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Frank JR, Karpinski J, Sherbino J, Snell LS, Atkinson A, Oswald A, Hall AK, Cooke L, Dojeiji S, Richardson D, Cheung WJ, Cavalcanti RB, Dalseg TR, Thoma B, Flynn L, Gofton W, Dudek N, Bhanji F, Wong BMF, Razack S, Anderson R, Dubois D, Boucher A, Gomes MM, Taber S, Gorman LJ, Fulford J, Naik V, Harris KA, St. Croix R, van Melle E. Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education. Perspect Med Educ 2024; 13:201-223. [PMID: 38525203 PMCID: PMC10959143 DOI: 10.5334/pme.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/16/2024] [Indexed: 03/26/2024]
Abstract
Postgraduate medical education is an essential societal enterprise that prepares highly skilled physicians for the health workforce. In recent years, PGME systems have been criticized worldwide for problems with variable graduate abilities, concerns about patient safety, and issues with teaching and assessment methods. In response, competency based medical education approaches, with an emphasis on graduate outcomes, have been proposed as the direction for 21st century health profession education. However, there are few published models of large-scale implementation of these approaches. We describe the rationale and design for a national, time-variable competency-based multi-specialty system for postgraduate medical education called Competence by Design. Fourteen innovations were bundled to create this new system, using the Van Melle Core Components of competency based medical education as the basis for the transformation. The successful execution of this transformational training system shows competency based medical education can be implemented at scale. The lessons learned in the early implementation of Competence by Design can inform competency based medical education innovation efforts across professions worldwide.
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Affiliation(s)
- Jason R. Frank
- Centre for Innovation in Medical Education and Professor, Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Jolanta Karpinski
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Competency Based Medical Education, University of Ottawa, Ottawa, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Linda S. Snell
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Medicine and Health Sciences Education, McGill University, Montreal, QC, Canada
| | - Adelle Atkinson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anna Oswald
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Competency Based Medical Education, University of Alberta, Edmonton, AB, Canada
| | - Andrew K. Hall
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lara Cooke
- Division of Neurology, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan Dojeiji
- Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, Canada
| | - Denyse Richardson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, Canada
| | - Warren J. Cheung
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rodrigo B. Cavalcanti
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- HoPingKong Centre, University Health Network, Toronto, ON, Canada
| | - Timothy R. Dalseg
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Brent Thoma
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Leslie Flynn
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Departments of Psychiatry and Family Medicine, and Co-Director Master of Health Sciences Education, Queen’s University, Kingston, ON, Canada
| | - Wade Gofton
- Department of Surgery (Division of Orthopedic Surgery), The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
| | - Nancy Dudek
- Department of Medicine (Division of Physical Medicine & Rehabilitation) and The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Brian M.-F. Wong
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Canada
| | - Saleem Razack
- Centre for Health Education Scholarship, University of British Columbia and BC Children’s Hospital, Vancouver, BC, Canada
| | - Robert Anderson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Daniel Dubois
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Andrée Boucher
- Department of Medicine (Division of Endocrinology), Universitéde Montréal, Montréal, QC, Canada
| | - Marcio M. Gomes
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sarah Taber
- Office of Standards and Assessment, Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | - Lisa J. Gorman
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | - Jane Fulford
- Canadian Internet Registration Authority, Canada
| | - Viren Naik
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Medical Council of Canada, Ottawa, ON, Canada
| | - Kenneth A. Harris
- Royal College of Physicians and Surgeons of Canada, Canada
- Emeritus, Western University, Canada
| | - Rhonda St. Croix
- Learning and Connecting at the Royal College of Physicians and Surgeons of Canada, Canada
| | - Elaine van Melle
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Family Medicine, Queen’s University, Kingston, ON, Canada
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Bhanji F, Naik V, Skoll A, Pittini R, Daniels VJ, Bacchus CM, Bandiera G. Competence by Design: The Role of High-Stakes Examinations in a Competence Based Medical Education System. Perspect Med Educ 2024; 13:68-74. [PMID: 38343558 PMCID: PMC10854425 DOI: 10.5334/pme.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/16/2023] [Indexed: 02/15/2024]
Abstract
Competency based medical education is developed utilizing a program of assessment that ideally supports learners to reflect on their knowledge and skills, allows them to exercise a growth mindset that prepares them for coaching and eventual lifelong learning, and can support important progression and certification decisions. Examinations can serve as an important anchor to that program of assessment, particularly when considering their strength as an independent, third-party assessment with evidence that they can predict future physician performance and patient outcomes. This paper describes the aims of the Royal College of Physicians and Surgeons of Canada's ("the Royal College") certification examinations, their future role, and how they relate to the Competence by Design model, particularly as the culture of workplace assessment and the evidence for validity evolves. For example, high-stakes examinations are stressful to candidates and focus learners on exam preparation rather than clinical learning opportunities, particularly when they should be developing greater autonomy. In response, the Royal College moved the written examination earlier in training and created an exam quality review, by a specialist uninvolved in development, to review the exam for clarity and relevance. While learners are likely to continue to focus on the examination as an important hurdle to overcome, they will be preparing earlier in training, allowing them the opportunity to be more present and refine their knowledge when discussing clinical cases with supervisors in the Transition to Practice phase. The quality review process better aligns the exam to clinical practice and can improve the educational impact of the examination preparation process.
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Affiliation(s)
- Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Viren Naik
- Medical Council of Canada, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Amanda Skoll
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Richard Pittini
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vijay John Daniels
- Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada
- General Internal Medicine Subspecialty Exam Board Chair, Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | - C. Maria Bacchus
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Glen Bandiera
- University of Toronto Temerty Faculty of Medicine, Executive Director, Standards and Assessment, Royal College of Physicians and Surgeons of Canada, Canada
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Richardson D, Landreville JM, Trier J, Cheung WJ, Bhanji F, Hall AK, Frank JR, Oswald A. Coaching in Competence by Design: A New Model of Coaching in the Moment and Coaching Over Time to Support Large Scale Implementation. Perspect Med Educ 2024; 13:33-43. [PMID: 38343553 PMCID: PMC10854464 DOI: 10.5334/pme.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/23/2023] [Indexed: 02/15/2024]
Abstract
Coaching is an increasingly popular means to provide individualized, learner-centered, developmental guidance to trainees in competency based medical education (CBME) curricula. Aligned with CBME's core components, coaching can assist in leveraging the full potential of this educational approach. With its focus on growth and improvement, coaching helps trainees develop clinical acumen and self-regulated learning skills. Developing a shared mental model for coaching in the medical education context is crucial to facilitate integration and subsequent evaluation of success. This paper describes the Royal College of Physicians and Surgeons of Canada's coaching model, one that is theory based, evidence informed, principle driven and iteratively and developed by a multidisciplinary team. The coaching model was specifically designed, fit for purpose to the postgraduate medical education (PGME) context and implemented as part of Competence by Design (CBD), a new competency based PGME program. This coaching model differentiates two coaching roles, which reflect different contexts in which postgraduate trainees learn and develop skills. Both roles are supported by the RX-OCR process: developing Relationship/Rapport, setting eXpectations, Observing, a Coaching conversation, and Recording/Reflecting. The CBD Coaching Model and its associated RX-OCR faculty development tool support the implementation of coaching in CBME. Coaching in the moment and coaching over time offer important mechanisms by which CBD brings value to trainees. For sustained change to occur and for learners and coaches to experience the model's intended benefits, ongoing professional development efforts are needed. Early post implementation reflections and lessons learned are provided.
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Affiliation(s)
- Denyse Richardson
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Jessica Trier
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, Canada
| | - Warren J. Cheung
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andrew K. Hall
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jason R. Frank
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Anna Oswald
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, ON, Canada
- Competency Based Medical Education, University of Alberta, Edmonton, AB, Canada
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Cheung WJ, Bhanji F, Gofton W, Hall AK, Karpinski J, Richardson D, Frank JR, Dudek N. Design and Implementation of a National Program of Assessment Model - Integrating Entrustable Professional Activity Assessments in Canadian Specialist Postgraduate Medical Education. Perspect Med Educ 2024; 13:44-55. [PMID: 38343554 PMCID: PMC10854461 DOI: 10.5334/pme.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/04/2023] [Indexed: 02/15/2024]
Abstract
Traditional approaches to assessment in health professions education systems, which have generally focused on the summative function of assessment through the development and episodic use of individual high-stakes examinations, may no longer be appropriate in an era of competency based medical education. Contemporary assessment programs should not only ensure collection of high-quality performance data to support robust decision-making on learners' achievement and competence development but also facilitate the provision of meaningful feedback to learners to support reflective practice and performance improvement. Programmatic assessment is a specific approach to designing assessment systems through the intentional selection and combination of a variety of assessment methods and activities embedded within an educational framework to simultaneously optimize the decision-making and learning function of assessment. It is a core component of competency based medical education and is aligned with the goals of promoting assessment for learning and coaching learners to achieve predefined levels of competence. In Canada, postgraduate specialist medical education has undergone a transformative change to a competency based model centred around entrustable professional activities (EPAs). In this paper, we describe and reflect on the large scale, national implementation of a program of assessment model designed to guide learning and ensure that robust data is collected to support defensible decisions about EPA achievement and progress through training. Reflecting on the design and implications of this assessment system may help others who want to incorporate a competency based approach in their own country.
