV vaccination. It helped us to suggest their needs in terms of practical training. Future changes should include pharmacists in the implementation of public health policies and to improve vaccination coverage.
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Affiliation(s)
- S Dahes
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - M Damerval
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - T Bataillard
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France
| | - Q Lepiller
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France; EA3181 - Université de Franche-Comté, F-25000 Besançon, France; Université de Franche-Comté, CHU Besançon, Service de Virologie, F-25030 Besançon Cedex, France EA3181 - Université de Franche-Comté, F-25000 Besançon, France
| | - V Nerich
- CHU Besançon, Pôle Pharmacie, F-25030 Besançon Cedex, France; INSERM, EFS BFC, UMR1098, RIGHT, Université de Bourgogne - Franche-Comté, F-25000 Besançon, France; Université de Franche-Comté, CHU Besançon, Service de Virologie, F-25030 Besançon Cedex, France EA3181 - Université de Franche-Comté, F-25000 Besançon, France.
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Lee HD, Huh Y, Kim S, Baek JW, Lee H, Park SM, Kim JK. Educational effects of and satisfaction with mixed-reality-based major trauma care simulator: A preliminary evaluation. Medicine (Baltimore) 2024; 103:e36816. [PMID: 38181252 PMCID: PMC10766292 DOI: 10.1097/md.0000000000036816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
Mixed reality (MR) is a hybrid system that projects virtual elements into reality. MR technology provides immersive learning using various real-world tools. However, studies on educational programs using MR are scarce. This study aimed to investigate the educational effects of and satisfaction with an MR-based trauma decision-making simulator. A total 40 of trainees self-selected to participate in this study. All of them participated in the MR trauma simulator for approximately 30 minutes and conducted voluntary learning without any external help. Declarative knowledge, measured using 20 multiple-choice questions, was assessed before and after MR trauma training. To confirm the educational effect, test scores before and after MR trauma training were compared using a paired t-test. Student satisfaction after training was measured using a ten-item questionnaire rated on a five-point Likert scale. A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased (from a mean of 42.3, SD 12.4-54.8, SD 13) after the MR-based trauma assessment and treatment training (P < .001). Of the participants, 79.45% were satisfied with the overall experience of using the MR simulator. This study demonstrated a meaningful educational effect of the MR-based trauma training system even after a short training time.
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Affiliation(s)
- Han-Dong Lee
- Department of Orthopedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Yo Huh
- Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sora Kim
- Gyeonggi South Regional Trauma Center, Ajou University Hospital, Suwon, Republic of Korea
| | - Ji-Woong Baek
- Department of Orthopedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Hojun Lee
- Armed Forces Trauma Center, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Sang-Min Park
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin-Kak Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Burt L, Clark L, Park C. Stronger together: learner reactions on a team-based, interprofessional first death simulation experience. J Interprof Care 2024; 38:95-103. [PMID: 37422861 DOI: 10.1080/13561820.2023.2232408] [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: 09/27/2022] [Revised: 06/08/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
Patient death is a common experience that may be traumatic for health care providers. Although current rates of burnout are high, evidence supports that interprofessional coping can improve clinician mental health. While health care simulation affords learners freedom of safety to participate in a variety of educational experiences, current application of simulation during patient death is limited to professional duties, without explicitly addressing learner emotional well-being. We designed a patient death simulation scenario within a supportive and reflective interprofessional environment to teach foundational coping and well-being strategies to preclinical nursing, medical, and pharmacy students. Sixty-one students participated in this team-based, First Death simulation experience. Debriefings were analyzed using qualitative inductive content analysis methodology. Students reacted to being part of an interprofessional team after having participated in simulation about the death of a patient as described by five categories: emotional awareness, communication insight, feeling stronger together, with role curiosity, and through reflections on support. Findings suggested that simulation is an effective teaching modality for mentoring interprofessional students on humanistic well-being strategies. Furthermore, the experience fostered reactions transcending interprofessional competencies, which are transferrable to future clinical practice.
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Affiliation(s)
- Leah Burt
- College of Nursing Department of Biobehavioral Nursing Science, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lou Clark
- M Simulation, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Park
- College of Medicine, Simulation and Integrative Learning (SAIL) Institute, University of Illinois, Chicago, Illinois, USA
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Nagarajappa A, Kaur S. Simulation in contemporary medical education: Current practices and the way forward. Indian J Anaesth 2024; 68:17-23. [PMID: 38406335 PMCID: PMC10893808 DOI: 10.4103/ija.ija_1203_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 02/27/2024] Open
Abstract
Integration of theoretical knowledge and practical skills is critical for effective medical education. Simulation is crucial in bridging the gap to prepare medical professionals for high-quality patient care in a safe environment. Simulation-based teaching has become the standard practice in medical education, especially in postgraduate courses like Anaesthesia. However, undergraduate medical education and other doctoral courses are still nascent. In line with the current National Medical Commission guidelines, it is imperative to complement the existing curriculum with a simulation-based approach as early as the first year of medical school. This review focuses on the current practices related to simulation-based medical education during undergraduate and postgraduate courses, particularly on anaesthesiology. We aim to discuss different types of simulation, the advantages of integration, students' perspectives, and the role of simulation in assessment and feedback. Finally, recommendations for future advancements of simulation in medical education and the way forward will be laid.
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Affiliation(s)
- Abhishek Nagarajappa
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Maurya I, Ahmed SM, Garg R. Simulation in airway management teaching and training. Indian J Anaesth 2024; 68:52-57. [PMID: 38406347 PMCID: PMC10893796 DOI: 10.4103/ija.ija_1234_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/25/2023] [Accepted: 12/31/2023] [Indexed: 02/27/2024] Open
Abstract
There is a gradual shift in training and teaching methods in the medical field. We are slowly moving from the traditional model and adopting active learning methods like simulation-based training. Airway management is an essential clinical skill for any anaesthesiologist, and a trained anaesthesiologist must perform quick and definitive airway management using various techniques. Airway simulations have been used for the past few decades. It ensures active involvement, upgrading the trainees' airway management knowledge and skills, including basic airway skills, invasive procedures, and difficult clinical scenarios. Trainees also learn non-technical skills such as communication, teamwork, and coordination. A wide range of airway simulators are available. However, texture surface characteristics vary from one type to another. The simulation-based airway management training requires availability, understanding, faculty development, and a structured curriculum for effective delivery. This article explored the available evidence on simulation-based airway management teaching and training.
