SIMULATION-BASED TRAINING AND ASSESSMENT IMPROVE RESIDENTS’ CLINICAL SKILL IN MANAGEMENT OF ACUTE ASTHMATIC ATTACK AND DIFFICULT ASTHMA

Respirology ◽  
2017 ◽  
Vol 22 ◽  
pp. 165-165
Author(s):  
Elizabeth L. MacQuillan ◽  
Jennifer Ford ◽  
Kristin Baird

Purpose: This study aimed to translate simulation-based dietitian nutritionist education to clinical competency attainment in a group of practicing Registered Dietitian Nutritionists (RDNs). Using a standardized instrument to measure performance on the newly-required clinical skill, Nutrition Focused Physical Exam (NFPE), competence was measured both before and after a simulation-based education (SBE) session. Methods: Total 18 practicing RDNs were recruited by their employer Spectrum Health system. Following a pre-brief session, participants completed an initial 10-minute encounter, performing NFPE on a standardized patient (SP). Next, participants completed a 90-minute SBE training session on skills within NFPE, including hands-on practice and role play, followed by a post-training SP encounter. Video recordings of the SP encounters were scored to assess competence on seven skill areas within the NFPE. Scores were for initial competence and change in competence.. Results: Initial competence rates ranged from 0- 44% of participants across the seven skills assessed. The only competency where participants scored in the “meets expectations” range initially was “approach to the patient(. When raw competence scores were assessed for change from pre- to post-SBE training, a paired t-test indicated significant increased in all seven competency areas following the simulation-based training (P< .001). Conclusion: This study showed the effectiveness of a SBE training for increased competence scores of practicing dietitian nutritionist on a defined clinical skill.


2017 ◽  
Vol 4 ◽  
pp. 238212051771001 ◽  
Author(s):  
Jenny Castillo ◽  
Jared Kutzin ◽  
Kathleen Agoglia ◽  
Patricia Janicke ◽  
Zachary Milligan ◽  
...  

During a 1-year hospital-based residency, dental residents are required to rotate through many departments including surgery, medicine, and emergency medicine. It became apparent that there was a gap between clinical skills knowledge taught in dental school curriculum and skills required for hospital-based patient care. In response, a simulation-based intensive clinical skill “boot camp” was created. The boot camp provided an intensive, interactive 3-day session for the dental residents. During the 3 days, residents were introduced to medical knowledge and skills that were necessary for their inpatient hospital rotations but were lacking in traditional dental school curriculum. Effectiveness of the boot camp was assessed in terms of knowledge base and comfort through presession and postsession surveys. According to resident feedback, this intensive introduction for the dental residents improved their readiness for their inpatient hospital-based residency.


2021 ◽  
pp. 1-10
Author(s):  
Amanda Reed ◽  
Alexandra Andre ◽  
Saradha Ananthakrishnan ◽  
Peggy Korczak

Purpose Simulation is a tool commonly used in the clinical training of students within the health professions fields, such as medicine and nursing. The effectiveness of simulation as a teaching technique has been extensively documented in numerous health care professions; however, little is known about the effectiveness of simulation techniques in audiology education. This study assesses the effectiveness of a simulation activity focused on auditory brainstem response (ABR) testing conducted with students of an applied doctoral program in audiology. Method Twelve 2nd year audiology graduate students enrolled in the auditory electrophysiology course at Towson University in Fall 2018 participated in this pre–post study. Over a 3-week period, each student (a) received didactic instruction in ABR testing, (b) underwent a presimulation exercise skills assessment, (c) participated in a simulation exercise, and (d) underwent a postsimulation exercise skills assessment. Results Significant improvements were observed in clinical skill level for the ABR tasks evaluated in terms of both accuracy and efficiency (time in seconds needed to complete the task). The tasks evaluated included skin preparation, identification of scalp electrode placement sites, and scalp electrode placement in a variety of configurations (single- and two-channel arrays, horizontal and vertical electrode montages). Benefits associated with simulation-based instruction varied by clinical skill as well as by student. Conclusions The data described in this study reinforce the need to incorporate simulation in audiology training programs, especially for complex clinical skills. It also emphasizes the need for additional research that can be useful in the design and implementation of simulation-based exercises.


2014 ◽  
Vol 15 (1) ◽  
pp. 61-63
Author(s):  
Anirban Sarkar ◽  
Anirban Das ◽  
Sibes Kumar Das ◽  
Soumya Das ◽  
Sabyasachi Choudhury

Partial or complete obstruction of bronchial tree by endobronchial tumours results in obstructive hyperinflation, non – resolving pneumonia, or atelectasis. Partial endobronchial obstruction may be associated with wheezes, which mimic asthmatic attack, non – responding to inhaled medications. Here, we report a rare case of bilateral endobronchial squamous cell carcinoma, presenting with obstructive hyperinflation and wheezes, which was wrongly diagnosed as ‘difficult asthma’ in a forty – year old male. Histopathology of endobronchial biopsy tissue ultimately revealed the truth.DOI: http://dx.doi.org/10.3329/jom.v15i1.19875 J Medicine 2014; 15: 61-63


2016 ◽  
Vol 4 (5) ◽  
pp. 151-165
Author(s):  
Cameron Garth Shultz ◽  
James M Cooke ◽  
Keri L Denay ◽  
Mikel Llanes ◽  
Philip Zazove ◽  
...  