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Affiliation(s)
- Warren J. Cheung
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada, 1053 Carling Avenue, Rm F660, Ottawa, ON K1Y 4E9, CA
| | - Farhan Bhanji
- Department of Pediatrics (Critical Care), Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
| | - Wade Gofton
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Surgery, Division of Orthopaedic Surgery, University of Ottawa, Ottawa, ON, CA
| | - Andrew K. Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
| | - Jolanta Karpinski
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Medicine, University of Ottawa, Ottawa, ON, CA
| | - Denyse Richardson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, CA
| | - Jason R. Frank
- Department of Emergency Medicine, Director, Centre for Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, CA
| | - Nancy Dudek
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, CA
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5
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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Sawyer T, McBride ME, Ades A, Kapadia VS, Leone TA, Lakshminrusimha S, Ali N, Marshall S, Schmölzer GM, Kadlec KD, Pusic MV, Bigham BL, Bhanji F, Donoghue AJ, Raymond T, Kamath-Rayne BD, de Caen A. Considerations on the Use of Neonatal and Pediatric Resuscitation Guidelines for Hospitalized Neonates and Infants: On Behalf of the American Heart Association Emergency Cardiovascular Care Committee and the American Academy of Pediatrics. Pediatrics 2024; 153:e2023064681. [PMID: 38105696 DOI: 10.1542/peds.2023-064681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/19/2023] Open
Abstract
Between 0.25% and 3% of admissions to the NICU, PICU, and PCICU receive cardiopulmonary resuscitation (CPR). Most CPR events occur in patients <1 year old. The incidence of CPR is 10 times higher in the NICU than at birth. Therefore, optimizing the approach to CPR in hospitalized neonates and infants is important. At birth, the resuscitation of newborns is performed according to neonatal resuscitation guidelines. In older infants and children, resuscitation is performed according to pediatric resuscitation guidelines. Neonatal and pediatric guidelines differ in several important ways. There are no published recommendations to guide the transition from neonatal to pediatric guidelines. Therefore, hospitalized neonates and infants can be resuscitated using neonatal guidelines, pediatric guidelines, or a hybrid approach. This report summarizes the current neonatal and pediatric resuscitation guidelines, considers how to apply them to hospitalized neonates and infants, and identifies knowledge gaps and future priorities. The lack of strong scientific data makes it impossible to provide definitive recommendations on when to transition from neonatal to pediatric resuscitation guidelines. Therefore, it is up to health care teams and institutions to decide if neonatal or pediatric guidelines are the best choice in a given location or situation, considering local circumstances, health care team preferences, and resource limitations.
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Affiliation(s)
- Taylor Sawyer
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Mary E McBride
- Divisions of Pediatric Cardiology and Pediatric Critical Care Medicine, Department of Pediatrics
| | | | - Vishal S Kapadia
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University Southwestern Medical Center, Dallas, Texas
| | - Tina A Leone
- Division of Neonatology, Department of Pediatrics, Columbia University, New York, New York
| | | | - Norjahan Ali
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University Southwestern Medical Center, Dallas, Texas
| | - Stephanie Marshall
- Neonatology, Department of Pediatrics, Northwestern University Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | - Kelly D Kadlec
- Division of Critical Care, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Martin V Pusic
- Division of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Blair L Bigham
- Division of Critical Care, Department of Anesthesia, Stanford University, Palo Alto, California
| | - Farhan Bhanji
- Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Aaron J Donoghue
- Pediatric Intensive Care, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tia Raymond
- Department of Pediatrics, Pediatric Cardiac Intensive Care, Medical City Children's Hospital, Dallas, Texas
| | - Beena D Kamath-Rayne
- Global Child Health and Life Support, American Academy of Pediatrics, Itasca, Illinois
| | - Allan de Caen
- Pediatric Critical Care, Department of Pediatrics, University of Alberta, Edmonton, Canada
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7
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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8
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Harley JM, Hin-Hei Lau C, Bilgic E, Moran RM, Fried GM, Bhanji F. Identifying Royal College-accredited simulation centre research priorities across Canada. Can Med Educ J 2023; 14:89-93. [PMID: 37719392 PMCID: PMC10500412 DOI: 10.36834/cmej.73911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
To advance the field of health sciences simulation, research must be of high quality and would benefit from multi-institutional collaboration where centres can leverage and share expertise as well as work together to overcome limits to the generalizability of research findings from single-institution studies. A needs assessment in emergency medicine simulation has illustrated the importance of identifying research priorities in Canada. The main purpose of this study was to identify simulation research priority directions for Canadian simulation centres. The current survey study drew on 16 research priorities developed through a two-round internal Delphi study at McGill University that 15 of 17 simulation centre advisory board members participated in. The final 16 research priorities were then rated by a total of 18 of 24 simulation centre directors and/or delegates contacted from 15 of 19 Royal College of Physicians and Surgeons of Canada-accredited simulation centres in Canada. Results revealed nine common research priorities that reached 70% or higher agreement for all respondents. We anticipate that our findings can contribute to building a shared vision of priorities, community, and collaboration to enhance health care simulation research quality amongst Canadian simulation centres.
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Affiliation(s)
- Jason M Harley
- Department of Surgery, McGill University, Quebec, Canada
- Research Institute of the McGill University Health Centre, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
| | | | - Elif Bilgic
- Department of Surgery, McGill University, Quebec, Canada
- Department of Pediatrics, McMaster University, Ontario, Canada
| | - Ricky Muller Moran
- Department of Surgery, McGill University, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Department of Surgery, University of Manitoba, Manitoba, Canada
| | - Gerald M Fried
- Department of Surgery, McGill University, Quebec, Canada
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
| | - Farhan Bhanji
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Quebec, Canada
- Institute for Health Sciences Education, McGill University, Quebec, Canada
- Department of Pediatrics, McGill University, Quebec, Canada
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9
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Schroeder DC, Semeraro F, Greif R, Bray J, Morley P, Parr M, Kondo Nakagawa N, Iwami T, Finke SR, Malta Hansen C, Lockey A, Del Rios M, Bhanji F, Sasson C, Schexnayder SM, Scquizzato T, Wetsch WA, Böttiger BW. KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren: A Narrative Review and Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2023. [PMID: 37194575 DOI: 10.1161/cir.0000000000001128] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren. METHODS After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included. RESULTS Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages. CONCLUSIONS Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.
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10
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Schroeder DC, Semeraro F, Greif R, Bray J, Morley P, Parr M, Kondo Nakagawa N, Iwami T, Finke SR, Malta Hansen C, Lockey A, Del Rios M, Bhanji F, Sasson C, Schexnayder SM, Scquizzato T, Wetsch WA, Böttiger BW. Temporarily Removed. Resuscitation 2023:109772. [PMID: 37190748 DOI: 10.1016/j.resuscitation.2023.109772] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren. METHODS After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included. RESULTS Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages. CONCLUSIONS Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.
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11
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Ying Y, Dupre J, Bhanji F. Female surgical trainee recruitment and attrition - A 10-year national retrospective review. Am J Surg 2023; 225:282-286. [PMID: 36008168 DOI: 10.1016/j.amjsurg.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Female trainees continue to be underrepresented in surgical specialties. Studies have shown lower enrollment and higher attrition of female trainees in surgery. However, there is no comprehensive data examining trends to determine if positive strides have been made towards greater equity. METHODS Retrospective cohort study examining Canadian surgical residents who began training between 2000 and 2010. Enrollment data was compared to how many of those individuals registered for their final surgical certifying examinations by 2018, which indicated completion of residency. RESULTS In the 10-year period, overall attrition rates of surgical trainees was 8%. Female residents were twice as likely to leave training compared to their male counterparts (12.4 vs 6.1% p < 0.001). Attrition rates for female residents appeared to trend downwards. Enrollment of female surgical trainees across all surgical specialties increased from 27.3% to 39.2% during this time. CONCLUSION Equity in Canadian surgical training enrollment and retention improved for those who began training from 2000 to 2010, but there continued to be differences in female trainee recruitment and attrition rates compared to their male counterparts.
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Affiliation(s)
- Yvonne Ying
- University of Ottawa, Department of Surgery, Ottawa, Canada; Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
| | | | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada; Department of Pediatrics, McGill University, Montreal, Canada.
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12
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Phil Chung S, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar J, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Gene Ong YK, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Pediatrics 2023; 151:189896. [PMID: 36325925 DOI: 10.1542/peds.2022-060463] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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13
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Ong YKG, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2022; 146:e483-e557. [PMID: 36325905 DOI: 10.1161/cir.0000000000001095] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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14
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Phil Chung S, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Gene Ong YK, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM, Cartledge S, Dawson JA, Elgohary MM, Ersdal HL, Finan E, Flaatten HI, Flores GE, Fuerch J, Garg R, Gately C, Goh M, Halamek LP, Handley AJ, Hatanaka T, Hoover A, Issa M, Johnson S, Kamlin CO, Ko YC, Kule A, Leone TA, MacKenzie E, Macneil F, Montgomery W, O’Dochartaigh D, Ohshimo S, Stefano Palazzo F, Picard C, Quek BH, Raitt J, Ramaswamy VV, Scapigliati A, Shah BA, Stewart C, Strand ML, Szyld E, Thio M, Topjian AA, Udaeta E, Vaillancourt C, Wetsch WA, Wigginton J, Yamada NK, Yao S, Zace D, Zelop CM. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2022; 181:208-288. [PMID: 36336195 DOI: 10.1016/j.resuscitation.2022.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimising pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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15
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Terry M, Powell J, Gilmore WS, Way DP, Dwyer A, Bhanji F, Panchal AR. Deriving National Continued Competency Priorities for Emergency Medical Services Clinicians. PREHOSP EMERG CARE 2022; 27:439-448. [PMID: 36066437 DOI: 10.1080/10903127.2022.2120934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Continued competency is poorly defined in emergency medical services (EMS), with no established method for verifying continued competency at a national level. The objective of this project was to refine understanding of continued competency for EMS clinicians in the U.S. and establish priorities for developing competency assessments.Methods: A panel of EMS managers, educators, medical directors, and experts in competency assessment, simulation, and certification used a modified Delphi technique to address two questions: "What is the content for continued competency in EMS that should be assessed or verified?" (content) and "How should continued competency of EMS clinicians be demonstrated?" (process) The Delphi process was conducted through electronic conferencing and survey software over a 6-month period. In round one, panelists responded to open-ended prompts and their contributions were analyzed and categorized into themes by independent reviewers. In round two, the panel rated theme importance using five-point Likert-type scales. In round three, the panel ranked their top 10 themes, and in round four, the panel selected the most important themes for each of the two questions through consensus-building discussions. Descriptive statistics and thematic analyses were performed with Excel and STATA 16.Results: Fourteen invited experts participated in all Delphi activities. The panel contributed 70 content and 35 process items from the original prompts. Following thematic analysis, these contributions were reduced to 21 and 14 unique themes, respectively. The final top five prioritized themes for content important for continued competency included 1) airway, respiration, and ventilation, 2) patient assessment, 3) pharmacology, 4) pediatrics, and 5) management of time critical disease progressions. The final top five prioritized themes for the processes for continued competency assessment included 1) assessments of evidence-based practice, 2) performance-based assessments, 3) combined knowledge and skill assessments, 4) performance improvement over time, and 5) frequent, short knowledge assessments.Conclusion: This modified Delphi process identified priorities for content and assessment, laying the groundwork for EMS continued competency at a national level. These findings can be leveraged by national task forces to develop transparent and consistent guidelines for systems that verify continued competency related to certification, licensure, and local credentialing.
