1
|
Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
Collapse
|
2
|
Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
Collapse
|
3
|
Breckwoldt J, Cheng A, Lauridsen KG, Lockey A, Yeung J, Greif R. Stepwise approach to skills teaching in resuscitation: A systematic review. Resusc Plus 2023; 16:100457. [PMID: 37674547 PMCID: PMC10477803 DOI: 10.1016/j.resplu.2023.100457] [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: 07/17/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Aim To compare the effectiveness of Peyton's four-step approach for teaching resuscitation skills with alternative approaches. Methods For this systematic review, we followed the PICOST format (population, intervention, comparison, outcome, study design, timeframe) using Peyton's four-step approach as the standard. We included all studies analyzing skills training related to resuscitation and First Aid in any educational setting. Eligible were randomized controlled trials (RCTs) and non-randomized studies (non-randomized controlled trials, interrupted time series, controlled before-and-after studies, cohort studies, published conference abstracts, and case series where n ≥ 5). We excluded unpublished results (e.g. trial protocols), commentaries, editorials, reviews. Medline, Embase, PsycINFO, ERIC, CINAHL, and Cochrane were searched from inception until November 10, 2020 (updated November 25, 2022) for publications in all languages as long as there was an English abstract. Titles and abstracts of the papers retrieved were screened, and eligible publications were analysed in full text. From the final set of papers, data were extracted into a spreadsheet, subsequently risk of bias assessment was performed (using RoB2 and ROBINS-I), and the certainty of evidence (using GRADE) for each paper was assessed. Screening of studies, data extraction, risk-of-bias assessment, and assessment of certainty of evidence were all performed by two independent researchers. This review was conducted in adherence with PRISMA standards and was registered with PROSPERO (CRD42023377398). Results Overall, the search identified 2,574 studies from which 17 were included in the final analysis (14 RCTs, and 3 non-RCTs). The studies involved a total of 2,906 participants from various populations (from lay persons to health care professionals) and analysed nine different resuscitation skills being taught (ranging from chest compressions to needle cricotomy). The alternative teaching approaches ranged from two-steps to five-steps with various modifications of single steps. High methodological and clinical heterogeneity precluded a meta-analysis from being conducted. The risk of bias assessment showed considerable variation between the studies ranging from 'low' to 'serious'. Across all studies, certainty of evidence was rated as very low due to imprecision and inconsistency. Overall, 14 out of 17 studies showed no difference in skill acquisition or retention when comparing Peyton's four steps to other stepwise approaches. Conclusions Very low certainty evidence suggest that Peyton's four-step approach was not more effective in resuscitation skills training compared to alternative approaches. Funding None.
Collapse
Affiliation(s)
- Jan Breckwoldt
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
| | - Adam Cheng
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
| | - Kasper G. Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
| | - Andrew Lockey
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Education Implementation Team Task Force of the International Liaison Committee on Resuscitation ILCOR1
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| |
Collapse
|
4
|
Bergmans E, Billington A, Thies KC. From tradition to innovation: a comparison of the traditional 4-step approach versus a blended learning modification for technical skills teaching. Scand J Trauma Resusc Emerg Med 2023; 31:80. [PMID: 37964361 PMCID: PMC10644658 DOI: 10.1186/s13049-023-01127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/08/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND This experimental study was performed to evaluate the role of blended learning for technical skill teaching on the European Trauma Course (ETC). While online modules are extensively used for theoretical teaching, their role in skills training remains less well explored. The ETC currently relies on the established 4-step technique for teaching technical skills. However, the required large cohort of skilled instructors and the time intensity prove increasingly challenging in a current climate of staff shortages and funding constraints. This study assesses if blended learning, combining pre-course online elements with face-to-face training matches the effectiveness of the traditional 4-step approach whilst being more time-efficient. METHODS In a randomised, multi-centre trial, the conventional face-to-face 4-step technique for teaching a skill of medium complexity, the application of a pelvic binder, was compared with an innovative blended approach. It was hypothesised that the blended approach was non-inferior for skill performance measured after the teaching session and after two days (skill retention) with the time needed for teaching and student/teacher satisfaction as secondary outcomes. RESULTS Ninety participants, divided into 44 traditional and 46 blended method students, were analysed. Independent-samples t-test showed no significant difference in performance scores and non-inferiority of the blended approach with a half of one standard deviation margin. A statistically significant difference in mean retention scores favored the blended approach. A Mann-Whitney U Test revealed no significant difference in candidate satisfaction levels but a statistically significant difference in instructors' satisfaction levels in favour of the blended approach. Analysis with Welch' t-test demonstrated that the face-to-face teaching time needed for the blended approach was significantly shorter (by 6 min). CONCLUSIONS The integration of a blended approach with the 4-step technique for teaching pelvic binder application in the ETC streamlined teaching without compromising skill acquisition quality. This innovative approach addresses traditional limitations and shows promise in adapting medical education to modern learning and teaching demands. We suggest that blended learning could also be applied for other skills taught on life support courses. TRIAL REGISTRATION University of Dundee (Schools of Medicine and Life sciences Research Ethics Committee, REC number 22/59, 28th June 2022).
