Development and evaluation of simulation based neurosurgery curriculum. Pilot study at the Poznan University of Medical Sciences.

2018 ◽  
Vol 86 (4) ◽  
pp. 286
Author(s):  
Bartosz Sokół ◽  
Roman Jankowski ◽  
Barbara Więckowska ◽  
Łukasz Gąsiorowski ◽  
Michael Czekajlo
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critically Ill Patient ◽  
Medical Sciences ◽  
Questionnaire Response ◽  
Human Patient ◽  
Patient Simulator ◽  
Response Data ◽  
Simulation Based ◽  
Before And After

Introduction. Neurosurgical emergencies are complex tasks. The current learning environment limits students’ ability to manage acute neurosurgical emergencies due to legal and safety concerns. Simulation provides an opportunity to participate in the care of neurosurgical emergencies and develop clinical decision making skills. Aim. We aim to determine whether neuroscience simulation curriculum improves student ability to: manage a critically ill patient, recognize neurosurgical emergencies, to assess how stress tolerance affects experience during simulations and effectiveness of students performance. The third objective is to develop a tool for student assessment.Material and Methods. The simulation was performed on SimMan 3G Human Patient Simulator (Laerdal Medical). Scenarios included common neurosurgical emergencies. Students were assessed before and after the course by completing a Likert type questionnaire. Response data was analysed using Cronbach’s reliability for Likert-type response data  and Spearman's monotonic correlation. Results. 60 students of fifth and sixth year of medical studies attended the course. 39 students of them replied to the questionnaire. The simulated clinical experience was positive and it improved their knowledge about neurosurgical emergencies. There was an improvement in their confidence. Improvement in individual and team performance was also observed.Conclusions. Neurosurgical simulations improve students` ability to recognize neurosurgical emergencies. The level of stress related to simulation is important factor of the education process and should be reduced to improve students’ development. Our questionnaire is an effective tool for assessment of students experience during clinical simulations.

Clinical Case: Simulation-based evaluation of post-operative gait function to support clinical decision making in cerebral palsy

2017 ◽  
Vol 57 ◽  
pp. 102-103 ◽  
Author(s):  
Lorenzo Pitto ◽  
Antoine Falisse ◽  
Tessa Hoekstra ◽  
Hans Kainz ◽  
Mariska Wesseling ◽  
...  
Keyword(s):  
Decision Making ◽  
Cerebral Palsy ◽  
Clinical Case ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Simulation Based ◽  
Case Simulation ◽  
Gait Function

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 Computerized nursing process in the Intensive Care Unit: ergonomics and usability

2016 ◽  
Vol 50 (6) ◽  
pp. 998-1004 ◽  
Author(s):  
Sônia Regina Wagner de Almeida ◽  
◽  
Grace Teresinha Marcon Dal Sasso ◽  
Daniela Couto Carvalho Barra ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Nursing Process ◽  
Evaluation Instrument ◽  
Before And After ◽  
Quasi Experimental ◽  
Usability Criteria

Abstract OBJECTIVE Analyzing the ergonomics and usability criteria of the Computerized Nursing Process based on the International Classification for Nursing Practice in the Intensive Care Unit according to International Organization for Standardization(ISO). METHOD A quantitative, quasi-experimental, before-and-after study with a sample of 16 participants performed in an Intensive Care Unit. Data collection was performed through the application of five simulated clinical cases and an evaluation instrument. Data analysis was performed by descriptive and inferential statistics. RESULTS The organization, content and technical criteria were considered "excellent", and the interface criteria were considered "very good", obtaining means of 4.54, 4.60, 4.64 and 4.39, respectively. The analyzed standards obtained means above 4.0, being considered "very good" by the participants. CONCLUSION The Computerized Nursing Processmet ergonomic and usability standards according to the standards set by ISO. This technology supports nurses' clinical decision-making by providing complete and up-to-date content for Nursing practice in the Intensive Care Unit.

scholarly journals Deciphering the “Art” in Modeling and Simulation of the Knee Joint: Overall Strategy

2019 ◽  
Vol 141 (7) ◽  
Author(s):  
Ahmet Erdemir ◽  
Thor F. Besier ◽  
Jason P. Halloran ◽  
Carl W. Imhauser ◽  
Peter J. Laz ◽  
...  
Keyword(s):  
Modeling And Simulation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Tissue Mechanics ◽  
Rigid Body Dynamics ◽  
Element Analysis ◽  
Regulatory Affairs ◽  
Simulation Based ◽  
Body Dynamics ◽  
And Training

