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1.
Simul Healthc ; 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34175883

RESUMO

SUMMARY STATEMENT: As the field of healthcare simulation matures, formal accreditation for simulation fellowships and training programs has become increasingly available and touted as a solution to standardize the education of those specializing in healthcare simulation. Some simulation experts hold opposing views regarding the potential value of simulation fellowship program accreditation. We report on the proceedings of a spirited debate at the 20th International Meeting on Simulation in Healthcare in January 2020. Pro arguments view accreditation as the logical evolution of a maturing profession: improving training quality through standard setting, providing external validation for individual programs, and enhancing the program's return on investment. Con arguments view accreditation as an incompletely formulated construct; burdensome to the "financially strapped" fellowship director, misaligned with simulation fellows' needs and expectations, and confusing to administrators mistakenly equating accreditation with credentialing. In addition, opponents of accreditation postulate that incorporating curricular standards, practice guidelines, and strategies derived and implemented without rigor, supporting evidence and universal consensus is premature. This narrative review of our debate compares and contrasts contemporary perspectives on simulation fellowship program accreditation, concluding with formal recommendations for learners, administrators, sponsors, and accrediting bodies.

2.
Disaster Med Public Health Prep ; : 1-5, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33762048

RESUMO

OBJECTIVES: Coronavirus disease (COVID-19) has been identified as an acute respiratory illness leading to severe acute respiratory distress syndrome. As the disease spread, demands on health care systems increased, specifically the need to expand hospital capacity. Alternative care hospitals (ACHs) have been used to mitigate these issues; however, establishing an ACH has many challenges. The goal of this session was to perform systems testing, using a simulation-based evaluation to identify areas in need of improvement. METHODS: Four simulation cases were designed to depict common and high acuity situations encountered in the ACH, using a high technology simulator and standardized patient. A multidisciplinary observer group was given debriefing forms listing the objectives, critical actions, and specific areas to focus their attention. These forms were compiled for data collection. RESULTS: Logistical, operational, and patient safety issues were identified during the simulation and compiled into a simulation event report. Proposed solutions and protocol changes were made in response to the identified issues. CONCLUSION: Simulation was successfully used for systems testing, supporting efforts to maximize patient care and provider safety in a rapidly developed ACH. The simulation event report identified operational deficiencies and safety concerns directly resulting in equipment modifications and protocol changes.

3.
R I Med J (2013) ; 103(6): 8-13, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32752556

RESUMO

Field hospitals have long been used to extend health care capabilities in times of crisis. In response to the pandemic and an anticipated surge in patients, Rhode Island Gov. Gina Raimondo announced a plan to create three field hospitals, or "alternate hospital sites" (AHS), totaling 1,000 beds, in order to expand the state's hospital capacity. Following China's Fangcang shelter hospital model, the Lifespan AHS (LAHS) planning group attempted to identify existing public venues that could support rapid conversion to a site for large numbers of patients at a reasonable cost. After discussions with many stakeholders - pharmacy, laboratory, healthcare providers, security, emergency medical services, and infection control - design and equipment recommendations were given to the architects during daily teleconferencing and site visits. Specific patient criteria for the LAHS were established, staffing was prioritized, and clinical protocols were designed to facilitate care. Simulations using 4 different scenarios were practiced in order to assure proper patient care and flow, pharmacy utilization, and staffing.


Assuntos
Infecções por Coronavirus , Planejamento em Desastres , Hospitais de Isolamento , Unidades Móveis de Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , COVID-19 , Abrigo de Emergência , Humanos , Rhode Island , SARS-CoV-2
4.
R I Med J (2013) ; 103(4): 42-45, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32357593

RESUMO

BACKGROUND: Simulation in medical education is a well-accepted educational modality that allows for practice of high risk, low frequency events. The Obstetric Emergencies for Emergency Medicine course was developed to prepare trainees for challenging scenarios. METHODS: Six clinical scenarios were chosen: spontaneous vaginal delivery, neonatal resuscitation, pre- eclampsia, neonatal resuscitation with cardiopulmonary resuscitation (CPR), shoulder dystocia and postpartum hemorrhage. Development and facilitation was an interdepartmental effort with contributions from Emergency Medicine, Obstetrics and Gynecology, and Pediatric Emergency Medicine. Each case was allotted 35 minutes, including debriefing. Participants completed an evaluation survey for each scenario. RESULTS: All participants responded yes to the question "Would you recommend this simulation become part of the standard curriculum." The means of ratings for "scenario overall" and "relevance to training/duties" ranged from 4.95-5 out of 5 across all simulation groups. CONCLUSION: An interdepartmental and collaborative approach can optimize the success of a simulation educational program.


