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Sreedharan JK, Gopalakrishnan GK, Jose AM, Albalawi IA, Alkhathami MG, Satheesan KN, Alnasser M, AlEnezi M, Alqahtani AS. Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:473-486. [PMID: 38826695 PMCID: PMC11144405 DOI: 10.2147/amep.s464629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024]
Abstract
Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.
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Affiliation(s)
- Jithin K Sreedharan
- Department of Respiratory Therapy, College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | | | - Ann Mary Jose
- Department of Respiratory Care, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Ibrahim Ahmad Albalawi
- Advanced Centre for Clinical Simulation, Assistant Vice Dean of Academic Affairs, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Mohammed Ghaithan Alkhathami
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Keerthi N Satheesan
- Department of Respiratory Care, Royal Medical Services College of Nursing and Health Sciences, Manama, Bahrain
| | - Musallam Alnasser
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Meshal AlEnezi
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Abdullah S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
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Trevi R, Chiappinotto S, Palese A, Galazzi A. Virtual Reality for Cardiopulmonary Resuscitation Healthcare Professionals Training: A Systematic Review. J Med Syst 2024; 48:50. [PMID: 38748244 PMCID: PMC11096216 DOI: 10.1007/s10916-024-02063-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/08/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Virtual reality (VR) is becoming increasingly popular to train health-care professionals (HCPs) to acquire and/or maintain cardiopulmonary resuscitation (CPR) basic or advanced skills. AIM To understand whether VR in CPR training or retraining courses can have benefits for patients (neonatal, pediatric, and adult), HCPs and health-care organizations as compared to traditional CPR training. METHODS A systematic review (PROSPERO: CRD42023431768) following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. In June 2023, the PubMed, Cochrane Library, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched and included studies evaluated in their methodological quality with Joanna Briggs Institute checklists. Data were narratively summarized. RESULTS Fifteen studies published between 2013 and 2023 with overall fair quality were included. No studies investigated patients' outcomes. At the HCP level, the virtual learning environment was perceived to be engaging, realistic and facilitated the memorization of the procedures; however, limited decision-making, team building, psychological pressure and frenetic environment were underlined as disadvantages. Moreover, a general improvement in performance was reported in the use of the defibrillator and carrying out the chest compressions. At the organizational level, one study performed a cost/benefit evaluation in favor of VR as compared to traditional CPR training. CONCLUSIONS The use of VR for CPR training and retraining is in an early stage of development. Some benefits at the HCP level are promising. However, more research is needed with standardized approaches to ensure a progressive accumulation of the evidence and inform decisions regarding the best training methodology in this field.
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Affiliation(s)
- Roberto Trevi
- Master Degree in Nursing and Midwifery Science, University of Trieste and Udine, Trieste, Italy
- Azienda Sanitaria Universitaria G. Isontina, Trieste, Italy
| | | | - Alvisa Palese
- Department of Medicine, University of Udine, Udine, Italy.
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Ebm C, Del Pozo C, Barbarello A, Poli G, Brusa S. Unleashing excellence: using a project management approach to effectively implement a simulation curriculum to improve residents' preparedness. BMC MEDICAL EDUCATION 2024; 24:234. [PMID: 38438940 PMCID: PMC10913544 DOI: 10.1186/s12909-024-05166-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/12/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Integrating innovative, simulation-based training programs into medical curricula frequently encounters familiar challenges, including scepticism, limited faculty time, and financial constraints. Recognized for its success in business projects, the Harvard Project Management Theory emerges as a promising approach to optimizing the implementation process and achieving sustainable success. This study endeavours to elucidate the application of project management theory in our implementation process and assess its impact on the clinical preparedness of novice residents. METHODS The research utilized a structured four-phase implementation strategy-Planning, Build-up, Execution, and Closing-to develop a simulation-based education curriculum. Incorporating project management tools like project charters and risk management tools played a crucial role in facilitating the effective implementation of standardized processes and improved clinical outcomes. Essential components of this innovative management approach encompass stakeholder engagement, milestone definition, and the alignment of institutional policies and processes. RESULTS A collective of 395 residents actively engaged in eight monthly simulation-based events, reflecting an average participation rate of 39 residents per lecture (± 19). A noteworthy enhancement was observed in the average rating for knowledge gain, with a significant improvement from 5.9/10 to 8.8/10 (p = 0.0001). Participants highlighted the program's considerable impact on future clinical practice (4.7/5) and teamwork (4.8/5) as particularly valuable aspects. The introduction of a novel organizational structure received favourable feedback from faculty members, with a notable rating of 4.8/5 for predictive time planning. Qualitative insights from the evaluation highlighted the significance of targeted incentive schemes in optimizing the implementation process. CONCLUSION This project underscores the constructive influence of project management principles in designing simulation-based curricula, explicitly focusing on stakeholder engagement, faculty motivation, and data utilization. Adopting the Harvard Project Management Approach emerges as a catalyst for heightened success in curriculum design, contributing to enhanced emergency preparedness among novice residents. The positive outcomes observed in this study provide valuable insights for future implementations, offering a foundation for refining and optimizing medical education programs to meet the evolving needs of learners and stakeholders alike.
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Affiliation(s)
- Claudia Ebm
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
| | - Carolina Del Pozo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Giovani Poli
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Stefania Brusa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Davies E, Montagu A, Brazil V. Recommendations for embedding simulation in health services. Adv Simul (Lond) 2023; 8:23. [PMID: 37798755 PMCID: PMC10557368 DOI: 10.1186/s41077-023-00262-3] [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: 07/11/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
Aspirations to achieve quality and safety goals in health services through simulation have led to significant investments in simulation equipment, space and faculty. However, the optimal governance and operational models through which these resources are expertly applied in health services are not known. There is growing evidence supporting 'service' models for simulation. In these models, simulation activities are co-designed and delivered by a team of simulation experts in partnership with health service units, specifically targeting quality and safety goals. Embedded simulation specialist teams working within these programs offer benefits not fully captured by traditional models of health education or by traditional systems for quality and safety.In this article, we explore broad and specific recommendations for establishing a simulation consultancy service within an Australian metropolitan health service. We base these recommendations on a review of current Australian practice and healthcare simulation literature, and on a specific example within a large outer metropolitan health service. The broad domains discussed include (1) governance and leadership; (2) human resources; (3) principles and planning; (4) operationalise and evaluate and (5) look to the future.The recommendations recognise that healthcare simulation is moving beyond solely addressing individual learning outcomes. The value of simulation addressing organisation and system objectives through various simulation modalities is increasingly being explored and demonstrating value. There is a growing demand for translational simulation in these contexts, and a consequent requirement for organisations to consider how simulation services can be successfully operationalised. Recommendations included in this paper are discussed and described with the intent of facilitating a deeper appreciation of the complexities associated with, and opportunities afforded by, a well-integrated simulation service.
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Affiliation(s)
- Ellen Davies
- Adelaide Health Simulation, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
| | - Adam Montagu
- Adelaide Health Simulation, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Victoria Brazil
- Translational Simulation Collaborative, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Gold Coast Health Simulation Service, Gold Coast Hospital and Health Service, Gold Coast, QLD, Australia
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Ward EC, Caird E, Khanal S, Kularatna S, Byrnes J, Penman A, Mcallister S, Baldac S, Cardell E, Davenport R, Davidson B, Hewat S, Howells S, Mccabe P, Purcell A, Walters J, Hill AE. A cost analysis of a 5-day simulation-based learning program for speech-language pathology student training. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:688-696. [PMID: 36062806 DOI: 10.1080/17549507.2022.2115138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Purpose: There is poor reporting of the cost of simulation and greater transparency is needed. The primary study aim was to conduct a financial analysis of the university/training institution costs associated with a 5-day simulation-based learning program for speech-language pathology students. The secondary aim was to consider the economic costs of the model.Method: Costs associated with the delivery of a 5-day simulation-based learning program for speech-language pathology students from six Australian universities were collected regarding: (a) pre-program training, (b) personnel, (c) room hire, (d) equipment, and (e) consumables. Both financial costs and economic costs (Australian dollar, at June 2017) were calculated per university site, and per student.Result: The simulation program was run 21 times involving 176 students. Average total financial cost per program ranged from $4717 to $11 425, with cost variation primarily attributed to local labour costs and various use of in-kind support. Average financial cost per student was $859 (range $683-$1087), however this was almost double ($1461 per student, range $857-$2019) in the economic cost calculation. Personnel was the largest contributing cost component accounting for 76.6% of financial costs. Personnel was also the highest contributing cost in the economic analysis, followed by room hire.Conclusion: This study provides clarity regarding financial and economic costing for a 5-day simulation-based learning program. These data can help universities consider potential up-front financial costs, and well as strategies for financial cost minimisation, when implementing simulation-based learning within the university context.
