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Alberti S, Guasconi M, Bolzoni M, Donnini G, Volpi P, Rovesti S, Monaco F, Bonacaro A, Ferri P. Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale. BMC Nurs 2024; 23:300. [PMID: 38689264 PMCID: PMC11061976 DOI: 10.1186/s12912-024-01974-1] [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: 10/09/2023] [Accepted: 04/24/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students' satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale. METHODS A multi-centre cross-sectional study was conducted. The scale was administered to a sample of 266 undergraduate nursing students from two Italian universities after attending a medium- and high-fidelity simulation session in November 2022 and March 2023. Cronbach's alpha coefficient and item-total correlation were sorted out to assess internal consistency and reliability. The test-retest method was used as a measure of scale stability over time as well as the confirmatory factor analysis to verify construct validity. RESULTS The Cronbach's alpha value was 0.94 for the overall scale, indicating excellent reliability, and it was 0.84 or higher for each subscales, indicating good reliability. A large correlation coefficient of 0.60 or higher was found between each item and its subscale and between each item and the overall scale score. A medium test-retest correlation coefficient was found for most items (r > 0.30). The confirmatory factor analysis confirmed the factorial structure found in the original study. CONCLUSIONS Satisfaction is an important teaching and learning quality indicator along with the achievement of learning outcomes in simulation. The Satisfaction with Simulation Experience - Italian Version scale showed good reliability and validity; therefore, it could be a useful tool to assess simulation impact in Italian nursing students. The extensive utilization of the Satisfaction with Simulation Experience scale, along with its various validated versions, could facilitate assessing satisfaction in simulation across diverse contexts and enable comparisons of findings across studies in different countries.
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Affiliation(s)
- Sara Alberti
- Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, str. Giuseppe Campi n° 287, Modena, 41125, Italy.
| | - Massimo Guasconi
- Department of Medicine and Surgery, University of Parma, via Gramsci n° 14, Parma, 43126, Italy
- Azienda USL of Piacenza, via Taverna 49, Piacenza, 29121, Italy
| | - Marina Bolzoni
- Azienda USL of Piacenza, via Taverna 49, Piacenza, 29121, Italy
| | - Giulia Donnini
- University Hospital Polyclinic of Modena, via del Pozzo 71, Modena, 41124, Italy
| | - Paola Volpi
- University Hospital Polyclinic of Modena, via del Pozzo 71, Modena, 41124, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, str. Giuseppe Campi n° 287, Modena, 41125, Italy
| | - Federico Monaco
- Department of Medicine and Surgery, University of Parma, via Gramsci n° 14, Parma, 43126, Italy
| | - Antonio Bonacaro
- Department of Medicine and Surgery, University of Parma, via Gramsci n° 14, Parma, 43126, Italy
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, str. Giuseppe Campi n° 287, Modena, 41125, Italy
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Stirparo G, Di Fronzo P, Solla D, Bottignole D, Gambolò L. Are Italian Newly Licensed Nurses Ready? A Study on Self-Perceived Clinical Autonomy in Critical Care Scenarios. Healthcare (Basel) 2024; 12:809. [PMID: 38667571 PMCID: PMC11050123 DOI: 10.3390/healthcare12080809] [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: 02/28/2024] [Revised: 04/06/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
The experience and self-confidence of healthcare professionals play critical roles in reducing anxiety levels during emergencies. It is important to recognize the potential impact of anxiety on performance. To enhance preparedness and confidence in managing emergencies, healthcare professionals benefit from regular training and simulations. Additionally, repeated exposure to emergency scenarios can help modulate physiological responses. Managing anxiety effectively is key, as heightened sympathetic stimulation associated with anxiety can adversely affect performance. This study aimed to investigate nurses' self-assessed ability to manage emergency guidelines and their self-confidence in performing tasks in critical care settings. A questionnaire was provided to 1097 nurses. We compared the self-confidence of experienced nurses (ENs) and newly licensed nurses (NLNs) in managing emergency department shifts or critical patients, and found that ENs are more confident in these scenarios. This phenomenon was also observed in subjects who had taken simulation courses, although they were still a low percentage. Most NLNs feel sufficiently ready to work in medium-intensity wards. Attending advanced training courses enhances nurses' self-confidence and may improve patient safety management., improving patient recovery, and minimizing errors. Attending courses improves the perception of autonomy of nurses in different scenarios.
