1
|
Edmunds KJ, Shah A, Geis GL, Kerrey BT, Klein G, DeBra R, Zhang Y, Ahaus K, Boyd S, Thomas P, Dean P. Rapid cycle deliberate practice to improve airway skills and performance of trainees in a pediatric emergency department. AEM EDUCATION AND TRAINING 2024; 8:AET210928. [PMID: 38235393 PMCID: PMC10790190 DOI: 10.1002/aet2.10928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 01/19/2024]
Abstract
Objective The study objective was to determine the effect of a rapid cycle deliberate practice (RCDP) program on simulated and actual airway skills by pediatric emergency medicine (PEM) fellows. Methods We designed and implemented a 12-month RCDP airway skills curriculum for PEM fellows at an academic pediatric institution. The curriculum was designed using airway training literature, RCDP principals, and internal quality assurance airway video review program. Simulation training scenarios increased in complexity throughout the curriculum. PEM fellows participated in monthly sessions. Two PEM faculty facilitated the sessions, utilizing a step-by-step objective structured clinical evaluation (OSCE)-style tool for each scenario. Data were collected for all four levels of the Kirkpatrick Model of Training Evaluation-participant response (reaction, pre-post session survey), skills performance in the simulation setting (learning, pre-post OSCE), skills performance for actual patients (behavior, video review), and patient outcomes (results, video review). Results During the study period (August 2021 to June 2022), 13 PEM fellows participated in 112 sessions (mean nine sessions per fellow). PEM fellows reported improved comfort in all domains of airway management, including intubation performance. Participant OSCE scores improved posttraining (pretraining median score for trainees 57 [IQR 57-59], posttraining median 61 [IQR 61-62], p = 0.0005). Over the 12 months, PEM fellows performed 45 intubation attempts in the pediatric emergency department (median patient age 4 years [IQR 1-9 years]). Compared to a 5-year historical cohort, participants had higher first-pass success (87% vs. 71%, p = 0.028) and shorter attempt duration (22 s vs. 29 s, p = 0.018). There was no significant difference in the frequency of oxyhemoglobin desaturation in the training period versus the historical period (7% vs. 15%, p = 0.231). Conclusions At multiple levels of educational outcomes, including participant behavior and patient outcomes, an RCDP program was associated with improved airway skills and performance of PEM fellows.
Collapse
Affiliation(s)
- Katherine J. Edmunds
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
| | - Ashish Shah
- Division of Emergency Medicine, Rady Children's HospitalUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Gary L. Geis
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
- The Center for Simulation and ResearchCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Benjamin T. Kerrey
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
| | - Gina Klein
- The Center for Simulation and ResearchCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Rebecca DeBra
- The Center for Simulation and ResearchCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Yin Zhang
- Division of Biostatistics and EpidemiologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Karen Ahaus
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Stephanie Boyd
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Phillip Thomas
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Preston Dean
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiOhioUSA
| |
Collapse
|
2
|
Arno K, Bradby C, Shappell E, Mannix A, Fix M, Jordan J, Cooney R, Krzyzaniak SM, Gottlieb M. Differences in emergency medicine resident procedural reporting by race and ethnicity. AEM EDUCATION AND TRAINING 2024; 8:e10930. [PMID: 38235392 PMCID: PMC10790187 DOI: 10.1002/aet2.10930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/10/2023] [Accepted: 10/22/2023] [Indexed: 01/19/2024]
Abstract
Background The recruitment, retention, and training of physicians from groups underrepresented in medicine (UiM) is critically important to the practice of emergency medicine (EM). Studies across specialties have demonstrated disparities in operative experiences among UiM resident learners who are UiM; however, there are limited data on procedural disparities in EM. Objective We sought to quantify the association between racial and ethnic identities that are UiM and the number of procedures reported among EM residents. Methods We conducted a retrospective review of procedural differences by UiM status (using self-identified race and ethnicity) among graduating EM residents at nine training programs over a 10-year period. Sites were selected to ensure diversity of program length, program type, and geography. Data from residents in combined training programs, those who did not complete their full training at that institution, and those with missing data or electing not to report race/ethnicity were excluded. We calculated median and interquartile ranges for each procedure by UiM status. We conducted multivariable regression analyses accounting for UiM status, gender, and site as well as a sensitivity analysis excluding values >3 standard deviations from the mean for each procedure. Results We collected data from 988 total residents, with 718 (73%) being non-UiM, 204 (21%) being UiM, 48 (5%) electing not to specific race/ethnicity, and 18 (2%) missing race/ethnicity data. While unadjusted data demonstrated a difference between UiM and non-UiM resident numbers across several procedures, there were no significant differences in procedures reported after accounting for gender and site in the primary or sensitivity analyses. Conclusions We did not identify a statistically significant difference in reported procedures between UiM and non-UiM residents in EM. Future work should include qualitative investigations of UiM resident experience surrounding procedures as well as mixed-methods studies to examine how these data interact.
