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Abraham P, Dubois N, Rimmelé T, Lilot M, Balança B. Enhancing perioperative care through decontextualized simulation: A game-changer for non-technical skills training. J Clin Anesth 2024; 94:111428. [PMID: 38422954 DOI: 10.1016/j.jclinane.2024.111428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Paul Abraham
- Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France.
| | - Nadège Dubois
- Medical Simulation Center, Public Health Department, Liège University, Liège, Belgium
| | - Thomas Rimmelé
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; EA 7426, PI3 (Pathophysiology of Injury-Induced Immunosuppression), Claude Bernard University Lyon 1-Biomérieux-Hospices Civils de Lyon, Lyon, France
| | - Marc Lilot
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Unit of Pediatric and Congenital Cardio-thoracic Anesthesia and Intensive Care, Medical-Surgical Department of Congenital Cardiology of the Fœtus, Child and Adult. Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Baptiste Balança
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Neurologic Intensive care and Anesthesiology, Hospices Civils de Lyon, Pierre Wertheimer Hospital and Claude Bernard University Lyon 1 - Neuroscience Research Center, Lyon, France
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King A, Cairns S, Shepherd L, Barrett J, Inkster T. Advancing outbreak simulation training: a collaborative pilot study for dual-specialty medical trainees and infection prevention and control professionals. J Hosp Infect 2024; 147:68-76. [PMID: 38432585 DOI: 10.1016/j.jhin.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND In response to identified gaps in infection prevention and control (IPC) training within Scotland, a Short Life Working Group initiated an innovative outbreak simulation training programme. AIM To enhance the knowledge and confidence of medical microbiology and infectious diseases trainees and IPC professionals in managing healthcare-associated infection (HAI) outbreaks, employing the National Infection Prevention and Control Manual guidelines. METHODS Participants completed prerequisite online training in epidemiology and surveillance before engaging in a meticulously crafted vancomycin-resistant enterococci outbreak simulation, which mirrored a real-life incident and adhered to the standards set by the Association for Simulated Practice in Healthcare. The programme incorporated Kolb's experiential learning cycle, fostering an authentic and engaging learning environment. A total of 41 individuals participated in the synchronous online training phase, with eight individuals involved in the pilot outbreak simulation. Evaluation of the training's efficacy followed Kirkpatrick's model, combining quantitative (five-point Likert scales) and qualitative (open-ended questions and participant reflections) data collection methods. FINDINGS Results demonstrated significant improvements in participants' knowledge, skills, and confidence in outbreak management. Feedback highlighted the realism and educational value of the simulation, with 100% agreement on its efficacy in enhancing outbreak management capabilities. CONCLUSION The success of this pilot study underscores the potential of simulation training in IPC and paves the way for broader implementation. It emphasizes the effectiveness of structured, experiential learning in equipping healthcare professionals with practical skills and confidence for managing complex HAI outbreaks, contributing to a more competent and prepared workforce.
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Affiliation(s)
- A King
- NHS Education for Scotland, Glasgow, UK
| | - S Cairns
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), Delta House, Glasgow, UK
| | | | - J Barrett
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), Delta House, Glasgow, UK
| | - T Inkster
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), Delta House, Glasgow, UK.
