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1.
Medicine (Baltimore) ; 100(6): e24690, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578603

RESUMO

ABSTRACT: Pediatric procedural sedation (PPS) is often performed outside of the operating room, and by various sub-specialty providers. There is no consistency in how pediatric emergency medicine (PEM) fellows are trained in PPS. The objective of this study was to survey PEM program directors (PDs) and PEM fellows about their current sedation teaching practices via a direct survey. While many fellowship programs train PEM fellows in PPS, we hypothesize that there is no consistent method of developing and measuring this skill.A 12-question survey was sent to PEM PDs directly via email. A separate 17-question survey was sent to current PEM fellows via their program coordinators by email. Each survey had multiple choice, yes-no and select-all program questions. Responses were collected in an online (REDCap) database and summarized as frequencies and percentages.Based on identifiable email, 67 programs were contacted, with a PD response rate of 46 (59%). Sixty-two program coordinators were contacted based on identifiable email with 78 fellow responses. We noted that 11/46 PD respondents offer a formal PPS rotation. Thirty programs report using propofol in the emergency department and 93% of PD respondents (28/30) actively train fellows in the use of propofol. Approximately 62% of PEM fellow respondents (48/78) report sedating without any attending oversight. Twenty-eight percent of PEM fellow respondents report using simulation as a component of their sedation training.PPS is a critical skill. However, there is a lack of consistency in both education and evaluation of competency in this area. An organized PPS rotation would improve PPS case exposure and PPS skills.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Medicina de Emergência Pediátrica/educação , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/uso terapêutico , Competência Clínica/estatística & dados numéricos , Gerenciamento de Dados , Educação de Pós-Graduação em Medicina/métodos , Escolaridade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Internato e Residência/normas , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Propofol/administração & dosagem , Propofol/uso terapêutico , Treinamento por Simulação/estatística & dados numéricos , Inquéritos e Questionários
2.
J Laryngol Otol ; 135(2): 179-181, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33500010

RESUMO

BACKGROUND: Simulation training has become a core component in the training of ENT surgeons. It provides the opportunity for the repetitive practice of a surgical technique. Simulators are broadly categorised into low- and high-fidelity simulators. A method using a home microprocessor to enhance a low-fidelity surgical simulator is introduced. METHOD: The Yorick tonsil tie trainer was enhanced using an Arduino microcontroller attached to the simulated inferior pole of the tonsil. The Arduino was coded to give a visual stimulus when linear motion exceeded parameters. The prototype simulator was tested to gain information on whether the enhancement could identify differences between novice and expert users. CONCLUSION: An enhanced low-fidelity tonsil trainer was produced using a low-cost, simple home microprocessing board. The enhanced simulator gives objective feedback allowing for self-directed learning. Further research is required to evaluate the benefits of these enhancements above non-enhanced simulation training.


Assuntos
Otorrinolaringologistas/educação , Tonsila Palatina/cirurgia , Treinamento por Simulação/métodos , Melhoramento Biomédico/métodos , Competência Clínica/normas , Simulação por Computador , Retroalimentação , Humanos , Treinamento por Simulação/economia , Treinamento por Simulação/estatística & dados numéricos , Cirurgiões/educação
3.
J Surg Res ; 255: 158-163, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32563007

RESUMO

BACKGROUND: Surgical simulation is particularly attractive because it allows training in a safe, controlled, and standardized environment. However, the status of surgical simulation among Departments of Surgery (DoS) in the United States is unknown. The objective of this study was to characterize the status of simulation-based training in DoS in the United States. MATERIALS AND METHODS: A Qualtrics online survey was sent to 177 chairs of DoS in the United States in March 2018 regarding the utilization of surgical simulation in their department. Questions in the survey were focused on simulation capacities and activities as well as chairs' perception of the value and purpose of simulation. RESULTS: A total of 87 of 177 chairs responded to the survey (49% response rate). Most programs had either 20-50 trainees (42 of 87; 48%) or more than 50 trainees (37 of 87; 43%). Most chairs reported having a simulation center in their institution (85 of 87; 98%) or department (60 of 86; 70%) with a formal simulation curriculum for their trainees (83 of 87; 95%). Ninety percent (78 of 87) of DoS had protected time for simulation education for their residents, with most residents engaging in activities weekly or monthly (65 of 85; 76%). Although most chairs felt simulation improves patient safety (72 of 84; 86%) and is useful for practicing surgeons (68 of 84; 81%), only 40% reported that faculty use simulation to maintain technical skills and only 17% reported that faculty use simulation to address high complication rates. CONCLUSIONS: The vast majority of the DoS in the United States have established simulation activities for their trainees. However, engagement of faculty in simulation to maintain or improve their skills remains low.