The principal goal of most simulation-based learning is enhanced clinical skill, with the desired outcome being skill retention and improved performance over time. While evide nce supports simulation based training at the clerkship, graduate, and post graduate level, the evidence supporting its long term benefit at the pre clerkship level is less well established. Using quantitative methods, this research assessed the effect of skill based clinical simulation training on all second year medical students’ enrolled in two simulation courses at the University of Michigan during the 2013 2014 academic year (n=39). Pre course, post course, and 6 month follow up questionnaires were adm inistered, and analysis of variance was used to assess change in students' knowledge, self reported confidence, and competency. Students in Course 1 (n=12) completed a post course and 6 month follow up skills test, and results were compared to faculty cont rols. Differences between groups were assessed using t tests. Odds ratios were calculated.Knowledge improved from pre course to post course; the gain was retained at follow up only for students in Course 1. Students perceived the courses as improving know ledge, confidence, and skill, though scores were significantly lower at follow up. For the subset of students participating in the skills test, the time to complete central line and thoracentesis at follow up did not significantly differ from post course; however, an increase was observed for lumbar puncture. Compared to faculty, students took significantly more time to complete the central line procedure. Outcomes for needle redirects and correct sequencing were mixed, with most procedures showing no signi ficant difference between measurement periods. Assessing students’ skill and the maintenance of that skill over time using objective and empirically derived measures can be challenging. The evaluation strategy described herein could be adapted to many proc edures commonly practiced within primary care and other medical specialties. Brief exposure to clinical simulation early in medical training and prior to clerkships can have a positive and lasting effecton medical students’ knowledge, confidence, and skil l for selected procedures.


Author(s):  
Kata Eklics ◽  
Eszter Kárpáti ◽  
Robin Valerie Cathey ◽  
Andrew J. Lee ◽  
Ágnes Koppán

Medical communication training is being challenged to meet the demands of a more internationalized world. As a result, interdisciplinary simulation-based education is designed to advance clinical skill development, specifically in doctor-patient interactions. The Standardized Patient Program has been applied in American Medical Schools since the 1960s, implementing patient profiles based on authentic cases. At the University of Pécs, Medical School in Hungary, this model is being adapted to facilitate improving patient-interviewing, problem-solving, and medical reporting skills. The interdisciplinary program operates in Hungarian, German and English languages, utilizing actors to perform as simulated patients under the close observation of medical specialists and linguists. This innovative course is designed to train students to successfully collect patient histories while navigating medical, linguistic, emotional, and socio-cultural complexities of patients. Experts in medicine and language assess student performance, offering feedback and providing individualized training that students might improve their professional and communicative competencies. This paper examines how this interdisciplinary course provides valuable opportunities for more efficient patient-oriented communication practices. Through responding to medical emergencies, miscommunications, and conflicts in a safe environment, medical students prepare to deal with a diverse patient context, that more qualified and empathetic health personnel may be employed throughout clinics worldwide. Keywords: interdisciplinary simulation-based education, doctor-patient interaction, MediSkillsLab, medical history taking, language for specific purposes competencies


2019 ◽  
Author(s):  
Chia-Hui Hung ◽  
Tzu-Hua Ho ◽  
Chen-Yung Lin

Abstract Background Occupational therapy education programs need to produce students who can confidently and safely deliver services for children. The study incorporated a simulation of a real situation into a clinical skill observation of a pediatric occupational therapy curriculum. The purpose of the study was to determine whether situated simulation-based program could increase students’ perceived knowledge and clinical skills to better prepare them for pediatric practice. Methods The authors introduced a situated simulation-based program with video-based simulation training and a situated simulation-based exam during a pediatric occupational therapy course for thirty-two students in their fourth year of study in occupational therapy. The simulation program was two video-based simulation training sessions, tasked students with observing, evaluating and managing the children play. The debriefings were provided to connect student’s observation and basic evaluation skills. A post- simulation performance evaluation, the situated simulation-based exam, was created by faculty. The exam was prepared in a situated simulation therapeutic room was held to assess students’ skills in communication and interaction and basic evaluation skills. The scores of the video-based simulation training and the situated simulation-based exam were collected and examined. Results The video-based simulation scores explained 33.3% of the variance of performance in the situated simulation-based exam. The overall passing rates were as follows: situated simulation-based exam, 65.6%; communication and interaction station, 53.1%; basic evaluation station, 68.8%. Conclusions The video-based simulation training enhanced students’ communication and interaction skills. More relationship building skills were facilitated within the situated simulation-based exam with a real environment. The strategies that assist successful implementation of a situated simulation program to facilitate learning include course plans, clear scenario training goals, evaluation quality, and situated simulation contexts. This study provides preliminary support for simulation-based programs as training for improving the clinical skills of interaction and observation before students’ internships.


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