Virtual Reality Simulation in a Health Assessment Laboratory Course: A Mixed-methods Explanatory Study Examining Student Satisfaction and Self-confidence.

BACKGROUND: The purpose of this mixed-methods study was to examine the relationship between virtual reality simulation (VRS) and student satisfaction and self-confidence in a health assessment laboratory course. METHODS: Second-year students (n = 37) completed a postoperative respiratory distress scenario using Elsevier's Simulation Learning System with Virtual Reality. All participants completed the Satisfaction and Self-Confidence in Learning Scale; a subset participated in 1:1 semistructured interviews. RESULTS: Satisfaction and self-confidence scores were strongly correlated. VRS experiences of fidelity, communication confidence and competence, learning with peers, integrated learning and critical thinking, and a safe space to learn were related to students' satisfaction and self-confidence. CONCLUSIONS: VRS experiences are correlated with high student satisfaction and self-confidence.

Comparison of the Quality of Recovery-15 score in patients undergoing oncoplastic breast-conserving surgery under monitored anesthesia care versus general anesthesia: a prospective quality improvement study.

PURPOSE: Whether changing the institutional practice from general anesthesia (GA) to monitored anesthesia care (MAC) affects postoperative quality of recovery for oncoplastic breast-conserving surgery (BCS) is currently unknown. We designed this quasi-experimental study to evaluate a quality improvement (QI) initiative instituted in Edmonton, AB, Canada. METHODS: We chose a prospective controlled cohort study design for this QI study, where patients underwent oncoplastic BCS under MAC in one hospital and BCS under GA at another hospital (control). A total of 125 patients undergoing surgery between May 2021 and February 2022 were enrolled. Exclusion criteria were male sex, total mastectomy, or age under 18. All other patients were included. The primary outcome was the change in Quality of Recovery-15 score at 24 hr compared with a preoperative baseline. Secondary outcomes included intra- and postoperative time profiles, perioperative analgesic and antiemetic use and length of hospital stay. Statistical analysis included a propensity score analysis to account for confounding variables. RESULTS: Sixty-four patients received GA and 61 MAC. No enrolled patients were lost to follow up but two were excluded secondarily. No patients receiving MAC needed conversion to GA or unplanned airway management. Monitored anesthesia care was associated with superior outcomes for the primary outcome (ß/SE[ß], 3.31; 99.5% confidence interval, 0.45 to 6.17; P = 0.001) and most secondary outcomes, when accounting for confounding factors. CONCLUSIONS: A care transformation initiative for patients undergoing oncoplastic BCS under MAC was associated with a higher quality recovery profile and shorter length of stay without any increase in perioperative or postoperative adverse events.

RéSUMé: OBJECTIF: On ignore actuellement si le fait de modifier la pratique institutionnelle de l'anesthésie générale (AG) à la sédation procédurale (monitored anesthesia care) affecte la qualité de la récupération postopératoire en cas de chirurgie mammaire conservatrice oncoplastique. Nous avons conçu cette étude quasi expérimentale pour évaluer une initiative d'amélioration de la qualité mise en place à Edmonton, Alberta, Canada. MéTHODE: Nous avons choisi une méthodologie d'étude de cohorte prospective contrôlée pour cette étude d'amélioration de la qualité, dans laquelle des patientes ont bénéficié d'une chirurgie mammaire conservatrice oncoplastique sous sédation procédurale dans un hôpital et de la même chirurgie sous anesthésie générale dans un autre hôpital (groupe témoin). Au total, 125 patientes bénéficiant d'une intervention chirurgicale entre mai 2021 et février 2022 ont été recrutées. Les critères d'exclusion étaient le sexe masculin, la mastectomie totale ou un âge de moins de 18 ans. Toutes les autres personnes ont été incluses. Le critère d'évaluation principal était la variation du score de Qualité de la récupération 15 à 24 heures par rapport aux valeurs initiales préopératoires. Les critères d'évaluation secondaires comprenaient les profils temporels per- et postopératoires, l'utilisation périopératoire d'analgésiques et d'antiémétiques et la durée du séjour à l'hôpital. L'analyse statistique comprenait une analyse par score de propension pour tenir compte des variables de confusion. RéSULTATS: Soixante-quatre patientes ont reçu une anesthésie générale et 61 une sédation procédurale. Aucune patiente recrutée n'a été perdue au suivi, mais deux ont été exclues secondairement. Aucune patiente recevant une sédation procédurale n'a eu besoin d'une conversion en anesthésie générale ou d'une prise en charge non planifiée des voies aériennes. La sédation procédurale était associée à des issues supérieures pour le critère d'évaluation principal (ß/ET[ß], 3,31; intervalle de confiance à 99,5 %, 0,45 à 6,17; P = 0,001) et la plupart des critères d'évaluation secondaires, en tenant compte des facteurs de confusion. CONCLUSION: Une initiative de transformation des soins pour les patientes bénéficiant d'une chirurgie mammaire conservatrice oncoplastique sous sédation procédurale a été associée à un profil de récupération de meilleure qualité et à une durée de séjour plus courte sans augmentation des événements indésirables périopératoires ou postopératoires.

