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Horiuchi S, Soller T, Bykersma C, Huang S, Smith R, Vogel JP. Use of digital technologies for staff education and training programmes on newborn resuscitation and complication management: a scoping review. BMJ Paediatr Open 2024; 8:e002105. [PMID: 38754893 PMCID: PMC11097833 DOI: 10.1136/bmjpo-2023-002105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Poor-quality care is linked to higher rates of neonatal mortality in low-income and middle-income countries (LMICs). Limited educational and upskilling opportunities for healthcare professionals, particularly those who work in remote areas, are key barriers to providing quality neonatal care. Novel digital technologies, including mobile applications and virtual reality, can help bridge this gap. This scoping review aims to identify, analyse and compare available digital technologies for staff education and training to improve newborn care. METHODS We conducted a structured search of seven databases (MEDLINE (Ovid), EMBASE (Ovid), EMCARE (Ovid), Global Health (CABI), CINAHL (EBSCO), Global Index Medicus (WHO) and Cochrane Central Register of Controlled Trials on 1 June 2023. Eligible studies were those that aimed to improve healthcare providers' competency in newborn resuscitation and management of sepsis or respiratory distress during the early postnatal period. Studies published in English from 1 January 2000 onwards were included. Data were extracted using a predefined data extraction format. RESULTS The review identified 93 eligible studies, of which 35 were conducted in LMICs. E-learning platforms and mobile applications were common technologies used in LMICs for neonatal resuscitation training. Digital technologies were generally well accepted by trainees. Few studies reported on the long-term effects of these tools on healthcare providers' education or on neonatal health outcomes. Limited studies reported on costs and other necessary resources to maintain the educational intervention. CONCLUSIONS Lower-cost digital methods such as mobile applications, simulation games and/or mobile mentoring that engage healthcare providers in continuous skills practice are feasible methods for improving neonatal resuscitation skills in LMICs. To further consider the use of these digital technologies in resource-limited settings, assessments of the resources to sustain the intervention and the effectiveness of the digital technologies on long-term health provider performance and neonatal health outcomes are required.
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Affiliation(s)
- Sayaka Horiuchi
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Environmental Medicine, University of Yamanashi Graduate School of Medicine, Chuo, Yamanashi, Japan
| | - Tasmyn Soller
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Chloe Bykersma
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Shan Huang
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Rachel Smith
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
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Yang SY, Oh YH. Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study. Healthcare (Basel) 2024; 12:104. [PMID: 38201010 PMCID: PMC10779408 DOI: 10.3390/healthcare12010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 01/12/2024] Open
Abstract
The Rapid Cycle Deliberate Practice (RCDP) simulation during neonatal resuscitation program (NRP) training provides in-event feedback for each simulation step, repeats the simulation from the beginning, and undergoes a continuous improvement process. It also offers after-event debriefing that involves follow-up discussion and reflection after completing simulations. These two methods differ in the timing and frequency of feedback application, and there may be differences in the effectiveness of neonatal resuscitation training. A quasi-experimental simulation study with a pre- and post-test design was used; the experimental group received RCDP simulation NRP training, based on the self-determination theory, while the control group received an after-event debriefing, following the NRP scenario. The experimental group displayed significantly improved clinical decision-making skills compared with the control group. When responding to emergencies involving high-risk newborns, we found that RCDP simulation during NRP training and better preparation for neonatal resuscitation among nursing students improved outcomes for newborns.
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Affiliation(s)
- Sun-Yi Yang
- College of Nursing, Konyang University, Daejeon Medical Campus, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Republic of Korea
| | - Yun-Hee Oh
- Department of Nursing, Cheju Halla University, 38, Halladaehak-ro, Jeju-si 63092, Republic of Korea;
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Corvetto MA, Altermatt FR, Belmar F, Escudero E. Health Care Simulation as a Training Tool for Epidemic Management: A Systematic Review. Simul Healthc 2023; 18:382-391. [PMID: 36881436 DOI: 10.1097/sih.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
SUMMARY STATEMENT The objective of this research was to identify and review studies that have evaluated the impact of simulation-based training on health care professionals during epidemics.All studies in health care simulation-based training published during the last 5 epidemics with a global impact (SARS-CoV, H1N1, MERS, Ebola, SARS-CoV-2; through July 2021) were selected from a systematic search of PUBMED, EMBASE, and key journals.The search strategy identified 274 studies; 148 met the inclusion criteria and were included. Most of the studies were developed in response to SARS-CoV-2 infection (n = 117, 79.1%), used a descriptive approach (n = 54, 36.5%), and were used to train technical skills (n = 82, 55.4%).This review demonstrates a growing interest in publications related to health care simulation and epidemics. Most of the literature is marked by limited study designs and outcome measurements, although there is a trend toward the use of more refined methodologies in the most recent publications. Further research should seek the best evidence-based instructional strategies to design training programs in preparation for future outbreaks.