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Affiliation(s)
- Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Emma Caird
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Saval Khanal
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Sanjeewa Kularatna
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sue Mcallister
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | | | - Elizabeth Cardell
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Rachel Davenport
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Bronwyn Davidson
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Sally Hewat
- School of Health Science, The University of Newcastle, Callaghan, Australia, and
| | - Simone Howells
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Patricia Mccabe
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alison Purcell
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Joanne Walters
- School of Health Science, The University of Newcastle, Callaghan, Australia, and
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Mamcarz I, Sarna-Boś K, Chałas R, Sobieszczański J, Świątkowski W, Martins LAC, Torres K. Exploring academic teachers perspectives regarding the impact of using medical simulation in dentistry pre- and post-COVID-19 pandemic: a qualitative study. BMC MEDICAL EDUCATION 2023; 23:633. [PMID: 37667360 PMCID: PMC10478263 DOI: 10.1186/s12909-023-04586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Medical simulation allows for the achievement of many educational goals and the continued education of some practical skills. The COVID-19 pandemic's restrictions have led to a major increase in dental education simulations. The aim of this study was to analyse the perspectives of academic teachers towards dental simulation, their concerns and evaluation of this teaching method, as well as their opinion on the use of medical simulation during the COVID-19 pandemic. METHOD A focus study was conducted in a group of 5 academic teachers, comprising 10% of academic teachers of a Dental Faculty using simulation techniques. Prior to and during the COVID-19 pandemic, the interviewed teachers had expertise with medical simulation in dentistry education methods. A facilitator used pre-planned, open-ended questions about the use of simulation in dentistry also with regard to the COVID-19 pandemic period. The group discussion has been managed, monitored, and recorded. The data analysis model was based on Braun and Clarke's six phases of thematic analysis. Five thematic domains/fields were evaluated: (1) Simulation as a didactic method; (2) Simulation during COVID-19 pandemic; (3) General observations and expectations with regard to simulation; (4) Teachers in simulation; (5) Concerns in relation to simulation. Two researchers analysed the data. RESULTS Based on interviewed teachers' perspective the simulation allows students to learn basic and complex skills providing the repeatability of the procedures performed. During Covid-19 the simulation methods undoubtedly filled the gap in the training of future dentists. However, interviewed teachers pointed out the high cost of the methods dictated by the need to prepare the simulation environment at a high level, in order to reflect the real clinical situation. CONCLUSIONS The use of simulation methods requires adequate preparation of academic teachers, continuous education and updating of knowledge in the field of medical simulation. The COVID-19 pandemic significantly influenced the growth of dental education simulation techniques as well as staff knowledge of the usage of medical simulation.
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Affiliation(s)
- Izabela Mamcarz
- Chair of Medical Education, Simulation Laboratory for Patient Safety, Medical University of Lublin, 4 Chodzki Street, Lublin, 20-093 Poland
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, 6 Chodzki Street, Lublin, 20-093 Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, 6 Chodzki Street, Lublin, 20-093 Poland
| | - Jarosław Sobieszczański
- Preclinical Dentistry Lab, Medical University of Lublin, 6 Chodzki Street, Lublin, 20-093 Poland
| | - Wojciech Świątkowski
- Chair and Department of Dental Surgery, Medical University of Lublin, 6 Chodzki Street, Lublin, 20-093 Poland
| | - Luciano Augusto Cano Martins
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, 6 Chodzki Street, Lublin, 20-093 Poland
| | - Kamil Torres
- Chair of Medical Education, Medical University of Lublin, 4 Chodzki Street, Lublin, 20-093 Poland
- Department of Plastic and Reconstructive Surgery and Microsurgery, Medical University of Lublin, Lublin, 20-059 Poland
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Shah AP, Cleland J, Hawick L, Walker KA, Walker KG. Integrating simulation into surgical training: a qualitative case study of a national programme. Adv Simul (Lond) 2023; 8:20. [PMID: 37596692 PMCID: PMC10436455 DOI: 10.1186/s41077-023-00259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/31/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Applying simulation-based education (SBE) into surgical curricula is challenging and exacerbated by the absence of guidance on implementation processes. Empirical studies evaluating implementation of SBE interventions focus primarily on outcomes. However, understanding the processes involved in organising, planning, and delivering SBE adds knowledge on how best to develop, implement, and sustain surgical SBE. This study used a reform of early years surgical training to explore the implementation of a new SBE programme in Scotland. It aimed to understand the processes that are involved in the relative success (or failure) when implementing surgical SBE interventions. METHODS This qualitative case study, underpinned by social constructionism, used publicly available documents and the relevant surgical SBE literature to inform the research focus and contextualise data obtained from semi-structured interviews with core surgical trainees (n = 46), consultant surgeons (n = 25), and key leaders with roles in surgical training governance in Scotland (n = 7). Initial data coding and analysis were inductive. Secondary data analysis was then undertaken using Normalisation Process Theory (NPT). NPTs' four constructs (coherence, cognitive participation, collective action, reflexive monitoring) provided an explanatory framework for scrutinising how interventions are implemented, embedded, and integrated into practice, i.e. the "normalisation" process. RESULTS Distributed leadership (individual SBE initiatives assigned to faculty but overall programme overseen by a single leader) and the quality improvement practise of iterative refinement were identified as key novel processes promoting successful normalisation of the new SBE programme. Other processes widely described in the literature were also identified: stakeholder collaboration, personal contacts/relational processes, effective communication, faculty development, effective leadership, and tight programme management. The study also identified that learners valued SBE activities in group- or team-based social environments over isolated deliberate practice. CONCLUSIONS SBE is most effective when designed as a comprehensive programme aligned to the curriculum. Programmes incorporating both group-based and isolated SBE activities promote deliberate practice. Distributed leadership amongst faculty attracts wide engagement integral to SBE programme implementation, while iterative programme refinement through regular evaluation and action on feedback encourages integration into practice. The knowledge contributed by critically analysing SBE programme implementation processes can support development of much needed guidance in this area.
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Affiliation(s)
- Adarsh P Shah
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorraine Hawick
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Kim A Walker
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Kenneth G Walker
- NHS Education for Scotland, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK.
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Anderson LS, Olin SJ, Whittemore JC. Proficiency and Retention of Five Clinical Veterinary Skills Using Multipurpose Reusable Canine Manikins vs. Live Animals: Model Development and Validation. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20220103. [PMID: 36469404 DOI: 10.3138/jvme-2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Simulation in veterinary education provides a safe and ethical alternative to using live animals, but most simulators are single purpose and unvalidated. In this study, canine training manikins were created using readily available materials to teach fine needle aspiration (FNA) of peripheral lymph nodes, jugular venipuncture, cephalic venipuncture, intravenous catheterization, and cystocentesis. Undergraduate subjects were prospectively enrolled and stratified by veterinary experience prior to randomization into two groups. Students were taught a new skill each week through a written description of the technique, video training, and hands-on practice (live animal vs. manikin). The following week, participants were scored on the performance of the previous week's skill on a live animal using a standardized rubric by reviewers blinded to the training group. Six weeks later, the assessment was repeated for all skills. Scores were compared between groups and time points using repeated-measures ANOVA after logarithmic transformation. p < .05 was significant. There were no significant differences in scores for any of the skills between the groups immediately following or 6 weeks after training. Initial proficiency and short-term retention of clinical skills do not differ for students trained using a manikin vs. a live dog.
