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Kim EJ, Lee MH, Park B. Developing a pediatric nursing simulation scenario template in South Korea: applying real-time Delphi methods. CHILD HEALTH NURSING RESEARCH 2024; 30:142-153. [PMID: 38712463 PMCID: PMC11082506 DOI: 10.4094/chnr.2024.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE This study aimed to describe the process of developing a validated pediatric nursing simulation scenario template using the real-time Delphi method. METHODS A panel of 13 pediatric nursing experts participated in a real-time Delphi survey conducted over two rounds. Initially, 83 items were included in the questionnaire focusing on the structure and content of the simulation scenario template. Data analysis involved calculating the content validity ratio (CVR) and the coefficient of variation to assess item validity and stability. RESULTS Through iterative rounds of the Delphi survey, a consensus was reached among the experts, resulting in the development of a pediatric nursing simulation scenario template comprising 41 items across nine parts. The CVR values ranged from 0.85 to 1.0, indicating a high consensus among experts regarding the inclusion of all items in the template. CONCLUSION This study presents a novel approach for developing a pediatric nursing simulation scenario template using real-time Delphi methods. The real-time Delphi method facilitated the development of a comprehensive and scientifically grounded pediatric nursing simulation scenario template. Our template aligns with the International Nursing Association for Clinical Simulation and Learning standards, and provides valuable guidance for educators in designing effective simulation scenarios, contributing to enhanced learning outcomes and better preparation for pediatric clinical practice. However, consideration of cultural and contextual adaptations is necessary, and further research should explore alternative consensus criteria.
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Affiliation(s)
- Eun Joo Kim
- Associate Professor, Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Meen Hye Lee
- Assistant Professor, Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Bitna Park
- Lecturer, Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
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Alencar e Silva R, Fraiman P, Godeiro Júnior CDO. Facial phantom model: a low-cost and safe tool for teaching botulinum toxin application in neurology residencies. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-6. [PMID: 38286431 PMCID: PMC10824594 DOI: 10.1055/s-0044-1779037] [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: 07/15/2023] [Accepted: 10/01/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND The application of botulinum toxin (BoNT) in the treatment of blepharospasm and hemifacial spasm (HS) is a well-established practice. However, neurology residency programs often rely on real patients for training, which has limitations in terms of patient availability and skill acquisition. OBJECTIVE Assess the efficacy of a new facial phantom model for acquiring motor skills in BoNT application. METHODS An anthropomorphic facial phantom model was developed in collaboration with a medical training simulator start-up. A group of seven neurologists and one ophthalmologist with expertise in BoNT application evaluated the model using an adapted learning object review instrument (LORI). The instrument assessed aspects such as: content quality, alignment of learning objectives, feedback and adaptation, motivation, presentation design, and accessibility. RESULTS The facial phantom model received high scores in the LORI evaluation, with the highest ratings given to alignment with learning objectives and motivation. The model also scored well in terms of accessibility, content quality, and presentation design. However, feedback and adaptation received a lower score due to the static nature of the model. CONCLUSION The facial phantom model shows promise as a valuable tool for teaching and developing competence in BoNT application for HS and blepharospasm. The model reduces the reliance on real patients for training, providing a broader and safer learning experience for neurology residents. It also provides a realistic learning experience and offers portability, cost-effectiveness, and ease of manufacturing for use in various medical training scenarios. It is an effective and accessible tool for teaching BoNT application.
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Affiliation(s)
- Rodrigo Alencar e Silva
- Universidade Federal do Rio Grande do Norte, Hospital Universitário Onofre Lopes, Departamento de Neurologia, Natal RN, Brazil.
| | - Pedro Fraiman
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
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Leiphrakpam PD, Armijo PR, Are C. Incorporation of Simulation in Graduate Medical Education: Historical Perspectives, Current Status, and Future Directions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241257329. [PMID: 38808125 PMCID: PMC11131395 DOI: 10.1177/23821205241257329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
Technological advancement and improved training strategies have transformed the healthcare practice environment in the last few decades. Simulation has evolved as one of the leading training models for the next generation of healthcare professionals. Simulation-based training enables healthcare professionals to acquire knowledge and skills in a safe and educationally oriented environment and can be a valuable tool for improving clinical practice and patient outcomes. The field of healthcare simulation has been rapidly growing, and various graduate medical education programs around the world have started incorporating this modality into their curricula. In graduate medical education, simulation-based training helps implement an outcome-based curriculum that tests the trainee's actual skill level as the primary factor for the trainee's competency rather than relying on the current model of a predetermined training period. However, the major challenge revolves around developing an educational curriculum incorporating a simulation-based educational model, understanding the value of this new technology, the overall cost factor, and the lack of adequate infrastructure. Hence, embracing the full potential of simulation technology in graduate medical education curricula requires an innovative approach with participation from institutions and stakeholders.
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Affiliation(s)
- Premila D. Leiphrakpam
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Priscila R. Armijo
- iEXCEL, Academic Affairs, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chandrakanth Are
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Kshetrapal A, McBride ME, Mannarino C. Taking the Pulse of the Current State of Simulation. Crit Care Clin 2023; 39:373-384. [PMID: 36898780 DOI: 10.1016/j.ccc.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Simulation in health-care professions has grown in the last few decades. We provide an overview of the history of simulation in other fields, the trajectory of simulation in health professions education, and research in medical education, including the learning theories and tools to assess and evaluate simulation programs. We also propose future directions for simulation and research in health professions education.
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Affiliation(s)
- Anisha Kshetrapal
- Department of Pediatrics, Division of Emergency Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA.
| | - Mary E McBride
- Depatment of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA
| | - Candace Mannarino
- Depatment of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA
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Neuhaus C, Grawe P, Bergström J, St.Pierre M. The impact of " To Err Is Human" on patient safety in anesthesiology. A bibliometric analysis of 20 years of research. Front Med (Lausanne) 2022; 9:980684. [PMID: 36465924 PMCID: PMC9709126 DOI: 10.3389/fmed.2022.980684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/31/2022] [Indexed: 09/19/2023] Open
Abstract
Background Patient safety gained public notoriety following the 1999 report of the Institute of Medicine: To Err is Human - Building a Safer Health System which summarized a culminated decades' worth of research that had so far been largely ignored. The aim of this study was to analyze the report's impact on patient safety research in anesthesiology. Methods A bibliometric analysis was performed on all anesthesiologic publications from 2000 to 2019 that referenced To Err Is Human. In bibliometric literature, references are understood to represent an author's conscious decision to express a relationship between his own manuscript and the cited document. Results The anesthesiologic data base contained 1.036 publications. The journal with the most references to the IOM report is Anesthesia & Analgesia. By analyzing author keywords and patterns of collaboration, changes in the patient safety debate and its core themes in anesthesiology over time could be visualized. The generic notion of "error," while initially a central topic in the scientific discourse, was subsequently replaced by terms representing a more granular, team-oriented, and educational approach. Patient safety research in anesthesia, while profiting from a certain intellectual and conceptual head start, showed a discursive shift toward more managerial, quality-management related topics as observed in the health care system as a whole. Conclusions Over the last 20 years, the research context expanded from the initial focus set forth by the IOM report, which ultimately led to an underrepresentation of research on critical incident reporting and systemic approaches to safety. Important collaborations with safety researchers from outside of health care dating back to the 1990's were gradually reduced, while previous research within anesthesiology was aligned with a broader, more managerial patient safety agenda.
