BMJ Simulation & Technology Enhanced Learning最新文献

{"title":"Adaptation and use of media in an innovative simulation-based clinician training programme","authors":"E. Melson, Wentin Chen, Dengyi Zhou, E. Ooi, Nia Evans, Dwi Delson, M. Davitadze, P. Kempegowda","doi":"10.1136/bmjstel-2020-000808","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000808","url":null,"abstract":"[...]medical students and doctors in training have missed out on months of essential training and career progression. [...]the use of media has evolved and expanded exponentially to deliver medical education remotely.1 Hargis and Wilcox discussed the potential use of media in medical education to enhance the learning environment.2 Different types of media possess unique characteristics and are feasible educational tools to promote learning. Video Videos possess unique characteristics over other media and are a richer medium compared with text, infographics and audio as they offer moving visual pictures.4 Videos uploaded to video-sharing platforms, such as YouTube, have demonstrated rapid and international reach, thus vastly expanding their impact within medical education.7 As SIMBA is a novel medical education training programme, we commence each session by showing an animated video example of participant–moderator interaction to familiarise participants with the SIMBA model (still images shown in online supplemental material 2). Social media Social media facilitates rapid knowledge sharing with the ability to reach an international audience and can be viewed as an extensive open-access resource in medical education.6 Social media platforms offer an informal learning environment, which fosters engagement and a real-time dialogue that traditional means of communication lack.8 Facilitating SIMBA simulation via WhatsApp greatly enhances interaction and engagement in comparison to traditional forms of teaching.3 The ubiquity of WhatsApp has made SIMBA widely accessible, with international interest and participation.3 Additionally, Twitter (@SIMBAsimulation) and Facebook are used to advertise SIMBA sessions and attract international health professionals to participate.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77815079","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}

{"title":"Nothing about me without me: a scoping review of how illness experiences inform simulated participants' encounters in health profession education.","authors":"Linda Ní Chianáin, Richard Fallis, Jenny Johnston, Nancy McNaughton, Gerard Gormley","doi":"10.1136/bmjstel-2021-000886","DOIUrl":"10.1136/bmjstel-2021-000886","url":null,"abstract":"<p><strong>Background: </strong>Person-centred simulation in health professions education requires involvement of the person with illness experience.</p><p><strong>Objective: </strong>To investigated how real illness experiences inform simulated participants' (SP) portrayals in simulation education using a scoping review to map literature.</p><p><strong>Study selection: </strong>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.</p><p><strong>Findings: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83214780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-fidelity simulation and virtual reality: an evaluation of medical students’ experiences","authors":"A. F. Macnamara, K. Bird, Alana Rigby, T. Sathyapalan, David Hepburn","doi":"10.1136/bmjstel-2020-000625","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000625","url":null,"abstract":"Background Simulation technology is widely used in medical education, providing an environment in which students can develop and practise a multitude of skills that are relevant to clinical practice, without the risk of harm to patients. Methods We conducted a mixed methods cross-over study with quantitative and qualitative outcomes. This analysed students’ perceptions of two simulation technologies: a high-fidelity patient simulator and virtual reality. Twenty final year medical students completed a questionnaire after having experienced both simulation modalities. Results Students scored the patient simulator higher in domains such as developing team working and ‘ABCDE assessment skills’, whereas the virtual reality simulation was more immersive and fun. Participants found the patient simulator more useful in preparing them for clinical practice. Conclusion Medical students in this study expressed that a high-fidelity patient simulator, in a simulated clinical environment, was of greater value to their preparation for clinical practice than virtual reality simulation of a similar environment. However, the virtual reality simulation offered a near comparable experience, and was found to be was enjoyable, immersive and easily portable.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86534442","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}

