scholarly journals Effectiveness of simulation-based training for obstetric internal medicine: Impact of cognitive load and emotions on knowledge acquisition and retention

2021 ◽  
pp. 1753495X2110119
Author(s):  
Kelle D Hurd ◽  
Meghan EO Vlasschaert ◽  
T Lee Ann Hawkins ◽  
Jolene Haws ◽  
Julia N Kupis ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cognitive Load ◽  
Knowledge Acquisition ◽  
Learning Outcomes ◽  
Knowledge Retention ◽  
Knowledge Test ◽  
Negatively Associated ◽  
Simulation Based ◽  
Training Post ◽  
Over Time

Background Simulation-based training’s impact on learning outcomes may be related to cognitive load or emotions during training. We evaluated the association of validated measures of cognitive load and emotion with learning outcomes in simulation-based obstetric internal medicine cases. Methods All internal medicine learners (n = 15) who completed the knowledge test pre-training, post-training (knowledge acquisition), and at 3–6 months (knowledge retention) for all three simulation cases were included. Results Mean knowledge scores differed over time in all three cases (P < 0.0001 for all). Knowledge retention scores were significantly higher only for cases 1 and 3. Cognitive load associated with frustration was positively associated with knowledge acquisition for case 2 (beta = 5.18, P = 0.007), while excitement was negatively associated with knowledge retention in case 1 (beta = –33.07, P = 0.04). Conclusion Simulation-based education for obstetric internal medicine can be effective in select cases. Attention to cognitive load and emotion may optimize learning outcomes.

Inquiry Learning

2009 ◽  
Vol 23 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Astrid Wichmann ◽  
Detlev Leutner
Keyword(s):  
Scientific Reasoning ◽  
Inquiry Learning ◽  
Instructional Support ◽  
Test Results ◽  
Knowledge Test ◽  
Simulation Based ◽  
Scientific Experiments ◽  
Specific Support ◽  
Science Classes

Seventy-nine students from three science classes conducted simulation-based scientific experiments. They received one of three kinds of instructional support in order to encourage scientific reasoning during inquiry learning: (1) basic inquiry support, (2) advanced inquiry support including explanation prompts, or (3) advanced inquiry support including explanation prompts and regulation prompts. Knowledge test as well as application test results show that students with regulation prompts significantly outperformed students with explanation prompts (knowledge: d = 0.65; application: d = 0.80) and students with basic inquiry support only (knowledge: d = 0.57; application: d = 0.83). The results are in line with a theoretical focus on inquiry learning according to which students need specific support with respect to the regulation of scientific reasoning when developing explanations during experimentation activities.

5. A needs assessment for a CanMEDS-based curriculum in ambulatory care for internal medicine residents in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 29
Author(s):  
R. Wong ◽  
S. Roff
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Learning Outcomes ◽  
Delphi Technique ◽  
Training Programs ◽  
Internal Medicine Training ◽  
Modified Delphi ◽  
Ambulatory Training ◽  
Ambulatory Medicine ◽  
Care Training

In Canada, graduates of internal medicine training programs should be proficient in ambulatory medicine and practice. Before determining how to improve education in ambulatory care, a list of desired learning outcomes must be identified and used as the foundation for the design, implementation and evaluation of instructional events. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each round of questions. A modified Delphi technique was used to determine the competencies required for an ambulatory care curriculum based on the CanMEDS roles. Four groups deemed to be critical stakeholders in residency education were invited to take part in this study: 1. Medical educators and planners, 2. Members of the Canadian Society of Internal Medicine (CSIM), 3. Recent Royal College certificants in internal medicine, 4. Residents currently in core internal medicine residency programs. Panelists were sent questionnaires asking them to rate learning outcomes based on their importance to residency training in ambulatory care. Four hundred and nineteen participants completed the round 1 questionnaire that was comprised of 75 topics identified through a literature search. Using predefined criteria for degree of importance and consensus, 19 items were included in the compendium and 9 were excluded after one round. Forty-two items for which the panel that did not reach consensus, as well as 3 new items suggested by the panel were included in the questionnaire for round 2. Two hundred and forty participants completed the round 2 questionnaire; consensus was reached for each of the 45 items. After two rounds, 21 items were included in the final compendium as very high priority topics (“must be able to”). An additional 26 items were identified as high priority topics (“should be able to”). The overall ratings by each of the four groups were similar and there were no differences between groups that affected the selection of items for the final compendium. To our knowledge this is the first time a Delphi-process has been used to determine the content of an ambulatory care curriculum in internal medicine in Canada. The compendium could potentially be used as the basis to structure training programs in ambulatory care. Barker LR. Curriculum for Ambulatory Care Training in Medical residency: rationale, attitudes and generic proficiencies. J Gen Intern Med 1990; 5(supp.):S3-S14. Levinsky NG. A survey of changes in the proportions of ambulatory training in internal medicine clerkships and residencies from 1986-87 to 1996-97. Acad Med 1998; 73:1114-1115. Linn LS, Brook RH, Clarke VA, Fink A, Kosecoff J. Evaluation of ambulatory care training by graduates of internal medicine residencies. J Med Educ 1986; 61:293-302.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

