Efficacy of educational interventions in adolescent population with feeding and eating disorders: a systematic review.

BACKGROUND: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. METHODS: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). RESULTS: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive flexibility were identified. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. CONCLUSION: The results indicate that educational interventions can influence the improvement of knowledge level and have a positive effect on health outcomes. Although education is a common practice in the treatment of these pathologies, high-quality studies were not identified. Thus, this review concludes that additional evidence is needed to evaluate the effectiveness of educational programs, with further research studies, especially randomized controlled trials, to confirm these results. LEVEL OF EVIDENCE: Level I: Systematic review.

Efficacy of Virtual Reality Simulation in Teaching Basic Life Support and Its Retention at 6 Months.

Educational efficiency is the predetermining factor for increasing the survival rate of patients with cardiac arrest. Virtual reality (VR) simulation could help to improve the skills of those undergoing basic life support-automated external defibrillation (BLS-AED) training. Our purpose was to evaluate whether BLS-AED with virtual reality improves the skills and satisfaction of students enrolled in in-person training after completing the course and their retention of those skills 6 months later. This was an experimental study of first-year university students from a school of health sciences. We compared traditional training (control group-CG) with virtual reality simulation (experimental group-EG). The students were evaluated using a simulated case with three validated instruments after the completion of training and at 6 months. A total of 241 students participated in the study. After the training period, there were no statistically significant differences in knowledge evaluation or in practical skills when assessed using a feedback mannequin. Statistically significant results on defibrillation were poorer in the EG evaluated by the instructor. Retention at 6 months decreased significantly in both groups. The results of the teaching methodology using VR were similar to those obtained through traditional methodology: there was an increase in skills after training, and their retention decreased over time. Defibrillation results were better after traditional learning.

Competencies in Basic Life Support after a Course with or without Rescue Ventilation: Historical Cohort Study.

BACKGROUND: Simplifying the international guidelines to improve skills after training and their retention over time has been one of the top priorities in recent years. The objective of our study was to compare the results of the practical skills learned during training in basic life support with and without pulmonary ventilation. METHODS: This was a comparative study of historical cohorts consisting of undergraduate students in health sciences. In one cohort, rescue breathing was performed, and in the other, it was not. The same data collection instruments were used for both cohorts: a test type examination of knowledge, data from a smart mannequin and an instructor observation grid. The means of knowledge and practical skills scores collected by the mannequin were compared using independent sample t-tests. RESULTS: 497 students were recruited without significant differences between the two cohorts. The mean scores for knowledge and skills determined by the instructor and the mannequin were statistically higher in the cohort that did not perform rescue breathing. CONCLUSION: Students who participated in basic life support training that did not include rescue breathing scored better than those who participated in training that included this skill. Training with only compressions simplifies the guidelines and increases learning and content retention.

Adaptation and validation of a Spanish version of the KidSIM Team Performance Scale.

BACKGROUND: Interprofessional education offers students from different disciplines the opportunity to share learning experiences. PURPOSE: To develop and validate a Spanish version of the KidSIM Team Performance Scale, thus providing a tool for assessing the team performance of undergraduate health professionals in our cultural context. METHOD: Descriptive observational study consisting of two phases: a) translation and adaptation of the original instrument, b) validation of the Spanish version. RESULTS: The Spanish version comprises 11 items and is linguistically and conceptually equivalent to the original scale. Factor analysis yielded a model comprising three factors: roles and leadership capacity, communication, and use of resources. Internal consistency was good (Cronbach's alpha = 0.85), while inter-observer agreement was moderate (Cohen's kappa = 0.58). The RMSEA fit index was acceptable (0.0801 [0.0618-0.115]). CONCLUSION: The Spanish version of the KidSIM Team Performance Scale is a valid and reliable tool for assessing simulated teamwork among undergraduate health professionals.

Perioperative nurses' experiences in relation to surgical patient safety: A qualitative study.