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Affiliation(s)
- Christopher Neuhaus
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Grawe
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
| | - Johan Bergström
- Division of Risk Management and Societal Safety, Lund University, Lund, Sweden
| | - Michael St.Pierre
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
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Marcos-Pablos S, García-Peñalvo FJ. More than surgical tools: a systematic review of robots as didactic tools for the education of professionals in health sciences. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:1139-1176. [PMID: 35771316 PMCID: PMC9244888 DOI: 10.1007/s10459-022-10118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/23/2022] [Indexed: 06/15/2023]
Abstract
Within the field of robots in medical education, most of the work done during the last years has focused on surgeon training in robotic surgery, practicing surgery procedures through simulators. Apart from surgical education, robots have also been widely employed in assistive and rehabilitation procedures, where education has traditionally focused in the patient. Therefore, there has been extensive review bibliography in the field of medical robotics focused on surgical and rehabilitation and assistive robots, but there is a lack of survey papers that explore the potential of robotics in the education of healthcare students and professionals beyond their training in the use of the robotic system. The scope of the current review are works in which robots are used as didactic tools for the education of professionals in health sciences, investigating the enablers and barriers that affect the use of robots as learning facilitators. Systematic literature searches were conducted in WOS and Scopus, yielding a total of 3812 candidate papers. After removing duplicates, inclusion criteria were defined and applied, resulting in 171 papers. An in-depth quality assessment was then performed leading to 26 papers for qualitative synthesis. Results show that robots in health sciences education are still developed with a roboticist mindset, without clearly incorporating aspects of the teaching/learning process. However, they have proven potential to be used in health sciences as they allow to parameterize procedures, autonomously guide learners to achieve greater engagement, or enable collective learning including patients and instructors "in the loop". Although there exist documented added-value benefits, further research and efforts needs to be done to foster the inclusion of robots as didactic tools in the curricula of health sciences professionals. On the one hand, by analyzing how robotic technology should be developed to become more flexible and usable to support both teaching and learning processes in health sciences education, as final users are not necessarily well-versed in how to use it. On the other, there continues to be a need to develop effective and standard robotic enhanced learning evaluation tools, as well good quality studies that describe effective evaluation of robotic enhanced education for professionals in health sciences. As happens with other technologies when applied to the health sciences field, studies often fail to provide sufficient detail to support transferability or direct future robotic health care education programs.
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Affiliation(s)
- Samuel Marcos-Pablos
- GRIAL Research Group, University of Salamanca, IUCE, Paseo de Canalejas 169, 37008 Salamanca, Spain
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Eley C, Hawkes ND, Egan RJ, Robinson DB, Brown C, Murray S, Siau K, Lewis W. Face validity of a virtual reality simulation platform to improve competency in endoscopy: a prospective observational cohort study. Endosc Int Open 2022; 10:E1218-E1224. [PMID: 36118643 PMCID: PMC9473829 DOI: 10.1055/a-1882-4246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background and study aims Virtual reality endoscopic simulation training has the potential to expedite competency development in novice trainees. However, simulation platforms must be realistic and confer face validity. This study aimed to determine the face validity of high-fidelity virtual reality simulation (EndoSim, Surgical Science, Gothenburg), and establish benchmark metrics to guide the development of a Simulation Pathway to Improve Competency in Endoscopy (SPICE). Methods A pilot cohort of four experts rated simulated exercises (Likert scale score 1-5) and following iterative development, 10 experts completed 13 simulator-based endoscopy exercises amounting to 859 total metric values. Results Expert metric performance demonstrated equivalence ( P = 0.992). In contrast, face validity of each exercise varied among experts (median 4 (interquartile range [IQR] 3-5), P < 0.003) with Mucosal Examination receiving the highest scores (median 5 [IQR 4.5-5], P = 1.000) and Loop Management and Intubation exercises receiving the lowest scores (median 3 [IQR 1-3], P < 0.001, P = 0.004), respectively. The provisional validated SPICE comprised 13 exercises with pass marks and allowance buffers defined by median and IQR expert performance. Conclusions EndoSim Face Validity was very good related to early scope handling skills, but more advanced competencies and translation of acquired clinical skills require further research within an established training program. The existing training deficit with superadded adverse effects of the COVID pandemic make this initiative an urgent priority.
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Affiliation(s)
- Catherine Eley
- Health Education and Improvement Wales. Ty Dysgu, Cefn Coed, Nantgarw, UK
| | | | - Richard J Egan
- Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, UK,Swansea University, Singleton Park, Sketty, Swansea, UK
| | - David B Robinson
- Health Education and Improvement Wales. Ty Dysgu, Cefn Coed, Nantgarw, UK
| | - Chris Brown
- Health Education and Improvement Wales. Ty Dysgu, Cefn Coed, Nantgarw, UK,Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, UK
| | - Sam Murray
- Southmead Hospital, Southmead Road, Bristol, UK
| | - Keith Siau
- Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Wyn Lewis
- Health Education and Improvement Wales. Ty Dysgu, Cefn Coed, Nantgarw, UK
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Cotter T, Mongrain R, Driscoll M. Vacuum curette lumbar discectomy mechanics for use in spine surgical training simulators. Sci Rep 2022; 12:13517. [PMID: 35933556 PMCID: PMC9357010 DOI: 10.1038/s41598-022-17512-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022] Open
Abstract
Simulation in surgical training is a growing field and this study aims to understand the force and torque experienced during lumbar spine surgery to design simulator haptic feedback. It was hypothesized that force and torque would differ among lumbar spine levels and the amount of tissue removed by ≥ 7%, which would be detectable to a user. Force and torque profiles were measured during vacuum curette insertion and torsion, respectively, in multiple spinal levels on two cadavers. Multiple tests per level were performed. Linear and torsional resistances of 2.1 ± 1.6 N/mm and 5.6 ± 4.3 N mm/°, respectively, were quantified. Statistically significant differences were found in linear and torsional resistances between all passes through disc tissue (both p = 0.001). Tool depth (p < 0.001) and lumbar level (p < 0.001) impacted torsional resistance while tool speed affected linear resistance (p = 0.022). Average differences in these statistically significant comparisons were ≥ 7% and therefore detectable to a surgeon. The aforementioned factors should be considered when developing haptic force and torque feedback, as they will add to the simulated lumbar discectomy realism. These data can additionally be used inform next generation tool design. Advances in training and tools may help improve future surgeon training.
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Affiliation(s)
- Trevor Cotter
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, H3A 0C4, Canada.,Orthopedic Research Laboratory, Montreal General Hospital, Montreal, QC, H3H 1V8, Canada
| | - Rosaire Mongrain
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, H3A 0C4, Canada
| | - Mark Driscoll
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, H3A 0C4, Canada. .,Orthopedic Research Laboratory, Montreal General Hospital, Montreal, QC, H3H 1V8, Canada.
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9
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Vatral C, Biswas G, Cohn C, Davalos E, Mohammed N. Using the DiCoT framework for integrated multimodal analysis in mixed-reality training environments. Front Artif Intell 2022; 5:941825. [PMID: 35937140 PMCID: PMC9353401 DOI: 10.3389/frai.2022.941825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Simulation-based training (SBT) programs are commonly employed by organizations to train individuals and teams for effective workplace cognitive and psychomotor skills in a broad range of applications. Distributed cognition has become a popular cognitive framework for the design and evaluation of these SBT environments, with structured methodologies such as Distributed Cognition for Teamwork (DiCoT) used for analysis. However, the analysis and evaluations generated by such distributed cognition frameworks require extensive domain-knowledge and manual coding and interpretation, and the analysis is primarily qualitative. In this work, we propose and develop the application of multimodal learning analysis techniques to SBT scenarios. Using these analysis methods, we can use the rich multimodal data collected in SBT environments to generate more automated interpretations of trainee performance that supplement and extend traditional DiCoT analysis. To demonstrate the use of these methods, we present a case study of nurses training in a mixed-reality manikin-based (MRMB) training environment. We show how the combined analysis of the video, speech, and eye-tracking data collected as the nurses train in the MRMB environment supports and enhances traditional qualitative DiCoT analysis. By applying such quantitative data-driven analysis methods, we can better analyze trainee activities online in SBT and MRMB environments. With continued development, these analysis methods could be used to provide targeted feedback to learners, a detailed review of training performance to the instructors, and data-driven evidence for improving the environment to simulation designers.
