scholarly journals LO83: Quick Refresher Sessions (QRS): improving chest compression training for medical students

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S37-S38
Author(s):  
A. Cormier ◽  
E. Brennan

Innovation Concept: High-quality cardiopulmonary resuscitation saves lives; however, current certification standards can leave providers poorly prepared to perform effective chest compressions (CCs). We designed a training program based on the emerging model of skill maintenance through frequent short practice sessions. The ideal frequency of training is currently unknown. Our goal was to provide medical students with access to efficient and effective CC training and to determine an optimal training interval. Methods: Thirty-six second-year medical students were randomized to three groups that trained at different frequencies: once every two months (q2m) (n = 12), once every four months (q4m) (n = 13), and control (n = 11). Study duration was eight months with the intervention groups, q2m and q4m, participating in five and three sessions respectively. The control group was assessed at study start and end, receiving no training in between. At each session, participants completed a one-minute pre-test of CC performance, viewed a one-minute training video, practiced CCs for two minutes with real-time feedback, and completed a one-minute post-test. Performance parameters measured were CC depth, rate, release, and hand positioning. A final “compression score” assessed integrated performance across these parameters and served as our primary outcome. Participants also reported pre- and post-training comfort with performing CCs which served as our secondary outcome. Curriculum, Tool or Material: Our “Quick Refresher Sessions” (QRS) were completed by participants independently without requiring an assessor or facilitator. A manikin with the ability to record and provide real-time quantitative feedback on CC quality was connected to a laptop running a customized interface. Participants typed in an individualized code and were guided through their six-minute sessions automatically. Conclusion: Immediately following the first training session, subjects had significant improvement in compression score (p < 0.001) and skill comfort (p < 0.001). At eight months, both intervention groups, q2m and q4m, achieved higher compression scores than control (p = 0.001 and p = 0.011) and showed greater increase in comfort level (p = 0.002 and p = 0.010). Performance between intervention groups at eight months was not statistically different. Overall, we conclude that independent QRS training every two or four months led to improved CC quality and provider comfort. Future directions include increasing sample size and tailoring training intervals to individual performance.

POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 15-17
Author(s):  
Rimi Sambi, MD ◽  
Heather Sawula, MD ◽  
Brent Wolfrom, MD ◽  
Joseph Newbigging, MD

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.


2017 ◽  
Vol 7 (8) ◽  
pp. 794-800 ◽  
Author(s):  
Barrett S. Boody ◽  
Brett D. Rosenthal ◽  
Tyler J. Jenkins ◽  
Alpesh A. Patel ◽  
Jason W. Savage ◽  
...  

Study Design: Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center. Objectives: To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training. Methods: Twenty participants comprising senior medical students and orthopedic surgical residents. Participants were randomized to control (n = 9) or intervention (n = 11) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 40-minute bioskills training module, while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported by each participant (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Decompression Score metrics. Results: When compared with the control group, the intervention group yielded a significant mean improvement in OSATS ( P = .022) and PPDIS ( P = .0001) scores. The Objective Decompression Scores improved in the intervention group with a trend toward significance ( P = .058). Conclusions: We conclude that a concise lumbar laminectomy bioskills training session can be a useful educational tool for to augment clinical education. Although no direct clinical correlation can be concluded from this study, the improvement in trainee’s technical and procedural skills suggests that Sawbones training modules can be an efficient and effective tool for teaching fundamental spine surgical skills outside of the operating room.


2018 ◽  
Vol 4 (4) ◽  
pp. 184-189 ◽  
Author(s):  
Paolo Mannella ◽  
Rachele Antonelli ◽  
María Magdalena Montt-Guevara ◽  
Marta Caretto ◽  
Giulia Palla ◽  
...  

Background The learning process of physiological mechanisms of childbirth and its management are important elements in the education of medical students. In this study, we verify how the use of a high-fidelity simulator of childbirth improves competence of students in this regard.Methods A total of 132 medical students were recruited for the study in order to attend a physiological childbirth in a no-hospital environment after being assigned to two groups. The control group received only a normal cycle of lectures, while the simulation (SIM) group followed a specific training session on the simulator. Subsequently, both groups were assessed for their technical and non-technical skills in a simulated childbirth. Also, a self-assessment test regarding their self-confidence was administrated before and after simulation, and repeated after 8 weeks.Results The SIM group showed better performance in all the domains with a better comprehension of the mechanisms of childbirth, managing and assistance of labour and delivery. In addition, compared to the control group, they presented a better self-related awareness and self-assurance regarding the possibility of facing a birth by themselves.Conclusion The present study demonstrated that the use of a high-fidelity simulator for medical students allows a significant improvement in the acquisition of theoretical and technical expertise to assist a physiological birth.


