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1.
Semin Vasc Surg ; 32(1-2): 48-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540657

RESUMO

The evolving demands of surgical training have led to the successful implementation of skills examinations in the areas of laparoscopic and endoscopic surgery. Currently, there is no similar formal skills assessment in vascular surgery, despite endovascular intervention replacing open surgery in treatment of many vascular conditions. The adoption of less invasive techniques to treat aneurysm and occlusive disease has resulted in new training paradigms and technical challenges for trainees. The duty hour restriction for trainees and declining numbers of complex open vascular interventions have added to the challenges of vascular surgery training. Simulation is a promising avenue for both skills training and assessment. The ability to evaluate the fundamental skills of trainees would be an important step to ensure a degree of uniformity in trainees' technical abilities. The role of simulation-based training in acquiring, testing, and refining these skills is still in its infancy in the vascular surgery training paradigm. This article aims to impart a deeper understanding of the conditions for developing and implementing the fundamentals of vascular and endovascular surgery, and to provide guidance regarding the role of simulation-based training in a rapidly evolving specialty. There are various forms of simulation available, including benchtop models, high-fidelity simulators, and virtual-reality simulators, and each requires a different method of proficiency assessment. Both open surgery and endovascular skills can be assessed and the application of successful implementation in academic vascular surgery training program is presented.


Assuntos
Certificação , Instrução por Computador/métodos , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência , Treinamento por Simulação/métodos , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Certificação/normas , Competência Clínica , Instrução por Computador/normas , Currículo , Educação de Pós-Graduação em Medicina/normas , Humanos , Curva de Aprendizado , Treinamento por Simulação/normas , Cirurgiões/normas , Procedimentos Cirúrgicos Vasculares/normas
2.
Undersea Hyperb Med ; 46(4): 467-481, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509903

RESUMO

Introduction/Background: The incidence of complications and number of critically ill patients in hyperbaric medicine is relatively low [1]. This poses a challenge to those tasked with educating trainees as well as maintaining the skills of staff. Hyperbaric medicine fellows may not be exposed to critical patient scenarios or complications of hyperbaric medicine during a one-year fellowship. Additional staff may be unfamiliar with these situations as well. The purpose of hyperbaric simulation curriculum is to train health care providers for rare situations. To our knowledge, this hyperbaric simulation curriculum is the first published use of simulation education in the specialty of undersea and hyperbaric medicine. Materials and Methods: Two simulation cases have been developed that involve a patient with oxygen toxicity during hyperbaric treatment as well as an ICU patient with mucous plugging. Results: Medical training simulations are an effective method of teaching content and training multiple roles in Undersea and Hyperbaric Medicine. Summary/Conclusions: A hyperbaric simulation curriculum is an achievable educational initiative that is able to train multiple team members simultaneously in situations that they may not encounter on a regular basis. We believe that this could be easily exported to otherinstitutions for further education.


Assuntos
Currículo , Educação Médica/métodos , Oxigenação Hiperbárica , Treinamento por Simulação/métodos , Doenças do Sistema Nervoso Central/induzido quimicamente , Doenças do Sistema Nervoso Central/terapia , Bolsas de Estudo , Humanos , Oxigenação Hiperbárica/efeitos adversos , Unidades de Terapia Intensiva , Intubação Intratraqueal , Muco , Oxigênio/envenenamento , Simulação de Paciente
3.
Presse Med ; 48(7-8 Pt 1): 780-787, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31383383

RESUMO

Interprofessional simulation-based education is effective for learning non-technical critical care skills and strengthening interprofessional team collaboration to optimize quality of care and patient outcome. Implementation of interprofessional simulation sessions in initial and continuing education is facilitated by a team of "champions" from each discipline/profession to ensure educational quality and logistics. Interprofessional simulation training must be integrated into a broader interprofessional curriculum supported by managers, administrators and clinical colleagues from different professional programs. When conducting interprofessional simulation training, it is essential to account for sociological factors (hierarchy, power, authority, interprofessional conflicts, gender, access to information, professional identity) both in scenario design and debriefing. Teamwork assessment tools in interprofessional simulation training may be used to guide debriefing. The interprofessional simulation setting (in-situ or simulation centre) will be chosen according to the learning objectives and the logistics.


