scholarly journals Why Content and Cognition Matter: Integrating Conceptual Knowledge to Support Simulation-Based Procedural Skills Transfer

2019 ◽  
Vol 34 (6) ◽  
pp. 969-977 ◽  
Author(s):  
Jeffrey J. H. Cheung ◽  
Kulamakan M. Kulasegaram ◽  
Nicole N. Woods ◽  
Ryan Brydges
Keyword(s):  
Conceptual Knowledge ◽  
Procedural Skills ◽  
Skills Transfer ◽  
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.

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.

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.

scholarly journals The effect of dyad versus individual simulation‐based ultrasound training on skills transfer

2015 ◽  
Vol 49 (3) ◽  
pp. 286-295 ◽  
Author(s):  
Martin G Tolsgaard ◽  
Mette E Madsen ◽  
Charlotte Ringsted ◽  
Birgitte S Oxlund ◽  
Anna Oldenburg ◽  
...  
Keyword(s):  
Skills Transfer ◽  
Simulation Based

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.

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

scholarly journals Teaching surgical skills in obstetrics and gynaecology using cadaver simulation: an innovative teaching learning method

2017 ◽  
Vol 5 (10) ◽  
pp. 4411 ◽  
Author(s):  
Nandkishor B. Gaikwad ◽  
Pradnya Bhalerao ◽  
Tabssum Maner ◽  
Vidya D. Mule
Keyword(s):  
Medical Education ◽  
Teaching And Learning ◽  
Abdominal Hysterectomy ◽  
Procedural Skill ◽  
Learning Method ◽  
Procedural Skills ◽  
Obstetrics And Gynaecology ◽  
Simulation Based ◽  
Teaching Learning ◽  
Live Patient

Background: Transfer of knowledge from teachers to students traditionally occurs in one direction using blackboards, overhead projectors, power-point presentations and lectures. It has many disadvantages. The main challenge in medical education is to teach surgical skills. For the learning of critical interventions, simulation-based training is structured so that the acquisition of new skills does not harm patients. Thus, the objective of this study was to enhance and improve procedural skills of resident doctors of Obstetrics and Gynaecology department of Government Medical College, Miraj using cadaver simulation in doing abdominal hysterectomy.Methods: Second year resident doctors from Obstetrics and Gynaecology department of GMC, Miraj who had completed their first year successfully in terms of basic orientation regarding surgical procedures were taken for study purpose. They were divided in two groups randomly. The first group underwent conventional method of teaching to learn the abdominal hysterectomy procedure and underwent feedback from them regarding the conventional teaching learning method. Then they were allowed to perform the procedure on a live patient and their performance of procedural skill was assessed by DOPS. (Direct observation of procedural skills). The second group underwent innovative method of use of cadaver simulation for the abdominal hysterectomy procedure and feedback on the same. They were allowed to perform the procedure on a live patient and their performance of procedural skill was assessed by DOPS. (Direct observation of procedural skills). All data was collected, analysed and processed to study the outcome of research project.Results: In group B, all resident were fully satisfied with newer method of teaching and learning for abdominal hysterectomy as surgical procedure. As far as, the advantages and disadvantages of teaching and learning are concerned, all residents pointed out large number of disadvantages in the conventional method. Evaluation of the surgical procedural skill was done by DOPS by senior faculty members of the department as per the questionnaire which showed good performance from group B.Conclusions: The benefit of simulation based medical education (SBME) is that it offers both learners and patients a safe environment for practice and error. In addition, SBME can provide a learning cycle of debriefing and feedback for learners as well as assessment and certification for procedures and competency.

scholarly journals Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

2017 ◽  
Vol 4 ◽  
pp. 238212051668482 ◽  
Author(s):  
Serkan Toy ◽  
Robert SF McKay ◽  
James L Walker ◽  
Scott Johnson ◽  
Jacob L Arnett
Keyword(s):  
Medical Students ◽  
Lumbar Puncture ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Central Line ◽  
Arterial Line ◽  
Procedural Skills ◽  
Learner Centered ◽  
Line Placement ◽  
Simulation Based

Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001). Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t(23) = −2.92, P < .001, and arterial line placement, t(23) = −2.75, P < .001. Procedural performance scores for intubation ( t(23) = −17.29, P < .001), arterial line placement ( t(23) = −19.75, P < .001), lumbar puncture ( t(23) = −16.27, P < .001), and central line placement ( t(23) = −17.25, P < .001) showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

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