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1.
Rev. enferm. UERJ ; 28: e44488, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096023

RESUMO

Objetivo: identificar dúvidas de puérperas e familiares sobre cuidados domiciliares com o recém-nascido de baixo risco e analisar a roda de conversa, mediada por simulador realístico de baixa fidelidade, como uma tecnologia educativa para o preparo de famílias no processo de alta da maternidade. Método: pesquisa qualitativa, incluindo dezenove familiares de recém-nascidos de baixo risco em um hospital municipal de Rio das Ostras, Rio de Janeiro, de maio a outubro de 2018, por entrevista semiestruturada. Dados submetidos à Análise Temática. Resultados: as dúvidas dos familiares versaram sobre cuidados com higiene, alimentação, ambiente, afeto, saúde, sono e doenças. A roda de conversa com simulador de baixa fidelidade foi considerada uma estratégia positiva para mediar o aprendizado. Conclusão: a tecnologia educativa revelou-se útil na instrumentalização de famílias no processo de alta da maternidade, visto que o cuidador fortalece suas potencialidades, retira dúvidas e troca informações e experiências no grupo.


Objective: to identify puerperal and family members' questions about home care with low-risk newborns and to analyze the conversation circle, mediated by a realistic low fidelity simulator, as an educational technology for the preparation of families in the maternity discharge process. Method: qualitative research conducted with nineteen relatives of low-risk newborns in the municipal hospital in Rio das Ostras, Rio de Janeiro, Brazil, from May to October 2018, through semi-structured interview. Data submitted to thematic analysis. Results: the family members' doubts were about care with hygiene, food, environment, affection, health, sleep and diseases. The conversation wheel with low fidelity simulator was considered a positive strategy to mediate learning. Conclusion: the educational technology proved to be useful in the instrumentalization of families in the maternity discharge process, as the caregiver strengthens their potential, removes doubts and exchanges information and experiences in the group.


Objetivo: identificar dudas puerperales y familiares sobre atención domiciliaria con recién nacidos de bajo riesgo y analizar el círculo de conversación, mediado por simulador realista de baja fidelidad, como una tecnología educativa de preparación de familias en el proceso de alta de la maternidad. Método: investigación cualitativa, con diecinueve familiares de recién nacidos de bajo riesgo en un hospital municipal en Río das Ostras, Río de Janeiro, de mayo a octubre de 2018, a través de entrevistas semiestructuradas. Se utilizó a Análisis temático. Resultados: las dudas fueron sobre higiene, alimentación, medio ambiente, afecto, salud, sueño y enfermedades. El círculo de conversación con simulador se consideró una estrategia positiva para mediar en el aprendizaje. Conclusión: la tecnología educativa demostró ser útil en la instrumentalización de familias en el proceso de alta de la maternidad, porque el cuidador fortalece su potencial, elimina dudas e intercambia información y experiencias en el grupo.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Alta do Paciente , Recém-Nascido , Família , Cuidadores/educação , Tecnologia Educacional , Assistência Domiciliar/educação , Brasil , Tecnologia Educacional/métodos , Pesquisa Qualitativa , Treinamento por Simulação , Maternidades , Hospitais Municipais
2.
Medicine (Baltimore) ; 99(43): e22562, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120744

RESUMO

Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.


Assuntos
Ginecologia/educação , Obstetrícia/educação , Treinamento por Simulação , Estudantes de Medicina , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Competência Clínica , Estudos de Coortes , Comportamento Cooperativo , Currículo , Educação de Graduação em Medicina , Educação em Enfermagem , Humanos , Relações Interprofissionais
3.
Rev Esp Anestesiol Reanim ; 67(9): 487-495, 2020 11.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33036762