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Affiliation(s)
- Marcia A Corvetto
- From the Department of Anesthesiology (M.A.C., F.R.A.), Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Experimental Surgery and Simulation Center (M.A.C., F.B.), Department of Digestive Surgery, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; and Comité Académico de Fundación Garrahan (E.E.), Buenos Aires, Argentina
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Kishimoto N, Sanuki T, Liu Y, Tran SD, Seo K. Simulation training for medical emergencies of dental patients: A review of the dental literature. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:104-113. [PMID: 36937224 PMCID: PMC10017307 DOI: 10.1016/j.jdsr.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
In recent years, due to the aging of the population, the number of dental patients with comorbidities such as hypertension and diabetes has increased. Although it has been reported that these patients are increasingly developing medical emergencies during their dental treatments, many dental providers still do not possess the skills to manage medical emergencies appropriately. Simulation training is essential to improve this situation however, there is no report describing how to conduct an effective simulation in detail for dental office medical emergencies. The purpose of this review is to provide information on simulations that is effective and practical. The authors will highlight the key characteristics for providing effective simulation trainings, such as the selection of simulators, simulation locations, instructors, debriefings, methods for evaluating educational effectiveness, and the use of telesimulation as a method for simulation training due to the global COVID-19 pandemic. In addition, this review provides recommendations on tailoring an ideal simulation training course for those who wish to create one. The authors hope that this review will promote the spread of effective simulation training and in turn, contribute to improving the medical safety of dental patients.
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Affiliation(s)
- Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Corresponding author at: Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Younan Liu
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Kenji Seo
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Fang JL, Umoren RA. Telesimulation for neonatal resuscitation training. Semin Perinatol 2023; 47:151827. [PMID: 37743211 DOI: 10.1016/j.semperi.2023.151827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Telesimulation uses telecommunication and simulation to educate and assess remote learners, obviating the need for instructors or learners to travel off site. Telesimulation increases access to and convenience of simulation-based education for sites that do not have formal simulation centers, including rural/remote areas. Telesimulation is feasible, improves knowledge and skills, and is favorably received by learners and instructors. In general, telesimulation has been shown to be effective for neonatal resuscitation training, even in low- and middle-income countries. Post telesimulation debriefing, termed teledebriefing, requires many of the skills of in-person debriefing, and teledebriefing can optimize learning by exposing learners to content experts in geographically distant sites or from specialties not available locally. When implementing telesimulation for neonatal resuscitation training, key considerations include program design, telecommunication platform, pre-telesimulation preparation, and teledebriefing. Additional research is needed to identify whether lessons learned during telesimulation translate to clinical practice and impact patient outcomes.
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Affiliation(s)
- Jennifer L Fang
- Division of Neonatal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Rachel A Umoren
- Division of Neonatology, University of Washington, Seattle, WA, USA
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Chang CL, Dyess NF, Johnston LC. Simulation in a blended learning curriculum for neonatology. Semin Perinatol 2023; 47:151824. [PMID: 37748941 DOI: 10.1016/j.semperi.2023.151824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Blended learning is a learner-centered educational method that combines online and traditional face-to-face educational strategies. Simulation is a commonly utilized platform for experiential learning and an ideal component of a blended learning curriculum. This section describes blended learning, including its strengths and limitations, educational frameworks, uses within health professions education, best practices, and challenges. Also included is a brief introduction to simulation-based education, along with theoretical and real-world examples of how simulation may be integrated into a blended learning curriculum. Examples of blended learning in Neonatal-Perinatal Medicine, specifically within the Neonatal Resuscitation Program, procedural skills training, and the National Neonatology Curriculum, are reviewed.
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Affiliation(s)
- Catherine L Chang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States
| | - Nicolle Fernández Dyess
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States.