Collapse
Affiliation(s)
- Kimbia Arno
- Department of Emergency MedicineMaimonides Medical CenterBrooklynNew YorkUSA
| | - Cassandra Bradby
- Department of Emergency MedicineThe Brody School of Medicine at East Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Eric Shappell
- Department of Emergency MedicineMassachusetts General Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Alexandra Mannix
- Department of Emergency MedicineUniversity of Florida College of Medicine–JacksonvilleJacksonvilleFloridaUSA
| | - Megan Fix
- Department of Emergency MedicineUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Jaime Jordan
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Robert Cooney
- Emergency MedicineGeisinger Medical CenterDanvillePennsylvaniaUSA
| | - Sara M. Krzyzaniak
- Department of Emergency MedicineStanford UniversityPalo AltoCaliforniaUSA
| | - Michael Gottlieb
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
| |
Collapse
|
3
|
de Oliveira HC, Campos JF, de Souza LC, de Bakker GB, Ferreira LLB, da Silva RN, Dos Santos Pires PR, Brandão MAG. Theoretical, Conceptual, and Operational Aspects in Simulation Training With Rapid Cycle Deliberate Practice: An Integrative Review. Simul Healthc 2023:01266021-990000000-00083. [PMID: 37747465 DOI: 10.1097/sih.0000000000000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
SUMMARY STATEMENT An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training.
Collapse
Affiliation(s)
- Hudson Carmo de Oliveira
- Escola de Enfermagem Anna Nery-Universidade Federal do Rio de Janeiro (H.C.O., J.F.C., G.B.B., L.L.B.F., P.R.S.P., M.A.G.B.); Samaritano Hospital (L.C.S.); Municipal Health Department of Rio de Janeiro (R.N.S.), Rio de Janeiro, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Zhang C. A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4487. [PMID: 36901496 PMCID: PMC10002261 DOI: 10.3390/ijerph20054487] [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: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.
Collapse
Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Sunlight South Road 1, Beijing 102488, China
| |
Collapse
|
5
|
Ng C, Primiani N, Orchanian-Cheff A. Rapid Cycle Deliberate Practice in Healthcare Simulation: a Scoping Review. MEDICAL SCIENCE EDUCATOR 2021; 31:2105-2120. [PMID: 34950533 PMCID: PMC8651942 DOI: 10.1007/s40670-021-01446-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
Rapid cycle deliberate practice (RCDP) is a type of simulation-based medical education (SBME) where learners cycle between deliberate practice and directed feedback until skill mastery is achieved before progressing to subsequent learning objectives. This scoping review examines and summarizes the literature on RCDP, compares RCDP to other modes of instruction, and identifies knowledge gaps for future research. Of the 1224 articles identified, 23 studies met inclusion criteria. The studies varied in design, RCDP technique implementation strategies, and outcome measures. RCDP is associated with positive outcomes in immediate learner performance. It is unclear if RCDP is superior to traditional simulation.
