Pub Date : 2021-03-08DOI: 10.1136/bmjstel-2021-000888
S. Walsh, M. Costello, Ella Murphy, A. Lowery, B. Reid McDermott, D. Byrne
The letter provides practical tips for developing, implementing and scaling an effective simulation‑based education programme at a large scale for undergraduate medical students. Using time-lapsed scenarios and the pause-discuss method of debrief are some of the useful tips that are discussed further in the letter.
{"title":"Practical tips for introducing high-fidelity simulation to undergraduates at a large scale: learning from our experience","authors":"S. Walsh, M. Costello, Ella Murphy, A. Lowery, B. Reid McDermott, D. Byrne","doi":"10.1136/bmjstel-2021-000888","DOIUrl":"https://doi.org/10.1136/bmjstel-2021-000888","url":null,"abstract":"The letter provides practical tips for developing, implementing and scaling an effective simulation‑based education programme at a large scale for undergraduate medical students. Using time-lapsed scenarios and the pause-discuss method of debrief are some of the useful tips that are discussed further in the letter.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"59 1","pages":"452 - 453"},"PeriodicalIF":1.1,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90993669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-05DOI: 10.1136/bmjstel-2020-000797
F. Consorti, G. Panzera
Background Many studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results. Objectives The objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes. Study selection We searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model. Findings We selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (−0.19, 95% CI −0.44 to 0.06) and for time (−0.14, 95% CI −0.54 to 0.27). Conclusion Simulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.
许多研究探索了模拟在基础外科教育中的应用，有各种各样的设备、背景和结果，有时结果相互矛盾。本荟萃分析的目的是关注模拟中身体相似水平对医科本科生基本外科技能发展的影响，并为模拟的设计和实施提供基础，考虑其有效性和与学习结果的一致性。研究选择我们在PubMed和Scopus数据库中搜索具有不同相似程度的模拟之间的比较随机研究。在随机效应模型下，将结果综合为标准化平均差。我们从2091篇检索到的研究中选择了12篇，报道了373名本科生(平均受试者15.54±6.89)。结果是简单技能的表现和完成任务的时间。两项研究报告了一个评分系统;七项研究报告了完成一项任务的时间;三项研究同时报道了这两种情况。meta分析中包含的总分指标为456项，时间指标为504项。综合效应大小在评分系统(- 0.19,95% CI - 0.44至0.06)和时间(- 0.14,95% CI - 0.54至0.27)的高水平身体相似性模拟中没有显示出任何显著优势。结论低相似度模拟与高相似度模拟对大学生外科基本技能发展的影响相同。
{"title":"Low versus high level of physical resemblance in simulation for the acquisition of basic surgical skill: a meta-analysis","authors":"F. Consorti, G. Panzera","doi":"10.1136/bmjstel-2020-000797","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000797","url":null,"abstract":"Background Many studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results. Objectives The objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes. Study selection We searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model. Findings We selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (−0.19, 95% CI −0.44 to 0.06) and for time (−0.14, 95% CI −0.54 to 0.27). Conclusion Simulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"2 1","pages":"422 - 427"},"PeriodicalIF":1.1,"publicationDate":"2021-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78614655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-26DOI: 10.1136/bmjstel-2020-000774
S. Wong, B. Gill, Jacky Kt Chan, Alison Pui Han Cheung, Caroline Y. C. Charm, C. Fung, C. Lam, Mavis Ying Ting Tong, Cora Ka Yee Lo, A. Y. K. Tsang, D. Nestel
Background Healthcare simulation has been used as a pedagogical strategy in nursing education. Evidence has shown one of the positive impacts that simulations replace clinical placement. These wide-ranging initiatives are essential, and they can guide a nursing school’s simulation training. However, researching each innovation in the nursing field is beyond the scope. Methods To focus our research and develop the capacity and capability to incorporate healthcare simulation in nursing education, we used a consensus building process to establish a school’s research agenda. A modified Delphi process was adopted to reach a consensus among 10 nursing faculty members in one university with a visiting professor’s support. Results The three themes were identified as (1) embedding simulation into the baccalaureate in nursing curriculum, (2) designing effective simulation-based education and (3) simulating education in the broader world (adolescents). These themes were further categorised into two areas that used simulation in the educational and community settings. Sixty per cent of the faculty members agreed that the question, ‘How can simulation be incorporated into clinical placements to enhance students’ learning?' should be the highest research priority. Conclusion This study adds understanding to incorporate simulation-based education in the nursing curriculum and community provides insights into future research.