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Affiliation(s)
- Lane S Anderson
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996 USA
| | - Shelly J Olin
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996 USA
| | - Jacqueline C Whittemore
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996 USA
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Mallory LA, Doughty CB, Davis KI, Cheng A, Calhoun AW, Auerbach MA, Duff JP, Kessler DO. A Decade Later-Progress and Next Steps for Pediatric Simulation Research. Simul Healthc 2022; 17:366-376. [PMID: 34570084 DOI: 10.1097/sih.0000000000000611] [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: 11/26/2022]
Abstract
SUMMARY STATEMENT A decade ago, at the time of formation of the International Network for Pediatric Simulation-based Innovation, Research, and Education, the group embarked on a consensus building exercise. The goal was to forecast the facilitators and barriers to growth and maturity of science in the field of pediatric simulation-based research. This exercise produced 6 domains critical to progress in the field: (1) prioritization, (2) research methodology and outcomes, (3) academic collaboration, (4) integration/implementation/sustainability, (5) technology, and (6) resources/support/advocacy. This article reflects on and summarizes a decade of progress in the field of pediatric simulation research and suggests next steps in each domain as we look forward, including lessons learned by our collaborative grass roots network that can be used to accelerate research efforts in other domains within healthcare simulation science.
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Affiliation(s)
- Leah A Mallory
- From the Tufts University School of Medicine (L.A.M.), Boston, MA; Department of Medical Education (L.A.M.), The Hannaford Center for Simulation, Innovation and Education; Section of Hospital Medicine (L.A.M.), Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME; Section of Emergency Medicine (C.B.D.), Department of Pediatrics, Baylor College of Medicine; Simulation Center (C.B.D.), Texas Children's Hospital, Pediatric Emergency Medicine, Baylor College of Medicine; Section of Critical Care Medicine (K.I.D.), Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX; Departments of Pediatrics and Emergency Medicine (A.C.), University of Calgary, Calgary, Canada; Division of Pediatric Critical Care (A.W.C.), University of Louisville School of Medicine and Norton Children's Hospital, Louisville, KY; Section of Emergency Medicine (M.A.A.), Yale University School of Medicine, New Haven, CT; Division of Critical Care (J.P.D.), University of Alberta, Alberta, Canada; and Columbia University Vagelos College of Physicians and Surgeons (D.O.K.), New York, NY
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Martin R, Mandrusiak A, Russell T, Forbes R. A toolbox for teaching telehealth using simulation. CLINICAL TEACHER 2022; 19:270-275. [PMID: 35726556 PMCID: PMC9543712 DOI: 10.1111/tct.13510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Romany Martin
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Herston Rd, Herston, Queensland, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
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A Region-Wide All-Hazard Training Program for Prehospital Mass Casualty Incident Management: A Real-World Case Study. Disaster Med Public Health Prep 2022; 17:e184. [PMID: 35361292 DOI: 10.1017/dmp.2022.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We report the development, implementation, and results of a sustainable region-wide mass-casualty management prehospital training program implemented by the Regione Lombardia emergency medical services (EMS) agency AREU in Italy. METHODS The educational program learning objectives are: (1) command and control, communications, and resource management; (2) mass casualty triage and the START triage protocol; (3) on-scene management; (4) Regione Lombardia and AREU Mass Casualty standard operating procedures; and (5) inter-agency communications and relations. For each course edition data on participants' summative assessment, participants' feedback and costs were collected. RESULTS Between June 26, 2013, and December 31, 2020, a total of 84 editions of the provider training event were delivered, training an overall 1329 prehospital providers; 1239 (93%) passed the summative assessment and were qualified as being operationally "ready." Regarding participant feedback, the overall program was rated 4.4 ± 0.7 out of 5. The overall cost of running the provider program during the study period was €321 510 (circa US $382 000). The average cost per edition was €3828 and €242 per participant. CONCLUSIONS We have described a simple yet interactive simulation and blended-learning approach, which has yielded good pass rates, good participant satisfaction, and contained costs to systematically train emergency medical service personnel.
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Rees CE, Foo J, Nguyen VNB, Edouard V, Maloney S, Ottrey E, Palermo C. Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation. MEDICAL EDUCATION 2022; 56:407-417. [PMID: 34817093 DOI: 10.1111/medu.14701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Cost studies are increasingly popular given resource constraints. While scholars stress the context-dependent nature of cost, and the importance of theory, cost studies remain context-blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic programme theory. This preliminary REE serves to test and refine economic programme theory for supervision training programmes of different durations to better inform future programme design/implementation. METHODS Our preliminary REE unpacked how short (half-day) and extended (12 week) supervision training programmes in Victoria, Australia, produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised programme models were developed guided by identified cost-sensitive mechanisms and contexts. RESULTS As part of identified context-mechanism-outcome configurations (CMOCs) for both training programmes, we found a wider diversity of positive outcomes but greater costs for the extended programme (11 outcomes; AU$3069/learner) compared with the short programme (7 outcomes; $385/learner). We identified four shared cost-sensitive mechanisms for both programmes (training duration, learner protected time, learner engagement, and facilitator competence) and one shared cost-sensitive context (learners' supervisory experience). We developed two economically optimised programme models: (1) short programme for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended programme for inexperienced supervisors facilitated by junior educators ($2104/learner). DISCUSSION Our initial economic programme theory was somewhat supported, refuted and refined. Results were partly consistent with previous research, but also extended it through unpacking cost-sensitive mechanisms and contexts. Although our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator-learner dyad may help to balance the cost and outcomes of training programmes.
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Affiliation(s)
- Charlotte E Rees
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Jonathan Foo
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Van N B Nguyen
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Vicki Edouard
- Department of Mechanical and Aerospace Engineering, Faculty of Engineering, Monash University, Clayton, Victoria, Australia
| | - Stephen Maloney
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Ella Ottrey
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Kapralos B, Quevedo A, Da Silva C, Peisachovich E, Collins KC, Kanev K, Dubrowski A. Revisiting Pseudo-Haptics for Psychomotor Skills Development in Online Teaching. Cureus 2022; 14:e23664. [PMID: 35505750 PMCID: PMC9054356 DOI: 10.7759/cureus.23664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
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Boecker AH, Bank C, Kim BS, Aman M, Pears KH, Klasen M, Lambert S, Sopka S. Video-Assisted Peer Teaching for Surgical Skills Training - Innovative Potential for the Medical Curriculum and Beyond: A Randomized Controlled Trial. JOURNAL OF SURGICAL EDUCATION 2022; 79:441-451. [PMID: 34863673 DOI: 10.1016/j.jsurg.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/17/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Hygienic healthcare standards are essential for avoiding hospital infections. However, medical students and staff lack training in this field, which may be due to high personnel resources of present educational approaches. Thus, there is an urgent need for a novel and efficient approach. Aim of the study is to compare a newly developed video-assisted peer feedback (VAPF) method for teaching wound dressings to the traditional teaching method with qualified instructor feedback (QIF) with respect to essential learning outcomes. DESIGN, SETTING AND PARTICIPANTS In this randomized controlled noninferiority trial, 251 medical undergraduates were randomly assigned to one of two interventions (QIF n = 127; VAPF n = 124). In QIF, participants received feedback from a qualified instructor. In VAPF, participants video-recorded each other while performing a wound dressing and gave each other feedback assisted by a standardized checklist. Outcome measures were participants' score in an objective structured practical examination (OSPE) and a written exam after the course. RESULTS Noninferiority of VAPF (n = 123) compared to QIF (n = 127) was confirmed for both OSPE (QIF: 8.83 ± 1.30; VAPF: 8.88 ± 1.04; mean difference -0.04, 95% CI -0.34 to 0.25) and written exam (QIF: 8.99 ± 1.06; VAPF: 9.14 ± 1.05; mean difference -0.15, 95% CI -0.41 to 0.12). CONCLUSIONS VAPF is a cost-efficient and viable alternative to QIF commonly used in medical education. It provides comparable training outcomes to the traditional training method with lower personnel investment. VAPF is a promising educational method for improving essential clinical competencies.