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Niehaus JZ, Slaven JE, Fettig L. Virtual Adaptation of Empathetic Communication Training for Pediatric Interns. Am J Hosp Palliat Care 2023; 40:1074-1078. [PMID: 36863861 DOI: 10.1177/10499091221145921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE Evaluate feasibility and effectiveness of virtual adaptation of in-person simulation-based empathetic communication training. METHODS Pediatric interns participated in virtual training session then completed post-session and 3 months follow up surveys. RESULTS Self-reported preparedness on the skills all improved significantly. The interns report the educational value as extremely high both immediately after and 3 months after training. 73% of the interns report using the skills at least weekly. CONCLUSION A 1 day virtual simulation-based communication training is feasible, well received, and similarly effective as in-person training.
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Affiliation(s)
- Jason Z Niehaus
- Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Slaven
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyle Fettig
- Division of Hospice and Palliative Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Mileder LP, Bereiter M, Schwaberger B, Wegscheider T. Telesimulation for the Training of Medical Students in Neonatal Resuscitation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1502. [PMID: 37761463 PMCID: PMC10527675 DOI: 10.3390/children10091502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
Background: Telesimulation may be an alternative to face-to-face simulation-based training. Therefore, we investigated the effect of a single telesimulation training in inexperienced providers. Methods: First-year medical students were recruited for this prospective observational study. Participants received a low-fidelity mannequin and medical equipment for training purposes. The one-hour telesimulation session was delivered by an experienced trainer and broadcast via a video conference tool, covering all elements of the neonatal resuscitation algorithm. After the telesimulation training, each student underwent a standardized simulated scenario at our Clinical Skills Center. Performance was video-recorded and evaluated by a single neonatologist, using a composite score (maximum: 10 points). Pre- and post-training knowledge was assessed using a 20-question questionnaire. Results: Seven telesimulation sessions were held, with a total of 25 students participating. The median performance score was 6 (5-8). The median time until the first effective ventilation breath was 30.0 s (24.5-41.0) and the median number of effective ventilation breaths out of the first five ventilation attempts was 5 (4-5). Neonatal resuscitation knowledge scores increased significantly. Conclusions: Following a one-hour telesimulation session, students were able to perform most of the initial steps of the neonatal resuscitation algorithm effectively while demonstrating notable mask ventilation skills.
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Affiliation(s)
- Lukas P. Mileder
- Clinical Skills Center, Medical University of Graz, 8010 Graz, Austria
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria
| | - Michael Bereiter
- Clinical Skills Center, Medical University of Graz, 8010 Graz, Austria
| | - Bernhard Schwaberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria
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Park JO, Lee-Jayaram J, Sato E, Eto Y, Kahili-Heede M, Hirayama K, Berg BW. A scoping review of remote facilitation during simulation-based healthcare education. BMC MEDICAL EDUCATION 2023; 23:592. [PMID: 37605196 PMCID: PMC10464104 DOI: 10.1186/s12909-023-04551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Remote facilitation is a synchronous distance education method where instructors facilitate a lesson, in real-time, in physically separate conditions. In this scoping review, we aimed to describe types of remote facilitation used in a healthcare simulation, the influences on learner outcomes, and related factors. METHODS We accessed PubMed, EMBASE, CINAHL, ERIC, and Web of Science using our search strategies. Five reviewers performed the review using the Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews (PRISMA-ScR) framework, and the Johanna Briggs Institute (JBI) guidelines. RESULTS We included a total of 29 articles presenting 28 simulation studies. The most common tool was videoconferencing (n = 26, 89.7%). Knowledge improvement was the most frequently measured outcome. There was no significant difference in learning outcomes between the two teaching modes. There were differences in learners' preferences and satisfaction with remote facilitators before and after COVID-19. CONCLUSIONS Our scoping review indicates that remote facilitation has been widely accepted in many healthcare professions using various types of simulation modalities. Remote facilitation can be used to overcome logistical problems of synchronous multi-location education, and to improve learner knowledge, skills, and confidence measured by instructor evaluation or self-assessment.
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Affiliation(s)
- Ju Ok Park
- Department of Emergency Medicine, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea.
