scholarly journals Assessment of Obstetrics and Gynecology Residents’ Knowledge of Basic Obstetric Sonography and Psychomotor Evaluation With Motion Analysis Using a Computer-Based Simulator

2020 ◽  
Vol 36 (4) ◽  
pp. 312-321 ◽  
Author(s):  
Sundus H. Mohammad ◽  
Carolyn M. Sommerich ◽  
Angela N. Butwin ◽  
Kevin D. Evans
Keyword(s):  
Diagnostic Accuracy ◽  
Motion Analysis ◽  
High Volume ◽  
First Trimester ◽  
Obstetrics And Gynecology ◽  
High Fidelity ◽  
Psychomotor Skills ◽  
High Fidelity Simulation ◽  
Median Score ◽  
Computer Based

Purpose: Evaluate obstetrics and gynecology (OB/Gyn) residents’ current obstetric sonography knowledge, confidence, and psychomotor skills to provide clinical preceptors with a greater understanding of how to approach teaching sonography to residents. Methods: Ten OB/Gyn residents were assessed on their sonographic performance by measuring psychomotor skills and evaluating diagnostic accuracy of images. At the conclusion of the assessment, residents received feedback and completed a survey to establish their current confidence level in performing and interpreting sonograms. Results: Motion analysis revealed excessive transducer movements made by the residents when acquiring images, particularly in terms of angular movement. The median score on the assessment template was 33 out of 66 points (interquartile range, 26.75–42.5), where residents had difficulty acquiring all required criteria for first-trimester dating and biometry views/measurements, determining fetal situs, and identifying landmarks to ensure intended anatomy is visualized. Conclusions: Absence of formalized sonography training creates a need for clinical preceptors to teach basic anatomy/landmarks, transducer movements, and criteria for dating and biometry views/measurements. This poses a challenge for preceptors at high-volume sites; thus, high-fidelity simulation could be part of a solution. Simulation can provide residents with the opportunity to develop basic sonography skills outside of clinical, then refine and build upon those skills with preceptors.

Assessment of OB/Gyn Residents’ Knowledge of Basic Obstetric Sonography and Psychomotor Skills Posttraining on a Computer-Based Simulator

2021 ◽  
pp. 875647932110520
Author(s):  
Sundus H. Mohammad ◽  
Carolyn M. Sommerich ◽  
Angela N. Butwin ◽  
Kevin D. Evans
Keyword(s):  
Statistical Analysis ◽  
Confidence Level ◽  
Obstetrics And Gynecology ◽  
High Fidelity ◽  
Psychomotor Skills ◽  
Knowledge And Skills ◽  
Novice Learners ◽  
Significant Difference ◽  
Computer Based ◽  
Individualized Training

Objective: This study sought to evaluate how a high-fidelity computer-based sonography simulator (FCBSS) can be used in training obstetrics and gynecology residents and evaluate efficacy of high-fidelity CBSS in enhancing resident’s sonographic knowledge, psychomotor skills, and level of confidence in performing sonographic fetal assessments. Materials and Methods: Eleven postgraduate year 1 residents (PGY1s) and ten PGY2s were assessed on sonographic performance by measuring psychomotor skills and evaluating the accuracy of the sonographic images. PGY2s received traditional sonography training while PGY1s received three individualized training sessions on a high-fidelity CBSS. At the conclusion, all residents received feedback and completed a survey to establish their current confidence level in performing and interpreting sonograms. Results: PGY2s scored a median of 33/66 points on the assessment, while PGY1s scored a median of 64/66 points. Statistical analysis performed from motion analysis metrics between cohorts revealed a statistically significant difference, with PGY1s demonstrating higher psychomotor skills. Interquartile ranges of PGY1s’ scores were smaller than PGY2s’, revealing consistency in knowledge and skills among the PGY1 cohort. Conclusion: Findings suggests that high-fidelity CBSS can be used effectively in training residents. It also demonstrates that implementation of formalized sonography training, using a high-fidelity CBSS, can be achieved and potentially expedite and enhance the learning of novice learners.