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Affiliation(s)
- Arne Hendrik Boecker
- Department of Plastic Surgery, Reconstructive and Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany
| | - Corinna Bank
- Department of Hospital Hygiene, University Hospital RWTH Aachen, Aachen, Germany
| | - Bong-Sung Kim
- Department of Plastic Surgery, Reconstructive and Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany; Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Martin Aman
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic and Hand Surgery, University of Heidelberg, BG Trauma Hospital Ludwigshafen, Ludwigshafen, Germany
| | - Kim Hannah Pears
- AIXTRA - Competency Center for Training and Patient Safety, University Hospital RWTH Aachen University, Aachen, Germany
| | - Martin Klasen
- AIXTRA - Competency Center for Training and Patient Safety, University Hospital RWTH Aachen University, Aachen, Germany
| | - Sophie Lambert
- AIXTRA - Competency Center for Training and Patient Safety, University Hospital RWTH Aachen University, Aachen, Germany
| | - Saša Sopka
- AIXTRA - Competency Center for Training and Patient Safety, University Hospital RWTH Aachen University, Aachen, Germany.
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Lemke KC, Velasquez ST, Bland L, Lopez E, Ajtai R, Ford LA, Amezaga B, Cleveland JA, Ferguson D, Richardson W, Saenz D, Zorek JA. Simulation interprofessional education in health professions education: a scoping review protocol. JBI Evid Synth 2021; 19:3058-3072. [PMID: 34374688 DOI: 10.11124/jbies-20-00487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this scoping review is to identify, collate, and map the evidence on simulation interprofessional education activities in any setting for the education of health professional students. INTRODUCTION Simulation interprofessional education activities comprise in-person and collaborative online learning embedded in formal curricula. Though the number of simulation interprofessional education activities has increased with the knowledge of the importance of effective interprofessional collaboration, the literature still lacks a description of the characteristics of existing activities. INCLUSION CRITERIA This scoping review will consider interprofessional education activities taking place within a simulation environment. Included papers will report on activities with two or more types of learners in health professional programs. METHODS The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. Databases searched will include PubMed, CINAHL, and ERIC. Results will be limited to English-language publications from 2016 to the present year. Data extraction will be performed using a purposefully developed data extraction tool. Teams of reviewers will screen abstracts and full texts of articles for potential inclusion, and decisions will be determined via consensus of two out of three reviewers. Extracted data will be presented in diagrammatic or tabular form in a manner that aligns with the objective of this scoping review. A narrative summary will accompany the tabulated and/or charted results and will describe how the results relate to the review's objective and questions, and how the results might inform future simulation interprofessional education activities in health professions education.
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Affiliation(s)
- Kelly C Lemke
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sadie Trammell Velasquez
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Leticia Bland
- School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Emme Lopez
- Briscoe Library, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rebecca Ajtai
- Briscoe Library, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Lark A Ford
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Braulio Amezaga
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - James A Cleveland
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Diane Ferguson
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Wesley Richardson
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Daniel Saenz
- Graduate School of Biomedical Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Joseph A Zorek
- Office of the Vice President for Academic, Faculty and Student Affairs and School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Ajmi SC, Kurz MW, Ersdal H, Lindner T, Goyal M, Issenberg SB, Vossius C. Cost-effectiveness of a quality improvement project, including simulation-based training, on reducing door-to-needle times in stroke thrombolysis. BMJ Qual Saf 2021; 31:569-578. [PMID: 34599087 DOI: 10.1136/bmjqs-2021-013398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Rapid revascularisation in acute ischaemic stroke is crucial to reduce its total burden including societal costs. A quality improvement (QI) project that included streamlining the stroke care pathway and simulation-based training was followed by a significant reduction in median door-to-needle time (27 to 13 min) and improved patient outcomes after stroke thrombolysis at our centre. Here, we present a retrospective cost-effectiveness analysis of the QI project. METHODS Costs for implementing and sustaining QI were assessed using recognised frameworks for economic evaluations. Effectiveness was calculated from previously published outcome measures. Cost-effectiveness was presented as incremental cost-effectiveness ratios including costs per minute door-to-needle time reduction per patient, and costs per averted death in the 13-month post-intervention period. We also estimated incremental cost-effectiveness ratios for a projected 5-year post-intervention period and for varying numbers of patients treated with thrombolysis. Furthermore, we performed a sensitivity analysis including and excluding costs of unpaid time. RESULTS All costs including fixed costs for implementing the QI project totalled US$44 802, while monthly costs were US$2141. We calculated a mean reduction in door-to-needle time of 13.1 min per patient and 6.36 annual averted deaths. Across different scenarios, the estimated costs per minute reduction in door-to-needle time per patient ranged from US$13 to US$29, and the estimated costs per averted death ranged from US$4679 to US$10 543. CONCLUSIONS We have shown that a QI project aiming to improve stroke thrombolysis treatment at our centre can be implemented and sustained at a relatively low cost with increasing cost-effectiveness over time. Our work builds on the emerging theory and practice for economic evaluations in QI projects and simulation-based training. The presented cost-effectiveness data might help guide healthcare leaders planning similar interventions.
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Affiliation(s)
- Soffien Chadli Ajmi
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway .,Faculty of Health Sciences, Universitetet i Stavanger, Stavanger, Norway
| | - Martin W Kurz
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway.,Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hege Ersdal
- Faculty of Health Sciences, Universitetet i Stavanger, Stavanger, Norway.,Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
| | - Thomas Lindner
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.,The Regional Centre for Emergency Medical Research and Development, Stavanger, Norway
| | - Mayank Goyal
- Department of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - S Barry Issenberg
- The Gordon Centre for Research in Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Corinna Vossius
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Foo J, Cook DA, Tolsgaard M, Rivers G, Cleland J, Walsh K, Abdalla ME, You Y, Ilic D, Golub R, Levin H, Maloney S. How to conduct cost and value analyses in health professions education: AMEE Guide No. 139. MEDICAL TEACHER 2021; 43:984-998. [PMID: 33280483 DOI: 10.1080/0142159x.2020.1838466] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Growing demand for accountability, transparency, and efficiency in health professions education is expected to drive increased demand for, and use of, cost and value analyses. In this AMEE Guide, we introduce key concepts, methods, and literature that will enable novices in economics to conduct simple cost and value analyses, hold informed discussions with economic specialists, and undertake further learning on more advanced economic topics. The practical structure for conducting analyses provided in this guide will enable researchers to produce robust results that are meaningful and useful for improving educational practice. Key steps include defining the economic research question, identifying an appropriate economic study design, carefully identifying cost ingredients, quantifying, and pricing the ingredients consumed, and conducting sensitivity analyses to explore uncertainties in the results.
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Affiliation(s)
- Jonathan Foo
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - David A Cook
- Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, NY, USA
| | - Martin Tolsgaard
- Centre for Clinical Education, University of Copenhagen, Copenhagen, Denmark
| | - George Rivers
- Department of Economics, Monash Business School, Monash University, Melbourne, Australia
| | - Jennifer Cleland
- Medical Education Research and Scholarship Unit, Nanyang Technological University, Singapore
| | - Kieran Walsh
- BMJ Learning and Quality, BMJ, London, United Kingdom
| | | | - You You
- National Center for Health Professions Education Development, Institute of Medical Education, and Institute of Economics of Education, Peking University, Beijing, China
| | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert Golub
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Henry Levin
- Teachers College, Columbia University, New York, NY, USA
| | - Stephen Maloney
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
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Salman H. Most significant barriers and proposed solutions for medical schools to facilitate simulation-based undergraduate curriculum in OBGYN. Arch Gynecol Obstet 2021; 304:1383-1386. [PMID: 34215936 PMCID: PMC8253239 DOI: 10.1007/s00404-021-06133-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Despite having a good understanding of medicine, doctors lack clinical skills, problem-solving abilities, and the ability to apply knowledge to patient care, particularly in unanticipated circumstances. To overcome this, medical education has evolved into a system-oriented core curriculum with cognitive, psychomotor, and affective learning goals. With an emphasis on problem-based learning, the educator's aim is to establish a long-term, predetermined improvement in the learner's behavior, acquired skills, and attitudes (Datta R, Upadhyay KK, Jaideep CN. Simulation and its role in medical education. Med J Armed Forces India. 2012;68(2):167-172. https://doi.org/10.1016/S0377-1237(12)60040-9 ). However, teaching these disciplines to real patients is almost impossible; this is where simulation comes in. This opinion paper will discuss the relevance and necessity of a simulation-based undergraduate curriculum in obstetrics and gynecology. What are the biggest obstacles that medical schools face in making the most of simulation-based learning, and how can they be overcome?
