BMJ Simulation & Technology Enhanced Learning最新文献

Background: Person-centred simulation in health professions education requires involvement of the person with illness experience.

Objective: To investigated how real illness experiences inform simulated participants' (SP) portrayals in simulation education using a scoping review to map literature.

Study selection: Arksey and O'Malley's framework was used to search, select, chart and analyse data with the assistance of personal and public involvement. MEDLINE, Embase, CINAHL, Scopus and Web of Science databases were searched. A final consultation exercise was conducted using results.

Findings: 37 articles were within scope. Reporting and training of SPs are inconsistent. SPs were actors, volunteers or the person with the illness experience. Real illness experience was commonly drawn on in communication interactions. People with illness experience could be directly involved in various ways, such as through conversation with an SP, or indirectly, such as a recording of heart sounds. The impact on the learner was rarely considered.

Conclusion: Authentic illness experiences help create meaningful person-centred simulation education. Patients and SPs may both require support when sharing or portraying illness experience. Patients' voices profoundly enrich the educational contributions made by SPs.

The interprofessional education (IPE) simulation literature lacks research assessing long-term IPE outcomes. During the 2018-19 and 2019-20 academic year, third year and fourth year medical students, respectively, engaged in an IPE simulation experience focused on cardiopulmonary resuscitation. Students completed the Interprofessional Collaborative Competencies Attainment Survey. There was a statistically significant positive change (p<0.05) in student perceptions of their interprofessional collaborative skills immediately following a single IPE simulation activity for both third and fourth year students. However, a statistically significant decline in means was noted from third year post-questions to fourth year pre-questions. A single annual IPE simulation activity may not be sufficient to support students in building confidence in their collaborative skills without regression.

Introduction: Emergent paediatric intubation is an infrequent but high-stakes procedure in the paediatric emergency department (PED). Successful intubations depend on efficient and accurate preparation. The aim of this study was to use airway drills (brief in-situ simulations) to identify gaps in our paediatric endotracheal intubation preparation process, to improve on our process and to demonstrate sustainability of these improvements over time in a new staff cohort.

Method: This was a single-centre, simulation-based improvement study. Baseline simulated airway drills were used to identify barriers in our airway preparation process. Drills were scored for time and accuracy on an iteratively developed 16-item rubric. Interventions were identified and their impact was measured using simulated airway drills. Statistical analysis was performed using unpaired t-tests between the three data collection periods.

Results: Twenty-five simulated airway drills identified gaps in our airway preparation process and served as our baseline performance. The main problem identified was that staff members had difficulty locating essential airway equipment. Therefore, we optimised and implemented a weight-based airway cart. We demonstrated significant improvement and sustainability in the accuracy of obtaining essential airway equipment from baseline to postintervention (62% vs 74%; p=0.014), and postintervention to sustainability periods (74% vs 77%; p=0.573). Similarly, we decreased and sustained the time (in seconds) required to prepare for a paediatric intubation from baseline to postintervention (173 vs 109; p=0.001) and postintervention to sustainability (109 vs 103; p=0.576).

Conclusions: Simulated airway drills can be used as a tool to identify process gaps, measure and improve paediatric intubation readiness.