Assuntos
Cuidados Críticos/métodos , Educação Médica/métodos , Relações Interprofissionais , Equipe de Assistência ao Paciente , Treinamento por Simulação , Competência Clínica , Cuidados Críticos/normas , Currículo/normas , Educação Médica/normas , Avaliação Educacional/métodos , Humanos , Ciência da Implementação , Equipe de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/normas , Treinamento por Simulação/métodos , Treinamento por Simulação/organização & administração , Treinamento por Simulação/normas
4.
Rev Col Bras Cir ; 46(3): e20192163, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389523

RESUMO

OBJECTIVE: to describe the teaching strategy based on the Multiple Victims Incident (MVI) simulation, discussing and evaluating the performance of the students involved in the initial care of trauma victims. METHODS: a cross-sectional, and quantitative study was performed. A realistic MVI simulation involving students, and professionals from nursery and medical schools, as well as a prehospital care team was performed. RESULTS: it was possible to notice that the classification according to the START method (Simple Triage and Rapid Treatment) was correct in 94.1% of the time from the analysis of 17 preestablished checklists. Following the primary evaluation with the ABCDE mnemonic, all steps were performed correctly in 70%. However, there was only supply of oxygen in high flow in 64.7% of the examination. The search for visible and hidden bleeding was performed in 70.6% of the examination. The neurological evaluation with the Glasgow coma scale and pupillary evaluation occurred in 70.6% of the victims. The victims exposure was performed in 70.6% of the examination. CONCLUSION: a simulated environment allows the consolidation and improvement of professional skills, especially when we are talking about a poorly trained area during the undergraduate program, such as the MVI. Early training and teamwork encourage clinical thinking, integration and communication, essential abilities when facing chaotic situations.


Assuntos
Competência Clínica , Serviços Médicos de Emergência/métodos , Simulação de Paciente , Treinamento por Simulação/métodos , Triagem/métodos , Estudos Transversais , Feminino , Humanos , Masculino , Estudantes de Medicina , Estudantes de Enfermagem , Universidades
5.
Rev Bras Enferm ; 72(3): 788-794, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269147

RESUMO

OBJECTIVE: Evaluate the contribution of debriefing after clinical simulations for nursing students. METHOD: Quantitative study, conducted with 35 nursing students who participated in five clinical simulation scenarios with planned debriefings based on the model of the National League Nursing/Jeffries Simulation Theory. After the fifth scenario, students answered the Debriefing Evaluation Scale associated with the Simulation. RESULTS: The items evaluated involved the psychosocial, cognitive, and affective values, and within a scale from one to five, the highest mean was found in cognitive value with 4.23 (±0.56) points, then in psychosocial value with 3.77 (±0.53), and finally in affective value with 3.71 (±0.63) points. CONCLUSION: The debriefing conducted after the clinical simulation scenarios was a reflective exercise that contributed to the student integrating multiple knowledges in affective, cognitive and psychosocial values, and thus develop the competencies required.


Assuntos
Avaliação Educacional/normas , Retroalimentação , Treinamento por Simulação/métodos , Treinamento por Simulação/normas , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Brasil , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Avaliação Educacional/métodos , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Masculino
6.
J Laryngol Otol ; 133(8): 700-703, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31317846

RESUMO

OBJECTIVE: The completion of a laser safety course remains a core surgical curriculum requirement for otolaryngologists training in the UK. This project aimed to develop a comprehensive laser safety course utilising both technical and non-technical skills simulation. METHODS: Otolaryngology trainees and consultants from the West of Scotland Deanery attended a 1-day course comprising lectures, two high-fidelity simulation scenarios and a technical simulation of safe laser use in practice. RESULTS: The course, and in particular the use of simulation training, received excellent feedback from otolaryngology trainees and consultants who participated. Both simulation scenarios were validated for future use in laser simulation. CONCLUSION: The course has been recognised as a laser safety course sufficient for the otolaryngology Certificate of Completion of Training. To the authors' knowledge, this article represents the first description of using in situ non-technical skills simulation training for teaching laser use in otolaryngology.


