Simulation of childbirth improves clinical management capacity and self-confidence in medical students

Background The learning process of physiological mechanisms of childbirth and its management are important elements in the education of medical students. In this study, we verify how the use of a high-fidelity simulator of childbirth improves competence of students in this regard.Methods A total of 132 medical students were recruited for the study in order to attend a physiological childbirth in a no-hospital environment after being assigned to two groups. The control group received only a normal cycle of lectures, while the simulation (SIM) group followed a specific training session on the simulator. Subsequently, both groups were assessed for their technical and non-technical skills in a simulated childbirth. Also, a self-assessment test regarding their self-confidence was administrated before and after simulation, and repeated after 8 weeks.Results The SIM group showed better performance in all the domains with a better comprehension of the mechanisms of childbirth, managing and assistance of labour and delivery. In addition, compared to the control group, they presented a better self-related awareness and self-assurance regarding the possibility of facing a birth by themselves.Conclusion The present study demonstrated that the use of a high-fidelity simulator for medical students allows a significant improvement in the acquisition of theoretical and technical expertise to assist a physiological birth.

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The Flipped Classroom Is Effective for Medical Students to Improve Deep Tendon Reflex Examination Skills: A Mixed-Method Study

10.21203/rs.3.rs-139775/v1 ◽

2021 ◽

Author(s):

Shun Uchida ◽

Kiyoshi Shikino ◽

Kosuke Ishizuka ◽

Yosuke Yamauchi ◽

Yasutaka Yanagita ◽

...

Keyword(s):

Medical Students ◽

Flipped Classroom ◽

Deep Tendon Reflex ◽

Intervention Group ◽

General Medicine ◽

Likert Scale ◽

University Hospital ◽

Control Group ◽

Self Confidence ◽

Before And After

Abstract Background: Deep tendon reflexes (DTR) are a prerequisite skill in clinical clerkships. However, many medical students are not confident in their technique and need to be effectively trained. We evaluated the effectiveness of a flipped classroom for teaching DTR skills. Methods: We recruited 83 fifth-year medical students who participated in a clinical clerkship at the Department of General Medicine, Chiba University Hospital, from November 2018 to July 2019. They were allocated to the flipped classroom technique (intervention group, n=39) or the traditional technique instruction group (control group, n=44). Before procedural teaching, while the intervention group learned about DTR by e-learning, the control group did so face-to-face. A 5-point Likert scale was used to evaluate self-confidence in DTR examination before and after the procedural teaching (1=no confidence, 5=confidence). We evaluated the mastery of techniques after procedural teaching using the Direct Observation of Procedural Skills (DOPS). Unpaired t-test was used to analyze the results of the 5-point Likert scale and DOPS. We assessed self-confidence in DTR examination before and after procedural teaching using a free description questionnaire in the two groups. Additionally, in the intervention group, focus group interviews (FGI) (7 groups, n=39) were conducted to assess the effectiveness of the flipped classroom after procedural teaching.Results: Pre-test self-confidence in the DTR examination was significantly higher in the intervention group than in the control group (2.8 vs. 2.3, P=0.005). Post-test self-confidence in the DTR examination was not significantly different between the two groups (3.9 vs. 4.1, P=0.31), and so was mastery (4.3 vs. 4.1, P=0.68). The questionnaires before the procedural teaching revealed themes common to the two groups, including “lack of knowledge” and “lack of self-confidence.” Themes about prior learning, including “acquisition of knowledge” and “promoting understanding,” were specific in the intervention group. The FGI revealed themes including “application of knowledge,” “improvement in DTR technique,” and “increased self-confidence.” Conclusions: Teaching DTR skills to medical students in flipped classrooms improves readiness for learning and increases self-confidence in performing the procedure at a point before procedural teaching.

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Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/9251849 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Lona Prasad ◽

Aneesha Varrey ◽

Giovanni Sisti

Keyword(s):

Medical Students ◽

Perceived Stress ◽

Well Being ◽

Self Assessment ◽

Self Confidence ◽

Stress Levels ◽

Before And After ◽

Survey Results ◽

Personal Wellbeing ◽

Reducing Stress

Objective. To determine the effect of six weeks of yoga and meditation on medical students’ levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students’ written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs–32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p=0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.

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Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0231 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Enkhtsogt Sainbayar ◽

Nathan Holt ◽

Amber Jacobson ◽

Shalini Bhatia ◽

Christina Weaver

Keyword(s):

Medical Students ◽

Intervention Group ◽

Training Session ◽

Likert Scale ◽

Control Group ◽

First Year ◽

Hemorrhage Control ◽

Term Retention ◽

Long Term Retention

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

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PETTLEP imagery and tennis service performance: an applied investigation

Journal of Imagery Research in Sport and Physical Activity ◽

10.1515/jirspa-2019-0013 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Nafih Cherappurath ◽

Masilamani Elayaraja ◽

Dilshith A. Kabeer ◽

Amila Anjum ◽

Paris Vogazianos ◽

...

