scholarly journals The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster

CJEM ◽  
2010 ◽  
Vol 12 (01) ◽  
pp. 27-32 ◽  
Author(s):  
Jeffrey Michael Franc-Law ◽  
Pier Luigi Ingrassia ◽  
Luca Ragazzoni ◽  
Francesco Della Corte
Keyword(s):  
Medical Students ◽  
Student Performance ◽  
Intervention Group ◽  
Command And Control ◽  
Disaster Medicine ◽  
Simulated Patients ◽  
Control Group ◽  
Number Of Patients ◽  
Simulation Based ◽  
And Control

ABSTRACT Objective: Training in practical aspects of disaster medicine is often impossible, and simulation may offer an educational opportunity superior to traditional didactic methods. We sought to determine whether exposure to an electronic simulation tool would improve the ability of medical students to manage a simulated disaster. Methods: We stratified 22 students by year of education and randomly assigned 50% from each category to form the intervention group, with the remaining 50% forming the control group. Both groups received the same didactic training sessions. The intervention group received additional disaster medicine training on a patient simulator (disastermed.ca), and the control group spent equal time on the simulator in a nondisaster setting. We compared markers of patient flow during a simulated disaster, including mean differences in time and number of patients to reach triage, bed assignment, patient assessment and disposition. In addition, we compared triage accuracy and scores on a structured command-and-control instrument. We collected data on the students' evaluations of the course for secondary purposes. Results: Participants in the intervention group triaged their patients more quickly than participants in the control group (mean difference 43 s, 99.5% confidence interval [CI] 12 to 75 s). The score of performance indicators on a standardized scale was also significantly higher in the intervention group (18/18) when compared with the control group (8/18) (p < 0.001). All students indicated that they preferred the simulation-based curriculum to a lecture-based curriculum. When asked to rate the exercise overall, both groups gave a median score of 8 on a 10-point modified Likert scale. Conclusion: Participation in an electronic disaster simulation using the disastermed.ca software package appears to increase the speed at which medical students triage simulated patients and increase their score on a structured command-and-control performance indicator instrument. Participants indicated that the simulation-based curriculum in disaster medicine is preferable to a lecture-based curriculum. Overall student satisfaction with the simulation-based curriculum was high.

scholarly journals A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial

Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 204
Author(s):  
Anissa Aharaz ◽  
Jens Henning Rasmussen ◽  
Helle Bach Ølgaard McNulty ◽  
Arne Cyron ◽  
Pia Keinicke Fabricius ◽  
...  
Keyword(s):  
Pilot Study ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Patient Interviews ◽  
Number Of Patients ◽  
Multimorbid Patients ◽  
And Control

Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.

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 CRITICAL REFLECTION AND FEEDBACK FOR MEDICAL STUDENTS: A COMPARATIVE STUDY

2018 ◽  
Vol 7 (1) ◽  
pp. 84
Author(s):  
Imelda Ritunga ◽  
Gandes Retno Rahayu ◽  
Yoyo Suhoyo
Keyword(s):  
Medical Students ◽  
Transformative Learning ◽  
Critical Reflection ◽  
Intervention Group ◽  
Simple Random Sampling ◽  
Control Group ◽  
Control Group Design ◽  
Post Test ◽  
Giving Feedback ◽  
And Control

Background: The physician who reflects critically will interpret the experience, aware of its limitations, and will become life long learner. When implementing reflection learning in medical education, it is necessary to assess the ability of learners to help improve the ability of reflection. The objective of the research is to know the students 'reflection ability by giving feedback and different of reflection ability between intervention group and control group.Method: Research using pre and post control group design. The subjects of the study were 62 students medical students of Faculty of Medicine UGM year II who had collected narrative reflection to Gamel (n = 176 students) and willing to participate, divided into 2 groups with simple random sampling. Intervention of treatment group are giving feedback based on the result of narrative reflection from Gamel followed by narrative reflection assignment. The subjects' narrative reflection was assessed using the REFLECT rubric, and analyzed by Wilcoxon and Mann-Whitney tests.Results: The results showed that students' pre and post test reflection ability is in the reflection stage. Giving feedback once does not increase the ability from  reflection stage to the critical reflection stage. This result may be due to several things: critical reflection does not occur without significant / dramatic experience that shifts perspective resulting in transformative learning, feedback is given regularly, lack of trustworhty to instructors who are not university lecturers. Another result of a decrease in the ability of reflection in general after 6 months indicates the need to do reflection activity / assignment in each semester to maintain and improve the ability of reflection. Conclusion: Increased reflection ability from reflection stage to critical reflection stage does not occur with single feedback. If reflection is not done regularly, it can cause a decrease in reflection ability.

