scholarly journals Digitalised remote-delivery of AVATr Simulation in Psychiatry: a unique success in COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S146-S146
Author(s):  
Vimal Mannali ◽  
Paul Strickland ◽  
Craig laBuscagne ◽  
Joy Clift
Keyword(s):  
Medical Education ◽  
Hybrid Model ◽  
Professional Growth ◽  
Clinical Training ◽  
Care Home ◽  
Training Session ◽  
Patient Simulation ◽  
Virtual Patient ◽  
Capacity Sharing ◽  
Person Perspective

AimsSurrey and Borders NHS Foundation Trust's AVATr (Augmented Virtual-reality Avatar in Training) is a unique ground-breaking Virtual Patient Simulation System, which uses the Xenodu platform to train learners in essential clinical and complex communication skills. Over 30 patient scenarios have been developed after identifying learner-specific development needs, including exploration of overt psychosis, assessment of capacity, sharing bad news, and neglect in care home residents. Actors are filmed responding to several domains of clinical questions, further categorised into three narrative-modes of being ‘Engaged, Neutral or Disengaged’, to build a bank of scenarios. During the session, the trainee is projected on to a large screen, using a camera and video special effects, which results in a life-like interaction with the Virtual Patient. Trainees can view themselves interacting with the Virtual Patient in real-time, from a unique ‘out-of-body' perspective, immersed in a custom-designed interactive virtual environment. The simulation facilitator engages with the learner and determines the appropriate choices of responses for the Virtual Patient and if needed, can prompt with explorative cues to continue the narrative-linked conversation. AVATr model pioneered in United Kingdom the use of an innovative ‘self-observational approach’ in Psychiatry training. This is different to a first-person perspective used in virtual or augmented-reality systems in several clinical specialties. The use of Facilitated-Debrief and Peer-Debrief in sessions, render another layer to the simulation experience.MethodDuring the COVID-19 pandemic, we evolved the AVATr model to remote or hybrid sessions, where simulations were digitally enhanced, and have been run through Microsoft Teams. The simulation facilitator is connected to a multi-user video call, enabling the Virtual Patient to be projected as an attendee using Microsoft Teams.ResultThe hybrid model of AVATr has received tremendous feedback, as it now simulates video-consultations that a vast majority of Psychiatry trainees, especially community-based, undertake due to COVID-19 restrictions. The format of AVATr simulation sessions has remained unchanged, and the remote delivery has been particularly successful as it allows trainees to log in from different remote locations to come together for an interactive training session, without any physical restrictions.ConclusionSince 2015, our simulation platform has been utilised for Post-Graduate Medical Education, to enhance essential professional skills and stimulate professional growth. Currently the hybrid model of AVATr is being expanded to Nursing, Psychology and Allied Health Professional (AHP) clinical training streams, along with Undergraduate Medical Education, to address identified gaps in face-to-face training amidst COVID-19 pandemic.

scholarly journals Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

2021 ◽  
pp. 153473462110118
Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis
Keyword(s):  
Medical Education ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Schools ◽  
Web Based ◽  
Clinical Exposure ◽  
Virtual Teaching ◽  
Based Medicine ◽  
The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

scholarly journals Virtual Reality Technology and Remote Digital Application for Tele-Simulation and Global Medical Education: An Innovative Hybrid System for Clinical Training

2021 ◽  
pp. 104687812110082
Author(s):  
Omamah Almousa ◽  
Ruby Zhang ◽  
Meghan Dimma ◽  
Jieming Yao ◽  
Arden Allen ◽  
...  
Keyword(s):  
Medical Education ◽  
Virtual Reality ◽  
Real Time ◽  
Global Education ◽  
Clinical Training ◽  
Simulation Training ◽  
Virtual Space ◽  
Control Panel ◽  
Clinical Simulation ◽  
Clinical Scenarios

Objective. Although simulation-based medical education is fundamental for acquisition and maintenance of knowledge and skills; simulators are often located in urban centers and they are not easily accessible due to cost, time, and geographic constraints. Our objective is to develop a proof-of-concept innovative prototype using virtual reality (VR) technology for clinical tele simulation training to facilitate access and global academic collaborations. Methodology. Our project is a VR-based system using Oculus Quest as a standalone, portable, and wireless head-mounted device, along with a digital platform to deliver immersive clinical simulation sessions. Instructor’s control panel (ICP) application is designed to create VR-clinical scenarios remotely, live-stream sessions, communicate with learners and control VR-clinical training in real-time. Results. The Virtual Clinical Simulation (VCS) system offers realistic clinical training in virtual space that mimics hospital environments. Those VR clinical scenarios are customizable to suit the need, with high-fidelity lifelike characters designed to deliver interactive and immersive learning experience. The real-time connection and live-stream between ICP and VR-training system enables interactive academic learning and facilitates access to tele simulation training. Conclusions. VCS system provides innovative solutions to major challenges associated with conventional simulation training such as access, cost, personnel, and curriculum. VCS facilitates the delivery of academic and interactive clinical training that is similar to real-life settings. Tele-clinical simulation systems like VCS facilitate necessary academic-community partnerships, as well as global education network between resource-rich and low-income countries.