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Affiliation(s)
| | | | | | | | - Luca Gambolò
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), 43125 Parma, Italy; (G.S.); (P.D.F.); (D.S.); (D.B.)
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Coelho DL, Amaral RC, Silva IC, Oliveira AVOB, Neto AS, Silva JFP, Joviano-Santos JV. Realistic simulation and medical students' performance in the Advanced Cardiac Life Support course: a comparative study. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:61-68. [PMID: 37994405 DOI: 10.1152/advan.00113.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Clinical practice has benefited from new methodologies such as realistic simulation (RS). RS involves recreating lifelike scenarios to more accurately reflect real clinical practice, enhancing learners' skills and decision-making within controlled environments, and experiencing remarkable growth in medical education. However, RS requires substantial financial investments and infrastructure. Hence, it is essential to determine the effectiveness of RS in the development of skills among medical students, which will improve the allocation of resources while optimizing learning. This cross-sectional study was carried out in the simulation laboratory of a medical school, and the performance of students who underwent two different curriculum matrices (without RS and with RS, from 2021 to 2022) in the Advanced Cardiac Life Support (ACLS) course was compared. This test was chosen considering that the competencies involved in cardiac life support are essential, regardless of the medical specialty, and that ACLS is a set of life-saving protocols used worldwide. We observed that the impact of RS can be different for practical abilities when compared with the theoretical ones. There was no correlation between the general academic performance and students' grades reflecting the RS impact. We conclude that RS leads to less remediation and increased competence in practical skills. RS is an important learning strategy that allows repeating, reviewing, and discussing clinical practices without exposing the patient to risks.NEW & NOTEWORTHY Realistic simulation (RS) positively affected the performance of the students differently; it had more influence on practical abilities than theoretical knowledge. No correlation between the general academic performance and grades of the students without RS or with RS was found, providing evidence that RS is an important tool in Advanced Cardiac Life Support education.
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Affiliation(s)
- Débora L Coelho
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosana C Amaral
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabella C Silva
- Student of the Course in Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Virgínia O B Oliveira
- Student of the Course in Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Augusto Scalabrini Neto
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Felippe P Silva
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Julliane V Joviano-Santos
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Investigações NeuroCardíacas, Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Stirparo G, Gambolò L, Bellini L, Sarli L, Signorelli C, Ristagno G. The impact of ACLS training in theoretical knowledge. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023226. [PMID: 38054681 PMCID: PMC10734239 DOI: 10.23750/abm.v94i6.14905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/09/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND AND AIM Italy has a public health system where also young physicians hold various jobs, including Emergency Services. Advanced Cardiovascular Life Support (ACLS) course is developed for the management of cardiovascular emergencies. This study evaluates the preparation of Italian physicians on ACLS and their perceived need to be trained on it. METHODS surveys had been administered to 4698 Medical Doctors. They consisted of questions on sociodemographic characteristics, knowledge of ACLS protocol, and willingness to attend an ACLS course. RESULTS Online survey reached 4698 physicians, 137 of them had been excluded for invalid answering. People who had attended an ACLS course scored significantly higher on the test (M=5.68 SD=1.89) than those who had not (M=4.71 SD=1.91). Experienced physicians scored significantly higher (M=5.25 SD=1.96) than recently licensed ones (M=4.84 SD=1.94). Multiple regression was used to predict the ACLS test score. CONCLUSIONS ACLS training has a stronger effect on Cardiovascular Emergency management knowledge (d=-.510) than general working experience (d=-.212). The median score in ACLS knowledge is low (5/10), despite its importance. Multiple linear regression reveals that ACLS has the greatest impact on the score. A small portion of doctors have attended an ACLS course (22%), but the majority of them would participate (89%).
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Affiliation(s)
| | - Luca Gambolò
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy).
| | - Lorenzo Bellini
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Milan, (Italy)..
| | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, (Italy).
| | - Carlo Signorelli
- Faculty of Medicine, School of Public Health,University of Vita-Salute San Raffaele, Milan (IT).
| | - Giuseppe Ristagno
- Department of Anesthesiology, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (IT); Department of Pathophysiology and Transplantation, University of Milan, Italy.