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Auflem M, Kohtala S, Jung M, Steinert M. Facing the FACS-Using AI to Evaluate and Control Facial Action Units in Humanoid Robot Face Development. Front Robot AI 2022; 9:887645. [PMID: 35774595 PMCID: PMC9237251 DOI: 10.3389/frobt.2022.887645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
This paper presents a new approach for evaluating and controlling expressive humanoid robotic faces using open-source computer vision and machine learning methods. Existing research in Human-Robot Interaction lacks flexible and simple tools that are scalable for evaluating and controlling various robotic faces; thus, our goal is to demonstrate the use of readily available AI-based solutions to support the process. We use a newly developed humanoid robot prototype intended for medical training applications as a case example. The approach automatically captures the robot’s facial action units through a webcam during random motion, which are components traditionally used to describe facial muscle movements in humans. Instead of manipulating the actuators individually or training the robot to express specific emotions, we propose using action units as a means for controlling the robotic face, which enables a multitude of ways to generate dynamic motion, expressions, and behavior. The range of action units achieved by the robot is thus analyzed to discover its expressive capabilities and limitations and to develop a control model by correlating action units to actuation parameters. Because the approach is not dependent on specific facial attributes or actuation capabilities, it can be used for different designs and continuously inform the development process. In healthcare training applications, our goal is to establish a prerequisite of expressive capabilities of humanoid robots bounded by industrial and medical design constraints. Furthermore, to mediate human interpretation and thus enable decision-making based on observed cognitive, emotional, and expressive cues, our approach aims to find the minimum viable expressive capabilities of the robot without having to optimize for realism. The results from our case example demonstrate the flexibility and efficiency of the presented AI-based solutions to support the development of humanoid facial robots.
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Affiliation(s)
- Marius Auflem
- TrollLABS, Department of Mechanical and Industrial Engineering, Faculty of Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Sampsa Kohtala
- TrollLABS, Department of Mechanical and Industrial Engineering, Faculty of Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Malte Jung
- Robots in Groups Lab, Department of Information Science, Cornell University, Ithaca, NY, United States
| | - Martin Steinert
- TrollLABS, Department of Mechanical and Industrial Engineering, Faculty of Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Jung AR, Park EA. The Effectiveness of Learning to Use HMD-Based VR Technologies on Nursing Students: Chemoport Insertion Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084823. [PMID: 35457689 PMCID: PMC9028481 DOI: 10.3390/ijerph19084823] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/25/2022]
Abstract
Background: The purpose of this study was to develop a mobile head mounted display (HMD)-based virtual reality (VR) nursing education program (VRP), and to evaluate the effects on knowledge, learning attitude, satisfaction with self-practice, and learning motivation in nursing students. Methods: This was a quasi-experimental study using a nonequivalent control group pretest-posttest design to evaluate the effects of HMD-based VRP on nursing students. A Chemoport insertion surgery nursing scenario was developed with HMD-based VRP. The experimental group consisting of 30 nursing students underwent pre-debriefing, followed by VRP using HMD and debriefing. The control group, consisting of 30 nursing students, underwent pre-debriefing, followed by self-learning using handouts about Chemoport insertion surgery procedures for 30 min, and debriefing. Results: The experimental group that underwent HMD-based VRP showed significantly improved post-intervention knowledge on operating nursing (p = 0.001), learning attitude (p = 0.002), and satisfaction (p = 0.017) compared to the control group. Sub-domains of motivation, attention (p < 0.05), and relevance (p < 0.05) were significantly different between the two groups, post-intervention. Conclusions: HMD-based VRP of Chemoport insertion surgery is expected to contribute to knowledge, learning attitude, satisfaction, attention, and relevance in nursing students.
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Affiliation(s)
- Ae-Ri Jung
- College of Nursing, Bucheon University, Bucheon 14774, Korea;
- College of Nursing, Eulji University, Uijeongbu 11759, Korea
| | - Eun-A Park
- College of Nursing, Bucheon University, Bucheon 14774, Korea;
- Correspondence: ; Tel.: +82-32-610-8309
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12
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Ayaz O, Ismail FW. Healthcare Simulation: A Key to the Future of Medical Education - A Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:301-308. [PMID: 35411198 PMCID: PMC8994530 DOI: 10.2147/amep.s353777] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
AIM Simulation originates from its application in the military and aviation. It is implemented at various levels of healthcare education and certification today. However, its use remains unevenly distributed across the globe due to misconception regarding its cost and complexity and to lack of evidence for its consistency and validity. Implementation may also be hindered by an array of factors unique to the locale and its norms. Resource-poor settings may benefit from diverting external funds for short-term simulation projects towards collaboration with local experts and local material sourcing to reduce the overall cost and achieve long-term benefits. The recent shift of focus towards patient safety and calls for reduction in training duration have burdened educators with providing adequate quantity and quality of clinical exposure to students and residents in a short time. Furthermore, the COVID-19 pandemic has severely hindered clinical education to curb the spread of illness. Simulation may be beneficial in these circumstances and improve learner confidence. We undertook a literature search on MEDLINE using MeSH terms to obtain relevant information on simulation-based medical education and how to best apply it. Integration of simulation into curricula is an essential step of its implementation. With allocations for deliberate practice and mastery learning under supervision of qualified facilitators, this technology is becoming essential in medical education. PURPOSE To review the adaptation, spectrum of use, importance, and resource challenges of simulation in medical education and how best to implement it according to learning theories and best practice guides. CONCLUSION Simulation offers students and residents with adequate opportunities to practice their clinical skills in a risk-free environment. Unprecedented global catastrophes provide opportunities to explore simulation as a viable training tool. Future research should focus on sustainability of simulation-based medical education in LMICs.
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Affiliation(s)
- Omair Ayaz
- Aga Khan University Medical College, Karachi, Sindh, Pakistan
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Bliss DZ, Becker AJ, Gurvich OV, Bradley C, Olson ET, Steffes MT, Flaten C, Jameson S, Condon JP. Projected Augmented Reality (P-AR) for Enhancing Nursing Education About Pressure Injury: A Pilot Evaluation Study. J Wound Ostomy Continence Nurs 2022; 49:128-136. [PMID: 35255063 PMCID: PMC8908808 DOI: 10.1097/won.0000000000000858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To describe results of a study evaluating a Projected Augmented Reality (P-AR) system for its potential to enhance nursing education about pressure injuries. DESIGN Pilot evaluation survey. SUBJECTS AND SETTING The sample comprised nursing students and faculty at a school of nursing in a large, Midwestern public university. A total of 32 participants, which included 27 students (30% BSN, 44% MN, and 26% DNP students; 81% female) and 5 faculty members (80% female) participated. METHODS The P-AR system was prototyped using commercial-off-the-shelf components and software algorithms, applied to pressure injury nursing education content. After interaction with the P-AR system, participants completed a survey evaluating the following features of the P-AR system for potential: engagement, effectiveness, usefulness, user-friendliness, and realism, and users' overall impression and satisfaction with system features. Evaluation statements used a 5-level Likert-scale; open-ended questions about what was liked, disliked, or anything else offered opportunity for comments. RESULTS Student and faculty median evaluation scores were 5 (strongly agree or very satisfied) and 4 (agree or satisfied) for nearly all evaluation and satisfaction statements. Students' satisfaction with "realism" received a median score of 3 (neutral). The P-AR system was refined to include realistic still and animated images. CONCLUSION The P-AR system, an innovative technology using 3-dimensional dynamic images, was applied to nursing education content about pressure injury and was evaluated as having potential to enhance pressure injury teaching and learning. Education about complex processes of pressure injury development and management may benefit from using cutting-edge simulation technologies such as P-AR.
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Affiliation(s)
- Donna Z. Bliss
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Adam J. Becker
- Innovative Design Labs, Inc., Minneapolis, Minnesota, USA
| | - Olga V. Gurvich
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Cynthia Bradley
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Erica Timko Olson
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Mary T. Steffes
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Carol Flaten
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | | | - John P. Condon
- Innovative Design Labs, Inc., Minneapolis, Minnesota, USA
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Weaver JM. HISTORICAL SELECTION: Rosenberg MB. Simulation technology in anesthesiology. Anesth Prog. 2000;47(1):8-11. Anesth Prog 2021; 68:242-244. [PMID: 34911062 DOI: 10.2344/anpr-68-04-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Joel M Weaver
- Dentist Anesthesiologist Specialist, Professor Emeritus, College of Dentistry and Department of Anesthesiology, Wexner Medical Center, The Ohio State University, ADSA Jay A. Heidbrink Award (1998), ASDA Leonard M. Monheim Award (2003), IFDAS Horace Wells Award (2006)
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Dillon S. Simulation in Obstetrics and Gynecology: A Review of the Past, Present, and Future. Obstet Gynecol Clin North Am 2021; 48:689-703. [PMID: 34756290 DOI: 10.1016/j.ogc.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Simulation in obstetrics and gynecology has advanced significantly since its beginnings in the seventeenth century with wooden birthing and pelvic models. In recent years, more and more evidence has emerged showing improvements in participant confidence, skills, behaviors, and, finally, patient outcomes following simulation program implementation. Several regulatory bodies and national organizations have begun to require simulation of obstetrician-gynecologists, and the newer generation of physicians has experienced simulation throughout their training. Simulation is embedded in the medical culture and hopefully is making obstetrician-gynecologists better for it.