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Affiliation(s)
- Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH, U.S.A
| | - Jonathan Powell
- National Registry of Emergency Medical Technicians, Columbus, OH, U.S.A.,Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH
| | - W Scott Gilmore
- National Registry of Emergency Medical Technicians, Columbus, OH, U.S.A.,St. Louis Fire Department, St. Louis, MO, U.S.A.,Mercy Clinic East Communities, St. Louis, MO, U.S.A
| | - David P Way
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, U.S.A
| | - Andrew Dwyer
- The American Board of Pediatrics, Chapel Hill, NC, U.S.A
| | - Farhan Bhanji
- Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada.,Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Ashish R Panchal
- National Registry of Emergency Medical Technicians, Columbus, OH, U.S.A.,Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH.,Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, U.S.A
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16
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Morgan RW, Atkins DL, Hsu A, Kamath-Rayne BD, Aziz K, Berg RA, Bhanji F, Chan M, Cheng A, Chiotos K, de Caen A, Duff JP, Fuchs S, Joyner BL, Kleinman M, Lasa JJ, Lee HC, Lehotzky RE, Levy A, McBride ME, Meckler G, Nadkarni V, Raymond T, Roberts K, Schexnayder SM, Sutton RM, Terry M, Walsh B, Zelop CM, Sasson C, Topjian A. Guidance for Cardiopulmonary Resuscitation of Children With Suspected or Confirmed COVID-19. Pediatrics 2022; 150:188494. [PMID: 35818123 DOI: 10.1542/peds.2021-056043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/24/2022] Open
Abstract
This article aims to provide guidance to health care workers for the provision of basic and advanced life support to children and neonates with suspected or confirmed coronavirus disease 2019 (COVID-19). It aligns with the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular care while providing strategies for reducing risk of transmission of severe acute respiratory syndrome coronavirus 2 to health care providers. Patients with suspected or confirmed COVID-19 and cardiac arrest should receive chest compressions and defibrillation, when indicated, as soon as possible. Because of the importance of ventilation during pediatric and neonatal resuscitation, oxygenation and ventilation should be prioritized. All CPR events should therefore be considered aerosol-generating procedures. Thus, personal protective equipment (PPE) appropriate for aerosol-generating procedures (including N95 respirators or an equivalent) should be donned before resuscitation, and high-efficiency particulate air filters should be used. Any personnel without appropriate PPE should be immediately excused by providers wearing appropriate PPE. Neonatal resuscitation guidance is unchanged from standard algorithms, except for specific attention to infection prevention and control. In summary, health care personnel should continue to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission through vaccination and use of appropriate PPE during pediatric resuscitations. Health care organizations should ensure the availability and appropriate use of PPE. Because delays or withheld CPR increases the risk to patients for poor clinical outcomes, children and neonates with suspected or confirmed COVID-19 should receive prompt, high-quality CPR in accordance with evidence-based guidelines.
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Affiliation(s)
- Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Dianne L Atkins
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Antony Hsu
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Superior Township, Michigan
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, Illinois
| | - Khalid Aziz
- Department of Pediatrics, Division of Newborn Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Farhan Bhanji
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Melissa Chan
- Departments of Pediatrics and Pediatric Emergency Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Cheng
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen Chiotos
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Allan de Caen
- Department of Pediatrics, Division of Critical Care, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan P Duff
- Department of Pediatrics, Division of Critical Care, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | | | - Benny L Joyner
- Departments of Pediatrics, Anesthesiology & Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Monica Kleinman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Javier J Lasa
- Cardiovascular ICU, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Henry C Lee
- Division of Neonatology, Stanford University, Stanford, California
| | | | - Arielle Levy
- Departments of Pediatrics and Pediatric Emergency Medicine, Sainte-Justine Hospital University Center, University of Montreal, Montreal, Quebec, Canada
| | - Mary E McBride
- Cardiology, and Critical Care Medicine, Northwestern University, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Garth Meckler
- Departments of Pediatrics and Pediatric Emergency Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vinay Nadkarni
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Tia Raymond
- Department of Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, Texas
| | - Kathryn Roberts
- Center for Nursing Excellence, Education & Innovation, Joe DiMaggio Children's Hospital, Hollywood, Florida
| | - Stephen M Schexnayder
- Departments of Critical Care Medicine and Emergency Medicine, Arkansas Children's Hospital, Springdale, Arkansas
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, Ohio
| | - Brian Walsh
- Respiratory Care, Children's Hospital Colorado, Aurora, Colorado
| | - Carolyn M Zelop
- Department of Obstetrics and Gynecology, NYU School of Medicine and The Valley Hospital, New York City, New York
| | - Comilla Sasson
- ECC Science & Innovation, American Heart Association, Dallas, Texas
| | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Ko Y, Hsieh M, Cheng A, Lauridsen KG, Sawyer TL, Bhanji F, Greif R. Faculty Development Approaches for Life Support Courses: A Scoping Review. J Am Heart Assoc 2022; 11:e025661. [PMID: 35656992 PMCID: PMC9238697 DOI: 10.1161/jaha.122.025661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022]
Abstract
The aim of this scoping review initiated by the Education, Implementation and Teams Task Force of the International Liaison Committee on Resuscitation was to identify faculty development approaches to improve instructional competence in accredited life support courses. We searched PubMed, Ovid Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register of Controlled Trials to identify studies published from January 1, 1966 to December 31, 2021 on approaches to improve faculty development for life support courses. Data on participant characteristics, interventions, design, and outcomes of included studies were extracted. Of the initially identified 10 310 studies, we included 20 studies (5 conference abstracts, 1 short communication, 14 full-length articles). Among them, 12 studies aimed to improve instructors/candidates' teaching ability in basic life support courses. A wide variety of interventions were identified. The interventions were categorized into 4 themes: instructor qualification/training (n=9), assessment tools (n=3), teaching skills enhancement (n=3), and additional courses for instructors (n=5). Most studies showed that these interventions improved specific teaching ability or confidence of the instructors and learning outcomes in different kinds of life support courses. However, no studies addressed clinical outcomes of patients. In conclusion, the faculty development approaches for instructors are generally associated with improved learning outcomes for participants, and also improved teaching ability and self-confidence of the instructors. It is encouraged that local organizations implement faculty development programs for their teaching staff of their accredited resuscitation courses. Further studies should explore the best ways to strengthen and maintain instructor competency, and define the cost-effectiveness of various different faculty development strategies.
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Affiliation(s)
- Ying‐Chih Ko
- Department of Emergency MedicineNational Taiwan University HospitalTaipeiTaiwan
| | - Ming‐Ju Hsieh
- Department of Emergency MedicineNational Taiwan University HospitalTaipeiTaiwan
| | - Adam Cheng
- Departments of Pediatrics and Emergency MedicineUniversity of CalgaryAlbertaCanada
| | - Kasper G. Lauridsen
- Research Center for Emergency MedicineAarhus University HospitalAarhusDenmark
- Emergency DepartmentRanders Regional HospitalRandersDenmark
- Department of Anesthesiology and Critical Care MedicineChildren's Hospital of PhiladelphiaPhiladelphiaPA
| | - Taylor L. Sawyer
- University of Washington School of MedicineSeattleWA
- Seattle Children’s HospitalSeattleWA
| | - Farhan Bhanji
- Department of PediatricsMcGill UniversityMontrealCanada
| | - Robert Greif
- Department of Anaesthesiology and Pain MedicineBern University HospitalUniversity of BernBernSwitzerland
- School of MedicineSigmund Freud University ViennaViennaAustria
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18
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Dainty KN, Colquitt B, Bhanji F, Hunt EA, Jefkins T, Leary M, Ornato JP, Swor RA, Panchal A. Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2022; 145:e852-e867. [PMID: 35306832 DOI: 10.1161/cir.0000000000001054] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.