2021 ◽  
Vol 11 (3) ◽  
pp. 90
Author(s):  
Douglas McHugh ◽  
Richard Feinn ◽  
Jeff McIlvenna ◽  
Matt Trevithick

Learner-centered coaching and feedback are relevant to various educational contexts. Spaced retrieval enhances long-term knowledge retention. We examined the efficacy of Blank Slate, a novel spaced retrieval software application, to promote learning and prevent forgetting, while gathering and analyzing data in the background about learners’ performance. A total of 93 students from 6 universities in the United States were assigned randomly to control, sequential or algorithm conditions. Participants watched a video on the Republic of Georgia before taking a 60 multiple-choice-question assessment. Sequential (non-spaced retrieval) and algorithm (spaced retrieval) groups had access to Blank Slate and 60 digital cards. The algorithm group reviewed subsets of cards daily based on previous individual performance. The sequential group reviewed all 60 cards daily. All 93 participants were re-assessed 4 weeks later. Sequential and algorithm groups were significantly different from the control group but not from each other with regard to after and delta scores. Blank Slate prevented anticipated forgetting; authentic learning improvement and retention happened instead, with spaced retrieval incurring one-third of the time investment experienced by non-spaced retrieval. Embedded analytics allowed for real-time monitoring of learning progress that could form the basis of helpful feedback to learners for self-directed learning and educators for coaching.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Philip Toner ◽  
Michael Connolly ◽  
Patrice McGrath ◽  
Leanne Laverty ◽  
David Connolly ◽  
...  

Aims: Northern Ireland has one of the highest incidences of ischaemic heart disease in the world. Teaching BLS to school children has previously been recommended. Our aim was to assess if eleven year old children can aquire and retain knowledge of basic life support (BLS) skills six months after a course of instruction (Study 1) and to assess the effectiveness of a three tier ‘peer training’ model using medical students, teachers and pupils (Study 2). This would be a cost effective way of significantly decreasing mortality from out-of-hospital cardiac arrests. Methods: The ‘ABC for Life’ programme is a regional course in BLS training in Northern Ireland specifically designed for 10 –12 year old school children. Medical students are trained as instructors in BLS by cardiac resuscitation officers at a major teaching hospital. Children were given a 22 point questionnaire before training and immediately after training to assess acquisition of BLS, and again six months after training to assess retention of knowledge (Study 1). In study 2, medical students instructed teachers how to teach BLS to their pupils. Pupils were given the same questionnaire to assess knowledge of BLS immediately before and after a teacher led training session at their school. Results: Study 1: Children showed a highly significant increase in knowledge following the training session (46.8% vs 82.7%, p<0.001). Six months later their knowledge remained significantly higher than that of a control group who had never been trained (61.1% vs 46.8%, p<0.01). Study 2: Thirty eight teachers were trained from one education board. The first five children trained at each school were randomly selected. Questionnaires were returned for 44.7% pupils at baseline and 42.1% pupils after training. Mean baseline scores improved significantly after training (57.2% vs 77.7%, p<0.001). Conclusion These studies demonstrate that by using medical students and teachers, a large number of children can be trained in a short time period and at relatively low cost. Children can acquire and retain knowledge of BLS for at least six months. The initiative provides manikins and training resources to all schools. To date, the programme has trained 350 schools. We have commenced research of physical skills using a recordable mainikin.


2009 ◽  
Vol 48 (05) ◽  
pp. 493-501 ◽  
Author(s):  
F. Hummel ◽  
C. Gerloff ◽  
H. Handels ◽  
M. Färber

Summary Objectives: Lumbar puncture (LP) is performed by inserting a needle into the spinal canal to extract cerebrospinal fluid for diagnostic purposes. A virtual reality (VR) lumbar puncture simulator based on real patient data has been developed and evaluated. Methods: A haptic device with six degrees of freedom is used to steer the virtual needle and to generate feedback forces that resist needle insertion and rotation. An extended haptic volume-rendering approach is applied to calculate forces. This approach combines information from segmented data and original CT data which contributes density information in unsegmented image structures. The system has been evaluated in a pilot study with medical students. Participants of two groups, a training and a control group, completed different first training protocols. User performance has been recorded during a second training session to measure the training effect. Furthermore user acceptance has been evaluated in a questionnaire using a 6-point Likert scale with eight items. Results: Forty-two medical students in two groups evaluated the system. Trained users performed better than less trained users (an average of 39% successfully completed virtual LPs compared to 30%). Findings of the questionnaire show that the simulator is very well accepted. E.g. the users agree that training with such a simulator is useful (Likert grade of 1.5 ± 0.7 with 1 = “strongly agree” and 6 = “strongly disagree”). Conclusions: Results show that the VR LP simulator gives a realistic haptic and visual impression of the needle insertion and enables new insights into the anatomy of the lumbar region. It offers a new way for increasing skills of students and young residents before applying an LP in patients.