Collapse
Affiliation(s)
- Carly Ng
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada
| | - Nadia Primiani
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada
| | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, ON Canada
| |
Collapse
|
6
|
Burns B, Bailey J, Hartenstein M, Sullivan D, Burns E, Lin A, Chan D, Plainkum P, Techapaitoon S, Pandee U, Ma OJ. A novel program to enhance pediatric emergency medicine training in Thailand. AEM EDUCATION AND TRAINING 2021; 5:e10596. [PMID: 34124528 PMCID: PMC8171775 DOI: 10.1002/aet2.10596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In Thailand, there are few pediatric emergency medicine (PEM) fellowship-trained providers, and emergency departments (EDs) are staffed by pediatricians and emergency physicians. Our pediatric ED collaborated with Thailand's largest private hospital system to develop a training program designed to improve emergency care for children. OBJECTIVE The objective was to develop, implement, and assess the efficacy of a curriculum to improve PEM care by emergency providers in a Thai health system. METHODS We conducted a prospective study from January 2018 to July 2019. After an initial needs assessment, we developed a curriculum with 22 modules, divided into basic and advanced courses. Each course began with baseline testing, consisting of written tests and several simulated cases led by physician-nurse teams. Each course was administered longitudinally through electronic modules over 6 months, with in-person shadowing and skills workshops at the course midpoint, culminating in final summative examinations and repeat simulation testing. RESULTS On written examination scores for the basic course, physicians (n = 5) improved by 37.6% (95% confidence interval [CI] = 29.8% to 45.4%, p < 0.001), while nurses (n = 5) improved by 55.7% (95% CI = 45.8% to 65.6%, p < 0.001). For simulation testing among physician-nurse dyads, performance improved by 19.5% (95% CI = 3.9% to 35.1%, p = 0.004) for critical action items and by 3.0 points (95% CI = 2.3 to 3.7, p < 0.001) on a 16-point teamwork scale. For the advanced course, physicians improved on the written examination by 36.9% (95% CI = 29.2% to 44.7%, p < 0.001) and nurses by 50.6 (95% CI = 47.3% to 54.0%, p < 0.001). For simulation testing, performance improved from 22.2% (95% CI = 8.2% to 35.6%, p < 0.001) for critical actions and 1.3 points (95% CI = 0.2 to 2.2, p = 0.005) on teamwork measures. CONCLUSIONS We designed an interdisciplinary curriculum and successfully trained Thai physicians and nurses to improve PEM knowledge and teamwork.
Collapse
Affiliation(s)
- Beech Burns
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Jessica Bailey
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Melinda Hartenstein
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Danielle Sullivan
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Erin Burns
- Department of PediatricsOregon Health and Science UniversityPortlandOregonUSA
| | - Amber Lin
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Daniela Chan
- Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| | - Parit Plainkum
- Department of Emergency MedicineSamitivej Children’s HospitalBangkokThailand
| | | | - Uthen Pandee
- Department of Emergency MedicineSamitivej Children’s HospitalBangkokThailand
| | - O. John Ma
- Formerly affiliated with the Department of Emergency MedicineOregon Health and Science UniversityPortlandOregonUSA
| |
Collapse
|
7
|
Juckett LA, Bunger AC, Jarrott SE, Dabelko-Schoeny HI, Krok-Schoen J, Poling RM, Mion LC, Tucker S. Determinants of Fall Prevention Guideline Implementation in the Home- and Community-Based Service Setting. THE GERONTOLOGIST 2020; 61:942-953. [DOI: 10.1093/geront/gnaa133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Objectives
Home- and community-based service (HCBS) recipients often possess multiple fall risk factors, suggesting that the implementation of evidence-based fall prevention guidelines may be appropriate for the HCBS setting. The purpose of this exploratory study was to examine the determinants of fall prevention guideline implementation and the potential strategies that can support implementation in HCBS organizations.
Research Design and Methods
Semistructured interview and focus group data were collected from 26 HCBS professionals representing the home-delivered meals, personal care, and wellness programs. Qualitative codes were mapped to the Consolidated Framework for Implementation Research by means of directed content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings of this study.
Results
We identified 7 major determinants of guideline implementation: recipient needs and resources, cosmopolitanism, external policy and incentives, networks and communication, compatibility, available resources, and knowledge/beliefs. Strategies to support guideline implementation included the involvement of recipient and caregiver feedback, building fall prevention networks, and conducting educational meetings for HCBS staff.
Discussion and Implications
Falls and fall-related injuries will continue to plague the older adult community unless innovative approaches to fall prevention are developed and adopted. The implementation of fall prevention guidelines in the HCBS setting can help mitigate fall risk among a highly vulnerable older adult population and may be facilitated through the application of multifaceted implementation strategies.
