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1.
PLoS One ; 15(8): e0238226, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866197

RESUMO

Virtual patients are an active learning pedagogical tool which simulate clinical scenarios in a three-dimensional environment. Their use in pharmacy education is under-researched in comparison to other healthcare professions. In the United Kingdom, pre-registration training refers to a year of workplace based training which pharmacy graduates must complete prior to professional registration as pharmacists. This study aimed to evaluate pre-registration pharmacists' perceptions on the integration, usefulness and enjoyment of completing virtual patient simulations or non-interactive case studies as part of their training. Pre-registration trainees completed three virtual patient simulations or three non-interactive case studies on the topics of: emergency hormonal contraception, renal function and childhood illnesses. Telephone interviews were conducted with twenty pre-registration pharmacists, exploring their perspectives on the use of the virtual patient or non-interactive case studies. Data was analysed using the five-stage framework approach. Four main themes emerged from the data: case study design; usefulness of the case studies as a training tool; support in pre-registration training; utility of the learning tools. Trainees also identified technical issues they had experienced while completing the virtual patient simulations, specifically with keyword recognition. Pre-registration trainees who used the virtual patients provided comments relating to the novelty, realism and enjoyment in completing them. Trainees in both groups reported developing knowledge and skills from completing the case studies; those who used the virtual patient commented on the development of communication skills and an increase in confidence for practice and those who used the non-interactive cases focused on knowledge acquisition and numeracy. Participants were enthusiastic about virtual patients as a novel training tool which provided an opportunity for learners to practice realistic scenarios in a safe environment. Virtual patients offer the potential to 'bridge the gap' in pharmacist pre-registration sector-related training variation, promote learning through reflection on doing and increase overall preparedness for practice.


Assuntos
Educação em Farmácia/métodos , Aprendizagem Baseada em Problemas/métodos , Atitude do Pessoal de Saúde , Competência Clínica , Feminino , Humanos , Masculino , Simulação de Paciente , Farmacêuticos , Pesquisa Qualitativa , Reino Unido
3.
J Obstet Gynaecol Can ; 42(8): 1017-1020, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32736852

RESUMO

Health care team training and simulation-based education are important for preparing obstetrical services to meet the challenges of the COVID-19 pandemic. Priorities for training are identified in two key areas. First, the impact of infection prevention and control protocols on processes of care (e.g., appropriate and correct use of personal protective equipment, patient transport, preparation for emergency cesarean delivery with the potential for emergency intubation, management of simultaneous obstetric emergencies, delivery in alternate locations in the hospital, potential for increased decision-to-delivery intervals, and communication with patients). And second, the effects of COVID-19 pathophysiology on obstetrical patients (e.g., testing and diagnosis, best use of modified obstetric early warning systems, approach to maternal respiratory compromise, collaboration with critical care teams, and potential need for cardiopulmonary resuscitation). However, such training is more challenging during the COVID-19 pandemic because of the requirements for social distancing. This article outlines strategies (spatial, temporal, video-recording, video-conferencing, and virtual) to effectively engage in health care team training and simulation-based education while maintaining social distancing during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Parto Obstétrico , Controle de Infecções/métodos , Obstetrícia , Pandemias , Pneumonia Viral , Complicações Infecciosas na Gravidez , Treinamento por Simulação , Desenvolvimento de Pessoal/métodos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Parto Obstétrico/educação , Parto Obstétrico/métodos , Tratamento de Emergência/métodos , Feminino , Humanos , Práticas Interdisciplinares/métodos , Obstetrícia/educação , Obstetrícia/métodos , Pandemias/prevenção & controle , Simulação de Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Treinamento por Simulação/métodos , Treinamento por Simulação/organização & administração
4.
Orv Hetil ; 161(33): 1355-1362, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32749235