Assuntos
Cirurgia Geral/educação , Treinamento por Simulação/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos
4.
Medicine (Baltimore) ; 99(22): e20047, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481374

RESUMO

Clinical pharmacists are indispensable providers of emergency medical services. However, the training of Chinese clinical pharmacists in medical emergency skills is apparently insufficient.The current study aimed to evaluate the effect of the "Warrior" emergency simulator application in the emergency medical education of clinical pharmacy students (CP students).The "Warrior" system, which contains a pharmacokinetics/pharmacodynamics-linked model and a drug database, was successfully employed to train CP students and improve their capability to deal with various medical emergency situations. Both an objective (in-class) test and the subjective Dundee Ready Education Environment Measure (DREEM) were administered to 20 CP students, randomly divided into an intervention group and a control group, to estimate the teaching effect of the "Warrior" system.The scores of CP students from the intervention group were significantly higher (P < .01) in the in-class test than the scores of students from the control group due to the diverse situational teaching using the "Warrior" system. The results of the DREEM showed that CP students from the intervention group obtained considerably better (P < .01) marks for "students' perceptions of learning" and "students' perceptions of atmosphere" than those from the control group. Furthermore, the intervention group scored much higher (P < .01) than the control group on the total DREEM.The "Warrior" system provides an excellent training path for clinical pharmacists that supplies a more realistic clinical simulation experience and significantly improves the teaching effect. The "Warrior" system exhibits high potential for future development in emergency medical education.


Assuntos
Educação em Farmácia/métodos , Serviços Médicos de Emergência , Farmacêuticos , Treinamento por Simulação/métodos , Feminino , Humanos , Masculino , Treinamento por Simulação/estatística & dados numéricos , Adulto Jovem
5.
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
6.
Nurse Educ Today ; 86: 104324, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31901748

RESUMO

BACKGROUND: Teaching strategies to promote experiential learning in the classroom are important to facilitate students' clinical reasoning abilities. Using video to simulate unfolding patient scenarios in the classroom has the potential to engage students through active learning and to enhance their ability to connect theory to practice. OBJECTIVES: Study objectives were to: (1) Evaluate nursing students' satisfaction and self-confidence in learning and perceptions of the design of a simulated patient scenario delivered via video in the classroom and (2) Compare findings to students' satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulation experiences in the laboratory. DESIGN: A quasi-experimental approach was used. SETTING: The study setting was a nursing classroom at a University in the southeast United States. PARTICIPANTS: Convenience sampling was utilized and 54 students in their final semester of a pre-licensure baccalaureate nursing program participated. METHODS: The intervention was an unfolding video patient scenario delivered in the classroom. Prior to the intervention, participants completed two measurement tools to collect information about their satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulations. After the intervention, these tools were administered again to collect data about the video simulation experience in the classroom. RESULTS: Participants had a higher level of satisfaction (p = 0.002) and self-confidence (p < 0.001) following the classroom intervention than for prior high-fidelity simulations in the laboratory. Student perceptions of the simulation design were more favorable for the classroom intervention than for prior laboratory simulations (p < 0.001). CONCLUSIONS: Use of unfolding video patient scenarios in the classroom can promote student engagement in learning. Nurse educators should consider this teaching strategy that provides students with opportunities to connect and apply classroom content to patient care.


