scholarly journals Simulation-based surgical education for glaucoma versus conventional training alone: the GLAucoma Simulated Surgery (GLASS) trial. A multicentre, multicountry, randomised controlled, investigator-masked educational intervention efficacy trial in Kenya, South Africa, Tanzania, Uganda and Zimbabwe

2021 ◽  
pp. bjophthalmol-2020-318049
Author(s):  
William H Dean ◽  
John Buchan ◽  
Stephen Gichuhi ◽  
Heiko Philippin ◽  
Simon Arunga ◽  
...  
Keyword(s):  
Surgical Education ◽  
Outcome Measurement ◽  
Intervention Group ◽  
Glaucoma Surgery ◽  
Sub Saharan Africa ◽  
Training Intervention ◽  
Control Group ◽  
Simulation Based ◽  
Randomised Controlled ◽  
The Impact

Background/AimGlaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma.MethodsWe designed a randomised controlled, parallel-group trial. Those assessing outcomes were masked to group assignment. Fifty-one trainee ophthalmologists from six university training institutions in sub-Saharan Africa were enrolled by inclusion criteria of having performed no surgical trabeculectomies and were randomised. Those randomised to the control group received no placebo intervention, but received the training intervention after the initial 12-month follow-up period. The intervention was an intense simulation-based surgical training course over 1 week. The primary outcome measure was overall simulation surgical competency at 3 months.ResultsTwenty-five were assigned to the intervention group and 26 to the control group, with 2 dropouts from the intervention group. Forty-nine were included in the final intention-to-treat analysis. Surgical competence at baseline was comparable between the arms. This increased to 30.4 (76.1%) and 9.8 (24.4%) for the intervention and the control group, respectively, 3 months after the training intervention for the intervention group, a difference of 20.6 points (95% CI 18.3 to 22.9, p<0.001). At 1 year, the mean surgical competency score of the intervention arm participants was 28.6 (71.5%), compared with 11.6 (29.0%) for the control (difference 17.0, 95% CI 14.8 to 19.4, p<0.001).ConclusionThese results support the pursuit of financial, advocacy and research investments to establish simulation surgery training units and courses including instruction, feedback, deliberate practice and reflection with outcome measurement to enable trainee glaucoma surgeons to engage in intense simulation training for glaucoma surgery.Trial registration numberPACTR201803002159198.

scholarly journals Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care

2020 ◽  
Author(s):  
Ricard Carrillo Muñoz ◽  
Jose Luis Ballve Moreno ◽  
Ivan Villar Balboa ◽  
Yolanda Rando Matos ◽  
Oriol Cunillera Puertolas ◽  
...  
Keyword(s):  
Primary Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Perceived Disability ◽  
Randomised Controlled ◽  
The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

scholarly journals The Impact of a New Pedagogical Intervention on Nursing Students’ Knowledge Acquisition in Simulation-Based Learning: A Quasi-Experimental Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Thor Arne Haukedal ◽  
Inger Åse Reierson ◽  
Hanne Hedeman ◽  
Ida Torunn Bjørk
Keyword(s):  
Experimental Study ◽  
Nursing Students ◽  
Intervention Group ◽  
Control Group ◽  
Theoretical Knowledge ◽  
Knowledge Test ◽  
Patient Deterioration ◽  
Simulation Based ◽  
Quasi Experimental ◽  
The Impact

Simulation-based learning is an effective technique for teaching nursing students’ skills and knowledge related to patient deterioration. This study examined students’ acquisition of theoretical knowledge about symptoms, pathophysiology, and nursing actions after implementing an educational intervention during simulation-based learning. A quasi-experimental study compared theoretical knowledge among two groups of students before and after implementation of the intervention. The intervention introduced the following new components to the existing technique: a knowledge test prior to the simulation, video-recording of the performance, and introduction of a structured observation form used by students and facilitator during observation and debriefing. The intervention group had significantly higher scores on a knowledge test conducted after the simulations in comparison to the scores in the control group. In both groups scores were highest on knowledge of symptoms and lowest on knowledge of pathophysiology; the intervention group had significantly higher scores than the control group on both topics. Students’ theoretical knowledge of patient deterioration may be enhanced by improving the students’ prerequisites for learning and by strengthening debriefing after simulation.

