Feedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis

2013 ◽  
Vol 19 (2) ◽  
pp. 251-272 ◽  
Author(s):  
Rose Hatala ◽  
David A. Cook ◽  
Benjamin Zendejas ◽  
Stanley J. Hamstra ◽  
Ryan Brydges
Keyword(s):  
Meta Analysis ◽  
Skills Training ◽  
Narrative Synthesis ◽  
Procedural Skills ◽  
Simulation Based

A Canadian Perspective of simulation-based skill attainment in Internal Medicine Residency (Preprint)

2018 ◽  
Author(s):  
Tamer Abdel Moaein ◽  
Chirsty Tompkins ◽  
Natalie Bandrauk ◽  
Heidi Coombs-Thorne
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Training Programs ◽  
Skill Training ◽  
Skills Training ◽  
Skill Learning ◽  
Comfort Level ◽  
Procedural Skills ◽  
Internal Medicine Training ◽  
Simulation Based

BACKGROUND Clinical simulation is defined as “a technique to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion”. In medicine, its advantages include repeatability, a nonthreatening environment, absence of the need to intervene for patient safety issues during critical events, thus minimizing ethical concerns and promotion of self-reflection with facilitation of feedback [1] Apparently, simulation based education is a standard tool for introducing procedural skills in residency training [3]. However, while performance is clearly enhanced in the simulated setting, there is little information available on the translation of these skills to the actual patient care environment (transferability) and the retention rates of skills acquired in simulation-based training [1]. There has been significant interest in using simulation for both learning and assessment [2]. As Canadian internal medicine training programs are moving towards assessing entrustable professional activities (EPA), simulation will become imperative for training, assessment and identifying opportunities for improvement [4, 5]. Hence, it is crucial to assess the current state of skill learning, acquisition and retention in Canadian IM residency training programs. Also, identifying any challenges to consolidating these skills. We hope the results of this survey would provide material that would help in implementing an effective and targeted simulation-based skill training (skill mastery). OBJECTIVE 1. Appraise the status and impact of existing simulation training on procedural skill performance 2. Identify factors that might interfere with skill acquisition, consolidation and transferability METHODS An electronic bilingual web-based survey; Fluid survey platform utilized, was designed (Appendix 1). It consists of a mix of closed-ended, open-ended and check list questions to examine the attitudes, perceptions, experiences and feedback of internal medicine (IM) residents. The survey has been piloted locally with a sample of five residents. After making any necessary corrections, it will be distributed via e-mail to the program directors of all Canadian IM residency training programs, then to all residents registered in each program. Two follow up reminder e-mails will be sent to all participating institutions. Participation will be voluntarily and to keep anonymity, there will be no direct contact with residents and survey data will be summarized in an aggregate form. SPSS Software will be used for data analysis, and results will be shared with all participating institutions. The survey results will be used for display and presentation purposes during medical conferences and forums and might be submitted for publication. All data will be stored within the office of internal medicine program at Memorial University for a period of five years. Approval of Local Research Ethics board (HREB) at Memorial University has been obtained. RESULTS Pilot Results Residents confirmed having simulation-based training for many of the core clinical skills, although some gaps persist There was some concern regarding the number of sim sessions, lack of clinical opportunities, competition by other services and lack of bed side supervision Some residents used internet video to fill their training gaps and/or increase their skill comfort level before performing clinical procedure Resident feedback included desire for more corrective feedback, and more sim sessions per skill (Average 2-4 sessions) CONCLUSIONS This study is anticipated to provide data on current practices for skill development in Canadian IM residency training programs. Information gathered will be used to foster a discourse between training programs including discussion of barriers, sharing of solutions and proposing recommendations for optimal use of simulation in the continuum of procedural skills training.

Preliminary evaluation of the efficacy of an intervention incorporating precision teaching to train procedural skills among final cycle medical students

2017 ◽  
Vol 3 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Sinéad Lydon ◽  
Nadine Burns ◽  
Olive Healy ◽  
Paul O'Connor ◽  
Bronwyn Reid McDermott ◽  
...  
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Skills Training ◽  
Precision Teaching ◽  
Control Group ◽  
Junior Doctors ◽  
Preliminary Evaluation ◽  
Procedural Skills ◽  
Preparedness For Practice ◽  
Simulation Based

IntroductionA lack of preparedness for practice has been observed among new medical graduates. Simulation technology may offer one means of producing competency. This paper describes the application of a simulation-based intervention incorporating precision teaching (PT), a method of defining target skills, assessing individual progress and guiding instructional decisions, which is used to monitor learning and the development of behavioural fluency in other domains, to procedural skills training. Behavioural fluency refers to accurate and rapid responding that does not deteriorate with time, is resistant to distraction and can be adapted into new, more complex responses.MethodThis study used a between-groups design to evaluate the efficacy of a simulation-based intervention incorporating PT for teaching venepuncture among 11 medical students. The intervention consisted of timed learning trials during which participants carried out the skill in pairs and received corrective feedback. Two control groups of 11 untrained medical students and 11 junior doctors were also included in the study.ResultsIntervention group participants required an average of five trials and 21.9 min to reach the criterion for fluency. The intervention group demonstrated significantly higher accuracy in venepuncture performance than either control group. Improvements persisted over time, did not deteriorate during distraction, generalised to performance with patients and performance of an untargeted skill also improved.ConclusionsThe outcomes of this preliminary study support the application of PT within medical education. The implications of these data for clinical and procedural skills training are explored and suggestions are made for further research.

