Utilizing Telesimulation for Advanced Skills Training in Consultation and Handoff Communication: A Post-COVID-19 GME Bootcamp Experience

Author(s):  
Keme Carter ◽  
Jeremy Podczerwinski ◽  
Latassa Love ◽  
Megham Twiss ◽  
Anita Blanchard ◽  
...  

COVID-19 forced the switch to virtual for many educational strategies, including simulation. Virtual formats have the potential to broaden access to simulation training, especially in resource-heavy “bootcamp”-type settings. We converted our in-person communication skills bootcamp to telesimulation and compared effectiveness and satisfaction between formats. During June 2020 orientation, 130 entering interns at one institution participated, using Zoom® to perform one mock consultation and three mock handoffs. Faculty rated performance with checklists and gave feedback. Post-bootcamp surveys assessed participant satisfaction and practice preparedness. Telesimulation performance was comparable to in-person for consultations and slightly inferior for handoffs. Survey response rate was 100%. Compared to in-person, there was higher satisfaction with telesimulation, and interns felt more prepared for practice (95% vs 78%, P < .01); 99% recommended the experience. Fifty percent fewer faculty were required for implementation. Telesimulation was well-received and comparable to in-person bootcamp, representing a feasible, scalable training strategy for communication skills essential in hospital medicine.

Author(s):  
JoAnna K Leyenaar ◽  
Wade Harrison ◽  
Jessica J Truelove ◽  
Samantha House ◽  
Gary L Freed ◽  
...  

BACKGROUND AND OBJECTIVES: In 2016, the American Board of Medical Specialties (ABMS) approved pediatric hospital medicine (PHM) as the newest pediatric subspecialty. To characterize development of the field, this article aims to: (1) describe the responsibilities and practice settings of US pediatricians self-identifying as hospitalists; and (2) determine how exclusive PHM practice, compared with PHM practice in combination with general or subspecialty care, was associated with professional development interests. METHODS: Pediatricians enrolling in the 2017-2018 American Board of Pediatrics (ABP) Maintenance of Certification program were offered a voluntary survey about their responsibilities, interests, and practice settings. Logistic regression was employed to characterize associations between exclusive PHM practice and: (1) interest in quality improvement (QI) leadership; (2) intention to take the PHM certifying exam; (3) satisfaction with allocation of professional time; and (4) intention to maintain more than one ABP certification. RESULTS: The survey response rate was 70.0%; 1662 (13.1%) self-reported PHM practice. Four hundred ninety-one (29.5%) practiced PHM exclusively, 518 (31.1%) practiced PHM and general pediatrics, and 653 (39.3%) practiced PHM and one or more subspecialties. Respondents reporting exclusive PHM practice were significantly more likely to report interest in QI leadership or consultation (adjusted odds ratio [OR], 1.39; 95% CI, 1.09-1.79), PHM exam certification (adjusted OR, 7.10; 95% CI, 5.45-9.25), and maintenance of more than one ABP certification (adjusted OR, 2.64; 95% CI, 1.89-3.68). CONCLUSIONS: Hospitalists reported diverse clinical and nonclinical responsibilities. Those practicing PHM exclusively expressed high levels of interest in board certification and QI leadership. Ongoing monitoring of PHM responsibilities and practice settings will be important to support the professional development of the PHM workforce.


Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.


MedEdPORTAL ◽  
2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Rock ◽  
Nina Gadmer ◽  
Robert Arnold ◽  
David Roberts ◽  
Asha Anandaiah ◽  
...  

2020 ◽  
Vol 81 (2) ◽  
pp. 91-93
Author(s):  
Anna Angelinas ◽  
Roseann Nasser ◽  
Amanda Geradts ◽  
Justine Herle ◽  
Kristen Schott ◽  
...  

Purpose: Living Your Best Weight (LYBW) is an outpatient program based on Health at Every Size (HAES) principles for adults interested in managing their weight. The purpose of this pilot study was to determine perceptions of participants and their satisfaction with the LYBW program. Methods: A survey was developed to determine participant satisfaction of the LYBW program. Fifty-six participants who completed the LYBW program from June 2017 to February 2018 were contacted via telephone and invited to participate in the study. Forty-five participants agreed to receive the survey by mail or email. Results: Thirty-four participants completed the survey for a response rate of 61%. The average age of respondents was 52 years. Seventy-nine percent of respondents agreed that the program helped them to focus on health instead of weight. Eighty-two percent agreed that the program helped them respond to internal cues of hunger and fullness, and 94% were satisfied with the program. Conclusion: Participants reported that they were satisfied with the LYBW program and perceived improvements in their health. Future programming may benefit from using a HAES-based approach with adults.


2021 ◽  
Author(s):  
Diego A Vicente ◽  
Obinna Ugochukwu ◽  
Michael G Johnston ◽  
Chad Craft ◽  
Virginia Damin ◽  
...  