Assuntos
Lasers/efeitos adversos , Otolaringologia/educação , Treinamento por Simulação/métodos , Competência Clínica , Simulação por Computador , Educação Médica Continuada , Humanos , Internato e Residência , Reino Unido
7.
Soins ; 64(837): 41-44, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31345309

RESUMO

Virtual reality is an innovative solution in simulation when it is used to reinforce caregivers' skills. A health facility has set up a continuing professional development programme using this technique. It has enabled caregivers to reinforce their skills in the area of blood transfusion safety.


Assuntos
Transfusão de Sangue/enfermagem , Educação Continuada em Enfermagem , Treinamento por Simulação/métodos , Realidade Virtual , Competência Clínica , Difusão de Inovações , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Segurança do Paciente
8.
Rev Bras Enferm ; 72(3): 624-631, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269125

RESUMO

OBJECTIVE: To construct and validate a clinical simulation setting for postpartum haemorrhage. METHOD: Quantitative research of methodological development, carried out from May to July of 2016 with 22 expert judges and 30 students. Analysis was performed from descriptive statistics, Binomial Test and Content Validity Index (CVI), considering CVI ≥ 80%. RESULTS: Setting construction was based on learning objectives, fidelity, evaluation tool, pre-setting activities and debriefing. Agreement, regarding its validity, was satisfactory in the 23 items analyzed. Items evaluated by judges had CVI> 0.90; in the evaluation by students, CVI was > 0.95. CONCLUSION: It was considered validated and suitable for training and use by nursing students. Other studies should be carried out in order to test its effectiveness in the construction of theoretical and practical knowledge of both nursing students and nurses during Permanent Education.


Assuntos
Hemorragia Pós-Parto/terapia , Treinamento por Simulação/normas , Adulto , Competência Clínica/normas , Feminino , Humanos , Pessoa de Meia-Idade , Simulação de Paciente , Gravidez , Treinamento por Simulação/métodos , Treinamento por Simulação/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
9.
Medicine (Baltimore) ; 98(27): e16330, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277181

RESUMO

Nursing educators have the responsibility to equip nursing students with knowledge about the meaning of life, positive beliefs, and well-being in order to enhance their physical, psychological, spiritual, and social health education and promotion. The purpose of this study was to explore nursing students' simulated directed-learning in a life-education intervention on the meaning of life, positive beliefs, and well-being in regard to immediate and delayed effects in improving physical, psychological, spiritual, and social health education and promotion.The method of this study was constituted a quasi-experimental design with experimental and control groups for pre-test, post-test, and post-post-test. Purposive sampling and non-random distribution were used in the study. Assigned to the experimental group, 54 participants were third-year nursing students enrolled in a health education course with simulated directed-learning in a life-education intervention. Assigned to the control group, 56 participants were third-year nursing students enrolled in a caring care course without simulated directed-learning in a life-education intervention. A 56-item questionnaire was utilized, and the content validity index (CVI) was 0.95, as determined by seven expert scholars. The reliability of the questionnaire (n = 45) on Cronbach's α were: meaning of life 0.96, positive beliefs 0.95, and well-being 0.96. The statistical package SPSS 23.0 was used to analyze all of the data in the study. Frequencies, percentages, pre-test mean and SD, post-test mean and SD, post-post-test mean and SD, chi-squared test, t test, and generalized estimating equation (GEE) were employed for data analysis.Nursing students in the experimental group compared with the control group exhibited significant differences in meaning of life on the pre-post-test (ß = 16.40, P < .001) and pre-post post-test (ß = 25.94, P < .001), positive beliefs on the pre-post-test (ß = 5.64, P < .01) and pre-post post-test (ß = 9.21, P < .001), and well-being on the pre-post-test (ß = 14.33, P < .001) and pre-post post-test (ß = 23.68, P < .001).Nursing students in the experimental group showed a significant improvement in the simulated directed-learning with a life-education intervention on meaning of life, positive beliefs, and well-being in the immediate and delayed effects that enhanced their physical, psychological, spiritual, and social health education and promotion.