RESUMO

INTRODUCTION: The current SARS-CoV-2 pandemic has been the world's largest socio-health crisis experienced in the last century. Each healthcare center has been compelled to adapt the treatment guidelines established by the different scientific societies. OBJECTIVES: Analyze the impact of the methodology based on simulation as a tool to improve our clinical practice: work dynamics, effectiveness and safety of all the physicians involved in the management of labor in COVID pregnant women and its usefulness to facilitate the adaptation of protocols to a specific clinical context. METHOD: Descriptive observational study that includes the C-sections and deliveries of COVID pregnant women performed in our hospital. The actions carried out in each procedure were analyzed using the simulation multidisciplinary briefing and debriefing tools, before and after each case. RESULTS: A total of 5 clinical cases were analyzed. Difficulties were found in the execution of the protocols established for the care of the COVID pregnant. Organizational, structural, material resources and human factors obstacles were the most common. CONCLUSIONS: Our results showed that the analysis example using simulation methodology was a tool of great value in three aspects: teamwork improvement, actions consent and improvement proposals for the adaptation and implementation of protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Parto Obstétrico/métodos , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/terapia , Complicações Infecciosas na Gravidez/terapia , Treinamento por Simulação/métodos , Adulto , Cesárea , Tomada de Decisão Clínica , Técnicas de Laboratório Clínico/métodos , Protocolos Clínicos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Delegação Vertical de Responsabilidades Profissionais , Emergências , Feminino , Humanos , Comunicação Interdisciplinar , Pandemias , Admissão e Escalonamento de Pessoal , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Adulto Jovem
4.
Curr Opin Anaesthesiol ; 33(6): 800-807, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33060385

RESUMO

PURPOSE OF REVIEW: The landscape of medical education continues to evolve. Educators and learners must stay informed on current medical literature, in addition to focusing efforts on current educational trends and evidence-based methods. The present review summarizes recent advancements in anesthesiology education, specifically highlighting trends in e-learning and telesimulation, and identifies possible future directions for the field. RECENT FINDINGS: Websites and online platforms continue to be a primary source of educational content; top websites are more likely to utilize standardized editorial processes. Podcasts and videocasts are important tools desired by learners for asynchronous education. Social media has been utilized to enhance the reach and visibility of journal articles, and less often as a primary educational venue; its efficacy in comparison with other e-learning platforms has not been adequately evaluated. Telesimulation can effectively disseminate practical techniques and clinical knowledge sharing, extending the capabilities of simulation beyond previous restrictions in geography, space, and available expertise. SUMMARY: E-learning has changed the way anesthesiology learners acquire knowledge, expanding content and curricula available and promoting international collaboration. More work should be done to expand the principles of accessible and collaborative education to psychomotor and cognitive learning via telesimulation.


Assuntos
Anestesia , Anestesiologia/educação , Instrução por Computador , Educação Médica/métodos , Treinamento por Simulação/métodos , Anestesiologia/tendências , Currículo , Humanos , Aprendizagem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33121028

RESUMO

Due to the coronavirus disease (COVID-19) pandemic, there are many restrictions in effect in clinical nursing practice. Since effective educational strategies are required to enhance nursing students' competency in clinical practice, this study sought to evaluate the effectiveness of simulation problem-based learning (S-PBL). A quasi-experimental control group pretest-post-test design was used. Nursing students were allocated randomly to the control group (n = 31) and the experimental group (n = 47). Students in the control group participated in a traditional maternity clinical practicum for a week, while students in the experimental group participated S-PBL for a week. The students in the experimental group were trained in small groups using a childbirth patient simulator (Gaumard® Noelle® S554.100, Miami, USA) based on a standardized scenario related to obstetric care. The students' learning attitude, metacognition, and critical thinking were then measured via a self-reported questionnaire. Compared with the control group, the pre-post difference in learning attitude and critical thinking increased significantly (p < 0.01) in the experimental group. S-PBL was found to be an effective strategy for improving nursing students' learning transfer. Thus, S-PBL that reflects various clinical situations is recommended to improve the training in maternal health nursing.