The effect of animal-assisted intervention on undergraduate students' perception of momentary stress.

Background: Student mental wellness is a priority in higher education. Animal Assisted Interventions (AAIs') are gaining momentum in universities across North America (Dell et al., 2015). Aims: This study explored the relationships between AAIs', demographic variables, and perceived momentary stress among university students. Methods: Using a descriptive correlational design, students completed a Perceived Momentary Stress questionnaire that included the Stress Numerical Rating Scale-11 (Stress NRS-11) and the Visual Analog Scale (VAS) to measure perceived stress before and after AAIs'. Data were analyzed using R (4.1.2) (R Core Team, Vienna, Austria) to identify relationships between students' perceptions of momentary stress, AAIs' and sociodemographic and demographic variables. Results: First-year students, female students, and students identifying as sexual minorities were found to benefit the most from AAIs'. Conclusion: Results from this study reflect relationships between exposure to animal-assisted interventions and student demographic variables.

Virtual Health Assessment Laboratory Course Delivery and Nursing Student Clinical Judgment: A Mixed-Methods Exploratory Study.

BACKGROUND: It is essential to explore virtual learning experiences to identify their impact on nursing students' learning. PURPOSE: The purpose of this study was to investigate the relationship between the virtual delivery of a health assessment laboratory course and nursing students' clinical judgment. METHODS: Using a mixed-methods explanatory sequential design, the investigators appraised the final laboratory examinations of both in-person and virtual delivery cohorts using the Lasater Clinical Judgment Rubric (LCJR) and then interviewed faculty members. RESULTS: The LCJR total mean scores (mean = 10.64) and mean scores for Effective Noticing (mean = 3.48) were higher for the virtual delivery students. The faculty reported that virtual delivery advances students' critical appraisal skills related to subjective assessment but advocated for in-person delivery to develop physical examination techniques. CONCLUSION: Although the mean clinical judgment scores were higher for the students whose course delivery was virtual, in-person experiences are necessary to develop psychomotor techniques to prepare students for clinical practice.

Vision of conspecifics decreases the effectiveness of ethanol on zebrafish behaviour.

Aquatic organisms in pharmacology and toxicology research are often exposed to compounds in isolation prior to physiological or behavioural testing. Recent evidence suggests that the presence of conspecifics during a stressful event can modulate behavioural outcomes (called 'social buffering') when testing occurs within the same context. It is unknown, however, whether the social environment during exposure interacts with the efficacy of anxiety-altering substances when subsequently tested in the absence of conspecifics. In this study, zebrafish were individually exposed to habitat water or ethanol (1.0% vol/vol) while untreated conspecifics were visually present or absent during dosing. Using the novel object approach test, a validated test of boldness and anxiety-like behaviour, we observed significantly greater effects of ethanol in isolated fish, compared to fish with a view of conspecifics during dosing. These results were not explained by altered locomotion during exposure, which might otherwise increase drug uptake. This highlights the need to consider the social environment during exposure when conducting and interpreting behavioural research involving drug or toxicant exposure.