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Kassutto S, Clancy C, Harbison S, Tsao S. A virtual simulation-based clinical skills course. CLINICAL TEACHER 2024:e13727. [PMID: 38273464 DOI: 10.1111/tct.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/09/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Advancements in technology continue to transform the landscape of medical education. Virtual reality (VR) and remote simulation represent unique approaches to teaching students clinical skills through experiential learning. APPROACH We developed, implemented and evaluated a virtual simulation-based course modelled on Kolb's Learning Cycle. A 5-day, 15-h virtual clerkship clinical skills curriculum designed to help students recognise a patient requiring urgent or emergent care was piloted in May 2020. VR and remote simulations facilitated concrete experiences, reflective observation, concept formation, and active experimentation. Curricular evaluation included analysis of usage, performance, self-assessment, and perceptions of educational value. EVALUATION One hundred and fifty-six students completed 436 VR sessions (median 3 per student). Students repeated virtual cases, on average, 75% of the time, demonstrating improvement in average performance scores from 59% (attempt 1) to 72% (attempt 2). Post-course evaluations, completed by 109 (69.9%) students, demonstrated significant improvements in mean scores in all domains of a self-assessment based on emergent care skills. IMPLICATIONS We developed and implemented a virtual clinical skills course that allowed students to progress through all four stages of Kolb's Learning Cycle. VR and remote simulations represent an opportunity for educators to reimagine and expand opportunities for experiential learning. The number of students accommodated, total virtual simulations completed, and positive student feedback suggests that this may be a feasible, acceptable, and scalable method for increasing opportunities for progression through Kolb's Learning Cycle. Further investigation into impact on educational outcomes is needed.
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Affiliation(s)
- Stacey Kassutto
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Caitlin Clancy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sean Harbison
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suzana Tsao
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Sam CP, Nathan JL, Aroksamy JA, Ramasamy N, Mamat NHB, Nadarajah VD. A Qualitative Study on the Experiences of Preclinical Students in Learning Clinical and Communication Skills at a Simulation Centre. MEDICAL SCIENCE EDUCATOR 2023; 33:1127-1137. [PMID: 37886265 PMCID: PMC10597961 DOI: 10.1007/s40670-023-01851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 10/28/2023]
Abstract
Introduction Simulation centres (SC) and its learning resources are now firmly established as part of medical education. In SC, medical students obtain both knowledge and skills based on a combination of theory and practice using provided resources. This study aims to explore medical students' use of SC learning resources to learn clinical and communication skills based on Kolb's experiential learning cycle. This is based on the research question 'How are the SC resources useful in supporting preclinical medical students' clinical and communication skills learning?' The findings of the study can make a case for further enhancement of SC design and resources for medical students in the preclinical phase. Methods A qualitative study involving 20 preclinical medical students with learning experiences in SC was conducted between December 2019 and 2020 at a medical school in Malaysia. Semi-structured interview questions were developed based on Kolb's learning cycle. The data were thematically analysed using the six phases of Braun and Clarke's thematic analysis. Results Three main themes were identified based on preclinical medical students' experiences in SC; they were 'preparation for authentic clinical experience', 'accessibility of multiple resources for learning and support' and 'opportunities to learn and improve'. Conclusions The SC's resources have a significant and positive role in supporting preclinical medical students learn clinical and communication skills. The SC resources prepared them for authentic clinical experiences with a patient-centred care approach and self-directed learning opportunities. Social support from peers, peer tutors and academics emerged as a key finding and resource of the SC as they help preclinical students learn and improve.
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Affiliation(s)
- Chong Pek Sam
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Joann Lalita Nathan
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Jacintha Anita Aroksamy
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Nithia Ramasamy
- Clinical Skills & Simulation Centre, International Medical University (IMU), Kuala Lumpur, Malaysia
| | | | - Vishna Devi Nadarajah
- Department of Human Biology and IMU Centre for Education, International Medical University (IMU), Kuala Lumpur, Malaysia
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Hakemi A, Blamoun J, Lundahl A, Armstead T, Hakemi K, Malik M. A Conceptual Framework for Instructional Design of a High Acuity and Low Occurrence Event - Simulation Based Education Training of Residents, Medical Students, and Nurses in Anaphylaxis Utilizing Curated Educational Theories. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:101-107. [PMID: 36798716 PMCID: PMC9926979 DOI: 10.2147/amep.s398013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The broad goal of this educational curriculum is utilization and optimization of Simulation-Based Education (SBE) in the training of residents, medical students, and nursing staff involved in the rapid and timely recognition of Anaphylaxis and its optimized treatment. A critical gap in Anaphylaxis Diagnosis, Management, and Treatment (ADAM) has been well established across medical disciplines. It is imperative to include all members of the healthcare team, as nurses and pharmacists play key roles in anaphylaxis recognition and care. Nurses and pharmacists are proficiently trained in the initial assessment of acute patient complaints, status, and in proper dosing/administration considerations. Anaphylaxis is a High Acuity and Low Occurrence (HALO) event. Delayed recognition and administration of epinephrine-autoinjector (EAI) is a patient safety concern. Suboptimal technique and expertise in this regard is common. Literature abounds with reports of physician trainee doubts and uncertainties in the recognition and optimized management of Anaphylaxis. Importantly, Anaphylaxis is frequently misdiagnosed in hospital emergency departments. SBE methodologies are ideal for instructing HALO experiences. The framework of the "Zone of Simulation Matrix" supports the utilization of a simulation experience in this instance. Learning will be effective, enhanced, and made durable by embedding numerous specifically curated educational theories. Given the paucity in training of residents and nursing staff in Anaphylaxis, such instruction is imperative. Of note, a special emphasis in this curricular framework is the debriefing experience. Considerations will be given to the psychological safety of the trainees and the importance of the heterogeneity of prior experiences. Precise diagnosis minimizes mortality. In the hospital setting, nurses are the first responders to critical HALO events, and there is a lack of awareness of ADAM by nursing students.