{"title":"School-based research agenda on healthcare simulation for nursing education in Hong Kong","authors":"S. Wong, B. Gill, Jacky Kt Chan, Alison Pui Han Cheung, Caroline Y. C. Charm, C. Fung, C. Lam, Mavis Ying Ting Tong, Cora Ka Yee Lo, A. Y. K. Tsang, D. Nestel","doi":"10.1136/bmjstel-2020-000774","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000774","url":null,"abstract":"Background Healthcare simulation has been used as a pedagogical strategy in nursing education. Evidence has shown one of the positive impacts that simulations replace clinical placement. These wide-ranging initiatives are essential, and they can guide a nursing school’s simulation training. However, researching each innovation in the nursing field is beyond the scope. Methods To focus our research and develop the capacity and capability to incorporate healthcare simulation in nursing education, we used a consensus building process to establish a school’s research agenda. A modified Delphi process was adopted to reach a consensus among 10 nursing faculty members in one university with a visiting professor’s support. Results The three themes were identified as (1) embedding simulation into the baccalaureate in nursing curriculum, (2) designing effective simulation-based education and (3) simulating education in the broader world (adolescents). These themes were further categorised into two areas that used simulation in the educational and community settings. Sixty per cent of the faculty members agreed that the question, ‘How can simulation be incorporated into clinical placements to enhance students’ learning?' should be the highest research priority. Conclusion This study adds understanding to incorporate simulation-based education in the nursing curriculum and community provides insights into future research.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"28 1","pages":"435 - 437"},"PeriodicalIF":1.1,"publicationDate":"2021-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77954736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-24DOI: 10.1136/bmjstel-2020-000782
T. Caruso, Olivia Hess, Kenny Roy, Ellen Wang, S. Rodriguez, Coby Palivathukal, N. Haber
Augmented reality (AR) has been studied as a clinical teaching tool, however eye-tracking capabilities integrated within an AR medical simulator have limited research. The recently developed Chariot Augmented Reality Medical (CHARM) simulator integrates real-time communication into a portable medical simulator. The purpose of this project was to refine the gaze-tracking capabilities of the CHARM simulator on the Magic Leap One (ML1). Adults aged 18 years and older were recruited using convenience sampling. Participants were provided with an ML1 headset that projected a hologram of a patient, bed and monitor. They were instructed via audio recording to gaze at variables in this scenario. The participant gaze targets from the ML1 output were compared with the specified gaze points from the audio recording. A priori investigators planned to iterative modifications of the eye-tracking software until a capture rate of 80% was achieved. Two consecutive participants with a capture rate less than 80% triggered software modifications and the project concluded after three consecutive participants’ capture rates were greater than 80%. Thirteen participants were included in the study. Eye-tracking concordance was less than 80% reliable in the first 10 participants. The investigators hypothesised that the eye movement detection threshold was too sensitive, thus the algorithm was adjusted to reduce noise. The project concluded after the final three participants’ gaze capture rates were 80%, 80% and 80.1%, respectively. This report suggests that eye-tracking technology can be reliably used with the ML1 enabled with CHARM simulator software.
增强现实(AR)已被研究作为临床教学工具，然而眼动追踪功能集成在AR医学模拟器有限的研究。最近开发的战车增强现实医疗(CHARM)模拟器将实时通信集成到便携式医疗模拟器中。这个项目的目的是改进Magic Leap One (ML1)上的CHARM模拟器的注视跟踪功能。采用方便抽样方法招募18岁及以上的成年人。参与者被提供了一个ML1头戴式耳机，该耳机投射了病人、床和监视器的全息图。他们通过录音被指示盯着这个场景中的变量。将ML1输出的被试凝视目标与音频记录的指定凝视点进行比较。先验研究人员计划对眼球追踪软件进行反复修改，直到达到80%的捕获率。连续两个捕获率低于80%的参与者触发软件修改，连续三个参与者捕获率大于80%后项目结束。13名参与者参与了这项研究。在前10名参与者中，眼球追踪一致性的可靠性低于80%。研究人员假设眼动检测阈值过于敏感，因此对算法进行了调整以降低噪声。当最后三名参与者的凝视捕捉率分别达到80%、80%和80.1%时，项目结束。该报告表明，眼动追踪技术可以可靠地使用具有CHARM模拟器软件的ML1。