Assuntos
Percepção , Autoeficácia , Treinamento por Simulação/normas , Estudantes de Enfermagem/psicologia , Gravação de Videoteipe/métodos , Humanos , Simulação de Paciente , Satisfação Pessoal , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Sudeste dos Estados Unidos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Gravação de Videoteipe/tendências
8.
J Trauma Acute Care Surg ; 88(2): 242-248, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31804411

RESUMO

BACKGROUND: Establishing proficiency in specific trauma procedures during surgical residency has been limited to annual courses with limited data on its effect on the delivery of health care and patient outcomes. There is a wide variety of training on content and complexity with recent studies looking at time to imaging or secondary survey. In this study, we implement monthly case-based simulation after initial training on a variety of bedside trauma procedures. The overall goal is to evaluate the effect of simulation on time to specific interventions. METHODS: This is a prospective, observational study between July 2018 and February 2019 at a single-institution, Level I trauma center with a large surgical residency program. A trauma simulation program was implemented in November 2018 to train and evaluate surgical residents from post-graduate year 1 through 5. All rotating residents participated in an initial course on basic trauma procedures, such as percutaneous sheath placement, tube thoracostomy, and resuscitative thoracotomy followed by an end-of-month simulation. All Level I activations from preintervention starting in July to October 2018 (preintervention) and October 2018 through February 2019 (postintervention) were reviewed; monitored variables included age, sex, mechanism of injury, blunt or penetrating, and time to intervention in the trauma bay. Median times to intervention were recorded with interquartile ranges (IQR). Pearson's coefficient was used to measure the strength of the relationship between simulation and time to patient intervention. RESULTS: Median time to most interventions improved over time but with more consistent improvement after the implementation of formal simulation and procedural training in November 2018. Median pretraining time for resuscitative thoracotomy was 14 minutes (IQR, 8-32 minutes); posttraining median time was 3 minutes (IQR, 2.7-8 minutes, p = 0.02). Median pretraining time to tube thoracostomy was 13 minutes (IQR, 5.5-19 minutes); posttraining time was 6 minutes (IQR, 4-31 minutes, p = 0.04). Pearson's coefficient (r) measured strength of correlation and was highest for tube thoracostomy followed by resuscitative thoracotomy and percutaneous sheath access with r values of 0.46, 0.35, and 0.24, respectively. CONCLUSION: High-complexity, routine procedural training, and trauma simulation are associated with decreased time to interventions within a short period of time. Routine implementation of a training program emphasizing efficient, effective approaches to bedside procedures is necessary to train our residents in these high-acuity, low-frequency situations. Future investigations are warranted in the effect of simulation on short-term and long-term patient outcomes. LEVEL OF EVIDENCE: Therapeutic, level III.


Assuntos
Internato e Residência/métodos , Treinamento por Simulação/métodos , Especialidades Cirúrgicas/educação , Tempo para o Tratamento/estatística & dados numéricos , Ferimentos e Lesões/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Melhoria de Qualidade , Treinamento por Simulação/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
9.
J Surg Res ; 247: 150-155, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31776024

RESUMO

BACKGROUND: Time away from surgical practice can lead to skills decay. Research residents are thought to be prone to skills decay, given their limited experience and reduced exposure to clinical activities during their research training years. This study takes a cross-sectional approach to assess differences in residents' skills at the beginning and end of their research years using virtual reality. We hypothesized that research residents will have measurable decay in psychomotor skills when evaluated using virtual reality. METHODS: Surgical residents (n = 28) were divided into two groups; the first group was just beginning their research time (clinical residents: n = 19) and the second group (research residents: n = 9) had just finished at least 2 y of research. All participants were asked to perform a target-tracking task using a haptic device, and their performance was compared using Welch's t-test. RESULTS: Research residents showed a higher level of "tracking error" (1.69 ± 0.44 cm versus 1.40 ± 0.19 cm; P = 0.04) and a similar level of "path length" (62.5 ± 10.5 cm versus 62.1 ± 5.2 cm; P = 0.92) when compared with clinical residents. CONCLUSIONS: The increased "tracking error" among residents at the end of their research time suggests fine psychomotor skills decay in residents who spend time away from clinical duties during laboratory time. This decay demonstrates the need for research residents to regularly participate in clinical activities, simulation, or assessments to minimize and monitor skills decay while away from clinical practice. Additional longitudinal studies may help better map learning and decay curves for residents who spend time away from clinical practice.


