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1.
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
2.
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
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.
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
5.
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
6.
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
7.
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
8.
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
9.
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
10.
J Am Acad Orthop Surg ; 28(21): e939-e947, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32796368

RESUMO

The current surgical training environment has sparked a paradigm shift toward the use of surgical training simulation. An apprentice-based model has historically been used in surgical education, but current financial and practical constraints have led to a more variable training experience. Surgical simulation has demonstrated efficacy in many facets of orthopaedic training and has most recently been implemented to fine-tune surgical skill in reconstruction of traumatic skeletal injuries. Although some surgical skills learned during residency training are not fully used in later practice, most surgeons require a baseline level of competence in managing skeletal trauma. Fracture surgery is heavily dependent on technical skill. Trainee simulation use in skill acquisition has potential to improve proficiency during actual surgery. Furthermore, in a specialty where the standard axiom has been repetition matters, education augmentation with simulation provides overall benefit. Work remains to maximize the effectiveness of surgical simulation in fracture treatment through improved model integration and access.


Assuntos
Competência Clínica , Simulação por Computador , Fixação de Fratura/educação , Fixação de Fratura/métodos , Fraturas Ósseas/cirurgia , Internato e Residência , Ortopedia/educação , Treinamento por Simulação/métodos , Fraturas do Quadril/cirurgia , Humanos , Aprendizagem , Procedimentos Cirúrgicos Reconstrutivos/educação
11.
Ann Surg ; 272(5): 709-714, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32833763

RESUMO

OBJECTIVE: To evaluate if "state-of-the-art" 3D- versus 4K-display techniques could influence surgical performance. BACKGROUND: High quality minimally invasive surgery is challenging. Therefore excellent vision is crucial. 3D display technique (3D) and 2D-4K technique (4K) are designed to facilitate surgical performance, either due to spatial resolution (3D) or due to very high resolution (4K). METHODS: In randomized cross-over trial the surgical performance of medical students (MS), non-board certified surgeons (NBC), and board certified surgeons (BC) was compared using 3D versus 4K display technique at a minimally invasive training Parkour. RESULTS: One hundred twenty-eight participants were included (February 2018 through October 2019, 49 MS, 39 NBC, 40 BC). The overall Parkour time (s) 3D versus 4K was 712.5 s ± 17.5 s versus 999.5 s ±â€Š25.1 s (P < 0.001) for all levels of experience. It was (3D vs 4K) for MS (30 tasks) 555.4 s ±â€Š28.9 s versus 858.7 s ±â€Š41.6 s, (P < 0.0001), for NBC (42 tasks) 935.9 s ±â€Š31.5 s versus 1274.1 s ±â€Š45.1 s (P =< 0.001) and for BC (42 task) 646.3 s ±â€Š30.9 s versus 865.7 s ±â€Š43.7 s (P < 0.001). The overall number of mistakes was (3D vs 4K) 10.0 ±â€Š0.5 versus 13.3 ±â€Š0.7 (P < 0.001), for MS 8.9 ±â€Š0.9 versus 13.1 ±â€Š1.1 (P < 0.001), for NBC 12.45 ±â€Š1.0 versus 16.7 ±â€Š1.2 (P < 0.001) and for BC 8.8 ±â€Š1.0 versus 10.0 ±â€Š1.2 (P = 0.18). MS, BC, and NBC showed shorter performance time in 100% of the task with 3D (significantly in 6/7 tasks). For number of mistakes the effect was less pronounced for more experienced surgeons. The National Aeronautics and Space Administration-task load index was lower with 3D. CONCLUSION: 3D laparoscopic display technique optimizes surgical performance compared to the 4K technique. Surgeons benefit from the improved visualization regardless of their individual surgical expertise.


Assuntos
Competência Clínica , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Treinamento por Simulação/métodos , Cirurgia Vídeoassistida/instrumentação , Adulto , Estudos Cross-Over , Feminino , Humanos , Imageamento Tridimensional , Masculino , Desempenho Psicomotor , Método Simples-Cego
13.
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
16.
Am J Infect Control ; 48(10): 1244-1247, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32763351

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has created many challenges for health care providers. At the forefront is the need to balance optimal patient care with the safety of those providing that care. This is especially true during resuscitations where life-saving procedures cause widespread aerosolization of the virus. Efforts to mitigate this exposure to front-line providers are therefore paramount. We share how we used simulation to prepare our pediatric emergency department for COVID-19 resuscitations.


