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Loscalzo SM, White LJ, Rosenblatt S, Woods-Hill CZ, Teran F, Wolfe H, Himebauch AS, Glau C, Nishisaki A, Conlon TW. Ultrasound in Cardiopulmonary Arrest and Resuscitation: Constructing Comprehensive Implementation Frameworks in High-Risk Settings. Pediatr Emerg Care 2024:00006565-990000000-00444. [PMID: 38713851 DOI: 10.1097/pec.0000000000003165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
OBJECTIVES Information obtained from point-of-care ultrasound during cardiopulmonary arrest and resuscitation (POCUS-CA) can be used to identify underlying pathophysiology and provide life-sustaining interventions. However, integration of POCUS-CA into resuscitation care is inconsistent. We used expert consensus building methodology to help identify discrete barriers to clinical integration. We subsequently applied implementation science frameworks to generate generalizable strategies to overcome these barriers. MEASURES AND MAIN RESULTS Two multidisciplinary expert working groups used KJ Reverse-Merlin consensus building method to identify and characterize barriers contributing to failed POCUS-CA utilization in a hypothetical future state. Identified barriers were organized into affinity groups. The Center for Implementation Research (CFIR) framework and Expert Recommendations for Implementing Change (CFIR-ERIC) tool were used to identify strategies to guide POCUS-US implementation. RESULTS Sixteen multidisciplinary resuscitation content experts participated in the working groups and identified individual barriers, consolidated into 19 unique affinity groups that mapped 12 separate CFIR constructs, representing all 5 CFIR domains. The CFIR-ERIC tool identified the following strategies as most impactful to address barriers described in the affinity groups: identify and prepare champions, conduct local needs assessment, conduct local consensus discussions, and conduct educational meetings. CONCLUSIONS KJ Reverse-Merlin consensus building identified multiple barriers to implementing POCUS-CA. Implementation science methodologies identified and prioritized strategies to overcome barriers and guide POCUS-CA implementation across diverse clinical settings.
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Affiliation(s)
| | - Lauren J White
- Department of Pediatrics, Critical Care Medicine, Yale New Haven Children's Hospital, Yale School of Medicine, New Haven, CT
| | - Samuel Rosenblatt
- From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
| | | | - Felipe Teran
- Department of Emergency Medicine, Weill Cornell Medical College, New York, NY
| | | | - Adam S Himebauch
- From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
| | - Christie Glau
- From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
| | - Akira Nishisaki
- From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
| | - Thomas W Conlon
- From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia
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Pollitt S, Gurbutt D, Harrison N, Duckworth JE. Capturing, the experiences of undergraduate student nurses undertaking a pre-registration nursing degree course using an adapted experience based co-design approach. NURSE EDUCATION TODAY 2023; 125:105795. [PMID: 36989638 DOI: 10.1016/j.nedt.2023.105795] [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: 01/05/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The quality of student experience in higher education plays an increasingly important role in attracting and retaining pre-registration nurses. Identifying and understanding the students' experiences of their course is a necessary step in the move towards improving the student experience. Experience Based Co-design (EBCD) is successfully established as an effective process for improving patient experience in a health care setting. This study presents the use of EBCD outside of healthcare, specifically in a higher education setting. OBJECTIVES To capture, explore and understand the experiences of students' undertaking a pre-registration (adult) nursing course, and co-design potential improvements for future experiences through the application of an EBCD approach. METHODS An adapted EBCD approach was utilised for gaining insight into what shapes students' experience of the nursing course and to collaboratively produce priority recommendations for course improvement. Semi-structured interviews, emotional touchpoint mapping and co-design events were conducted with undergraduate nursing students (n = 22) and staff stakeholders in a pre-registration (adult) nursing course (n = 19). Findings were analysed using the 'Six phases of thematic analysis' (Braun & Clarke, 2006). RESULTS Students had varied experiences on the nursing course, both positive and negative, particularly with student support. Three priority recommendations for course improvement were identified from the findings including: facilitating and supporting student development of independent study skills, enhancing student support in the clinical practice placement environment and clarifying and enhancing the role of the academic advisor. CONCLUSIONS Findings from this study highlight areas for improvement on a pre-registration nursing course that could impact future students' experience. Furthermore, this study appears to be the first documented as using EBCD in a higher education setting with the focus on students, that enabled students and staff stakeholders in the nursing course to co-design priority recommendations for course improvement.