Assuntos
Pesquisa Biomédica/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Desempenho Psicomotor , Treinamento por Simulação/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Treinamento por Simulação/métodos , Fatores de Tempo , Realidade Virtual
10.
Nurse Educ Pract ; 42: 102635, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31864035

RESUMO

Undergraduate midwifery programs across Australia have embedded simulation into their curriculum although there is limited but emerging evidence to support the use of simulation as an effective teaching strategy. The purpose of this study was to evaluate the impact that a simulated learning activity (insertion and management of a neonatal nasogastric tube), had on midwifery students' knowledge, confidence and skills post-simulation, and on completion of a clinical placement. A descriptive explorative study was undertaken in two phases. Phase 1: Midwifery students (n = 60) completed a purpose-designed questionnaire to assess their knowledge, confidence and skills, pre and post simulation. Phase 2: Students (n = 46) repeated the questionnaire to reassess their knowledge, confidence and skills after the completion of a neonatal nursery placement. The findings demonstrate that simulation is an effective learning strategy in an undergraduate midwifery program. Students' knowledge, confidence and skills increased significantly post-simulation activity (p0.001). A further increase in these areas was noted post-placement. Key aspects that contributed to student learning included; the demonstrators' level of knowledge, expertise and currency of practice, as well as the role the student assumes in the simulation activity.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Recém-Nascido Prematuro , Enfermagem Neonatal/normas , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Austrália , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Currículo/normas , Currículo/tendências , Bacharelado em Enfermagem/métodos , Humanos , Recém-Nascido , Tocologia/educação , Tocologia/métodos , Tocologia/normas , Enfermagem Neonatal/educação , Enfermagem Neonatal/estatística & dados numéricos , Treinamento por Simulação/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
11.
Nurse Educ Pract ; 42: 102678, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31812785

RESUMO

Training nursing students in older patient education may be facilitated by the student elderly simulated-patient strategy. The purpose of this study was to determine the effects of simulation-based learning on students' skills in providing education to older patients. A quasi-experimental design with repeated measures was used. Nursing students enrolled in clinical courses in their semesters 7 and 8 of the program were randomly assigned to simulation-based learning (SBL) group (n = 35) or lecture-based learning (LBL) group (n = 35). In SBL, the student simulated-elderly patients equipped with devices for the age-related hearing loss, vision impairment, and neck, finger, and arm joint stiffness was trained to present the educational content to the students. Outcome (knowledge, attitudes, and skills) data were collected at pre-test, post-test, and one-month follow-up, using reliable measures. Data were analyzed with repeated measures analysis of variance. Students in the SBL and LBL groups were comparable at pre-test. All students demonstrated improvement in knowledge and skills in older patient education over time; however, students in the SBL group had larger and more durable improvements in these outcomes than those in the LBL group (all p's < .001). SBL is a promising instructional method, with long term benefits in improving students' skills.


Assuntos
Geriatria/educação , Educação de Pacientes como Assunto/métodos , Treinamento por Simulação/normas , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Feminino , Geriatria/métodos , Humanos , Irã (Geográfico) , Masculino , Educação de Pacientes como Assunto/estatística & dados numéricos , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos
12.
Nurse Educ Today ; 84: 104216, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31669966