Keyword(s):

Age Groups ◽

Training Session ◽

Performance Outcomes ◽

Service Performance ◽

Control Group ◽

Specific Training ◽

Tennis Players ◽

Imagery Training ◽

Before And After ◽

Junior Tennis

AbstractTennis is one of the most popular and widely played sports enjoyed by players of different age groups and genders as a profession as well as a mode of recreation. A novel method, PETTLEP imagery combines both conventional and non-conventional style of training of an athlete and improves one’s performance. This study aimed to analyze the tennis service performance of junior tennis players based on PETTLEP imagery training. Forty-four junior male tennis players (Mage=13.22 years, SD=0.42) were selected for the study. The investigator handed over the MIQ-R questionnaire to all the participants in which they scored 16 and above points as per previous research. The participants were equally divided (n=11) into three experimental groups (E1, E2, and E3) and a control group. The service performance outcomes of all the players were compared before and after a training session. The three experimental groups were assigned with service-specific training, service-specific training combined with PETTLEP imagery training, and PETTLEP imagery training alone, respectively, for three days per week for 12 weeks. They were tested on their service accuracy based on the International tennis number (ITN) manual on-court assessment test. The data were assessed for normality and analyzed using non-parametric methods to reveal main effects (each training method alone) as well as to calculate the combined effect of PETTLEP and service-specific training. Certain significant improvements in tennis service were observed with service-specific training alone. Though it marginally outperformed the PETTLEP imagery method, the most improved services were observed with both PETTLEP and service-specific training utilized together. This implies an additive effect when both methods are used together.

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Simulation-based Training for Pelvic and Breast Physical Examination: Effect on the Anxiety and Self-confidence of Medical Students

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1718433 ◽

2020 ◽

Vol 42 (11) ◽

pp. 739-745

Author(s):

Talles Dias Orsi ◽

Ana Lucia Ribeiro Valadares ◽

Paula Miranda Esteves Orsi ◽

Isabella Miranda Esteves Orsi ◽

Alexandre Sampaio Moura

Keyword(s):

Medical Students ◽

Self Report ◽

Student Anxiety ◽

Factors Associated ◽

Confidence Levels ◽

Learning Satisfaction ◽

Self Confidence ◽

Breast Examination ◽

Simulation Based ◽

Before And After

Abstract Objective To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination. Methods A longitudinal study was conducted with 4th year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated. Results Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; p < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; p < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders. Conclusion The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.

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Stress of nursing students in clinical simulation: a randomized clinical trial

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2017-0187 ◽

2018 ◽

Vol 71 (3) ◽

pp. 967-974 ◽

Cited By ~ 6

Author(s):

Radamés Boostel ◽

Jorge Vinícius Cestari Felix ◽

Carina Bortolato-Major ◽

Edivane Pedrolo ◽

Stela Adami Vayego ◽

...

Keyword(s):

Clinical Trial ◽

Nursing Students ◽

Randomized Clinical Trial ◽

Interpersonal Relationships ◽

Control Group ◽

High Fidelity ◽

Clinical Simulation ◽

Skill Laboratory ◽

Before And After ◽

Experimental Group

ABSTRACT Objective: To evaluate and compare the perception of stressors by nursing students before and after a high-fidelity clinical simulation or conventional laboratory practice class. Method: This is a randomized clinical trial conducted with 52 nursing students. Both groups had theoretical classes about cardiothoracic physical examination, followed by practice class in skill laboratory. In addition, the experimental group took part in a high-fidelity simulation scenario. Stressors were evaluated before and after class, with the application of KEZKAK questionnaire. Results: The experimental group was significantly more worried about six factors related to lack of competence and to interpersonal relationships (p < 0.05), while the control group was significantly more worried about being in contact with suffering (p = 0.0315). Conclusion: The simulation affects students’ perception of stressors and promotes their self-evaluation and critical thinking regarding the responsibility that comes with their learning.

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Immunization competence retention in medical students: a comparation between conventional lectures and lectures with simulations method

Paediatrica Indonesiana ◽

10.14238/pi55.6.2015.339-44 ◽

2016 ◽

Vol 55 (6) ◽

pp. 339 ◽

Cited By ~ 1

Author(s):

Hartono Gunadi ◽

Rini Sekartini ◽

Retno Asti Werdhani ◽

Ardi Findyartini ◽

Muhammad Arvianda Kevin Kurnia

Keyword(s):

Experimental Study ◽

Medical Students ◽

Medical School ◽

Intervention Group ◽

Control Group ◽

Vaccine Preventable Diseases ◽

Before And After ◽

Quasi Experimental

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.

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Effects of high-fidelity simulation education on medical students’ anxiety and confidence

PLoS ONE ◽

10.1371/journal.pone.0251078 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251078

Author(s):

Ji Hye Yu ◽

Hye Jin Chang ◽

Soon Sun Kim ◽

Ji Eun Park ◽

Wou Young Chung ◽

...