RESUMO

INTRODUCTION: During the state of emergency caused by the coronavirus pandemic, the Doctor-patient communication training for medical students at the University of Szeged was moved online. The training is based on the method of video analysis, involving simulated patients, making online implementation extremely challenging. AIM: The study aims to present our experiences with the online training and to analyse the students' evaluations. METHOD: We used the free version of Zoom for small groups of five students, a trainer and a simulated patient. All students participated in a situation that we recorded. The viewing of the recordings was followed by group discussion. Then, the students evaluated the course using an online questionnaire. We used descriptive statistics and content analysis. RESULTS: 74.4% of the students (n = 64) completed the questionnaire. 78.1-100% of them gave a good (4) or excellent (5) evaluation for the questions. The highest average score (4.95 ± 0.21) was given to the professionalism of the trainers, the lowest was given to the choice of topic of the theoretical part (4.06 ± 1.02). The majority of the students were satisfied with the course, they would be happy to attend it again; however, in-person learning still seems to be the preferred option. CONCLUSION: The online practice was a success. In many ways, it proved to be an adequate replacement for the traditional form. The students evaluated the training similarly to those of previous years. The lack of personal contact is a limiting factor, thus, online practice should not be seen as an alternative to personal communication trainings; however, as an independent form of training, it can make a significant contribution to effective, modern education. Orv Hetil. 2020; 161(33): 1355-1362.


Assuntos
Coronavirus , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/organização & administração , Simulação de Paciente , Relações Médico-Paciente , Estudantes de Medicina/psicologia , Adulto , Competência Clínica , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias
5.
Am J Disaster Med ; 15(2): 85-92, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804388

RESUMO

OBJECTIVE: To determine whether application of a gum-elastic bougie (GEB), a visual stylet used to improve success rates of difficult intubations, reduces the time, and number of attempts to achieve successful intubation while wearing personal protective equipment (PPE). DESIGN: A randomized cross-over study comparing orotracheal intubations performed on an AirMan® Mannequin, using either a semirigid stylet or a GEB, while wearing an active hood with a charcoal impregnated suit and butyl rubber gloves. SETTING: Simulation training field of the Israel Defense Force Medical Corps. PARTICIPANTS: 27 military physicians and 23 paramedics (PMs). INTERVENTIONS: Comparing intubation with and without using the GEB while wearing PPE. MAIN OUTCOME MEASURE(S): Airway (AW) control was considered successful if the "lungs" of the mannequin ex-panded during bag ventilation. Three unsuccessful attempts or a procedure exceeding 60 seconds were regarded as a failure. Correlations between parameters of self-assessment of skills and successful intubation were also determined. RESULTS: With the GEB, success rate was lower (82 percent versus 100 percent, p = 0.002), more attempts were needed (1.4 ± 0.7 versus 1.0 ± 0.2, p = 0.005) and time-to-achieve AW control was longer (43.6 ± 14.6 sec-onds versus 23.1 ± 10.5 seconds, P < 0.001) than without it. Participants with high self-assessment of GEB-assisted AW management skills needed less attempts to perform successful intubation with GEB than participants with low self-assessment (1.0 ± 0.0 versus 1.4 ± 0.8, p = 0.001), but not less time to achieve it. CONCLUSIONS: While donning PPE, the use of GEB (versus semirigid stylets) did not reduce the time or the number of attempts necessary to achieve successful intubation.


Assuntos
Obstrução das Vias Respiratórias/terapia , Intubação Intratraqueal/instrumentação , Equipamento de Proteção Individual , Treinamento por Simulação , Estudos Cross-Over , Desenho de Equipamento , Humanos , Intubação Intratraqueal/métodos , Israel , Manequins , Simulação de Paciente
6.
Z Evid Fortbild Qual Gesundhwes ; 153-154: 104-110, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32712178