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Tavares W, Gofton W, Bhanji F, Dudek N. Reframing the O-SCORE as a Retrospective Supervision Scale Using Validity Theory. J Grad Med Educ 2022; 14:22-24. [PMID: 35222815 PMCID: PMC8848889 DOI: 10.4300/jgme-d-21-00592.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Walter Tavares
- Walter Tavares, PhD, is Assistant Professor and Scientist, The Wilson Centre and Temerty Faculty of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Wade Gofton
- Wade Gofton, MD, MEd, is Professor, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Farhan Bhanji
- Farhan Bhanji, MD, MSc(Ed), is Professor, Department of Pediatrics, McGill University, Montreal, Quebec, Canada, and Associate Director of Assessment Strategy Royal College of Physicians and Surgeons, Ottawa, Ontario, Canada
| | - Nancy Dudek
- Nancy Dudek, MD, MEd, is Professor, Department of Medicine, Division of Physical Medicine and Rehabilitation, and The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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Atkins DL, Sasson C, Hsu A, Aziz K, Becker LB, Berg RA, Bhanji F, Bradley SM, Brooks SC, Chan M, Chan PS, Cheng A, Clemency BM, de Caen A, Duff JP, Edelson DP, Flores GE, Fuchs S, Girotra S, Hinkson C, Joyner BL, Kamath-Rayne BD, Kleinman M, Kudenchuk PJ, Lasa JJ, Lavonas EJ, Lee HC, Lehotzky RE, Levy A, McBride ME, Meckler G, Merchant RM, Moitra VK, Nadkarni V, Panchal AR, Ann Peberdy M, Raymond T, Roberts K, Sayre MR, Schexnayder SM, Sutton RM, Terry M, Topjian A, Walsh B, Wang DS, Zelop CM, Morgan RW. 2022 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration With the American Academy of Pediatrics, American Association for Respiratory Care, the Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists. Circ Cardiovasc Qual Outcomes 2022; 15:e008900. [PMID: 35072519 DOI: 10.1161/circoutcomes.122.008900] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Dianne L Atkins
- Carver College of Medicine, University of Iowa (D.L.A., S.G.)
| | | | - Antony Hsu
- St Joseph Mercy Hospital, Ann Arbor, MI (A.H.)
| | - Khalid Aziz
- University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B Becker
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A Berg
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | | | - Steven M Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | | | - Melissa Chan
- University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada (M.C., G.M.)
| | - Paul S Chan
- Mid America Heart Institute and the University of Missouri-Kansas City, MO (P.S.C.)
| | - Adam Cheng
- Alberta Children's Hospital, University of Calgary, AB, Canada (A.C.)
| | | | - Allan de Caen
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Jonathan P Duff
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | | | - Gustavo E Flores
- Emergency & Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL (S.F., M.E.M.)
| | - Saket Girotra
- Carver College of Medicine, University of Iowa (D.L.A., S.G.)
| | - Carl Hinkson
- Providence Regional Medical Center, Everett, WA (C.H.)
| | - Benny L Joyner
- University of North Carolina at Chapel Hill, NC (B.L.J.)
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | | | | | | | | | | | | | - Arielle Levy
- Sainte-Justine Hospital University Center, University of Montreal, QC, Canada (A.L.)
| | - Mary E McBride
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL (S.F., M.E.M.)
| | - Garth Meckler
- University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada (M.C., G.M.)
| | - Raina M Merchant
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.).,University of Pennsylvania, Philadelphia, PA (R.M.M.)
| | - Vivek K Moitra
- College of Physicians & Surgeons of Columbia University, NY (V.K.M.)
| | - Vinay Nadkarni
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | - Ashish R Panchal
- The Ohio State University Wexner Medical Center, Columbus, OH (A.R.P.)
| | | | - Tia Raymond
- Medical City Children's Hospital, Dallas, TX (T.R.)
| | | | | | | | - Robert M Sutton
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Alexis Topjian
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Brian Walsh
- Children's Hospital Colorado, Aurora, CO (B.W.)
| | - David S Wang
- Columbia University Irving Medical Center, NY (D.S.W.)
| | | | - Ryan W Morgan
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
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21
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Lou NM, Montreuil T, Feldman LS, Fried GM, Lavoie-Tremblay M, Bhanji F, Kennedy H, Kaneva P, Harley JM. Nurses' and Physicians' Distress, Burnout, and Coping Strategies During COVID-19: Stress and Impact on Perceived Performance and Intentions to Quit. J Contin Educ Health Prof 2022; 42:e44-e52. [PMID: 33973927 DOI: 10.1097/ceh.0000000000000365] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Health care providers (HCPs) have experienced more stress and burnout during COVID-19 than before. We compared sources and levels of stress, distress, and approaches to coping between nurses and physicians, and examined whether coping strategies helped mitigate the negative impact of stress and intentions to quit. METHODS Using a cross-sectional study design, burnout was measured with the Maslach Burnout Inventory. Psychological distress was measured using the Depression, Anxiety, and Stress Scale. A self-reported survey was used to evaluate stressors, impact on perceived performance, and intentions to quit. The data were analyzed using t-tests and linear regression models. RESULTS Responses of 119 HCPs were analyzed. Findings suggest that (1) compared to physicians, nurses experienced a higher level of distress and burnout, and used more maladaptive coping strategies. (2) Both nurses and physicians experienced more distress and burnout during COVID-19 than before. (3) Adaptive coping strategies moderated the negative impact of stress on work performance (4) Adaptive coping strategies moderated the negative effect of stress on burnout, which in turn reduced intentions to quit. Stress negatively impacted work performance and burnout only for those with low, but not high, levels of adaptive coping strategies. DISCUSSION The current findings of HCPs' challenges, risks, and protective factors provide valuable information (1) on COVID-19's impact on HCPs, (2) to guide the distribution of institutional supportive efforts and recommend adaptive coping strategies, and (3) to inform medical education, such as resilience training, focusing on adaptive coping approaches.
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Affiliation(s)
- Nigel Mantou Lou
- Dr. Lou: Postdoctoral Fellow, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Montreuil: Assistant professor, Department of Educational and Counselling Psychology, McGill University, Montreal, CA; Associate Member, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, CA; and Associate Investigator, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Feldman: Professor and Chair, Department of Surgery, Faculty of Medicine and Health Sciences, and Chair, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Dr. Fried: Professor, Department of Surgery, Faculty of Medicine and Health Sciences, Director, Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, CA. Dr. Lavoie-Tremblay: Associate Professor, Ingram School of Nursing, McGill University, Montreal, CA. Dr. Bhanji: Director of Education, Steinberg Centre for Simulation and Interactive Learning, Professor, Department of Pediatrics, Faculty of Medicine and Health Sciences, and Associate member, Institute for Health Sciences Education, McGill University, Montreal, CA. Ms. Kaneva: Program coordinator, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Ms. Kennedy: Doctoral student, Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, CA. Dr. Harley: Assistant professor, Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, CA, Scientist, Research Institute of the McGill University Health Centre, Montreal, CA; Associate Member, Department of Educational and Counselling Psychology; Director of Research, Steinberg Centre for Simulation and Interactive Learning; and Associate Member, Institute for Health Sciences Education, McGill University, Montreal, CA
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22
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, El-Naggar W, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami MD, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation 2021; 145:e645-e721. [PMID: 34813356 DOI: 10.1161/cir.0000000000001017] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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23
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami M, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2021; 169:229-311. [PMID: 34933747 PMCID: PMC8581280 DOI: 10.1016/j.resuscitation.2021.10.040] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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24
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Hsu A, Sasson C, Kudenchuk PJ, Atkins DL, Aziz K, Becker LB, Berg RA, Bhanji F, Bradley SM, Brooks SC, Chan M, Chan PS, Cheng A, Clemency BM, de Caen A, Duff JP, Edelson DP, Flores GE, Fuchs S, Girotra S, Hinkson C, Joyner BL, Kamath-Rayne BD, Kleinman M, Lasa JJ, Lavonas EJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Moitra VK, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sayre MR, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Topjian A. 2021 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circ Cardiovasc Qual Outcomes 2021; 14:e008396. [PMID: 34641719 PMCID: PMC8522336 DOI: 10.1161/circoutcomes.121.008396] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Antony Hsu
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI (A.H.)
| | - Comilla Sasson
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Peter J Kudenchuk
- Department of Medicine/Division of Cardiology (P.J.K.), University of Washington, Seattle
| | - Dianne L Atkins
- Stead Family Department of Pediatrics (D.L.A), Carver College of Medicine, University of Iowa
| | - Khalid Aziz
- Division of Newborn Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B Becker
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Farhan Bhanji
- Department of Pediatrics, McGill University, Montreal, QC, Canada (F.B.)
| | - Steven M Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | - Steven C Brooks
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada (S.C.B.)
| | - Melissa Chan
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Paul S Chan
- Department of Internal Medicine, Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City (P.S.C.)
| | - Adam Cheng
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Canada (A.C.)
| | - Brian M Clemency
- Department of Emergency Medicine, University at Buffalo, NY (B.M.C.)
| | - Allan de Caen
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Jonathan P Duff
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Dana P Edelson
- Section of Hospital Medicine, University of Chicago, IL (D.P.E.)
| | - Gustavo E Flores
- Emergency and Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Division of Emergency Medicine (S.F.), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Saket Girotra
- Department of Internal Medicine and Division of Cardiovascular Diseases (S.G.), Carver College of Medicine, University of Iowa
| | - Carl Hinkson
- Respiratory Care, Providence Regional Medical Center, Everett, WA (C.H.)
| | - Benny L Joyner
- Departments of Pediatrics, Anesthesiology & Social Medicine, University of North Carolina at Chapel Hill (B.L.J.)
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | - Monica Kleinman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, MA (M.K.)
| | - Javier J Lasa
- Cardiovascular Intensive Care Unit, Texas Children's Hospital, Baylor College Of Medicine, Houston (J.J.L.)
| | - Eric J Lavonas
- Department of Emergency Medicine, Denver Health and Hospital Authority, CO (E.J.L.)
| | - Henry C Lee
- Division of Neonatology, Stanford University, CA (H.C.L.)
| | - Rebecca E Lehotzky
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Arielle Levy
- Department of Pediatrics and Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Center, University of Montreal, QC, Canada (A.L.)
| | - Mary E Mancini
- College of Nursing, University of Texas at Arlington (M.E. Mancini)
| | - Mary E McBride
- Divisions of Cardiology and Critical Care Medicine (M.E. McBride), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Garth Meckler
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Raina M Merchant
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia (R.M.M.)
| | - Vivek K Moitra
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.)
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Vinay Nadkarni
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Ashish R Panchal
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus (A.R.P.)
| | - Mary Ann Peberdy
- Division of Cardiology, Virginia Commonwealth University, Richmond (M.A.P.)
| | - Tia Raymond
- Department of Pediatrics and Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, TX (T.R.)
| | - Kathryn Roberts
- Center for Nursing Excellence, Education & Innovation, Joe DiMaggio Children's Hospital, Hollywood, FL (K.R.)
| | - Michael R Sayre
- Department of Emergency Medicine (M.R.S.), University of Washington, Seattle
| | - Stephen M Schexnayder
- Departments of Critical Care Medicine and Emergency Medicine, Arkansas Children's Hospital, Little Rock (S.M.S.)