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Abstract
OBJECTIVES This study investigated the costs of 2-hour multiprofessional in situ hospital trauma team simulation training and its effects on teams' non-technical skills using the T-NOTECHS instrument. BACKGROUND Simulation is a feasible and effective teaching and learning method. Calculating the costs of simulated trauma team training in medical emergency situations can yield valuable information for improving its overall cost-effectiveness. DESIGN A prospective cohort study. SETTING Trauma resuscitation room in Central Finland Hospital, Finland. PARTICIPANTS 475 medical professionals in 81 consecutive, simulated trauma teams. PRIMARY AND SECONDARY OUTCOME MEASURES Team simulation training costs in 2017 and 2018 were analysed in the following two phases: (1) start-up costs and (2) costs of education. Primary outcome measures were training costs per participant and training costs per team. Secondary outcome measures were non-technical skills, which were measured on a 5-25-point scale using the T-NOTECHS instrument. RESULTS The annual mean total costs of trauma team simulation training were €58 000 for 40 training sessions and 238 professionals. Mean cost per participant was €203. Mean cost per team was €1220. The annual costs of simulation training markedly decreased when at least 70-80 teams participated in the training. Mean change in T-NOTECHS score after simulation training was +2.86 points (95% CI 1.97 to 3.75;+14.5%). CONCLUSIONS The greater the number of teams trained per year, the lower the costs per trauma team. In this study, we developed an activity-based costing method to calculate the costs of trauma team simulation training to help stakeholders make decisions about whether to initiate or increase existing trauma team simulation training or to obtain these services elsewhere.
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Affiliation(s)
- Eerika Rosqvist
- Department of Educational Services, The Center of Medical Expertise, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Marika Ylönen
- Department of Anesthesiology and Intensive Care, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Paulus Torkki
- Department of Public Health, Helsingin Yliopisto, Helsinki, Finland
| | - Jussi P Repo
- Department of Orthopaedics and Traumatology, Unit of Muskuloskeletal Surgery, Tampere University Hospital, Tampere, Finland
- University of Tampere, Tampere, Finland
| | - Juha Paloneva
- Department of Surgery, Central Finland Central Hospital, Jyvaskyla, Finland
- University of Eastern Finland, Kuopio, Finland
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Pezel T, Bernard A, Lavie Badie Y, Dreyfus J, Audureau E, Bohbot Y, Fard D, Hubert A, Nguyen LS, Monteil C, Bière L, Le Ven F, Canu M, Ribeyrolles S, Mion B, Mouhat B, Bazire B, Fauvel C, Ternacle J, Cautela J, Cambet T, Le Tourneau T, Donal E, Lafitte S, Mansencal N, Coisne A. Rational and Design of the SIMULATOR Study: A Multicentre Randomized Study to Assess the Impact of SIMULation-bAsed Training on Transoesophageal echocardiOgraphy leaRning for Cardiology Residents. Front Cardiovasc Med 2021; 8:661355. [PMID: 34109225 PMCID: PMC8180582 DOI: 10.3389/fcvm.2021.661355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. To assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology. Materials and Methods: Nationwide prospective randomized multicenter study involving 43 centers throughout France allowing for the inclusion of >70% of all French cardiology residents. All cardiology residents naive from TEE will be included. Randomization with stratification by center will allocate residents to either a control group receiving theoretical knowledge by e-learning only, or to an intervention group receiving two simulation-based training sessions on a TEE simulator in addition. Results: All residents will undergo both a theoretical test (0-100 points) and a practical test on a TEE simulator (0-100 points) before and 3 months after the training. Satisfaction will be assessed by a 5-points Likert scale. The primary outcomes will be to compare the scores in the final theoretical and practical tests between the two groups, 3 months after the completion of the training. Conclusion: Data regarding simulation-based learning in TEE are limited to non-randomized or single-center studies. The randomized multicenter SIMULATOR study will assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology, and whether such an educational program should be proposed in first line for TEE teaching.
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Affiliation(s)
- Théo Pezel
- University of Paris, Department of Cardiology, Lariboisiere Hospital—APHP, Paris, France
- INSERM UMRS 942, Paris, France
- Ilumens Healthcare Simulation Department, Paris University, Paris, France
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Anne Bernard
- Service de Cardiologie, CHRU de Tours, Toulouse, France
- EA4245, Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France
- Centre Régional d'Enseignement par la Simulation en Santé, Faculté de Médecine de Tours, Tours, France
| | - Yoan Lavie Badie
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Julien Dreyfus
- Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France
| | - Etienne Audureau
- Clinical Epidemiology and Ageing (CEPIA), IMRB U955, UPEC, Creteil, France
- CHU Henri Mondor, AP-HP, Creteil, France
| | - Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, Amiens, France
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Health Simulation Center SimUSanté®, Amiens University Hospital, Amiens, France
| | - Damien Fard
- Department of Cardiology, Cardiology Intensive Care Unit, Henri-Mondor University Hospital, AP-HP, INSERM U955, Université Paris-Est Créteil, Créteil, France
| | | | - Lee S. Nguyen
- Research and Innovation, RICAP, CMC Ambroise Paré, Neuilly-sur-Seine, France
| | - Cécile Monteil
- Ilumens Healthcare Simulation Department, Paris University, Paris, France
| | - Loïc Bière
- Department of Cardiology, Angers University Hospital, Angers, France
| | - Florent Le Ven
- Department of Cardiology, Brest University Hospital, CHRU de la Cavale Blanche, Brest, France
| | - Marjorie Canu
- Department of Cardiology, Grenoble University Hospital, Grenoble, France
| | | | - Baptiste Mion
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Basile Mouhat
- Department of Cardiology, University Hospital, Besançon, France
| | - Baptiste Bazire
- University of Paris, Department of Cardiology, Bichat Hospital—APHP, Paris, France
| | - Charles Fauvel
- Department of Cardiology, CHU Rouen, FHU REMOD-VHF, Rouen, France
| | - Julien Ternacle
- Hôpital Cardiologique Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Jennifer Cautela
- Aix-Marseille University, University Mediterranean Center of Cardio-Oncology, Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, North Hospital, Assistance Publique—Hôpitaux de Marseille, Centre for CardioVascular and Nutrition Research (C2VN), Marseille, France
| | - Théo Cambet
- Explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Thierry Le Tourneau
- Inserm UMR1087, Institut du thorax, Université de Nantes, CHU de Nantes, Nantes, France
| | - Erwan Donal
- Cardiologie, CHU de Rennes, LTSI, Rennes, France
| | - Stéphane Lafitte
- Hôpital Cardiologique Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Nicolas Mansencal
- Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France
- INSERM U-1018, CESP, Epidémiologie clinique, UVSQ, Université de Paris Saclay, Villejuif, France
| | - Augustin Coisne
- Department of Cardiovascular Explorations and Echocardiography—Heart Valve Clinic, CHU Lille, Lille, France
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
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Nickson CP, Petrosoniak A, Barwick S, Brazil V. Translational simulation: from description to action. Adv Simul (Lond) 2021; 6:6. [PMID: 33663603 PMCID: PMC7930894 DOI: 10.1186/s41077-021-00160-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/11/2021] [Indexed: 11/10/2022] Open
Abstract
This article describes an operational framework for implementing translational simulation in everyday practice. The framework, based on an input-process-output model, is developed from a critical review of the existing translational simulation literature and the collective experience of the authors' affiliated translational simulation services. The article describes how translational simulation may be used to explore work environments and/or people in them, improve quality through targeted interventions focused on clinical performance/patient outcomes, and be used to design and test planned infrastructure or interventions. Representative case vignettes are used to show how the framework can be applied to real world healthcare problems, including clinical space testing, process development, and culture. Finally, future directions for translational simulation are discussed. As such, the article provides a road map for practitioners who seek to address health service outcomes using translational simulation.