scholarly journals Rational and Design of the SIMULATOR Study: A Multicentre Randomized Study to Assess the Impact of SIMULation-bAsed Training on Transoesophageal echocardiOgraphy leaRning for Cardiology Residents

2021 ◽  
Vol 8 ◽  
Author(s):  
Théo Pezel ◽  
Anne Bernard ◽  
Yoan Lavie Badie ◽  
Julien Dreyfus ◽  
Etienne Audureau ◽  
...  
Keyword(s):  
Randomized Study ◽  
Intervention Group ◽  
Medical Residents ◽  
Control Group ◽  
Traditional Teaching ◽  
Single Center ◽  
Simulation Based ◽  
Simulator Study ◽  
And Performance ◽  
The Impact

Introduction: Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. To assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology.Materials and Methods: Nationwide prospective randomized multicenter study involving 43 centers throughout France allowing for the inclusion of &gt;70% of all French cardiology residents. All cardiology residents naive from TEE will be included. Randomization with stratification by center will allocate residents to either a control group receiving theoretical knowledge by e-learning only, or to an intervention group receiving two simulation-based training sessions on a TEE simulator in addition.Results: All residents will undergo both a theoretical test (0–100 points) and a practical test on a TEE simulator (0–100 points) before and 3 months after the training. Satisfaction will be assessed by a 5-points Likert scale. The primary outcomes will be to compare the scores in the final theoretical and practical tests between the two groups, 3 months after the completion of the training.Conclusion: Data regarding simulation-based learning in TEE are limited to non-randomized or single-center studies. The randomized multicenter SIMULATOR study will assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology, and whether such an educational program should be proposed in first line for TEE teaching.

Impact of convex ostomy appliances on leakage frequency, peristomal skin health and stomal protrusion

2021 ◽  
Vol 19 (Sup9) ◽  
pp. S30-S37
Author(s):  
Eugenia Rodriguez González ◽  
Carmen del Pino Zurita ◽  
Gemma Arrontes Caballero ◽  
Araceli Hoyo Rodríguez ◽  
Eugenia Zapatero Rodríguez ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Anova Analysis ◽  
Independent Variables ◽  
Peristomal Skin ◽  
Randomised Controlled ◽  
The Impact

Aim: The Convexity in Ostomy (ECOS) study measured the impact of soft convex ostomy appliances on leakage frequency, peristomal skin health, and patient satisfaction, as well as stomal protrusion and body profile. Methods: This prospective non-randomised controlled trial included people with a stoma, divided into a control group using a convex appliance throughout (Alterna Confort Convex or Easiflex Confort Convex Light, Coloplast A/S, Humlebæk, Denmark), and an intervention group who were using a flat appliance at baseline before switching to a convex appliance for the rest of the study. Leakage frequency was counted within the past 2 weeks; peristomal skin health was assessed using the discolouration, erosion and tissue overgrowth (DET) Ostomy Skin Tool; and patient satisfaction was measured with a 0-10 Likert scale of self-reported satisfaction with the appliance. Measurements were taken at three visits: baseline (V1), 2-8 weeks (V2) and 6 months (V3). The Kruskal-Wallis and analysis of variance (ANOVA) tests were used for comparison. Multiple regression analysis was used to evaluate the effect of independent variables on the change in leakage frequency and DET score between baseline and 6 months. Findings: Of 253 participants screened, 245 completed the follow-up, with 151 in the intervention group and 94 in the control group. Mean leakage frequency period went from 5.85 ± 5.55 (V1) to 0.63 ± 1.42 (V2) and 0.23 ± 0.75 (V3) (p<.0001). Mean DET score changed from 4.8 ± 3.47 (V1) to 1.41 ± 2.17 (V2) and 0.54 ± 1.57 (V3) (p<.0001). Mean satisfaction changed from 6.0 ± 2.25 (V1) to 8.6 ± 1.14 (V2) and 9.17 ± 0.93 (V3) (p<.0001). From V1 to V3, the proportion of patients with a depressed peristomal area went from 45.7% to 31.4%, a normal peristomal area went from 45.3% to 65.3%, stoma protrusion went from 31.4% to 47.3% and stoma retraction went from 28.6% to 15.5%. By group, mean leakage frequency decreased in the intervention group by 7.65, from 7.57 to 0.11, and in the control group by 2.37, from 2.94 to 0.46 (p<0.0001). Multiple ANOVA analysis confirmed independent variables in reducing leakage to be initiating convexity and appliance coupling. By group, mean DET score decreased in the intervention group by 4.82, from 5.24 to 0.42, and in the control group by 3.52, from 4.34 to 0.76. Multiple ANOVA analysis showed independent variables for DET score to be initiating convexity, emergency surgery and stoma siting. Conclusion: People with a stoma experiencing repeated leakage benefitted from shifting from a flat to a soft convex appliance in terms of leakage frequency, peristomal skin health, stomal protrusion and body profile.

