Value of simulation as a means of evaluating learning on the management of patients with COVID19.

INTRODUCTION: Medical simulation is a crucial educational tool for training healthcare professionals, renowned for its effectiveness in learning. However, its application as an assessment tool remains uncommon. AIM: To evaluate simulation as a tool for assessing training in the management of COVID-19 patients. METHODS: This descriptive cross-sectional study was conducted in June 2021 at the Department of Pediatrics, Sahloul University Hospital in Sousse, Tunisia. All medical and paramedical staff in the department underwent comprehensive training in the management of COVID-19 patients, including video training for donning and doffing protective equipment when in contact with infected patients. A simulation-based assessment of these procedures was carried out among the department staff having received this training. RESULTS: Our study included a total of 67 participants, comprising 28 medical staff (41.8%) and 39 paramedical staff (58.2%). During the assessment scenario, over 50% of participants successfully completed the main steps for both donning (8 out of 11 steps) and doffing procedures (10 out of 11 steps). However, there were instances of incorrect execution in some critical steps. In the doffing test, only 16.4% of participants performed the fitcheck correctly, with a notable difference between paramedical staff and medical staff (25.6% vs 3.6%, p=0.02). The practice of double gloving was observed in only 38.8% of cases, with higher adherence among physicians compared to paramedical staff (57.1% vs 25.6%, p=0.009). Regarding the doffing procedure, we observed that not all staff performed hydroalcoholic friction adequately. Similarly, only 22.4% of participants followed the recommended sequence of gestures, with a significantly higher compliance rate among doctors compared to paramedical staff (50% vs 2.6%, p<0.001). CONCLUSIONS: Simulation is a swiftly expanding assessment tool. In our study, it helped reveal specific skill deficiencies that would have gone unnoticed in written or oral assessments.

Epidemiological, Bacteriological, and Evolutive Features of Children Hospitalized for Infective Endocarditis in a Tertiary Tunisian Pediatric Department.

Background: Infective endocarditis is a rare condition in childhood, and there is limited data on this disease in Tunisia. Objective: This study aims to analyze the epidemiological profile, bacteriological data, and prognosis of infective endocarditis in children admitted to the pediatric department of a University Hospital in Tunisia. Methods: We conducted a comparative cross-sectional study in the pediatric department of Sahloul Teaching Hospital in Sousse, a tertiary referral hospital in Tunisia. The study included all children aged ≤ 18 years with infective endocarditis admitted to the tertiary referral center for pediatrics in Sahloul University Hospital from January 1994 to December 2022. The diagnosis of infective endocarditis was based on modified Duke's criteria. Results: Thirty-six patients met the diagnostic criteria for infective endocarditis, resulting in a proportion of 07 cases per 1000 hospital admissions. The mean age was 6 years (range: 40 days to 16 years). Congenital heart disease was identified as the underlying lesion in 23 cases (63.9 %). Blood cultures were positive in 20 patients (55.6 %), predominantly with Staphylococcus species (55 %). The most frequent complications involved the central nervous system (8 cases; 22.2 %). The mortality rate was 25 %, and factors predicting mortality included heart failure on admission or during the hospital stay, increased leukocyte count, and decreased prothrombin time. Conclusion: Our study reveals a shift in the prevalent underlying lesions, with rheumatic heart diseases no longer being the most common. Staphylococcus spp. emerged as the predominant organism in blood cultures. Notably, mortality predictors included heart failure, an elevated leukocyte count, and a decreased prothrombin time rate.