Collapse
Affiliation(s)
- Elonka Bergmans
- Klinik für Anästhesiologie, Intensiv-, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld, Bethel, Burgstieg 13, 33617, Bielefeld, Germany.
- Centre for Medical Education, University of Dundee, Nethergate, Dundee, Scotland, UK.
| | - Alistair Billington
- European Trauma Course Organisation, PO Box 452, Market Drayton, TF9 9FB, UK
| | - Karl-Christian Thies
- Klinik für Anästhesiologie, Intensiv-, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld, Bethel, Burgstieg 13, 33617, Bielefeld, Germany
| |
Collapse
|
5
|
Chucherd O, Vallibhakara SAO, Paiwattananupant K, Puranitee P, Wattanayingcharoenchai R, Vallibhakara O. The effect of online video-assisted teaching program on medical students learning procedure of fractional curettage. BMC MEDICAL EDUCATION 2023; 23:82. [PMID: 36732732 PMCID: PMC9893180 DOI: 10.1186/s12909-023-04052-3] [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: 09/23/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Since 2020, with the entire world in crisis over the coronavirus pandemic (COVID-19), medical students have adapted to hybrid and distance learning. This study aims to compare the learning outcomes of students learning the procedure of fractional curettage in an online video-assisted teaching program to those of students learning the procedure in a traditional class. METHODS A quasi-experimental study was conducted among fourth-year medical students who rotated to Obstetrics and Gynecology courses between April 2021 and October 2021. Participants in the first two rotations were enrolled in traditional classes, and the online video-assisted teaching program was introduced in the subsequent two rotations. Both study groups took OSCEs (objective structured clinical examinations), a pre-test and post-test with MCQs (multiple choice questions), and a confidence and satisfaction level questionnaire. RESULTS A total of 106 fourth-year medical students, 54 in the traditional group and 52 in the online video-assisted teaching program, were recruited. The online video-assisted group showed a statistically better mean OSCE score (85.67 ± 11.29 vs. 73.87 ± 13.01, p < 0.001) and mean post-test MCQ score than the traditional group (4.21 ± 0.87 vs. 3.80 ± 0.98, p = 0.0232). Moreover, the mean difference between the two groups' pre and post-test MCQ scores was significantly different (0.96 ± 1.37 vs. 1.79 ± 1.50 in traditional and online video-assisted teaching program groups, respectively, P = 0.0038). The participants in the experimental group reported significantly greater confidence (P < 0.001) in performing the fractional curettage procedure. However, the mean satisfaction score was significantly higher in the control group (p = 0.0053). CONCLUSION The online video-assisted teaching program on the fractional curettage procedure, a necessary and skill-demanding procedure, is an effective and advantageous education tool that improves skills, knowledge, and confidence in fourth-year medical students. We recommend that the video-assisted teaching program is another effectively procedural teaching method for medical students.
