Mobile healthcare simulation units: a narrative review.

For healthcare professionals working and living in geographical isolation, there are few opportunities to maintain skills and knowledge, and to update themselves with recent advances in care compared to their citydwelling peers. It is known that within a short period and limited practice, clinical skills erode. A mobile healthcare simulation unit provides high-quality, technologicallyenhanced, convenient, and affordable training for healthcare professionals under expert supervision in any remote setting. The current narrative review was planned to summarise the outcomes and challenges related to developing and effectively utilising mobile healthcare simulation units as experienced globally. A literature search was performed on PubMed, Google Scholar and Cochrane databases for relevant articles published between 2000 and 2020, which resulted in 18 articles that were shortlisted and three major themes. The identification of common strengths, weaknesses and challenges will be a starting point for those engaged in planning and operating such a centre in any location.

Availability and use of Automated External Defibrillators in Karachi, Pakistan: A cross-sectional study.

OBJECTIVE: To assess the availability and use of automated external defibrillators in various public and private establishments, and to assess knowledge, attitude and practices related to its use. METHODS: The telephone-based survey was conducted from March to August 2019 in Karachi after approval from the ethics review committee of the Aga Khan University, Karachi, and comprised public and private establishments identified through purposive sampling based on the standard requirements for automated external defibrillators installation. Data was collected using a predesigned questionnaire which was pilot-tested for reliability and validity. Data was analysed using SPSS 23. RESULTS: Of the 53 establishments, 32(60.4%) were private and 21(39.6%) were public. Overall, 9(17%) establishments were aware of automated external defibrillators and 1(1.9%) had an automated external defibrillator on the premises. Also, 25(47.2%) establishments believed that having an automated external defibrillator on the premises would be useful, while 25(47.2%) were undecided. Besides, 22(41.5%) establishments said they would consider installing an automated external defibrillator on the premises, while 24(45.3%) were undecided. Finally, 37(69.8%) establishments expressed a positive desire to get trained in giving basic life support. Conclusion: There was a need for a city-wide automated external defibrillator placement project for a reduction in mortality due to out-of-hospital cardiac arrest.

SonoGames: sounds of the right kind introducing gamification into radiology training.

BACKGROUND: Radiology as compared to other fields of medicine has lagged, in incorporating modern training modalities such as gamification and simulation into its teaching curriculum. OBJECTIVE: This study aims to evaluate effectiveness of simulation-based teaching in collaboration with gamification. Bandura's conception of self-efficacy was used to provide qualitative assessment of participants' learning process through training event. Modified competitive game-based teaching methodology was utilized in an experimental study conducted for radiology residents. Workshop was divided into two sessions, first being three interactive didactic lectures followed by three competitive rounds. All participants were required to fill pre and post-self-efficacy questionnaire along with an activity evaluation form. RESULTS: Significant self-efficacy scores were calculated for simulation-based stations of knowledge assessment and hands-on stations. Whereas significant association was also found between gender and knowledge assessment in communication skill (0.054), Professionalism (0.004), and general knowledge (0.018). Similarly, noteworthy correlation was found between gender and all hands-on skills. In conclusion, study reported an overall increase in knowledge of post-test scores compared to pre-test scores due to use of gamification in combination with simulation-based teaching which shows a positive role in clinical training. However, further consideration is needed to improve process of integrating simulation in clinical training of participants.

Simulated learning in rural community environment: pushing the boundary.

Experiential learning through simulation can play a very significant role, not only in hospital settings but also in community contexts (Lubbers and Rossman, Nurse Educ. Today 48:140-144; Wheeler and McNelis, Nurs. Educ. Perspect 35:259-261). This paper discusses the concept of creating a novel simulated village set-up within a modern simulation center, to effectively deliver contemporary learning outcomes. It also highlights the challenges and risks of developing a simulated village set-up and strategies to counteract them. Furthermore, it describes the role of simulation specialists as innovators and explicates the gamut of expertise in education, management, and technologies that are required to deliver excellence in simulation-based education.

The need for simulation in surgical education in developing countries. The wind of change. Review article.