Assuntos
Atitude Frente a Saúde , Satisfação Pessoal , Qualidade de Vida , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem
10.
J Nurses Prof Dev ; 35(4): E1-E8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31206418

RESUMO

Early recognition of and prompt intervention for the deteriorating pediatric patient remains paramount in preventing cardiac arrests from occurring outside intensive care units. To decrease these events, we developed a three-part simulation-based blended learning course consisting of a computer-based training module, a simulation scenario, and follow-up in situ scenarios for inpatient nurses. After initiation of the course, our facility has seen a decrease in the number of codes outside critical care areas.


Assuntos
Conscientização , Deterioração Clínica , Parada Cardíaca/prevenção & controle , Treinamento por Simulação/métodos , Criança , Competência Clínica , Humanos , Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem no Hospital/educação , Pediatria
11.
Thorac Surg Clin ; 29(3): 329-337, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31235302

RESUMO

Virtual reality and augmented reality technologies have evolved with a growing presence in both clinical care and surgical training.


Assuntos
Cirurgia Geral/educação , Planejamento de Assistência ao Paciente , Treinamento por Simulação/métodos , Realidade Virtual , Cirurgia Geral/métodos , Humanos
12.
Unfallchirurg ; 122(6): 431-438, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31065737

RESUMO

Arthroscopy is a technically challenging surgical procedure with a relatively shallow learning curve compared to open procedures. To become an expert special cognitive and manual abilities have to be acquired and trained. The current situation in further medical education combined with the increasing economic pressure in the medical field does not leave enough room for a time-consuming training in arthroscopic techniques. A structured simulation training could be an alternative solution to this problem. The benefits of arthroscopic simulation training are meanwhile well documented. The complex tasks that an expert carries out during arthroscopy can be fragmented into more simple and elementary exercises and can be trained in a stress-free environment outside the operation room. An essential advantage of simulation training is the assessment of objective measurement parameters during the individual exercises. These parameters can be used to evaluate the learning process and performance of arthroscopic tasks. The aim of this review is to reflect the current state of simulation technology in arthroscopy and to show how simulator training can be meaningfully and effectively integrated into arthroscopic further training, exemplified by a modern medical further education concept.


Assuntos
Artroscopia/educação , Treinamento por Simulação/normas , Artroscopia/normas , Artroscopia/tendências , Competência Clínica , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Previsões , Humanos , Treinamento por Simulação/métodos , Treinamento por Simulação/tendências , Jogos de Vídeo , Realidade Virtual
13.
Nurse Educ Today ; 79: 153-160, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31132727

RESUMO

BACKGROUND: Virtual Reality (VR) simulation has recently been developed and has improved surgical training. Most VR simulators focus on learning technical skills and few on procedural skills. Studies that evaluated VR simulators focused on feasibility, reliability or easiness of use, but few of them used a specific acceptability measurement tool. OBJECTIVES: The aim of the study was to assess acceptability and usability of a new VR simulator for procedural skill training among scrub nurses, based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model. PARTICIPANTS: The simulator training system was tested with a convenience sample of 16 non-expert users and 13 expert scrub nurses from the neurosurgery department of a French University Hospital. METHODS: The scenario was designed to train scrub nurses in the preparation of the instrumentation table for a craniotomy in the operating room (OR). RESULTS: Acceptability of the VR simulator was demonstrated with no significant difference between expert scrub nurses and non-experts. There was no effect of age, gender or expertise. Workload, immersion and simulator sickness were also rated equally by all participants. Most participants stressed its pedagogical interest, fun and realism, but some of them also regretted its lack of visual comfort. CONCLUSION: This VR simulator designed to teach surgical procedures can be widely used as a tool in initial or vocational training.