Assuntos
Educação Baseada em Competências/métodos , Metacognição , Aprendizagem Baseada em Problemas/métodos , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Pensamento , Betacoronavirus , Competência Clínica , Infecções por Coronavirus/epidemiologia , Bacharelado em Enfermagem/métodos , Avaliação Educacional , Feminino , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Preceptoria , Gravidez
6.
Medicine (Baltimore) ; 99(41): e22622, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031321

RESUMO

Validation of the anatomically complex configurations of the Lumbar Puncture Simulator II (KYOTO KAGAKU CO., LTD., 15 Kitanekoya-cho Fushimi-ku Kyoto, Japan 612-8388) have not been reported. Previous validation of the normal anatomic configuration has been reported. This study aims to evaluate evidence for construct and content validity of 4 interchangeable lumbar puncture (LP) complex anatomic configurations of this simulator.We performed a cross-sectional study between April 2018 and May 2019. Novice volunteer medical students and expert physicians who had performed over 30 LP procedures performed sequential LP procedures on each of 4 simulated interchangeable anatomic LP puncture blocks (normal, obesity, geriatric, combined geriatric/obesity). Primary outcome measures compared between groups for each LP procedure were return of cerebrospinal fluid within 5 minutes and a calculated performance score. Subjective face validity and content validity 5-point Likert questionnaires were completed by participants.35 novice (n = 19) and expert (n = 16) subjects completed 140 procedures. Significant differences were found between novice and expert groups for both cerebrospinal fluid success rates and performance scores for normal (P = .001/P = .001) geriatric (P = .005/P = .002) and obesity (P = .003/P = < .001) configurations. There were no differences for the geriatric/obesity configuration. Expert median score of simulator realism (face validity) was 4 (range 3-4); median score of utility as a training tool (content validity) was 4 (range 4-5).We provide evidence for construct validity for each of the complex LP configurations, except combined geriatric/obesity. Expert physicians found the simulator sufficiently realistic to effectively teach LP skills.


Assuntos
Treinamento por Simulação , Punção Espinal , Estudos Transversais , Humanos
7.
PLoS One ; 15(10): e0237563, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33021984

RESUMO

In the development of ship anchorage training systems, the problems of low efficiency and poor fidelity exist in the simulation of flexible anchor chains, and a position-based dynamics (PBD) method is proposed to express the chain movement. To satisfy the requirements of simulating anchoring manipulation, the PBD method modifies the position of anchor chain particles by controlling constraints. Using the original distance constraint and bending constraint of the PBD approach, two novel constraints, namely, the long-range attachment (LRA) constraint and pin constraint, are developed to simulate the bending and stretching of the anchor chain. Simulation of ordinary ropes can be achieved using distance and bending constraints. The developed LRA constraint is capable of preventing anchor chain particles from being overstretched. Adoption of the pin constraint is proposed to integrate two particles into one to be calculated as an attempt to simulate the connection between the chain and the anchor. The continuous collision detection (CCD) constraint method considering friction and viscosity is used to detect collisions in the ship anchoring training system. Collision detection covers chain collisions with other objects and chains. Finally, the PBD method is more efficient and robust than the Newton method. Since it has sufficient visual plausibility and can realize real-time visualization, the simulation system developed by the PBD method effective for training crew members.


Assuntos
Navios , Algoritmos , Simulação por Computador , Humanos , Fenômenos Físicos , Navios/instrumentação , Navios/estatística & dados numéricos , Treinamento por Simulação
8.
Surgery ; 168(5): 898-903, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32868108