scholarly journals Effect of an editorial intervention to improve the completeness of reporting of randomised trials: a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036799 ◽  
Author(s):  
David Blanco ◽  
Sara Schroter ◽  
Adrian Aldcroft ◽  
David Moher ◽  
Isabelle Boutron ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Peer Review ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Randomised Trials ◽  
Randomised Controlled ◽  
The Impact ◽  
Completeness Of Reporting

ObjectiveTo evaluate the impact of an editorial intervention to improve completeness of reporting of reports of randomised trials.DesignRandomised controlled trial (RCT).SettingBMJ Open’s quality improvement programme.Participants24 manuscripts describing RCTs.InterventionsWe used an R Shiny application to randomise manuscripts (1:1 allocation ratio, blocks of 4) to the intervention (n=12) or control (n=12) group. The intervention was performed by a researcher with expertise in the content of the Consolidated Standards of Reporting Trials (CONSORT) and consisted of an evaluation of completeness of reporting of eight core CONSORT items using the submitted checklist to locate information, and the production of a report containing specific requests for authors based on the reporting issues found, provided alongside the peer review reports. The control group underwent the usual peer review.OutcomesThe primary outcome is the number of adequately reported items (0–8 scale) in the revised manuscript after the first round of peer review. The main analysis was intention-to-treat (n=24), and we imputed the scores of lost to follow-up manuscripts (rejected after peer review and not resubmitted). The secondary outcome is the proportion of manuscripts where each item was adequately reported. Two blinded reviewers assessed the outcomes independently and in duplicate and solved disagreements by consensus. We also recorded the amount of time to perform the intervention.ResultsManuscripts in the intervention group (mean: 7.01; SD: 1.47) were more completely reported than those in the control group (mean: 5.68; SD: 1.43) (mean difference 1.43, 95% CI 0.31 to 2.58). We observed the main differences in items 6a (outcomes), 9 (allocation concealment mechanism), 11a (blinding) and 17a (outcomes and estimation). The mean time to perform the intervention was 87 (SD 42) min.ConclusionsWe demonstrated the benefit of involving a reporting guideline expert in the editorial process. Improving the completeness of RCTs is essential to enhance their usability.Trial registration numberNCT03751878.

scholarly journals Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Rebecca Hibbs ◽  
Nicholas Magill ◽  
Elizabeth Goddard ◽  
Charlotte Rhind ◽  
Simone Raenker ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Patient Treatment ◽  
Training Intervention ◽  
Randomised Controlled ◽  
The Impact

BackgroundFamilies express a need for information to support people with severe anorexia nervosa.AimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.MethodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.ResultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.ConclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.

scholarly journals Nutrition Education Impact on Nutrition Knowledge, Attitude and Practice of Schoolchildren: A Pilot Study in Ghana