A Canadian Perspective of simulation-based skill attainment in Internal Medicine Residency (Preprint)

2018 ◽  
Author(s):  
Tamer Abdel Moaein ◽  
Chirsty Tompkins ◽  
Natalie Bandrauk ◽  
Heidi Coombs-Thorne
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Training Programs ◽  
Skill Training ◽  
Skills Training ◽  
Skill Learning ◽  
Comfort Level ◽  
Procedural Skills ◽  
Internal Medicine Training ◽  
Simulation Based

BACKGROUND Clinical simulation is defined as “a technique to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion”. In medicine, its advantages include repeatability, a nonthreatening environment, absence of the need to intervene for patient safety issues during critical events, thus minimizing ethical concerns and promotion of self-reflection with facilitation of feedback [1] Apparently, simulation based education is a standard tool for introducing procedural skills in residency training [3]. However, while performance is clearly enhanced in the simulated setting, there is little information available on the translation of these skills to the actual patient care environment (transferability) and the retention rates of skills acquired in simulation-based training [1]. There has been significant interest in using simulation for both learning and assessment [2]. As Canadian internal medicine training programs are moving towards assessing entrustable professional activities (EPA), simulation will become imperative for training, assessment and identifying opportunities for improvement [4, 5]. Hence, it is crucial to assess the current state of skill learning, acquisition and retention in Canadian IM residency training programs. Also, identifying any challenges to consolidating these skills. We hope the results of this survey would provide material that would help in implementing an effective and targeted simulation-based skill training (skill mastery). OBJECTIVE 1. Appraise the status and impact of existing simulation training on procedural skill performance 2. Identify factors that might interfere with skill acquisition, consolidation and transferability METHODS An electronic bilingual web-based survey; Fluid survey platform utilized, was designed (Appendix 1). It consists of a mix of closed-ended, open-ended and check list questions to examine the attitudes, perceptions, experiences and feedback of internal medicine (IM) residents. The survey has been piloted locally with a sample of five residents. After making any necessary corrections, it will be distributed via e-mail to the program directors of all Canadian IM residency training programs, then to all residents registered in each program. Two follow up reminder e-mails will be sent to all participating institutions. Participation will be voluntarily and to keep anonymity, there will be no direct contact with residents and survey data will be summarized in an aggregate form. SPSS Software will be used for data analysis, and results will be shared with all participating institutions. The survey results will be used for display and presentation purposes during medical conferences and forums and might be submitted for publication. All data will be stored within the office of internal medicine program at Memorial University for a period of five years. Approval of Local Research Ethics board (HREB) at Memorial University has been obtained. RESULTS Pilot Results Residents confirmed having simulation-based training for many of the core clinical skills, although some gaps persist There was some concern regarding the number of sim sessions, lack of clinical opportunities, competition by other services and lack of bed side supervision Some residents used internet video to fill their training gaps and/or increase their skill comfort level before performing clinical procedure Resident feedback included desire for more corrective feedback, and more sim sessions per skill (Average 2-4 sessions) CONCLUSIONS This study is anticipated to provide data on current practices for skill development in Canadian IM residency training programs. Information gathered will be used to foster a discourse between training programs including discussion of barriers, sharing of solutions and proposing recommendations for optimal use of simulation in the continuum of procedural skills training.

scholarly journals A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e102-e113 ◽  
Author(s):  
Manasi M Mittinty ◽  
Sara Kindt ◽  
Murthy N Mittinty ◽  
Sonia Bernardes ◽  
Annmarie Cano ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Relationship Quality ◽  
Positive Association ◽  
Psychological Outcomes ◽  
Dyadic Coping ◽  
Negatively Associated ◽  
Curve Model ◽  
The Relationship ◽  
Over Time

Abstract Objective Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner’s relationship quality and anxiety, stress, and depression over time. Methods One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping. Results Patient-perceived supportive dyadic coping was positively associated with both partners’ relationship quality but was negatively associated with spouses’ stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners’ relationship quality and positively associated with patients’ depression and spouses’ depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses’ depression at baseline and patients’ depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner’s anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model. Conclusions As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners’ relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.

Do Different Roles of Anesthesia Residents Improve Knowledge Retention after Non-Technical Skills Workshop?