Assuntos
Competência Clínica , Aprendizagem , Treinamento por Simulação/métodos , Realidade Virtual , Adulto , Craniotomia , Educação em Enfermagem/métodos , Feminino , Humanos , Masculino , Enfermagem de Centro Cirúrgico/métodos , Reprodutibilidade dos Testes , Interface Usuário-Computador
14.
Nurse Educ Pract ; 37: 88-96, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31129530

RESUMO

A systematic review was conducted on electronic databases of MEDLINE/PubMed, Scopus, ISI Web of Science, CINAHL, and Embase until December 2017, using relevant keywords for educational games developed for nursing students in perioperative field. To evaluate the level of strength and quality of the evidence, the Association of periOperative Registered Nurses (AORN) revised model for evidence appraisal was used. Of the 852 evidence, only 10 met the criteria and were reviewed and appraised. Educational games had focused on different learning domains, including skills, feelings, emotion, knowledge, performance, attitude, motivation, and interest. With respect to the evidence level, most evidence was categorized as V (expert opinion = 2, case report = 2, literature review = 1, and organizational experiences = 1), and only one was in level I (randomized controlled trial). The quality level of most evidence was high (n = 4) and low (n = 4), and the rating of most of them was moderate (n = 4) and limited (n = 4). Based on the findings, most evidence had inappropriate quality and was found to be weak. It seems that the investigated games are insufficient to promote the nursing students' learning outcomes in different domains. Accordingly, more high-quality studies are required to design and develop innovative and practical games for students in perioperative nursing by considering validity and reliability process.


Assuntos
Enfermagem Perioperatória , Jogos e Brinquedos , Treinamento por Simulação/métodos , Estudantes de Enfermagem , Competência Clínica , Humanos , Aprendizagem , Pesquisa em Educação de Enfermagem , Pesquisa Qualitativa , Reprodutibilidade dos Testes
15.
Acta Cir Bras ; 34(4): e201900410, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31038587

RESUMO

PURPOSE: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. METHODS: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. RESULTS: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. CONCLUSIONS: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.


Assuntos
Modelos Anatômicos , Silicones , Treinamento por Simulação/métodos , Técnicas de Sutura/educação , Desempenho Acadêmico , Competência Clínica , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/normas , Humanos , Reprodutibilidade dos Testes , Treinamento por Simulação/normas , Estudantes de Medicina , Inquéritos e Questionários
16.
Orv Hetil ; 160(19): 747-755, 2019 May.
Artigo em Húngaro | MEDLINE | ID: mdl-31055963