RESUMO

BACKGROUND: This study utilized the Team Strategies and Tools to Enhance Performance and Patient Safety and the Nontechnical Skills for Surgeons grading systems to evaluate the nontechnical skills of general surgery and obstetrician/gynecologist residents to see if these grading systems were concordant. These simulations were also intended to teach about crisis resources available at our institution. METHODS: Nineteen teams were created consisting of either one general surgery resident or 2 Obstetrician/Gynecologist residents plus 2 Anesthesia residents and 2 to 4 nurses. Each team was given a short briefing on Team Strategies and Tools to Enhance Performance and Patient Safety, then performed 2 simulated operating room crises. All exercises were graded by 2 independent observers with experience in the operating room and in using the Team Strategies and Tools to Enhance Performance and Patient Safety and Nontechnical Skills for Surgeons grading systems. RESULTS: Averaged general surgery Team Strategies and Tools To Enhance Performance and Patient Safety score increased between scenarios (14.3-17; P ≤ .01), as did obstetrician/gynecologist Team Strategies and Tools to Enhance Performance and Patient Safety score (14.9-19.2; P ≤ .01). Averaged general surgery Nontechnical Skills for Surgeons score increased between scenarios (10.3-12.2; P ≤ .02), as did obstetrician/gynecologist Nontechnical Skills for Surgeons score (10.2-14.3; P ≤ .01). Surgery Team Strategies and Tools to Enhance Performance and Patient Safety scores demonstrated a strong correlation of movement with Nontechnical Skills for Surgeons scores (r = 0.83), as did obstetrician/gynecologist (r = 0.91). On average both general surgery (11%-100%; P ≤ .01) and obstetrician/gynecologist (50%-90%; P ≤ .01) saw a statistically significant increase in their awareness of the crisis checklist. CONCLUSION: Team Strategies and Tools to Enhance and Patient Safety scores and Nontechnical Skills for Surgeons are effective and concordant tools for gauging general surgery and obstetrician/gynecologist resident nontechnical skills. In situ simulations are an effective way to teach general surgery and obstetrician/gynecologist residents about available crisis resources.


Assuntos
Competência Clínica , Cirurgia Geral/educação , Ginecologia/educação , Internato e Residência , Obstetrícia/educação , Salas Cirúrgicas , Treinamento por Simulação , Humanos , Equipe de Assistência ao Paciente , Segurança do Paciente
9.
J Cancer Res Ther ; 16(4): 780-787, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930118

RESUMO

Background: There are "blind spots" on chest computed tomography (CT) where pulmonary nodules can easily be overlooked. The number of missed pulmonary nodules can be minimized by instituting a training program with particular focus on the depiction of nodules at blind spots. Purpose: The purpose of this study was to assess the variation in lung nodule detection in chest CT based on location, attenuation characteristics, and reader experience. Materials and Methods: We selected 18 noncalcified lung nodules (6-8 mm) suspicious of primary and metastatic lung cancer with solid (n = 7), pure ground-glass (6), and part-solid ground-glass (5) attenuation from 12 chest CT scans. These nodules were randomly inserted in chest CT of 34 patients in lung hila, 1st costochondral junction, branching vessels, paramediastinal lungs, lung apices, juxta-diaphragm, and middle and outer thirds of the lungs. Two residents and two chest imaging clinical fellows evaluated the CT images twice, over a 4-month interval. Before the second reading session, the readers were trained and made aware of the potential blind spots. Chi-square test was used to assess statistical significance. Results: Pretraining session: Fellows detected significantly more part-solid ground-glass nodules compared to residents (P = 0.008). A substantial number of nodules adjacent to branching vessels and posterior mediastinum were missed. Posttraining session: There was a significant increase in detectability independent of attenuation and location of nodules for all readers (P < 0.0008). Conclusion: Dedicated chest CT training improves detection of lung nodules, especially the part-solid ground-glass nodules. Detection of nodules adjacent to branching vessels and the posterior mediastinal lungs is difficult even for fellowship-trained radiologists.


Assuntos
Neoplasias Pulmonares/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico , Radiologia/educação , Treinamento por Simulação/métodos , Nódulo Pulmonar Solitário/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Mediastino/diagnóstico por imagem , Mediastino/patologia , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/patologia , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Radiologia/métodos , Software , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
10.
J Interprof Care ; 34(5): 706-710, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32917099

RESUMO

This report describes the Obstetric and Neonatal Simulation (ONE-Sim) workshop run in a remote learning format for medical and midwifery students in an interprofessional setting during the COVID-19 pandemic. It explores the observation of students as participants in the online learning of using Personal Protective Equipment and simulation-based learning of perinatal emergency management. This was followed by their mutual interaction and reflections. This paper aims to understand the role of synchronous remote learning through simulation and its impact on interprofessional interactions. We describe the experience of medical and midwifery students with the ONE-Sim workshop, facilitated by medical (obstetric and neonatal) and midwifery educators. Formal thematic analysis will be performed as part of the ongoing study; however, initial direct observation demonstrated that students reacted positively to the online ONE-Sim workshop and engaged well with facilitators and peers. Students mutually interacted amongst themselves, shared their previous experiences, knowledge of roles as medical and midwifery practitioners and how they see themselves in those roles in a perinatal emergency setting. The initial observations demonstrate that interprofessional education delivered in an e-learning format can be useful and meaningful, and may be utilized across a number of specialties.