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Affiliation(s)
- Christopher Peter Nickson
- Intensive Care Unit and Centre for Health Innovation, Alfred Health, Melbourne, Australia.
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
| | - Andrew Petrosoniak
- St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie Barwick
- Mater Education, South Brisbane, Queensland, Australia
- Bond University, Gold Coast, Australia
| | - Victoria Brazil
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Chumbley SD, Devaraj VS, Mattick K. An Approach to Economic Evaluation in Undergraduate Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:171-183. [PMID: 32745338 DOI: 10.1002/ase.2008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
Medical education research is becoming increasingly concerned with the value (defined as "educational outcomes per dollar spent") of different teaching approaches. However, the financial costs of various approaches to teaching anatomy are under-researched, making evidence-based comparisons of the value of different teaching approaches impossible. Therefore, the aims of this study were to report the cost of six popular anatomy teaching methods through a specific, yet generalizable approach, and to demonstrate a process in which these results can be used in conjunction with existing effectiveness data to undertake an economic evaluation. A cost analysis was conducted to report the direct and indirect costs of six anatomy teaching methods, using an established approach to cost-reporting. The financial information was then combined with previously published information about the effectiveness of these six teaching methods in increasing anatomy knowledge, thereby demonstrating how estimations of value can be made. Dissection was reported as the most expensive teaching approach and computer aided instruction/learning (CAI/L) was the least, based on an estimation of total cost per student per year and assuming a student cohort size of just over 1,000 (the United Kingdom average). The demonstrated approach to economic evaluation suggested computer aided instruction/learning as the approach that provided the most value, in terms of education outcomes per dollar spent. The study concludes by suggesting that future medical education research should incorporate substantially greater consideration of cost, in order to draw important conclusions about value for learners.
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Affiliation(s)
- Samuel D Chumbley
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Vikram S Devaraj
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Karen Mattick
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Devon, United Kingdom
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Svellingen AH, Søvik MB, Røykenes K, Brattebø G. The effect of multiple exposures in scenario-based simulation-A mixed study systematic review. Nurs Open 2021; 8:380-394. [PMID: 33318846 PMCID: PMC7729777 DOI: 10.1002/nop2.639] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 11/11/2022] Open
Abstract
Aims To examine the use and effects of multiple simulations in nursing education. Design A mixed study systematic review. Databases (CINAHL, Medline, PubMed, EMBASE, ERIC, Education source and Science Direct) were searched for studies published until April 2020. Method Researchers analysed the articles. Bias risk was evaluated using the Critical Appraisal Skills Programme and Cochrane Risk of Bias tool. Results In total, 27 studies were included and four themes identified. Students participated in multiple simulation sessions, over weeks to years, which included 1-4 scenarios in various nursing contexts. Simulations were used to prepare for, or partly replace, students' clinical practice. Learning was described in terms of knowledge, competence and confidence. Conclusion Multiple scenario-based simulation is a positive intervention that can be implemented in various courses during every academic year to promote nursing students' learning. Further longitudinal research is required, including randomized studies, with transparency regarding study design and instruments.
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Affiliation(s)
- Alette H. Svellingen
- Centre of Diaconia and Professional PracticeVID Specialized UniversityOsloNorway
- Faculty of Health StudiesVID Specialized UniversityBergenNorway
| | | | - Kari Røykenes
- Faculty of Health StudiesVID Specialized UniversityBergenNorway
| | - Guttorm Brattebø
- Department of Anaesthesia & Intensive CareHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
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Pritchard SA, Keating JL, Nestel D, Blackstock FC. Physiotherapy students can be educated to portray realistic patient roles in simulation: a pragmatic observational study. BMC MEDICAL EDUCATION 2020; 20:471. [PMID: 33243213 PMCID: PMC7689969 DOI: 10.1186/s12909-020-02382-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Simulation-based education (SBE) has many benefits for learners, but costs can limit embedding SBE in health professional curricula. Peer simulation involves students portraying patient roles, and may reduce costs while still providing the benefits of other SBE experiences. However, the quality of the SBE may be impacted if students cannot portray authentic and realistic patient roles. The aim of this study was to investigate whether targeted education was associated with observable changes to physiotherapy students' abilities to portray patient roles in SBE. METHODS Second year pre-registration physiotherapy students (n = 40) participated. Students completed online and face-to-face education about SBE, patient portrayal skills, and how to portray a specific patient role. Students were video-recorded portraying patient roles in practical exams before and after the program. Three blinded independent assessors rated the overall quality of portrayals using a purpose-developed assessment instrument. RESULTS Twenty-three sets of pre- and post-program videos were analysed. Correlations between assessor scores spanned 0.62 to 0.82 for analyses of interest, which justified using average assessor ratings in analysis. Statistically significant higher scores were seen for post-program assessments for overall portrayal scores (mean difference 6.5, 95%CI [1.51-11.45], p = 0.013), accuracy (mean difference 3.4, 95%CI [0.69-6.13], p = 0.016) and quality (mean difference 3.1, 95%CI [0.64-5.49], p = 0.016). CONCLUSIONS Physiotherapy students appear capable of playing realistic patient roles. Peer simulation can be embedded into health professional programs, and education in patient role portrayal appears to be associated with improvements in portrayal quality and realism. Given these findings, further investigation, including testing program effects in a randomised study, is warranted.
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Affiliation(s)
- Shane A. Pritchard
- Department of Physiotherapy, Monash University, Moorooduc Highway, Frankston, Victoria 3199 Australia
| | - Jennifer L. Keating
- Department of Physiotherapy, Monash University, Moorooduc Highway, Frankston, Victoria 3199 Australia
| | - Debra Nestel
- Monash Institute for Health and Clinical Education (MIHCE), Monash University, Clayton, Victoria Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria Australia
| | - Felicity C. Blackstock
- School of Science and Health, Western Sydney University, Campbelltown, New South Wales Australia
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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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Ferguson J, Astbury J, Willis S, Silverthorne J, Schafheutle E. Implementing, embedding and sustaining simulation-based education: What helps, what hinders. MEDICAL EDUCATION 2020; 54:915-924. [PMID: 32306437 DOI: 10.1111/medu.14182] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/30/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Although there is much evidence to support the use of simulation-based education (SBE) in undergraduate education of health care professionals, less attention has been paid to how SBE, viewed as a complex intervention, is implemented and becomes embedded and sustained. This paper aims to explore factors that inhibited or promoted SBE becoming normal practice in undergraduate health care professional programmes. METHODS Participants involved in the organisation, design and delivery of SBE in the north of England were recruited purposefully from higher education institutions (HEI) and National Health Service (NHS) Trusts through local networks for qualitative telephone interviews. Transcripts were analysed inductively using a hybrid approach involving simultaneous inductive open coding and deductive coding using normalisation process theory (NPT) as a theoretical lens. FINDINGS A total of 12 NHS staff from 11 trusts and seven individuals from four HEIs were interviewed. There was considerable variation in the approach taken to implementation across organisations, which resulted in varying degrees of embeddedness. Implementation was challenged or enabled by organisational leadership, professional buy-in and the development and maturity of the strategic approach. Variation in understanding of the scope and pedagogical aims of SBE led to inequity between professions and organisations in investment and participation, as well as design and delivery of SBE. CONCLUSIONS Given the complexity of SBE, best practice in implementation should be considered fundamental to the successful delivery of SBE. The findings provide an explanation of how contextual factors can support or hinder implementation to maximise potential benefits and learning outcomes; this understanding can be used to better inform development of SBE strategies and highlight potential factors needed to navigate contextual barriers so that learning outcomes can be maximised.