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Affiliation(s)
- Indubala Maurya
- Department of Anaesthesiology, Kalyan Singh Super Specialty Cancer Institute, Lucknow, Uttar Pradesh, India
| | - Syed M. Ahmed
- Department of Anaesthesiology and Critical Care, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rakesh Garg
- Department of Onco-Anaesthesia, Pain and Palliative Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Leiphrakpam PD, Armijo PR, Are C. Incorporation of Simulation in Graduate Medical Education: Historical Perspectives, Current Status, and Future Directions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241257329. [PMID: 38808125 PMCID: PMC11131395 DOI: 10.1177/23821205241257329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
Technological advancement and improved training strategies have transformed the healthcare practice environment in the last few decades. Simulation has evolved as one of the leading training models for the next generation of healthcare professionals. Simulation-based training enables healthcare professionals to acquire knowledge and skills in a safe and educationally oriented environment and can be a valuable tool for improving clinical practice and patient outcomes. The field of healthcare simulation has been rapidly growing, and various graduate medical education programs around the world have started incorporating this modality into their curricula. In graduate medical education, simulation-based training helps implement an outcome-based curriculum that tests the trainee's actual skill level as the primary factor for the trainee's competency rather than relying on the current model of a predetermined training period. However, the major challenge revolves around developing an educational curriculum incorporating a simulation-based educational model, understanding the value of this new technology, the overall cost factor, and the lack of adequate infrastructure. Hence, embracing the full potential of simulation technology in graduate medical education curricula requires an innovative approach with participation from institutions and stakeholders.
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Affiliation(s)
- Premila D. Leiphrakpam
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Priscila R. Armijo
- iEXCEL, Academic Affairs, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chandrakanth Are
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Miutescu B, Dhir V. Impact and assessment of training models in interventional endoscopic ultrasound. Dig Endosc 2024; 36:59-73. [PMID: 37634116 DOI: 10.1111/den.14667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/20/2023] [Indexed: 08/28/2023]
Abstract
Interventional endoscopic ultrasound (IEUS) has gained significant popularity in recent years because of its diagnostic and therapeutic capabilities. The proper training of endoscopists is critical to ensure safe and effective procedures. This review study aims to assess the impact of different training models on the competence of trainees performing IEUS. Eight studies that evaluated simulators for IEUS were identified in the medical literature. Various training models have been used, including the EASIE-R, Mumbai EUS, EUS Magic Box, EndoSim, Thai Association for Gastrointestinal Endoscopy model, and an ex vivo porcine model (HiFi SAM). The trainees underwent traditional didactic lectures, hands-on training using simulators, and direct supervision by experienced endoscopists. The effectiveness of these models has been evaluated based on objective and subjective parameters such as technical proficiency, operative time, diagnostic success, and participant feedback. As expected, the majority of skills were improved after the training sessions concluded, although the risk of bias is high in the absence of external validation. It is difficult to determine the ideal simulator among the existing ones because of the wide variation between them in terms of costs, reusability, design, fidelity of anatomical structures and feedback, and types of procedures performed. There is a need for a standardized approach for the evaluation of IEUS simulators and the ways skills are acquired by trainees, as well as a clearer definition of the key personal attributes necessary for developing a physician into a skilled endoscopist capable of performing basic and advanced therapeutic EUS interventions.
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Affiliation(s)
- Bogdan Miutescu
- Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy, Timisoara, Romania
| | - Vinay Dhir
- Institute of Digestive and Liver Care, SL Raheja Hospital, Mumbai, India
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Pai DR, Kumar VRH, Sobana R. Perioperative crisis resource management simulation training in anaesthesia. Indian J Anaesth 2024; 68:36-44. [PMID: 38406342 PMCID: PMC10893817 DOI: 10.4103/ija.ija_1151_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 02/27/2024] Open
Abstract
Simulation-based education is now recognised to be a valuable tool to impart both technical and non-technical skills to healthcare professionals of all levels. Simulation is an well accepted educational tool for cultivating teamwork skills among residents globally. Simulation-based education encompasses diverse modalities, ranging from task trainers and simulated patients to sophisticated high-fidelity patient simulators. Notably, anaesthesiologists globally were early advocates of integrating simulation into education, particularly to instruct anaesthesia residents about the intricacies of perioperative crisis resource management and collaborative interdisciplinary teamwork. Given the inherent high-risk nature of anaesthesia, where effective teamwork is pivotal to averting adverse patient outcomes, and also to improve overall outcome of the patient, simulation training becomes imperative. This narrative review delves into the contemporary landscape of simulation training in perioperative anaesthesia management, examining the pedagogical approaches, simulators, techniques and technologies employed to facilitate this training.
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Affiliation(s)
- Dinker R. Pai
- Director, Medical Simulation Centre, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry
- Department of Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - VR Hemanth Kumar
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - R Sobana
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
- Dy Director, Medical Simulation Centre, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry
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Pebolo PF, Okot J, Bongomin F, Awor S, Arwinyo B, Ojara S, Opee J, Jackline A, Ssennuni E, Ouma S. Efficacy of the Gulu University Reproductive Health Simulation Training for final year medical students and interns: a before-and-after study. Ther Adv Reprod Health 2024; 18:26334941241251967. [PMID: 38800825 PMCID: PMC11127575 DOI: 10.1177/26334941241251967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/09/2024] [Indexed: 05/29/2024] Open
Abstract
Background Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design A before-and-after study. Methods A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t-tests was used to test the difference in pre- and post-test scores. Independent sample t-tests compared median post-test results between interns and students, with a p-value <0.05 considered significant. Results A total of 153 participants were enrolled, the majority being males (78.4%, n = 120) and medical students (73.9%, n = 113). Among the 40 interns, 55% (n = 22) were doctors, 30% (n = 12) were midwives, and 15% (n = 6) were nurses. The study participants showed an increase in knowledge, with median post-test scores higher than pre-test scores for all participants [63% (interquartile ranges, IQR: 57-71%) versus 49% (42-54%), with a median difference of 14% (8-23%), p < 0.001]. Conclusion The SBT effectively imparts key knowledge competencies to the interns and fifth-year medical students. We recommend that SBT be included as part of the course units that students should take and for continuous medical education for qualified healthcare workers in resource-limited settings.