| | - Jannet Lee-Jayaram
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Eri Sato
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Yuka Eto
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Melissa Kahili-Heede
- Health Science Library, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu Hawaii, USA
| | - Krystal Hirayama
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Benjamin W Berg
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
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Yasser NBM, Tan AJQ, Harder N, Ashokka B, Chua WL, Liaw SY. Telesimulation in healthcare education: A scoping review. NURSE EDUCATION TODAY 2023; 126:105805. [PMID: 37062239 DOI: 10.1016/j.nedt.2023.105805] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To provide a comprehensive overview on the utilization and effectiveness of telesimulation in healthcare education. DESIGN A scoping review. DATA SOURCES A search of five databases including PubMed, Web of Science, Cochrane, EMBASE and ProQuest was conducted between 2000 and 2022. REVIEW METHODS Arksey and O' Malley's scoping review framework was utilised. Data were narratively synthesised. RESULTS 29 articles were included. More than half of the publications on telesimulation were borne out of need during the COVID-19 pandemic. Innovation reports were the most prevalent publications followed by descriptive studies. Telesimulation was applied for the delivery of diverse learning content including patient care management, procedural skills and team training. A variety of videoconferencing software and simulation modalities have been used for telesimulation. Telesimulation was generally well-received, despite its technical challenges. Learning effectiveness of telesimulation was evident in quasi-experimental studies. CONCLUSION Telesimulation has been gaining acceptance as a distance-based simulation education modality. It will continue to evolve and potentially blend with in-person simulation. More rigorous research is warranted to evaluate learning outcomes and establish best practices in telesimulation.
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Affiliation(s)
| | - Apphia J Q Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Nicole Harder
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Balakrishnan Ashokka
- Department of Anaesthesia, National University Hospital, Singapore; Centre for Medical Education, CenMED, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Camilo BHN, Freitas LBD, Okido ACC. Contributions of telesimulation to the knowledge of mothers about foreign body airway obstruction. Rev Gaucha Enferm 2023; 44:e20220241. [PMID: 37377273 DOI: 10.1590/1983-1447.2023.20220241.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/21/2022] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To analyze the contributions of telesimulation to the knowledge of mothers faced with foreign body airway obstruction in children under 1 year of age and identify the related factors. METHODS A quasi-experimental study of the pre- and post-test design carried out between April and September 2021 with 49 mothers from a city in São Paulo. It was organized into four stages: pre-test, telesimulation, immediate and late post-test (60 days later). All steps were carried out remotely via the free online platform Google Hangouts® and Google Forms®. Data analyzed by descriptive and analytical statistics. RESULTS There was a significant difference in the knowledge score between the assessments (p<0.001). Statistically significant relationships were identified between pre-test knowledge and choking experience (p=0.012), promotion of immediate knowledge and another child's choking (p=0.040) and schooling (p=0.006) and promotion of late knowledge with occupation (p=0.012) and choking of another child (p=0.011). CONCLUSIONS There was a significant improvement in knowledge after telesimulation, especially among those who had never experienced a choking situation and had a higher level of education.
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Affiliation(s)
- Beatriz Helena Naddaf Camilo
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Enfermagem. SãoCarlos, São Paulo, Brasil
| | - Larissa Bono de Freitas
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Enfermagem. SãoCarlos, São Paulo, Brasil
| | - Aline Cristiane Cavicchioli Okido
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Enfermagem. SãoCarlos, São Paulo, Brasil
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Ahn E, Kamath-Rayne BD, Perlman J, Berkelhamer S. Capacity Building in Remote Facilitation of Newborn Resuscitation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1038. [PMID: 37371269 DOI: 10.3390/children10061038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
The past decade has been notable for widespread dissemination of newborn resuscitation training in low-resource settings through simplified training programs including Helping Babies Breathe. Since 2020, implementation efforts have been impacted by restrictions on travel and in-person gatherings with the SARS-CoV-2 pandemic, prompting the development of alternative methods of training. While previous studies have demonstrated feasibility of remote neonatal resuscitation training, this perspective paper covers common barriers identified and key lessons learned developing a cadre of remote facilitators. Challenges of remote facilitation include mastering videoconferencing platforms, establishing personal connections, and providing effective oversight of skills practice. Training sessions can be used to support facilitators in acquiring comfort and competency in harnessing videoconferencing platforms for effective facilitation. Optimization of approaches and investment in capacity building of remote facilitators are imperative for effective implementation of remote neonatal resuscitation training.