{"title":"Integrated eye tracking on Magic Leap One during augmented reality medical simulation: a technical report","authors":"T. Caruso, Olivia Hess, Kenny Roy, Ellen Wang, S. Rodriguez, Coby Palivathukal, N. Haber","doi":"10.1136/bmjstel-2020-000782","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000782","url":null,"abstract":"Augmented reality (AR) has been studied as a clinical teaching tool, however eye-tracking capabilities integrated within an AR medical simulator have limited research. The recently developed Chariot Augmented Reality Medical (CHARM) simulator integrates real-time communication into a portable medical simulator. The purpose of this project was to refine the gaze-tracking capabilities of the CHARM simulator on the Magic Leap One (ML1). Adults aged 18 years and older were recruited using convenience sampling. Participants were provided with an ML1 headset that projected a hologram of a patient, bed and monitor. They were instructed via audio recording to gaze at variables in this scenario. The participant gaze targets from the ML1 output were compared with the specified gaze points from the audio recording. A priori investigators planned to iterative modifications of the eye-tracking software until a capture rate of 80% was achieved. Two consecutive participants with a capture rate less than 80% triggered software modifications and the project concluded after three consecutive participants’ capture rates were greater than 80%. Thirteen participants were included in the study. Eye-tracking concordance was less than 80% reliable in the first 10 participants. The investigators hypothesised that the eye movement detection threshold was too sensitive, thus the algorithm was adjusted to reduce noise. The project concluded after the final three participants’ gaze capture rates were 80%, 80% and 80.1%, respectively. This report suggests that eye-tracking technology can be reliably used with the ML1 enabled with CHARM simulator software.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"73 1","pages":"431 - 434"},"PeriodicalIF":1.1,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86075253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-12DOI: 10.1136/bmjstel-2020-000814
Natasha Houghton, Will Houstoun, Sophie Yates, B. Badley, R. Kneebone
The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning—through simulation or direct patient contact—is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely. The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.
{"title":"Cross-disciplinary perspectives on the transition to remote education","authors":"Natasha Houghton, Will Houstoun, Sophie Yates, B. Badley, R. Kneebone","doi":"10.1136/bmjstel-2020-000814","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000814","url":null,"abstract":"The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning—through simulation or direct patient contact—is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely. The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"22 1","pages":"586 - 589"},"PeriodicalIF":1.1,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82563260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-08DOI: 10.1136/bmjstel-2020-000807
A. Gamble, M. Bearman, D. Nestel
Background Real patients in clinical placements are important for learning and may well be the ‘gold standard’. However, simulated patients (SPs) are a viable alternative in the absence of this opportunity. While adult SPs contribute to health professions education, child and adolescent simulated patients (CASPs) are less common. This research aims to explore the perspectives of healthcare educators regarding the engagement of young SPs, specifically the identification of barriers and enablers to involving CASPs. Methods We used an interpretive paradigm of qualitative description. Thirteen interviewees, all educators involved in SP programmes, participated in semistructured interviews. Data were transcribed verbatim and analysed using an inductive thematic approach. Findings Not all participants saw value in engaging CASPs. A number of barriers and enablers to involving them were acknowledged in six themes: challenges and concerns; logistical barriers; benefits of CASPs; overcoming challenges; an ethical minefield; and child safety. Opinions differed with respect to feasibility and necessity for involving CASPs, particularly in the hospital setting where real patients are accessible. All participants articulated the critical importance of ensuring adequate support and adherence to ethical principles if CASPs were involved. Conclusions The involvement of CASPs in health professions education is a divisive issue. CASPs’ ability to provide a realistic option for supporting learning is recognised yet perhaps not wholly perceived as a feasible alternative to real patients. Their engagement raises critical ethical, practical, logistical and financial challenges.