scholarly journals Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation

2017 ◽  
Vol 67 (656) ◽  
pp. e201-e208 ◽  
Author(s):  
Olga Kostopoulou ◽  
Talya Porat ◽  
Derek Corrigan ◽  
Samhar Mahmoud ◽  
Brendan C Delaney
Keyword(s):  
Patient Satisfaction ◽  
Decision Support ◽  
Decision Support System ◽  
Diagnostic Accuracy ◽  
Support System ◽  
Experimental Studies ◽  
Patient Specific ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Data Coding

BackgroundObservational and experimental studies of the diagnostic task have demonstrated the importance of the first hypotheses that come to mind for accurate diagnosis. A prototype decision support system (DSS) designed to support GPs’ first impressions has been integrated with a commercial electronic health record (EHR) system.AimTo evaluate the prototype DSS in a high-fidelity simulation.Design and settingWithin-participant design: 34 GPs consulted with six standardised patients (actors) using their usual EHR. On a different day, GPs used the EHR with the integrated DSS to consult with six other patients, matched for difficulty and counterbalanced.MethodEntering the reason for encounter triggered the DSS, which provided a patient-specific list of potential diagnoses, and supported coding of symptoms during the consultation. At each consultation, GPs recorded their diagnosis and management. At the end, they completed a usability questionnaire. The actors completed a satisfaction questionnaire after each consultation.ResultsThere was an 8–9% absolute improvement in diagnostic accuracy when the DSS was used. This improvement was significant (odds ratio [OR] 1.41, 95% confidence interval [CI] = 1.13 to 1.77, P<0.01). There was no associated increase of investigations ordered or consultation length. GPs coded significantly more data when using the DSS (mean 12.35 with the DSS versus 1.64 without), and were generally satisfied with its usability. Patient satisfaction ratings were the same for consultations with and without the DSS.ConclusionThe DSS prototype was successfully employed in simulated consultations of high fidelity, with no measurable influences on patient satisfaction. The substantially increased data coding can operate as motivation for future DSS adoption.

How do deployed general surgeons acquire relevant skill sets and competencies and mitigate skill fade?

2020 ◽  
pp. bmjmilitary-2020-001641
Author(s):  
Matthew Robert Cant ◽  
D N Naumann ◽  
T C König ◽  
D M Bowley
Keyword(s):  
Simulation Training ◽  
Armed Forces ◽  
High Volume ◽  
Trauma Centre ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Surgical Skill ◽  
Skill Sets ◽  
Skill Gaps ◽  
General Surgeons

There are recognised difficulties internationally with acquisition and retention of skills among deployed military general surgeons. These are compounded by reduced trauma workload in non-deployed roles or during low tempo or limited activity deployments, and the winding-down of combat operations in Iraq and Afghanistan. We summarise the relevant military-run courses, military-civilian collaborations and potential future strategies that have been used to address skill sets and competencies of deployed surgeons. We use examples from the American, British, Danish, French, German and Swedish Armed Forces. There is variation between nations in training, with a combination of didactic lectures, simulation training and trauma placements in civilian settings at home and overseas. Data regarding effectiveness of these techniques are sparse. It is likely that combat surgical skill-set acquisition and maintenance requires a combination of employment at a high-volume trauma centre during a surgeon’s non-deployed role, together with military-specific courses and high-fidelity simulation to fill skill gaps. There are multiple newer modalities of training that require further evaluation if they are to prove effective in the future. We aimed to summarise the current methods used internationally to ensure acquisition and retention of vital skill sets for these surgeons.