Operative skills are the heart and soul of surgical practice. An extensive amount of literature has been devoted to the art and science of acquiring these skills which start by mastering basic skills until automaticity has been achieved. The current model of surgical education is purely based on sheer volume of patients, restrictions in the maximum number of working hours for trainees and increased pressures of operating room efficiency. This leads to limited teaching time. Adding to the scenario is the emphasis on patient safety and greater awareness of medico-legal consequences following medical errors. All this has significantly hampered the learning experience of surgical trainees and limited the expert surgeon's ability to fulfil trainees' learning needs during complex procedures. Thus, learning strategies outside the operating room were required to provide an ideal environment for learning without putting patients' health at risk. This has led to increased use of simulators in modern surgical training. The situation is even more worrisome in developing countries where the availability of these facilities is either extremely limited or nonexistent. The current narrative review was planned to go over the importance of simulation in surgical education and to question its utility in developing countries.

Developing a national competency-based curriculum for technical nurses in Egypt.

Nursing in Egypt has evolved over recent decades. Development has accelerated following recent government recognition of the contribution nurses make to healthcare access, quality and delivery. A vision to enhance nursing capacity resulted in a recent mandate requiring all nursing curricula to be competency based. Concurrently, the Educational Development Fund of the Egyptian Cabinet of Ministers drafted a nursing educational plan including a strategy to develop and implement a contextually congruent educational model with proven success comparable to international standards. This report discusses the 4-year curriculum development project designed to upgrade the current technical-level nursing curriculum to a consistent competency-based model. The competency-based educational model will be trialled in 3 technical institutes before nationwide rollout and implementation. Details of the project plan are described, including an overview of curriculum development considerations. This report provides insights for policy-makers and educators embarking on similar health workforce reform and capacity development initiatives.

The quality of information received by parents of children with chronic ill health attending hospitals as indicated by measures of illness uncertainty.

BACKGROUND: The effectiveness of communication can be defined in terms of one of its outcomes: the uncertainty that it eliminates. Clear unambiguous communication is important for the parents of children to help them understand problems, explore alternative solutions and help make decisions. Persistent uncertainty is known to produce anxiety, unpredictable responses, emotional distress and poor quality of life. The uncertainty experienced by parents is one indicator of quality in the healthcare system which could have diagnostic and predictive value. AIM: To assess the uncertainty experienced by parents of children with chronic conditions in the United Arab Emirates (UAE). DESIGN: An exploratory descriptive, cross-sectional design was chosen across different sites in the UAE. METHODS: Data were collected from parents accompanying children receiving treatment either as an inpatient or outpatient, using the previously validated, culturally adapted 'Parent Perception of Uncertainty Scale' (PPUS). RESULTS: Most study participants experienced moderate or high levels of uncertainty. Parents who did not speak the local language, whose child was less than 1 year old or who was acutely ill had significantly more uncertainty than others, as did those parents whose child was approaching adolescence and puberty. CONCLUSIONS: As only 5% of all participants reported low levels of uncertainty this should be of major concern as both an indicator of the quality of communication between health professionals and parents, and of the adverse health effects and poor quality of life experienced by parents of patients with chronic illness.

Research Priorities for School Nursing in the United Arab Emirates (UAE).

School nurses are challenged with more children having complex conditions, who are now surviving into school age. This is paralleled by a shift in focus of health systems toward primary care, and national efforts to develop the health-care services, especially those offered to vulnerable populations. Being at the forefront of this change, school nurses in United Arab Emirates (UAE) are finding themselves under pressure to adapt to and facilitate these changes both by improving their practice and by contributing to its underpinning evidence. A cross-sectional design was used in this study in which 370 school nurses participated, identifying 11 research priorities. The three most important, as ranked by participants, were management of children with complex health-care needs; nutrition, obesity, and lifestyle issues of schoolchildren; and managing illnesses, injuries, and emergencies in schools and provision of medical support. These priorities should direct future research activities in the field.

Determinants of Quality of Care for Adolescents and Young Adults With Chronic Illnesses: A Mixed Methods Study.