RESUMO

BACKGROUND: The use of simulation methods in nursing education is important in terms of decreasing anxiety of students in a safe and realistic environment due to the improvement of knowledge and skills of students in terms of cardiac auscultation and their attitudes to prepare for clinical applications. OBJECTIVES: The aim of this study is to compare the effectiveness of high-fidelity simulator and traditional teaching method on nursing students' knowledge and skill development in terms of cardiac auscultation and their anxiety levels. DESIGN: Randomized controlled study. SETTING: The study was conducted in the simulation laboratory of the Nursing Department in the Health College and in the inpatient clinics of the Medicine Faculty Hospital. PARTICIPANTS: 72 first-year nursing students (simulation group = 36, control group = 36). METHODS: The students were randomly distributed to the simulation and control groups. The students in the simulation group received a cardiac auscultation training by using a high-fidelity simulator while the students in the control group received training with the traditional teaching method. After the training sessions, all students practiced their skills in the laboratory and on real patients in clinical setting under the supervision of the researcher. The data were collected by using the Demographic Information Form, Knowledge Assessment Form for Cardiac Auscultation, Skill Evaluation Form for Cardiac Auscultation and State Anxiety Inventory (SAI). RESULTS: High-fidelity simulators and traditional teaching method were found to be effective in increasing the students' knowledge and skill levels in terms of cardiac auscultation. However, it was found that the high-fidelity simulator method was more effective than the traditional teaching method to increase the students' knowledge (p = 0.001) and skill (p < 0.001) levels; this increase was significant. In addition, it was found that the students in the high-fidelity simulator group showed a significant decrease in anxiety scores compared to the students who were trained with traditional education method (p < 0.001). CONCLUSIONS: The results showed that the use of high-fidelity simulator in nursing education was more effective than traditional method in terms of improving the students' knowledge, skill levels for cardiac auscultation and reducing their anxiety.


Assuntos
Ansiedade/classificação , Competência Clínica/normas , Auscultação Cardíaca/métodos , Treinamento por Simulação/normas , Estudantes de Enfermagem/psicologia , Ansiedade/etiologia , Ansiedade/psicologia , Competência Clínica/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Bacharelado em Enfermagem/estatística & dados numéricos , Avaliação Educacional/métodos , Feminino , Auscultação Cardíaca/enfermagem , Humanos , Conhecimento , Masculino , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Turquia , Adulto Jovem
13.
Am J Surg ; 219(4): 622-626, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-30654918

RESUMO

INTRODUCTION: Approximately 100 surgeons in Zambia serve a population of 16 million, a severe shortage in basic surgical care. Surgical education in Zambia and other low-middle income countries has not been well characterized. The aim of this study was to evaluate surgical training resources from a resident perspective. METHODS: 6 of 8 COSECSA-accredited major medical centers were included. We developed a Surgical Education Capacity Tool to evaluate hospital characteristics including infrastructure, education, and research. The questionnaire was completed by administrators and trainees. RESULTS: 18 of 45 trainees were surveyed. Caseloads and faculty-to-trainee ratio varied by location. No sites had surgical skills, simulation, or research labs. Most had medical libraries, lecture halls, and internet. Outpatient clinics, bedside teaching, M&M conferences, and senior supervision were widely available. Despite some exposure, research mentorship, basic science, and grant application guidance were critically limited. CONCLUSIONS: Lack of access to proper infrastructure, research, and personnel all impact surgical training and education. The Surgical Education Capacity Tool offers insights into areas of potential improvement, and is applicable to other LMICs.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Internato e Residência/organização & administração , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Biomédica , Países em Desenvolvimento , Docentes de Medicina/provisão & distribução , Humanos , Mentores/estatística & dados numéricos , Treinamento por Simulação/estatística & dados numéricos , Inquéritos e Questionários , Zâmbia
14.
Anat Sci Educ ; 13(2): 206-217, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31066239

RESUMO

Teaching internal structures obscured from direct view is a major challenge of anatomy education. High-fidelity interactive three-dimensional (3D) micro-computed tomography (CT) models with virtual dissection present a possible solution. However, their utility for teaching complex internal structures of the human body is unclear. The purpose of this study was to investigate the use of a realistic 3D micro-CT interactive visualization computer model to teach paranasal sinus anatomy in a laboratory setting during pre-clinical medical training. Year 1 (n = 79) and Year 2 (n = 59) medical students undertook self-directed activities focused on paranasal sinus anatomy in one of two laboratories (traditional laboratory and 3D model). All participants completed pre and posttests before and after the laboratory session. Results of regression analyses predicting post-laboratory knowledge indicate that, when students were inexperienced with the 3D computer technology, use of the model was detrimental to learning for students with greater prior knowledge of the relevant anatomy (P < 0.05). For participants experienced with the 3D computer technology, however, the use of the model was detrimental for students with less prior knowledge of the relevant anatomy (P < 0.001). These results emphasize that several factors need to be considered in the design and effective implementation of such models in the classroom. Under the right conditions, the 3D model is equal to traditional laboratory resources when used as a learning tool. This paper discusses the importance of preparatory training for students and the technical consideration necessary to successfully integrate such models into medical anatomical curricula.


