scholarly journals Evaluation of Heart Rate Assessment Timing, Communication, Accuracy, and Clinical Decision-Making during High Fidelity Simulation of Neonatal Resuscitation

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Win Boon ◽  
Jennifer McAllister ◽  
Mohammad A. Attar ◽  
Rachel L. Chapman ◽  
Patricia B. Mullan ◽  
...  
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Neonatal Intensive Care ◽  
Clinical Decision Making ◽  
Neonatal Resuscitation ◽  
Clinical Decision ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Chi Square ◽  
Chi Square Analysis

Objective. Accurate heart rate (HR) determination during neonatal resuscitation (NR) informs subsequent NR actions. This study’s objective was to evaluate HR determination timeliness, communication, and accuracy during high fidelity NR simulations that house officers completed during neonatal intensive care unit (NICU) rotations.Methods. In 2010, house officers in NICU rotations completed high fidelity NR simulation. We reviewed 80 house officers’ videotaped performance on their initial high fidelity simulation session, prior to training and performance debriefing. We calculated the proportion of cases congruent with NR guidelines, using chi square analysis to evaluate performance across HR ranges relevant to NR decision-making: <60, 60–99, and ≥100 beats per minute (bpm).Results. 87% used umbilical cord palpation, 57% initiated HR assessment within 30 seconds, 70% were accurate, and 74% were communicated appropriately. HR determination accuracy varied significantly across HR ranges, with 87%, 57%, and 68% for HR <60, 60–99, and ≥100 bpm, respectively (P<0.001).Conclusions. Timeliness, communication, and accuracy of house officers’ HR determination are suboptimal, particularly for HR 60–100 bpm, which might lead to inappropriate decision-making and NR care. Training implications include emphasizing more accurate HR determination methods, better communication, and improved HR interpretation during NR.

scholarly journals The use of multiple-criteria decision-making theory to measure students’ perceptions of high-fidelity simulation

2017 ◽  
Vol 3 (3) ◽  
pp. 88-93 ◽  
Author(s):  
Maureen Anne Jersby ◽  
Paul Van-Schaik ◽  
Stephen Green ◽  
Lili Nacheva-Skopalik
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Repeated Measures ◽  
Clinical Decision Making ◽  
Learning Experience ◽  
Clinical Decision ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Initial Exposure ◽  
Repeated Measures Design

BackgroundHigh-Fidelity Simulation (HFS) has great potential to improve decision-making in clinical practice. Previous studies have found HFS promotes self-confidence, but its effectiveness in clinical practice has not been established. The aim of this research is to establish if HFS facilitates learning that informs decision-making skills in clinical practice using MultipleCriteria DecisionMaking Theory (MCDMT).MethodsThe sample was 2nd year undergraduate pre-registration adult nursing students.MCDMT was used to measure the students’ experience of HFS and how it developed their clinical decision-making skills. MCDMT requires characteristic measurements which for the learning experience were based on five factors that underpin successful learning, and for clinical decision-making, an analytical framework was used. The study used a repeated-measures design to take two measurements: the first one after the first simulation experience and the second one after clinical placement. Baseline measurements were obtained from academics. Data were analysed using the MCDMT tool.ResultsAfter their initial exposure to simulation learning, students reported that HFS provides a high-quality learning experience (87%) and supports all aspects of clinical decision-making (85%). Following clinical practice, the level of support for clinical decision-making remained at 85%, suggesting that students believe HFS promotes transferability of knowledge to the practice setting.ConclusionOverall, students report a high level of support for learning and developing clinical decision-making skills from HFS. However, there are no comparative data available from classroom teaching of similar content so it cannot be established if these results are due to HFS alone.