Keyword(s):

Clinical Practice ◽

Medical Students ◽

Patient Care ◽

Clinical Setting ◽

Clinical Performance ◽

High Fidelity ◽

High Fidelity Simulation ◽

Simulation Education ◽

Before And After ◽

Care Situation

Introduction Psychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students. Materials and methods This study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students’ level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience. Results Students had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience. Conclusions We confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

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Development and Evaluation of an Objective Tympanic Membrane Visualization Assessment Technique

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420912438 ◽

2020 ◽

Vol 129 (8) ◽

pp. 767-771 ◽

Cited By ~ 1

Author(s):

Amir A. Hakimi ◽

Simon P. Lalehzarian ◽

Aaron S. Lalehzarian ◽

Ariel M. Azhdam ◽

Benjamin D. Boodaie ◽

...

Keyword(s):

Medical Students ◽

Tympanic Membrane ◽

Low Cost ◽

Training Session ◽

Standardized Patients ◽

First Year ◽

First Year Students ◽

Before And After ◽

Cohort Groups ◽

Tympanic Membranes

Objectives: To introduce an inexpensive method for objectively evaluating otoscopic visualization of the tympanic membrane wherein learners match what they visualize in standardized patients to tympanic membrane photographs. Methods: Two standardized patients had photographs taken of their tympanic membranes using a commercially-available digital otoscope. First- and third-year medical students were asked to perform an otoscopic examination on each patient using a conventional handheld otoscope and to match what they saw with the correct tympanic membrane image among distractor photographs belonging to other patients. The ability of students to match the standardized patients’ tympanic membrane to the correct photographs was assessed before and after a didactic training session. These measurements were compared between the two cohort groups for construct validity. Results: Fifty-one first-year medical students (with no previous otoscopy experience) and 44 third-year medical students (with otoscopy experience from completing pediatric and family medicine clinical clerkships) were recruited to voluntarily participate in this study. At baseline, a larger percentage of third-year students correctly matched both tympanic membranes compared to first-year students (27% vs 8%, P < .01). After otoscopy training, correct matching of both tympanic membranes significantly improved among both first-year students (8-31%, P < .01) and third-year students (27-54%, P < .01). Conclusion: The use of tympanic membrane photographs from standardized patients provides a novel technique for objectively assessing proficiency in otoscopic visualization of the middle ear. The concept is low cost, uses live patients, and can be easily implemented in pre-clinical instruction and beyond.

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LO83: Quick Refresher Sessions (QRS): improving chest compression training for medical students

CJEM ◽

10.1017/cem.2019.125 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S37-S38

Author(s):

A. Cormier ◽

E. Brennan

Keyword(s):

Medical Students ◽

Real Time ◽

Test Performance ◽

Training Session ◽

Individual Performance ◽

Comfort Level ◽

Secondary Outcome ◽

Control Group ◽

Skill Maintenance ◽

Training Interval

Innovation Concept: High-quality cardiopulmonary resuscitation saves lives; however, current certification standards can leave providers poorly prepared to perform effective chest compressions (CCs). We designed a training program based on the emerging model of skill maintenance through frequent short practice sessions. The ideal frequency of training is currently unknown. Our goal was to provide medical students with access to efficient and effective CC training and to determine an optimal training interval. Methods: Thirty-six second-year medical students were randomized to three groups that trained at different frequencies: once every two months (q2m) (n = 12), once every four months (q4m) (n = 13), and control (n = 11). Study duration was eight months with the intervention groups, q2m and q4m, participating in five and three sessions respectively. The control group was assessed at study start and end, receiving no training in between. At each session, participants completed a one-minute pre-test of CC performance, viewed a one-minute training video, practiced CCs for two minutes with real-time feedback, and completed a one-minute post-test. Performance parameters measured were CC depth, rate, release, and hand positioning. A final “compression score” assessed integrated performance across these parameters and served as our primary outcome. Participants also reported pre- and post-training comfort with performing CCs which served as our secondary outcome. Curriculum, Tool or Material: Our “Quick Refresher Sessions” (QRS) were completed by participants independently without requiring an assessor or facilitator. A manikin with the ability to record and provide real-time quantitative feedback on CC quality was connected to a laptop running a customized interface. Participants typed in an individualized code and were guided through their six-minute sessions automatically. Conclusion: Immediately following the first training session, subjects had significant improvement in compression score (p < 0.001) and skill comfort (p < 0.001). At eight months, both intervention groups, q2m and q4m, achieved higher compression scores than control (p = 0.001 and p = 0.011) and showed greater increase in comfort level (p = 0.002 and p = 0.010). Performance between intervention groups at eight months was not statistically different. Overall, we conclude that independent QRS training every two or four months led to improved CC quality and provider comfort. Future directions include increasing sample size and tailoring training intervals to individual performance.

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