{"title":"Impact of simulation training on decision to delivery interval in cord prolapse","authors":"G. Gallagher, Alison Griffin, Sharon Clipperton, S. Janssens","doi":"10.1136/bmjstel-2021-000860","DOIUrl":"https://doi.org/10.1136/bmjstel-2021-000860","url":null,"abstract":"Background Umbilical cord prolapse is a rare obstetric emergency requiring rapid coordination of a multidisciplinary team to effect urgent delivery. The decision to delivery interval (DDI) is a marker of quality of teamwork. Multidisciplinary team simulation-based training can be used to improve clinical and teamwork performance. Aim To assess the DDI for cord prolapse before and after the introduction of simulation-based training at a quaternary maternity unit in Australia. Method A retrospective, observational cohort study comparing the DDI before and after the introduction of simulation-based training activities. The general linear model was used to estimate the association between DDI and simulation training while adjusting for potential confounders including model of care (public or private) and time of birth (regular or after hours). Results After the introduction of simulation training, mean DDI decreased by 4.1 min (difference −4.1, 95% CI −6.2 to −1.9), after adjustment for confounding factors. Despite this, there was no difference in selected neonatal outcomes including Apgar score at 5 min and arterial cord pH. Conclusions The introduction of simulation-based training was associated with a decrease in the DDI in the setting of cord prolapse.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82992742","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}

{"title":"Examining novice anaesthesia trainee simulation performance: a tale of two clusters","authors":"R. D. Daly Guris, Christina R Miller, A. Schiavi, S. Toy","doi":"10.1136/bmjstel-2020-000812","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000812","url":null,"abstract":"Introduction Understanding performance differences between learners may provide useful context for optimising medical education. This pilot study aimed to explore a technique to contextualise performance differences through retrospective secondary analyses of two randomised controlled simulation studies. One study focused on speaking up (non-technical skill); the other focused on oxygen desaturation management (technical skill). Methods We retrospectively analysed data from two independent simulation studies conducted in 2017 and 2018. We used multivariate hierarchical cluster analysis to explore whether participants in each study formed homogenous performance clusters. We then used mixed-design analyses of variance and χ2 analyses to examine whether reported task load differences or demographic variables were associated with cluster membership. Results In both instances, a two-cluster solution emerged; one cluster represented trainees exhibiting higher performance relative to peers in the second cluster. Cluster membership was independent of experimental allocation in each of the original studies. There were no discernible demographic differences between cluster members. Performance differences between clusters persisted for at least 8 months for the non-technical skill but quickly disappeared following simulation training for the technical skill. High performers in speaking up initially reported lower task load than standard performers, a difference that disappeared over time. There was no association between performance and task load during desaturation management. Conclusion This pilot study suggests that cluster analysis can be used to objectively identify high-performing trainees for both a technical and a non-technical skill as observed in a simulated clinical setting. Non-technical skills may be more difficult to teach and retain than purely technical ones, and there may be an association between task load and initial non-technical performance. Further study is needed to understand what factors may confer inherent performance advantages, whether these advantages translate to clinical performance and how curricula can best be designed to drive targeted improvement for individual trainees.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79626874","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}

{"title":"Long-term impact of a single interprofessional education high-fidelity simulation experience: a pilot study.","authors":"Tina Gunaldo, Cornelius Rosenbaum, Alison Davis","doi":"10.1136/bmjstel-2021-000863","DOIUrl":"10.1136/bmjstel-2021-000863","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89994654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic literature search, review and dissemination methodology for the COVID-19 pandemic","authors":"C. Reynard, D. Darbyshire, G. Prager, A. Jafar, M. Naguib, Govind Oliver, Patricia van den Berg, R. Body, Harriet Ambroziak, S. Carley","doi":"10.1136/bmjstel-2020-000817","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000817","url":null,"abstract":"Purpose of the study SARS-CoV-2 has caused healthcare systems globally to reorganise. A pandemic paradox emerged; while clinicians were desperate for information on a new disease, they had less time to find and evaluate the vast volume of publications at times of significant strain on healthcare systems. A multidisciplinary team undertook a weekly literature search capturing all COVID-19 publications. We also monitored free open access medical education (FOAMed) sources for emerging themes. Title and abstract screening pooled the most relevant papers for emergency medicine. Three summary types were created, a ‘Top 5 Flash Update’, a journal club and a rapid response to emerging FOAMed themes. From these summaries, three modes of dissemination were used: short written summaries, blogs and podcasts. These were amplified through social media. Study design A retrospective review was conducted assessing the impact of this knowledge dissemination strategy for the period of March to September 2020. Results In total, 64 687 papers were identified and screened. Of the papers included in the ‘Top 5’, 28.3% were on epidemiology, 23.6% treatment, 16.7% diagnostics, 12% prognosis, 8.7% pathophysiology with the remaining 10.7% consisting of PPE, public health, well-being and ‘other’. We published 37 blogs, 17 podcasts and 18 Top 5 Flash Updates. The blogs were read 138 343 times, the Top 5 Flash Updates 68 610 times and the podcasts had 72 501 listens. Conclusion A combination of traditional academic and novel social media approaches can address the pandemic paradox clinicians are facing.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75813480","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}

