BMJ Simulation & Technology Enhanced Learning最新文献

{"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":"26 1","pages":"555 - 560"},"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":"67 1","pages":"624 - 626"},"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":"Development and clinical implementation of a structured, simulation-based training programme in laparoscopic appendectomy: description, validation and evaluation","authors":"Benedicte Skjold-Odegaard, H. Ersdal, J. Assmus, B. Nedrebø, O. Sjo, K. Søreide","doi":"10.1136/bmjstel-2020-000728","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000728","url":null,"abstract":"Background Laparoscopic appendectomy is a common procedure in general surgery but is likely underused in structured and real-life teaching. This study describes the development, validation and evaluation of implementing a structured training programme for laparoscopic appendectomy. Study design A structured curriculum and simulation-based programme for trainees and trainers was developed. All general surgery trainees and trainers were involved in laparoscopic appendectomies. All trainees and trainers underwent the structured preprocedure training programme before real-life surgery evaluation. A standardised form evaluated eight technical steps (skills) of the procedure as well as an overall assessment, and nine elements of communication (feedback), and was used for bilateral evaluation by each trainee and trainer. A consecutive, observational cohort over a 12-month period was used to gauge real-life implementation. Results During 277 eligible real-life appendectomies, structured evaluation was performed in 173 (62%) laparoscopic appendectomies, for which 165 forms were completed by 19 trainees. Construct validity was found satisfactory. Inter-rater reliability demonstrated good correlation between trainee and trainer. The trainees’ and trainers’ stepwise and overall assessments of technical skills had an overall good reliability (intraclass correlation coefficient of 0.88). The vast majority (92.2%) of the trainees either agreed or strongly agreed that the training met their expectations. Conclusion Structured training for general surgery residents can be implemented for laparoscopic appendectomy. Skills assessment by trainees and trainers indicated reliable self-assessment. Overall, the trainees were satisfied with the training, including the feedback from the trainers.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"2016 1","pages":"517 - 523"},"PeriodicalIF":1.1,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86332059","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":"Does simulation training in final year make new graduates feel more prepared for the realities of professional practice?","authors":"Ciara Carpenter, Tom Keegan, Gill Vince, L. Brewster","doi":"10.1136/bmjstel-2020-000836","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000836","url":null,"abstract":"Introduction The transition from medical student to doctor has long been a source of concern, with widespread reporting of new graduates’ lack of preparedness for medical practice. Simulation has been suggested as a way to improve preparedness, particularly due to the difficulties in allowing full autonomy for patient care for undergraduate medical students. Few studies look at simulation alone for this purpose, and no studies have compared different simulation formats to assess their impact on preparedness. Methods This mixed-method study looked at two different simulation courses in two UK universities. Data were collected in two phases: immediately after the simulation and 3–4 months into the same students’ postgraduate training. Questionnaires provided quantitative data measuring preparedness and interviews provided a more in-depth analysis of experiential learning across final year and how this contributed to preparedness. Results There were no significant differences between the two courses for overall preparedness, stress or views on simulation, and no significant differences in opinions longitudinally. Although the study initially set out to look at simulation alone, emergent qualitative findings emphasised experiential learning as key in both clinical and simulated settings. This inter-relationship between simulation and the student assistantship prepared students for practice. Longitudinally, the emphasis on experiential learning in simulation was maintained and participants demonstrated using skills they had practised in simulation in their daily practice as doctors. Nevertheless, there was evidence that although students felt prepared, they were still scared about facing certain scenarios as foundation doctors. Discussion The results of this study suggest that simulation may positively affect students’ preparedness for practice as doctors. Simulation will never be a replacement for real clinical experience. However, when used prior to and alongside clinical experience, it may have positive effects on new doctors’ confidence and competence, and, therefore, positively impact patient care.