Assuntos
Anatomia/educação , Simulação por Computador , Educação de Graduação em Medicina/métodos , Treinamento por Simulação/estatística & dados numéricos , Microtomografia por Raio-X , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
15.
Nurse Educ Pract ; 42: 102666, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31734516

RESUMO

Challenges related to limited clinical sites and shortage of clinical instructors may reduce the quality of clinical experiences, leading to increased demand for the establishment of simulation-based training programs in the curricula of educational institutions. However, simulation-based training programs in health education place great demands on faculty resources. It is interesting, therefore, to investigate peers contributions in formal assessment, and how this compares to faculty assessment. This paper report the results from the comparison of direct observation by peer observers who had received short rater training, and post-hoc video-based assessment by trained facilitators. An observation form with six learning outcomes was used to rate team performance. Altogether 262 postgraduate nursing students, bachelor of nursing students and medical students participated, organized into 44 interprofessional teams. A total of 84 peers and two facilitators rated team performance. The sum score of all six learning outcomes showed that facilitators were more lenient than peer observers (p = .014). The inter-rater reliability varied considerably when comparing scores from peer observers from the three different professions with those of the facilitators. The results indicate that peer assessment may support, but not replace, faculty assessment.


Assuntos
Docentes de Enfermagem/normas , Relações Interprofissionais , Revisão por Pares/métodos , Treinamento por Simulação/normas , Estudantes de Enfermagem/psicologia , Adulto , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Docentes de Enfermagem/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Revisão por Pares/normas , Reprodutibilidade dos Testes , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos
16.
Knee Surg Sports Traumatol Arthrosc ; 28(3): 862-868, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31079163

RESUMO

PURPOSE: The aim of this work is to evaluate the effectiveness of training with the low-fidelity ArthroBox® regarding performance of different basic arthroscopy tasks using a validated high-fidelity virtual reality simulator of the knee. METHODS: Nineteen volunteers (14 females and 5 males) without any previous experience in arthroscopy were randomly assigned either to the ArthroBox® training group (n =10) or the non-training group (n =9). The training group underwent a supervised ArthroBox ® training consisting of a daily 60-min session for three consecutive days. Both groups completed the basic and the final assessment using a validated virtual reality-based passive haptic knee arthroscopy simulator (ArthroS, VirtaMed™). The following three factors were measured in different exercises (explained in "Materials and methods"): amount of time to finish the task, length of camera and scope path within the joint. Furthermore, the volunteers' demographics (age, sex, dexterity, video game experience, sport activities and profession) was assessed but showed no differences between the groups. RESULTS: There were no significant differences between the training and non-training group regarding the above-mentioned demographic factors. However, the training group showed significant improvement from baseline to follow-up in most activities (e.g. task performance time in seconds, intra-articular camera and grasp distance in centimetres; see Table 1) in comparison to the non-training group. CONCLUSIONS: The results from this study demonstrate that training for three consecutive days using a portable and versatile low-fidelity simulator significantly improves arthroscopy performance when using a validated high-fidelity virtual knee simulator. Arthroscopic triangulation training outside the operating theatre with a portable, low-cost simulator has proven to be a valuable educational tool to improve the arthroscopic skills of trainee surgeons. LEVEL OF EVIDENCE: Diagnostic study, Level II.


Assuntos
Artroscopia/educação , Articulação do Joelho/cirurgia , Treinamento por Simulação/métodos , Realidade Virtual , Adulto , Competência Clínica , Simulação por Computador , Feminino , Humanos , Masculino , Treinamento por Simulação/estatística & dados numéricos , Análise e Desempenho de Tarefas
17.
Rev. bras. enferm ; 72(6): 1618-1623, Nov.-Dec. 2019. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1042167

RESUMO

ABSTRACT Objective: To evaluate the self-confidence of nurses in the care of critically ill patients, before and after a simulated intervention. Method: A quasi-experimental study was carried out with 103 nurses who participated in a workshop on the care of critically ill patients in the first semester of 2016. A clinical simulation pedagogical instrument was used throughout the event, and self-confidence was assessed by the Portuguese version of the Self-confidence Scale (SCSvp). Results: Most participants reported not being prepared to provide first care to critically ill patients, which was carried out during care practice. The participants presented a significant increase in self-confidence after the simulated intervention (p<0.001) in the cardiac, neurological, and respiratory dimensions. Conclusion: Simulation has proved to be an effective strategy for the development of individuals' self-confidence, which contributes to the improvement of skills required for professional practice.


