Acquiring and Maintaining Competence in the Application of Extrication Cervical Collars by a Group of First Responders

2008 ◽  
Vol 23 (6) ◽  
pp. 530-536 ◽  
Author(s):  
Colin J. Ireland ◽  
Kathryn M. Zeitz ◽  
Franklin H.G. Bridgewater

AbstractIntroduction:Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.Objective:This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.Methods:Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.Results:Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.Conclusions:Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.

Author(s):  
JACKSON VINÍCIUS DE LIMA BERTUOL ◽  
NATASHA LURE BUENO CAMARGO ◽  
FERNANDO ANTONIO CAMPELO SPENCER NETTO ◽  
ANDRÉ PEREIRA WESTPHALEN

ABSTRACT Introduction: simulation based teaching is a powerful tool in medical education, allowing hands on practice under a controlled environment and with repeated maneuvers. Central venous access venipuncture is one of the most frequent procedures carried out in the hospital setting, due to its various clinical indications and, when performed with the help of ultrasonography, the risk of adverse events is minimized. Aim: to develop, to describe and to test a porcine model that simulates the central venous access puncture aided by ultrasonography. Method: a low cost porcine model was developed to train medical students and residents on central venous access guided by ultrasonography. Both students and medical residents underwent a theoretical training regarding the model, followed by a hands-on training session. Afterwards, the participants assessed the model by answering a questionnaire. Results: there were 51 participants. The average score regarding the similarity between the model and the human anatomy was 9.15. When the characteristics were separately assessed, the mean scores regarding the similarity of the vessels, anatomic disposition and ultrasonographic characteristics as well as the venipuncture were, respectively, 9.27; 9.31; 9.54 and 8.86. Conclusion: The model was approved and considered appropriate for the training of central venous venipuncture by all the participants. Furthermore, it is a low cost, simple and reproducible model, that presents high similarity with the human anatomy. Therefore, it may be used as an aid to train people on ultrasonography guided central venous access.


Author(s):  
Eric Anthony Day ◽  
Charlene Stokes ◽  
Erich C. Fein

The extant literature on goal orientation is primarily focused on scholastic and athletic achievement. This study extends the literature by examining the viability of three goal orientation dimensions (learning, performance-approach, and performance-avoid) as predictors of complex skill acquisition. Ninety-eight males participated in 7 hours of training in order to learn a computer-based task that simulated the demands of a dynamic aviation environment. Participants completed paper-and-pencil measures of global and task-specific goal orientation as well as a test of general cognitive ability ( g). Training outcomes included declarative knowledge, knowledge structure accuracy, skill acquisition, skill retention, and skill transfer. The results indicated that both performance-approach and performance-avoid orientations explained unique variance in training outcomes beyond that explained by g. However, both performance orientations were related to the training outcomes only when operationalized as task-specific orientations, not when operationalized as global dispositions. Learning orientation was not significantly related to the training outcomes.


2020 ◽  
pp. emermed-2020-210497
Author(s):  
Kevin Mackway-Jones ◽  
David Adler ◽  
Ian Gibbons ◽  
Andrew Helming ◽  
Joshua Lupton ◽  
...  

A review was carried out to see whether hands-on defibrillation could be performed safely. 6 papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that hands-on defibrillation has the potential to be performed safely if the rescuer uses appropriate electrical insulating barriers such as polyethylene gloves or class 1 electrical insulating gloves. The safety profile of nitrile gloves is unclear. Since detection of shock was used as a proxy for safety, additional investigation is warranted before hands-on defibrillation becomes common practice.


2017 ◽  
Vol 5 (2) ◽  
pp. 291-303
Author(s):  
Maxime Trempe ◽  
Jean-Luc Gohier ◽  
Mathieu Charbonneau ◽  
Jonathan Tremblay

In recent years, it has been shown that spacing training sessions by several hours allows the consolidation of motor skills in the brain, a process leading to the stabilization of the skills and, sometimes, further improvement without additional practice. At the moment, it is unknown whether consolidation can lead to an improvement in performance when the learner performs complex full-body movements. To explore this question, we recruited 10 divers and had them practice a challenging diving maneuver. Divers first performed an initial training session, consisting of 12 dives during which visual feedback was provided immediately after each dive through video replay. Two retention tests without feedback were performed 30 min and 24 hr after the initial training session. All dives were recorded using a video camera and the participants’ performance was assessed by measuring the verticality of the body segments at water entry. Significant performance gains were observed in the 24-hr retention test (p < .05). These results suggest that the learning of complex full-body movements can benefit from consolidation and that splitting practice sessions can be used as a training tool to facilitate skill acquisition.


2020 ◽  
Vol 08 (02) ◽  
pp. E186-E188
Author(s):  
Ivo Boškoski ◽  
George Webster ◽  
Andrea Tringali ◽  
Pietro Familiari ◽  
Vincenzo Perri ◽  
...  

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) requires extensive hands-on training. Currently in ERCP training there are two very important problems that need attention: lack of standardized commands for communication, and misunderstanding between the trainee and the trainer. Methods A method of “blind-eye” cannulation was developed with two paired trainees using the Boškoski-Costamagna ERCP Trainer. The trainee who was holding the duodenoscope was blind-folded and the other trainee gave instructions on what maneuvers were necessary to achieve cannulation, under the supervision of a trainer. Before starting cannulation, a standard list of commands was agreed by the operators. Results The blind-eye method of cannulation teaches the operator trainee to listen and the assistant trainee to teach. Trainees use standardized commands. During the training session the two trainees swapped roles. Conclusions Currently, we do not have proof that this type of training is useful, therefore, scientific studies are needed for confirmation. However, we believe that this ERCP model may provide an entirely safe means of improving communication and technical proficiency.


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