Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation.

BACKGROUND: Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient. METHODS: The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience. RESULTS: The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study. CONCLUSIONS: All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.

Simulation-based summative assessment in healthcare: an overview of key principles for practice.

BACKGROUND: Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, "the use of simulation for summative assessment" requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start. METHODS: First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potential recommendations for future directions. Results were cross-checked among groups and reviewed by an independent expert committee. RESULTS: Seven topics were selected by the task force: "What can be assessed in simulation?", "Assessment tools for SBSA", "Consequences of undergoing the SBSA process", "Scenarios for SBSA", "Debriefing, video, and research for SBSA", "Trainers for SBSA", and "Implementation of SBSA in healthcare". Together, these seven explorations provide an overview of what is known and can be done with relative certainty, and what is unknown and probably needs further investigation. Based on this work, we highlighted the trustworthiness of different summative assessment-related conclusions, the remaining important problems and questions, and their consequences for participants and institutions of how SBSA is conducted. CONCLUSION: Our results identified among the seven topics one area with robust evidence in the literature ("What can be assessed in simulation?"), three areas with evidence that require guidance by expert opinion ("Assessment tools for SBSA", "Scenarios for SBSA", "Implementation of SBSA in healthcare"), and three areas with weak or emerging evidence ("Consequences of undergoing the SBSA process", "Debriefing for SBSA", "Trainers for SBSA"). Using SBSA holds much promise, with increasing demand for this application. Due to the important stakes involved, it must be rigorously conducted and supervised. Guidelines for good practice should be formalized to help with conduct and implementation. We believe this baseline can direct future investigation and the development of guidelines.

Interprofessional Collaborative Clinical Practice in Medicine and Pharmacy: Measure of Student Perceptions Using the SPICE-R2F Instrument to Bridge Health-Care Policy and Education in France.

BACKGROUND: Public health policies in France and the USA promote health professionals' collaborative practices in accordance with World Health Organization recommendations emphasizing the need to promote interprofessional education and training. To optimize alignment of health-care policy and education, a scientific evidence-based approach is required. METHODS: A French translation (SPICE-R2F) of the Student Perceptions of Interprofessional Clinical Education-Revised instrument, version 2 (SPICE-R2) was generated. SPICE-R2F was then completed by a multicentric cohort of French health students, and confirmatory factor analysis was utilized to evaluate the validity and reliability of this instrument based on response patterns. RESULTS: Translation of SPICE-R2 was validated evaluating psychometric properties and conducting a confirmatory factor analysis (CFA). Adequate model fit was demonstrated using RMSEA (root mean square error of approximation) and CFI (comparative fit index) model fit criteria. Within each factor, however, low to moderate levels of reliability were observed between items. These observations diverge from other countries and highlight a potential French singularity. CONCLUSION: Our results suggest the need to improve interprofessional clinical practice education in France at early stages in the health-care curricula. The SPICE-R2F instrument may represent a valuable evidence-based tool to characterize perceptions of interprofessional education and training of health-care students and professionals in France.