RESUMEN Objetivo: Verificar la autoconfianza del enfermero en la atención del paciente crítico antes y después de una intervención simulada. Método: Estudio cuasi-experimental, realizado con 103 enfermeros que participaron de un workshop de atención al paciente crítico en el primer semestre de 2016. Fue utilizada la herramienta pedagógica de simulación clínica durante todo el evento, y la autoconfianza fue verificada mediante Self-Confident Scale, versión portuguesa (SCSvp). Resultados: La mayoría de los sujetos consideró no estar preparado para brindar la primera atención al paciente crítico, afirmando haberlo realizado durante la práctica asistencial. Los participantes expresaron aumento significativo de autoconfianza luego de la intervención simulada (p<0,001) en las dimensiones cardíaca, neurológica y respiratoria. Conclusión: La simulación ha demostrado ser una estrategia eficaz para desarrollar la autoconfianza del individuo, factor que contribuye al crecimiento de las competencias exigidas para el ejercicio profesional.


RESUMO Objetivo: Verificar a autoconfiança do enfermeiro no atendimento ao paciente crítico pré e pós-intervenção simulada. Método: Estudo quase experimental realizado com 103 enfermeiros que participaram de um workshop de atendimento ao paciente crítico no primeiro semestre de 2016. Foi utilizada a ferramenta pedagógica de simulação clínica em todo o evento, e a autoconfiança foi verificada pela Self-Confidence Scale, versão portuguesa (SCSvp). Resultados: A maior parte dos sujeitos julgou não estar preparada para prestar o primeiro atendimento ao paciente crítico, afirmando tê-lo realizado durante a prática assistencial. Os participantes apresentaram aumento significativo de autoconfiança após a intervenção simulada (p <0,001) nas dimensões cardíacas, neurológica e respiratória. Conclusão: A simulação tem-se mostrado uma estratégia eficaz para o desenvolvimento da autoconfiança do indivíduo, o que contribui para o acréscimo das competências exigidas para o exercício profissional.


Assuntos
Humanos , Masculino , Feminino , Adulto , Autoimagem , Estado Terminal/enfermagem , Treinamento por Simulação/normas , Enfermeiras e Enfermeiros/psicologia , Brasil , Educação/métodos , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos
18.
J Emerg Med ; 57(6): 844-847, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31708313

RESUMO

BACKGROUND: Thoracic injuries present many challenges for management in the acute and inpatient settings, including achieving appropriate pain control. Traditional modalities, such as opioids and spinal epidural anesthesia, are associated with multiple complications. Ultrasound-guided regional nerve blocks are becoming more prevalent, and they have been shown to be an effective modality of pain control for other traumatic injuries. Models comprised of animal tissue to simulate human anatomy are widely utilized to facilitate training of needle-guided procedures, but no such model for the serratus anterior plane block has yet been defined in the literature. OBJECTIVES: Our goal was to produce a high-functionality serratus anterior plane block model with reasonable anatomic fidelity from low-cost materials. DISCUSSION: We describe the creation of an inexpensive high-functionality serratus anterior plane block model from common materials, including pork ribs and chicken breasts, to realistically simulate human anatomy, including multiple muscle and fascial planes, as well as to allow hydrodissection. CONCLUSIONS: This model will facilitate training and can improve success when caring for patients with thoracic trauma.