scholarly journals The effect of simulation-based education on nursing students’ knowledge and performance of adult basic cardiopulmonary resuscitation: A randomized clinical trial

2020 ◽  
Author(s):  
Tahereh Habibli ◽  
Tahereh Najafi Ghezeljeh ◽  
Shima Haghani
Keyword(s):  
Nursing Students ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Intervention Group ◽  
Control Group ◽  
Random Allocation ◽  
Simulation Based ◽  
And Performance ◽  
And Control

Background & Aim: Cardiopulmonary arrest as a life-threatening condition needs urgent interventions to protect individuals’ life and prevent irreversible damages to vital organs. This study aimed to investigate the effect of simulation-based education on the knowledge and performance of nursing students of adult essential life support cardiopulmonary resuscitation (BLS-CPR). Methods & Materials: This study used a pretest-posttest study with a control group. It was conducted at Iran University of medical sciences, Tehran, Iran, in 2017. In this study, 49 nursing students at the sixth education semester were assigned using the simple random allocation into two groups of intervention (n=28) and control (n=21). Initially, the conventional BLS education was provided to the two groups of intervention and control using the conventional method. Next, the intervention group received a simulation-based education. The knowledge and performance of the students before, immediately after, and three months after the intervention was assessed using a modified knowledge assessment questionnaire and a modified performance evaluation checklist about BLS in adults. Results: The students’ knowledge in the intervention group immediately after (p<0.001) and three months after the intervention (p<0.05) were significantly higher than the control group. The mean scores of performance immediately after (p<0.001) and three months after the intervention (p<0.001) were significantly higher than the control group. Conclusions: Simulation-based education increased the knowledge and performance of nursing students in the field of BLS-CPR. According to the results, integrating conventional training with simulation-based education can be effective in learning BLS among nursing students.

Reversing Type 2 Diabetes in a Primary Care-Anchored eHealth Web-based Lifestyle Coaching Program in Denmark: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Jeanette Reffstrup Christensen ◽  
Camilla Sortsø ◽  
Jørgen T Lauridsen ◽  
Pernille R Jakobsen ◽  
Ditte H Laursen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
And Control

BACKGROUND Lifestyle interventions can delay and reverse the onset of type 2 diabetes (T2D) and decrease morbidity and mortality. Studies suggest that digital coaching based on real-time monitoring can lead to clinically relevant weight loss, as well as decreased or normalized hemoglobin A1c (HbA1c) for a significant number of patients. OBJECTIVE To assess whether an eHealth lifestyle coaching program (LIVA 2.0) for patients with T2D who are motivated for lifestyle changes leads to significant weight loss and decreased HbA1c, compared to usual care. METHODS In a randomized controlled single-blinded trial, 170 patients with T2D were enrolled from March 2018 to March 2019 and randomized to the intervention (100) and control (70) groups. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The intervention comprised an initial face-to-face motivational interview followed by digital coaching. The same healthcare professional coach provided synchronous and asynchronous multimodal feedback and used digital behavioral change techniques enabled by an app providing live monitoring of lifestyle behaviors. Primary outcome was body weight. Secondary outcomes were changes in HbA1c, body composition, lipids, and quality of life at 6 months. RESULTS At 6 months, 75 patients (75%) in the intervention group and 53 patients (76%) in the control group remained in the study. Mean body weight loss was 4.2 kg (95% CI, 5.5- 3.0) in the intervention group vs 1.5 kg (95% CI, 2.57- 0.48) in the control group (P = .005). In the intervention group, 36 (52%) patients lost > 3% body weight, compared to 12 (32%) patients in the control group. Mean HbA1c was lower in both groups at 6 months, with reductions of 8.2% (95% CI, 11.01 to 5.29) and 5.5% (95% CI, 8.75 to 2.76) for the intervention and control groups, respectively (P = .203). In the intervention group, 24 (32%) had an HbA1c <6.5% at 6 months, compared to 8 (15%) in the control group (P = .03). CONCLUSIONS Reduction in body weight and remission rate for HbA1c, as well as improved body composition can be enhanced by using digital lifestyle coaching for patients with T2D. CLINICALTRIAL Trial Registration: Clinicaltrials.gov NCT03788915 https://clinicaltrials.gov/ct2/show/NCT03788915 International Registered Report Identifier (IRRID): DERR2-10.2196/19172 INTERNATIONAL REGISTERED REPORT RR2-10.2196/19172

Rubric-based debriefing to enhance nursing students’ critical thinking via simulation

2020 ◽  
Vol 7 (1) ◽  
pp. 11-16
Author(s):  
Janet Yuen Ha Wong ◽  
Maggie Mee Kie Chan ◽  
Vivien Wai Yin Tsang ◽  
Michelle Tsz Ha Pang ◽  
Claudia Kor Yee Chan ◽  
...  
Keyword(s):  
Critical Thinking ◽  
Nursing Students ◽  
Qualitative Data ◽  
Intervention Group ◽  
Estimating Equation ◽  
Vital Role ◽  
Simulated Patients ◽  
Control Group ◽  
Quasi Experimental ◽  
And Control

IntroductionDebriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning.ObjectivesWe evaluated the effects of rubric-based debriefing on students’ critical thinking, level of confidence in performing tasks and communication.MethodThis is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question.ResultsBased on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students’ critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities.ConclusionsThis is the first study to provide evidence that a rubric-based debriefing enhances students’ critical thinking in simulation learning.

scholarly journals 883. Evaluation of Post-operative Antibiotic Prophylaxis in Patients Undergoing Urologic Procedures

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Mohamed Elmarakbi ◽  
Julianne Care ◽  
Jillian Laude ◽  
Pharm D
Keyword(s):  
Adverse Effects ◽  
Antibiotic Prophylaxis ◽  
Intervention Group ◽  
Adverse Outcomes ◽  
Control Group ◽  
Round Table Discussion ◽  
Control Groups ◽  
Number Of Patients ◽  
Tract Infections ◽  
And Control

Abstract Background Many national guidelines do not recommend post-operative antibiotic prophylaxis due to lack of literature supporting its use; however, they are frequently prescribed at ChristianaCare for urologic procedures. Use of post-operative antibiotics has not correlated with reduction in post-operative infections, and has been show to increase risk for resistant infections, Clostridiodes difficile (C. difficile) and acute kidney injury (AKI). Methods A single center retrospective chart review was conducted to evaluate endpoints of patients who underwent a urologic procedure and received post-operative antibiotics (intervention group) compared to those who did not (control group) from June 1st 2018 to September 1st 2019. The primary endpoint was to compare the incidence of post-operative infections, including surgical site infections (SSIs), bacteremia, and urinary tract infections (UTIs) between the intervention and control groups. The secondary endpoints included comparing the incidence of prespecified adverse outcomes, between the two groups. Results A total of 250 patients were included in this study. Baseline demographics were similar across a number of characteristics in both groups. There was no difference between the intervention and control groups in the incidence of post-operative bacteremia (p = 0.608), SSIs (p = 0.491) and 30 day UTIs (p = 0.307). The rate of AKI between both groups were similar. There was a higher percentage of resistant organisms seen in the intervention group compared to the control group (21.4 % vs. 16.7%). The intervention group experienced an increase in post-operative antibiotic related adverse effects. Although a small number of patients were tested for C. difficile, there was one positive C. difficile PCR in the intervention group compared to zero in the control group. Conclusion The results of this study support withholding post-operative antibiotics in urologic procedures given no benefit in reducing post-operative infections and potential to increase adverse effects and development of resistant organisms. Efforts to change this current practice at our institution will be implemented via collaboration with the urology section and review of current order sets. Disclosures Jillian Laude, Pharm D, BCPS, Shionogi Inc (Other Financial or Material Support, Received one-time speaker fee for a round table discussion. The financial relationship does not relate to this research project.)

scholarly journals WhatsApp™ as a Tool in Teaching Elementar Electrocardiogram in Medical Graduation

2020 ◽  
Vol 3 (2) ◽  
pp. 64-69
Author(s):  
Gilson Soares Feitosa-Filho ◽  
Raiza Martins ◽  
Monique Matos ◽  
Yuri Santo ◽  
Rodrigo Amaral ◽  
...  
Keyword(s):  
Medical Students ◽  
Early Stage ◽  
Group Discussion ◽  
Intervention Group ◽  
Control Group ◽  
Similar Increase ◽  
Intention To Treat ◽  
Teacher Control ◽  
And Control ◽  
Ecg Interpretation

Objective: To observe whether the use of WhatsApp™ can contribute to the improvement and retention of ECG knowledge during medical graduation in a period-time of 4 months. Material and Methods: A controlled, quasi-randomized, intention-to-treat, clinical trial. Medical students of the 2nd and 3rd semester attended a 2-hour class on elementar ECG interpretation. A test with 10 ECG tracings covering subjects was applied with a possible 0-10 score at 4 different times: immediately before the lesson (M1), immediately after the lesson (M2), one month after the lesson (M3) and four months after the lesson (M4). Intervention group, formed by 2nd-semester students, were included, shortly after M2, in a WhatsApp™ group, in which final year medical students and a cardiology resident discussed ECG tracings frequently in the absence of a teacher. Control group, formed by 3rd-semester students, was instructed to study on their own. Results: 13 students were included from the 2nd semester and 11 from the 3rd semester. In M1, the intervention and control group obtained a median of 0.0. In M2, both groups presented a similar increase with a median of 4.0 (IIQ=2.8-5.0) for the intervention group and 4.5 (IIQ= 3.3-5.5) for the control group. In M3, there was a difference between group scores, with a median of 6.0 (IIQ= 3.5-7.0) for the intervention group and 2.0 (IIQ=0-4.0) for the control group (p=0.016). In M4, difference was maintained (4.0 for intervention group [IIQ= 3.0-6.3] vs. 1.0 [IIQ= 1.0-3.0] for control group [p= 0.006]). Conclusion: Early-stage medical students learned and retained more elementar ECG knowledge when participating in WhatsApp™ ECG group discussion with more advanced medical students and medical resident, even without a teacher in this group.

