scholarly journals TP8.2.26 A new simulation-based course to improve trauma management by junior doctors

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Schneiders
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Small Group ◽  
Unmet Need ◽  
Junior Doctors ◽  
Trauma Management ◽  
Likert Scales ◽  
Sample Group ◽  
Simulation Based

Abstract Aims Trauma calls at small hospitals are often attended by small and/or junior teams, especially overnight. The quality of primary surveys was subjectively observed to be extremely variable, sufficient to cause concern about patient safety. In addition, the introduction of the ‘ward trauma call’ for falls was generating anxiety amongst juniors. I recognised an unmet need and gained permission from the Director of Medical Education to create a half-day ‘Introduction to Trauma’ simulation-based course. Method A sample group of Foundation doctors attended a pilot course. Confidence in aspects of trauma management was assessed using Likert scales. Results Pre-course results indicated doctors were reasonably confident with their A-E assessments (63% moderately or very confident) but lacked confidence in trauma skills such as using a scoop. After the course 100% reported increased confidence about what will happen in a trauma call, and 63% reported increased confidence in their A-E assessments. Increased confidence was also widely reported in trauma skills (e.g. log roll 88%), how to manage a ward trauma call (100%), and where to find further guidance (100%). Conclusions This pilot demonstrated that a small group simulation-based teaching intervention can significantly increase the confidence of foundation doctors in all aspects of their role in trauma management. The most notable increases were in trauma equipment use and in managing ward trauma, suggesting these are areas where foundation doctors lack guidance or experience. The course is now part of trust induction for new foundation doctors.

11 Filling the void: preparing future junior doctors for challenging conversations

2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
Small Group ◽  
End Of Life ◽  
Communication Skills ◽  
Skills Training ◽  
Junior Doctors ◽  
List Type ◽  
The Impact

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

Training and Assessment of Trauma Management: The Role of Simulation-Based Medical Education

2007 ◽  
Vol 25 (1) ◽  
pp. 65-74 ◽  
Author(s):  
Haim Berkenstadt ◽  
David Erez ◽  
Yaron Munz ◽  
Daniel Simon ◽  
Amitai Ziv
Keyword(s):  
Medical Education ◽  
Trauma Management ◽  
Simulation Based

scholarly journals TraumaTutor: Perceptions of a Smartphone Application as a Learning Resource for Trauma Management

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
James Wigley ◽  
Saran Shantikumar
Keyword(s):  
Medical Education ◽  
User Interface ◽  
Smartphone Application ◽  
Hospital Staff ◽  
Educational Material ◽  
Trauma Management ◽  
Smartphone Applications ◽  
Learning Resource ◽  
The Right

Aim. We investigated perceptions of a new smartphone application (app) as a learning resource. Methods. We developed TraumaTutor, an iPhone app consisting of 150 questions and explanatory answers on trauma management. This was used by 20 hospital staff that either had a special interest in managing trauma or who were studying for relevant exams, such as ATLS. A subsequent questionnaire assessed users’ experience of smartphone applications and their perceptions of TraumaTutor. Results. Of those surveyed, 85% had a device capable of running app software, and 94% of them had used apps for medical education. Specific to TraumaTutor, 85% agreed that it was pitched at the right level, 95% felt that the explanations improved understanding of trauma management, and 100% found the app easy to use. In fact, on open questioning, the clear user interface and the quality of the educational material were seen as the major advantages of TraumaTutor, and 85% agreed that the app would be a useful learning resource. Conclusions. Smartphone applications are considered a valuable educational adjunct and are commonly used by our target audience. TraumaTutor shows overwhelming promise as a learning supplement due to its immediacy, accessibility, and relevance to those preparing for courses and managing trauma.

scholarly journals Why clinical training in China should improve: a cross-sectional study of MD graduates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoning Zhang ◽  
Chong Li ◽  
Cailing Yue ◽  
Xue Jiang ◽  
Junli Cao ◽  
...  
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Clinical Supervision ◽  
Clinical Training ◽  
Online Survey ◽  
Task Force ◽  
Teaching Quality ◽  
Academic Degree ◽  
And Training