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Brian Walsh
- Respiratory Care, Children's Hospital Colorado, Aurora (B.W.)
| | - David S Wang
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.).,Department of Obstetrics and Gynecology, New York, NY (D.S.W.)
| | - Carolyn M Zelop
- NYU School of Medicine, New York, NY and The Valley Hospital, Ridgewood, NJ (C.M.Z.)
| | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
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Levett JY, Allard SB, Chamass E, Chami S, Ehlebracht A, Elbaz S, Essebag A, Skiadopoulos C, Bhanji F. The McGill World Restart a Heart 2020 Campaign: a student-led, patient-engaged, large-scale online simulation program. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac arrest is a leading cause of death, with the majority of cases occurring in homes or public places. Up to 55% are witnessed by family members, colleagues or friends, yet most victims don't receive cardiopulmonary resuscitation (CPR), which can triple the odds of survival. Mortality therefore remains high at over 90%. Enhancing bystander CPR skills is a crucial public health investment.
Objective
Engage the Canadian and global community in a thought-provoking and immersive experience to explore cardiac arrests, destigmatize bystander CPR, and enhance resuscitation knowledge and skills. Partner with patients, leverage innovative technologies, and social media, to develop a digital scalable simulation/educational exercise.
Methods
Interprofessional healthcare students from the Faculty coordinated a University World Restart a Heart (WRAH) 2020 Campaign as part of a global initiative. Amplified by social media influencers, the Campaign team produced a bilingual digital Campaign with succinct and high-impact videos including survivor and non-survivor family perspectives, digital live events, a patient education guide for families of cardiac arrest patients, and an open access eModule. Our Steering Committee comprised University leadership, intensive and emergency care physicians, a cardiac arrest survivor, and the communications team from the Faculty, Centre for Simulation and Interactive Learning, and University Health Centre.
Results
The Campaign garnered an international audience with over 74,636 impressions across social media platforms (Facebook, Instagram, and Twitter), 42,600 views of Campaign videos, and 1,500 views of hour-long webinars. Campaign ambassadors had a combined viewership of over 500,000 followers, and included astronaut physicians, Olympic athletes, adult and pediatric cardiac arrest survivors, and social media influencers. The Campaign launched an innovative bystander resuscitation eModule that delivers scalable screen-based simulation. The patient education guide, in collaboration with the University Health Centre's Patient Education Office, focuses on the chain of survival and expectations for acute management, hospitalization and recovery.
Conclusion
Tens of thousands of individuals reached through the University WRAH 2020 Campaign are now empowered to initiate CPR, which may help reduce the morbidity and mortality of cardiac arrests.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The McGill Fund.
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Affiliation(s)
- J Y Levett
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - S B Allard
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - E Chamass
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - S Chami
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - A Ehlebracht
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - S Elbaz
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - A Essebag
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - C Skiadopoulos
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - F Bhanji
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
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26
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Ross S, Hauer KE, Wycliffe-Jones K, Hall AK, Molgaard L, Richardson D, Oswald A, Bhanji F. Key considerations in planning and designing programmatic assessment in competency-based medical education. Med Teach 2021; 43:758-764. [PMID: 34061700 DOI: 10.1080/0142159x.2021.1925099] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Programmatic assessment as a concept is still novel for many in clinical education, and there may be a disconnect between the academics who publish about programmatic assessment and the front-line clinical educators who must put theory into practice. In this paper, we clearly define programmatic assessment and present high-level guidelines about its implementation in competency-based medical education (CBME) programs. The guidelines are informed by literature and by lessons learned from established programmatic assessment approaches. We articulate five steps to consider when implementing programmatic assessment in CBME contexts: articulate the purpose of the program of assessment, determine what must be assessed, choose tools fit for purpose, consider the stakes of assessments, and define processes for interpreting assessment data. In the process, we seek to offer a helpful guide or template for front-line clinical educators. We dispel some myths about programmatic assessment to help training programs as they look to design-or redesign-programs of assessment. In particular, we highlight the notion that programmatic assessment is not 'one size fits all'; rather, it is a system of assessment that results when shared common principles are considered and applied by individual programs as they plan and design their own bespoke model of programmatic assessment for CBME in their unique context.
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Affiliation(s)
- Shelley Ross
- Department of Family Medicine, University of Alberta, Edmonton, Canada
- Canadian Association for Medical Education, Edmonton, Canada
| | | | - Keith Wycliffe-Jones
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andrew K Hall
- Department of Emergency Medicine, Queen's University, Kingston, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Laura Molgaard
- University of Minnesota College of Veterinary Medicine, St. Paul, MIN, USA
| | - Denyse Richardson
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
- Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada
| | - Anna Oswald
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
- Department of Medicine and CBME lead for the Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
- Pediatrics at McGill University, Montreal, Canada
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27
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Dainty KN, Atkins DL, Breckwoldt J, Maconochie I, Schexnayder SM, Skrifvars MB, Tijssen J, Wyllie J, Furuta M, Aickin R, Acworth J, Atkins D, Couto TB, Guerguerian AM, Kleinman M, Kloeck D, Nadkarni V, Ng KC, Nuthall G, Ong YKG, Reis A, Rodriguez-Nunez A, Schexnayder S, Scholefield B, Tijssen J, Voorde PVD, Wyckoff M, Liley H, El-Naggar W, Fabres J, Fawke J, Foglia E, Guinsburg R, Hosono S, Isayama T, Kawakami M, Kapadia V, Kim HS, McKinlay C, Roehr C, Schmolzer G, Sugiura T, Trevisanuto D, Weiner G, Greif R, Bhanji F, Bray J, Breckwoldt J, Cheng A, Duff J, Eastwood K, Gilfoyle E, Hsieh MJ, Lauridsen K, Lockey A, Matsuyama T, Patocka C, Pellegrino J, Sawyer T, Schnaubel S, Yeung J. Family presence during resuscitation in paediatric and neonatal cardiac arrest: A systematic review. Resuscitation 2021; 162:20-34. [PMID: 33577966 DOI: 10.1016/j.resuscitation.2021.01.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
CONTEXT Parent/family presence at pediatric resuscitations has been slow to become consistent practice in hospital settings and has not been universally implemented. A systematic review of the literature on family presence during pediatric and neonatal resuscitation has not been previously conducted. OBJECTIVE To conduct a systematic review of the published evidence related to family presence during pediatric and neonatal resuscitation. DATA SOURCES Six major bibliographic databases was undertaken with defined search terms and including literature up to June 14, 2020. STUDY SELECTION 3200 titles were retrieved in the initial search; 36 ultimately included for review. DATA EXTRACTION Data was double extracted independently by two reviewers and confirmed with the review team. All eligible studies were either survey or interview-based and as such we turned to narrative systematic review methodology. RESULTS The authors identified two key sets of findings: first, parents/family members want to be offered the option to be present for their child's resuscitation. Secondly, health care provider attitudes varied widely (ranging from 15% to >85%), however, support for family presence increased with previous experience and level of seniority. LIMITATIONS English language only; lack of randomized control trials; quality of the publications. CONCLUSIONS Parents wish to be offered the opportunity to be present but opinions and perspectives on the family presence vary greatly among health care providers. This topic urgently needs high quality, comparative research to measure the actual impact of family presence on patient, family and staff outcomes. PROSPERO REGISTRATION NUMBER CRD42020140363.
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Affiliation(s)
- Katie N Dainty
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada.
| | - Dianne L Atkins
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jan Breckwoldt
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ian Maconochie
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Steve M Schexnayder
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Markus B Skrifvars
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janice Tijssen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jonathan Wyllie
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Marie Furuta
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Richard Aickin
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jason Acworth
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Dianne Atkins
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Thomaz Bittencourt Couto
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Anne-Marie Guerguerian
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Monica Kleinman
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - David Kloeck
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Vinay Nadkarni
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kee-Chong Ng
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Gabrielle Nuthall
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Yong-Kwang Gene Ong
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Amelia Reis
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Antonio Rodriguez-Nunez
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Steve Schexnayder
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Barney Scholefield
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janice Tijssen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Patrick van de Voorde
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Myra Wyckoff
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Helen Liley
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Walid El-Naggar
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jorge Fabres
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Joe Fawke
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Elizabeth Foglia
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ruth Guinsburg
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Shigeharu Hosono
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Tetsuya Isayama
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Mandira Kawakami
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Vishal Kapadia
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Han-Suk Kim
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Chris McKinlay
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Charles Roehr
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Georg Schmolzer
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Takahiro Sugiura
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Daniele Trevisanuto
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Gary Weiner
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Robert Greif
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Farhan Bhanji
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janet Bray
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jan Breckwoldt
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Adam Cheng
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jonathan Duff
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kathryn Eastwood
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Elaine Gilfoyle
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ming-Ju Hsieh
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kasper Lauridsen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Andrew Lockey
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Tasuku Matsuyama
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Catherine Patocka
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jeffrey Pellegrino
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Taylor Sawyer
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Sebastian Schnaubel
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Joyce Yeung
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
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Lou NM, Montreuil T, Feldman LS, Fried GM, Lavoie-Tremblay M, Bhanji F, Kennedy H, Kaneva P, Drouin S, Harley JM. Evaluations of Healthcare Providers' Perceived Support From Personal, Hospital, and System Resources: Implications for Well-Being and Management in Healthcare in Montreal, Quebec, During COVID-19. Eval Health Prof 2021; 44:319-322. [PMID: 33902348 PMCID: PMC8326888 DOI: 10.1177/01632787211012742] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Increased stressful experiences are pervasive among healthcare providers (HCPs) during the COVID-19 pandemic. Identifying resources that help mitigate stress is critical to maintaining HCPs' well-being. However, to our knowledge, no instrument has systematically examined how different levels of resources help HCPs cope with stress during COVID-19. This cross-sectional study involved 119 HCPs (64 nurses and 55 physicians) and evaluated the perceived availability, utilization, and helpfulness of a list of personal, hospital, and healthcare system resources. Participants also reported on their level of burnout, psychological distress, and intentions to quit. Results revealed that HCPs perceived the most useful personal resource to be family support; the most useful hospital resources were a safe environment, personal protective equipment, and support from colleagues; the most useful system resources were job protection, and clear communication and information about COVID. Moreover, HCPs who perceived having more available hospital resources also reported lower levels of psychological distress symptoms, burnout, and intentions to quit. Finally, although training and counseling services were perceived as useful to reduce stress, training was not perceived as widely available, and counseling services, though reported as being available, were underutilized. This instrument helps identify resources that support HCPs, providing implications for healthcare management.