RESUMO

INTRODUCTION: Even in well-developed healthcare systems, raising awareness for undesirable dangers and risks of modern healthcare services among the clinical staff is a continuous and methodical challenge. The concept of the so-called "Room of Horrors" is both an innovative and a low-fidelity simulation approach for team-based training of patient safety-relevant hazards. The purpose of this evaluation study is to report on practicability and acceptance of such a low-threshold simulation training. METHOD: A fictitious patient room including a patient manikin (lying in bed) was set up in the hospital to simulate the Room of Horrors. Additional artifacts such as a side table, medication and the medical record completed the simulation, in which 12 typical errors or latent risks related to patient safety were hidden. After a short briefing, individuals or groups (2-5 participants) should enter the room and try to find as many errors as possible. The error detection rate was evaluated immediately followed by a debriefing. The participants were then asked to answer a short structured questionnaire to provide content-related feedback about the patient safety simulation. RESULTS: Within three days, the Room of Horrors was visited by a total of 89 participants (27 teams and 6 individuals). Average error detection rate was 8.54 out of 12 hidden errors (71%), whereby the teams showed a slightly better result. All the surveyed participants found the simulation to be educational and beneficial. The importance of team discussion was particularly emphasized by a majority of participants. 91% of the participants found the wrong patient identification wristband and in spite of a documented lactose intolerance a yogurt on the side table. 88% of the participants recognized the bell which was out of the patients reach. Few participants found the missing indication of a permanent catheter (24%) and a doubled prescription of paracetamol (42%). DISCUSSION: A comparison of several international studies about so-called Rooms of Horrors shows that the present study has a relatively high average detection rate (71%), although a significant percentage of the participants are not engaged in medical or nursing services. Not surprisingly, the average detection of errors of the teams were higher than individuals. This strengthens the theory that a discursive discussion and exchange of dialogue among the clinical staff in a patient's room increases patient safety or at least strengthens situational awareness for clinical risks. The consistently positive feedback coincides with the evaluation results of other clinics and thus demonstrates the acceptance of simulation-based on-site training. The organizational and financial effort to execute the simulation training remained very low (apart from the resulting costs incurred due to the participants missing from their regular hospital duties). Hence, the evaluation study proves practicability and acceptance of this simulation method. CONCLUSION: The study provides no information about the extent to which the simulation actually influences the behavior and situational awareness of the participants. At least the awareness of the participants for real risks, hazards and errors of modern patient care was raised temporarily. The Room of Horrors can be easily adapted to different learning goals and settings. It is a flexible and practical learning arrangement. In comparison to the organizational and financial efforts involved, the implementation can be recommended without exception.


Assuntos
Competência Clínica , Segurança do Paciente , Alemanha , Hospitalização , Humanos , Simulação de Paciente
7.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(3): 141-149, mayo-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193881

RESUMO

INTRODUCCIÓN: La fidelidad es un elemento crucial, pero difuso, en los programas de simulación clínica. Es común que se la defina en base a preguntas de satisfacción, con enfoques subjetivos y pequeños tamaños de muestra. Se necesitan instrumentos de medición validados para una consideración más objetiva de fidelidad en escenas con participantes simulados o con maniquíes y en entornos sofisticados o no. SUJETOS Y MÉTODOS: Los indicadores se definieron mediante búsqueda bibliográfica de temas afines en artículos publicados en revistas indizadas, con las palabras clave 'fidelidad', 'realismo', 'verosimilitud' y 'alta, media y baja fidelidad', cruzadas con 'simulación clínica', en castellano e inglés. Esta es la primera fase, conceptual, de una investigación que validará formularios universales para medir la fidelidad. RESULTADOS: Se conceptualizaron tres dimensiones generales donde medir la fidelidad. A cada dimensión se le asignaron unidades específicas que se desglosaron en indicadores agrupados en tres variables de uso sistémico. La unidad mínima de medición fue el indicador. Se designaron tasadores múltiples y diferentes para cada dimensión. CONCLUSIONES: Los indicadores permiten aclarar los términos fidelidad/realismo para su uso estandarizado, definen y hacen medibles las diferentes expresiones de realismo, permiten prever y obtener el verdadero coste/beneficio de la inversión en la reproducción fiel de los entornos por parte de las instituciones, permiten describir la trazabilidad de la fidelidad ingeniera en los productos biotecnológicos y posibilitan que los activos y productos de la simulación sean validados por expertos clínicos con fundamento científico, reduciendo los sesgos por desconocimiento o indefinición


INTRODUCTION: Fidelity is a crucial, but diffuse, element in clinical simulation programs. It is commonly defined based on satisfaction questions, with subjective approaches and small sample sizes. Validated measuring instruments are needed for more objective consideration of fidelity in scenes with simulated participants and/or mannequins and in sophisticated or non-sophisticated environments. SUBJECTS AND METHODS: The indicators were defined by a bibliographic search of related topics in articles published in indexed journals with the keywords 'fidelity', 'realism', and 'high, medium and low fidelity' crossed with 'healthcare simulation', in Spanish and English. This is the first phase, conceptual, of a deeper research that will validate universal forms to measure fidelity. RESULTS: Three general dimensions were conceptualized to measure fidelity. Each dimension was assigned specific units that were broken down into indicators grouped into three systemic use variables. The minimum unit of measurement was the indicator. Multiple and different appraisers were designated for each dimension. CONCLUSIONS: The indicators make possible to clarify the terms fidelity/realism for their standardized use. They define and make measurable the different expressions of realism. They make it possible to foresee and obtain the true cost/benefit of the investment in the faithful reproduction of the environments by the institutions. They make it possible to describe the traceability of the engineering fidelity in biotechnology products. They also make possible that the assets and products of the simulation are validated by clinical experts with a scientific basis, reducing the biases due to lack of knowledge or lack of definition