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1287-1287
Author(s):  
Janet Antwi
Keyword(s):  
Nutrition Education ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Nutrition Knowledge ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Nutrition Status ◽  
Control Group ◽  
Positive Effects ◽  
The Impact

Abstract Objectives Malnutrition among children, and adolescents remains a crucial public health concern in sub-Saharan Africa. Nutrition education contributes to acquisition of nutrition knowledge, attitude, and practices (KAP) which may lead to improved nutrition status and health, and brings greatest benefits to the poor and the most vulnerable particularly school-age children (SAC). We evaluated the impact of a 6-week nutrition education intervention on nutrition KAP, and nutrition status of SAC. The effect of nutrition education training on the knowledge of teachers and caregivers was also evaluated. Methods Pretest-posttest controlled design was used in elementary schools in Ghana. A total of 325 SAC 6–12 years old, 6 teachers and 99 caregivers completed the study. Nutrition KAP were estimated using a standardized questionnaire. Nutrition status was calculated using height and weight measurements. Results Schoolchildren in the intervention group had significantly higher knowledge scores (8.8 ± 2.0 vs. 5.9 ± 2.1, P &lt; 0.0001) compared to controls in lower elementary level. The attitude of children in learning about food and nutrition issues was a higher proportion in the intervention group as compared to control group (88% vs. 77%, P = 0.031). Dietary diversity score did not differ significantly between intervention and control groups (4.8 ± 2.0 vs. 5.1 ± 1.4, P = 0.184). Intervention group had a marginally lower proportion of stunted SAC at the end of the study period as compared to control group (3.6% vs. 8.2%, P = 0.080). The nutrition knowledge of teachers, and caregivers significantly improved (12.5 ± 1.87 vs. 9.2 ± 2.1; P = 0.031) and (5.85 ± 0.73 to 6.29 ± 1.02, P = 0.009), respectively. Conclusions Nutrition education could have positive effects for passing on nutrition knowledge, and attitudes to elementary school children which are essential to developing healthy behaviors, and managing nutrition status. Funding Sources This study was funded by the Institute of International Education with award of the Carnegie African Diaspora Fellowship Program.

scholarly journals Protocol for a randomised controlled trial on the feasibility and effects of 10-hour time-restricted eating on cardiometabolic disease risk among career firefighters doing 24-hour shift work: the Healthy Heroes Study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045537
Author(s):  
Emily N C Manoogian ◽  
Adena Zadourian ◽  
Hannah C Lo ◽  
Nikko R Gutierrez ◽  
Azarin Shoghi ◽  
...  
Keyword(s):  
Disease Risk ◽  
Light Exposure ◽  
Intervention Group ◽  
Cardiometabolic Disease ◽  
Calorie Intake ◽  
Control Group ◽  
Biological Studies ◽  
Disease Risks ◽  
Randomised Controlled ◽  
The Impact

Introduction Career firefighters experience chronic circadian rhythm disruption, increasing their risk of cardiometabolic disease. The recent discovery that eating patterns regulate circadian rhythmicity in metabolic organs has raised the hypothesis that maintaining a consistent daily cycle of eating and fasting can support circadian rhythms and reduce disease risks. Preclinical animal studies and preliminary clinical trials have shown promising effects of time-restricted eating (TRE) to reduce disease risk without compromising physical performance. However, there is a lack of research on TRE in shift workers including firefighters. This study aims to investigate the feasibility and efficacy of 10-hour TRE on health parameters that contribute to cardiometabolic disease risks among career firefighters who work on a 24-hour shift schedule. Methods and analyses The Healthy Heroes Study is a randomised controlled parallel open-label clinical trial with 150 firefighters over 1 year. Firefighters are randomised with a 1:1 ratio to either the control or intervention group. The control group receives Mediterranean diet nutritional counselling (standard of care, ‘SOC’). The intervention group receives the same SOC and a self-selected 10-hour TRE window. After the 2-week baseline, participants enter a 3-month monitored intervention, followed by a 9-month self-guided period with follow-up assessments. The impact of TRE on blood glucose, body weight, body composition, biomarkers (neuroendocrine, inflammatory and metabolic), sleep and mood is evaluated. These assessments occur at baseline, at the end of intervention and at 6, 9 and 12-month follow-ups. Temporal calorie intake is monitored with the smartphone application myCircadianClock throughout the study. Continuous glucose monitors, wrist-worn actigraphy device and questionnaires are used to monitor glucose levels, activity, sleep and light exposure. Ethics and dissemination The study was approved by the Institutional Review Boards of the University of California San Diego and the Salk Institute for Biological Studies. Results will be disseminated through peer-reviewed manuscripts, reports and presentations. Trial registration number NCT03533023; Pre result.