A Computer-Based Tutor to Teach Nursing Trauma Care That Works as an Adjunct to High-Fidelity Simulation

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christopher M. Garrison ◽  
Frank E. Ritter ◽  
Benjamin R. Bauchwitz ◽  
James Niehaus ◽  
Peter W. Weyhrauch
Keyword(s):  
Trauma Care ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Computer Based

A randomized cross-over trial in patients suspected of PAD on diagnostic accuracy of ankle-brachial index by Doppler-based versus four-point oscillometry based measurements

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 516-522 ◽  
Author(s):  
Verena Mayr ◽  
Mirko Hirschl ◽  
Peter Klein-Weigel ◽  
Luka Girardi ◽  
Michael Kundi
Keyword(s):  
Diagnostic Accuracy ◽  
Ankle Brachial Index ◽  
Area Under The Curve ◽  
High Volume ◽  
Epidemiologic Studies ◽  
Lower Sensitivity ◽  
Oscillometric Device ◽  
Specificity And Sensitivity ◽  
Time Requirements ◽  
Peripheral Arterial

Summary. Background: For diagnosis of peripheral arterial occlusive disease (PAD), a Doppler-based ankle-brachial-index (dABI) is recommended as the first non-invasive measurement. Due to limitations of dABI, oscillometry might be used as an alternative. The aim of our study was to investigate whether a semi-automatic, four-point oscillometric device provides comparable diagnostic accuracy. Furthermore, time requirements and patient preferences were evaluated. Patients and methods: 286 patients were recruited for the study; 140 without and 146 with PAD. The Doppler-based (dABI) and oscillometric (oABI and pulse wave index – PWI) measurements were performed on the same day in a randomized cross-over design. Specificity and sensitivity against verified PAD diagnosis were computed and compared by McNemar tests. ROC analyses were performed and areas under the curve were compared by non-parametric methods. Results: oABI had significantly lower sensitivity (65.8%, 95% CI: 59.2%–71.9%) compared to dABI (87.3%, CI: 81.9–91.3%) but significantly higher specificity (79.7%, 74.7–83.9% vs. 67.0%, 61.3–72.2%). PWI had a comparable sensitivity to dABI. The combination of oABI and PWI had the highest sensitivity (88.8%, 85.7–91.4%). ROC analysis revealed that PWI had the largest area under the curve, but no significant differences between oABI and dABI were observed. Time requirement for oABI was significantly shorter by about 5 min and significantly more patients would prefer oABI for future testing. Conclusions: Semi-automatic oABI measurements using the AngER-device provide comparable diagnostic results to the conventional Doppler method while PWI performed best. The time saved by oscillometry could be important, especially in high volume centers and epidemiologic studies.

The Perceptions of Nurse Educators regarding the use of High Fidelity Simulation in Nursing Education

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Viola Janse van Vuuren ◽  
Eunice Seekoe ◽  
Daniel Ter Goon
Keyword(s):  
Nursing Education ◽  
South African ◽  
Clinical Training ◽  
Nurse Educators ◽  
Teaching Staff ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Simulation Based ◽  
Nursing College ◽  
Faculty Shortages

Although nurse educators are aware of the advantages of simulation-based training, some still feel uncomfortable to use technology or lack the motivation to learn how to use the technology. The aging population of nurse educators causes frustration and anxiety. They struggle with how to include these tools particularly in the light of faculty shortages. Nursing education programmes are increasingly adopting simulation in both undergraduate and graduate curricula. The aim of this study was to determine the perceptions of nurse educators regarding the use of high fidelity simulation (HFS) in nursing education at a South African private nursing college. A national survey of nurse educators and clinical training specialists was completed with 118 participants; however, only 79 completed the survey. The findings indicate that everyone is at the same level as far as technology readiness is concerned, however, it does not play a significant role in the use of HFS. These findings support the educators’ need for training to adequately prepare them to use simulation equipment. There is a need for further research to determine what other factors play a role in the use of HFS; and if the benefits of HFS are superior to other teaching strategies warranting the time and financial commitment. The findings of this study can be used as guidelines for other institutions to prepare their teaching staff in the use of HFS.

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