ABSTRACT Introduction Navy Medicine's Role 2 Light Maneuver (R2LM) Emergency Resuscitative Surgical Systems (ERSS) are austere surgical teams manned, trained, and equipped to provide life-saving damage control resuscitation and surgery in any environment on land or sea. Given the restrictions related to the COVID-19 pandemic, the previously established pre-deployment training pipeline for was modified to prepare a new R2LM team augmenting a Role 1 shipboard medical department. Methods The modified curriculum created in response to COVID-19 related restriction is compared and contrasted to the established pre-deployment R2LM ERSS curriculum. Subject Matter Experts and currently deployed R2LM members critically evaluate the two curricula. Results Both curricula included the team R2LM platform training and exposure to cadaver based team trauma skills training. The modified curriculum included didactics on shipboard resuscitation, anesthesia and surgery, shipboard COVID-19 management, and prolonged field care in austere maritime environments. Conclusions We describe Navy Medicines R2LM ERSS capability and compare and contrast the standard R2LM pre-COVID-19 curriculum to the modified curriculum. Central to both curricula, the standard R2LM platform training is important for developing and honing team dynamics, communication skills and fluid leadership; important for the successful function austere surgical teams. Several opportunities for improvement in the pre-deployment training were identified for R2LM teams augmenting shipboard Role 1 medical departments.


Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 592
Author(s):  
Shamoukh Alshahrani ◽  
Abrar Alshuaibi ◽  
Malak Alkhaldi ◽  
Pradeep Koppolu

Aim: The present study aims to evaluate the perception and awareness of interdental aids in different regions of Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted, in order to evaluate the perception and knowledge of patients towards oral hygiene products among the population of the Kingdom of Saudi Arabia. In total, 812 out of 1124 participants responded and completed the survey (response rate 72.2%). The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. p < 0.05 was used to indicate statistical significance. Results: A total of 812 participants responded, of which 486 participants (60%) declared using a toothpaste and toothbrush for cleaning their teeth. The cohort consisted of 274 (34%) females who brushed twice daily, while 96 (33%) males brushed their teeth once a day and 18% of the participants did not even brush once a day. The results indicated that 332 (64%) female participants and 174 (60%) male participants had perception and knowledge of the use of dental floss or any other device to clean between their teeth, while 174 (48.50%) male participants and 174 (49.10%) female participants cleaned their tongue with the same brush, rather than using a tongue scrubber or any other aids. Conclusion: The total awareness of interdental aids in Saudi Arabia is unsatisfactory, as demonstrated by the participants not being conscious or informed about the maintenance of their oral health. A majority of participants did not report adopting basic techniques, such as tongue brushing. This study reveals that no interdental aids were used by 16% of the participants. Thus, it is crucial to develop an effective educational program which emphasizes oral healthcare in this population.


2021 ◽  
Vol 8 ◽  
pp. 238212052110003
Author(s):  
Denise L. F. Davis ◽  
DoQuyen Tran-Taylor ◽  
Elizabeth Imbert ◽  
Jeffrey O. Wong ◽  
Calvin L. Chou

Problem: Medical students often feel unprepared to care for patients whose cultural backgrounds differ from their own. Programs in medical schools have begun to address health: inequities; however, interventions vary in intensity, effectiveness, and student experience. Intervention: The authors describe an intensive 2-day diversity, equity, and inclusion curriculum for medical students in their orientation week prior to starting formal classes. Rather than using solely a knowledge-based “cultural competence” or a reflective “cultural humility” approach, an experiential curriculum was employed that links directly to fundamental communication skills vital to interactions with patients and teams, and critically important to addressing interpersonal disparities. Specifically, personal narratives were incorporated to promote individuation and decrease implicit bias, relationship-centered skills practice to improve communication across differences, and mindfulness skills to help respond to bias when it occurs. Brief didactics highlighting student and faculty narratives of difference were followed by small group sessions run by faculty trained to facilitate sessions on equity and inclusion. Context: Orientation week for matriculating first-year students at a US medical school. Impact: Matriculating students highly regarded an innovative 2-day diversity, equity, and inclusion orientation curriculum that emphasized significant relationship-building with peers, in addition to core concepts and skills in diversity, equity, and inclusion. Lessons learned: This orientation represented an important primer to concepts, skills, and literature that reinforce the necessity of training in diversity, equity, and inclusion. The design team found that intensive faculty development and incorporating diversity concepts into fundamental communication skills training were necessary to perpetuate this learning. Two areas of further work emerged: (1) the emphasis on addressing racism and racial equity as paradigmatic belies further essential understanding of intersectionality, and (2) uncomfortable conversations about privilege and marginalization arose, requiring expert facilitation.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sally Byford ◽  
Sarah Janssens ◽  
Rachel Cook

Abstract Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.


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