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Affiliation(s)
- Ahmad Hakemi
- College of Health Professions, Central Michigan University, Mount Pleasant, MI, 48859, USA
| | - John Blamoun
- Clinical Education, College of Medicine, Central Michigan University, Mount Pleasant, MI, 48859, USA
| | - Andrew Lundahl
- Clinical Pharmacy Services, Mission Pharmacy, Mount Pleasant, MI, 48858, USA
| | - Teresa Armstead
- School of Engineering and Technology, Central Michigan University, Mount Pleasant, MI, 48859, USA
| | - Kelvin Hakemi
- Behavioral Health, Healthsource, Saginaw, MI, 48603, USA
| | - Mishaal Malik
- Medical Student, College of Medicine, Central Michigan University, Mount Pleasant, MI, 48859, USA
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Muacevic A, Adler JR, Bakti NI. Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics. Cureus 2022; 14:e31788. [PMID: 36569726 PMCID: PMC9777351 DOI: 10.7759/cureus.31788] [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] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION A junior doctor teaching program delivered by near-peers can foster collaboration in a less-pressured and conducive learning environment. The aim of this study was to provide an analysis of an orthopedic teaching program in a high-resource environment utilizing readily available tools and resources that are potentially available in most hospitals globally. Methods: This study involved the utilization of an outcome-based learning approach with regular formal feedback. An anonymized Google Forms survey using a 10-point Likert scale was conducted after a 30-week period. The survey tool was sent out to 28 doctors and two senior nurse practitioners who participated in the program either as tutors, learners, or both. A total of 19 out of 30 respondents completed the survey giving a 63% survey completion rate. The setting for this study was the trauma and orthopedics department in a United Kingdom district general hospital. RESULTS Learners' confidence in their orthopedic knowledge and skills pre-program had a median response of eight with a mode of seven whereas confidence following engagement on the program improved with a median response of nine and a mode of 10. At an alpha level of 0.05, this observed improvement was statistically significant using the Mann-Whitney U test (p=0.466). Tutors' perception of the usefulness of the teaching feedback had a median response of nine with a mode of 10. Relevance of the selected topics had a median response of nine and a mode of 10. Inclusion in the teaching program to cater to learner diversity had a median response of nine and a mode of 10. The effectiveness of a blended approach for learning had a median response of nine and a mode of 10. Conclusion: This study has provided evidence of the benefits of a near-peer teaching program. This is especially important in the post-coronavirus disease (COVID) pandemic recovery period where easily accessible and well-grounded educational programs will be useful to complement the deanery teachings for trainees. This is important as this may be the main source of formal teaching for non-trainee junior doctors in many hospital settings. Additional research will be needed to further explore the pros and cons of such programs within a surgical specialty like orthopedics with an emphasis on the various pedagogical approaches to teaching and learning for junior doctors working in a busy clinical setting.
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