Collapse
Affiliation(s)
- Lisa A Juckett
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | | | | | | | - Jessica Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Rachael M Poling
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | | | - Sharon Tucker
- College of Nursing, The Ohio State University, Columbus
| |
Collapse
|
8
|
Holzemer NF, Pomeranz ES, Tomlinson S. Improving the Pediatric Emergency Department Learning Experience: A Simulation-Based Orientation for Pediatric PGY 1 Residents. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:10919. [PMID: 32656335 PMCID: PMC7331952 DOI: 10.15766/mep_2374-8265.10919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 12/15/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Rotations in the pediatric emergency department (PED) may expose residents to very few critically ill patients. In our previous work, interns at our institution showed low self-confidence in decision-making and preparedness to stabilize acutely ill patients. In order to improve this, we designed a new, peer-led, simulation-based orientation to the PED rotation for interns focusing on workflow and decision-making. The cases presented learners with practical and generalizable challenges, such as ordering initial labs and medications and defining the ultimate disposition for the patient. METHODS This orientation curriculum was designed for first-year residents using high-fidelity simulation mannequins. In the first of two cases, learners managed a 10-year-old boy presenting with status asthmaticus who required continuous albuterol and parenteral magnesium to achieve stability for admission. In the second case, a 4-year-old girl with short gut syndrome and an indwelling central line presented with fever, was found to be septic, but responded well to fluid resuscitation and antibiotic therapy. RESULTS Over 2 years of implementation, 39 residents participated. Pre- and postintervention Likert-based survey evaluations showed significant increases in confidence in decision-making and preparedness to stabilize acutely ill children that were not seen in a control group during the pilot year. A subsequent class-wide implementation showed similar significant improvements, as well as increased comfort initiating treatment prior to staffing. DISCUSSION Using simulation mannequins in a case-based orientation can improve PGY 1 residents' self-confidence and sense of preparedness during their first rotation in the PED.
Collapse
Affiliation(s)
| | - Elaine S. Pomeranz
- Associate Professor, Department of Emergency Medicine, Michigan Medicine; Associate Professor, Department of Pediatrics, Michigan Medicine
| | - Sarah Tomlinson
- Assistant Professor, Department of Emergency Medicine, Michigan Medicine; Assistant Professor, Department of Pediatrics, Michigan Medicine
| |
Collapse
|
9
|
Yan DH, Slidell MB, McQueen A. Using rapid cycle deliberate practice to improve primary and secondary survey in pediatric trauma. BMC MEDICAL EDUCATION 2020; 20:131. [PMID: 32345288 PMCID: PMC7189590 DOI: 10.1186/s12909-020-02038-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Optimal performance of the primary and secondary survey is the foundation of Advance Trauma Life Support care. Despite its importance, not all primary surveys completed at level 1 pediatric trauma centers are performed according to established guidelines (Gala et al., Pediatr Emerg Care 32:756-762, 2016, Carter et al., Resuscitation 84:66-71, 2013). We hypothesize that rapid cycle deliberate practice (RCDP) will improve surgical residents' confidence in performing the primary and secondary survey. METHODS We developed a curriculum to teach surgical interns the principles of performing the primary and secondary survey using RCDP. Surveys distributed after each session assessed the impact of the curriculum on learner confidence and perception that this curriculum would benefit patient care. Questions were scored on a 5-point Likert scale. Sixteen surgical interns participated during intern orientation and 100% of the participants completed the post curriculum survey. RESULTS Thirteen (81%) of participants agreed or strongly agreed that the simulation would impact future performance in the pediatric trauma bay. The curriculum also significantly improved the confidence of our learners to perform trauma surveys (p < 0.001). CONCLUSION This curriculum improves the confidence of junior surgical residents in learning the primary and secondary survey. Most learners enjoyed the session and felt that the curriculum would positively impact their performance.
Collapse
Affiliation(s)
- Diana Hou Yan
- Department of Pediatrics, Section of Emergency Medicine, University of Chicago Medicine, 5841 S Maryland Ave, Mailcode 0810, Chicago, IL 60637 USA
| | - Mark B Slidell
- Department of Surgery, University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL USA
| | - Alisa McQueen
- Department of Pediatrics, Section of Emergency Medicine, University of Chicago Medicine, 5841 S Maryland Ave, Mailcode 0810, Chicago, IL 60637 USA
| |
Collapse
|
10
|
Friedrich C, Teaford H, Taubenheim A, Sick B. Interprofessional Health Care Escape Room for Advanced Learners. J Nurs Educ 2020; 59:46-50. [DOI: 10.3928/01484834-20191223-11] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/23/2019] [Indexed: 11/20/2022]
|