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Benhamou D, Tant S, Gille B, Bornemann Y, Ruscio L, Kamel K, Dunyach C, Jeannin B, Bouilliant-Linet M, Blanié A. An observer tool to enhance learning of incoming anesthesia residents' skills during simulation training of central venous catheter insertion: a randomized controlled trial. BMC Med Educ 2023; 23:942. [PMID: 38082446 PMCID: PMC10714635 DOI: 10.1186/s12909-023-04915-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined. METHODS Incoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook. RESULTS Immediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups. Analysis of the logbook showed no difference between groups. No serious complications were reported. CONCLUSIONS The use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.
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Affiliation(s)
- Dan Benhamou
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
- CIAMS, Univ. Paris-Saclay, Université Paris-Saclay, Orsay Cedex, 91405, France
- CIAMS, Université d'Orléans, Orléans, 45067, France
| | - Sarah Tant
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Benoit Gille
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Yannis Bornemann
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Laura Ruscio
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Karl Kamel
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Chloé Dunyach
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Bénédicte Jeannin
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Maxime Bouilliant-Linet
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Antonia Blanié
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France.
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France.
- CIAMS, Univ. Paris-Saclay, Université Paris-Saclay, Orsay Cedex, 91405, France.
- CIAMS, Université d'Orléans, Orléans, 45067, France.
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Guenancia TN, Rosa A, Damoisel C, Mercier FJ, Jeannin B. Implementation of a non-invasive oxygenation support strategy during the COVID-19 pandemic in an ephemeral Respiratory Intermediate Care Unit. Anaesth Crit Care Pain Med 2020; 39:459-460. [PMID: 32651097 PMCID: PMC7313489 DOI: 10.1016/j.accpm.2020.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Tsipora N Guenancia
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, université Paris-Saclay, AP-HP, 157, rue de la Porte de Trivaux, 92140 Clamart, France.
| | - Anne Rosa
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, université Paris-Saclay, AP-HP, 157, rue de la Porte de Trivaux, 92140 Clamart, France
| | - Charles Damoisel
- Réanimation polyvalente, hôpital Antoine-Béclère, université Paris-Saclay, AP-HP, 157, rue de la Porte de Trivaux, 92140 Clamart, France
| | - Frédéric J Mercier
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, université Paris-Saclay, AP-HP, 157, rue de la Porte de Trivaux, 92140 Clamart, France
| | - Bénédicte Jeannin
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, université Paris-Saclay, AP-HP, 157, rue de la Porte de Trivaux, 92140 Clamart, France
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Skvortsova N, Gasc A, Jeannin B, Herbort CP. Evolution of choroidal thickness over time and effect of early and sustained therapy in birdshot retinochoroiditis. Eye (Lond) 2017; 31:1205-1211. [PMID: 28430182 PMCID: PMC5558223 DOI: 10.1038/eye.2017.54] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/09/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose To follow choroidal thickness (ChT) over time in birdshot retinochoroiditis (BRC) using enhanced depth imaging optical coherence tomography (EDI-OCT) and study the effect of early and sustained treatment on ChT. Patients and methods Eighteen patients were included and EDI-OCT measurements of ChT were analyzed retrospectively in five groups of patients with follow-up times ranging from 1 year to ≥15 years. The OCT images were evaluated and ChT was calculated under the foveola and 1500 μm temporal, nasal, superior, and inferior to the foveola. To assess the effect of treatment, 13 patients with a disease duration ≥10 years were divided into two groups depending on their treatment status: early and sustained therapy vs insufficient, late, or no treatment. ChT was compared in these two groups along with the number of typical fundus BRC lesions. Results The ChT decreased (r=–0.41, P=0.0018) over the disease duration, which ranged from <1 year to ≥15 years. In patients with a disease duration ≥10 years, a significant difference in ChT was noted between adequately and undertreated patients (288.3±76.9 μm vs 161.4±39.2 μm; P=0.004). At the last follow-up, in the group with insufficient therapy 10 of 11 eyes presented typical fundus BRC lesions vs 2 of 13 eyes in the treated group (P≤0.0006, F-test). Conclusions Choroidal thickness decreases significantly over time in BRC. If undertreated, patients show thinner choroids compared with adequately treated individuals and present significantly more BRC lesions.
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Affiliation(s)
- N Skvortsova
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Lausanne, Switzerland.,Posterior Eye Segment Diagnostics and Surgery Center, Moscow, Russia
| | - A Gasc
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Lausanne, Switzerland
| | - B Jeannin
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Lausanne, Switzerland
| | - C P Herbort
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Lausanne, Switzerland.,University of Lausanne, Lausanne, Switzerland
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