Abstract Background China is experiencing major medical education reforms that include establishing national training standards, standards for health professionals, and advanced health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) with PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with research rather than clinical training. Unfortunately, there is a shortage of quality information regarding the clinical training of MD graduates from Chinese medical schools. To fill this gap, this general investigation aims to provide the perspective of recent MD graduates in China for the different subspecialties of clinical training as experienced in different contexts. Methods There were 432 MD graduates who participated in an online survey regarding their clinical training. Information collected included overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Results Only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported they knew who provided clinical supervision; but only 35.5% rated the quality of clinical supervision as high; 51.8% reported that they judged senior physicians as “not competent”; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback; 48.1% believed that their concerns about education and training would be addressed. Conclusions This study suggests that the quality of clinical training for MD graduates should be improved. While the overall satisfaction with the teaching quality was acceptable, the quality of many clinical training aspects scored poorly. A major problem seems an undue focus on research in MD/PhD training at the cost of the quality of clinical training, due to career perspectives that undervalue clinical competence. The findings of this study should benefit from a deeper investigation to understand the causes and possible remediation. Suggestions include defining subspecialties and training lengths; monitoring, evaluation, and integration SST with MD degree; providing funds or rewards for academic and clinical training; establishing supervising teams to guide clinical training; and establishing physician scientist task force to help overcome challenges.

Patient safety and simulation-based medical education

2000 ◽  
Vol 22 (5) ◽  
pp. 489-495 ◽  
Author(s):  
Amitai Ziv, Stephen D. Small, Paul Root Wo
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Simulation Based

scholarly journals Constructing high-quality rest facilities to maximise performance and ensure patient safety

2021 ◽  
Vol 10 (3) ◽  
pp. e001403
Author(s):  
Geeth Silva ◽  
Aiken Yam ◽  
Jessica Court ◽  
Rabia Imtiaz ◽  
Cath Chisholm
Keyword(s):  
Patient Safety ◽  
Well Being ◽  
Recovery Phase ◽  
Alternative Methods ◽  
Junior Doctors ◽  
High Quality ◽  
Ensure Patient Safety ◽  
Being There ◽  
Exception Reporting

IntroductionJunior doctors are working in an increasingly overstretched National Health Service. In 2018, Kettering General Hospital (KGH) was awarded £60 800 of government funds to create high-quality rest facilities and improve junior doctor well-being.MethodsAn audit and survey in KGH identified the structural and functional improvements needed. From November 2019 to June 2020, £47 841.24 was spent on creating new rest facilities. On completion, a postaction review assessed how the changes impacted morale, well-being and quality of patient care.ResultsThe majority of doctors were happy with the new rest areas (60%), a majority felt that they would use the on-call room area (63%) and the renovation improved morale and well-being. There was an increased ability to take breaks. However, the majority of doctors are not exception-reporting missing breaks: 79% (2019), 74% (2020).Conclusions and ImplicationsThis report recommends the maintenance of increased staffing levels and rest facilities during the recovery phase of COVID-19. The remaining £12 958.76 should be directed at sustaining the quality of KGH rest facilities. Lastly, the rate of exception-reporting must be increased through improving awareness, exploring alternative methods and supporting the action when necessary. The continual investment into rest facilities ensures workforce well-being and translates into patient safety.

scholarly journals Impact and Implementation of Simulation-Based Training for Safety

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Federico F. Bilotta ◽  
Samantha M. Werner ◽  
Sergio D. Bergese ◽  
Giovanni Rosa
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Clinical Practice ◽  
Deliberate Practice ◽  
Aviation Industry ◽  
Medical Professionals ◽  
Research Needs ◽  
Medical Environment ◽  
Simulation Based ◽  
Training Research

Patient safety is an issue of imminent concern in the high-risk field of medicine, and systematic changes that alter the way medical professionals approach patient care are needed. Simulation-based training (SBT) is an exemplary solution for addressing the dynamic medical environment of today. Grounded in methodologies developed by the aviation industry, SBT exceeds traditional didactic and apprenticeship models in terms of speed of learning, amount of information retained, and capability for deliberate practice. SBT remains an option in many medical schools and continuing medical education curriculums (CMEs), though its use in training has been shown to improve clinical practice. Future simulation-based anesthesiology training research needs to develop methods for measuring both the degree to which training translates into increased practitioner competency and the effect of training on safety improvements for patients.

scholarly journals Effect of Simulation-based Medical Education in Small Groups on Improving the Quality of Nursing Care in Patients Under Electroconvulsive Therapy

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Fatemeh Shakeri ◽  
Kourosh Zarea ◽  
Dariush Rokhafroz ◽  
Elham Maraghei
Keyword(s):  
Medical Education ◽  
Nursing Care ◽  
Small Groups ◽  
Electroconvulsive Therapy ◽  
Intervention Group ◽  
Simulation Method ◽  
Simulation Based ◽  
Before And After ◽  
Quality Of Nursing