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Affiliation(s)
| | - Jerom Okot
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | - Silvia Awor
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Baifa Arwinyo
- Department of Obstetrics and Gynecology, Gulu Regional Referral Hospital, Gulu, Uganda
| | - Sande Ojara
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Jimmyy Opee
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | | | - Simple Ouma
- Research Department, The Aids Support Organisation, Kampala, Uganda
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Alemu FM, Yimer NB, Kasegn BB, Kassie BA, Ibrahim IY, Abdo AA, Worke MD. Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study. BMC MEDICAL EDUCATION 2023; 23:961. [PMID: 38098058 PMCID: PMC10722683 DOI: 10.1186/s12909-023-04968-w] [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: 10/02/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in Ethiopia. METHODS A quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020. RESULT The age of the respondents varies from 24 to 34 years, with the control group's mean age being 28.8 (± 2.3) years and the intervention group's mean age being 27.2 (± 2.01) years. The intervention and control groups' pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these. CONCLUSIONS The study showed that simulation-based education improved students' procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.
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Affiliation(s)
| | - Nigus Bililgn Yimer
- Department of Midwifery, College of Health Sciences, Woldia University, Weldiya, Ethiopia
| | | | - Belayneh Ayanaw Kassie
- Department of Midwifery, College of Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Abdella Amano Abdo
- Department of Public Health, School of Public Health, Hawassa University, Hawassa, Ethiopia
| | - Mulugeta Dile Worke
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debra Tabor, Ethiopia.
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Sim GY, Caparó M, Varrassi G, Lu CR, Ding ME, Singh R, Slinchenkova K, Shaparin N, Koushik SS, Viswanath O, Gitkind AI. Comparing the Effectiveness of Hands-on vs. Observational Training of Residents in Interlaminar Epidural Steroid Injections (ILESI) Using a High-Fidelity Spine Simulator. Cureus 2023; 15:e49829. [PMID: 38164314 PMCID: PMC10758203 DOI: 10.7759/cureus.49829] [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] [Received: 09/25/2023] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction The Accreditation Council for Graduate Medical Education (ACGME) requires that residents in the Physical Medicine and Rehabilitation (PM&R) residency observe or perform certain interventional procedures, one of which is an interlaminar epidural steroid injection (ILESI). While the traditional learning model relying heavily on observation is commonplace, it leaves the practice phase of learning to happen on real patients. High-fidelity simulation may be a worthwhile alternative as a training approach to increase physician comfort with the procedure and improve patient safety. Methods Current PM&R residents from two programs between their second and fourth year, inclusively, who lacked prior training experience in ILESI attended one hour of either: (1) an experimental arm of supervised hands-on training on a simulation device or (2) a control arm observing the procedures performed by an attending on the same device. Assignments were made based on resident schedule availability. Pre-training knowledge, training, and post-training knowledge were assessed at the Multidisciplinary Pain Clinic at Montefiore Medical Center. Participants were assessed on their procedural competence using an adapted version of a previously published grading checklist before the session. Participants also evaluated their confidence in performing the procedure prior to and after training. Data was analyzed using the Wilcoxon signed-rank test and the Wilcoxon rank-sum test. SAS Version 9.4 was used for analysis. Results Fifteen residents initially participated, but three residents dropped out at the 15-week follow-up. There was a significant increase in test scores in both arms immediately after the intervention (p=0.008 in control, p=0.016 in the experiment), with greater improvement shown in the hands-on training group (p=0.063). At the 15-week follow-up, there was no significant change in test scores in the control arm (p=0.969) while there was a decrease in the experiment arm (p<0.001). Conclusion Hands-on learning with high-fidelity simulation demonstrated more improvement for short-term motor-skill acquisition, while observational learning with repetition showed more benefits for long-term retention. Optimal procedural training should employ both educational modalities for best short- and long-term results.
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Affiliation(s)
- Geum Y Sim
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
| | - Moorice Caparó
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
| | | | - Christopher R Lu
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
| | - Michael E Ding
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
| | - Rohini Singh
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
| | | | - Naum Shaparin
- Anesthesiology, Albert Einstein College of Medicine, The Bronx, USA
| | - Sarang S Koushik
- Anesthesiology, Creighton University School of Medicine, Phoenix, USA
- Anesthesiology, Valleywise Health Medical Center, Phoenix, USA
| | - Omar Viswanath
- Anesthesiology, Creighton University School of Medicine, Phoenix, USA
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Andrew I Gitkind
- Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, The Bronx, USA
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Pek JH, Quah LJJ, Valente M, Ragazzoni L, Della Corte F. Use of Simulation in Full-Scale Exercises for Response to Disasters and Mass-Casualty Incidents: A Scoping Review. Prehosp Disaster Med 2023; 38:792-806. [PMID: 37997445 DOI: 10.1017/s1049023x2300660x] [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] [Indexed: 11/25/2023]
Abstract
Disasters or mass-casualty incidents are uncommon events. The use of simulation is an ideal training modality in full-scale exercises as it immerses the participants in a replication of the actual environment where they can respond to simulated casualties in accordance with existing protocols.The objective of this scoping review is to answer the research question: "How effective is simulation, as assessed in full-scale exercises, for response to disasters and mass-casualty incidents world-wide?" Studies on full-scale exercises, as defined in World Health Organization (WHO) simulation exercise toolbox, that were published in peer-reviewed journals using the English language from 2001 through 2021 were included. Twenty studies were included from searching PubMed, Embase, and Web of Science. Simulated casualties were the most common simulation modality. Using Kirkpatrick's levels of evaluation to synthesize the data, simulation was reported to be generally effective and mostly demonstrated at the levels of learning of individuals and/or systems, as well as reaction of individuals. Evaluations at levels of behavior and results were limited due to the uncommon nature of disasters and mass-casualty incidents. However, evaluation outcomes across the full-scale exercises were varied, leading to the inability to consolidate effectiveness of simulation into a single measure. It is recommended for best evidence-based practices for simulation to be adhered to in full-scale exercises so that the trainings could translate into better outcomes for casualties during an actual disaster or mass-casualty incident. In addition, the reporting of simulation use in full-scale exercises should be standardized using a framework, and the evaluation process should be rigorous so that effectiveness could be determined and compared across full-scale exercises.