RESUMO

Introduction: Three-dimensional (3D) modelling and printing greatly supports advances in individualized medicine and surgery. In congenital cardiac surgery, 3D-models and printed prototypes offer advantages of better understanding of complex anatomy, hands-on preoperative surgical planning and emulation, improved communication within the multidisciplinary team and to patients. 3D-virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios. Aim: Validity and realisation of possible clinical benefits were studied. Method: Computed tomography-angiography raw-data were segmented into 3D-virtual models of the heart-great vessels. Prototypes were 3D-printed as real-size "blood-volume" (rigid material), and 1.5×-scaled "hollow" (translucent, flexible material). Accuracy of the models was evaluated intraoperatively. Results: We produced 3D-prototypes of the heart-great vessels for 12 case-scenarios (6 males, median age: 11 months) undergoing complex intracardiac repairs. Accuracy was excellent in millimeter-range. Representation of the atrioventricular valves is currently unsatisfactory. Models refined diagnostics in 8/12 and provided new anatomic information in 6/12 cases (e.g., aberrant coronary origin/course, newly-discovered intracardiac communication, etc.); in 10/12 cases they contributed to an improved operative plan (surgical approach, modification of intracardiac repair, etc.); an alternative operative plan emerged in 6/12 cases. Complex operative procedures (staged reoperations in 10/12; Aristotle-score median: 11; 10-14) emulated on 3D-models were materialized successfully. No morbidity/mortality occurred. Acceptance-index of the 3D-models was maximal among the multidisciplinary clinical team and patients/relatives. Conclusion: 3D-printed models can contribute to the safety of complex congenital cardiac surgeries in selected scenarios. Besides their numerous benefits, currently inadequate financial coverage of the extra time/labour and material/machinery by insurance is mentioned as a major drawback. Orv Hetil. 2019; 160(19): 747-755.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Cardiopatias/congênito , Cardiopatias/cirurgia , Imagem Tridimensional , Segurança do Paciente , Impressão Tridimensional , Treinamento por Simulação/métodos , Criança , Humanos , Lactente , Masculino
17.
Arq Bras Cir Dig ; 32(2): e1436, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31038561

RESUMO

BACKGROUND: A General Surgery Residency may last between 2-6 years, depending on the country. A shorter General Surgery Residency must optimize residents' surgical exposure. Simulated surgical training is known to shorten the learning curves, but information related to how it affects a General Surgery Residency regarding clinical exposure is scarce. AIM: To analyze the effect of introducing a validated laparoscopic simulated training program in abdominal procedures performed by residents in a three-year General Surgery Residency program. METHODS: A non-concurrent cohort study was designed. Four-generations (2012-2015) of graduated surgeons were included. Only abdominal procedures in which the graduated surgeons were the primary surgeon were described and analyzed. The control group was of graduated surgeons from 2012 without the laparoscopic simulated training program. Surgical procedures per program year, surgical technique, emergency/elective intervention and hospital-site (main/community hospitals) were described. RESULTS: Interventions of 28 graduated surgeons were analyzed (control group=5; laparoscopic simulated training program=23). Graduated surgeons performed a mean of 372 abdominal procedures, with a higher mean number of medium-to-complex procedures in laparoscopic simulated training program group (48 vs. 30, p=0.02). Graduated surgeons trained with laparoscopic simulated training program performed a higher number of total abdominal procedures (384 vs. 319, p=0.04) and laparoscopic procedures (183 vs. 148, p<0.05). CONCLUSIONS: The introduction of laparoscopic simulated training program may increase the number and complexity of total and laparoscopic procedures in a three-year General Surgery Residency.


Assuntos
Internato e Residência/métodos , Laparoscopia/métodos , Treinamento por Simulação/métodos , Procedimentos Cirúrgicos Operatórios/educação , Abdome/cirurgia , Análise de Variância , Competência Clínica , Estudos de Coortes , Humanos , Avaliação de Programas e Projetos de Saúde , Reprodutibilidade dos Testes , Estatísticas não Paramétricas
18.
Med Educ Online ; 24(1): 1611305, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31056011

RESUMO

BACKGROUND: Pediatrics residents are expected by the Accreditation Council for Graduate Medical Education to competently perform 13 procedures. However, residents are graduating with poor self-perceived competency for these procedures. OBJECTIVE: We developed a curriculum using simulation training at the beginning of internship and 'refresher' workshops throughout the year in order to increase procedure exposure and improve self-perceived competency. DESIGN: Procedural workshops were taught during intern orientation and to all pediatrics residents throughout the academic year. Residents provided a quantitative competency self-assessment before and after each workshop; interns provided an additional self-assessment at the end of the intern year. RESULTS: The curriculum was well-liked and led to more procedural experience. Mean competency self-assessment scores improved immediately after almost every procedure workshop. Mean scores were retained at the end of intern year for most procedures. However, end-of-year mean competency self-assessment and procedural experience on actual patients were similar to interns from a previous year that had not participated in the curriculum. CONCLUSIONS: A pre-internship procedure workshop coupled with longitudinal workshops is a feasible way to improve intern exposure to pediatric procedural training. However, it was not sufficient to improve mean competency self-assessments compared to a traditional model of bedside procedural training.