Collapse
Affiliation(s)
- Oracha Chucherd
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Sakda Arj-Ong Vallibhakara
- Faculty of Medicine, BangkokThonburi University, Bangkok, 10170, Thailand
- Child Safety Promotion and Injury Prevention Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Krissada Paiwattananupant
- Department of Obstetrics and Gynaecology, Gynecologic Oncology Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Pongtong Puranitee
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Rujira Wattanayingcharoenchai
- Department of Obstetrics and Gynaecology, Female Pelvic Medicine and Reconstructive Surgery Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Orawin Vallibhakara
- Department of Obstetrics and Gynaecology, Reproductive Endocrinology and Infertility Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
| |
Collapse
|
6
|
Deconstructing forearm casting task by videos with step-by-step simulation teaching improved performance of medical students: is making working student's memory work better similar to a process of artificial intelligence or just an improvement of the prefrontal cortex homunculus? INTERNATIONAL ORTHOPAEDICS 2023; 47:467-477. [PMID: 36370162 DOI: 10.1007/s00264-022-05626-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To compare two teaching methods of a forearm cast in medical students through simulation, the traditional method (Trad) based on a continuous demonstration of the procedure and the task deconstruction method (Decon) with the procedure fragmenting into its constituent parts using videos. METHODS During simulation training of the below elbow casting technique, 64 medical students were randomized in two groups. Trad group demonstrated the entire procedure without pausing. Decon group received step-wise teaching with educational videos emphasizing key components of the procedure. Direct and video evaluations were performed immediately after training (day 0) and at six months. Performance in casting was assessed using a 25-item checklist, a seven item global rating scale (GRS Performance), and a one item GRS (GRS Final Product). RESULTS Fifty-two students (Trad n = 24; Decon n = 28) underwent both day zero and six month assessments. At day zero, the Decon group showed higher performance via video evaluation for OSATS (p = 0.035); GRS performance (p < 0.001); GRS final product (p < 0.001), and for GRS performance (p < 0.001) and GRS final product (p = 0.011) via direct evaluation. After six months, performance was decreased in both groups with ultimately no difference in performance between groups via both direct and video evaluation. Having done a rotation in orthopaedic surgery was the only independent factor associated to higher performance. CONCLUSIONS The modified video-based version simulation led to a higher performance than the traditional method immediately after the course and could be the preferred method for teaching complex skills.
Collapse
|
7
|
Learning Success and Influencing Factors in Out-of-Hospital Placement of Intravenous Catheters. Prehosp Disaster Med 2022; 37:788-793. [PMID: 36156192 DOI: 10.1017/s1049023x22001327] [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: 11/06/2022]
Abstract
INTRODUCTION Placing peripheral intravenous catheters ("IV lines") is a standard procedure for health care professionals in acute and emergency medicine. The study aimed to determine the learning curve and success rates in applying IV lines during a three-year paramedic training and the factors influencing successful placement. METHODS This was a prospective and noninterventional observational study to determine the influencing factors, learning outcomes, and performance in the placement of IV lines by trainees and experienced paramedics. Trial registration: German Clinical Trials Register, ID DRKS00024631. RESULTS From February 1, 2016 through December 31, 2021, a total of 3,547 peripheral venous accesses attempts were performed: 76.5% (n = 2,712) by trainees and 23.5% (n = 835) by experienced practitioners. The trainee group had one-to-three years of training and the experienced group had 11 (SD = 11) years of work experience after training (one-to-35 years). The learning or success curve in the successful placement of peripheral venous accesses was 85.2% in the first year of training, 88.5% in the second year of training, and 92.5% in the third year (and the end of training). It was then 94.3% in the fourth year (first year of being experienced). Successful insertion of peripheral venous accesses in the experienced group was up to 97.0%. The first-attempt success rate was 90.4% across the entire trainee group versus 95.9% in the experienced group (P <.0001).Significant factors influencing successful placement of IV lines were puncture site (P = .022), catheter size (OR = 0.600; P = .002), and number of attempts (OR = 0.370; P <.001). The time of day (or night) was not influential. Work experience, patient age, or blood pressure were also not significant.