Assuntos
Infecções por Coronavirus , Educação a Distância , Comunicação Interdisciplinar , Tocologia/educação , Pandemias , Pneumonia Viral , Treinamento por Simulação , Estudantes de Medicina , Betacoronavirus , Cuidados Críticos , Humanos , Obstetrícia/educação , Assistência Perinatal , Avaliação de Programas e Projetos de Saúde , Gravação em Vídeo
11.
PLoS One ; 15(9): e0238952, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941466

RESUMO

OBJECTIVE: To meet increasing demands to train neuroendovascular techniques, we developed a dedicated simulator applying individualized three-dimensional intracranial aneurysm models ('HANNES'; Hamburg Anatomic Neurointerventional Endovascular Simulator). We hypothesized that HANNES provides a realistic and reproducible training environment to practice coil embolization and to exemplify disparities between neurointerventionalists, thus objectively benchmarking operators at different levels of experience. METHODS: Six physicians with different degrees of neurointerventional procedural experience were recruited into a standardized training protocol comprising catheterization of two internal carotid artery (ICA) aneurysms and one basilar tip aneurysm, followed by introduction of one framing coil into each aneurysm and finally complete coil embolization of one determined ICA aneurysm. The level of difficulty increased with every aneurysm. Fluoroscopy was recorded and assessed for procedural characteristics and adverse events. RESULTS: Physicians were divided into inexperienced and experienced operators, depending on their experience with microcatheter handling. Mean overall catheterization times increased with difficulty of the aneurysm model. Inexperienced operators showed longer catheterization times (median; IQR: 47; 30-84s) than experienced operators (21; 13-58s, p = 0.011) and became significantly faster during the course of the attempts (rho = -0.493, p = 0.009) than the experienced physicians (rho = -0.318, p = 0.106). Number of dangerous maneuvers throughout all attempts was significantly higher for inexperienced operators (median; IQR: 1.0; 0.0-1.5) as compared to experienced operators (0.0; 0.0-1.0, p = 0.014). CONCLUSION: HANNES represents a modular neurointerventional training environment for practicing aneurysm coil embolization in vitro. Objective procedural metrics correlate with operator experience, suggesting that the system could be useful for assessing operator proficiency.


Assuntos
Educação Médica/métodos , Embolização Terapêutica/métodos , Treinamento por Simulação/métodos , Adulto , Prótese Vascular , Cateterismo/métodos , Angiografia Cerebral/métodos , Simulação por Computador , Estudos de Viabilidade , Feminino , Humanos , Aneurisma Intracraniano/terapia , Masculino , Pessoa de Meia-Idade , Modelos Biológicos
12.
PLoS One ; 15(9): e0238542, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886733

RESUMO

OBJECTIVES: Simulation-based training (SBT) is increasingly used to teach clinical patient-doctor communication skills (CS) to medical students. However, the long-lasting impact of this training has been poorly studied. METHODS: In this observational study we included all fourth-year undergraduate medical students from a French medical school who undertook a CS objective structured clinical examination (OSCE) and who answered a post-examination survey. OSCE scores and students' feedback were compared by whether students had received a specific CS-SBT or not 12 months prior to the OSCE. RESULTS: A total of 173 students were included in the study. Of them, 97 (56%) had followed the CS-SBT before the OSCE. Students who had undergone CS-SBT had significantly higher CS-OSCE scores in the multivariate analysis compared to untrained students (mean score 7.5/10 ±1.1 vs. 7.0/10 ±1.6, respectively, Cohen's d = 0.4, p<0.01). They also tended to experience less nervousness during the OSCE (p = 0.09) and increased motivation to further train in "real-life" internships (p = 0.08). However, they overall expressed a general lack of CS in therapeutic patient education, delivering bad news, and disclosing medical errors. CONCLUSIONS: Fourth-year medical students who benefited from a CS-SBT 12 months before examination displayed higher CS-OSCE scores than their counterparts. PRACTICE IMPLICATIONS: These results support the early introduction of practical training to improve communication skills in undergraduate medical curricula. Studies are required to assess the sustainability of this improvement over time and its effect on further real doctor-patient communication.