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Affiliation(s)
- Sam Pollitt
- School of Nursing, University of Central Lancashire, Preston PR1 2HE, United Kingdom of Great Britain and Northern Ireland.
| | - Dawne Gurbutt
- Centre for Collaborative Learning, University of Central Lancashire, Preston PR1 2HE, United Kingdom of Great Britain and Northern Ireland.
| | - Nigel Harrison
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom of Great Britain and Northern Ireland.
| | - Jean E Duckworth
- Community Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, United Kingdom of Great Britain and Northern Ireland.
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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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Colman N, Doughty C, Arnold J, Stone K, Reid J, Dalpiaz A, Hebbar KB. Simulation-based clinical systems testing for healthcare spaces: from intake through implementation. Adv Simul (Lond) 2019; 4:19. [PMID: 31388455 PMCID: PMC6676572 DOI: 10.1186/s41077-019-0108-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/18/2019] [Indexed: 11/17/2022] Open
Abstract
Healthcare systems are urged to build facilities that support safe and efficient delivery of care. Literature demonstrates that the built environment impacts patient safety. Design decisions made early in the planning process may introduce flaws into the system, known as latent safety threats (LSTs). Simulation-based clinical systems testing (SbCST) has successfully been incorporated in the post-construction evaluation process in order to identify LSTs prior to patient exposure and promote preparedness, easing the transition into newly built facilities. As the application of simulation in healthcare extends into the realm of process and systems testing, there is a need for a standardized approach by which to conduct SbCST in order to effectively evaluate newly built healthcare facilities. This paper describes a systemic approach by which to conduct SbCST and provides documentation and evaluation tools in order to develop, implement, and evaluate a newly built environment to identify LSTs and system inefficiencies prior to patient exposure.
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Affiliation(s)
- Nora Colman
- Department of Pediatrics, Division of Pediatric Critical Care, Children’s Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30329 USA
| | - Cara Doughty
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6621 Fannin Street, Suite A210, Houston, TX 77030 USA
| | - Jennifer Arnold
- Department of Pediatrics, Maternal, Fetal, Neonatal Institute, Johns Hopkins All Children’s Hospital, 501 6th Avenue S, St. Petersburg, FL 33701 USA
| | - Kimberly Stone
- Department of Pediatrics, Division of Emergency Medicine, Seattle Children’s Hospital and University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Jennifer Reid
- Department of Pediatrics, Division of Emergency Medicine, Seattle Children’s Hospital and University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Ashley Dalpiaz
- Department of Pediatrics, Children’s Healthcare of Atlanta, 1655 Tullie Circle, Atlanta, GA 30329 USA
| | - Kiran B. Hebbar
- Department of Pediatrics, Division of Pediatric Critical Care, Children’s Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30329 USA
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Building a Community of Practice for Researchers: The International Network for Simulation-Based Pediatric Innovation, Research and Education. Simul Healthc 2018; 13:S28-S34. [PMID: 29117090 DOI: 10.1097/sih.0000000000000269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STATEMENT The scope and breadth of simulation-based research is growing rapidly; however, few mechanisms exist for conducting multicenter, collaborative research. Failure to foster collaborative research efforts is a critical gap that lies in the path of advancing healthcare simulation. The 2017 Research Summit hosted by the Society for Simulation in Healthcare highlighted how simulation-based research networks can produce studies that positively impact the delivery of healthcare. In 2011, the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE) was formed to facilitate multicenter, collaborative simulation-based research with the aim of developing a community of practice for simulation researchers. Since its formation, the network has successfully completed and published numerous collaborative research projects. In this article, we describe INSPIRE's history, structure, and internal processes with the goal of highlighting the community of practice model for other groups seeking to form a simulation-based research network.
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Cheng A, Calhoun A, Topps D, Adler MD, Ellaway R. Using the METRICS model for defining routes to scholarship in healthcare simulation. MEDICAL TEACHER 2018; 40:652-660. [PMID: 29720011 DOI: 10.1080/0142159x.2018.1465184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION In this paper, we explored the utility and value of the METRICS model for modeling scholarship in healthcare simulation by: (1) describing the distribution of articles in four healthcare simulation journals across the seven areas of METRICS scholarship; and (2) appraising patterns of scholarship expressed in three programs of simulation scholarship and reflecting on how these patterns potentially influence the pursuit of future scholarly activities. METHODS Two raters reviewed abstracts of papers published between January 2015 and August 2017 in four healthcare simulation journals and coded them using METRICS. Descriptive statistics were calculated for scholarship type and distribution across journals. Twenty-eight articles from three scholars were reviewed, with patterns of scholarship within articles mapped to METRICS. Descriptive synthesis was constructed through discussion between two reviewers. RESULTS A total of 432 articles from four journals were reviewed. The three most commonly published areas of scholarship were: 32.2% (139/432) evaluation, 18.8% (81/432) innovation, and 15.3% (66/432) conceptual. The METRICS model was able to represent different kinds of scholarship expressed in all of the papers reviewed and across programs of research. Reflecting on patterns of scholarship within their scholarly programs was helpful for research in planning future directions. CONCLUSIONS The METRICS model for scholarship can describe a wide range of patterns of simulation scholarship within individual articles, programs of research, or across journals.