Assuntos
Humanos , Treinamento com Simulação de Alta Fidelidade/métodos , Treinamento com Simulação de Alta Fidelidade/normas , Treinamento por Simulação/métodos , Educação Médica/métodos , Simulação de Paciente , Treinamento com Simulação de Alta Fidelidade/organização & administração , Treinamento com Simulação de Alta Fidelidade/estatística & dados numéricos , Treinamento por Simulação/estatística & dados numéricos , Educação Médica/organização & administração
10.
Dentomaxillofac Radiol ; 49(7): 20200154, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32491941

RESUMO

OBJECTIVES: To assess dental students' ability to recognize head positioning errors in panoramic (PAN) images after individual learning via computer-assisted-learning (CAL) and in a simulation clinic (SIM). Both cognitive skills and performance in patient examination were assessed. METHODS AND MATERIALS: 60 students (mean age 23.25 years) participated in lectures on the relation between PAN-image errors and patient's head position. Immediately after they took a test, based on which they were randomized to three groups: control (CON) group, CAL group, and SIM group (both CAL and training in a simulation clinic with a phantom). 4-5 weeks after intervention/no intervention, all students individually examined a patient with PAN-exposure. A blinded rater, not knowing group allocation, supervised patient exposure and assessed student's performance (correct/incorrect head position in three planes). 1-2 weeks after, the students scored positioning errors in 40 PAN-images. Differences in cognitive test scores between groups were evaluated by ANOVA and in patient examination by χ2 tests, and within-group differences by sign-tests. RESULTS: No statistically significant difference in cognitive test scores was seen between the SIM and CAL group, while the CON group scored lower (p < 0.003). In all groups, several students positioned the patient incorrectly in the Frankfort horizontal plane. All students performed well in the sagittal plane. Students in SIM group positioned the patient more correctly in the coronal plane. CONCLUSIONS: Training with CAL increased students' cognitive skills compared with a control group. Simulated patient exposure with a phantom increased to some extent their performance skills in examination of patients.


Assuntos
Desenho Assistido por Computador , Cabeça , Radiografia Panorâmica , Estudantes de Odontologia , Adulto , Competência Clínica , Cognição , Educação em Odontologia/métodos , Avaliação Educacional , Humanos , Aprendizagem , Simulação de Paciente , Adulto Jovem
13.
Curr Opin Anaesthesiol ; 33(3): 272-276, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32371644

RESUMO

PURPOSE OF REVIEW: Simulation training (crew resource management training and scenario training) has become an important tool in the education of anesthesiologists. This review summarizes recent research performed in this area, focusing more specifically on obstetric anesthesia. RECENT FINDINGS: Simulation training is becoming more integrated in the modern education of anesthesiologists. Research regarding the most effective way to perform simulation training in terms of learning outcomes and long-term skill retention has started to appear. Scenarios which are played independently and that allow for simulated mortality, as well as relaxation techniques before debriefing might have positive effects in this regard. Furthermore, simulation has been investigated as a tool to improve patient safety in low-resource settings. In addition, simulation training in the domain of obstetrics has been rapidly expanding and has an important role in this field of medicine as well. SUMMARY: Simulation training has acquired a central role in modern education of anesthesiologists. Further research regarding elements to optimize simulation training in terms of learning outcomes and long-term skill retention is desirable. In addition, little data exist concerning the effect of simulation training on possible improvement of patient outcomes in anesthesia.