Assuntos
Relações Médico-Paciente , Treinamento por Simulação/métodos , Competência Clínica , Comunicação , Avaliação Educacional , Feminino , Humanos , Masculino , Simulação de Paciente , Exame Físico/métodos , Estudantes de Medicina
13.
PLoS One ; 15(9): e0238437, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936813

RESUMO

OBJECTIVES: Schizophrenia is one of the most prevalent mental illnesses contributing to national burden worldwide. It is well known that mental health nursing education, including clinical placement, is still insufficient to reach the optimal level of competency in nursing students. This study suggests a new form of mental health virtual reality (VR) simulation that is user-friendly and engaging to improve education about schizophrenia, thereby improving its treatment. METHOD: A mixed-methods study was conducted with a total of 60 nursing students, using 360-degree videos of five different scenarios reflecting clinical symptoms of schizophrenia patients and related treatment tasks delivered via head-mounted displays (HMDs). We used a 17-item quantitative questionnaire and a 7-item open-ended qualitative questionnaire to evaluate the ease of use and usefulness of the VR simulation program and to identify areas where further improvement is required. RESULTS: The VR simulation program was perceived as useful and exciting. Participants stressed that the high realism of the simulation increased their engagement in and motivation to learn about mental health nursing. Some participants made suggestions, such as further refining the picture and sound quality in order to achieve satisfactory educational outcomes. CONCLUSION: VR simulation using 360-degree videos and HMDs could serve as an effective alternative form of clinical training in mental health nursing. Education could be enhanced by its benefits of being engaging and exciting, as reported by this study's participants.


Assuntos
Educação em Enfermagem/métodos , Treinamento por Simulação/métodos , Realidade Virtual , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Saúde Mental , Motivação , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Estudantes de Enfermagem/psicologia
14.
Knee Surg Sports Traumatol Arthrosc ; 28(10): 3087-3093, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32926255

RESUMO

PURPOSE: The COVID-19 pandemic has presented an unprecedented challenge to the orthopedic residency training programs to adapt to a form of a web-based learning process and simulation-based training. This study focusses on the viewpoint of the orthopedic residents to the paradigm shift in clinical care as well as the academic activities. METHODS: An anonymous questionnaire was created in an online survey generator and was sent through e-mail to 227 orthopedic residents of seven tertiary care centres in North India. The questionnaire was divided into three sections, academic activity section, mental health section, and clinical activity section. There were a total of 44 single answer questions with answers according to the increasing difficulty at present situation compared to a previous time before the COVID-19 pandemic. RESULTS: A total of 158 questionnaires were filled by 107 junior residents (67.7%) and 51 senior residents (32.3%). 49 residents (31%) were quarantined and three became positive for COVID-19. Although all of them knew about necessary precautions, personal protective equipment was difficult to avail at times. Increased difficulty in recruiting new patients for research (48.9%) and conducting prospective research (48.7%) was observed. The online-based learning process was reported to be easier (44.2%) by most of the residents. Routine clinical work in the operating room, out-patient department, and inpatient department was found to be difficult according to the majority of the residents along with the anxiety of contracting the infection. CONCLUSION: There are unique opportunities for improvement of residency programs during these times of uncertainty and the findings of this study can help the universities as well as program chairs to develop a robust program that can outlive this pandemic. The web-based learning process might prove to be useful and can be incorporated into the resident training program in the long term. LEVEL OF EVIDENCE: Level V.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/métodos , Ortopedia/educação , Pandemias , Pneumonia Viral/epidemiologia , Treinamento por Simulação , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos , Inquéritos e Questionários
15.
J Nurs Educ ; 59(9): 518-521, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32865586