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Affiliation(s)
- Jen Heng Pek
- Department of Emergency Medicine, Sengkang General Hospital, Singapore
| | - Li Juan Joy Quah
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | - Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Francesco Della Corte
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
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Pek JH, Quah LJJ, Teng KPD, Yeo YWM, Lee CYJ. Developing the Disaster Medical Responder's Course in Singapore. Western Pac Surveill Response J 2023; 14:1-6. [PMID: 38298249 PMCID: PMC10824630 DOI: 10.5365/wpsar.2023.14.6.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Problem Emergency medical teams (EMTs) deployed to mass casualty incidents (MCIs) are required to work outside their usual settings and according to different principles, which may affect their performance and the survival of casualties. Prior to 2013, training offered to domestic EMTs was limited to ad hoc and infrequent simulation exercises. Context Domestic EMTs are activated from public tertiary hospitals to provide pre-hospital medical support to the Singapore Civil Defence Force and establish a first-aid post (FAP) for triaging, stabilizing and treating casualties. These casualties are then evacuated to public hospitals for further management. Action Recognizing the need for a more systematic approach to the training of domestic EMTs, the Disaster Medical Responder's Course (the Course) was developed as a multiinstitutional collaboration to equip EMT members attending a MCI with the necessary skills to perform effectively at the FAP. Outcome The Course was first run in 2013 and is usually offered six to eight times a year. Since June 2019, a total of 414 health-care staff and allied health professionals have participated. There have been numerous revisions of the course content and delivery to reflect the latest concepts in operations and global best practice, as well as developments in educational methodologies. Discussion Preparedness is crucial to optimize the survival and outcomes of casualties. The Course provides standardized training of domestic EMTs and plays a pivotal role in ensuring operational readiness for MCIs in Singapore.
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Affiliation(s)
- Jen Heng Pek
- Disaster Site Medical Command, Ministry of Health, Singapore
- Department of Emergency Medicine, Sengkang General Hospital, Singapore
| | - Li Juan Joy Quah
- Disaster Site Medical Command, Ministry of Health, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | - Kuan Peng David Teng
- Disaster Site Medical Command, Ministry of Health, Singapore
- Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore
| | - Yi Wen Mathew Yeo
- Disaster Site Medical Command, Ministry of Health, Singapore
- Department of Emergency Medicine, Khoo Teck Puat Hospital, Singapore
| | - Chan Yu Jimmy Lee
- Disaster Site Medical Command, Ministry of Health, Singapore
- Department of Emergency Medicine, Ng Teng Fong Hospital, Singapore
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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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Moon H, Chen M, Jack L, Lakhani F, Lezaj S, Mahaffey M, Kleinheksel AJ. Development and Validation of a Measure of Medical Student Leadership in Team-Based Simulations. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S209. [PMID: 37983455 DOI: 10.1097/acm.0000000000005340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Hyunchang Moon
- Author affiliations: H. Moon, M. Chen, L. Jack, F. Lakhani, S. Lezaj, M. Mahaffey, A.J. Kleinheksel, Augusta University
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Agrawal V, Agrawal S, Bomanwar A, Dubey T, Jaiswal A. Exploring the Risks, Benefits, Advances, and Challenges in Internet Integration in Medicine With the Advent of 5G Technology: A Comprehensive Review. Cureus 2023; 15:e48767. [PMID: 38098915 PMCID: PMC10719543 DOI: 10.7759/cureus.48767] [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: 10/29/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
The integration of 5G technology in the healthcare sector is poised to bring about transformative changes, offering numerous advantages such as enhanced telemedicine services, expedited data transfer for medical records, improved remote surgery capabilities, real-time monitoring and diagnostics, advancements in wearable medical devices, and the potential for precision medicine. However, this technological shift is not without its concerns, including potential health implications related to 5G radiation exposure, heightened cybersecurity risks for medical devices and data systems, potential system failures due to technology dependence, and privacy issues linked to data breaches in healthcare. We are striking a balance between harnessing these benefits and addressing the associated risks. Achieving this equilibrium requires the establishment of a robust regulatory framework, ongoing research into the health impacts of 5G radiation, the implementation of stringent cybersecurity measures, education and training for healthcare professionals, and the development of ethical standards. The future of 5G in the medical field holds immense promise, but success depends on our ability to navigate this evolving landscape while prioritizing patient safety, privacy, and ethical practice.