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Affiliation(s)
- Emily Ahn
- Division of Neonatology, New York-Presbyterian Weill Cornell Medicine, New York, NY 10065, USA
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL 60143, USA
| | - Jeffrey Perlman
- Division of Neonatology, New York-Presbyterian Weill Cornell Medicine, New York, NY 10065, USA
| | - Sara Berkelhamer
- Division of Neonatology, Seattle Children's Hospital, University of Washington, Seattle, WA 98105, USA
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Eckart F, Kaufmann M, Rüdiger M, Birdir C, Mense L. [Telemedical support of feto-neonatal care in one region - Part II: Structural requirements and areas of application in neonatology]. Z Geburtshilfe Neonatol 2023; 227:87-95. [PMID: 36702135 DOI: 10.1055/a-1977-9102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Telemedical infrastructure for patient assessment, care and follow-up as well as interdisciplinary exchange can contribute to ensuring patient care that is close to home and meets the highest quality standards, even outside specialised centres. In neonatology, synchronous audio-visual communication across institutions has been used for many years, especially in the Anglo-American countries. Areas of application include extended neonatal primary care and resuscitation, specific diagnostic applications, e.g. ROP screening and echocardiography, as well as parental care, regular telemedical ward rounds and further training of medical staff, especially using simulation training. For the implementation of such telemedical infrastructures, certain organisational, medical-legal and technical requirements for hardware, software and structural and process organisation must be met. The concrete realisation of a telemedical infrastructure currently being implemented for the region of Eastern Saxony is demonstrated here using the example of the Saxony Center for feto/neonatal Health (SCFNH). Within the framework of feto-neonatal competence networks such as the SCFNH, the quality of medical care, patient safety and satisfaction in a region can be increased by means of a comprehensive, well-structured and established telemedical infrastructure.
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Affiliation(s)
- Falk Eckart
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Fachbereich Neonatologie & Pädiatrische Intensivmedizin, Medizinische Fakultät, TU Dresden, Dresden, Germany.,Zentrum für Feto/Neonatale Gesundheit, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Maxi Kaufmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Fachbereich Neonatologie & Pädiatrische Intensivmedizin, Medizinische Fakultät, TU Dresden, Dresden, Germany.,Zentrum für Feto/Neonatale Gesundheit, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Mario Rüdiger
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Fachbereich Neonatologie & Pädiatrische Intensivmedizin, Medizinische Fakultät, TU Dresden, Dresden, Germany.,Zentrum für Feto/Neonatale Gesundheit, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Cahit Birdir
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Medizinische Fakultät, TU Dresden, Dresden, Germany.,Zentrum für Feto/Neonatale Gesundheit, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Lars Mense
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Fachbereich Neonatologie & Pädiatrische Intensivmedizin, Medizinische Fakultät, TU Dresden, Dresden, Germany.,Zentrum für Feto/Neonatale Gesundheit, Medizinische Fakultät, TU Dresden, Dresden, Germany
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Gerstenberger JP, Hayes L, Chow CJ, Raaum S. Medical Student Experiential Learning in Telesimulation. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231216067. [PMID: 38025030 PMCID: PMC10664437 DOI: 10.1177/23821205231216067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Telesimulation utilizes telecommunication technology to engage learners in simulation while in different physical locations. Despite this potential advantage, understanding of the student experience and assessment of student learning in telesimulation activities is limited. This study evaluates medical student emotional experience and self-identified learning in telesimulation through the Kolb experiential learning framework and qualitative analysis. METHODS Fourth-year medical students enrolled in the Spencer Fox Eccles School of Medicine at the University of Utah participated in 3 telesimulation activities as part of a required internal medicine course. Students were surveyed regarding their satisfaction with the activity (N = 114) and responded to questions about their emotional experience and self-identified areas of learning. Free-text responses were analyzed using qualitative content analysis to identify themes until thematic saturation (N = 66). RESULTS Students were highly satisfied with telesimulation, with greater than 90% of students expressing a positive view of simulation realism, debrief quality, and group size. Themes of anxiety and uncertainty, confidence versus incompetence, team dynamics, fun, and difficult patient interaction were identified regarding the emotional experience. Themes of communication and teamwork, managing emotions, information gathering, differential diagnosis, resource reference, executing treatment, and medical knowledge were identified regarding student-identified learning. CONCLUSION In this analysis of medical student experiences with telesimulation, we found students have rich emotional, cognitive, and behavioral experiences and self-identify learning across a variety of domains. Our findings support further study of telesimulation for medical student learning and demonstrate how assessment of outcomes via Kolb framework, using the learner's reflective observation and self-identified learning, may help better define learning outcomes from simulation.
