The use of simulation as a teaching modality for paramedic education: a scoping review.

BACKGROUND: Simulation is a broad concept used as an education pedagogy for a wide range of disciplines. The use of simulation to educate paramedics is a frequently used but untested modality to teach psycho-motor skills, acquire new knowledge and gain competence in practice. This review identifies how simulation is currently being used for the education of paramedics, and establish the context for future application. METHODS: A scoping review of the literature was undertaken following the PRISMA systematic approach. Flexible inclusion criteria were used to capture research and non-research articles that would contribute to the synthesis of literature with a specific knowledge base pertaining to simulation use for paramedic education. RESULTS: Initial searching yielded 1388 records, of which 22 remained after initial title and abstract reading. Following secondary full-text screening, 18 articles were deemed appropriate for final inclusion: eight are research, two literature reviews and eight non-research. Across all the literature, a range of concepts are discussed: Skill vs Scenario, Virtual Learning, Inter-Professional Learning, Fidelity, Cost, Equipment, Improvement of Competency, Patient Safety, Perception of Simulation. CONCLUSION: It is evident that simulation is a primary teaching modality, consistently used to educate and train paramedics. Simulation is inherently effective at teaching clinical skills and building student competence in particular areas. Similarly, simulation is effective at providing paramedics with experiences and opportunities to learn in varied environments using differing techniques. This allows students to apply the relevant skills and knowledge when faced with real patients.

Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update.

Oral lichenoid reactions (OLRs) comprise a group of conditions with a common clinical appearance and histopathologic pattern that may be induced by several conditions or medications. This report describes an OLR possibly induced by a biologic agent. A 69-year-old woman with rheumatoid arthritis presented with a chief complaint of oral pain. The patient retroactively reported of skin lesions as well. Clinically, she had mixed red-white mucosal lesions and ulcers suggestive of an OLR. This diagnosis was supported by histopathologic findings. Withholding the putative etiologic agent, abatacept, resulted in immediate alleviation of both oral and skin lesions. Abatacept and other biologics are thought to help treat inflammation and are becoming more commonly prescribed to treat rheumatoid arthritis. However, the clinicians should explore these medications as a causative factor for OLR.