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"89 1","pages":"510 - 516"},"PeriodicalIF":1.1,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84083666","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":"Creating an intramuscular injection pad for the SimMan 3G","authors":"R. Sinclair, Alan Inglis","doi":"10.1136/bmjstel-2021-000874","DOIUrl":"https://doi.org/10.1136/bmjstel-2021-000874","url":null,"abstract":"This short report outlines the rationale, design and method of production for a thigh-mounted intramuscular (IM) pad in the thigh of a SimMan 3G manikin. The aim of this project was to create an IM injection site in the manikin’s thigh to allow simulation participants to practise administering IM injections in a safe, supported environment. After creating a prototype from a plastic bottle, a module was designed to use with the SimMan 3G. A mould of SimMan’s leg was created using plaster of Paris, and then a relief was added to this mould to create the shape required to hold the sponge. Once the mould was completed, glass reinforced plastic (GRP) was applied to create the final module. Using an electric rotary tool, a hole was cut in the SimMan’s thigh to enable the module to be fitted. The final product was waterproof, lightweight and strong. It sits discretely beneath the SimMan 3G’s leg skin enabling students to practise high-fidelity IM injections on the manikin’s leg without faculty intervention. This module is a cost-effective solution for allowing participants to practise IM injections on a manikin during healthcare simulation.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"2 1","pages":"617 - 619"},"PeriodicalIF":1.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73160667","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":"COVID-19 challenges in organising teaching at a faculty of pharmacy","authors":"O. Rahić, M. Sirbubalo, A. Tucak, J. Hadžiabdić, A. Elezovic, E. Vranić","doi":"10.1136/bmjstel-2021-000896","DOIUrl":"https://doi.org/10.1136/bmjstel-2021-000896","url":null,"abstract":"© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. We come from Bosnia and Herzegovina, a small country in western Balkans. Our Faculty of Pharmacy at the University of Sarajevo was opened in 1973, but from then on there was no kind of online teaching. So when the COVID-19 pandemic broke out, and when the university decided to stop all kinds of ‘inclass’ teaching (12 March 2020), we were faced with something new. We work at the Department of Pharmaceutical Technology, where we teach regular courses on ‘Drug Formulation’ and ‘Industrial Pharmacy’. Students take classes in these subjects in the seventh, eighth and ninth semesters. The exercises are practical and last several hours. On 25 March 2020, classes in the lecture hall were suspended until further notice by the decision of the Senate of the University of Sarajevo, and then we realised that we must embark on the adventure of organising online classes. We carried out short research on available online teaching platforms to find basic information on the platform’s capabilities, identify their advantages and disadvantages, and check their commercial prices. We studied the following platforms for online courses: Google Meet, Adobe Connect, Zoom and BigBlueButton, and the following platforms for online examinations: Exam. net, Virtualx, Google Forms, Skillsbook, Papershala, Edbase, Kaldin and TCExam. After examining the possibilities of the available online teaching platforms, we agreed that Zoom and Google Meet provide the best results for running online courses. Adobe Connect, Blackboard Collaborate and BigBlueButton work on the same principle, but professional versions of these platforms were quite unaffordable to us. The results for the online examination platforms are summarised in table 1. Given the security and price of the platforms, we concluded that Exam. net currently meets our criteria, but that it would be necessary to use two platforms simultaneously during the examination, one of which would allow an established video connection with students during the examination (eg, a combination of Exam. net and Zoom). Students accessed the examination platform from their laptop while simultaneously established a video connection with the teacher on their mobile device. At the end of the semester, we conducted an online survey in which 60 (70.93%) of 86 students participated, and for 98.4% of the students this was their first online learning experience. Although it is assumed that current students (digital natives) have adequate information and communications technology competence, they differ in their computer and information literacy as they come from different socioeconomic backgrounds. Of the students, 21.3% had technical difficulties (ie, unstable connection). One of them said she/he has problems with misunderstanding from parents who required help with housework at the time of the lecture because she/he comes from the countryside. ","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"2 1","pages":"646 - 647"},"PeriodicalIF":1.