scholarly journals Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wafa Aftab ◽  
Mishal Khan ◽  
Sonia Rego ◽  
Nishant Chavan ◽  
Afifah Rahman-Shepherd ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Systems ◽  
Clinical Training ◽  
Medical Training ◽  
Grey Literature ◽  
Analytical Framework ◽  
Online News ◽  
Country Comparison ◽  
Education Delivery ◽  
The Right

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.

scholarly journals A Novel Microsurgical Suturing Pilot Course for Ophthalmology Residents Based on Kern's Model for Curriculum Development

2020 ◽  
Vol 12 (02) ◽  
pp. e244-e250
Author(s):  
Aliya C. Roginiel ◽  
Christopher C. Teng ◽  
Jessica H. Chow
Keyword(s):  
Curriculum Development ◽  
Clinical Training ◽  
Training Session ◽  
Surgical Instruments ◽  
Knowledge Assessment ◽  
Skills Assessment ◽  
Practical Skills ◽  
Teaching Session ◽  
Suturing Techniques ◽  
Practice Time

Abstract Background Sutureless ophthalmic procedures are becoming more commonplace, reducing opportunities for ophthalmology residents to learn microsurgical suturing techniques. There is no standard curriculum in place to address this gap in clinical training among ophthalmology residency programs. Objective The aim of this study was to design, implement, and evaluate a preliminary microsurgical suturing curriculum for ophthalmology residents using Kern's six-step approach for curriculum development as a guideline, and the principles of distributed practice and guided, self-directed practice. Methods We designed a faculty-led teaching session on fundamental microsurgical suturing techniques for all 15 ophthalmology residents from Yale University over one academic year. Suturing skills were evaluated, followed by a guided teaching session, 30 days of self-directed practice time, and a re-evaluation of skills. The residents were evaluated through a written knowledge assessment and practical skills assessment. The residents also evaluated their skill level before and after the teaching session and practice period through written Likert-scale surveys. Data were evaluated in Excel using descriptive statistics and the paired t-test. Results After the session, postgraduate year 2 (PGY-2) residents felt more confident in recognition and use of surgical instruments (p < 0.01). PGY-3 residents felt less confident in their knowledge of microsurgical suturing after the session (p = 0.02). PGY-4 residents felt they were better able to identify different suture types after the session (p = 0.02). All residents improved on the written knowledge assessment (p < 0.001) and in all categories of the practical skills assessment (p < 0.001). Conclusions Implementation of a faculty-led microsurgical suturing training session, followed by 1-month of practice time, significantly improved residents' knowledge and practical application of various microsurgical suturing techniques that are necessary for performing common ophthalmic procedures.

The (future) doctor will see you now: Piloting a longitudinal virtual patient in medical education, simulating general practice

2020 ◽  
pp. 1-5
Author(s):  
Thomas Dale MacLaine ◽  
Cornelia Juengst ◽  
David Harris ◽  
Catherine Fenn ◽  
Helen Gabathuler ◽  
...  
Keyword(s):  
Medical Education ◽  
General Practice ◽  
Virtual Patient ◽  
The Future ◽  
Future Doctor

scholarly journals Establishing the acceptability and usability of an animated virtual patient simulation

2021 ◽  
pp. 100069
Author(s):  
Charlotte Lucy Richardson ◽  
Stephen Chapman ◽  
Simon White
Keyword(s):  
Patient Simulation ◽  
Virtual Patient

Establishment of Primary Care Continuity Experiences in Community Pediatricians' Offices: Nuts and Bolts

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1185-1189
Author(s):  
Janice R. Sargent ◽  
Lucy M. Osborn ◽  
Kenneth B. Roberts ◽  
Thomas G. DeWitt
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Professional Education ◽  
Primary Care Physicians ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Tertiary Care ◽  
Ambulatory Training ◽  
Lengths Of Stay ◽  
Tertiary Care Centers

During the past 30 years, there has been an increasing awareness of the importance of ambulatory care training in medical education. The discrepancy between education and practice was pointed out in the General Professional Education Panel report that indicated training was based largely in hospital settings even though the vast majority of doctor-patient encounters do not result in hospitalization.1 Perkoff,2 noting changes in hospital care such as shorter lengths of stay, increased outpatient care, and the need for well-trained primary care physicians, stated that programs need to make a major effort to emphasize clinical teaching in outpatient settings. Recognizing the need for these changes, the Accreditation Council on Graduate Medical Education (ACGME) has increased dramatically the requirement in primary care specialties for clinical ambulatory training.3 For pediatrics, these requirements have progressed from the suggestion that clinical training should be obtained in outpatient clinics (1961) to requiring clinical training in primary care clinics weekly for 3 years (1985). The problems in providing good training in ambulatory settings have been well described.2-4 In comparison inpatient teaching, training students and residents in an outpatient clinic is inefficient and costly. One of the methods suggested to address these problems has been to move ambulatory training out of tertiary care centers to community sites.5-9 Many pediatric programs are now using community sites for at least a portion of resident education.10 Alpert et al10 and Greenberg et al,11 although encouraging the use of these sites to reduce the gap between pediatric education and the service delivery system, pointed out that there are no standards for use of community sites.

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