Effect of high fidelity simulation on clinical decision-making among nursing students

2021 ◽  
pp. 1-9
Author(s):  
Ahmad Ayed ◽  
Malakeh Z. Malak ◽  
Rsmieh M. Alamer ◽  
Ahmad Batran ◽  
Basma Salameh ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
High Fidelity ◽  
High Fidelity Simulation

scholarly journals SP2.2.9Using high fidelity simulation to improve hospital-based medical student education

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Marc Huttman ◽  
Hui Fen Koo ◽  
Charlotte Boardman ◽  
Michael Saunders
Keyword(s):  
Medical Students ◽  
Clinical Decision Making ◽  
Medical Student Education ◽  
District General Hospital ◽  
Clinical Decision ◽  
Free Text ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Qualitative Feedback ◽  
Before And After

Abstract Introduction The evidence shows that experiential learning has multiple benefits in preparing medical students for foundation training. An immersive ‘on call simulation’ session was designed for final-year medical students at a district general hospital. The aim of this project was to assess how beneficial the sessions were and how they can be improved. Methods Pairs of students received 12 bleeps over 2 hours directing them to wards where mock patient folders were placed. Students prioritised bleeps involving deteriorating patients, chasing results and dealing with nursing queries. Simulated senior input was available from the session facilitator. A structured debrief session allowed discussion of each case. Quantitative feedback was gathered using a sliding scale (measured in percentage) for confidence before and after the session. Qualitative feedback was gathered using a free-text box. Results Four sessions were held between October 2020 and January 2021 for a total of 28 students, of which 26 provided feedback. Average confidence increased from 38% to 66%. 96% of students were ‘extremely satisfied’ with the session. Feedback included: “Incredibly immersive and fun” and “I was made to think through my priorities and decisions”. Improvements could be made by using actors/mannequins to simulate unwell patients and by use of skills models. Conclusion High fidelity simulation training is valuable and should be considered a standard part of the student curriculum. It is particularly suited to final year students who have the required clinical knowledge for foundation training but are still developing confidence in clinical decision making and prioritisation.

scholarly journals Use of EHR-based simulation to diagnose aetiology of information gathering issues in struggling learners: a proof of concept study

2017 ◽  
Vol 4 (2) ◽  
pp. 92-94 ◽  
Author(s):  
Vishnu Mohan ◽  
Gretchen Scholl ◽  
Jeffrey A Gold
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Large Fraction ◽  
Clinical Information ◽  
Clinical Decision ◽  
Information Gathering ◽  
High Fidelity ◽  
Struggling Learners ◽  
Effective Decision Making ◽  
Main Component

Learners who struggle with clinical decision making are often the most challenging to identify and remediate. While for some learners, struggles can be directly traced to a poor knowledge base, for many others, it is more difficult to understand the reason for their struggles. One of the main component of effective decision making is access to accurate and complete clinical information. The electronic health record (EHR) is the main source of clinical information and, with its widespread adoption, has come increased realisation that a large fraction of users have difficulty in effectively gathering and subsequently processing information out of the EHR. We previously documented that high-fidelity EHR-based simulation improves EHR usability and, when combined with eye and screen tracking, generates important measures of usability. We hypothesised that the same simulation exercise could help distinguish whether learners had difficulty in knowledge, information gathering or information processing. We report the results of the first three struggling learners who participated in this exercise. In each case, the simulation was able to ‘diagnose’ the aetiology for the learners’ struggle and assist in formulating an appropriate solution. We suggest that high-fidelity EHR-based simulation can be a powerful tool in the standard approach to understanding struggling learners.

scholarly journals Clinical Decision Making of Nurses Working in Hospital Settings

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Ida Torunn Bjørk ◽  
Glenys A. Hamilton
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Continuum Theory ◽  
Clinical Decision ◽  
Further Education ◽  
Time Data ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Rational Models

This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies,t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

scholarly journals Enhancing Nurse and Physician Collaboration in Clinical Decision Making Through High-fidelity Interdisciplinary Simulation Training

2011 ◽  
Vol 86 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Pamela M. Maxson ◽  
Eric J. Dozois ◽  
Stefan D. Holubar ◽  
Diane M. Wrobleski ◽  
Joyce A. Overman Dube ◽  
...  
Keyword(s):  
Decision Making ◽  
Simulation Training ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
High Fidelity
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