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89458603","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":"Multidisciplinary simulation training for endotracheal intubation during COVID-19 in one Hong Kong regional hospital: strengthening of existing procedures and preparedness","authors":"E. H. So, N. Chia, G. Ng, Osburga P K Chan, S. Yuen, D. Lung, W. C. Li, S. So, V. Cheung","doi":"10.1136/bmjstel-2020-000766","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000766","url":null,"abstract":"Introduction In early 2020, our hospital responded with high alertness when novel coronavirus SARS-CoV-2 appeared. A hospital-based training programme was rapidly arranged to prepare staff for the imminent threat. Objective We developed a hospital-wide multidisciplinary infection control training programme on endotracheal intubation for healthcare workers to minimise nosocomial spread of COVID-19 during this high-stress and time-sensitive risky procedure. Methodology Major stakeholders (Quality & Safety Department, Infection Control Team, Central Nursing Division, high-risk clinical departments and hospital training centre) formed a training programme task group. This group was tasked with developing high-fidelity scenario-based simulation training curriculum for COVID-19 endotracheal intubation with standard workflow and infection control practice. This group then implemented and evaluated the training programme for its effectiveness. Results 101 training classes of 2-hour session were conducted from 5 February to 18 March 2020, involving 1415 hospital staff (~81% of target participants with training needs) either inside the hospital training centre or as in situ simulation training (intensive care unit or accident and emergency department). Learners’ satisfaction was reflected by overall positive response percentage at 90%. Opinions of participating staff were incorporated into the standard airway management and infection control practice for endotracheal intubation of adult patients with COVID-19. Thirty-five patients with COVID-19 were intubated with the current workflow and guideline without any nosocomial transmission. Conclusion An early planned and well-structured multidisciplinary hospital-wide simulation training programme was organised expeditiously to provide extensive staff coverage. The insight and experience gained from this project is valuable for future infectious disease challenges.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"84 1","pages":"501 - 509"},"PeriodicalIF":1.1,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90152940","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":"Dealing with death: simulation for final-year medical students.","authors":"John Smiddy, Agra Dilshani Hunukumbure, Ritu Gupta","doi":"10.1136/bmjstel-2021-000866","DOIUrl":"10.1136/bmjstel-2021-000866","url":null,"abstract":"","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"7 1","pages":"643-644"},"PeriodicalIF":1.1,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81869685","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":"Preparing for COVID-19 tracheostomy care in a pandemic field hospital setting: use of ‘in situ’ simulation recordings","authors":"J. Rudd, A. Iacovidou, J. Cooke, N. Lee, C. Laws-Chapman, A. Hall","doi":"10.1136/bmjstel-2021-000910","DOIUrl":"https://doi.org/10.1136/bmjstel-2021-000910","url":null,"abstract":"","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"89 1","pages":"645 - 645"},"PeriodicalIF":1.1,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76707832","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":"Effectiveness of preoperative tour to a simulated anaesthesia induction at operating theatre in reducing preoperative anxiety in children and their parents: a pragmatic, single-blinded, randomised controlled trial/ King Fahad Medical City","authors":"Hussein Battah, Usamah Alzoraigi, Firas A. Shubbak","doi":"10.1136/bmjstel-2020-000707","DOIUrl":"https://doi.org/10.1136/bmjstel-2020-000707","url":null,"abstract":"Objective To evaluate the effectiveness of a preoperative tour to a simulated anaesthesia induction at operating theatre on reducing children’s and parents’ preoperative anxiety. Design A pragmatic, single-centre, assessor-blinded, randomised controlled trial. Setting In preoperative anaesthesia clinic and the operating room at a tertiary care centre in Saudi Arabia. Participants One hundred and sixteen children–parents dyads (pairs) (n=57) intervention group (IG); (n=59) control group (CG) with children aged 4–14 years who were planned for day case procedures under general anaesthesia. Interventions Participants’ dyads were randomly allocated through a computer to receive either a preoperative tour to a real operating theatre and simulate anaesthesia induction or standard of care. Main outcome measure The primary study outcome was children’s anxiety levels as measured by the modified-Yale Preoperative Anxiety Scale (m-YPAS), and the parent’s anxiety level as assessed by the Beck Anxiety Inventory Scale. The children’s anxiety levels were measured at two time points, the preoperative holding area (T0) and before the anaesthesia induction (T1), and the parents’ anxiety level was measured after the anaesthesia induction. The secondary outcomes were the prevalence of preoperative anxiety and children’s somatic signs of anxiety including heart rate and systolic blood pressure. Results The Mann-Whitney U test of m-YPAS scores showed significant differences in the children’s anxiety levels between the CG and IG at T0 (Z −5.009); p<0.01) and T1 (Z −6.599); p<0.01). BIAS analysis revealed a significant difference in the parents’ anxiety level between the CG and IG (Z −4.353); p<0.01). The prevalence of children’s anxiety was reported by 55 (93.2%) in the CG compared with 25 (43.9%) in the IG, with a statistically significant difference (p<0.001). Conclusion The preoperative simulated anaesthesia induction was effective in reducing preoperative anxiety in children and their parents.","PeriodicalId":44757,"journal":{"name":"BMJ Simulation & Technology Enhanced Learning","volume":"62 1","pages":"397 - 403"},"PeriodicalIF":1.1,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88450877","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}