Assuntos
Internato e Residência/métodos , Pediatria/educação , Treinamento por Simulação/métodos , Acreditação , Atitude do Pessoal de Saúde , Criança , Competência Clínica , Humanos , Masculino , Autoavaliação
19.
J Nurs Educ ; 58(4): 221-224, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30943297

RESUMO

BACKGROUND: The Patient Protection and Affordable Care Act increased numbers of insured individuals and demands for health care cost reductions. A national call for nursing education to focus on health promotion activities exists. Nurse educators can address this shift in health care by including motivational interviewing (MI), a health promotion technique, in the curriculum. METHOD: This exploratory descriptive pilot survey examined postlicensure nursing students' perceptions and self-reported behaviors following an online synchronous telehealth simulation-based experience in which they practiced MI. RESULTS: The survey yielded a 45% (n = 10) response rate. All participants agreed the experience was beneficial to their learning and provided insights on a new clinical practice environment. Eighty percent of participants would have liked to have learned MI in their prelicensure program, and 50% of participants have integrated it in their current practice. CONCLUSION: This tele-health simulation-based experience positively affected the learning and behaviors of postlicensure nursing students. [J Nurs Educ. 2019;58(4):221-224.].


Assuntos
Aprendizagem , Entrevista Motivacional , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Telemedicina , Currículo , Educação de Pós-Graduação em Enfermagem/organização & administração , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Projetos Piloto
20.
GMS J Med Educ ; 36(2): Doc17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30993175

RESUMO

Objective: This project is part of the "PJ-STArT-Block", a one-week course preparing 10th semester medical students for their final practical year. The focus is on sensitizing students to aspects of medication safety by becoming aware of their skills and their deficits in terms of application and communication of pharmacological knowledge. The modules were evaluated regarding feasibility, acceptance and possible effects. Furthermore, the areas in which students see their pharmacological deficits or learning successes were gathered. Methods: In simulated physician-patient conversations, the students are to identify drug-related problems such as medication errors, adverse drug events or interactions. Together with their fellow students and under medical or pharmaceutical moderation, they then have to find solutions for the identified problems and communicate these solutions to the patients. Based on paper cases, students practice, reflect, and discuss the research of reliable information about drugs and medication therapy. The written evaluation included the evaluation by school grades and the possibility of comments in free text. A content analysis of interviews with students at the beginning of the project aimed to identify areas of pharmacology in which they see their own deficits. Results: Evaluation results including the free text comments indicate students' acceptance of our pharmacology modules. According to this, the students realize the importance of aspects relevant for medication safety. The areas mentioned in 35 interviews in which students localize deficits, correspond to the topics that were intended when conceiving the modules and which are important for medication safety (e.g. interactions, adverse drug effects, dosages). Conclusion: Implementation of context-based, application-oriented teaching formats as recently claimed for pharmacological education to improve the quality of prescriptions, is possible, as the Cologne example shows. The student evaluation turns out positively and indicates a critical self-reflection. The students identified various pharmacological deficits in themselves, which have since been confirmed and quantified in another study.


Assuntos
Segurança do Paciente/normas , Farmacologia/educação , Relações Médico-Paciente , Estudantes de Medicina/psicologia , Comunicação , Educação de Graduação em Medicina/métodos , Humanos , Erros de Medicação/prevenção & controle , Erros de Medicação/psicologia , Farmacologia/métodos , Pesquisa Qualitativa , Treinamento por Simulação/métodos , Estudantes de Medicina/estatística & dados numéricos
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