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Affiliation(s)
- Nigel Mantou Lou
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Tina Montreuil
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
| | - Liane S Feldman
- Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,The Steinberg-Bernstein Centre for Minimally Invasive Surgery, 5620McGill University, Montreal, Quebec, Canada
| | - Gerald M Fried
- Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada
| | - Mélanie Lavoie-Tremblay
- Department of Pediatrics, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada
| | - Farhan Bhanji
- Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada
| | - Heather Kennedy
- Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Pepa Kaneva
- The Steinberg-Bernstein Centre for Minimally Invasive Surgery, 5620McGill University, Montreal, Quebec, Canada
| | - Susan Drouin
- Ingram School of Nursing, 5620McGill University, Montreal, Quebec, Canada
| | - Jason M Harley
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada
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29
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Duff JP, Bhanji F, Lin Y, Overly F, Brown LL, Bragg EA, Kessler D, Tofil NM, Bank I, Hunt EA, Nadkarni V, Cheng A. Change in Cardiopulmonary Resuscitation Performance Over Time During Simulated Pediatric Cardiac Arrest and the Effect of Just-in-Time Training and Feedback. Pediatr Emerg Care 2021; 37:133-137. [PMID: 33651758 DOI: 10.1097/pec.0000000000002359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Effective cardiopulmonary resuscitation (CPR) is critical to ensure optimal outcomes from cardiac arrest, yet trained health care providers consistently struggle to provide guideline-compliant CPR. Rescuer fatigue can impact chest compression (CC) quality during a cardiac arrest event, although it is unknown if visual feedback or just-in-time training influences change of CC quality over time. In this study, we attempt to describe the changes in CC quality over a 12-minute simulated resuscitation and examine the influence of just-in-time training and visual feedback on CC quality over time. METHODS We conducted secondary analysis of data collected from the CPRCARES study, a multicenter randomized trial in which CPR-certified health care providers from 10 different pediatric tertiary care centers were randomized to receive visual feedback, just-in-time CPR training, or no intervention. They participated in a simulated cardiac arrest scenario with 2 team members providing CCs. We compared the quality of CCs delivered (depth and rate) at the beginning (0-4 minutes), middle (4-8 minutes), and end (8-12 minutes) of the resuscitation. RESULTS There was no significant change in depth over the 3 time intervals in any of the arms. There was a significant increase in rate (128 to 133 CC/min) in the no intervention arm over the scenario duration (P < 0.05). CONCLUSIONS There was no significant drop in CC depth over a 12-minute cardiac arrest scenario with 2 team members providing compressions.
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Affiliation(s)
| | | | - Yiqun Lin
- University of Calgary, Calgary, Canada
| | | | | | | | - David Kessler
- Columbia University Vagelos College of Physicians and Surgeons New York, NY
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30
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Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S222-S283. [PMID: 33084395 DOI: 10.1161/cir.0000000000000896] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
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31
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Nolan JP, Maconochie I, Soar J, Olasveengen TM, Greif R, Wyckoff MH, Singletary EM, Aickin R, Berg KM, Mancini ME, Bhanji F, Wyllie J, Zideman D, Neumar RW, Perkins GD, Castrén M, Morley PT, Montgomery WH, Nadkarni VM, Billi JE, Merchant RM, de Caen A, Escalante-Kanashiro R, Kloeck D, Wang TL, Hazinski MF. Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S2-S27. [PMID: 33084397 DOI: 10.1161/cir.0000000000000890] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nolan JP, Maconochie I, Soar J, Olasveengen TM, Greif R, Wyckoff MH, Singletary EM, Aickin R, Berg KM, Mancini ME, Bhanji F, Wyllie J, Zideman D, Neumar RW, Perkins GD, Castrén M, Morley PT, Montgomery WH, Nadkarni VM, Billi JE, Merchant RM, de Caen A, Escalante-Kanashiro R, Kloeck D, Wang TL, Hazinski MF. Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A1-A22. [PMID: 33098915 PMCID: PMC7576314 DOI: 10.1016/j.resuscitation.2020.09.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC, Baldi E, Beck S, Beckers SK, Blewer AL, Boulton A, Cheng-Heng L, Yang CW, Coppola A, Dainty KN, Damjanovic D, Djärv T, Donoghue A, Georgiou M, Gunson I, Krob JL, Kuzovlev A, Ko YC, Leary M, Lin Y, Mancini ME, Matsuyama T, Navarro K, Nehme Z, Orkin AM, Pellis T, Pflanzl-Knizacek L, Pisapia L, Saviani M, Sawyer T, Scapigliati A, Schnaubelt S, Scholefield B, Semeraro F, Shammet S, Smyth MA, Ward A, Zace D. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A188-A239. [PMID: 33098918 DOI: 10.1016/j.resuscitation.2020.09.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
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Berg KM, Cheng A, Panchal AR, Topjian AA, Aziz K, Bhanji F, Bigham BL, Hirsch KG, Hoover AV, Kurz MC, Levy A, Lin Y, Magid DJ, Mahgoub M, Peberdy MA, Rodriguez AJ, Sasson C, Lavonas EJ. Part 7: Systems of Care: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S580-S604. [PMID: 33081524 DOI: 10.1161/cir.0000000000000899] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Survival after cardiac arrest requires an integrated system of people, training, equipment, and organizations working together to achieve a common goal. Part 7 of the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care focuses on systems of care, with an emphasis on elements that are relevant to a broad range of resuscitation situations. Previous systems of care guidelines have identified a Chain of Survival, beginning with prevention and early identification of cardiac arrest and proceeding through resuscitation to post-cardiac arrest care. This concept is reinforced by the addition of recovery as an important stage in cardiac arrest survival. Debriefing and other quality improvement strategies were previously mentioned and are now emphasized. Specific to out-of-hospital cardiac arrest, this Part contains recommendations about community initiatives to promote cardiac arrest recognition, cardiopulmonary resuscitation, public access defibrillation, mobile phone technologies to summon first responders, and an enhanced role for emergency telecommunicators. Germane to in-hospital cardiac arrest are recommendations about the recognition and stabilization of hospital patients at risk for developing cardiac arrest. This Part also includes recommendations about clinical debriefing, transport to specialized cardiac arrest centers, organ donation, and performance measurement across the continuum of resuscitation situations.
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Topjian A, Aziz K, Kamath-Rayne BD, Atkins DL, Becker L, Berg RA, Bradley SM, Bhanji F, Brooks S, Chan M, Chan P, Cheng A, de Caen A, Duff JP, Escobedo M, Flores GE, Fuchs S, Girotra S, Hsu A, Joyner BL, Kleinman M, Lasa JJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sasson C, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Edelson DP. Interim Guidance for Basic and Advanced Life Support in Children and Neonates With Suspected or Confirmed COVID-19. Pediatrics 2020:e20201405. [PMID: 32366608 DOI: 10.1542/peds.2020-1405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bhanji F, Miller G, Cheung WJ, Puligandla PS, Winthrop A, Baird R, Davies D, Lopushinsky SR, Webber EM. The future is here! Pediatric surgery and the move to the royal college of physicians and surgeons of Canada's competence by design. J Pediatr Surg 2020; 55:796-799. [PMID: 32085917 DOI: 10.1016/j.jpedsurg.2020.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 01/25/2020] [Indexed: 11/25/2022]
Abstract
This interactive session was held at the 51st Annual Meeting of the Canadian Association of Pediatric Surgeons (CAPS) in preparation for the transition of Pediatric Surgery training in Canada to Competency by Design (a CBME-based model of residency training developed by the Royal College of Physicians and Surgeons of Canada).