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Affiliation(s)
- Varun Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aarya Bomanwar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tanishq Dubey
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arpita Jaiswal
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Zayapragassarazan Z, Sumathy MK, Wyawahare M, Pai D. A protocol to evaluate the effectiveness of competency-based simulation training modules on the educational outcomes among MBBS students - A mixed method study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:375. [PMID: 38144029 PMCID: PMC10743914 DOI: 10.4103/jehp.jehp_338_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/08/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The growing recognition of the importance of simulation-based training has been a present focus of medical education curriculum planners. This study aims to design, develop, implement, and evaluate the educational outcomes of training modules for a list of essential skills that MBBS students in a tertiary care teaching hospital in South India need to learn as part of their competency-based MBBS curriculum. MATERIALS AND METHODS This sequential transformative mixed method study will be implemented in three phases: i) identification of essential skills for simulation-based training following the modified Delphi method, ii) development of skill training modules using ADDIE model of instructional design, implementation of the modules and collection of data on the educational outcomes and iii) a qualitative study involving in-depth interview and focus group discussion on understanding the potential for incorporating the modules into the present MBBS curriculum. Data on educational outcomes relevant to the study objectives will be collected using appropriate tools and analyzed using descriptive statistics and qualitative analytic methods. RESULTS Phase one will tabulate the list of five essential skills and phase two educational outcomes will contain descriptive statistics on knowledge and skill acquisition, perception of simulation-based teaching and learning, and higher-order thinking skills. Phase three qualitative analysis will highlight the enabling and barrier aspects for incorporating this approach of simulation-based skill training within the current MBBS curriculum. CONCLUSIONS The study outcomes will provide curriculum planners and educators insights into designing and implementing simulation-based skill training for undergraduate medical students. It will also help policymakers develop policies in medical education technologies to provide quality medical education and fulfill the objective of quality healthcare for all.
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Affiliation(s)
| | - Masanam Kasi Sumathy
- Department of Medical Education, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mukta Wyawahare
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dinker Pai
- Department of Surgery and Medical Simulation Centre, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Alrashidi N, Pasay An E, Alrashedi MS, Alqarni AS, Gonzales F, Bassuni EM, Pangket P, Estadilla L, Benjamin LS, Ahmed KE. Effects of simulation in improving the self-confidence of student nurses in clinical practice: a systematic review. BMC MEDICAL EDUCATION 2023; 23:815. [PMID: 37904153 PMCID: PMC10614341 DOI: 10.1186/s12909-023-04793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Considering the positive influence of simulation from previous literature may encourage educators to regard it as a valuable teaching strategy in nursing schools. This literature review aims to investigate whether the use of simulation improves undergraduate nurses' self-confidence during clinical practice. METHODOLOGY This study employed a literature-based design. Five academic databases, including CINAHL, EBSCO, ProQuest, PubMed and Medline, were utilised to extract relevant studies using appropriate keywords and Boolean operators. Studies published in the last 15 years (2005-2020) were included in the search. Studies were retrieved using the Exclusion and Inclusion criteria. The Critical Appraisal Skills Programme (CASP) was used to critically appraise the studies. RESULTS A total of 15 primary research studies were extracted for review. Four major themes emerged from the review: Improved self-confidence to carry out clinical tasks, Increased ability to work in teams, Improved self-confidence to perform community work and Improved self-confidence in communicating with patients and team members. CONCLUSION Clinical simulation is a useful tool in increasing the self-confidence of nursing students to perform clinical tasks, make clinical judgements, communicate with patients and team members and improve their teamwork. To improve the quality of care received by patients, it is recommended that clinical simulations be integrated into the nursing curriculum in Saudi Arabia. Increasing the confidence of students has been shown to be associated with greater confidence in performing clinical tasks.
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Affiliation(s)
- Nojoud Alrashidi
- College of Nursing, University of Hail, Hail City, Saudi Arabia.
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Tokuç B, Varol G. Medical Education in the Era of Advancing Technology. Balkan Med J 2023; 40:395-399. [PMID: 37706676 PMCID: PMC10613744 DOI: 10.4274/balkanmedj.galenos.2023.2023-7-79] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023] Open
Abstract
Technology is developing rapidly and affecting the field of medicine in two main areas- medical education and health care. As a rapidly evolving field with the need and ability to constantly incorporate newer technologies, medical education must be able to prepare future doctors as per changing trends in practice patterns, the role of medicine in disease diagnosis and treatment, and innovations, and advances in medical science. In this article, we discuss the various digital learning tools introduced into medical education, as well as their advantages and disadvantages. We also try to understand how the shift to artificial intelligence may affect medical education and practice and how we can make technology efficient without losing the human dimension in doctor-patient relationships.
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Affiliation(s)
- Burcu Tokuç
- Department of Medical Education, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye
| | - Gamze Varol
- Department of Public Health, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye
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Orsega-Smith E, Leonard T, Ruggiero L, Amato N, O'Hara J. Impact of a simulation-based education approach for health sciences: demo, debrief, and do. BMC MEDICAL EDUCATION 2023; 23:747. [PMID: 37817105 PMCID: PMC10566061 DOI: 10.1186/s12909-023-04655-w] [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: 10/06/2022] [Accepted: 09/04/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Skill-based practice (e.g., communication skills) is important for individuals to incorporate into students' learning and can be challenging in large classes. Simulation-based education (SBE) is a method where students can learn and practice skills in a safe environment to use in real world settings with assistance of peer coaching. The COVID-19 pandemic presented challenges to providing students with sufficient SBE. The purpose of this paper is to: a.) describe a SBE approach for health coaching referred to as "Demo, Debrief, and Do" (DDD), b.) discuss how this approach became important in COVID-19 classroom experiences, c.) describe the impact of DDD activity on students in a health sciences curriculum. DDD is a collaborative activity where graduate health coaching students demonstrate coaching skills, debrief their demonstration, and support undergraduate students to demonstrate (or do) their own coaching skills in a small virtual online setting. METHODS Qualitative feedback from 121 undergraduate students enrolled in 3 sections of a behavior change strategies course and quantitative surveys to examine their confidence in applying the skills and overall satisfaction with DDD were gathered. RESULTS The overall average confidence level following the lab was 31.7 (0-35). The average satisfaction level following the lab was 23.3 (0-25 range). The most common highlight of this DDD experience described was observing the coaching demonstration (i.e., demo), followed by the feedback (i.e., debrief), and the practice (i.e., do). CONCLUSION The (DDD) simulation approach fulfilled an educational need during the COVID 19 pandemic and filled a gap in offering SBE opportunities for both graduate and undergraduate students while learning effective client-communication skills health coaching delivery.