{"title":"In situ simulation improves perceived self-efficacy of OR nurses and anaesthesiologists during COVID-19 pandemic","authors":"F. Lois, C. Hallet, N. Samalea Suarez, A. Ghuysen, J. Brichant","doi":"10.1136/bmjstel-2020-000840","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000840","url":null,"abstract":"Introduction Self-efficacy is defined as people’s internal beliefs about their ability to have an impact on events that affect their lives. As part of the COVID-19 pandemic, we carried out in situ simulation for anaesthesiologists and operating room (OR) nurses. Simulation was focused on the recommendations on the use of specific personal protective equipment (PPE) as well as on airway management and intubation. We hypothesised that in situ procedural simulation should increase their perceived self-efficacy. Methods Between 16 March and 20 March 2020, 208 healthcare workers took part in in situ procedural simulation. A questionnaire was sent to participants on 21 April 2020. Six self-efficacy items related to PPE and airway manoeuvres were assessed before and after training on a Numeric Rating Scale from 0 to 10. Results Sixty-seven participants (32%) replied to the questionnaire. The before–after comparison of the six items revealed an increase in perceived self-efficacy for each of them. A before training difference was observed between nurses, board-certified anaesthetists and trainees in anaesthesia in perceived self-efficacy for putting on (6 (3–8) vs 4.5 (2.25–6) vs 2 (0–6), p=0.007) and remove PPE (8 (5–8) vs 4.5 (3.25–6) vs 4 (1–6), p=0.009). No difference in perceived self-efficacy after training was observed between nurses, board-certified anaesthetists and trainees in anaesthesia. Conclusions In situ simulation improves the perceived self-efficacy of OR nurses and anaesthesiologists on specific skills related to the care of patients with COVID-19.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87948643","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}

{"title":"Multiperspective simulations for implementing a change in service: stroke telethrombolysis","authors":"C. Brown, P. Elofuke","doi":"10.1136/bmjstel-2020-000848","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000848","url":null,"abstract":"Simulation-based training has been used in a variety of ways to demonstrate and improve process elements of patient care. One example of this is in improving door-to-needle times in hyperacute stroke care. Changes in service by one team which affect another bring difference of opinions between service providers involved and can lead to interdepartmental conflict. In this report, we use Kurt Lewin’s model for change to describe how a series of multiperspective simulation-based exercises were used in implementing a change in practice with the introduction of telethrombolysis within a large tertiary stroke referral hospital. The use of multiperspective or bidirectional simulation allowed a ‘meeting of minds’ with each service able to illustrate key themes to the other service. This was demonstrated through a series of simulation-based exercises. Following successful simulation-based exercises and subsequent interdepartmental agreement, a telethrombolysis pilot has been conducted within our centre. Ongoing audit of practice continues as this method of treatment delivery is continued. Further simulation work is planned as a national thrombectomy service is instigated.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74811182","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}

{"title":"Simulated airway drills as a tool to measure and guide improvements in endotracheal intubation preparation in the paediatric emergency department.","authors":"Kei U Wong, Isabel Gross, Beth L Emerson, Michael P Goldman","doi":"10.1136/bmjstel-2020-000810","DOIUrl":"10.1136/bmjstel-2020-000810","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Simulated airway drills can be used as a tool to identify process gaps, measure and improve paediatric intubation readiness.</p>","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78125589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}