Collapse
|
8
|
Eimer C, Duschek M, Jung AE, Zick G, Caliebe A, Lindner M, Weiler N, Elke G. Video-based, student tutor- versus faculty staff-led ultrasound course for medical students - a prospective randomized study. BMC MEDICAL EDUCATION 2020; 20:512. [PMID: 33327947 PMCID: PMC7741871 DOI: 10.1186/s12909-020-02431-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/07/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos. METHODS Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick's evaluation model with scale-rated closed and open questions. RESULTS 79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14-52% and 48-88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos. CONCLUSIONS A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation.
Collapse
Affiliation(s)
- Christine Eimer
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Max Duschek
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Andreas Emanuel Jung
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Günther Zick
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Christian-Albrechts-University Kiel, University Medical Center Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Matthias Lindner
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Norbert Weiler
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Gunnar Elke
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany.
| |
Collapse
|
9
|
Seifert LB, Schnurr B, Stefanescu MC, Sader R, Ruesseler M, Sterz J. Comparing video-based versions of Halsted's 'see one, do one' and Peyton's '4-step approach' for teaching surgical skills: a randomized controlled trial. BMC MEDICAL EDUCATION 2020; 20:194. [PMID: 32552805 PMCID: PMC7298758 DOI: 10.1186/s12909-020-02105-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton's '4-step Approach' and Halsted's 'See One, Do One' are compared. We hypothesized that the video-based '4-step Approach' would be more effective in learning procedural skills than the 'See One, Do One Approach'. METHODS One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq's tamponade with either Halsted's (n = 57) or Peyton's (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using structured checklists. An item-analysis was also carried out. RESULTS At T1, performance scores significantly differed in favor of the video-based '4-step Approach' (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton's method was significantly more effective in the complex subparts of both skills. CONCLUSIONS The modified video-based version of Peyton's '4-step Approach' is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton's method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.
Collapse
Affiliation(s)
- Lukas B Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Benedikt Schnurr
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Maria-Christina Stefanescu
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Miriam Ruesseler
- Department of Trauma, Reconstructive and Hand Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Jasmina Sterz
- Department of Trauma, Reconstructive and Hand Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| |
Collapse
|
10
|
Altersberger M, Pavelka P, Sachs A, Weber M, Wagner-Menghin M, Prosch H. Student Perceptions of Instructional Ultrasound Videos as Preparation for a Practical Assessment. Ultrasound Int Open 2019; 5:E81-E88. [PMID: 31720557 PMCID: PMC6837857 DOI: 10.1055/a-1024-4573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/04/2019] [Accepted: 10/06/2019] [Indexed: 01/03/2023] Open
Abstract
Background Learning ultrasound early in the medical school curriculum
helps students to understand anatomy and pathology and to perform defined
ultrasound standard views. Instructional videos are a potentially valuable
tool for improving the process of learning ultrasound skills. It was the aim
of the present study to investigate how students perceived instructional
videos as a learning aid, compared to other learning opportunities, in
preparation for an Objective Structured Clinical Examination (OSCE). Materials and Methods
Eleven concise ultrasound videos were created
and implemented in the 4
th
year at the Medical University of
Vienna. The videos illustrate the predefined examination process, image
optimization, and nine standardized ultrasound views. The videos were
available to be used in preparation for the practical ultrasound
examination, which was part of the objective structured clinical
examination. The students’ perceptions of the instructional videos
and other learning methods were surveyed using an online questionnaire.
Results In total, 445 of 640 students (69.5% of the cohort)
used the instructional videos. Of those students, 134 (30%) answered
the questionnaire. Of this group, 88.9% rated the instructional
videos as very helpful (49.6% as extremely helpful). An ANOVA
revealed a significant difference between various learning materials in
terms of helpfulness. Post hoc analysis showed that instructional videos
were perceived as the second most helpful learning material after
“self-execution and feedback.” Conclusion The study revealed that students use instructional videos
frequently and appreciate them as an extra tool for effective studying.