Recent explorations of knee biomechanics have benefited from computational modeling, specifically leveraging advancements in finite element analysis and rigid body dynamics of joint and tissue mechanics. A large number of models have emerged with different levels of fidelity in anatomical and mechanical representation. Adapted modeling and simulation processes vary widely, based on justifiable choices in relation to anticipated use of the model. However, there are situations where modelers' decisions seem to be subjective, arbitrary, and difficult to rationalize. Regardless of the basis, these decisions form the “art” of modeling, which impact the conclusions of simulation-based studies on knee function. These decisions may also hinder the reproducibility of models and simulations, impeding their broader use in areas such as clinical decision making and personalized medicine. This document summarizes an ongoing project that aims to capture the modeling and simulation workflow in its entirety—operation procedures, deviations, models, by-products of modeling, simulation results, and comparative evaluations of case studies and applications. The ultimate goal of the project is to delineate the art of a cohort of knee modeling teams through a publicly accessible, transparent approach and begin to unravel the complex array of factors that may lead to a lack of reproducibility. This manuscript outlines our approach along with progress made so far. Potential implications on reproducibility, on science, engineering, and training of modeling and simulation, on modeling standards, and on regulatory affairs are also noted.

Administration of the Canadian Occupational Performance Measure: Effect on practice

2012 ◽  
Vol 79 (2) ◽  
pp. 120-128 ◽  
Author(s):  
Heather L. Colquhoun ◽  
Lori J. Letts ◽  
Mary C. Law ◽  
Joy C. MacDermid ◽  
Cheryl A. Missiuna
Keyword(s):  
Occupational Therapy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Performance Measure ◽  
Occupational Performance ◽  
Chart Audit ◽  
Canadian Occupational Performance Measure ◽  
Before And After ◽  
Practice Methods ◽  
Client Progress

Background. The Canadian Occupational Performance Measure (COPM) is recommended as a systematic approach to identify issues and determine client progress in occupational therapy, yet little empirical evidence is available that supports this practice. Purpose. To determine if COPM administration was associated with changes in eight dimensions of occupational therapy practice. Methods. Twenty-four occupational therapists on eight geriatric rehabilitation sites completed a before-and-after study with a repeated baseline. The eight practice dimensions were assessed after three months of usual care (no COPM use) and after three months of intervention (COPM use) using chart stimulated recall (CSR) interviews and chart audit. Findings. Mean practice scores for CSR interviews indicated a statistically significant practice improvement (p < .0001) across the eight dimensions, including knowledge of client perspective, clinical decision making, clinician ability to articulate outcomes, and documentation. Chart audit indicated that COPM use resulted in identifying more occupation-focused issues. Implications. COPM administration could improve occupational therapy practice.

scholarly journals Transcutaneous versus Total Serum Bilirubin Measurements in Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Thivia Jegathesan ◽  
Douglas M. Campbell ◽  
Joel G. Ray ◽  
Vibhuti Shah ◽  
Howard Berger ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Clinical Decision Making ◽  
Serum Bilirubin ◽  
Clinical Decision ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Treatment Thresholds ◽  
Before And After ◽  
The Mean

<b><i>Introduction:</i></b> Transcutaneous bilirubin (TcB) measurement offers a noninvasive approach for bilirubin screening; however, its accuracy in preterm infants is unclear. This study determined the agreement between TcB and total serum bilirubin (TSB) among preterm infants. <b><i>Methods:</i></b> A multisite prospective cohort study was conducted at 3 NICUs in Ontario, Canada, September 2016 to June 2018. Among 296 preterm infants born at 24<sup>0/7</sup> to 35<sup>6/7</sup> weeks, 856 TcB levels were taken at the forehead, sternum, and before and after the initiation of phototherapy with TSB measurements. Bland-Altman plots and 95% limits of agreement (LOA) expressed agreement between TcB and TSB. <b><i>Results:</i></b> The overall mean TcB-TSB difference was −24.5 μmol/L (95% LOA −103.3 to 54.3), 1.6 μmol/L (95% LOA −73.4 to 76.5) before phototherapy, and −31.1 μmol/L (95% LOA −105.5 to 43.4) after the initiation of phototherapy. The overall mean TcB-TSB difference was −15.2 μmol/L (95% LOA −86.8 to 56.3) at the forehead and −24.4 μmol/L (95% LOA −112.9 to 64.0) at the sternum. The mean TcB-TSB difference was −31.4 μmol/L (95% LOA −95.3 to 32.4) among infants born 24–28 weeks, −25.5 μmol/L (95% LOA −102.7 to 51.8) at 29–32 weeks, and −15.9 μmol/L (95% LOA −107.4 to 75.6) at 33–35 weeks. Measures did not differ by maternal ethnicity. <b><i>Conclusion:</i></b> Among preterm infants, TcB may offer a noninvasive, immediate approach to screening for hyperbilirubinemia with more careful use in preterm infants born at &#x3c;33 weeks’ gestation, as TcB approaches treatment thresholds. Its underestimation of TSB after the initiation of phototherapy warrants the use of TSB for clinical decision-making after the initiation of phototherapy.

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