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Affiliation(s)
- Jane Ferguson
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jayne Astbury
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Sarah Willis
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Ellen Schafheutle
- Division of Pharmacy and Optometry, School of Health Sciences, Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
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Lin Y, Hecker K, Cheng A, Grant VJ, Currie G. Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:297-303. [DOI: 10.1136/bmjstel-2020-000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/18/2020] [Accepted: 09/12/2020] [Indexed: 11/04/2022]
Abstract
ContextAlthough distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR training.MethodsWe measured educational resource use, costs, and outcomes of both conventional training and distributed training groups in a prospective-randomised trial conducted with paediatric acute care providers over 12 months. Costs were calculated and reported from the perspective of the health institution. Incremental costs and effectiveness of distributed CPR training relative to conventional training were presented. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) if appropriate. One-way sensitivity analyses and probabilistic sensitivity analysis were conducted.ResultsA total of 87 of 101 enrolled participants completed the training (46/53 in intervention and 41/48 in the control). Compared with conventional training, the distributed CPR training group had a higher proportion of participants achieving CPR excellence, defined as over 90% guideline compliant for chest compression depth, rate and recoil (control: 0.146 (6/41) vs intervention 0.543 (25/46), incremental effectiveness: +0.397) with decreased costs (control: $C266.50 vs intervention $C224.88 per trainee, incremental costs: −$C41.62). The sensitivity analysis showed that when the institution does not pay for the training time, distributed CPR training results in an ICER of $C147.05 per extra excellent CPR provider.ConclusionWorkplace-based distributed CPR training with real-time feedback resulted in improved CPR quality by paediatric healthcare providers and decreased training costs, when training time is paid by the institution. If the institution does not pay for training time, implementing distributed training resulted in better CPR quality and increased costs, compared with conventional training. These findings contribute further evidence to the decision-making processes as to whether institutions/programmes should financially adopt these training programmes.
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Whitfill T, Auerbach M, Diaz MCG, Walsh B, Scherzer DJ, Gross IT, Cicero MX. Cost-effectiveness of a video game versus live simulation for disaster training. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:268-273. [DOI: 10.1136/bmjstel-2019-000497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 11/04/2022]
Abstract
IntroductionDisaster triage training for emergency medical service (EMS) providers is unstandardised. We hypothesised that disaster triage training with the paediatric disaster triage (PDT) video game ‘60 s to Survival’ would be a cost-effective alternative to live simulation-based PDT training.MethodsWe synthesised data for a cost-effectiveness analysis from two previous studies. The video game data were from the intervention arm of a randomised controlled trial that compared triage accuracy in a live simulation scenario of exposed vs unexposed groups to the video game. The live simulation and feedback data were from a prospective cohort study evaluating live simulation and feedback for improving disaster triage skills. Postintervention scores of triage accuracy were measured for participants via live simulations and compared between both groups. Cost-effectiveness between the live simulation and video game groups was assessed using (1) A net benefit regression model at various willingness-to-pay (WTP) values. (2) A cost-effectiveness acceptability curve (CEAC).ResultsThe total cost for the live simulation and feedback training programme was $81 313.50 and the cost for the video game was $67 822. Incremental net benefit values at various WTP values revealed positive incremental net benefit values, indicating that the video game is more cost-effective compared with live simulation and feedback. Moreover, the CEAC revealed a high probability (>0.6) at various WTP values that the video game is more cost-effective.ConclusionsA video game-based simulation disaster triage training programme was more cost-effective than a live simulation and feedback-based programme. Video game-based training could be a simple, scalable and sustainable solution to training EMS providers.
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Astbury J, Ferguson J, Silverthorne J, Willis S, Schafheutle E. High-fidelity simulation-based education in pre-registration healthcare programmes: a systematic review of reviews to inform collaborative and interprofessional best practice. J Interprof Care 2020; 35:622-632. [PMID: 32530344 DOI: 10.1080/13561820.2020.1762551] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Simulation-based education (SBE) is recognized as an effective interprofessional teaching and learning method. Whilst there is a large volume of research evidence concerning elements of SBE there is a lack of clarity concerning foundational principles of best practice. This is important for educators wishing to utilize high-quality SBE to deliver interprofessional education. The aim of this review is to synthesize review evidence of SBE best practice in a broad range of pre-registration healthcare programs and contextualize findings in light of relevant educational theory. A systematic search of PubMed, Scopus, Medline/Ovid, British Nursing Index, and the Cochrane Library databases was undertaken in February 2020. Data extraction and quality evaluation were undertaken by two authors. Fifteen reviews were included. In addition to identifying barriers and enablers to implementation, three interdependent themes regarding SBE best practice were found: curriculum level integration and planning (curriculum level integration, the opportunity for deliberate repeated practice, distribution, and sequencing); simulation design and delivery (clearly defined learning outcomes and benchmarks, pre-brief, multiple learning strategies, interactivity and individualized learning, feedback, and debrief); and resources (facilitator competency, controlled environments). These themes broadly align with the social constructivist theory of experiential learning whereby structured opportunities to learn via concrete experience, reflective observation, abstract conceptualization, and active experimentation are provided through effective planning, design, and delivery of SBE. Interdependencies suggest that integration of SBE at curriculum-level enables planning and implementation of best practice principles which are associated with effective learning, which also inform and facilitate the availability of adequate simulation resources.
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Affiliation(s)
- Jayne Astbury
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Jane Ferguson
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | | | - Sarah Willis
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
| | - Ellen Schafheutle
- Centre for Pharmacy Workforce Studies, The University of Manchester, Manchester, UK
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Improving Pediatric Administrative Disaster Preparedness Through Simulated Disaster Huddles. Disaster Med Public Health Prep 2020; 15:352-357. [PMID: 32172716 DOI: 10.1017/dmp.2020.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Members of an emergency department (ED) staff need to be prepared for mass casualty incidents (MCIs) at all times. Didactic sessions, drills, and functional exercises have shown to be effective, but it is challenging to find time and resources for appropriate training. We conducted brief, task-specific drills (deemed "disaster huddles") in a pediatric ED (PED) to examine if such an approach could be an alternative or supplement to traditional MCI training paradigms. Over the course of the study, we observed an improving trend in the overall score for administrative disaster preparedness. Disaster huddles may be an effective way to improve administrative disaster preparedness in the PED. Low-effort, low-time commitment education could be an attractive way for further disaster preparedness efforts. Further studies are indicated to show a potential impact on lasting behavior and patient outcomes.
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A Call to Action: The Future of Simulation-based Research in Emergency Medicine in Canada. CAN J EMERG MED 2020; 22:8-10. [PMID: 31965962 DOI: 10.1017/cem.2019.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Foo J, Cook DA, Walsh K, Golub R, Abdalla ME, Ilic D, Maloney S. Cost evaluations in health professions education: a systematic review of methods and reporting quality. MEDICAL EDUCATION 2019; 53:1196-1208. [PMID: 31402515 DOI: 10.1111/medu.13936] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/27/2019] [Accepted: 06/20/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT High-quality research into education costs can inform better decision making. Improvements to cost research can be guided by information about the research questions, methods and reporting of studies evaluating costs in health professions education (HPE). Our objective was to appraise the overall state of the field and evaluate temporal trends in the methods and reporting quality of cost evaluations in HPE research. METHODS We searched the MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, Business Source Complete and ERIC (Education Resources Information Centre) databases on 31 July 2017. To evaluate trends over time, we sampled research reports at 5-year intervals (2001, 2006, 2011 and 2016). All original research studies in HPE that reported a cost outcome were included. The Medical Education Research Study Quality Instrument (MERSQI) and the BMJ economic checklist were used to appraise methodological and reporting quality, respectively. Trends in quality over time were analysed. RESULTS A total of 78 studies were included, of which 16 were published in 2001, 15 in 2006, 20 in 2011 and 27 in 2016. The region most commonly represented was the USA (n = 43). The profession most commonly referred to was that of the physician (n = 46). The mean ± standard deviation (SD) MERSQI score was 10.9 ± 2.6 out of 18, with no significant change over time (p = 0.55). The mean ± SD BMJ score was 13.5 ± 7.1 out of 35, with no significant change over time (p = 0.39). A total of 49 (63%) studies stated a cost-related research question, 23 (29%) stated the type of cost evaluation used, and 31 (40%) described the method of estimating resource quantities and unit costs. A total of 16 studies compared two or more interventions and reported both cost and learning outcomes. CONCLUSIONS The absolute number of cost evaluations in HPE is increasing. However, there are shortcomings in the quality of methodology and reporting, and these are not improving over time.