Background: Considering the high risk and vital nature of electroconvulsive therapy (ECT) process, as well as the subsequent intensive, essential, and life-saving cares, it is necessary to promote the skills of nurses providing this kind of care. Objectives: This study aimed to determine the effect of simulation on developing the quality of care in nurses working in the ECT department. Methods: This experimental study compared two groups before and after the intervention. Fifty nurses who met the inclusion criteria were randomly allocated into two groups of intervention and control. Low-tech (static) task trainer was used for simulation-based medical education (SBME) in the intervention group. Data were collected using a checklist to investigate the quality of nursing care before and after the intervention. Results: The mean scores obtained from initial preparation subscales, preparation of tools and equipment, measures during ECT, post-ECT measures, and checking patient’s status in pre-test and post-test in the intervention group were significantly different. This suggests that simulation intervention in small groups is effective in improving the quality of nursing care in ECT (P < 0.05). Conclusions: Our results showed that promoting ECT nursing care knowledge among the nurses in small groups by simulation method is an effective intervention.

scholarly journals Clinical training in China needs to be improved: A cross-sectional study of MD graduates

2020 ◽  
Author(s):  
XIAONING ZHANG ◽  
Chong Li ◽  
Cailing Yue ◽  
Xue Jiang ◽  
Junli Cao
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Clinical Supervision ◽  
Clinical Training ◽  
Academic Research ◽  
Teaching Quality ◽  
Academic Degree ◽  
National Quality ◽  
Training Quality

Abstract Background: China is experiencing medical education reform to construct national quality standards, modernise and standardise health professionals, and advance health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) and PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with academic research rather than clinical training. Quality information regarding the clinical training of MD graduates from Chinese medical schools is lacking. This general investigation aims to provide an overview from the perspective of recent MD graduates in China. Methods: Self-reports on MD clinical training were obtained from 432 MD graduates in 2017 via an online survey. The reports included information on overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Descriptive analysis was used to summarise the outcome. Results: Of the 432 MD graduates surveyed, only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported that they knew who provided clinical supervision; only 35.5% highly rated the quality of clinical supervision; 51.8% reported that they judged senior physicians as “not competent”; 48.1% believed that their concerns about education and training would be addressed; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback. Conclusions: This study suggests that the quality of clinical training for MD graduates needs to be improved; however, even though most participants seemed satisfied with their clinical training. The overall satisfaction with the teaching quality was acceptable, whereas the quality of many clinical training aspects was scored poorly. Each aspect may encourage a deeper investigation into the understanding of causes and possible remediation. Some suggestions include improving safe and effective care, providing positive clinical supervision, offering appropriate practice opportunities, providing health care services, and maintaining optimal patient safety.

scholarly journals Objective Structured Assessment of Debriefing (OSAD) in simulation-based medical education: Translation and validation of the German version

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244816
Author(s):  
Sandra Abegglen ◽  
Andrea Krieg ◽  
Helen Eigenmann ◽  
Robert Greif
Keyword(s):  
Medical Education ◽  
Interrater Reliability ◽  
Evidence Based ◽  
Validity Evidence ◽  
German Version ◽  
Simulation Based ◽  
Expert Input ◽  
Test Retest Reliability ◽  
Composite Reliability

Debriefing is essential for effective learning during simulation-based medical education. To assess the quality of debriefings, reliable and validated tools are necessary. One widely used validated tool is the Objective Structured Assessment of Debriefing (OSAD), which was originally developed in English. The aim of this study was to translate the OSAD into German, and to evaluate the reliability and validity of this German version (G-OSAD) according the ‘Standards of Educational and Psychological Measurement’. In Phase 1, the validity evidence based on content was established by a multistage cross-cultural adaptation translation of the original English OSAD. Additionally, we collected expert input on the adequacy of the content of the G-OSAD to measure debriefing quality. In Phase 2, three trained raters assessed 57 video recorded debriefings to gather validity evidence based on internal structure. Interrater reliability, test-retest reliability, internal consistency, and composite reliability were examined. Finally, we assessed the internal structure by applying confirmatory factorial analysis. The expert input supported the adequacy of the content of the G-OSAD to measure debriefing quality. Interrater reliability (intraclass correlation coefficient) was excellent for the average ratings (three raters: ICC = 0.848; two raters: ICC = 0.790), and good for the single rater (ICC = 0.650). Test-retest reliability was excellent (ICC = 0.976), internal consistency was acceptable (Cronbach’s α = 0.865), and composite reliability was excellent (ω = 0.93). Factor analyses supported the unidimensionality of the G-OSAD, which indicates that these G-OSAD ratings measure debriefing quality as intended. The G-OSAD shows good psychometric qualities to assess debriefing quality, which are comparable to the original OSAD. Thus, this G-OSAD is a tool that has the potential to optimise the quality of debriefings in German-speaking countries.

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