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Affiliation(s)
- Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Professor of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Grant Miller
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Warren J Cheung
- Department of Emergency Medicine, University of Ottawa
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Pramod S Puligandla
- The Harvey E. Beardmore Division of Pediatric Surgery, Department of Pediatric Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Andrea Winthrop
- Queen's University School of Medicine, Kingston, Ontario, Canada
| | - Robert Baird
- University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Dafydd Davies
- Faculty of Medicine, Dalhousie University, IWK Health Centre, Dartmouth, Nova Scotia, Canada
| | | | - Eric M Webber
- Queen's University School of Medicine, Kingston, Ontario, Canada
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Soar J, Maconochie I, Wyckoff MH, Olasveengen TM, Singletary EM, Greif R, Aickin R, Bhanji F, Donnino MW, Mancini ME, Wyllie JP, Zideman D, Andersen LW, Atkins DL, Aziz K, Bendall J, Berg KM, Berry DC, Bigham BL, Bingham R, Couto TB, Böttiger BW, Borra V, Bray JE, Breckwoldt J, Brooks SC, Buick J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Couper K, Dainty KN, Dawson JA, de Almeida MF, de Caen AR, Deakin CD, Drennan IR, Duff JP, Epstein JL, Escalante R, Gazmuri RJ, Gilfoyle E, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Holmberg MJ, Hood N, Hosono S, Hsieh MJ, Isayama T, Iwami T, Jensen JL, Kapadia V, Kim HS, Kleinman ME, Kudenchuk PJ, Lang E, Lavonas E, Liley H, Lim SH, Lockey A, Lofgren B, Ma MHM, Markenson D, Meaney PA, Meyran D, Mildenhall L, Monsieurs KG, Montgomery W, Morley PT, Morrison LJ, Nadkarni VM, Nation K, Neumar RW, Ng KC, Nicholson T, Nikolaou N, Nishiyama C, Nuthall G, Ohshimo S, Okamoto D, O’Neil B, Yong-Kwang Ong G, Paiva EF, Parr M, Pellegrino JL, Perkins GD, Perlman J, Rabi Y, Reis A, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Schexnayder SM, Scholefield BR, Shimizu N, Skrifvars MB, Smyth MA, Stanton D, Swain J, Szyld E, Tijssen J, Travers A, Trevisanuto D, Vaillancourt C, Van de Voorde P, Velaphi S, Wang TL, Weiner G, Welsford M, Woodin JA, Yeung J, Nolan JP, Fran Hazinski M. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2019; 140:e826-e880. [DOI: 10.1161/cir.0000000000000734] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
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Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
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Nolan JP, Berg RA, Andersen LW, Bhanji F, Chan PS, Donnino MW, Lim SH, Ma MHM, Nadkarni VM, Starks MA, Perkins GD, Morley PT, Soar J. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest: A Consensus Report From a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia). Circulation 2019; 140:e746-e757. [PMID: 31522544 DOI: 10.1161/cir.0000000000000710] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Utstein-style reporting templates provide a structured framework with which to compare systems of care for cardiac arrest. The 2004 Utstein reporting template encompassed both out-of-hospital and in-hospital cardiac arrest. A 2015 update of the Utstein template focused on out-of-hospital cardiac arrest, which makes this update of the in-hospital template timely. Representatives of the International Liaison Committee on Resuscitation developed an updated in-hospital Utstein reporting template iteratively by meeting face-to-face, by teleconference, and by online surveys between 2013 and 2018. Data elements were grouped by hospital factors, patient variables, pre-event factors, cardiac arrest and postresuscitation processes, and outcomes. Elements were classified as core or supplemental by use of a modified Delphi process. Variables were described as core if they were considered essential. Core variables should enable reasonable comparisons between systems and are considered essential for quality improvement programs. Together with core variables, supplementary variables are considered useful for research.
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Nolan JP, Berg RA, Andersen LW, Bhanji F, Chan PS, Donnino MW, Lim SH, Ma MHM, Nadkarni VM, Starks MA, Perkins GD, Morley PT, Soar J. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest: A Consensus Report From a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia). Resuscitation 2019; 144:166-177. [PMID: 31536777 DOI: 10.1016/j.resuscitation.2019.08.021] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Utstein-style reporting templates provide a structured framework with which to compare systems of care for cardiac arrest. The 2004 Utstein reporting template encompassed both out-of-hospital and in-hospital cardiac arrest. A 2015 update of the Utstein template focused on out-of-hospital cardiac arrest, which makes this update of the in-hospital template timely. Representatives of the International Liaison Committee on Resuscitation developed an updated in-hospital Utstein reporting template iteratively by meeting face-to-face, by teleconference, and by online surveys between 2013 and 2018. Data elements were grouped by hospital factors, patient variables, pre-event factors, cardiac arrest and postresuscitation processes, and outcomes. Elements were classified as core or supplemental by use of a modified Delphi process. Variables were described as core if they were considered essential. Core variables should enable reasonable comparisons between systems and are considered essential for quality improvement programs. Together with core variables, supplementary variables are considered useful for research.
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Kleinman ME, Perkins GD, Bhanji F, Billi JE, Bray JE, Callaway CW, de Caen A, Finn JC, Hazinski MF, Lim SH, Maconochie I, Nadkarni V, Neumar RW, Nikolaou N, Nolan JP, Reis A, Sierra AF, Singletary EM, Soar J, Stanton D, Travers A, Welsford M, Zideman D. ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement. Circulation 2018; 137:e802-e819. [PMID: 29700123 DOI: 10.1161/cir.0000000000000561] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process. Key publications since the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations are referenced, along with known ongoing clinical trials that are likely to affect future guidelines.
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Alawadhi A, Saint-Martin C, Bhanji F, Srour M, Atkinson J, Sébire G. Acute Hemorrhagic Encephalitis Responding to Combined Decompressive Craniectomy, Intravenous Immunoglobulin, and Corticosteroid Therapies: Association with Novel RANBP2 Variant. Front Neurol 2018; 9:130. [PMID: 29593631 PMCID: PMC5857578 DOI: 10.3389/fneur.2018.00130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/21/2018] [Indexed: 11/21/2022] Open
Abstract
Background Acute hemorrhagic encephalomyelitis (AHEM) is considered as a rare form of acute disseminated encephalomyelitis characterized by fulminant encephalopathy with hemorrhagic necrosis and most often fatal outcome. Objective To report the association with Ran Binding Protein (RANBP2) gene variant and the response to decompressive craniectomy and high-dose intravenous methylprednisolone (IVMP) in life-threatening AHEM. Design Single case study. Case report A 6-year-old girl known to have sickle cell disease (SCD) presented an acquired demyelinating syndrome (ADS) with diplopia due to sudden unilateral fourth nerve palsy. She received five pulses of IVMP (30 mg/kg/day). Two weeks after steroid weaning, she developed right hemiplegia and coma. Brain magnetic resonance imaging showed a left frontal necrotico-hemorrhagic lesion and new multifocal areas of demyelination. She underwent decompressive craniotomy and evacuation of an ongoing left frontoparietal hemorrhage. Comprehensive investigations ruled out vascular and infectious process. The neurological deterioration stopped concomitantly with combined neurosurgical drainage of the hematoma, decompressive craniotomy, IVMP, and intravenous immunoglobulins (IVIG). She developed during the following months Crohn disease and sclerosing cholangitis. After 2-year follow-up, there was no new neurological manifestation. The patient still suffered right hemiplegia and aphasia, but was able to walk. Cognitive/behavioral abilities significantly recovered. A heterozygous novel rare missense variant (c.4993A>G, p.Lys1665Glu) was identified in RANBP2, a gene associated with acute necrotizing encephalopathy. RANBP2 is a protein playing an important role in the energy homeostasis of neuronal cells. Conclusion In any ADS occurring in the context of SCD and/or autoimmune condition, we recommend to slowly wean steroids and to closely monitor the patient after weaning to quickly treat any recurrence of neurological symptom with IVMP. This case report, in addition to others, stresses the likely efficacy of combined craniotomy, IVIG, and IVMP treatments in AHEM. RANBP2 mutations may sensitize the brain to inflammation and predispose to AHEM.
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Affiliation(s)
- Abdulla Alawadhi
- Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada
| | - Christine Saint-Martin
- Department of Medical Imaging, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Farhan Bhanji
- Pediatric Intensive Care Unit, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Myriam Srour
- Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada
| | - Jeffrey Atkinson
- Division of Neurosurgery, Department of Surgery, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Guillaume Sébire
- Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada
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Francoeur C, Shea S, Ruddy M, Fontela P, Bhanji F, Razack S, Gottesman R, Di Genova T. It Takes a Village to Move a Hospital: Simulation Improves Intensive Care Team Preparedness for a Move to a New Site. Hosp Pediatr 2018; 8:148-156. [PMID: 29449317 DOI: 10.1542/hpeds.2017-0112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing. RESULTS Response rates were initially 100% and 67% at the 6-month follow-up. In the initial phase, all questions had statistically significant improvements in post- versus presimulation scores. Participants felt better prepared (presimulation: 6.20, postsimulation: 7.90, P < .001) and more confident about caring for real patients (presimulation: 5.49, postsimulation: 7.41, P < .001). They felt more comfortable working in the new unit (presimulation: 5.65, postsimulation: 7.50, P < .001) and better able to deliver safe care (presimulation: 5.85, postsimulation: 7.60, P < .001). Six months postmove, participants still believed that simulation was helpful (7.43, SD: 2.20) and still reported improved team confidence (7.36, SD: 2.11). Only 1 of 28 participants preferred less simulation. Exercises were described as helpful in identifying process and latent patient safety issues. CONCLUSIONS Our pediatric intensive care team found simulations to be beneficial in preparation for providing care to critically ill children in a complex new setting. Simulations uncovered latent process, personnel, and patient-safety issues that were addressed before actual patient care.
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Affiliation(s)
- Conall Francoeur
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Sarah Shea
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Margaret Ruddy
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Patricia Fontela
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Farhan Bhanji
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Saleem Razack
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Ronald Gottesman
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
| | - Tanya Di Genova
- Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada
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Mueller CL, Cyr G, Bank I, Bhanji F, Birnbaum L, Boillat M, Bolduc ME, Chankowsky J, Constantin E, Cummings BA, Fisher R, Legault P, Hugo Marchand N, Monton L, Rudkin T, Sabsabi B, Soilis N, Zigman D, Aggarwal R. The Steinberg Centre for Simulation and Interactive Learning at McGill University. J Surg Educ 2017; 74:1135-1141. [PMID: 28688969 DOI: 10.1016/j.jsurg.2017.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
Simulation allows for learner-centered health professions training by providing a safe environment to practice and make mistakes without jeopardizing patient care. It was with this goal in mind that the McGill Medical Simulation Center was officially opened on September 14, 2006, as a partnership between McGill University, the Faculty of Medicine and its affiliated hospitals. Its mandate is to provide state-of-the-art facilities to support simulation-based medical and allied health education initiatives. Since its inception, the center, recently renamed the Steinberg Center for Simulation and Interactive Learning (SCSIL), has undergone a major expansion and logged more than 130,000 learner visits. Educational activities are offered at all levels of medical and allied health care training, and include standardized patient encounters, partial task trainers, multidisciplinary courses, and high-fidelity trainers, among many others. In addition to its educational mandate, the center also supports an active research program, programs to enhance collaboration with disciplines outside of health care to spur innovation, and community outreach initiatives.