Collapse
Affiliation(s)
- Martin Altersberger
- University Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria.,Teaching Center, Medical University of Vienna, Vienna, Austria
| | - Philipp Pavelka
- Teaching Center, Medical University of Vienna, Vienna, Austria
| | - Alexander Sachs
- University Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Weber
- University Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Helmut Prosch
- University Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
11
|
Ruesseler M, Tomczak M, Thrun M, Pfau S, Marzi I, Sterz J. The Influence of the Instructional Approach on Acquiring Clinical Skills in Surgery: A Comparative Effectiveness Study. JOURNAL OF SURGICAL EDUCATION 2019; 76:140-149. [PMID: 30122637 DOI: 10.1016/j.jsurg.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/20/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The instructional approach used to teach skills and competencies seems to have a critical impact on retaining and performing the learned skills/competencies. However, for most of them, the effect of different instructional approaches as well as evidence for appropriate approaches is unknown. The aim of the present study was to analyze and compare the impact of different instructional approaches in the acquisition of basic skills during undergraduate surgical training. DESIGN Randomized controlled cohort study. For the intervention, four instructional approaches ('See one - Do one', 'Video 4-Step Approach', 'Mental Group Mapping', and 'Control') were compared in six basic skills. Students completed a six-station OSCE (one for each skill) during their skills lab training week after the intervention. SETTING This study was conducted at the medical faculty of the Goethe University, Frankfurt, Germany. PARTICIPANTS Medical students in their fourth year completing their four week of obligatory surgical training. RESULTS A total of 151 students were included. The group 'Mental Group Mapping' scored significantly higher in comparison to 'See one - Do one' in four of the six skills and 'Control' in five skills. The group 'Video 4-Step Approach' scored significantly higher in comparison to 'See one - Do one' (three skills) in comparison to 'Control' (two skills). There were no significant differences between the approaches 'Mental Group Mapping' and 'Video 4-Step Approach' as well as between the approaches 'See one - Do one' and 'Control'. CONCLUSION Activating instructional approaches such as the '4-Step Approach' and 'Mental Group Mapping' have a significant impact on performing the learned skills and competencies.
Collapse
Affiliation(s)
- Miriam Ruesseler
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Mairen Tomczak
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Monika Thrun
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Sebastian Pfau
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Ingo Marzi
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Jasmina Sterz
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| |
Collapse
|
12
|
Schröder H, Henke A, Stieger L, Beckers S, Biermann H, Rossaint R, Sopka S. Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study. PLoS One 2017; 12:e0178210. [PMID: 28542636 PMCID: PMC5439953 DOI: 10.1371/journal.pone.0178210] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/09/2017] [Indexed: 11/17/2022] Open
Abstract
Background Learning and training basic life support (BLS)—especially external chest compressions (ECC) within the BLS-algorithm—are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton’s four-step approach for BLS training. Methods A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb’s Learning Styles Inventory. Students’ BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. Results The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. Conclusions The findings of this work show that the four-step-approach for BLS training addresses all types of learners independent of their learning styles and does not lead to significant differences in the performance of CPR.