scholarly journals Medical Emergency Management in the Dental Office (MEMDO): A Pilot Study Assessing a Simulation-Based Training Curriculum for Dentists

2021 ◽  
Vol 68 (2) ◽  
pp. 76-84
Author(s):  
Jesse W. Manton ◽  
Kelly S. Kennedy ◽  
Jonathan A. Lipps ◽  
Sheryl A. Pfeil ◽  
Bryant W. Cornelius
Keyword(s):  
Pilot Study ◽  
Emergency Preparedness ◽  
Intervention Group ◽  
Medical Emergency ◽  
Control Group ◽  
Standard Curriculum ◽  
Dental Office ◽  
Simulation Based ◽  
Medical Emergencies ◽  
The Impact

In the event of a medical emergency in the dental office, the dentist must be able to identify a patient in distress, assess the situation, and institute proper management. This study assessed the impact of a simulation-based medical emergency preparedness curriculum on a resident's ability to manage medical emergencies. This interventional and pre-post educational pilot study included 8 participants who completed a standard curriculum and 8 who completed a modified curriculum (N = 16). The intervention consisted of a comprehensive medical emergency preparedness curriculum that replaced lecture sessions in a standard curriculum. Participants completed performance assessments using scenario-based objective structured clinical examinations (OSCEs) that were recorded and evaluated by calibrated faculty reviewers using a customized scoring grid. The intervention group performed significantly better than the control group on their summative OSCEs, averaging 90.9 versus 61.2 points out of 128 (p = .0009). All participants from the intervention group passed their summative OSCE with scores &gt;60%, while none from the control group received passing scores. Completion of a simulation-based medical emergency preparedness curriculum significantly improved resident performance during simulated medical emergencies.

scholarly journals Design and evaluation of a simulated wound management course for postgraduate year one surgery residents

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11104
Author(s):  
Xin Qi ◽  
Rui He ◽  
Bing Wen ◽  
Qiang Li ◽  
Hongbin Wu
Keyword(s):  
Outcome Measurement ◽  
Subcutaneous Tissue ◽  
Mastery Learning ◽  
Intervention Group ◽  
Resident Training ◽  
Wound Management ◽  
Control Group ◽  
Process Measurement ◽  
Simulation Based ◽  
Quasi Experimental

Background It is vital to cover wound management knowledge and operations in the early stages of resident training. With this in mind, a simulated wound management course for postgraduate year one surgery residents (PGY1s) was designed and its effectiveness was evaluated. Methods A retrospective quasi-experimental method was used. PGY1s in 2014 constituted the control group, and PGY1s in 2015 and 2016 constituted the intervention group. The course given to the control group comprised didactic teaching followed by deliberate practice plus immediate personalized feedback. The newly designed course given to the intervention group was reconstructed and disassembled into four components according to the simulation-based mastery learning model, which were baseline test, interactive learning, basic skills practice, and reflective learning. The same performance assessments were used in the control and intervention group, including process measurement and outcome measurement. Results The process measurement showed that the intervention group’s scores were significantly higher in the “dissociation of subcutaneous tissue” and “quality of suturing and knots”. The outcome measurement showed that the accuracy of debridement was greatly improved and both key and total suture numbers were significantly higher in the intervention group. Conclusions Simulation-based mastery learning was incorporated into our proposed course framework, promoting the learning outcome of PGY1s. It has the potential to be adapted for other surgical training sites for residents in China.

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