Assuntos
Anestesia Obstétrica , Anestesiologia , Obstetrícia , Simulação de Paciente , Treinamento por Simulação , Competência Clínica , Feminino , Humanos , Gravidez
14.
Clin Med (Lond) ; 20(4): e66-e71, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32430344

RESUMO

BACKGROUND: COVID-19 poses many challenges to healthcare systems and workers. Responding to medical emergencies in patients with suspected COVID-19 will require new guidelines and protocols. Simulation can support their development. METHODS: We organised seven simulations involving patients with suspected COVID-19 for staff at Brighton and Sussex University Hospitals. Participants completed pre- and post-simulation questionnaires. RESULTS: Fifty-six staff participated and they reported being significantly less prepared to respond to an emergency in a patient with suspected COVID-19 than in one in whom it is not suspected. The simulations significantly improved the participants' confidence in responding to emergencies in patients with suspected COVID-19. Numerous challenges were identified along the themes of equipment, personnel, communication and procedures. CONCLUSIONS: Low-fidelity simulation can provide relevant and timely information on how prepared health systems and their workforce are to respond to emergencies. We urge NHS trusts nationally to implement simulations to identify problems and develop effective solutions.


Assuntos
Infecções por Coronavirus/complicações , Parada Cardíaca/complicações , Parada Cardíaca/terapia , Pneumonia Viral/complicações , Autoeficácia , Treinamento por Simulação/métodos , Idoso , Comunicação , Emergências , Humanos , Masculino , Pandemias , Simulação de Paciente , Equipamento de Proteção Individual , Projetos Piloto , Inquéritos e Questionários
15.
PLoS One ; 15(5): e0233538, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469920

RESUMO

INTRODUCTION: Simulation is a powerful tool for training and evaluating clinicians. However, few studies have examined the consistency of actor performances during simulation based medical education (SBME). The Simulated Communication with ICU Proxies trial (ClinicalTrials.gov NCT02721810) used simulation to evaluate the effect of a behavioral intervention on physician communication. The purpose of this secondary analysis of data generated by the quality assurance team during the trial was to assess how quality assurance monitoring procedures impacted rates of actor errors during simulations. METHODS: The trial used rigorous quality assurance to train actors, evaluate performances, and ensure the intervention was delivered within a standardized environment. The quality assurance team evaluated video recordings and documented errors. Actors received both timely, formative feedback and participated in group feedback sessions. RESULTS: Error rates varied significantly across three actors (H(2) = 8.22, p = 0.02). In adjusted analyses, there was a decrease in the incidence of actor error over time, and errors decreased sharply after the first group feedback session (Incidence Rate Ratio = 0.25, 95% confidence interval 0.14-0.42). CONCLUSIONS: Rigorous quality assurance procedures may help ensure consistent actor performances during SBME.


Assuntos
Feedback Formativo , Simulação de Paciente , Garantia da Qualidade dos Cuidados de Saúde/métodos , Idoso de 80 Anos ou mais , Humanos , Masculino
16.
Otolaryngol Head Neck Surg ; 163(2): 250-258, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32450759

RESUMO

OBJECTIVES: Our objectives were (1) to use in situ simulation to assess the clinical environment and identify latent safety threats (LSTs) related to the management of pediatric tracheostomy patients and (2) to analyze the effects of systems interventions and team factors on LSTs and simulation performance. METHODS: A multicenter, prospective study to assess LSTs related to pediatric tracheostomy care management was conducted in emergency departments (EDs) and intensive care units (ICUs). LSTs were identified through equipment checklists and in situ simulations via structured debriefs and blinded ratings of team performance. The research team and unit champions developed action plans with interventions to address each LST. Reassessment by equipment checklists and in situ simulations was repeated after 6 to 9 months. RESULTS: Forty-one LSTs were identified over 21 simulations, 24 in the preintervention group and 17 in the postintervention group. These included LSTs in access to equipment (ie, availability of suction catheters, lack of awareness of the location of tracheostomy tubes) and clinical knowledge gaps. Mean equipment checklist scores improved from 76% to 87%. Twenty-one unique teams (65 participants) participated in the simulations. The average simulation score was 6.19 out of 16 points. DISCUSSION: In situ simulation is feasible and effective as an assessment tool to identify latent safety threats and thus measure the system-level performance of a clinical care environment. IMPLICATIONS FOR PRACTICE: In situ simulation can be used to identify and reassess latent safety threats related to pediatric tracheostomy management and thereby support quality improvement and educational initiatives.