scholarly journals A Comprehensive Infant Lumber Puncture Novice Procedural Skills Training Package: An INSPIRE Simulation-Based Procedural Skills Training Package

MedEdPORTAL ◽  
2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Marc Auerbach ◽  
Todd Chang ◽  
Daniel Fein ◽  
Marjorie White ◽  
Renuka Mehta ◽  
...  
Keyword(s):  
Skills Training ◽  
Procedural Skills ◽  
Training Package ◽  
Simulation Based

Teaching Communication Skills in Breast Imaging

2019 ◽  
Vol 1 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Carolynn M DeBenedectis
Keyword(s):  
Communication Skills ◽  
Breast Imaging ◽  
Image Interpretation ◽  
Effective Communication ◽  
Skills Training ◽  
Good News ◽  
Communication Skills Training ◽  
Procedural Skills ◽  
Simulation Based

Abstract Breast radiologists communicate life-changing results to patients every day. It is critical for breast radiologists to be effective communicators and to deliver difficult and good news effectively and empathetically. Communication skills can be just as important as image interpretation and procedural skills in breast imaging. Breast radiologists can learn effective communication through practice. In addition, simulation-based communication skills training can help our trainees practice their communication skills in a low-stakes environment and become more comfortable with communicating difficult results. This manuscript sets out to familiarize breast radiologists with what effective communication skills are, as well as how to learn and teach them.

scholarly journals Simulation-based training in critical resuscitation procedures improves residents' competence

CJEM ◽  
2009 ◽  
Vol 11 (06) ◽  
pp. 535-539 ◽  
Author(s):  
Trevor S. Langhan ◽  
Ian J. Rigby ◽  
Ian W. Walker ◽  
Daniel Howes ◽  
Tyrone Donnon ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Clinical Skills ◽  
Skills Training ◽  
The Self ◽  
Self Assessment ◽  
Procedural Skills ◽  
Training Course ◽  
Simulation Based ◽  
The Impact

ABSTRACT Objective: Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures. Methods: We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station. Results: We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods (p < 0.001). The participants' year of postgraduate training influenced their self-assessment of knowledge (F 2,25 = 4.91, p < 0.01) and clinical skills (F 2,25 = 10.89, p < 0.001). At the 3-month follow-up, junior-level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course. Conclusion: Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.

Simulation-Based Procedural Skills Training in Pediatric Emergency Medicine

2016 ◽  
Vol 17 (3) ◽  
pp. 169-178 ◽  
Author(s):  
Selin Tuysuzoglu Sagalowsky ◽  
Sheri-Ann Wynter ◽  
Marc Auerbach ◽  
Martin V. Pusic ◽  
David O. Kessler
Keyword(s):  
Emergency Medicine ◽  
Skills Training ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine ◽  
Procedural Skills ◽  
Simulation Based

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

Dialectical Behaviour Therapy Skills Training Groups for Common Mental Health Disorders: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Chantal P Delaquis ◽  
Kayla M. Joyce ◽  
Maureen Zalewski ◽  
Laurence Katz ◽  
Julia Sulymka ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Meta Analysis ◽  
Skills Training ◽  
Mental Health Disorders ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Transdiagnostic Treatment ◽  
Training Groups ◽  
Health Disorders

Context: Emotion regulation deficits are increasingly recognized as an underlying mechanism of many disorders. Dialectical behaviour therapy (DBT) holds potential as a transdiagnostic treatment for disorders with underlying emotion regulation deficits.Objective: Systematically review the evidence for DBT skills training groups as a transdiagnostic treatment for common mental health disorders via meta-analysis. Study Selection: Randomized control trials (RCTs) of DBT skills training groups for adults with common mental health disorders, and no comorbid personality disorder, were included. Data Synthesis: Twelve RCTs met inclusion criteria (N = 425 participants). DBT had a moderate-to-large effect on symptom reduction (g = 0.79, 95% CI [0.52, 1.06], p &lt; .0001). Improvements in emotion regulation yielded a small-to-moderate effect (g = 0.48, 95% CI [0.22, 0.74], p &lt; .01). Results showed significant effects of DBT on depression (g = 0.50, 95% CI [0.25, 0.75], p = .002), eating disorders (g = 0.83, 95% CI [0.49, 1.17], p = .001) and anxiety (g = 0.45, 95% CI [0.08, 0.83], p = .03).Conclusions: Findings suggest DBT is an effective treatment for common mental health disorders and may be considered as a promising transdiagnostic therapy.

scholarly journals Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sally Byford ◽  
Sarah Janssens ◽  
Rachel Cook
Keyword(s):  
Early Pregnancy ◽  
Confidence Level ◽  
Simulation Training ◽  
Systematic Approach ◽  
Transvaginal Ultrasound ◽  
Skills Training ◽  
Ultrasound Simulation ◽  
Learning Gap ◽  
Assessment Scores ◽  
Simulation Based

Abstract Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.

scholarly journals Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
T. Ahluwalia ◽  
S. Toy ◽  
C. Gutierrez ◽  
K. Boggs ◽  
K. Douglass
Keyword(s):  
Emergency Medicine ◽  
Self Efficacy ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Procedural Skills ◽  
Knowledge And Skills ◽  
Post Graduate ◽  
Pediatric Emergencies ◽  
Simulation Based

Abstract Background Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees’ self-efficacy, knowledge, and skills in pediatric care. Methods We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. Results Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. Conclusions A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees’ self-efficacy, knowledge, and skills in pediatric emergency care.

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