UNLABELLED: Measuring the quality of service and user experience is an acknowledged priority for healthcare services; however it seems that healthcare systems have to work very hard to achieve this goal as evidenced by reports of gaps and disparities in the quality of care provided to clients, especially within pediatric and adolescent populations. OBJECTIVES: To identify quality determinants for healthcare services for adolescents and young adults with chronic conditions based on the perceptions and the experiences of adolescents and young adults themselves. METHODOLOGY: A sequential exploratory mixed method design guided this study. The initial qualitative phase employed semi-structured in-depth interviews to elicit the elements and determinants of quality of care as identified by adolescents and young adults living with chronic conditions. The second phase employed a questionnaire developed from the data gathered during the qualitative phase to survey the target population. This was distributed to a larger sample of adolescents and young adults with chronic conditions to determine and confirm the relevance of the identified care elements and quality determinants. RESULTS: The study revealed 4 main determinants: the provision of adolescent friendly information relating to all aspects of living with chronic conditions, services that facilitate and encourage independence, services characterized by structure with the capacity to be both dynamic and responsive, and finally health care professionals knowledgeable and skilled in relation to adolescent specific issues.

Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.

Problem-based learning (PBL): assessing students' learning preferences using VARK.

OBJECTIVE: This study was conducted to describe learning styles of third year nursing students. DESIGN: An interventional study Setting: a public university in Jordan. SUBJECTS: Used a purposive sample of 92 nursing students who were enrolled in maternity nursing course. MAIN OUTCOME MEASURES: Measure the difference in learning styles of nursing students after introducing an intervention of PBL as a teaching methodology. RESULTS: The dominant learning preference of the students was the read/write preference followed by the kinesthetic, still most of the students represented a multimodal learning preference. No significant difference was found between males and females. A significant difference in the learning preferences of the students in the pre-post test was found. In the pretest the mean of the total VARK score 13.9 (SD=2) where as in the post test the mean of the total VARK score=16.5 (SD=3.5). In the pre-test 54% of students had a multimodal preference whereas 68% of students have a multimodal preference post-test. CONCLUSIONS: Most students are able to learn effectively as long as the instructor provides different learning activities in the areas assessed in VARK. Active learning might be enhanced in large classrooms by presenting models and demonstrations, discussions, debates, answering questions, and role playing.

The structure and content of the nursing component of a pilot electronic health record for the cardiac managed clinical network in Scotland.

The development of a Portal for the Cardiac Managed Clinical Network (MCN) in Glasgow, Scotland, provided an opportunity to move towards a paperless environment for health care records. Nursing diagnoses within NANDA were ranked and 39 core to cardiac nursing identified. Appropriate nursing interventions and outcomes were grouped to form 'templates' adaptable to the individual. A system was proposed to facilitate the use of these templates to ease the process of producing care plans. However, this did no more than serve as an ideal. This exercise acknowledges the complexity of nursing activity and highlights the need to standardise protocols and procedures in nursing practice. It also illustrates the imperative for nurses to be actively involved in developing clinical systems fit for purpose.

eLearning techniques supporting problem based learning in clinical simulation.

UNLABELLED: This paper details the results of the first phase of a project using eLearning to support students' learning within a simulated environment. The locus was a purpose built clinical simulation laboratory (CSL) where the School's philosophy of problem based learning (PBL) was challenged through lecturers using traditional teaching methods. THE SOLUTION: a student-centred, problem based approach to the acquisition of clinical skills that used high quality learning objects embedded within web pages, substituting for lecturers providing instruction and demonstration. This encouraged student nurses to explore, analyse and make decisions within the safety of a clinical simulation. Learning was facilitated through network communications and reflection on video performances of self and others. Evaluations were positive, students demonstrating increased satisfaction with PBL, improved performance in exams, and increased self-efficacy in the performance of nursing activities. These results indicate that eLearning techniques can help students acquire clinical skills in the safety of a simulated environment within the context of a problem based learning curriculum.

Using Elearning techniques to support problem based learning within a clinical simulation laboratory.

This paper details the results of the first phase of a project that used eLearning to support students' learning within a simulated environment. The locus was a purpose built Clinical Simulation Laboratory (CSL) where the School's newly adopted philosophy of Problem Based Learning (PBL) was challenged through lecturers reverting to traditional teaching methods. The solution, a student-centred, problem-based approach to the acquisition of clinical skills was developed using learning objects embedded within web pages that substituted for lecturers providing instruction and demonstration. This allowed lecturers to retain their facilitator role, and encouraged students to explore, analyse and make decisions within the safety of a clinical simulation. Learning was enhanced through network communications and reflection on video performances of self and others. Evaluations were positive, students demonstrating increased satisfaction with PBL, improved performance in exams, and increased self-efficacy in the performance of nursing activities. These results indicate that an elearning approach can support PBL in delivering a student centred learning experience.