Assuntos
Educação Continuada/normas , Treinamento por Simulação/normas , Traumatismos Torácicos/diagnóstico , Ultrassonografia de Intervenção/métodos , Educação Continuada/métodos , Educação Continuada/estatística & dados numéricos , Humanos , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Traumatismos Torácicos/fisiopatologia
19.
Curr Pharm Teach Learn ; 11(9): 936-942, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31570132

RESUMO

BACKGROUND AND PURPOSE: The goal of this prospective, observational cohort study was to determine if simulated interdisciplinary teaching rounds improved student perceptions of confidence and attitudes towards working as part of a team. The secondary objective of this study was to investigate changes in student knowledge of the management of sepsis. EDUCATIONAL ACTIVITY AND SETTING: Students participated in a traditional sepsis lecture followed by a simulated interdisciplinary rounding experience. Confidence and collaborative attitudes were assessed using a 5-point Likert scale (1=strongly disagree, 5=strongly agree). Changes in knowledge were measured using multiple choice questions. Students completed these tools at three points in time: pre-lecture, post-lecture, and post-simulation. FINDINGS: Student confidence and attitudes related to interdisciplinary rounds improved following the simulation (2 of 4 items, p=0.003; 2 of 5 items, p<0.05). Also, most students agreed or strongly-agreed that the simulation reinforced knowledge gained from lecture (94.7%), that lecture followed by a simulation was the most effective way to learn about sepsis (94.7%), and that the simulation helped reinforce critical-thinking skills (94.7%). Knowledge improved between the didactic lecture and the simulation, but these differences were not found to be statistically significant. SUMMARY: A simulated interdisciplinary rounding experience may increase student confidence during teaching rounds and improve attitudes towards working alongside other healthcare professionals. Incorporating rounding simulations into pharmacy curricula may be beneficial towards student success on rounds.


Assuntos
Sepse/tratamento farmacológico , Treinamento por Simulação/normas , Estudantes de Farmácia/estatística & dados numéricos , Visitas com Preceptor/métodos , Adulto , Educação em Farmácia/métodos , Educação em Farmácia/normas , Feminino , Humanos , Masculino , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Inquéritos e Questionários , Visitas com Preceptor/tendências
20.
J Trauma Acute Care Surg ; 87(4): 841-848, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589193

RESUMO

BACKGROUND: Although use of simulation-based team training for pediatric trauma resuscitation has increased, its impact on patient outcomes has not yet been shown. The purpose of this study was to determine the association between simulation use and patient outcomes. METHODS: Trauma centers that participate in the American College of Surgeons (ACS) Pediatric Trauma Quality Improvement Program (TQIP) were surveyed to determine frequency of simulation use in 2014 and 2015. Center-specific clinical data for 2016 and 2017 were abstracted from the ACS TQIP registry (n = 57,916 patients) and linked to survey responses. Center-specific risk-adjusted mortality was estimated using multivariable hierarchical logistic regression and compared across four levels of simulation-based training use: no training, low-volume training, high-volume training, and survey nonresponders (unknown training use). RESULTS: Survey response rate was 75% (94/125 centers) with 78% of the responding centers (73/94) reporting simulation use. The average risk-adjusted odds of mortality was lower in centers with a high volume of training compared with centers not using simulation (odds ratio, 0.58; 95% confidence interval, 0.37-0.92). The times required for resuscitation processes, evaluations, and critical procedures (endotracheal intubation, head computed tomography, craniotomy, and surgery for hemorrhage control) were not different between centers based on levels of simulation use. CONCLUSION: Risk-adjusted mortality is lower in TQIP-Pediatric centers using simulation-based training, but this improvement in mortality may not be mediated by a reduction in time to critical procedures. Further investigation into alternative mediators of improved mortality associated with simulation use is warranted, including assessment of resuscitation quality, improved communication, enhanced teamwork skills, and decreased errors. LEVEL OF EVIDENCE: Therapeutic/care management, Level III.


Assuntos
Capacitação em Serviço , Pediatria/educação , Treinamento por Simulação , Centros de Traumatologia , Ferimentos e Lesões , Benchmarking , Criança , Feminino , Humanos , Capacitação em Serviço/métodos , Capacitação em Serviço/estatística & dados numéricos , Masculino , Melhoria de Qualidade/organização & administração , Fatores de Risco , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Centros de Traumatologia/normas , Centros de Traumatologia/estatística & dados numéricos , Estados Unidos , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/terapia
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