RESUMO

BACKGROUND: The integration of telehealth simulation experiences enables nursing students to effectively care for postnatal clients through interactive video technologies. METHOD: Faculty created a telehealth postnatal triage simulation in response to a need for client interaction due to COVID-19 social isolation restrictions. RESULTS: Telehealth triage is an inexpensive, engaging teaching strategy and formative assessment method that can be easily created with existing resources and implemented in a postnatal simulation experience. CONCLUSION: Faculty concluded that this telehealth simulation experience is valuable in meeting student clinical learning outcomes and its continued use after social restrictions are removed is recommended. In the future, effectiveness of the simulation experience should be studied and measured along with incorporation of inter-and intraprofessional collaboration activities. [J Nurs Educ. 2020;59(9):518-521.].


Assuntos
Bacharelado em Enfermagem/organização & administração , Treinamento por Simulação/organização & administração , Telemedicina/organização & administração , Triagem/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Aprendizagem , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pesquisa Metodológica em Enfermagem , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Estudantes de Enfermagem/psicologia
16.
J Nurs Educ ; 59(9): 522-525, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32865587

RESUMO

BACKGROUND: Amidst the COVID-19 pandemic, university instruction was transitioned online, including an undergraduate nursing clinical course. Charged with developing and executing virtual simulations, an online clinical course was conceived. METHOD: Simulated clinical experiences were crafted using a combination of student preassignments and video-conferencing facilitated by faculty. Each experience included the collective review of a case study and student-developed care plans before viewing and debriefing a series of videos. Students summarized their experience in a weekly written reflection. RESULTS: Student feedback was examined through their reflections and verbal responses. The videos served as catalysts for robust discussion. Feedback was overwhelmingly positive related to an interactive experience, a heightened sense of teamwork, and enhanced comprehension by sharing differing perspectives of common experiences. CONCLUSION: This educational innovation was successful in creating an engaging environment that facilitated student learning and a sense of togetherness during a global pandemic. The use of technology enabled the continuity of a productive teaching-learning experience. [J Nurs Educ. 2020;59(9):522-525.].


Assuntos
Currículo , Educação a Distância/organização & administração , Bacharelado em Enfermagem/organização & administração , Treinamento por Simulação/organização & administração , Infecções por Coronavirus/epidemiologia , Difusão de Inovações , Humanos , Aprendizagem , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pandemias , Pneumonia Viral/epidemiologia , Estudantes de Enfermagem/psicologia
17.
Rev Col Bras Cir ; 47: e20202530, 2020 Sep 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901707

RESUMO

INTRODUCTION: simulation based teaching is a powerful tool in medical education, allowing hands on practice under a controlled environment and with repeated maneuvers. Central venous access venipuncture is one of the most frequent procedures carried out in the hospital setting, due to its various clinical indications and, when performed with the help of ultrasonography, the risk of adverse events is minimized. Aim: to develop, to describe and to test a porcine model that simulates the central venous access puncture aided by ultrasonography. METHOD: a low cost porcine model was developed to train medical students and residents on central venous access guided by ultrasonography. Both students and medical residents underwent a theoretical training regarding the model, followed by a hands-on training session. Afterwards, the participants assessed the model by answering a questionnaire. RESULTS: there were 51 participants. The average score regarding the similarity between the model and the human anatomy was 9.15. When the characteristics were separately assessed, the mean scores regarding the similarity of the vessels, anatomic disposition and ultrasonographic characteristics as well as the venipuncture were, respectively, 9.27; 9.31; 9.54 and 8.86. CONCLUSION: The model was approved and considered appropriate for the training of central venous venipuncture by all the participants. Furthermore, it is a low cost, simple and reproducible model, that presents high similarity with the human anatomy. Therefore, it may be used as an aid to train people on ultrasonography guided central venous access.