Surgical patient safety remains a concern worldwide as, despite World Health Organization recommendations and implementation of its Surgical Safety Checklist, adverse events continue to occur. The aim of this qualitative study was to explore the views and experiences of perioperative nurses regarding the factors that impact surgical patient safety. Data were collected through five focus groups involving a total of 50 perioperative nurses recruited from four public hospitals in Spain. Content analysis of the focus groups yielded four main themes: personal qualities of the perioperative nurse, the surgical environment, safety culture, and perioperative nursing care plans. One of the main findings concerned barriers to the exercise of leadership by nurses, especially regarding completion of the Surgical Safety Checklist. Some of the key factors that impacted the ability of perioperative nurses to fulfil their duties and ensure patient safety were the stress associated with working in the operating room, time pressures, and ineffective communication in the multidisciplinary team. Targeting these aspects through training initiatives could contribute to the professional development of perioperative nurses and reduce the incidence of adverse events by enhancing the surgical safety culture.

Estudio experimental aleatorizado de innovación docente que compara metodología mixta frente a presencial para la formación en soporte vital básico estándar del European Resuscitation Council / Standard basic life support training of the European Resuscitation Council versus blended training: a randomized trial of a new teaching method

Objetivo. Evaluar los resultados de la formación mixta frente a la presencial en un curso de soporte vital básico/desfibrilador externo automático (SVB/DEA), así como su retención a los 9 meses. Método. Estudio experimental aleatorizado que compara los resultados de la formación en SVB/DEA entre un grupo control (GC) que recibió formación presencial de 4 horas frente a un grupo experimental (GE) que recibió formación en metodología mixta: 2 horas virtuales y 2 horas presenciales. Resultados. Participaron 89 alumnos (45 del GC y 44 del GE). Después de la formación, el GC obtuvo mejores puntuaciones en conocimientos [8,6 (DE 0,9) frente a 8,0 (DE 1,14), p = 0,013]. El GE obtuvo mejores puntuaciones en las habilidades del tiempo en segundos de "hands off" y en el porcentaje de la rexpansión completa del tórax. Los conocimientos decaen a los 9 meses, pero sin diferencias entre los dos grupos. La retención global baja de 8,31 (DE 1,1) a 6,04 (DE 1,6) (p = 0,001), en 9 meses, pero de forma similar en ambos grupos. En las habilidades prácticas no hubo diferencias entre los dos grupos ni al finalizar el curso ni a los 9 meses. Conclusiones. Con la metodología virtual se obtienen mejores resultados en algunos parámetros de las habilidades

Objective. To evaluate the immediate and 9-month results of blended versus standard training in basic life support and the use of an automatic external defibrillator (BLS/AED). Methods. Randomized trial comparing the results of standard BLS/AED training to blended training. The control group received 4 hours of standard instruction from a trainer and the experimental blended-training group received 2 hours of virtual training and 2 hours of in-person instruction. Results. Eighty-nine students participated, 45 in the control group and 44 in the experimental group. The controls achieved better mean (SD) knowledge scores immediately after training (8.6 [0.9] vs 8.0 [1.14] in the experimental group, P=.013). The blended training group scored better on certain skill markers (hands-off time in seconds and compressions followed by complete chest recoil). Participant knowledge had decreased at 9 months without significant between-group differences. Overall, retention fell from a score of 8.31 (1.1) to 6.04 (1.6) (P=.001) in 9 months and the loss was similar in the 2 groups. No differences in practical skills between the groups were observed at the end of the course or 9 months later. Conclusions. The blended training method led to better results on some skill ítems

Cost minimization analysis for basic life support.