Assuntos
Simulação de Paciente , Melhoria de Qualidade , Traqueostomia/educação , Traqueostomia/normas , Criança , Humanos , Segurança do Paciente , Estudos Prospectivos
17.
Pediatr Emerg Care ; 36(5): 222-228, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32356959

RESUMO

OBJECTIVES: High-quality clinical research of resuscitations in a pediatric emergency department is challenging because of the limitations of traditional methods of data collection (chart review, self-report) and the low frequency of cases in a single center. To facilitate valid and reliable research for resuscitations in the pediatric emergency department, investigators from 3 pediatric centers, each with experience completing successful single-center, video-based studies, formed the Videography In Pediatric Emergency Research (VIPER) collaborative. METHODS: Our initial effort was the development of a multicenter, video-based registry and simulation-based testing of the feasibility and reliability of the VIPER registry. Feasibility of data collection was assessed by the frequency of an indeterminate response for all data elements in the registry. Reliability was assessed by the calculation of Cohen κ for dichotomous data elements and intraclass correlation coefficients for continuous data elements. RESULTS: Video-based data collection was completed for 8 simulated pediatric resuscitations, with at least 2 reviewers per case. Data were labeled as indeterminate by at least 1 reviewer for 18 (3%) of 524 relevant data fields. The Cohen κ for all dichotomous data fields together was 0.81 (95% confidence interval, 0.61-1.0). For all continuous (time-based) variables combined, the intraclass correlation coefficient was 0.88 (95% confidence interval, 0.70-0.96). CONCLUSIONS: Initial simulation-based testing suggests video-based data collection using the VIPER registry is feasible and reliable. Our next step is to assess feasibility and reliability for actual pediatric resuscitations and to complete several prospective, hypothesis-based studies of specific aspects of resuscitative care, including of cardiopulmonary resuscitation, tracheal intubation, and teamwork and communication.


Assuntos
Coleta de Dados/métodos , Medicina de Emergência , Pediatria , Sistema de Registros , Ressuscitação , Gravação em Vídeo , Pesquisa Biomédica , Criança , Serviço Hospitalar de Emergência , Estudos de Viabilidade , Humanos , Simulação de Paciente
18.
Anaesthesia ; 75(8): 1014-1021, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32397008

RESUMO

The coronavirus disease 2019 pandemic has led to the manufacturing of novel devices to protect clinicians from the risk of transmission, including the aerosol box for use during tracheal intubation. We evaluated the impact of two aerosol boxes (an early-generation box and a latest-generation box) on intubations in patients with severe coronavirus disease 2019 with an in-situ simulation crossover study. The simulated process complied with the Safe Airway Society coronavirus disease 2019 airway management guidelines. The primary outcome was intubation time; secondary outcomes included first-pass success and breaches to personal protective equipment. All intubations were performed by specialist (consultant) anaesthetists and video recorded. Twelve anaesthetists performed 36 intubations. Intubation time with no aerosol box was significantly shorter than with the early-generation box (median (IQR [range]) 42.9 (32.9-46.9 [30.9-57.6])s vs. 82.1 (45.1-98.3 [30.8-180.0])s p = 0.002) and the latest-generation box (52.4 (43.1-70.3 [35.7-169.2])s, p = 0.008). No intubations without a box took more than 1 min, whereas 14 (58%) intubations with a box took over 1 min and 4 (17%) took over 2 min (including one failure). Without an aerosol box, all anaesthetists obtained first-pass success. With the early-generation and latest-generation boxes, 9 (75%) and 10 (83%) participants obtained first-pass success, respectively. One breach of personal protective equipment occurred using the early-generation box and seven breaches occurred using the latest-generation box. Aerosol boxes may increase intubation times and therefore expose patients to the risk of hypoxia. They may cause damage to conventional personal protective equipment and therefore place clinicians at risk of infection. Further research is required before these devices can be considered safe for clinical use.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Intubação Intratraqueal/instrumentação , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Adulto , Aerossóis , Anestesiologistas , Infecções por Coronavirus/transmissão , Cuidados Críticos/métodos , Estudos Cross-Over , Desenho de Equipamento , Feminino , Humanos , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Simulação de Paciente , Pneumonia Viral/transmissão
19.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(2): 75-79, mar.-abr. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-191322