Assuntos
Cateteres Venosos Centrais , Educação Médica , Treinamento por Simulação , Estudantes de Medicina/psicologia , Ultrassonografia de Intervenção/métodos , Animais , Humanos , Modelos Animais , Suínos
18.
West J Emerg Med ; 21(5): 1089-1094, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32970559

RESUMO

INTRODUCTION: The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient. METHODS: This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences. RESULTS: All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%. CONCLUSION: A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Educação Médica Continuada/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Treinamento por Simulação/métodos , California , Lista de Checagem , Competência Clínica/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Serviço Hospitalar de Emergência , Humanos , Controle de Infecções/instrumentação , Pneumonia Viral/transmissão
19.
BMC Med Educ ; 20(1): 332, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977781

RESUMO

BACKGROUND: The Coronavirus Disease 19 (COVID-19) pandemic brought significant disruption to in-hospital medical training. Virtual reality simulating the clinical environment has the potential to overcome this issue and can be particularly useful to supplement the traditional in-hospital medical training during the COVID-19 pandemic, when hospital access is banned for medical students. The aim of this study was to assess medical students' perception on fully online training including simulated clinical scenarios during COVID-19 pandemic. METHODS: From May to July 2020 when in-hospital training was not possible, 122 students attending the sixth year of the course of Medicine and Surgery underwent online training sessions including an online platform with simulated clinical scenarios (Body Interact™) of 21 patient-based cases. Each session focused on one case, lasted 2 h and was divided into three different parts: introduction, virtual patient-based training, and debriefing. In the same period, adjunctive online training with formal presentation and discussion of clinical cases was also given. At the completion of training, a survey was performed, and students filled in a 12-item anonymous questionnaire on a voluntary basis to rate the training quality. Results were reported as percentages or with numeric ratings from 1 to 4. Due to the study design, no sample size was calculated. RESULTS: One hundred and fifteen students (94%) completed the questionnaire: 104 (90%) gave positive evaluation to virtual reality training and 107 (93%) appreciated the format in which online training was structured. The majority of participants considered the platform of virtual reality training realistic for the initial clinical assessment (77%), diagnostic activity (94%), and treatment options (81%). Furthermore, 97 (84%) considered the future use of this virtual reality training useful in addition to the apprenticeship at patient's bedside. Finally, 32 (28%) participants found the online access difficult due to technical issues. CONCLUSIONS: During the COVID-19 pandemic, online medical training including simulated clinical scenarios avoided training interruption and the majority of participant students gave a positive response on the perceived quality of this training modality. During this time frame, a non-negligible proportion of students experienced difficulties in online access to this virtual reality platform.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Educação a Distância/organização & administração , Educação de Graduação em Medicina/organização & administração , Pneumonia Viral/epidemiologia , Treinamento por Simulação/organização & administração , Realidade Virtual , Competência Clínica , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Inquéritos e Questionários
20.
Br J Hosp Med (Lond) ; 81(9): 1-6, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32990069

RESUMO

Hands-on wet lab simulation training is a vital part of modern surgical training. Since 2010, surgical 'boot camps' have been run by many UK deaneries to teach core surgical trainees basic entry level skills. Training in advanced skills often requires attendance at national fee-paying courses. In the Wessex Deanery, multiple, free of charge, core surgical 'field camps' were developed to provide more advanced level teaching in the particular specialty preference of each core surgical trainee. After the COVID-19 pandemic, national hands-on courses will be challenging to provide and deanery-based advanced skills training may be the way forward for craft-based specialties. The experiences over 2 years of delivering the Wessex core surgical field camps are shared, giving a guide and advice for other trainers on how to run a field camp.


Assuntos
Competência Clínica , Infecções por Coronavirus , Educação , Cirurgia Geral/educação , Pandemias , Pneumonia Viral , Treinamento por Simulação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação/métodos , Educação/organização & administração , Avaliação Educacional , Humanos , Modelos Anatômicos , Modelos Educacionais , Pandemias/prevenção & controle , Satisfação Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Autoimagem , Treinamento por Simulação/métodos , Treinamento por Simulação/organização & administração , Apoio ao Desenvolvimento de Recursos Humanos/métodos , Reino Unido
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