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Affiliation(s)
- Shena Dillon
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9032, USA.
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Pien LC, Colbert CY, Hoyt A, French JC. Current trends in medical education affecting allergy and immunology physicians and learners. Ann Allergy Asthma Immunol 2021; 128:248-255. [PMID: 34673222 DOI: 10.1016/j.anai.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To review current and relevant trends in medical education, undergraduate medical education, graduate medical education, and continuing medical education for the allergy and clinical immunology (A/I) community. DATA SOURCES English-only published literature from the past 5 years were obtained by means of a PubMed search and Google Scholar searches in addition to pertinent review articles and relevant textbooks as selected by the authors. STUDY SELECTIONS A total of 62 articles were selected for their relevance to the article's objective. Older references regarding medical education trends were included when they were felt to be essential. RESULTS Competency-based medical education is the contextual framework for curriculum, instruction, and assessment. Current trends influencing competency-based medical education are the following: e-learning; interprofessional education; simulation-based medical education; diversity, inclusion, and equity; and mentoring. This review clarifies terminology and offers examples of the potential impact of these trends within the A/I educational community. The development of knowledge and skills related to these topics can be achieved through formal faculty development, mentoring, and self-directed, asynchronous instruction. CONCLUSION Medical education continues to evolve as health care adapts to meet the changing needs of the health care system and our patients. The A/I physicians should be aware of current trends because these trends impact their roles as instructors and lifelong learners.
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Affiliation(s)
- Lily C Pien
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; Office of Educator and Scholar Development, Education Institute, Cleveland Clinic, Cleveland, Ohio; Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, Ohio.
| | - Colleen Y Colbert
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; Office of Educator and Scholar Development, Education Institute, Cleveland Clinic, Cleveland, Ohio
| | - Alice Hoyt
- Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, Ohio
| | - Judith C French
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
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He L, Herzig N, Lusignan SD, Scimeca L, Maiolino P, Iida F, Nanayakkara T. An Abdominal Phantom With Tunable Stiffness Nodules and Force Sensing Capability for Palpation Training. IEEE T ROBOT 2021. [DOI: 10.1109/tro.2020.3043717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Simulation-based medical education (SBME) provides experiential learning for medical trainees without any risk of harm to patients. Simulation is now included in most medical school and residency curricula. In psychiatric education, simulation programs are rapidly expanding and innovating. Major applications of SBME in psychiatry include achieving close observation of trainees with patients, preparing trainees for unstable patient scenarios, and exposing trainees to a broader range of psychopathology. This review article covers the history of SBME, simulation modalities, current use of SBME in psychiatry, a case study from one institution, and recommendations for incorporating simulation in psychiatry education.
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Affiliation(s)
- Shannon R McGue
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christine M Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA
| | - Austin McCadden
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christopher G Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA.
| | - A Lee Lewis
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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Jaskiewicz F, Kowalewski D, Starosta K, Cierniak M, Timler D. Chest compressions quality during sudden cardiac arrest scenario performed in virtual reality: A crossover study in a training environment. Medicine (Baltimore) 2020; 99:e23374. [PMID: 33235109 PMCID: PMC7710239 DOI: 10.1097/md.0000000000023374] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Potential attributes of virtual reality (VR) can be a breakthrough in the improvement of sudden cardiac arrest (SCA) training. However, interference with the virtual world is associated with the need of placing additional equipment on the trainee's body. The primary aim of the study was to evaluate if it does not affect the quality of chest compressions (CCs).91 voluntarily included in the study medical students participated twice in the scenario of SCA - Traditional Scenario (TS) and Virtual Reality Scenario (VRS). In both cases two minutes of resuscitation was performed.If VRS was the first scenario there were significant differences in CCs depth (VRS - Me = 47 mm [IQR 43 - 52] vs TS - Me = 48 mm [IQR 43 - 55]; P = .02) and chest relaxation (VRS - Me = 37% [IQR 5 - 91] vs TS - Me = 97% [IQR 87 - 100]; P < .001). 97.8% of respondents believe that training with the use of VR is more effective than a traditional method (P < .01). Most of the study group (91%, P < .01) denied any negative symptoms during the VR scenario.Virtual reality can be a safe and highly valued by medical students, method of hands-on CPR training. However additional VR equipment placed on the trainee's body may cause chest compressions harder to provide. If it is not preceded by traditional training, the use of VR may have an adverse impact on depth and full chest relaxation during the training. To make the best use of all the potential that virtual reality offers, future studies should focus on finding the most effective way to combine VR with traditional skill training in CPR courses curriculum.
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Abstract
This article explores high-fidelity simulation in anesthesiology education and provides strategies for its use to improve management of critical events. Educational theories that underlie the use of simulation are described. High-fidelity simulation is useful in teaching technical (diagnostic and procedural) and nontechnical (communication and professionalism) skills, including crisis resource management (CRM) skills. The practice of CRM is fundamental to ensuring patient safety during critical events and to the safe practice of anesthesiology, and its critical elements are presented. A discussion of the use of high-fidelity simulation to learn to combine highly complex procedural skills and CRM is also provided.
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Fujita K, Yoshimura R, Tanaka Y, Kawabata M, Masumitsu A, Kawasaki S, Kato Y, Kato S, Nakao N. The Wakayama-Immediate Stroke Life Support Course: Achieving Successful Training on the Stroke Emergency System without using Mechanical Medical Training Simulators. Asian J Neurosurg 2020; 15:970-975. [PMID: 33708672 PMCID: PMC7869296 DOI: 10.4103/ajns.ajns_254_20] [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: 05/24/2020] [Revised: 06/19/2020] [Accepted: 07/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background The Immediate Stroke Life Support (ISLS) course run in Wakayama (Wakayama-ISLS course) is an off-the-job training course for understanding the initial treatment of acute stroke. A total of 22 Wakayama-ISLS courses have been held in Wakayama Prefecture since 2008. To begin with, the case presentation was performed using human-like, mechanical manikins for simulation training. However, as the course progressed, we found the students paying great attention to the display monitor, and less to the patients' neurological status. Methods From the fourth Wakayama-ISLS course onward, we conducted the group work with the facilitators pretending to be patients, i.e., without medical training manikins. Results When the facilitators acted as patients, the students gained a more realistic and expressive perception of neurological symptoms. As a result, they expressed a high level of satisfaction with the course in the questionnaire sent immediately afterwards, regardless of their profession or prior experience. Moreover, as we did not need to transfer medical training simulators, we were able to carry out three ISLS courses at locations some distance from Wakayama city on a low-cost basis. This also enabled the regional medical staff in rural hospitals to participate in the courses easily. Conclusion The Wakayama-ISLS course without medical training manikins is an entirely feasible off-the-job training course, which provides training on fast and excellent treatment of acute stroke problems based on clinical practice. The course has the potential to spread not only across Japan but throughout the world, including to developing countries, given the cost perspective.