Assuntos
Currículo , Parto Obstétrico/educação , Educação Médica/métodos , Tratamento de Emergência , Obstetrícia/educação , Treinamento por Simulação , Competência Clínica , Distocia/terapia , Eclampsia/terapia , Feminino , Pessoal de Saúde/educação , Humanos , Recém-Nascido , Manequins , Complicações do Trabalho de Parto/terapia , Equipe de Assistência ao Paciente , Hemorragia Pós-Parto/terapia , Gravidez , Ressuscitação/métodos
5.
West J Emerg Med ; 21(1): 33-36, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31913815

RESUMO

INTRODUCTION: Journal club holds a well-respected place in medical education by promoting critical review of the literature and fostering scholarly discussions. Journal clubs are often not available to trainees with niche interests due to the geographic limitations of subspecialty programs such as simulation, medical education, disaster medicine, ultrasound, global health, and women's health. METHODS: A recurring online journal club was held on a quarterly basis to connect simulation fellows. An online conferencing program with screen-sharing capabilities served as the platform for this scholarly exchange. Articles were presented by fellows supported by more seasoned mentors. We surveyed participants to evaluate the program and provide feedback to the presenter. RESULTS: The first eight sessions drew participants from across the United States and Canada. The program was highly rated by participants who commented specifically on its value. Presenters were also highly rated, suggesting that fellows, with online support and mentoring, were effective in providing a quality program. CONCLUSION: Online synchronous journal clubs can fill an educational niche for subspecialists and their trainees, as demonstrated with this curriculum piloted with simulation fellows. Challenges of scheduling across time zones, distribution of materials, and recruitment of participants can be overcome by a dedicated team of facilitators aided by readily accessible technology.


Assuntos
Internet , Relações Interprofissionais , Publicações Periódicas como Assunto , Especialização , Canadá , Bolsas de Estudo , Humanos , Mentores , Pesquisa Qualitativa , Inquéritos e Questionários , Estados Unidos
6.
Perm J ; 24: 1-6, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33482932

RESUMO

INTRODUCTION: Differential standards in academic medicine based on gender have been described for self-promoting behavior. BACKGROUND: Objective: To explore differences in office display of professional and personal items between male and female academic physicians as a proxy for self-promotion. METHODS: A university hospital's faculty was invited to participate in a study on office setup. Participants were blinded to the study aim. Investigators evaluated offices to assess the number of professional and personal displays. De-identified data on participant characteristics and office physical characteristics were recorded. Correlations with the number of items displayed were analyzed by univariable and multivariable Poisson regression. RESULTS: Forty-eight physicians participated: 23 (47.9%) from emergency medicine, 9 (18.8%) from surgery, and 16 (33.3%) from internal medicine. The median number of professional displays was 5.0 for women (interquartile range [IQR] = 3.0-9.0) and 6.0 for men (IQR = 2.0-12.0). Controlling for specialty and academic rank, no significant difference existed in professional display rates by women (incidence rate ratio = 1.1, 95% confidence interval = 0.8-1.4). The median number of personal displays was 14.5 items for women (IQR = 8.0-25.0) and 6.0 items for men (IQR = 3.0-15.0), with a significantly different rate (incidence rate ratio = 1.4, 95% confidence interval = 1.2-1.7) when we controlled for specialty, generation, rank, and office characteristics. CONCLUSION: Women displayed more personal items than did men, with no difference in professional display rates. Future studies should examine this difference to understand its cause, which may be linked to differences in academic promotion between men and women.


Assuntos
Médicas , Médicos , Docentes de Medicina , Feminino , Humanos , Medicina Interna , Masculino , Fatores Sexuais
7.
Simul Healthc ; 14(4): 228-234, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31116170

RESUMO

INTRODUCTION: Healthcare simulation supports educational opportunities while maintaining patient safety. To reduce costs and increase the availability of training, a randomized controlled study evaluated central venous catheter (CVC) insertion training in the simulation laboratory with nonphysician competent facilitators (NPCFs) as instructors. METHOD: A group of learners naive to central line placement participated in a blended curriculum consisting of interactive online materials and simulation-based training. Learners were randomized to training with NPCFs or attending physician faculty. The primary outcome was simulated CVC insertion task performance, graded with a validated checklist by blinded physician reviewers. Learner knowledge and satisfaction were also evaluated. Analysis was conducted using noninferiority testing. RESULTS: Eighty-five students, 11 attending physicians, and 7 NPCFs voluntarily participated. Noninferiority testing of the difference in CVC insertion performance between NPCF-trained learners versus physician-trained learners found no significant difference [rejecting the null hypothesis of inferiority using an 8% noninferiority margin (P < 0.01)]. In addition, there was no difference found between the 2 groups on pre/post knowledge scores, self-reported learner comfort, course satisfaction, or instructor satisfaction. CONCLUSIONS: An introductory CVC curriculum can be taught to novice learners by carefully trained and supported NPCFs and achieve skill and knowledge outcomes similar to learners taught by physicians.


Assuntos
Cateterismo Venoso Central , Educação de Pós-Graduação em Medicina/organização & administração , Treinamento por Simulação/organização & administração , Ensino/organização & administração , Adulto , Competência Clínica , Currículo , Avaliação Educacional , Feminino , Humanos , Masculino , Enfermeiras Anestesistas/educação
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