2021 ◽  
Vol 104 (9) ◽  
pp. 1519-1527
Keyword(s):  
Test Scores ◽  
Linear Regression Analysis ◽  
Technical Skills ◽  
Knowledge Retention ◽  
University Hospital ◽  
Multivariate Linear Regression Analysis ◽  
Simulation Based ◽  
Post Test ◽  
Anesthesia Residents ◽  
Predictors Of Change

Objective: The authors assessed whether anesthesia residents who acted as a scenario creators would have better knowledge retention than their juniors 90 days after participating in a simulation-based anesthetists’ non-technical skills (ANTS) workshop. Materials and Methods: A prospective observational study via simulation ANTS workshop was conducted at a university hospital in southern Thailand in November 2017. Seven third-year post-graduate (PGY-3) residents volunteered as scenario creators, while the remaining anesthesia residents were randomly selected to participate in or observe three case scenarios, which were cardiac arrest, hypotension, and difficult ventilation. Resident’s knowledge was assessed before, immediately after, and 90 days after the workshop using a 20-item multiple-choice questionnaire. Predictors of change in knowledge scores were analyzed using multivariate linear regression analysis and presented as beta coefficient (β) and 95% confidence limits (CL). Results: Twenty-four anesthesia residents were recruited in the present study and included eight PGY-1, seven PGY-2, and nine PGY-3. The roles consisted of seven scenario creators, seven participants, and 10 observers. The overall immediate post-test and 90-day post-test scores increased significantly compared to the pre-test scores with a mean of 15.5 and 13.2 versus 11.7 (p<0.001 and p=0.007, respectively). The predictors of change in 90-day scores were PGY-3 versus PGY-1 (β 95% CL 4.0 [0.5 to 7.6], p=0.039), and role of participants and observers versus scenario creator (β 95% CL 5.5 [2.2 to 8.8] and 6.7 [2.8 to 10.6], p=0.004, respectively). Conclusion: Anesthesia residents who were participants or observers could improve their knowledge 90 days after a simulation-based ANTS workshop without necessarily being a scenario creator. Keywords: Anesthetists’ non-technical skill; Knowledge retention; Scenario creator; Simulation workshop

The Impact of Design Elements on Undergraduate Nursing Students’ Educational Outcomes in Simulation Education: Protocol for a Systematic Review

2021 ◽  
Author(s):  
Matthew Jackson ◽  
Lauren McTier ◽  
Laura A Brooks ◽  
Rochelle Wynne
Keyword(s):  
Systematic Review ◽  
Nursing Students ◽  
Learning Outcomes ◽  
Educational Outcomes ◽  
Undergraduate Nursing Students ◽  
Design Elements ◽  
Undergraduate Nursing ◽  
Search Terms ◽  
Simulation Based ◽  
The Impact

Abstract Background: Although simulation-based education (SBE) has become increasingly popular as a mode of teaching in undergraduate nursing courses its effect on associated student learning outcomes remains ambiguous. Educational outcomes are influenced by SBE quality that is governed by technology, training, resources and SBE design elements. This paper reports the protocol for a systematic review to identify, appraise and synthesise the best available evidence regarding the impact of SBE on undergraduate nurses’ learning outcomes. Methods: Databases to be searched from 1st of January 1990 include the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Medical Literature Analysis and Retrieval System Online (MEDLINE), American Psychological Association (APA) PsycInfo and the Education Resources Information Centre (ERIC) via the EBSCO host platform. The Excerpta Medica database (EMBASE) will be searched via the OVID platform. We will review the reference lists of relevant articles for additional citations. A combination of search terms including ‘nursing students’, ‘simulation training, ‘patient simulation’, and ‘immersive simulation’ with common Boolean operators will be used. Specific search terms will be combined with either MeSH or Emtree terms and appropriate permutations for each database. Search findings will be imported into reference management software (Endnote© Version.X9) then uploaded into Covidence where two reviewers will independently screen titles, abstracts and retrieved full text. A third reviewer will be available to resolve conflicts and moderate consensus discussions. Quantitative primary research studies evaluating the effect of SBE on undergraduate nursing students’ educational outcomes will be included. The Mixed Methods Appraisal Tool (MMAT) will be used for quality assessment of core criteria, in addition to the Cochrane RoB 2 and ROBINS-I to assess risk of bias for randomised and non-randomised studies, respectively. Primary outcomes are any measure of knowledge, skills, or attitude. Discussion: SBE has been widely adopted by healthcare disciplines in tertiary teaching settings. This systematic review will reveal (i) the effect of SBE on learning outcomes, (ii) SBE element variability, and (iii) interplay between SBE elements and learning outcome. Findings will specify SBE design elements to inform the design and implementation of future strategies for simulation-based undergraduate nursing education.Systematic Review Registration: PROSPERO CRD42021244530

scholarly journals Development of Interest and Role of Choice During Sequential Knowledge Acquisition

2018 ◽  
Author(s):  
Greta M. Fastrich ◽  
Kou Murayama
Keyword(s):  
Knowledge Acquisition ◽  
Growth Curve ◽  
School Environment ◽  
Interest Development ◽  
Growth Curve Modelling ◽  
Over Time

Interest is an important motivational element for learning in the school environment. However, little research has directly addressed how interest develops over time as knowledge accumulates. To gain a better understanding of interest development, we developed a paradigm where participants gain step-by-step information about lesser known countries. After reading each piece of information, participants rated their interest in and liking of the country. Growth-curve modelling showed that interest grows during knowledge acquisition until it eventually stalls and starts to decline. We also found that the opportunity to choose information boosted the growth in interest and delayed its decline. Further analysis revealed that people disengaged from a topic (i.e. stopped accessing information about a particular country) when their interest started to decrease.

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