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Affiliation(s)
- Koji Fujita
- Department of Neurological Surgery, Naga Municipal Hospital, Kinokawa, Japan
| | - Ryo Yoshimura
- Department of Neurological Surgery, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Yoshiyuki Tanaka
- Department of Neurological Surgery, Mimihara General Hospital, Sakai, Osaka, Japan
| | - Masayuki Kawabata
- Department of Neurological Surgery, National Hospital Organization Minami Wakayama Medical Center, Wakayama, Japan
| | - Akane Masumitsu
- Department of Critical Care Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Sadao Kawasaki
- Department of Critical Care Medicine, National Hospital Organization Minami Wakayama Medical Center, Tanabe, Japan
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Seiya Kato
- Department of Critical Care Medicine, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoyuki Nakao
- Department of Neurological Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan
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Affiliation(s)
- Alexandra Moss
- Department of Cardiology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Victoria M Stoll
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,Department of Cardiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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Kurul R, Ögün MN, Neriman Narin A, Avci Ş, Yazgan B. An Alternative Method for Anatomy Training: Immersive Virtual Reality. ANATOMICAL SCIENCES EDUCATION 2020; 13:648-656. [PMID: 32163659 DOI: 10.1002/ase.1959] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 06/10/2023]
Abstract
The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.
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Affiliation(s)
- Ramazan Kurul
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Muhammed Nur Ögün
- Department of Neurology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ayşe Neriman Narin
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Şebnem Avci
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Beyza Yazgan
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Abstract
This article discusses modernizing the education of pediatric anesthesiologists in the United States. First, the current education requirements to become an American Board of Anesthesiology certified pediatric anesthesiologist are detailed and then, through a historical lens, the development of the subspecialty is examined. Gaps and challenges in the current training system are identified and interventions for improvement discussed. Additionally, suggestions are made and questions posed on how to move from a time-based model towards a competency-based curriculum.
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Affiliation(s)
- Tanna J Boyer
- Department of Anesthesia, Indiana University School of Medicine, 1130 West Michigan Street, Fesler Hall 204, Indianapolis, IN 46202, USA.
| | - Jian Ye
- Department of Anesthesia, Indiana University School of Medicine, 1130 West Michigan Street, Fesler Hall 204, Indianapolis, IN 46202, USA
| | - Michael Andrew Ford
- Department of Anesthesia, Indiana University School of Medicine, 1130 West Michigan Street, Fesler Hall 204, Indianapolis, IN 46202, USA
| | - Sally A Mitchell
- Department of Anesthesia, Indiana University School of Medicine, 1130 West Michigan Street, Fesler Hall 204, Indianapolis, IN 46202, USA
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Blackburn MB, Wang SC, Ross BE, Holcombe SA, Kempski KM, Blackburn AN, DeLorenzo RA, Ryan KL. Anatomic accuracy of airway training manikins compared with humans. Anaesthesia 2020; 76:366-372. [PMID: 32856291 DOI: 10.1111/anae.15238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2020] [Indexed: 01/21/2023]
Abstract
Airway simulators, or training manikins, are frequently used in research studies for device development and training purposes. This study was designed to determine the anatomic accuracy of the most frequently used low-fidelity airway training manikins. Computerised tomography scans and ruler measurements were taken of the SynDaver® , Laerdal® and AirSim® manikins. These measurements were compared with human computerised tomography (CT) scans (n = 33) from patients at the University of Michigan Medical Center or previously published values. Manikin measurements were scored as a percentile among the distribution of the same measurements in the human population and 10 out of 27 manikin measurements (nine measurements each in three manikins) were outside of two standard deviations from the mean in the participants. All three manikins were visually identifiable as outliers when plotting the first two dimensions from multidimensional scaling. In particular, the airway space between the epiglottis and posterior pharyngeal wall, through which airway devices must pass, was too large in all three manikins. SynDaver, Laerdal and AirSim manikins do not have anatomically correct static dimensions in relation to humans and these inaccuracies may lead to imprecise airway device development, negatively affect training and cause over-confidence in users.
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Affiliation(s)
- M B Blackburn
- United States Institute of Surgical Research, Joint Base San Antonio, Houston, TX, USA
| | - S C Wang
- Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
| | - B E Ross
- Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
| | - S A Holcombe
- Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
| | - K M Kempski
- Johns Hopkins University, Baltimore, MD, USA
| | | | - R A DeLorenzo
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - K L Ryan
- United States Institute of Surgical Research, Joint Base San Antonio, Houston, TX, USA
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Bushell M, Frost J, Deeks L, Kosari S, Hussain Z, Naunton M. Evaluation of Vaccination Training in Pharmacy Curriculum: Preparing Students for Workforce Needs. PHARMACY 2020; 8:E151. [PMID: 32825470 PMCID: PMC7559293 DOI: 10.3390/pharmacy8030151] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To introduce and evaluate a university vaccination training program, preparing final year Bachelor of Pharmacy (BPharm) and Master of Pharmacy (MPharm) students to administer vaccinations to children and adults in community pharmacy and offsite (mobile and outreach) settings. METHODS Final year BPharm and MPharm students were trained to administer intramuscular vaccinations to adults and children. The education program embedded in pharmacy degree curriculum was congruent with the requirements of the Australian National Immunisation Education Framework. The training used a mix of pedagogies including online learning; interactive lectures; and simulation, which included augmented reality and role play. All pharmacy students completing the program in 2019 were required to carry out pre- and post-knowledge assessments. Student skill of vaccination was assessed using an objective structured clinical assessment rubric. Students were invited to complete pre and post questionnaires on confidence. The post questionnaire incorporated student evaluation of learning experience questions. RESULTS In both cohorts, student vaccination knowledge increased significantly after the completion of the vaccination training program; pre-intervention and post-intervention mean knowledge score (SD) of BPharm and MPharm were (14.3 ± 2.7 vs. 22.7 ± 3.3; p < 0.001) and (15.7 ± 2.9 vs. 21.4 ± 3.2; p < 0.001) respectively. There was no difference between the BPharm and MPharm in the overall knowledge test scores, (p = 0.81; p = 0.95) pre and post scores respectively. Using the OSCA rubric, all students (n = 52) were identified as competent in the skill of injection and could administer an IM deltoid injection to a child and adult mannequin. Students agreed that the training increased their self-confidence to administer injections to both children and adults. Students found value in the use of mixed reality to enhance student understanding of the anatomy of injection sites. CONCLUSION The developed vaccination training program improved both student knowledge and confidence. Pharmacy students who complete such training should be able to administer vaccinations to children and adults, improving workforce capability. Mixed reality in the education of pharmacy students can be used to improve student satisfaction and enhance learning.
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Affiliation(s)
- Mary Bushell
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra 2617, Australia; (J.F.); (L.D.); (S.K.); (Z.H.); (M.N.)
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Urdiales AIA, Struck GT, Guetter CR, Yaegashi CH, Temperly KS, Abreu P, Tomasich FS, Campos ACL. Surgical cricothyroidostomy. Analysis and comparison between teaching and validation models of simulator models. ACTA ACUST UNITED AC 2020; 47:e20202522. [PMID: 32520132 DOI: 10.1590/0100-6991e-20202522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE to compare the acquisition and retention of knowledge about surgical cricothyroidostomy by the rapid four-step technique (RFST), when taught by expository lecture, low fidelity and high-fidelity simulation models. METHODS ninety medical students at UFPR in the first years of training were randomized assigned into 3 groups, submitted to different teaching methods: 1) expository lectures, 2) low-fidelity simulator model, developed by the research team or 3) high-fidelity simulator model (commercial). The procedure chosen was surgical cricothyroidostomy using the RFST. Soon after lectures, the groups were submitted to a multiple-choice test with 20 questions (P1). Four months later, they underwent another test (P2) with similar content. Analysis of Variance was used to compare the grades of each group in P1 with their grades in P2, and the grades of the 3 groups 2 by 2 in P1 and P2. A multiple comparisons test (post-hoc) was used to check differences within each factor (test and group). Statistical significance was considered when p<0.05. Statistical analysis was performed in the statistical software R version 3.6.1. RESULTS each group was composed of 30 medical students, without demographic differences between them. The mean scores of the groups of the expositive lecture, of the simulator of low fidelity model and of high-fidelity simulator model in P1 were, respectively, 75.00, 76.09, and 68.79, (p<0.05). In P2 the grades were 69.84, 75.32, 69.46, respectively, (p>0.05). CONCLUSIONS the simulation of low fidelity model was more effective in learning and knowledge retention, being feasible for RFST cricothyroidostomy training in inexperienced students.