Collapse
Affiliation(s)
- Hanna Schröder
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany.,Aachen Interdisciplinary Training Centre for Medical Education, Medical Faculty RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany
| | - Alexandra Henke
- Department of Internal Medicine, Hermann-Josef-Hospital, Erkelenz, North Rhine-Westphalia, Germany
| | - Lina Stieger
- Aachen Interdisciplinary Training Centre for Medical Education, Medical Faculty RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany
| | - Stefan Beckers
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany.,Aachen Interdisciplinary Training Centre for Medical Education, Medical Faculty RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany
| | - Henning Biermann
- Department of Internal Medicine, Agaplesion Elisabethenstift, Darmstadt, Hesse, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany
| | - Saša Sopka
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany.,Aachen Interdisciplinary Training Centre for Medical Education, Medical Faculty RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany
| |
Collapse
|
13
|
Yang K, Perez M, Hubert N, Hossu G, Perrenot C, Hubert J. Effectiveness of an Integrated Video Recording and Replaying System in Robotic Surgical Training. Ann Surg 2017; 265:521-526. [DOI: 10.1097/sla.0000000000001699] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
14
|
Louise Hulse A. Structured learning in paediatric vascular access: effects on clinical practice. ACTA ACUST UNITED AC 2016; 25:S7-S15. [DOI: 10.12968/bjon.2016.25.14.s7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anna Louise Hulse
- Vascular Access Nurse Specialist, Alder Hey Children's NHS Foundation Trust, Liverpool
| |
Collapse
|
15
|
Milliez N. Comprendre la sémiologie psychiatrique par du matériel interactif. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Chacun retient mieux certains évènements historiques après les avoir vus au cinéma. Son fort pouvoir de mémorisation est lié au fait qu’il touche à la fois la vue, l’ouïe, mais aussi l’empathie et le vécu émotionnel. La psychiatrie a toujours utilisé la vidéo pour vulgariser des notions auprès du grand public ou pour enseigner aux étudiants : cassettes VHS, films grand public et maintenant youtube. La vidéo contextualise et donne accès à la dimension multi-sensorielle de la recherche sémiologique. Elle est utilisée pour introduire un cours, illustrer et expliquer des termes, et permettre une analyse critique. Filmer des entretiens permet aussi d’enseigner les bases de la relation médecin/patient et de développer l’empathie des étudiants. Les études ont prouvé que l’enseignement magistral avec vidéo a un apport positif dans l’apprentissage des étudiants – meilleurs résultats aux examens théoriques et pratiques [2–5]. Quel est donc l’apport actuel ? D’une part, la vidéo en accès libre sur un site internet touche une génération d’étudiants naturellement utilisatrice de ces nouvelles technologies . D’autre part, cet accès facilité au niveau national permet une uniformisation des données et de l’enseignement. L’usage de la vidéo en psychiatrie n’est pas sans problèmes éthiques : déontologiquement, il n’est pas possible de filmer des patients hospitalisés sous contrainte, dont le jugement est considéré comme altéré. Pour des fins d’enseignement, l’accès à de telles vidéos doit être protégé. Le site internet de l’AESP étant en accès libre pour un public d’étudiants en médecine, nous avons recours à des comédiens et cinéastes bénévoles. L’AESP a débuté deux projets :– créer des courts métrages illustrant la sémiologie en suivant des patients « comédiens » dans leur quotidien ;– illustrer par des séquences de quelques secondes les termes sémiologiques du dicosémiopsy de l’AESP, http://dicosemiopsy.asso-aesp.fr/.
Collapse
|
16
|
Mohamadirizi S, Fahami F, Bahadoran P, Ehsanpour S. The effect of four-phase teaching method on midwifery students' emotional intelligence in managing the childbirth. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2015; 4:47. [PMID: 26097861 PMCID: PMC4456870 DOI: 10.4103/2277-9531.157241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND An active teaching method has been used widely in medical education. The aim of this study was to determine the effectiveness of the four-phase teaching method on midwifery students' emotional intelligence (EQ) in managing the childbirth. MATERIALS AND METHODS This was an experimental study that performed in 2013 in Isfahan University of Medical Sciences. Thirty midwifery students were involved in this study and selected through a random sampling method. The EQ questionnaire (43Q) was completed by both the groups, before and after the education. The collected data were analyzed using SPSS 14, the independent t-test, and the paired t-test. The statistically significant level was considered to be <0.05. RESULTS The findings of the independent t-test did not show any significant difference between EQ scores of the experimental and the control group before the intervention, whereas a statistically significant difference was observed after the intervention between the scores of two groups (P = 0.009). The paired t-test showed a statistically significant difference in EQ scores in the two groups after the intervention in the four-phase and the control group, respectively, as P = 0.005 and P = 0.018. Furthermore, the rate of self-efficiency has increased in the experimental group and control group as 66% and 13% (P = 0.024), respectively. CONCLUSION The four-phase teaching method can increase the EQ levels of midwifery students. Therefore, the conduction of this educational model is recommended as an effective learning method.
Collapse
Affiliation(s)
- Soheila Mohamadirizi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Fahami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Bahadoran
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soheila Ehsanpour
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|