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Silvestri I, Merigo G, Bonetti C, Guerra MB, Pignatelli S, Stirparo G, Ristagno G. Concomitant hypokalemia and hypocalcemia: a very rare but life-threating combination of reversible causes of cardiac arrest - an unusual first manifestation of coeliac disease. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023264. [PMID: 38054675 PMCID: PMC10734231 DOI: 10.23750/abm.v94i6.15014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023]
Abstract
The causes of cardiac arrest are extremely heterogeneous. Among these, both hypokalemia and hypocalcemia are known reversible factors that can lead to cardiac arrest. In this report, we present a unique case report of a patient with previously undiagnosed coeliac disease who experienced cardiac arrest due a combination of hypokalemia and hypocalcemia resulting from malabsorption. A 66-year-old male presented to the emergency department with symptoms of malaise, weakness, weight loss, and persistent diarrhea. The patient exhibited characteristic signs of hypokalemia and hypocalcemia, including fasciculations, weakness, and swelling. An electrocardiogram showed a normal rhythm, and blood tests confirmed the electrolyte imbalances. Despite initial treatment, the patient experienced sudden cardiac arrest. Prompt resuscitation efforts were successful in restoring spontaneous circulation. However, recurrent episodes of ventricular arrhythmias and cardiac arrest occurred. Large doses of intravenous potassium chloride, in conjunction with magnesium, were needed prior to restore electrolyte balance. The concomitant severe hypocalcemia required caution calcium supplementation, to avoid further decreases in serum potassium levels. Appropriate ion replacements ultimately led to successful resuscitation with good functional recovery. During the hospital stay, the patient was diagnosed with coeliac disease. This case is noteworthy for its uniqueness, as there are no documented instances in the scientific literature linking cardiac arrest directly to coeliac disease. It is important to emphasize the need for investigating potential reversible causes of cardiac arrest, such as hypokalemia and hypocalcemia, and implementing appropriate interventions to address these factors.
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Bellini L, Fagoni N, Andreassi A, Sechi GM, Bonora R, Stirparo G. Effectiveness of Cardiopulmonary Resuscitation at the Workplace. LA MEDICINA DEL LAVORO 2023; 114:e2023010. [PMID: 37309884 PMCID: PMC10281073 DOI: 10.23749/mdl.v114i3.13995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/04/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Out-of-Hospital Cardiac Arrest (OHCA) is a medical emergency whose chances of survival can be increased by rapid Cardiopulmonary Resuscitation (CPR) and early use of Public Access Defibrillators (PAD). Basic Life Support (BLS) training became mandatory in Italy to spread knowledge of resuscitation maneuvers in the workplace. Basic Life Support (BLS) training became mandatory according to the DL 81/2008 law. To improve the level of cardioprotection in the workplace, the national law DL 116/2021 increased the number of places required to be provided with PADs. The study highlights the possibility of a Return to spontaneous circulation in OHCA in the workplace. METHODS A multivariate logistic regression model was fitted to the data to extrapolate associations between ROSC and the dependent variables. The associations' robustness was evaluated through sensitivity analysis. RESULTS The chance to receive CPR (OR 2.3; 95% CI:1.8-2.9), PAD (OR 7.2; 95% CI:4.9 - 10.7), and achieve Return to spontaneous circulation (ROSC) (crude OR 2.2; 95% CI:1.7-3.0, adjusted OR 1.6; 95% CI:1.2-2.2) is higher in the workplace compared to all other places. CONCLUSION The workplace could be considered cardioprotective, although further research is necessary to understand the causes of missed CPRs and identify the best places to increase BLS and defibrillation training to help policymakers implement correct programming on the activation of PAD projects.
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Affiliation(s)
- Lorenzo Bellini
- School of Public Health - University of Vita-Salute San Raffaele, Milano, Italy.
| | - Nazzareno Fagoni
- Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia.
| | | | | | | | - Giuseppe Stirparo
- School of Medicine, University Vita-Salute San Raffaele, Milan - Italy.