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Affiliation(s)
- Akihito Inca Atahualpa Urdiales
- - Hospital do Trabalhador/Federal University of Paraná, Department of Integrated Medicine - Curitiba - PR - Brazil.,- Hospital do Trabalhador/Federal University of Paraná, Department of Surgery - Curitiba - PR - Brazil.,- Federal University of Paraná, Postgraduate Program in Surgical Clinic - Curitiba - PR - Brazil
| | | | | | - Cecilia Hissai Yaegashi
- - Cajuru University Hospital- Pontifical Catholic University of Paraná, Department of Surgery - Curitiba - PR - Brazil
| | - Kassio Silva Temperly
- - Pontifical Catholic University of Paraná, Course of Medicina - Curitiba - PR - Brazil
| | - Phillipe Abreu
- - Hospital do Trabalhador/Federal University of Paraná, Department of Surgery - Curitiba - PR - Brazil
| | - Flavio Saavedra Tomasich
- - Hospital do Trabalhador/Federal University of Paraná, Department of Surgery - Curitiba - PR - Brazil.,- Federal University of Paraná, Department of Surgery - Curitiba - PR - Brazil
| | - Antônio Carlos Ligocki Campos
- - Federal University of Paraná, Postgraduate Program in Surgical Clinic - Curitiba - PR - Brazil.,- Federal University of Paraná, Department of Surgery - Curitiba - PR - Brazil
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Horvath MA, Hu L, Mueller T, Hochstein J, Rosalia L, Hibbert KA, Hardin CC, Roche ET. An organosynthetic soft robotic respiratory simulator. APL Bioeng 2020; 4:026108. [PMID: 32566890 PMCID: PMC7286700 DOI: 10.1063/1.5140760] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/18/2020] [Indexed: 11/24/2022] Open
Abstract
In this work, we describe a benchtop model that recreates the motion and function of the diaphragm using a combination of advanced robotic and organic tissue. First, we build a high-fidelity anthropomorphic model of the diaphragm using thermoplastic and elastomeric material based on clinical imaging data. We then attach pneumatic artificial muscles to this elastomeric diaphragm, pre-programmed to move in a clinically relevant manner when pressurized. By inserting this diaphragm as the divider between two chambers in a benchtop model—one representing the thorax and the other the abdomen—and subsequently activating the diaphragm, we can recreate the pressure changes that cause lungs to inflate and deflate during regular breathing. Insertion of organic lungs in the thoracic cavity demonstrates this inflation and deflation in response to the pressures generated by our robotic diaphragm. By tailoring the input pressures and timing, we can represent different breathing motions and disease states. We instrument the model with multiple sensors to measure pressures, volumes, and flows and display these data in real-time, allowing the user to vary inputs such as the breathing rate and compliance of various components, and so they can observe and measure the downstream effect of changing these parameters. In this way, the model elucidates fundamental physiological concepts and can demonstrate pathology and the interplay of components of the respiratory system. This model will serve as an innovative and effective pedagogical tool for educating students on respiratory physiology and pathology in a user-controlled, interactive manner. It will also serve as an anatomically and physiologically accurate testbed for devices or pleural sealants that reside in the thoracic cavity, representing a vast improvement over existing models and ultimately reducing the requirement for testing these technologies in animal models. Finally, it will act as an impactful visualization tool for educating and engaging the broader community.
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Dishman D, Fallacaro MD, Damico N, Wright MC. Adaptation and Validation of the Situation Awareness Global Assessment Technique for Nurse Anesthesia Graduate Students. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Virtual Operating Room Simulation Setup (VORSS) for Procedural Training in Minimally Invasive Surgery – a Pilot Study. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02131-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
AbstractVirtual reality (VR) training is widely used in several minimal invasive surgery (MIS) training curricula for procedural training. However, VR training in its current state lack immersive training environments, such as using head-mounted displays that is implemented in military or aviation training and even entertainment. The virtual operating room simulation setup (VORSS) is explored in this study to determine the effectiveness of immersive training in MIS. Twenty-eight surgeons and surgical trainees performed a laparoscopic cholecystectomy on the VORSS comprising of a head-mounted 360-degree realistic OR surrounding on a VR laparoscopic simulator. The VORSS replicated a full setup of instruments and surgical team-members as well as some of the distractions occurring during surgical procedures. Questionnaires were followed by semi-structured interviews to collect the data. Experts and novices found the VORSS to be intuitive and easy to use (p = 0.001). The outcome of the usability test, applying QUESI and NASA-TLX, reflected the usability of the VORSS (p < 0.05), at the cognitive level, which indicates a good sense of immersion and satisfaction, when performing the procedure within VORSS. The need for personalized experience within the setup was strongly noted from most of the participants. The VORSS for procedural training has the potential to become a useful tool to provide immersive training in MIS surgery. Further optimizing of the VORSS realism and introduction of distractors in the OR should result in an improvement of the system.
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Performance improvement to address anesthesia hazards. Int Anesthesiol Clin 2020; 58:38-44. [DOI: 10.1097/aia.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah A, Mai CL, Shah R, Levine AI. Simulation-Based Education and Team Training. Otolaryngol Clin North Am 2019; 52:995-1003. [DOI: 10.1016/j.otc.2019.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The history of crises and crisis management in anesthesia: prevention, detection, and recovery. Int Anesthesiol Clin 2019; 58:2-6. [DOI: 10.1097/aia.0000000000000258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Albarran J, Scholes J. What's in this issue. Nurs Crit Care 2019; 24:249-252. [PMID: 31633278 DOI: 10.1111/nicc.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hepps JH, Yu CE, Calaman S. Simulation in Medical Education for the Hospitalist: Moving Beyond the Mock Code. Pediatr Clin North Am 2019; 66:855-866. [PMID: 31230627 DOI: 10.1016/j.pcl.2019.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Simulation in medical education has grown due to an evolution in health care. It uses 4 main modalities to re-create a situation from the clinical environment to allow experiential learning and improve patient care. Simulation must be considered as an educational strategy within a larger curriculum. Building an exercise requires first developing goals and objectives and then designing the scenario. There are 4 phases of implementation, wherein the final debrief phase is critical for learning. Educators have used simulation for multiple curricular needs: communication skills, interprofessional education, clinical reasoning, procedural training, and patient safety, which apply to the inpatient setting.
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Affiliation(s)
- Jennifer H Hepps
- Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA
| | - Clifton E Yu
- Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA
| | - Sharon Calaman
- St. Christopher's Hospital for Children, Drexel College of Medicine, 160 East Erie Avenue, Philadelphia, PA 19134, USA.
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Drummond D. Apprentissage par simulation en pédiatrie : l’exemple de l’arrêt cardiorespiratoire de l’enfant. ANNALES FRANCAISES DE MEDECINE D URGENCE 2019. [DOI: 10.3166/afmu-2019-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
La simulation en santé s’est diffusée très rapidement en pédiatrie à partir des années 2000 aux États-Unis et au Canada, puis à partir des années 2010 en France. L’arrêt cardiorespiratoire (ACR) de l’enfant représente le meilleur exemple des bénéfices qui peuvent être apportés par la simulation. La simulation peut reproduire à l’infini cette situation exceptionnelle, offre un apprentissage sans risque pour le patient ni pour l’apprenant, permet de travailler ses aspects cognitifs, techniques et humains. La simulation est effectivement associée à un gain en connaissance et en compétence chez les apprenants et participe à l’amélioration du pronostic des patients. Afin de maximiser l’efficacité pédagogique de l’enseignement de la prise en charge de l’ACR de l’enfant, les responsables pédagogiques devraient sans cesse évaluer leurs programmes, privilégier des curriculums qui associent la simulation avec d’autres modalités d’apprentissage et avoir pour objectif une pédagogie de la maîtrise. Les mannequins haute fidélité, s’ils sont appréciés par les apprenants, restent pédagogiquement équivalents aux mannequins basse fidélité pour l’apprentissage de la prise en charge de l’ACR de l’enfant.