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Affiliation(s)
- Carmen L Mueller
- Department of Surgery, McGill University, Montreal, Quebec, Canada.
| | - Genevieve Cyr
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, Quebec, Canada
| | - Ilana Bank
- Department of Paediatric Medicine, McGill University, Montreal, Quebec, Canada
| | - Farhan Bhanji
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Laura Birnbaum
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Miriam Boillat
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Marie-Eve Bolduc
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | | | - Evelyn Constantin
- Department of Paediatric Medicine, McGill University, Montreal, Quebec, Canada
| | - Beth-Ann Cummings
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Rachel Fisher
- Department of Anaesthesia, McGill University, Montreal, Quebec, Canada
| | - Philippe Legault
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, Quebec, Canada
| | - N Hugo Marchand
- School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Luis Monton
- Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Teresa Rudkin
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Bayane Sabsabi
- Department of Paediatric Medicine, McGill University, Montreal, Quebec, Canada
| | - Niki Soilis
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, Quebec, Canada
| | - Daniel Zigman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Rajesh Aggarwal
- Department of Surgery, McGill University, Montreal, Quebec, Canada
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Bhanji F, Praestgaard AH, Topjian AA. Different Pediatric Survival After Cardiac Arrest-Reply. JAMA Pediatr 2017; 171:709. [PMID: 28492817 DOI: 10.1001/jamapediatrics.2017.0876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Farhan Bhanji
- Centre for Medical Education and Department of Pediatrics, McGill University, Montreal, Quebec, Canada2Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada
| | - Amy H Praestgaard
- University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alexis A Topjian
- University of Pennsylvania Perelman School of Medicine, Philadelphia4Departments of Anesthesia and Critical Care Medicine and of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Harris P, Bhanji F, Topps M, Ross S, Lieberman S, Frank JR, Snell L, Sherbino J. Evolving concepts of assessment in a competency-based world. Med Teach 2017; 39:603-608. [PMID: 28598736 DOI: 10.1080/0142159x.2017.1315071] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Competency-based medical education (CBME) is an approach to the design of educational systems or curricula that focuses on graduate abilities or competencies. It has been adopted in many jurisdictions, and in recent years an explosion of publications has examined its implementation and provided a critique of the approach. Assessment in a CBME context is often based on observations or judgments about an individual's level of expertise; it emphasizes frequent, direct observation of performance along with constructive and timely feedback to ensure that learners, including clinicians, have the expertise they need to perform entrusted tasks. This paper explores recent developments since the publication in 2010 of Holmboe and colleagues' description of CBME assessment. Seven themes regarding assessment that arose at the second invitational summit on CBME, held in 2013, are described: competency frameworks, the reconceptualization of validity, qualitative methods, milestones, feedback, assessment processes, and assessment across the medical education continuum. Medical educators interested in CBME, or assessment more generally, should consider the implications for their practice of the review of these emerging concepts.
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Affiliation(s)
- Peter Harris
- a Office of Medical Education , University of New South Wales , Sydney , Australia
| | - Farhan Bhanji
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- c Centre for Medical and Department of General Internal Medicine , McGill University , Montreal , Quebec, Canada
| | - Maureen Topps
- d Cumming School of Medicine , University of Calgary , Calgary , Canada
| | - Shelley Ross
- e Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - Steven Lieberman
- f Office of the Dean of medicine, University of Texas Medical Branch , Galveston , TX , USA
| | - Jason R Frank
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- g Department of Emergency Medicine , University of Ottawa , Ottawa , Canada
| | - Linda Snell
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- c Centre for Medical and Department of General Internal Medicine , McGill University , Montreal , Quebec, Canada
| | - Jonathan Sherbino
- h Division of Emergency Medicine, Department of Medicine , McMaster University , Hamilton , Canada
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Gruppen L, Frank JR, Lockyer J, Ross S, Bould MD, Harris P, Bhanji F, Hodges BD, Snell L, Ten Cate O. Toward a research agenda for competency-based medical education. Med Teach 2017; 39:623-630. [PMID: 28598741 DOI: 10.1080/0142159x.2017.1315065] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of emerging research questions will warrant scholarly examination. In this paper, we describe a proposed CBME research agenda developed by the International CBME Collaborators. The resulting framework includes questions about the meaning of key concepts of CBME and their implications for learners, faculty members, and institutional structures. Other research questions relate to the learning process, the meaning of entrustment decisions, fundamental measurement issues, and the nature and definition of standards. The exploration of these questions will help to solidify the theoretical foundation of CBME, but many issues related to implementation also need to be addressed. These pertain to, among other things, nurturing independent learning, assembling and using assessment results to make decisions about competence, structuring feedback, supporting remediation, and how best to evaluate the longer-term outcomes of CBME. High-quality research on these questions will require rigorous outcome measures with strong validity evidence. The complexity of CBME necessitates theoretical and methodological diversity. It also requires multi-institutional studies that examine effects at multiple levels, from the learner to the team, the institution, and the health care system. Such a framework of research questions can guide and facilitate scholarly discourse on the theoretical and practical body of knowledge related to competency-based health professions education.
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Affiliation(s)
- Larry Gruppen
- a Department of Learning Health Sciences , University of Michigan Medical School , Ann Arbor , MI , USA
| | - Jason R Frank
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- c Department of Emergency Medicine , University of Ottawa , Ottawa , Canada
| | - Jocelyn Lockyer
- d Cumming School of Medicine , University of Calgary , Calgary , Canada
| | - Shelley Ross
- e Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - M Dylan Bould
- f Departments of Innovation in Medical Education , University of Ottawa and of Anesthesiology, University of Ottawa and Children's Hospital of Eastern Ontario , Ontario , Canada
| | - Peter Harris
- g Office of Medical Education, University of New South Wales , Sydney , Australia
| | - Farhan Bhanji
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- h Centre for Medical and Department of General Internal Medicine , McGill University , Montreal , Quebec , Canada
| | - Brian D Hodges
- i Department of Psychiatry , University of Toronto, Wilson Centre for Research in Education , Toronto , Canada
- j Centre for Research and Development of Education , University Health Network , Toronto , Canada
| | - Linda Snell
- b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- h Centre for Medical and Department of General Internal Medicine , McGill University , Montreal , Quebec , Canada
| | - Olle Ten Cate
- k Centre for Research and Development of Education, University Medical Center Utrecht , Utrecht , The Netherlands
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Abstract
BACKGROUND Role modelling is a fundamental method by which students learn from residents. To our knowledge, however, resident-as-teacher curricula have not explicitly addressed resident role modelling. The purpose of this project was to design, implement and evaluate an innovative programme to teach residents about role modelling. METHODS The authors designed a resident role-modelling programme and incorporated it into the 2015 and 2016 McGill University resident-as-teacher curriculum. Influenced by experiential and social learning theories, the programme incorporated flipped-classroom and simulation approaches to teach residents to be aware and deliberate role models. Outcomes were assessed through a pre- and immediate post-programme questionnaire evaluating reaction and learning, a delayed post-programme questionnaire evaluating learning, and a retrospective pre-post questionnaire (1 month following the programme) evaluating self-reported behaviour changes. RESULTS Thirty-three of 38 (87%) residents who participated in the programme completed the evaluation, with 25 residents (66%) completing all questionnaires. Participants rated the programme highly on a five-point Likert scale (where 1 = not helpful and 5 = very helpful; mean score, M = 4.57; standard deviation, SD = 0.50), and showed significant improvement in their perceptions of their importance as role models and their knowledge of deliberate role modelling. Residents also reported an increased use of deliberate role-modelling strategies 1 month after completing the programme. Resident-as-teacher curricula have not explicitly addressed resident role modelling DISCUSSION: The incorporation of resident role modelling into our resident-as-teacher curriculum positively influenced the participants' perceptions of their role-modelling abilities. This programme responds to a gap in resident training and has the potential to guide further programme development in this important and often overlooked area.
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Affiliation(s)
- Robert Sternszus
- Centre for Medical Education, McGill University, Montreal, Quebec, Canada
| | - Yvonne Steinert
- Centre for Medical Education, McGill University, Montreal, Quebec, Canada
| | - Farhan Bhanji
- Pediatrics Department, McGill University, Montreal, Quebec, Canada
| | - Sero Andonian
- Urology Department, McGill University, Montreal, Quebec, Canada
| | - Linda S Snell
- Centre for Medical Education, McGill University, Montreal, Quebec, Canada
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Saiki T, Snell L, Bhanji F. Twelve tips for promoting learning during presentations in cross cultural settings. Med Teach 2017; 39:458-462. [PMID: 28440721 DOI: 10.1080/0142159x.2017.1288860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Educators frequently learn together in cross cultural settings such as at international conferences. Cultural differences should influence how educational programs are designed and delivered to effectively support learning; cultural sensitivity and the competence to deal with such differences are important skills for health professions educators. Teaching without this approach may lead to lost learning opportunities. This article provides twelve tips for educators to consider when planning and delivering formal presentations (e.g. lectures and workshops) in cross cultural settings. The tips were constructed based on a literature review, the authors' experience, and interviews with international educators who frequently deliver and receive education in cross cultural settings. The tips are divided into three phases: (1) preparation for the session to optimize learners' experience (2) interaction when delivering the session and (3) reflection on the experience.
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Affiliation(s)
- Takuya Saiki
- a Medical Education Development Centre , Gifu University , Gifu , Japan
- b Centre for Medical Education , McGill University , Montreal , Québec , Canada
| | - Linda Snell
- a Medical Education Development Centre , Gifu University , Gifu , Japan
- b Centre for Medical Education , McGill University , Montreal , Québec , Canada
| | - Farhan Bhanji
- a Medical Education Development Centre , Gifu University , Gifu , Japan
- b Centre for Medical Education , McGill University , Montreal , Québec , Canada
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