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Stirparo G, Solla D, Gambolò L, Bellini L, Mantovanelli L, Trapani M, Pregliasco FE, Sarli L, Signorelli C. SIMED-New Doc course, a matter of reflection. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023035. [PMID: 36786254 PMCID: PMC9987498 DOI: 10.23750/abm.v94i1.13959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND AIM Obtaining a degree in medicine in Italy qualifies for the medical profession; this fact has entailed a newly qualified doctor's remarkable involvement on the medical activities of the National Health Service, especially during the Covid-19 pandemic. It is important to understand the knowledge of the newly qualified doctors and to create specific courses oriented to them. The aim of the study is to evaluate the impact of a peer learning course for the students who attend the last year of medicine school, with the purpose of defining the formal requests to integrate on the course. METHODS A pre and post qualitative research has been carried out on SIMED-NEWDOC course. The course consisted on peer teaching lectures, as lecturers were resident doctors part of SIMED board. At the end of the course it has been submitted a survey to the participants, and data has been analyzed. RESULTS The students enrolled were 139, the average of the participants was 27% of the registered. A qualitative evaluation questionnaire was submitted, the responses were 32 (86%). Average age was 25. Participants attending the last year of medicine school were 30 (95%). 40% of them declared to have attended at least 5 lessons. Among the course participants, 96% judged the course as very useful. CONCLUSIONS All questionnaire results are useful to reflect on future projects. It is necessary to implement further educational projects to better understand the phenomenon, considering the positive impact that participants declared.
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Affiliation(s)
- Giuseppe Stirparo
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Milan, (Italy)..
| | - Daniele Solla
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Milan, (Italy)..
| | - Luca Gambolò
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); University of Parma, Parma, (Italy)..
| | - Lorenzo Bellini
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Milan, (Italy)..
| | - Luca Mantovanelli
- SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma (Italy); University of Parma, Parma, (Italy)..
| | - Martino Trapani
- ASST Rhodense, Public Health Division, Garbagnate Hospital, Milan, (Italy)..
| | | | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, (Italy)..
| | - Carlo Signorelli
- School of Medicine, University Vita-Salute San Raffaele, Milan, (Italy)..
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Bushuven S, Bansbach J, Bentele M, Bentele S, Gerber B, Reinoso-Schiller N, Scheithauer S. Indications for hand and glove disinfection in Advanced Cardiovascular Life Support: A manikin simulation study. Front Med (Lausanne) 2023; 9:1025449. [PMID: 36687411 PMCID: PMC9853186 DOI: 10.3389/fmed.2022.1025449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/05/2022] [Indexed: 01/09/2023] Open
Abstract
Background and aim There are no investigations on hand hygiene during cardiopulmonary resuscitation (CPR), even though these patients are at high risk for healthcare-associated infections. We aimed to evaluate the number of indicated hand hygiene per CPR case in general and the fraction that could be accomplished without delay for other life-saving techniques through standardized observations. Materials and methods In 2022, we conducted Advanced Cardiovascular Life Support (ACLS) courses over 4 days, practicing 33 ACLS case vignettes with standard measurements of chest compression fractions and hand hygiene indications. A total of nine healthcare workers (six nurses and three physicians) participated. Results A total of 33 training scenarios resulted in 613 indications for hand disinfection. Of these, 150 (24%) occurred before patient contact and 310 (51%) before aseptic activities. In 282 out of 310 (91%) indications, which have the highest impact on patient safety, the medication administrator was responsible; in 28 out of 310 (9%) indications, the airway manager was responsible. Depending on the scenario and assuming 15 s to be sufficient for alcoholic disinfection, 56-100% (mean 84.1%, SD ± 13.1%) of all indications could have been accomplished without delaying patient resuscitation. Percentages were lower for 30-s of exposure time. Conclusion To the best of our knowledge, this is the first study investigating the feasibility of hand hygiene in a manikin CPR study. Even if the feasibility is overestimated due to the study setup, the fundamental conclusion is that a relevant part of the WHO indications for hand disinfection can be implemented without compromising quality in acute care, thus increasing the overall quality of patient care.
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Affiliation(s)
- Stefan Bushuven
- Institute for Infection Control and Infection Prevention, Hegau-Jugendwerk Gailingen, Health Care Association District of Constance, Gailingen, Germany,Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany,Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Freiburg, Germany,*Correspondence: Stefan Bushuven ✉
| | - Joachim Bansbach
- Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Bentele
- Institute for Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau Bodensee Hospital, Singen, Germany,Training Center for Emergency Medicine (NOTIS e.V), Engen, Germany
| | - Stefanie Bentele
- Institute for Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau Bodensee Hospital, Singen, Germany,Training Center for Emergency Medicine (NOTIS e.V), Engen, Germany,Department of Emergency Medicine, University-Hospital Augsburg, University of Augsburg, Augsburg, Germany
| | - Bianka Gerber
- Institute for Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau Bodensee Hospital, Singen, Germany
| | - Nicolas Reinoso-Schiller
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany
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