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Affiliation(s)
- John P. Gerstenberger
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lara Hayes
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Candace J. Chow
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sonja Raaum
- Internal Medicine, The University of Utah School of Medicine, Salt Lake City, UT, USA
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Nagdee N, Sebothoma B, Madahana M, Khoza-Shangase K, Moroe N. Simulations as a mode of clinical training in healthcare professions: A scoping review to guide planning in speech-language pathology and audiology during the COVID-19 pandemic and beyond. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e13. [PMID: 36073069 PMCID: PMC9452917 DOI: 10.4102/sajcd.v69i2.905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/25/2022] Open
Abstract
Background Simulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes. Objectives The scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLP&A) professions during the COVID-19 pandemic and beyond. Method A scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes. Results A total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes. Conclusions Current findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLP&A Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLP&A, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.
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Affiliation(s)
- Nabeelah Nagdee
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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16
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Löllgen RM, Berger-Estilita J, Rössler LA, Mileder LP. Avatar and distance simulation as a learning tool - virtual simulation technology as a facilitator or barrier? A questionnaire-based study on behalf of Netzwerk Kindersimulation e.V. Front Pediatr 2022; 10:853243. [PMID: 36389370 PMCID: PMC9644191 DOI: 10.3389/fped.2022.853243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Virtual simulation modalities have been implemented widely since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic restrictions in March 2020, as educators face persistent restrictions to face-to-face education of medical students and healthcare professionals.There is paucity of published data regarding the benefits and barriers of distance and avatar simulation training modalities. METHODS Following a 2-day virtual pediatric simulation competition facilitated by Netzwerk Kindersimulation e.V., using remote human avatars and distance simulation, we conducted a multicenter survey to explore the advantages and challenges of avatar and distance simulation among participants. We used a modified Delphi approach to draft and develop the 32-item online questionnaire with 7-point Likert-like scales (7 being the highest rating). RESULTS Twenty participants answered our questionnaire. Respondents indicated both a high overall satisfaction (median of 5.0 [Q25-Q75: 4.0-6.0] ) for avatar and distance simulation 6.0 (5.0-6.0), respectively, as well as a high achieved psychological safety with both simulation types (5.0 [4.0-6.0] vs. 5.0 [4.0-6.0]). The most frequently reported profits of avatar and distance simulation included the elimination of travel distances, associated lower costs, less time spent attending the education activity, and effective communication and leadership training, especially with avatar simulation. Most often named challenges were technical problems, limited reception of non-verbal cues and a spatial distance from the team/educator. DISCUSSION Based on the results of this pilot study, avatar and distance simulation can be employed successfully and appear to be good supplements to face-to-face simulation. Other studies are warranted to further explore the effectiveness of various types of virtual simulation compared to conventional presential simulation. We suggest using avatar-based simulation for targeted communication and leadership skills training and the application of distance simulation to bring simulation experts virtually to remote places where educator resources are lacking.
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Affiliation(s)
- Ruth M Löllgen
- Pediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.,Netzwerk Kindersimulation e.V., Tübingen, Germany
| | - Joana Berger-Estilita
- Netzwerk Kindersimulation e.V., Tübingen, Germany.,Institute for Medical Education, University of Bern, Bern, Switzerland.,Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine of Porto, Porto, Portugal
| | - Lisa A Rössler
- Netzwerk Kindersimulation e.V., Tübingen, Germany.,Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lukas P Mileder
- Netzwerk Kindersimulation e.V., Tübingen, Germany.,Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Costa RRDO, Araújo MSD, Medeiros SMD, Mata ANDS, Almeida RGDS, Mazzo A. Análise conceitual e aplicabilidade de telessimulação no ensino em saúde: Revisão de escopo. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0457pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo analisar o conceito de telessimulação e sua aplicabilidade no contexto do ensino em saúde. Método trata-se de uma análise conceitual, realizada através de uma scoping review realizada em maio de 2021, nas seguintes bases de dados: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online e Google Scholar, mediante o uso do descritor “telessimulação” e suas respectivas traduções para inglês e espanhol. Para análise dos estudos, avaliaram-se os atributos, antecedentes e consequentes do conceito. Resultados a telessimulação é definida como uma ramificação da simulação clínica que se caracteriza pela promoção/viabilização de práticas educativas no ensino em saúde, realizadas remotamente, síncrona, através de videochamada. Tem como objetivo facilitar o contato entre instrutores e participantes em situações de necessidade de distanciamento social, acesso dificultado por razões econômicas, como a escassez de recursos humanos e materiais, e/ou geograficamente distantes, com a intenção de desenvolver e aperfeiçoar competências e habilidades pertinentes as profissões da saúde. Conclusão e implicações para a prática a telessimulação representa uma nova oportunidade na formação em saúde, ao ampliar as possibilidades de ensino e romper barreiras que vão desde as geográficas até as econômicas.