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Affiliation(s)
- Adam Cheng
- a KidSIM Simulation Program, Department of Pediatrics , Alberta Children's Hospital, University of Calgary , Calgary , Canada
| | - Aaron Calhoun
- b Department of Pediatrics , University of Louisville , Louisville , KY , USA
| | - David Topps
- c Department of Family Medicine and Office of Health and Medical Education Scholarship (OHMES) , University of Calgary , Calgary , Canada
| | - Mark D Adler
- d Department of Pediatrics and Medical Education , Feinberg School of Medicine, Northwestern University , Chicago , IL , USA
| | - Rachel Ellaway
- e Department of Community Health Sciences and Office of Health and Medical Education Scholarship (OHMES) , University of Calgary , Calgary , Canada
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Cheng A, Kessler D, Mackinnon R, Chang TP, Nadkarni VM, Hunt EA, Duval-Arnould J, Lin Y, Pusic M, Auerbach M. Conducting multicenter research in healthcare simulation: Lessons learned from the INSPIRE network. Adv Simul (Lond) 2017; 2:6. [PMID: 29450007 PMCID: PMC5806260 DOI: 10.1186/s41077-017-0039-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 02/08/2017] [Indexed: 01/29/2023] Open
Abstract
Simulation-based research has grown substantially over the past two decades; however, relatively few published simulation studies are multicenter in nature. Multicenter research confers many distinct advantages over single-center studies, including larger sample sizes for more generalizable findings, sharing resources amongst collaborative sites, and promoting networking. Well-executed multicenter studies are more likely to improve provider performance and/or have a positive impact on patient outcomes. In this manuscript, we offer a step-by-step guide to conducting multicenter, simulation-based research based upon our collective experience with the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE). Like multicenter clinical research, simulation-based multicenter research can be divided into four distinct phases. Each phase has specific differences when applied to simulation research: (1) Planning phase, to define the research question, systematically review the literature, identify outcome measures, and conduct pilot studies to ensure feasibility and estimate power; (2) Project Development phase, when the primary investigator identifies collaborators, develops the protocol and research operations manual, prepares grant applications, obtains ethical approval and executes subsite contracts, registers the study in a clinical trial registry, forms a manuscript oversight committee, and conducts feasibility testing and data validation at each site; (3) Study Execution phase, involving recruitment and enrollment of subjects, clear communication and decision-making, quality assurance measures and data abstraction, validation, and analysis; and (4) Dissemination phase, where the research team shares results via conference presentations, publications, traditional media, social media, and implements strategies for translating results to practice. With this manuscript, we provide a guide to conducting quantitative multicenter research with a focus on simulation-specific issues.
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Affiliation(s)
- Adam Cheng
- Department of Pediatrics, Alberta Children’s Hospital, KidSim-ASPIRE Research Program, Section of Emergency Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB Canada T3B 6A8
| | - David Kessler
- Division of Pediatric Emergency Medicine, Columbia University Medical School, 3959 Broadway, CHN-1-116, New York, NY 10032 USA
| | - Ralph Mackinnon
- Department of Paediatric Anaesthesia and NWTS, First Floor Theatres, Royal Manchester Children’s Hospital, Hathersage Road, Manchester, UK M13 9WL
| | - Todd P. Chang
- Children’s Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027 USA
| | - Vinay M. Nadkarni
- The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Elizabeth A. Hunt
- Charlotte R. Bloomberg Children’s Center, Johns Hopkins University School of Medicine, 1800 Orleans St, Room 6321, Baltimore, MD 21287 USA
| | - Jordan Duval-Arnould
- Charlotte R. Bloomberg Children’s Center, Johns Hopkins University School of Medicine, 1800 Orleans St, Room 6321, Baltimore, MD 21287 USA
| | - Yiqun Lin
- Alberta Children’s Hospital, Cumming School of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB Canada T3B 6A8
| | - Martin Pusic
- Institute for Innovations in Medical Education, 550 First Ave, MSB G109, New York, NY 10016 USA
| | - Marc Auerbach
- Section of Pediatric Emergency Medicine, 100 York Street, Suite 1F, New Haven, CT 06520 USA
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Donoghue A, Duff J, Lin Y, Cheng A. Simulation as a Research Tool for Pediatric Emergency Medicine. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2016. [DOI: 10.1016/j.cpem.2016.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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