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Englar RE. Using a Standardized Client Encounter to Practice Death Notification after the Unexpected Death of a Feline Patient Following Routine Ovariohysterectomy. JOURNAL OF VETERINARY MEDICAL EDUCATION 2019; 46:489-505. [PMID: 30806560 DOI: 10.3138/jvme.0817-111r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Death notification is an important skill for health care providers to carry out, yet few clinicians feel adequately prepared to complete this task. To address these gaps in clinical training, some medical educators have incorporated standardized patients (SPs) into the curriculum to allow students to practice death notification in a safe, controlled environment. Veterinary educators agree that end-of-life communication skills are essential for success in clinical practice, and many rely on standardized clients (SCs) for role-play concerning euthanasia. However, anticipatory loss is distinct from unexpected death, and death notification is strikingly absent from the veterinary literature. To introduce students to death notification, Midwestern University College of Veterinary Medicine (MWU CVM) developed a communications curriculum that culminated in a scripted encounter, "Basil, the Scottish Fold." Students must explain to an SC that his kitten died following routine ovariohysterectomy. Pre- and post-event surveys completed by 19 students demonstrated valuable lessons in death notification word choice, particularly what not to say. I hope that this teaching tool may be adapted for use by other colleges of veterinary medicine to allow students to practice death notification.
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A high-fidelity, fully immersive simulation course to replicate ENT and head and neck emergencies. The Journal of Laryngology & Otology 2019; 133:115-118. [DOI: 10.1017/s0022215118002347] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundSimulation-based training has a fundamental role in medical education as it allows the learner to gain experience managing emergencies in a safe, controlled environment.MethodsThis 1-day course consisted of eight high-fidelity simulation scenarios, followed by a video-assisted debrief focusing on the technical and non-technical (communication skills, teamwork, leadership and situational awareness) aspects of managing ENT and head and neck emergencies.ResultsEight courses have run since June 2014. Post-course questionnaires demonstrated that candidates’ confidence scores in managing airway and head and neck emergencies increased following completion of the course (p < 0.0001).ConclusionThis was the first fully immersive ENT simulation course developed in the region. The learning objectives for each scenario were mapped to the ENT Intercollegiate Surgical Curriculum Programme. Feedback from the course indicated a continued demand for this style of training, leading to its inclusion in the training calendar.
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Massoth C, Röder H, Ohlenburg H, Hessler M, Zarbock A, Pöpping DM, Wenk M. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC MEDICAL EDUCATION 2019; 19:29. [PMID: 30665397 PMCID: PMC6341720 DOI: 10.1186/s12909-019-1464-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/09/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND Simulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees' outcomes is currently controversial and there are few data on the effects of these simulators on participants' personal confidence and self-assessment. METHODS One-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students' performance in simulated scenarios was recorded and rated by experts. RESULTS Participants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated. CONCLUSION The use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.
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Affiliation(s)
- Christina Massoth
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Hannah Röder
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Hendrik Ohlenburg
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Michael Hessler
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Alexander Zarbock
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Daniel M. Pöpping
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
| | - Manuel Wenk
- Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Campus 1 (A1), 48149 Münster, Germany
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Gauger VT, Rooney D, Kovatch KJ, Richey L, Powell A, Berhe H, Zopf DA. A multidisciplinary international collaborative implementing low cost, high fidelity 3D printed airway models to enhance Ethiopian anesthesia resident emergency cricothyroidotomy skills. Int J Pediatr Otorhinolaryngol 2018; 114:124-128. [PMID: 30262349 PMCID: PMC6170009 DOI: 10.1016/j.ijporl.2018.08.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Similar to other sub-Saharan countries, Ethiopia suffers from a severe shortage of adequately trained health professionals. Academic partnerships can support sustainable training programs and build capacity for low-resource settings. 3D modeling and simulation-based training provide necessary tools, especially for rarely-encountered clinical situations, such as needle cricothyroidotomy. METHODS Departments of Anesthesiology, Otolaryngology, and Learning Health Sciences collaborated to develop a low-cost, high-fidelity simulator and Cricothryoidotomy Skills Maintenance Program (CSMP). Twelve anesthesia residents at St. Paul's Hospital Medical Millennium College in Addis Ababa, Ethiopia participated in CSMP. The program consisted of a didactic session with presentation and demonstration and an immersive CICO scenario. Program evaluation was performed using pre/post-training knowledge and 2 procedural performance assessments-the CSMP Global Rating Scale and the Checklist. With consent, performances were videotaped and rated independently by 3 University of Michigan faculty. RESULTS Improvements were identified in all areas, including residents' knowledge, measured by mean summed test scores (Mpre = 3.31,Mpost = 4.46,p = 0.003), time to perform cricothyroidotomy (Mpre = 96.64,Mpost = 72.82,p = 0.12), residents' performance quality, measured by overall mean Global ratings, (Mpre = 0.20; Mpost = 0.70) with improvements identified at the item-level, p = 0.001 with moderate-large effect sizes, and residents' ability to complete tasks, measured by mean Checklist ratings (Mpre = 0.51,Mpost = 0.90, with item-level improvements observed, p ≤ 0.01, with small-large effect sizes. Residents' self-reported confidence also improved (Mpre = 1.69, Mpost = 3.08,p = 0.001). CONCLUSION Our work shows that cricothyroidotomy skills taught to anesthesia residents at SPHMMC with a 3D printed laryngotracheal model improves knowledge, skills, and confidence. The creation of a low-cost, high-fidelity simulator and a CSMP has the potential to impact patient care and safety world-wide.
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Affiliation(s)
- Virginia T Gauger
- Department of Anesthesiology, Michigan Medicine, Ann Arbor, MI, 48109, USA.
| | - Deborah Rooney
- Department of Learning Health Sciences, Michigan Medicine, Ann Arbor, MI, 48109, USA
| | - Kevin J Kovatch
- Department of Otolaryngology Head & Neck Surgery, Michigan Medicine, Ann Arbor, MI, 48109, USA
| | - Lauren Richey
- Department of Anesthesiology, Michigan Medicine, Ann Arbor, MI, 48109, USA
| | | | | | - David A Zopf
- Department of Otolaryngology Head & Neck Surgery, Michigan Medicine, Ann Arbor, MI, 48109, USA
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Maresky HS, Oikonomou A, Ali I, Ditkofsky N, Pakkal M, Ballyk B. Virtual reality and cardiac anatomy: Exploring immersive three‐dimensional cardiac imaging, a pilot study in undergraduate medical anatomy education. Clin Anat 2018; 32:238-243. [DOI: 10.1002/ca.23292] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/23/2018] [Accepted: 09/28/2018] [Indexed: 11/07/2022]
Affiliation(s)
- H. S. Maresky
- Department of Medical ImagingSunnybrook Health Sciences Center, fully affiliated with the University of Toronto
- Department of Diagnostic ImagingHospital for Sick Children Toronto Ontario Canada
- Department of Radiology & Anatomy, Sackler School of MedicineTel Aviv University Ramat Aviv Israel
| | - A. Oikonomou
- Department of Medical ImagingSunnybrook Health Sciences Center, fully affiliated with the University of Toronto
| | - I. Ali
- Department of Medical ImagingSunnybrook Health Sciences Center, fully affiliated with the University of Toronto
| | - N. Ditkofsky
- Department of Medical ImagingSunnybrook Health Sciences Center, fully affiliated with the University of Toronto
| | - M. Pakkal
- Toronto General Hospital/ Joint Division of Medical ImagingUniversity of Toronto
| | - B. Ballyk
- Division of Anatomy & Department of Surgery, Faculty of MedicineUniversity of Toronto
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Coupal TM, Buckley AR, Bhalla S, Li JL, Ho SGF, Holmes A, Harris AC. Management of Acute Contrast Reactions-Understanding Radiologists' Preparedness and the Efficacy of Simulation-Based Training in Canada. Can Assoc Radiol J 2018; 69:349-355. [PMID: 30245005 DOI: 10.1016/j.carj.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/05/2018] [Accepted: 05/07/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Acute radiologic emergencies, primarily severe contrast reactions, are rare but life-threatening events. Given a generalized paucity of formalized or mandated training, studies have shown that radiologists and trainees perform poorly when acutely managing such events. Moreover, skill base, knowledge, and comfort levels precipitously decline over time given the infrequent occurrence of these events during one's daily practice. The primary aim of this study was to assess radiologists' preparedness for managing acute radiologic emergencies and to determine the efficacy of a high-fidelity simulation based training model in an effort to provide a rationale for similar programs to be implemented on a provincial or national level. METHODS This was a prospective, observational study of radiology residents and attending radiologists throughout the province who were recruited to attend a full-day simulation-based course presenting various cases of acute radiologic emergencies. Participant demographics were collected at the time of commencement of the workshop. Course materials were disseminated 4 weeks prior to the workshop, and a 17-question knowledge quiz was administered before and after the workshop. Likert-type questionnaires were also distributed to survey comfort levels and equipment familiarity. The knowledge quiz and questionnaire were redistributed at 3- and 6-month intervals for acquisition of follow-up data. RESULTS A total of 14 attending radiologists and 7 residents attended the workshop, with all participants completing the preworkshop questionnaire and 90.5% (19 of 21) completing the post-workshop questionnaire. Participants' principle locations of practice were as follows: academic institutions (50%), community hospitals (36.9%), and private clinics (13.1%). A significant increase in knowledge was demonstrated, with average scores of 10 out of 17 (59%) and 14.5 out of 17 (85%) (P < .001) before and after the workshop, respectively. A significant increase in participants' comfort levels in recognizing acute anaphylactic reactions (3.5; 4.7, P < .001), commencing initial management for acute radiologic emergencies (3.3; 5.0, P < .001), and administering the correct dose for anaphylactic reactions (2.5; 4.8, P < .001) was also demonstrated. Moreover, participants became increasingly familiar with the contents and equipment found within contrast reaction kits (2.8; 3.8, P < .01). Repeat evaluations at 3 and 6 months found an average knowledge test score of 13.8 out of 17 (81%) and 10.8 out of 17 (64%), respectively. Comfort levels were also reassessed in recognizing acute anaphylactic reactions (4.5; 4.1), commencing initial management (4.0; 3.9) and administering the correct dose of medication (4.0; 3.7) at 3- and 6-month intervals. CONCLUSIONS Acute radiologic emergencies are rare but life-threatening events that require rapid diagnosis and treatment to mitigate associated morbidity and mortality. Simulation-based workshops are a highly efficacious training model to increase knowledge, comfort levels, and equipment familiarity for radiologists and trainees alike; however, retraining at regular intervals is required.