Assuntos
Infecções por Coronavirus/terapia , Serviço Hospitalar de Emergência , Pessoal de Saúde/educação , Pneumonia Viral/terapia , Ressuscitação/educação , Treinamento por Simulação/métodos , Betacoronavirus , Criança , Humanos , Pandemias , Integração de Sistemas
17.
J Surg Educ ; 77(5): 1005-1007, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32773336

RESUMO

OBJECTIVE: In response to ongoing concerns regarding transmission of the novel coronavirus (COVID-19), surgical practice has changed for the foreseeable future. Practice guidelines recommend only urgent or emergent surgical procedures be performed to minimize viral transmission. This effectively limits standard training and practice for surgical residents. The purpose of this article is to describe opportunities in surgical simulation, and highlights the challenges associated with training in the COVID-19 era. DESIGN: This is a perspective summarizing the potential role of surgical simulation to target training gaps caused by decreased surgical caseloads. CONCLUSIONS: This manuscript concisely discusses simulation options available to training programs, including the novel concept of "surgical kits." These kits include all instruments necessary to simulate a procedure at home, effectively pairing safety and utility.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Educação de Pós-Graduação em Medicina/métodos , Cirurgia Geral/educação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Impressão Tridimensional , Treinamento por Simulação/métodos , Competência Clínica , Feminino , Humanos , Internato e Residência/métodos , Masculino , Modelos Educacionais , Otolaringologia/educação , Gestão da Segurança , Estados Unidos
19.
J Laryngol Otol ; 134(6): 497-500, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32618522

RESUMO

OBJECTIVE: Rate of learning is often cited as a deterrent in the use of endoscopic ear surgery. This study investigated the learning curves of novice surgeons performing simulated ear surgery using either an endoscope or a microscope. METHODS: A prospective multi-site clinical research study was conducted. Seventy-two medical students were randomly allocated to the endoscope or microscope group, and performed 10 myringotomy and ventilation tube insertions. Trial times were used to produce learning curves. From these, slope (learning rate) and asymptote (optimal proficiency) were ascertained. RESULTS: There was no significant difference between the learning curves (p = 0.41). The learning rate value was 68.62 for the microscope group and 78.71 for the endoscope group. The optimal proficiency (seconds) was 32.83 for the microscope group and 27.87 for the endoscope group. CONCLUSION: The absence of a significant difference shows that the learning rates of each technique are statistically indistinguishable. This suggests that surgeons are not justified when citing 'steep learning curve' in arguments against the use of endoscopes in middle-ear surgery.


Assuntos
Endoscopia/instrumentação , Ventilação da Orelha Média/métodos , Procedimentos Cirúrgicos Otológicos/métodos , Educação Médica , Endoscópios , Feminino , Humanos , Curva de Aprendizado , Masculino , Microscopia/instrumentação , Ventilação da Orelha Média/educação , Procedimentos Cirúrgicos Otológicos/educação , Procedimentos Cirúrgicos Otológicos/tendências , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Treinamento por Simulação/métodos , Estudantes de Medicina/estatística & dados numéricos , Membrana Timpânica/cirurgia
20.
Ann Biol Clin (Paris) ; 78(4): 446-448, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32627731

RESUMO

Training and education are essential for medical students. During the COVID-19 outbreak, numerous schools and universities have had to close. Ensuring pedagogical continuity requires alternatives to the traditional classroom, especially in medical education. Usual distance learning tools such as videos and downloadable handouts are not sufficient to promote efficient teaching. Distance learning requires self-motivation and does not give you direct access to your instructor. Some students fear the loss of human contact with an instructor - like asking questions during and after class - which promotes learning, understanding and communication. Moreover, classical distance learning methods do not offer immediate feedback that can help students in their understanding of the lecture. In this context, interactive pedagogic tools (IPT) could be useful for medical education continuity and for maintaining human contact necessary in pedagogy. We briefly evaluated interactive pedagogic tool compared to traditionnal distancial tools on medical students. This study showed the importance to have direct contact with a teacher and feedback during a lecture and to not exclusively perform distance learning without direct interaction and feedback. Hence, in the present context, we encourage teacher to use this type of tools to maintain direct interaction with students - which is essential in pedagogy - and ensure a qualitative pedagogical continuity.


Assuntos
Instrução por Computador/métodos , Infecções por Coronavirus/epidemiologia , Educação a Distância/métodos , Educação Médica Continuada/métodos , Pneumonia Viral/epidemiologia , Treinamento por Simulação , Software , Betacoronavirus , Serviços de Laboratório Clínico/organização & administração , Instrução por Computador/normas , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Educação a Distância/organização & administração , Educação a Distância/normas , Educação Médica Continuada/organização & administração , Humanos , Internet/organização & administração , Internet/normas , Aprendizagem , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/organização & administração , Aprendizagem Baseada em Problemas/normas , Treinamento por Simulação/métodos , Treinamento por Simulação/organização & administração , Treinamento por Simulação/normas , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Gravação em Vídeo/métodos , Gravação em Vídeo/normas
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