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Affiliation(s)
- Jonathan Foo
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - David A Cook
- Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | | | - Robert Golub
- Northwestern University Feinberg School of Medicine Chicago, Chicago, Illinois, USA
- JAMA Editorial Office, Chicago, Illinois, USA
| | | | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University, Frankston, Victoria, Australia
- Monash Centre for Scholarship in Health Education, Monash University, Frankston, Victoria, Australia
| | - Stephen Maloney
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
- Monash Centre for Scholarship in Health Education, Monash University, Frankston, Victoria, Australia
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Lemke M, Lia H, Gabinet-Equihua A, Sheahan G, Winthrop A, Mann S, Fichtinger G, Zevin B. Optimizing resource utilization during proficiency-based training of suturing skills in medical students: a randomized controlled trial of faculty-led, peer tutor-led, and holography-augmented methods of teaching. Surg Endosc 2019; 34:1678-1687. [DOI: 10.1007/s00464-019-06944-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
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Lydon S, Reid McDermott B, Ryan E, O’Connor P, Dempsey S, Walsh C, Byrne D. Can simulation-based education and precision teaching improve paediatric trainees' behavioural fluency in performing lumbar puncture? A pilot study. BMC MEDICAL EDUCATION 2019; 19:138. [PMID: 31077216 PMCID: PMC6511218 DOI: 10.1186/s12909-019-1553-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/15/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Low levels of success in performing lumbar puncture have been observed among paediatric trainees. This study assessed the efficacy of simulation-based education with frequency building and precision teaching for training lumbar puncture to behavioural fluency. METHODS The intervention group was assessed at baseline, at the final training trial, in the presence of distraction, and a minimum of one month after the cessation of the intervention in order to ascertain whether behavioural fluency in lumbar puncture was obtained. Subsequently, the performance of this intervention group (10 paediatric senior house officers) was compared to the performance of a comparator group of 10 more senior colleagues (paediatric registrars) who had not received the intervention. Retrospective chart audit was utilised to examine performance in the clinical setting. RESULTS Intervention group participants required a mean of 5 trials to achieve fluency. Performance accuracy was significantly higher in the intervention group than the comparator group. Learning was retained at follow-up and persisted during distraction. Retrospective chart audit revealed no significant difference between the performance of the intervention group and a comparator group, comprised of more senior physicians, in the clinical setting, although the interpretation of these analyses are limited by a low number of lumbar punctures performed in the clinical setting. CONCLUSIONS The programme of simulation-based education with frequency building and precision teaching delivered produced behavioural fluency in lumbar puncture among paediatric trainees. Following the intervention, the performance of these participants was equivalent to, or greater than, that of senior paediatricians. This study supports the need for further research exploring the effectiveness of simulation-based education with precision teaching to train procedural skills to fluency, and the consideration of how best to explore the impact of these on patient outcomes.
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Affiliation(s)
- Sinéad Lydon
- School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Bronwyn Reid McDermott
- School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Ethel Ryan
- Department of Paediatrics, University Hospital Galway, Co. Galway, Ireland
| | - Paul O’Connor
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Sharon Dempsey
- Department of Paediatrics, The National Maternity Hospital, Holles Street, Co. Dublin, Ireland
| | - Chloe Walsh
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
| | - Dara Byrne
- School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Co. Galway, Ireland
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O'Dowd E, Lydon S, O'Connor P, Madden C, Byrne D. A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011-2018. MEDICAL EDUCATION 2019; 53:234-249. [PMID: 30609093 DOI: 10.1111/medu.13792] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/05/2018] [Accepted: 11/20/2018] [Indexed: 05/13/2023]
Abstract
PURPOSE This review aimed to synthesise some of the extant work on the use of entrustable professional activities (EPAs) for postgraduate physicians, to assess the quality of the work and provide direction for future research and practice. METHOD Systematic searches were conducted within five electronic databases (Medline, Scopus, Web of Science, PsycINFO and CINAHL) in September 2018. Reference lists, Google Scholar and Google were also searched. Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). RESULTS In total, 49 studies were included, classified as Development of EPAs (n = 37; 76% of total included), Implementation and/or assessment of EPAs (n = 10; 20%), or both (n = 2; 4%). EPAs were described for numerous specialties, including internal medicine (n = 14; 36%), paediatrics (n = 8; 21%) and psychiatry (n = 4; 10%). Of the development studies, 92% utilised more than one method to generate EPAs. The two most commonly used methods were developing initial EPAs in a working group, (n = 27; 69%) and revising through deliberation (n = 21; 54%). Development papers were of variable quality (mean QATSDD score = 20, range 6-41). Implementation and assessment studies utilised methods that included observing trainee performance (n = 6; 50%) and enrolling trainees in competency-based curricula, which included EPAs (n = 4; 33%). The methodological quality of these implementation studies varied (mean QATSDD score = 19.5, range = 6-32). CONCLUSIONS This review highlighted a need for: (i) consideration of best practice guidelines for EPA development; (ii) focus on the methodological quality of research on EPA development and of EPAs, and (iii) further work investigating the implementation of EPAs in the curriculum.
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Affiliation(s)
- Emily O'Dowd
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - Paul O'Connor
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Caoimhe Madden
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Dara Byrne
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
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Abstract
Three national nursing associations formed a collaborative partnership to research simulation use in acute care hospitals in the United States and military hospitals abroad. An electronic survey was used to determine simulation modalities used, participants engaged, space allocation, purposes of use, commonly taught skills, logistics, and barriers to use. Data from 521 respondents revealed widespread use of a variety of simulation modalities. However, use of this educational strategy could be expanded to patients and families.
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Nestel D, McNaughton N, Smith C, Schlegel C, Tierney T. Values and value in simulated participant methodology: A global perspective on contemporary practices. MEDICAL TEACHER 2018; 40:697-702. [PMID: 29798709 DOI: 10.1080/0142159x.2018.1472755] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article has been written for the 40th year of the publication of Medical Teacher. While we celebrate the contribution of simulated participants (SPs) to health professions education through values and value-based learning, we also offer critical reflection on elements of our practice, commencing with language. We argue for the use of the term simulated rather than standardized and acknowledge the dominant role of the SP as patient and the origins of the methodology. These shifts in terms and their implications in practice reflect changes in the conceptualization of SP-based methodology. Recently published standards for those who work with SPs (SP practitioners) are noted as an important milestone in our community's development. We consider contemporary practices addressing the complex notions of values and value in SP-based learning. We simultaneously refer to the work of SPs and SP practitioners. Phases of educational design including identifying learning objectives, scenario design, implementation, feedback and debriefing are used to illustrate methodological shifts. Within each of these phases, there are relational issues that have to date often gone unchecked and are under reported in literature. Finally, using the metaphor of a murmuration, we celebrate contemporary practices of the global SP practitioner community.
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Affiliation(s)
- D Nestel
- a Monash Institute for Health and Clinical Education , Monash University , Clayton , Australia
- b Department of Surgery (Austin) , University of Melbourne , Melbourne , Australia
| | - N McNaughton
- c The Michener Institute of Education at UHN , Toronto , Canada
| | - C Smith
- d Division of Training and Simulation , Baycrest Health Sciences , Toronto , Canada
| | - C Schlegel
- e Skillslab , Berner Bildungszentrum Pflege , Bern , Switzerland
| | - T Tierney
- f Lee Kong Chian School of Medicine , Nanyang Technological University , Singapore
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Nestel D, Brazil V, Hay M. You can't put a value on that… Or can you? Economic evaluation in simulation-based medical education. MEDICAL EDUCATION 2018; 52:139-141. [PMID: 29356084 DOI: 10.1111/medu.13505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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