RESUMO

INTRODUCCIÓN: Actualmente se plantean mejoras a los tradicionales sistemas de enseñanza-aprendizaje clinicoquirúrgicos. OBJETIVO: Demostrar un programa de formación basada en competencias durante la práctica clínico quirúrgica supervisada. Sujetos y métodos. Análisis cualitativo observacional (no experimental) seccional-transversal descriptivo del programa de residencia de cirugía general en un hospital universitario estatal con 17 médicos residentes, desde el 1 de junio de 2017 al 31 de mayo de 2018. RESULTADOS: Eficaz desempeño con evaluaciones durante los ateneos didácticos con casos clínicos validados como aceptable por la prueba alfa de Cronbach, así como en quirófanos. CONCLUSIÓN: Cumple con las condiciones exigibles para un proceso formativo con adquisición de una responsabilidad pro-gresiva independiente


INTRODUCTION: Improvements are currently being made to traditional clinical-surgical teaching-learning systems. AIM: To demonstrate a competency-based training program during supervised clinical-surgical practice. Subjects and methods. Descriptive sectional-cross-sectional qualitative analysis of the General Surgery Residence program at a state university hospital with 17 resident physicians from June 1st 2017 to May 31st 2018. RESULTS: Effective performance with evaluations during didactic clinical cases presentation validated as acceptable by the Cronbach's alpha test as well as in operating rooms. CONCLUSION: It sees the conditions required for a training process with acquisition of an independent progressive responsibility


Assuntos
Humanos , Masculino , Feminino , Adulto , Cirurgia Geral/educação , Internato e Residência , Hospitais Universitários , 25783 , Simulação de Paciente
20.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(2): 89-94, mar.-abr. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191324

RESUMO

INTRODUCCIÓN: La educación en odontología, desde sus inicios, ha utilizado escenarios de simulación para desarrollar habilidades motoras en estudiantes. En estos días, simuladores virtuales hápticos 3D de alta fidelidad están siendo utilizados como una herramienta didáctica que permite al estudiante realizar actividades de la profesión en un entorno simulado, seguro y controlado. OBJETIVO: Determinar la percepción sobre la utilidad de los simuladores virtuales hápticos para la práctica en odontología, por estudiantes de odontología (cuarto, quinto y sexto año), profesionales y académicos. Sujetos y métodos. Estudio no experimental, observacional, descriptivo y cuantitativo, que incluyó a 127 participantes (estudiantes de odontología, odontólogos y académicos). Se realizó un ejercicio preclínico con forma de cruz durante 5-10 minutos y luego una cavidad de clase II Black en un simulador virtual háptico en 3D. Se elaboró un cuestionario de 12 preguntas sobre la utilidad del simulador dental y las respuestas se analizaron estadísticamente. RESULTADOS: Estudiantes de la universidad, odontólogos locales y dentistas/académicos valoraron positivamente su experiencia con los simuladores virtuales hápticos, su utilidad como herramienta de enseñanza en el desarrollo de habilidades manuales y el realismo de sensación y uso del simulador. CONCLUSIÓN: Los participantes, independientemente de su experiencia previa con un simulador virtual, videojuegos, edad, experiencia en 3D o sexo, consideraron positiva su percepción de la utilidad del simulador de realidad virtual háptica VirTeaS y en educación, con una mejor retroalimentación


INTRODUCTION: Education in dentistry has provided simulation scenarios for training students to develop motor skills since its beginning, now days, high-fi delity 3D haptic virtual simulators are being used as a didactic tool, allowing dentistry students to perform activities of the professional discipline, in a safe and controlled simulated environment. AIM:To determine the perception on the usefulness of haptic virtual simulators for training in Dentistry, by dental students (4th, 5th and 6th year), practitioners and academics. Subjects and methods. Non-experimental, descriptive, observational, quantitative study, that involved 127 participants (dental students, dental practitioners and academics), that practiced on a cross preclinical exercise for 5-10 minuts and performed a Black's class II cavity in a 3D haptic virtual simulator. A 12-question questionnaire was constructed regarding the usefulness of the dental simulator and the answers were statistically analyzed. RESULTS:University students, local dental practitioners and dentists/academics rated as positive their experience with the haptic virtual simulators and its usefulness as a teaching tool in manual skills development, and realism of sensation and use of the simulator. CONCLUSION: Participants regardless of their previous experience with a virtual simulator, video-gaming, age, 3D experience, or gender considered positivetheir perception of usefulness of the VirTeaSy haptic virtual reality simulator in dental education, with the possibility of better feedback


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Educação em Odontologia/métodos , Treinamento por Simulação/métodos , Simulação de Paciente , Realidade Virtual , Inquéritos e Questionários , Estudos Transversais
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