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18
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Mayer MM, Xhinti N, Mashao L, Mlisana Z, Bobotyana L, Lowman C, Patterson J, Perlman JM, Velaphi S. Effect of Training Healthcare Providers in Helping Babies Breathe Program on Neonatal Mortality Rates. Front Pediatr 2022; 10:872694. [PMID: 35664883 PMCID: PMC9158330 DOI: 10.3389/fped.2022.872694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Training in the Helping Babies Breathe (HBB) Program has been associated with a reduction in early neonatal mortality rate (ENMR), the neonatal mortality rate (NMR), and fresh stillbirth rate (FSBR) in low- and middle-income countries (LMICs). This program was implemented in five different healthcare facilities in the Oliver Reginald Tambo (ORT) District, South Africa from September 2015 to December 2020. OBJECTIVE To determine and compare the FSBR, ENMR, and NMR between 2015 before initiation of the program (baseline) and subsequent years up to 2020 following the implementation of facility-based training of HBB in five hospitals in ORT District. METHODS Records of perinatal statistics from January 2015 to December 2020 were reviewed to calculate FSBR, ENMR, and NMR. Data were collected from the five healthcare facilities which included two district hospitals (Hospital A&B), two regional hospitals (Hospital C&D), and one tertiary hospital (Hospital E). Comparisons were made between pre- (2015) and post- (2016-2020) HBB implementation periods. Differences in changes over time were also assessed using linear regression analysis. RESULTS There were 19,275 births in 2015, increasing to 22,192 in 2020 with the majority (55.3%) of births occurring in regional hospitals. There were significant reductions in ENMR (OR-0.78, 95% CI 0.70-0.87) and NMR (OR-0.81, 95% CI 0.73-0.90), but not in FSBR, in the five hospitals combined when comparing the two time periods. Significant reduction was also noted in trends over time in ENMR (r 2 = 0.45, p = 0.001) and NMR (r 2 = 0.23, p = 0.026), but not in FSBR (r 2 = 0.0, p = 0.984) with all hospitals combined. In looking at individual hospitals, Hospital A (r 2 = 0.61, p < 0.001) and Hospital E (r 2 = 0.19, p = 0.048) showed a significant reduction in ENMR over time, but there were no significant changes in all mortality rates for Hospitals B, C, and D, and for the district or regional hospitals combined. CONCLUSION There was an overall reduction of 22% and 19% in ENMR and NMR, respectively, from pre- to post-HBB implementation periods, although there were variations from year to year over the 5-year period and, across hospitals. These differences suggest that there were other factors that affected the perinatal/neonatal outcomes in the hospital sites in addition to the implementation of training in HBB.
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Affiliation(s)
- Maria M Mayer
- Department of Paediatrics, Nelson Mandela Academic Hospital, Walter Sisulu University, Mthatha, South Africa
| | - Nomvuyo Xhinti
- Division of Education and Training, Helping Babies Breathe Programme, Resuscitation Council of Southern Africa, Johannesburg, South Africa
| | - Lolly Mashao
- Division of Education and Training, Helping Babies Breathe Programme, Resuscitation Council of Southern Africa, Johannesburg, South Africa
| | - Zolile Mlisana
- Department of Paediatrics, Mthatha Regional Hospital, Walter Sisulu University, Mthatha, South Africa
| | - Luzuko Bobotyana
- Department of Paediatrics, Nelson Mandela Academic Hospital, Walter Sisulu University, Mthatha, South Africa
| | - Casey Lowman
- Department of Global Child Health and Life Support, American Academy of Pediatrics, Itasca, IL, United States
| | - Janna Patterson
- Department of Global Child Health and Life Support, American Academy of Pediatrics, Itasca, IL, United States
| | - Jeffrey M Perlman
- Division of Newborn Medicine, Weil-Cornell University, New York, NY, United States
| | - Sithembiso Velaphi
- Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Costa RRDO, Araújo MSD, Medeiros SMD, Mata ANDS, Almeida RGDS, Mazzo A. Conceptual analysis and applicability of telesimulation in health education: A scoping review. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0457en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective to analyze the “telesimulation” concept and its applicability in the context of health education. Method this is a conceptual analysis performed through a scoping review carried out in May 2021 in the following databases: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online and Google Scholar, through the use of the descriptor “telesimulação” and its respective translations into English and Spanish. To analyze the studies, the concept’s attributes, antecedents, and consequences were assessed. Results telesimulation is defined as a branch of clinical simulation that is characterized by the promotion/enabling of educational practices in health education, performed remotely, synchronously, through video call. It aims to facilitate contact between instructors and participants in situations of need for social distance, access made difficult for economic reasons, such as the scarcity of human and material resources, and/or geographically distant, aiming at developing and improving relevant skills and abilities for health professions. Conclusion and implications for practice telesimulation represents a new opportunity in health education as it expands teaching possibilities and breaks down barriers ranging from geographic to economic.