{"title":"Engaging young people as simulated patients: a qualitative description of health professional educators’ perspectives","authors":"A. Gamble, M. Bearman, D. Nestel","doi":"10.1136/bmjstel-2020-000807","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000807","url":null,"abstract":"Background Real patients in clinical placements are important for learning and may well be the ‘gold standard’. However, simulated patients (SPs) are a viable alternative in the absence of this opportunity. While adult SPs contribute to health professions education, child and adolescent simulated patients (CASPs) are less common. This research aims to explore the perspectives of healthcare educators regarding the engagement of young SPs, specifically the identification of barriers and enablers to involving CASPs. Methods We used an interpretive paradigm of qualitative description. Thirteen interviewees, all educators involved in SP programmes, participated in semistructured interviews. Data were transcribed verbatim and analysed using an inductive thematic approach. Findings Not all participants saw value in engaging CASPs. A number of barriers and enablers to involving them were acknowledged in six themes: challenges and concerns; logistical barriers; benefits of CASPs; overcoming challenges; an ethical minefield; and child safety. Opinions differed with respect to feasibility and necessity for involving CASPs, particularly in the hospital setting where real patients are accessible. All participants articulated the critical importance of ensuring adequate support and adherence to ethical principles if CASPs were involved. Conclusions The involvement of CASPs in health professions education is a divisive issue. CASPs’ ability to provide a realistic option for supporting learning is recognised yet perhaps not wholly perceived as a feasible alternative to real patients. Their engagement raises critical ethical, practical, logistical and financial challenges.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"26 1","pages":"390 - 396"},"PeriodicalIF":1.1,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78268890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-28DOI: 10.1136/bmjstel-2020-000757
Saullo Queiroz Silveira, Leopoldo Muniz da Silva, A. Ho, C. M. Kakuda, Daniel Wagner de Castro Lima Santos, R. S. Nersessian, Arthur de Campos Vieira Abib, Marcella Pellicciotti de Sousa, G. Mizubuti
Background Orotracheal intubation (OTI) can result in aerosolisation leading to an increased risk of infection for healthcare providers, a key concern during the COVID-19 pandemic. Objective This study aimed to evaluate the OTI time and success rate of two aerosol-mitigating strategies under direct laryngoscopy and videolaryngoscopy performed by anaesthesiologists, intensive care physicians and emergency physicians who were voluntarily recruited for OTI in an airway simulation model. Methodology The outcomes were successful OTI, degree of airway visualisation and time required for OTI. Not using a stylet during OTI reduced the success rate among non-anaesthesiologists and increased the time required for intubation, regardless of the laryngoscopy device used. Results Success rates were similar among physicians from different specialties during OTI using videolaryngoscopy with a stylet. The time required for successful OTI by intensive care and emergency physicians using videolaryngoscopy with a stylet was longer compared with anaesthesiologists using the same technique. Videolaryngoscopy increased the time required for OTI among intensive care physicians compared with direct laryngoscopy. The aerosol-mitigating strategy under direct laryngoscopy with stylet did not increase the time required for intubation, nor did it interfere with OTI success, regardless of the specialty of the performing physician. Conclusions The use of a stylet within the endotracheal tube, especially for non-anaesthesiologists, had an impact on OTI success rates and decreased procedural time.
{"title":"Orotracheal intubation incorporating aerosol-mitigating strategies by anaesthesiologists, intensivists and emergency physicians: a simulation study","authors":"Saullo Queiroz Silveira, Leopoldo Muniz da Silva, A. Ho, C. M. Kakuda, Daniel Wagner de Castro Lima Santos, R. S. Nersessian, Arthur de Campos Vieira Abib, Marcella Pellicciotti de Sousa, G. Mizubuti","doi":"10.1136/bmjstel-2020-000757","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000757","url":null,"abstract":"Background Orotracheal intubation (OTI) can result in aerosolisation leading to an increased risk of infection for healthcare providers, a key concern during the COVID-19 pandemic. Objective This study aimed to evaluate the OTI time and success rate of two aerosol-mitigating strategies under direct laryngoscopy and videolaryngoscopy performed by anaesthesiologists, intensive care physicians and emergency physicians who were voluntarily recruited for OTI in an airway simulation model. Methodology The outcomes were successful OTI, degree of airway visualisation and time required for OTI. Not using a stylet during OTI reduced the success rate among non-anaesthesiologists and increased the time required for intubation, regardless of the laryngoscopy device used. Results Success rates were similar among physicians from different specialties during OTI using videolaryngoscopy with a stylet. The time required for successful OTI by intensive care and emergency physicians using videolaryngoscopy with a stylet was longer compared with anaesthesiologists using the same technique. Videolaryngoscopy increased the time required for OTI among intensive care physicians compared with direct laryngoscopy. The aerosol-mitigating strategy under direct laryngoscopy with stylet did not increase the time required for intubation, nor did it interfere with OTI success, regardless of the specialty of the performing physician. Conclusions The use of a stylet within the endotracheal tube, especially for non-anaesthesiologists, had an impact on OTI success rates and decreased procedural time.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"76 1","pages":"385 - 389"},"PeriodicalIF":1.1,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80709599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-12DOI: 10.1136/bmjstel-2020-000781
Vivienne Mak
Correspondence to Dr Vivienne Mak, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia;Vivienne.Mak@monash.edu Objective structured clinical examinations (OSCEs) are used as summative assessments in the pharmacy programme to assess students’ clinical knowledge and oral communication skills. [...]some learning outcomes were modified depending on adaptations required for online OSCE stations. In addition to medical devices, if there are any further props required for the OSCE station, these are provided and made available as PowerPoint presentations that are designed to be managed by the simulated patient/examiner.