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Affiliation(s)
- Elizabeth Orsega-Smith
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 North College Avenue, De 19716, Newark, USA.
| | - Tara Leonard
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 North College Avenue, De 19716, Newark, USA
| | - Laurie Ruggiero
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 North College Avenue, De 19716, Newark, USA
| | - Nicolette Amato
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 North College Avenue, De 19716, Newark, USA
| | - Jamie O'Hara
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 North College Avenue, De 19716, Newark, USA
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Kamal MM, Sohail AA, Qureshi NJ, Ullah H, Shahabuddin S, Kamal MY. Simulating aortic root replacement for a surgical wet laboratory in a resource-limited setting: an economical innovation. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2023; 37:ivad167. [PMID: 37843447 PMCID: PMC10598581 DOI: 10.1093/icvts/ivad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/15/2023] [Accepted: 10/14/2023] [Indexed: 10/17/2023]
Abstract
Traditional cardiac surgery residency programs rely mainly on teaching surgical skills in the operating room. The increasing complexity of cardiac surgical operations on high-risk patients and the time constraints placed on residents in this surgical discipline negatively impact the learning opportunities for those residents. Simulation models, though efficient, are very expensive. In Third World Countries, they are unavailable for trainees due to financial constraints. We have introduced an innovative and cost-effective way of simulating aortic root replacement in a wet laboratory by applying a hand-made valve conduit or 'pencil conduit' to a bovine heart. It is reproducible, easy to assemble, cost-effective and simple to use. It can help develop and enhance the surgical skills of residents and junior surgeons for this advanced operation, which requires a meticulous surgical technique performed within a limited time frame.
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Affiliation(s)
- Mian Mustafa Kamal
- Department of Cardiothoracic Surgery, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Abdul Ahad Sohail
- Department of Cardiothoracic Surgery, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Neelam Jawed Qureshi
- Department of Cardiothoracic Surgery, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Haseeb Ullah
- Rehman Medical College, Hayatabad, Peshawar, Khyber Pukhtoonkhwa, Pakistan
| | - Syed Shahabuddin
- Department of Cardiothoracic Surgery, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Mian Yasir Kamal
- Department of Cardiology, Khyber Teaching Hospital, University Road, Peshawar, Khyber Pukhtoonkhwa, Pakistan
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Koech CK, Rivera VI, Anton K, Dixon RG. Advancing IR in Underserved Regions: Interventional Radiology Simulation Near and Far. Semin Intervent Radiol 2023; 40:419-426. [PMID: 37927520 PMCID: PMC10622241 DOI: 10.1055/s-0043-1775723] [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: 11/07/2023]
Abstract
Simulation facilitates learning by imitating real-world systems or processes utilizing educational tools and models. Various fields, including business, aviation, and education use simulation for training. In healthcare, simulation provides trainees opportunities to develop procedural skills in a safe environment, building their understanding through hands-on interactions and experiences rather than passive didactics. Simulation is classified into low, medium, and high fidelity, based on how closely it mimics real-life experience. Its use in education is a valuable adjunct to instructional support and training with multiple potential benefits. Interventional radiology (IR) trainees can build technical and clinical proficiency prior to working directly on a patient. Simulation promotes experiential learning, constructivist learning, and student centeredness, thus giving students control over their learning and knowledge acquisition. More recently, the creative use of remote simulation has augmented traditional virtual didactic lectures, thereby further engaging international learners and enhancing remote collaboration. Despite the challenges to implementation, the addition of simulation in IR education is proving invaluable to supporting trainees and physicians in underserved regions.
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Affiliation(s)
| | - Victor I. Rivera
- Division of Interventional Radiology, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kevin Anton
- Division of Interventional Radiology, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Robert G. Dixon
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Marshall J, Raatz M, Ward EC, Penman A, Beak K, Moore M, Hill AE. Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study. Dysphagia 2023; 38:1308-1322. [PMID: 36692653 PMCID: PMC9872075 DOI: 10.1007/s00455-023-10556-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
Simulation enables learners to practice new skills in a supportive environment. Largely driven by the COVID-19 pandemic, simulation via telepractice, i.e., telesimulation, has emerged. Viable delivery of telesimulation requires consideration of the adaptations needed to conduct simulation via telepractice. The aim of this study was to design and pilot test the feasibility of using telesimulation to provide training in infant feeding management. An iterative process was used across four phases: (1) simulation design, (2) telesimulation adaptations, (3) user testing, feedback, and modifications, and (4) user testing of modified simulation, feedback, and final modifications. During Phases 1 and 2, team members worked together to design and test telepractice adaptations for a simulation experience. During Phases 3 and 4, the telesimulation was pilot tested with a group of speech pathologists, with feedback sought via open-ended survey questions and/or an optional focus group. Manifest content analysis was used to interpret user feedback. In Phase 2, several adaptations were explored to optimize telesimulation delivery and engagement, including Zoom® functions (e.g., 'spotlighting,' digital backgrounds) and supplementary video/auditory files. There were 11 participants across Phases 3 and 4. Specific feedback centered around simulation preparation and structure, session practicalities, supports for realism, Zoom® functions, group dynamics, participants' experiences, and future enhancements. An overall list of recommendations for telesimulation was generated. Telesimulation for feeding management was considered feasible and participant feedback was favorable. Further research is required to investigate if the learner outcomes of telesimulation are comparable to in-person simulation for infant feeding management.