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Yousef N, Moreau R, Soghier L. Simulation in neonatal care: towards a change in traditional training? Eur J Pediatr 2022; 181:1429-1436. [PMID: 35020049 PMCID: PMC8753020 DOI: 10.1007/s00431-022-04373-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/30/2021] [Accepted: 01/02/2022] [Indexed: 12/28/2022]
Abstract
UNLABELLED Simulation has traditionally been used in neonatal medicine for educational purposes which include training of novice learners, maintaining competency of health care providers, and training of multidisciplinary teams to handle crisis situations such as neonatal resuscitation. Current guidelines recommend the use of simulation as an education tool in neonatal practice. The place of simulation-based education has gradually expanded, including in limited resource settings, and is starting to show its impact on improving patient outcomes on a global basis. Over the past years, simulation has become a cornerstone in clinical settings with the goal of establishing high quality, safe, reliable systems. The aim of this review is to describe neonatal simulation training as an effective tool to improve quality of care and patient outcomes, and to encourage the use of simulation-based training in the neonatal intensive care unit (NICU) for not only education, but equally for team building, risk management and quality improvement. CONCLUSION Simulation is a promising tool to improve patient safety, team performance, and ultimately patient outcomes, but scarcity of data on clinically relevant outcomes makes it difficult to estimate its real impact. The integration of simulation into the clinical reality with a goal of establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes in neonatology must be a priority. WHAT IS KNOWN • Simulation-based education has traditionally focused on procedural and technical skills. • Simulation-based training is effective in teaching non-technical skills such as communication, leadership, and teamwork, and is recommended in neonatal resuscitation. WHAT IS NEW • There is emerging evidence for the impact of simulation-based training on patient outcomes in neonatal care, but data on clinically relevant outcomes are scarce. • Simulation is a promising tool for establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes.
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Affiliation(s)
- Nadya Yousef
- Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, "A.Béclère" Medical Center, Paris Saclay University Hospitals, APHP, Paris, France.
| | - Romain Moreau
- Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Lamia Soghier
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC USA ,Department of Neonatology, Children’s National, Washington, DC USA
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Comparison of In-Person and Telesimulation for Critical Care Training during the COVID-19 Pandemic. ATS Sch 2021; 2:581-594. [PMID: 35083463 PMCID: PMC8787731 DOI: 10.34197/ats-scholar.2021-0053oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has disrupted medical education
for trainees of all levels. Although telesimulation was initially used to
train in resource-limited environments, it may be a reasonable alternative
for replicating authentic patient experiences for medical students during
the COVID-19 pandemic. It is unclear whether a more passive approach through
telesimulation training is as effective as traditional in-person simulation
training. Objective Our aim was to evaluate the effectiveness of in-person versus remote
simulation training on learners’ comfort with managing critical care
scenarios. Methods This was a prospective observational cohort study assessing the impact of an
in-person versus remote simulation course on volunteer fourth-year medical
students from February to April 2021 at the University of California San
Diego School of Medicine. Precourse and postcourse surveys were performed
anonymously using an online secure resource. Results In the in-person learners, there was statistically significant improvement in
learner comfort across all technical, behavioral, and cognitive domains. In
remote learners, there was a trend toward improvement in self-reported
comfort across technical and cognitive domains in the telesimulation course.
However, the only statistically significant improvement in postcourse
surveys of telesimulation learners, compared with baseline, was in running
codes. Regardless of the training modality, the students had a positive
experience with the critical care simulation course, ranking it, on average,
9.6 out of 10 (9.9 in in-person simulation vs. 9.3 in telesimulation;
P = 0.06). Conclusion We demonstrated that implementation of a telesimulation-based simulation
course focusing on critical care cases is feasible and well received by
trainees. Although a telesimulation-based simulation course may not be as
effective for remote learners as active in-person participants, our study
provided evidence that there was still a trend toward improving provider
readiness across technical and cognitive domains when approaching critical
care cases.
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