{"title":"Online objective structured clinical examination overview","authors":"Vivienne Mak","doi":"10.1136/bmjstel-2020-000781","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000781","url":null,"abstract":"Correspondence to Dr Vivienne Mak, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia;Vivienne.Mak@monash.edu Objective structured clinical examinations (OSCEs) are used as summative assessments in the pharmacy programme to assess students’ clinical knowledge and oral communication skills. [...]some learning outcomes were modified depending on adaptations required for online OSCE stations. In addition to medical devices, if there are any further props required for the OSCE station, these are provided and made available as PowerPoint presentations that are designed to be managed by the simulated patient/examiner.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"36 1","pages":"461 - 462"},"PeriodicalIF":1.1,"publicationDate":"2021-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81198213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-07DOI: 10.1136/bmjstel-2020-000649
Rebekah Burns, M. Gray, Dana Peralta, Andrew Scheets, R. Umoren
Background The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) programme is an evidence-based approach to teamwork training. In-person education is not always feasible for medical student education. The aim of this study was to evaluate the impact of online, interactive TeamSTEPPS simulation versus an in-person simulation on medical students’ TeamSTEPPS knowledge and attitudes. Methods Fourth-year medical students self-selected into an in-person or online training designed to teach and evaluate teamwork skills. In-person participants received didactic sessions, team-based medical simulations and facilitated debriefing sessions. The online group received an equivalent online didactic session and participated in an interactive software-based simulation with immediate, personalised performance-based feedback and scripted debriefing. Both trainings used three iterations of a case of septic shock, each with increasing medical complexity. Participants completed a demographic survey, a preintervention/postintervention TeamSTEPPS Benchmarks test and a retrospective preintervention/postintervention TeamSTEPPS teamwork attitudes questionnaire. Data were analysed using descriptive statistics and repeated measures analysis of variance. Results Thirty-one students (18 in-person, 13 online) completed preintervention/postintervention surveys, tests and questionnaires. Gender, age and exposure to interprofessional education, teamwork training and games were similar between groups. There were no statistical differences in preintervention knowledge or teamwork attitude scores between in-person and online groups. Postintervention knowledge scores increased significantly from baseline (+2.0% p=0.047), and these gains did not differ significantly based on whether participants received in-person versus online training (+1.5% vs +2.9%; p=0.49). Teamwork attitudes scores also showed a statistically significant increase with training (+0.9, p<0.01) with no difference in the effect of training by group (+0.8 vs +1.0; p=0.64). Conclusions Graduating medical students who received in-person and online teamwork training showed similar increases in TeamSTEPPS knowledge and attitudes. Online simulations may be used to teach and reinforce team communication skills when in-person, interprofessional simulations are not feasible.
提高绩效和患者安全的团队策略和工具(TeamSTEPPS)计划是一种基于证据的团队培训方法。对医学生进行面对面教育并不总是可行的。本研究的目的是评估在线互动TeamSTEPPS模拟与现场模拟对医学生TeamSTEPPS知识和态度的影响。方法四年级医学生自行选择参加面对面或在线培训，以教授和评估团队合作技能。现场参与者接受了教学课程、基于团队的医疗模拟和便利的汇报会议。在线组接受了等效的在线教学课程，并参与了基于软件的交互式模拟，并获得了即时、个性化的基于表现的反馈和脚本化的汇报。两种训练都使用了感染性休克病例的三次迭代，每一次都增加了医疗复杂性。参与者完成了人口统计调查、干预前/干预后TeamSTEPPS基准测试和回顾性干预前/干预后TeamSTEPPS团队态度问卷。数据分析采用描述性统计和重复测量方差分析。结果31名学生(18人面对面，13人在线)完成了干预前/干预后调查、测试和问卷。性别、年龄、跨专业教育、团队合作训练和游戏的暴露程度在两组之间是相似的。现场组和在线组在干预前知识和团队合作态度得分上没有统计学差异。干预后的知识得分较基线显著增加(+2.0% p=0.047)，并且这些增益与参与者是否接受面对面培训和在线培训没有显著差异(+1.5% vs +2.9%;p = 0.49)。团队合作态度得分随训练的增加也有统计学意义(+0.9,p<0.01)，组间训练效果无差异(+0.8 vs +1.0;p = 0.64)。结论接受过现场和在线团队合作培训的医学生在TeamSTEPPS知识和态度上有相似的提高。当面对面的跨专业模拟不可行时，在线模拟可以用来教授和加强团队沟通技巧。
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