BACKGROUND: The use of online teaching methodology for basic life support (BLS) courses is progressively increasing. OBJECTIVE: The objective of this study was to verify whether the blended-learning methodology (virtual course with a short face-to-face complement) was more efficient than a course that followed the classical or face-to-face methodology in our university. MATERIALS AND METHODS: A cost minimization analysis was performed for two BLS and automatic external defibrillation (AED) courses, one of which was conducted face-to-face (Control Group) and the second of which was conducted via blended-learning (Experimental Group). The courses had the same duration and content according to the European Resuscitation Council (ERC) recommendations. In the face-to-face course, direct costs were considered those generated by the faculty and derived from the academic activity. Other costs were those generated by the use of classrooms and the amortization of manikins and AED training. The perspective of the analysis was that of the provider, the academic, and a time horizon of six months. The costs are expressed in € 2017. RESULTS: The savings of a course in BLS-AED based on the blended-learning methodology calculated for a total of 160 university nursing and medical students were € 2328.8 for the first year of its implementation and € 9048.8 for its second edition compared with the same course using a face-to-face methodology. CONCLUSIONS: The blended-learning methodology supposes a cost savings for BLS-AED courses, mainly due to the reduction of expenses of the teaching staff. The blended-learning methodology seems to be more efficient than the face-to-face methodology.

Basic life support and external defibrillation competences after instruction and at 6 months comparing face-to-face and blended training. Randomised trial.

AIM OF THE STUDY: The objective of this study was to compare the immediate and 6-month efficacy of basic life support (BLS) and automatic external defibrillation (AED) training using standard or blended methods. METHODS: First-year students of medicine and nursing (n = 129) were randomly assigned to a control group (face-to-face training based on the European Resuscitation Council [ERC] Guidelines) or to an experimental group that trained with a self-training video, a new website, a Moodle platform, an intelligent manikin, and 45 min of instructor presence. Both groups were homogeneous and were evaluated identically. Theoretical knowledge was evaluated using a multi-choice questionnaire (MCQ). Skill performance was evaluated by the instructor's rubric and on a high-fidelity Resusci Anne QCPR manikin. RESULTS: Immediately after the course, there were no statistically significant differences in knowledge between the two groups. The median score of practical evaluation assessed by the instructor was significantly better in the experimental group (8.15, SD 0.93 vs 7.7, SD 1.18; P = 0.02). No differences between groups were found when using a high-fidelity manikin to evaluate chest compressions and lung inflations. At six months, the scores in knowledge and skill performance were significantly lower compared to the evaluations at the end of the instruction, but they remained still higher compared to baseline. The experimental group had higher scores in practical skills evaluated by the instructor than the control group (7.44, SD 1.85 vs 6.10, SD 2.6; P = 0.01). CONCLUSIONS: The blended method provides the same or even higher levels of knowledge and skills than standard instruction both immediately after the course and six months later.

Prediction of postoperative pulmonary complications in a population-based surgical cohort.

BACKGROUND: Current knowledge of the risk for postoperative pulmonary complications (PPCs) rests on studies that narrowly selected patients and procedures. Hypothesizing that PPC occurrence could be predicted from a reduced set of perioperative variables, we aimed to develop a predictive index for a broad surgical population. METHODS: Patients undergoing surgical procedures given general, neuraxial, or regional anesthesia in 59 hospitals were randomly selected for this prospective, multicenter study. The main outcome was the development of at least one of the following: respiratory infection, respiratory failure, bronchospasm, atelectasis, pleural effusion, pneumothorax, or aspiration pneumonitis. The cohort was randomly divided into a development subsample to construct a logistic regression model and a validation subsample. A PPC predictive index was constructed. RESULTS: Of 2,464 patients studied, 252 events were observed in 123 (5%). Thirty-day mortality was higher in patients with a PPC (19.5%; 95% [CI], 12.5-26.5%) than in those without a PPC (0.5%; 95% CI, 0.2-0.8%). Regression modeling identified seven independent risk factors: low preoperative arterial oxygen saturation, acute respiratory infection during the previous month, age, preoperative anemia, upper abdominal or intrathoracic surgery, surgical duration of at least 2 h, and emergency surgery. The area under the receiver operating characteristic curve was 90% (95% CI, 85-94%) for the development subsample and 88% (95% CI, 84-93%) for the validation subsample. CONCLUSION: The risk index based on seven objective, easily assessed factors has excellent discriminative ability. The index can be used to assess individual risk of PPC and focus further research on measures to improve patient care.