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Affiliation(s)
- Jeanne Marshall
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Madeline Raatz
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Speech Pathology Department, Logan Hospital, Metro South Hospital and Health Service, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly Beak
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Madison Moore
- Speech Pathology Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Sam CP, Nathan JL, Aroksamy JA, Ramasamy N, Mamat NHB, Nadarajah VD. A Qualitative Study on the Experiences of Preclinical Students in Learning Clinical and Communication Skills at a Simulation Centre. MEDICAL SCIENCE EDUCATOR 2023; 33:1127-1137. [PMID: 37886265 PMCID: PMC10597961 DOI: 10.1007/s40670-023-01851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 10/28/2023]
Abstract
Introduction Simulation centres (SC) and its learning resources are now firmly established as part of medical education. In SC, medical students obtain both knowledge and skills based on a combination of theory and practice using provided resources. This study aims to explore medical students' use of SC learning resources to learn clinical and communication skills based on Kolb's experiential learning cycle. This is based on the research question 'How are the SC resources useful in supporting preclinical medical students' clinical and communication skills learning?' The findings of the study can make a case for further enhancement of SC design and resources for medical students in the preclinical phase. Methods A qualitative study involving 20 preclinical medical students with learning experiences in SC was conducted between December 2019 and 2020 at a medical school in Malaysia. Semi-structured interview questions were developed based on Kolb's learning cycle. The data were thematically analysed using the six phases of Braun and Clarke's thematic analysis. Results Three main themes were identified based on preclinical medical students' experiences in SC; they were 'preparation for authentic clinical experience', 'accessibility of multiple resources for learning and support' and 'opportunities to learn and improve'. Conclusions The SC's resources have a significant and positive role in supporting preclinical medical students learn clinical and communication skills. The SC resources prepared them for authentic clinical experiences with a patient-centred care approach and self-directed learning opportunities. Social support from peers, peer tutors and academics emerged as a key finding and resource of the SC as they help preclinical students learn and improve.
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Affiliation(s)
- Chong Pek Sam
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Joann Lalita Nathan
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Jacintha Anita Aroksamy
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Nithia Ramasamy
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | | | - Vishna Devi Nadarajah
- Department of Human Biology and IMU Centre for Education, International Medical University (IMU), Kuala Lumpur, Malaysia
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Savir S, Khan AA, Yunus RA, Rehman TA, Saeed S, Sohail M, Sharkey A, Mitchell J, Matyal R. Virtual Reality: The Future of Invasive Procedure Training? J Cardiothorac Vasc Anesth 2023; 37:2090-2097. [PMID: 37422335 DOI: 10.1053/j.jvca.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
Invasive procedures are associated with adverse events that are both hazardous to patients and expensive to treat. A trainee is expected to perform complex sterile invasive procedures in a dynamic environment under time pressure while maintaining patient safety at the highest standard of care. For mastery in performing an invasive procedure, the automatism of the technical aspects is required, as well as the ability to adapt to patient conditions, anatomic variability, and environmental stressors. Virtual reality (VR) simulation training is an immersive technology with immense potential for medical training, potentially enhancing clinical proficiency and improving patient safety. Virtual reality can project near-realistic environments onto a head-mounted display, allowing users to simulate and interact with various scenarios. Virtual reality has been used extensively for task training in various healthcare-related disciplines and other fields, such as the military. These scenarios often incorporate haptic feedback for the simulation of physical touch and audio and visual stimuli. In this manuscript, the authors have presented a historical review, the current status, and the potential application of VR simulation training for invasive procedures. They specifically explore a VR training module for central venous access as a prototype for invasive procedure training to describe the advantages and limitations of this evolving technology.
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Affiliation(s)
- Shiri Savir
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Adnan A Khan
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Rayaan A Yunus
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Taha A Rehman
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Shirin Saeed
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Mahnoor Sohail
- Department of Medicine, CMH Lahore Medical and Dental College, Lahore, Pakistan
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - John Mitchell
- Department of Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Health, Detroit, MI
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Gupta S, Mishra S, Behl S, Srikant N, Mascarenhas R. Knowledge of handling medical emergencies among general dental practitioners pan India: a cross-sectional survery. BMC Res Notes 2023; 16:221. [PMID: 37710327 PMCID: PMC10503061 DOI: 10.1186/s13104-023-06477-x] [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: 01/28/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Medical emergency situations in dental clinics have been contemplated to be an issue in most of the countries by reason of dentist's lack of knowledge and preparedness to attend emergency situations in dental offices. The aim of this paper is to observe the knowledge, attitude, and perceived confidence of the general dental practitioners regarding emergency medical care and its practical application. Questionnaire on knowledge assessment was circulated among 500 dentists using printed questionnaire formats and various social media platforms. The questionnaire included details on treating hypertensive patients, cardiopulmonary resuscitation training, accessibility of medical emergency equipments in the dental clinics, prevalence of medical emergency cases in the dental office and the self-assessed competence to handle medical emergency situations in the dental clinics. Data was surveyed and scrutinized using the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Descriptive statistics was tabulated and Chi square tests was applied. FINDINGS 500 general dental practitioners pan India were involved in the study (294 were females and 207 were males). They were grouped into different age groups (20-30 yrs, 30-40 yrs, 40-50 yrs, 50 and above) and experience (0-5 yrs, 5-10 yrs and more than 10 years). 279 participants did not attend any medical emergency training whereas, 222 participants from all groups attended training program. It was observed that with increased experience in the field, the knowledge, awareness and confidence to treat medical emergency situation in the dental clinics was better. Dentists should update themselves from time-to-time with the latest technologies in the field and need to attend training programs to handle any medical emergency situations in the dental offices. Medical emergencies in a dental clinic can be encountered at any point of time and the clinician should have apt knowledge in handling such situations. Majority of the dentists feel subdued in managing medical situations in dental offices. Training and workshops for handling medical situations in the dental offices should be mandated at the undergraduate and postgraduate levels. This will help the dentist to shape one's confidence in managing such situations without apprehension. Availability of proper infrastructure and equipments is recommended in every dental clinics so as to ease the handling of the situation. CONCLUSION This paper enlightens the need of basic life support training on regular basis among the dentists to improve the competence among them and to improve the confidence in handling such situations.
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Affiliation(s)
- Shubhangi Gupta
- Department of Oral and Maxillofacial Surgery, Sri Dharmasthala, Manjuatheswara College of Dental Sciences, Dharwad, India
| | - Stuti Mishra
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Shubhangi Behl
- Department of Periodontolgy, Bharati Vidyapeeth Dental College and Hospital, Pune, India
| | - N Srikant
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore Affliliated to Manipal Academy of Higher Education, Manipal, India
| | - Roma Mascarenhas
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India.