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Affiliation(s)
- Tyler M Coupal
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
| | - Anne R Buckley
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Sanjiv Bhalla
- Department of Radiology, Surrey Memorial Hospital, Surrey, British Columbia, Canada
| | - Jessica L Li
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Stephen G F Ho
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Allan Holmes
- Iridia Medical, Vancouver, British Columbia, Canada
| | - Alison C Harris
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
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Grillo FW, Souza VH, Matsuda RH, Rondinoni C, Pavan TZ, Baffa O, Machado HR, Carneiro AAO. Patient-specific neurosurgical phantom: assessment of visual quality, accuracy, and scaling effects. 3D Print Med 2018; 4:3. [PMID: 29782617 PMCID: PMC5954795 DOI: 10.1186/s41205-018-0025-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/26/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. Styrene-ethylene/butylene-styrene (SEBS) gels are biologically inert and present tunable properties, including mechanical properties that resemble the soft tissue. Therefore, SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulation-based neurosurgical training. RESULTS A 3D model was reconstructed and printed based on patient-specific magnetic resonance images. The fused deposition of polyactic acid (PLA) filament and selective laser sintering of polyamid were used for 3D printing. Silicone and SEBS materials were employed to mimic soft tissues. A neuronavigation protocol was performed on the 3D-printed models scaled to three different sizes, 100%, 50%, and 25% of the original dimensions. A neurosurgery team (17 individuals) evaluated the phantom realism as "very good" and "perfect" in 49% and 31% of the cases, respectively, and rated phantom utility as "very good" and "perfect" in 61% and 32% of the cases, respectively. Models in original size (100%) and scaled to 50% provided a quantitative and realistic visual analysis of the patient's cortical anatomy without distortion. However, reduction to one quarter of the original size (25%) hindered visualization of surface details and identification of anatomical landmarks. CONCLUSIONS A patient-specific phantom was developed with anatomically and spatially accurate shapes, that can be used as an alternative for surgical planning. Printed models scaled to sizes that avoided quality loss might save time and reduce medical training costs.
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Affiliation(s)
- Felipe Wilker Grillo
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Victor Hugo Souza
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Renan Hiroshi Matsuda
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Carlo Rondinoni
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Theo Zeferino Pavan
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Oswaldo Baffa
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Helio Rubens Machado
- Department of Surgery and Anatomy, Faculty of Medicine at Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Antonio Adilton Oliveira Carneiro
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
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Abstract
Human error and system failures continue to play a substantial role in preventable errors that lead to adverse patient outcomes or death. Many of these deaths are not the result of inadequate medical knowledge and skill, but occur because of problems involving communication and team management. Anesthesiologists pioneered the use of simulation for medical education in an effort to improve physician performance and patient safety. This article explores the use of simulation for performance improvement. Educational theories that underlie effective simulation programs are described as driving forces behind the advancement of simulation in performance improvement.
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Affiliation(s)
- Amanda Burden
- Cooper Medical School of Rowan University, 401 South Broadway Camden, NJ 08103, USA.
| | - Erin White Pukenas
- Cooper Medical School of Rowan University, 401 South Broadway Camden, NJ 08103, USA
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Higham H, Baxendale B. To err is human: use of simulation to enhance training and patient safety in anaesthesia. Br J Anaesth 2017; 119:i106-i114. [DOI: 10.1093/bja/aex302] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Onan A, Simsek N, Elcin M, Turan S, Erbil B, Deniz KZ. A review of simulation-enhanced, team-based cardiopulmonary resuscitation training for undergraduate students. Nurse Educ Pract 2017; 27:134-143. [PMID: 28892727 DOI: 10.1016/j.nepr.2017.08.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 08/16/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022]
Abstract
Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question. The findings are presented together with a discussion of the effectiveness of various educational interventions. In conclusion, student attitudes toward interprofessional learning and simulation experiences were more positive. Research reports emphasized the importance of adherence to established guidelines, adopting a holistic approach to training, and that preliminary training, briefing, deliberate practices, and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training.
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Affiliation(s)
- Arif Onan
- Department of Medical Education and Informatics, Hacettepe University, Faculty of Medicine, Sihhiye Campus, 06100 Altindag, Ankara, Turkey.
| | - Nurettin Simsek
- Department of Computer Education & Instructional Technology, Ankara University, Institute of Educational Sciences, 06590 Cebeci, Ankara, Turkey.
| | - Melih Elcin
- Department of Medical Education and Informatics, Hacettepe University, Faculty of Medicine, Sihhiye Campus, 06100 Altindag, Ankara, Turkey.
| | - Sevgi Turan
- Department of Medical Education and Informatics, Hacettepe University, Faculty of Medicine, Sihhiye Campus, 06100 Altindag, Ankara, Turkey.
| | - Bülent Erbil
- Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Sihhiye Campus 06100 Altindag, Ankara, Turkey.
| | - Kaan Zülfikar Deniz
- Graduate School of Educational Sciences, Ankara University, Institute of Educational Sciences 06590 Cebeci, Ankara, Turkey.
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An active simulator for neonatal intubation: Design, development and assessment. Med Eng Phys 2017; 39:57-65. [DOI: 10.1016/j.medengphy.2016.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/07/2016] [Accepted: 10/23/2016] [Indexed: 11/30/2022]
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Abstract
The field of health professions continues to struggle with the impact of increasing practitioner and educator shortages. Health professions education is also faced with the issues of limited clinical placements and an increasing demand for online education. To address these issues, health professions educators have increasingly turned to simulations to provide experiential learning in safe, controlled environments. One of the newest simulation technology innovations to emerge is that of virtual patient simulations. This chapter reviews the context in which virtual patients have emerged, the range of virtual patient technologies available, and the ways in which health professions educators currently use virtual patient simulations.
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