2013 ◽  
Vol 56 (1) ◽  
pp. 109-126
Author(s):  
P. Abramowicz ◽  
M. Gołębiewski ◽  
A. Górecka-Bruzda ◽  
P. Brzozowski

Abstract. The objective of this study was to investigate whether natural stockmanship training can be effective in the elimination of avoidance reactions by generating submissive behaviour in dairy cattle. The training session was divided into two procedures: natural stockmanship training focused on getting a submissive response to human approach; natural halter training focused on acceptance of stroking with a halter and fitting it. Both procedures were conducted on unrestrained animals by skilled trainer. Two tests were developed to assess the effectiveness of the method: »udder touching« testing natural stockmanship training and »halter-fitting« testing both natural stockmanship training and natural halter training. Training procedures followed the idea of employing natural behaviour of cattle (avoiding discomfort of pressure) to negative reinforcement conditioning (chasing away when an animal moved away) and habituation to trainer and training/testing arena. Sixty-three (n=63) animals from two barns were studied: 32 heifers and 31 cows followed by control group of 7 heifers and 11 cows. The approach developed proved to be an effective method of handling cattle: 93.7 % of animals completed »udder test« in an average 400.4 s and 75.8 % completed »halter fitting test« in an average 559.7 s compared to control group results: 77.8 % and 33.3 %, respectively. Animals responded with submission and avoidance distance was shortened to zero. Previous experience of being milked had a significant positive effect on »udder touching« test performance and duration but not »halter-fitting« test. No environmental impact was found and animals from both farms responded similarly.


2021 ◽  
pp. 1-38
Author(s):  
Greta Tuckute ◽  
Sofie Therese Hansen ◽  
Troels Wesenberg Kjaer ◽  
Lars Kai Hansen

Sustained attention is a cognitive ability to maintain task focus over extended periods of time (Mackworth, 1948; Chun, Golomb, & Turk-Browne, 2011). In this study, scalp electroencephalography (EEG) signals were processed in real time using a 32 dry-electrode system during a sustained visual attention task. An attention training paradigm was implemented, as designed in DeBettencourt, Cohen, Lee, Norman, and Turk-Browne (2015) in which the composition of a sequence of blended images is updated based on the participant's decoded attentional level to a primed image category. It was hypothesized that a single neurofeedback training session would improve sustained attention abilities. Twenty-two participants were trained on a single neurofeedback session with behavioral pretraining and posttraining sessions within three consecutive days. Half of the participants functioned as controls in a double-blinded design and received sham neurofeedback. During the neurofeedback session, attentional states to primed categories were decoded in real time and used to provide a continuous feedback signal customized to each participant in a closed-loop approach. We report a mean classifier decoding error rate of 34.3% (chance [Formula: see text] 50%). Within the neurofeedback group, there was a greater level of task-relevant attentional information decoded in the participant's brain before making a correct behavioral response than before an incorrect response. This effect was not visible in the control group (interaction [Formula: see text]e[Formula: see text]4), which strongly indicates that we were able to achieve a meaningful measure of subjective attentional state in real time and control participants' behavior during the neurofeedback session. We do not provide conclusive evidence whether the single neurofeedback session per se provided lasting effects in sustained attention abilities. We developed a portable EEG neurofeedback system capable of decoding attentional states and predicting behavioral choices in the attention task at hand. The neurofeedback code framework is Python based and open source, and it allows users to actively engage in the development of neurofeedback tools for scientific and translational use.


2021 ◽  
Author(s):  
Weibo Feng ◽  
Yuxian Zou ◽  
Yonghao Li ◽  
Tao Shen ◽  
Ya Gao ◽  
...  

Abstract Aim: A portable fundus camera could allow the third person to observe the technique essentials of direct ophthalmoscopy from a real time screen. This study was designed to compare the proficiency of teaching direct ophthalmoscopy using a portable camera with conventional way in medical students. Methods: Medical students of fourth year were invited to participate the study. At baseline, the participants were taught fundoscopy with a conventional direct ophthalmoscope shortly. Then they were randomized to be taught the skill of fundoscopy either with a portable fundus camera or with a conventional direct ophthalmoscope as control for two days. Accuracy tests to match a subject’s fundus with one of the four photographs after examining an undilated eye using a direct ophthalmoscope were performed at baseline and end point. Accuracy test scores and self-reported confidence were compared between the two groups. Results: A total of 160 students participated the study, with 79 assigned to the intervention group, and 81 to the control group. All the students finished the study. At baseline, there was no difference in accuracy test score between the two groups. After two-day training session, the accuracy score improved in 26/79 (32.9%) students of intervention group versus 15/81 (18.5%) of the control group (p=0.037). At end point, a total of 39/79 (49.4%) students in the intervention groups versus 25/81 (30.9%) in the control group identified the correct fundus photograph (p=0.017). The confidence levels were significantly higher in the intervention group than the control group. Conclusions: Teaching direct ophthalmoscope using a portable fundus camera is associated with improved accuracy score and elevated confidence level in medical students when compared with conventional method.


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