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore Affliliated to Manipal Academy of Higher Education, Manipal, India.
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Dybdal N, Horgan M, Costa L, Davis E, Lucero S, Nieves S, Quiroz V, Weberg K, Madigan JE. Equine Gunshot Euthanasia: Creation of a 3D-Printed Model with Integrated Sensors for Training. Animals (Basel) 2023; 13:2566. [PMID: 37627357 PMCID: PMC10452018 DOI: 10.3390/ani13162566] [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: 06/10/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
Challenges and issues related to the use of pentobarbital euthanasia and disposal of animal remains within the US have recently been reviewed. Environmental and public health challenges increasingly necessitate consideration of alternative methods such as gunshots, an American Veterinary Medical Association (AVMA) "acceptable with conditions" method, for the humane euthanasia of horses. A recent study reported a correctly aimed gunshot provides a humane option for euthanizing horses. However, although aiming guidelines exist, studies examining bullet trajectories in animals euthanized by gunshot have reported that inadequate disruption of the brain is a serious welfare issue. Here, we report the development and production of a portable, reusable, equine gunshot euthanasia training model. Using 3D printing, an anatomically accurate model of an equine head has been developed, with external aiming landmarks and equipped with integrated laser sensors and LED eyes. The laser sensors are embedded in two specific anatomical tracts (pons and medulla) with aiming paths associated with the aiming landmarks to train correct aiming angle. The LED eyes are linked to the laser sensors to provide instant feedback on aiming accuracy. When a beam from a commercially available blue training gun laser travels along the correct aiming path and strikes the sensor inside the head, the lights in the model's eyes go out and there is an audible signal, providing immediate feedback on the accuracy of the shot. The model facilitates the training of veterinary personnel and first responders in successful gunshot euthanasia, providing instantaneous feedback on the likelihood of a shot causing immediate, humane death in a live animal.
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Affiliation(s)
- Noël Dybdal
- International Animal Welfare Training Initiative, One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.C.); (E.D.)
| | - Molly Horgan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (M.H.); (S.N.); (K.W.); (J.E.M.)
| | - Lais Costa
- International Animal Welfare Training Initiative, One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.C.); (E.D.)
| | - Eric Davis
- International Animal Welfare Training Initiative, One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.C.); (E.D.)
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (M.H.); (S.N.); (K.W.); (J.E.M.)
| | - Steven Lucero
- Translating Engineering Advances to Medicine (TEAM) Lab, Biomedical Engineering, College of Engineering, University of California, Davis, CA 95616, USA; (S.L.); (V.Q.)
| | - Samantha Nieves
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (M.H.); (S.N.); (K.W.); (J.E.M.)
| | - Valerie Quiroz
- Translating Engineering Advances to Medicine (TEAM) Lab, Biomedical Engineering, College of Engineering, University of California, Davis, CA 95616, USA; (S.L.); (V.Q.)
| | - Kirsten Weberg
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (M.H.); (S.N.); (K.W.); (J.E.M.)
| | - John E. Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (M.H.); (S.N.); (K.W.); (J.E.M.)
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Nielsen MS, Raben‐Levetzau FN, Andersen SAW, Wennervaldt K, Konge L, Nielsen AB. Retention of emergency cricothyroidotomy skills: A multicenter randomized controlled trial. AEM EDUCATION AND TRAINING 2023; 7:e10900. [PMID: 37529172 PMCID: PMC10387827 DOI: 10.1002/aet2.10900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/26/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
Objectives Emergency cricothyroidotomy is the final approach to establishing a secure airway. The procedure is acute and highly infrequent, making it difficult to achieve and maintain competence in the clinic. Simulation-based training in emergency cricothyroidotomy is effective but it is unknown how often training should be repeated to maintain skills. This study aimed to assess novices' retention of technical skills in emergency cricothyroidotomy after completing SBT. Methods Novices in emergency cricothyroidotomy completed a structured, simulation-based training program and were randomized to retention tests after 1, 3, or 6 months. Participants completed two emergency cricothyroidotomy tests at end-of-training and follow-up retention testing. Test performances were video recorded and evaluated by two experienced blinded raters using a structured assessment tool. Differences in the performances and the pass/fail rates were analyzed. Results Eighty-two medical students from two different Danish universities were included from April 2021 to February 2022. Paired t-tests showed skills decay significantly after 1 month (mean loss 6.7 points, p < 0.001). The mean loss of points, representing the difference in global score points, from the end-of-training to retention test was 6.7 points (95% confidence interval [CI] 4.5-8.8) for the 1-month group, 8.2 points (95% CI 5.8-10.0) for the 3-months group, and 9.9 points (95% CI 8.1-11.7) for the 6-months group. Six participants in both the 1-month group (23.1%) and the 3-month group (24%) passed the first retention test, but no one in the 6-months group had a passing performance. Conclusions Novices' technical skills performance in emergency cricothyroidotomy decay significantly already after 1 month. This initial loss of skill seems to be stable until 3 months, after which there is a further significant loss of skills. Recurring training should be implemented for the benefit of patient safety and outcomes.
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Affiliation(s)
- Martine Siw Nielsen
- SimC—Simulation CenterOdense University HospitalOdenseDenmark
- Open Patient Data Explorative Network (OPEN)Odense University HospitalOdenseDenmark
| | - Felix Nicolai Raben‐Levetzau
- Copenhagen Academy for Medical Education and Simulation, Center for HR & EducationThe Capital Region of DenmarkCopenhagenDenmark
| | - Steven Arild Wuyts Andersen
- Copenhagen Academy for Medical Education and Simulation, Center for HR & EducationThe Capital Region of DenmarkCopenhagenDenmark
- Department of Otorhinolaryngology—Head and Neck SurgeryRigshospitaletCopenhagenDenmark
| | | | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Center for HR & EducationThe Capital Region of DenmarkCopenhagenDenmark
| | - Anders Bo Nielsen
- SimC—Simulation CenterOdense University HospitalOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
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