scholarly journals DIFFERENCE OF BOWEL SOUND RETURN TIME AMONG POST-LAPARATOMY SURGERY PATIENTS AFTER CHEWING GUM

2019 ◽  
Vol 5 (5) ◽  
pp. 204-211
Author(s):  
Warisya Miftah Amanda ◽  
Chandra Isabella Hostanida Purba ◽  
Ristina Mirwanti
Keyword(s):  
Intervention Group ◽  
Return Time ◽  
Chewing Gum ◽  
Control Group ◽  
P Value ◽  
Bowel Sound ◽  
Pharmacological Interventions ◽  
Control Group Design ◽  
Number Of Patients ◽  
And Control

Background: A surgical procedure using general anaesthesia in laparotomy surgery results in reduced bowel sound. A large number of patients who experience a delay in returning bowel sound after laparotomy surgery become the reason to give proper intervention in order to increase bowel sound return time. One of the non-pharmacological interventions that can be used is chewing gum.Objective: The purpose of this study is to identify the difference of bowel sound return time between groups of intervention and control after being given chewing gum intervention among post-laparotomy surgery patients.Methods: This quasi-experimental study used post-test only control group design. Thirty respondents were selected by purposive sampling technique. Data were collected through observation by calculating the bowel sound return time among post laparotomy surgery patients in the intervention group (n=15) and control group (n=15), and were analyzed using the Mann Whitney test.  The intervention group was asked to chew the gum once for 30 minutes, and bowel sound was measured every 30 minutes for 120 minutes.Results: The results showed that bowel sound return time in the intervention group was 90 minutes and the control group was 150 minutes, and p-value was 0.005.Conclusion: There was a difference in the return time of bowel sound between the intervention and control groups. Therefore, the intervention of chewing gum could become one of the non- pharmacological interventions that can be considered in increasing the bowel sound return time among post-laparotomy surgery patients.

scholarly journals INFLUENCE OF INFORMATION, MOTIVATION, AND BEHAVIOR OF “TRISNA” TO DRUG COMPLIANCE. NUTRITIONAL STATUS, AND FAMILY SUPPORT IN PATIENTS WITH TUBERCULOSI

2021 ◽  
Vol 21 (3) ◽  
pp. 222-229
Author(s):  
Rita Benya Adriani ◽  
Jenita DT Donsu ◽  
Dwi Sulistyowati
Keyword(s):  
Nutritional Status ◽  
Family Support ◽  
Medication Compliance ◽  
Intervention Group ◽  
Control Group ◽  
Drug Compliance ◽  
Control Group Design ◽  
Number Of Patients ◽  
And Behavior ◽  
And Control

Indonesia is one of the five countries with the highest number of patients with tuberculosis (TB) worldwide, owing to patients being undetected and untreated. This study aims to analyze the effect of the Information, Motivation, and Behavior (IMB) Skill with “Trisna” approach on the management of drug compliance, nutritional status, and family support for patients with TB. This research is a quasi-experiment with pretest-posttest and control group design. Information about tuberculosis, medication adherence, nutritional status, family support and motivation are provided through training. At the end of training, each patient is given an alarm clock that can be used as a reminder to take medication. One form of family support is done by teaching the song “satu-satu” to remind patients to take medicine so as to minimize forgetting to take medicine. “TRISNA” is an attitude that accompanies TB cadres in providing health services to TB patioents. The socialization of the attitude of “TRISNA” was given by researchers to TB cadres before carrying out IMB training for TB patients. Compliance after intervention in the intervention group (mean, 10.80; SD, 0.98) was higher than in the control group (mean, 10.46; SD, 1.12) and effect size (ES) value of 4.16. Body mass index (BMI) in the intervention group (mean, 23.40; SD, 1.08) was higher than in the control group (mean, 21.43; SD, 0.75) and ES value of 1.95. Family support in the intervention group (mean, 106.28; SD, 22.00) was higher than in the control group (mean, 94.00; SD, 8.40) and ES value of 0.69.  In managing patients with TB, the provision of IMB Intervention Skill with “Trisna” approach could improve medication compliance, nutritional status, and family support.

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