scholarly journals The Impact of the Fidelity of Simulation on Medical Undergraduate Education: A Meta-Analysis

2021 ◽  
Author(s):  
Yan Hua ◽  
Xiao-yan Cen ◽  
Sha Niu ◽  
Tao Yu
Keyword(s):  
Undergraduate Education ◽  
Meta Analysis ◽  
Mean Difference ◽  
Theoretical Knowledge ◽  
High Fidelity ◽  
Fidelity Level ◽  
Medical Undergraduate ◽  
Skill Performance ◽  
Standardized Mean Difference ◽  
Medical Undergraduate Education

Abstract Background: With the development of science and technology, simulation-based education has also developed rapidly. However, whether the fidelity level of simulators has a positive correlation with medical students' learning outcomes is controversial. This study aims to compare the theoretical knowledge, skill performance and confidence of undergraduate medical students through meta-analysis according to the fidelity level of the simulator.Methods: Two researchers independently searched the PubMed database, the Cochrane Library, and the Embase database through October 20, 2020, to retrieve articles on the differences in effectiveness between high-fidelity simulators and low-fidelity simulators in undergraduate medical education. The Cochrane risk of bias tool was used to evaluate all included literature. Quantitative meta-analysis of the included literature was performed with Review Manager 5.3.Results: Fifteen studies met the inclusion criteria, 11 of which were meta-analysed. Meta-analysis showed whether there were differences in students’ theoretical knowledge [standardized mean difference -0.51; 95% CI -1.30～0.29，P=0.21], skill performance [standardized mean difference -0.26; 95% CI -0.87～0.35, P = 0.40], and confidence [standardized mean difference 2.53; 95% CI -1.05～6.10, P = 0.17]: there were no significant differences between high-fidelity simulators and low-fidelity simulators.Conclusions: In medical undergraduate education, students who experience low-fidelity simulator training are not inferior to students who learn from high-fidelity simulators in their theoretical knowledge, skill performance, or confidence.

Intralymphatic immunotherapy for allergic rhinitis: A systematic review and meta-analysis

2021 ◽  
Vol 42 (4) ◽  
pp. 283-292 ◽  
Author(s):  
Michael T. Werner ◽  
John V. Bosso
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Adverse Event ◽  
Skin Prick Testing ◽  
Meta Analysis ◽  
Mean Difference ◽  
Random Effects Model ◽  
Nasal Provocation ◽  
Intralymphatic Immunotherapy ◽  
Standardized Mean Difference

Background: Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3‐5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. Objective: This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Methods: Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. Results: We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was ‐0.72 (95% confidence interval [CI], ‐0.98 to ‐0.46; p < 0.0001) (n = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was ‐1.00 (95% CI, ‐1.38 to ‐0.61; p < 0.0001) (n = 7) and ‐0.73 (95% CI, ‐0.99 to ‐0.47; p < 0.0001) (n = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Conclusion: Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.

Efficacy of Adjuvant Magnesium for Posttonsillectomy Morbidity in Children: A Meta-analysis

2017 ◽  
Vol 158 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Hye Kyung Cho ◽  
In Joon Park ◽  
Ho Young Yoon ◽  
Se Hwan Hwang
Keyword(s):  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Mean Difference ◽  
Local Administration ◽  
Control Group ◽  
Analgesic Requirement ◽  
Administration Routes ◽  
Randomized Controlled Studies ◽  
Subgroup Analyses ◽  
Standardized Mean Difference

Objectives The perioperative administration of magnesium is known to reduce postoperative morbidities in adults, such as pain, agitation, and laryngospasm. The objective is to assess the effects of perioperative magnesium as the adjuvant to tonsillectomy as compared with tonsillectomy in children. Data Source Five databases (PubMed, SCOPUS, Embase, Web of Science, Cochrane). Method Two authors independently searched databases up to January 2017. We compared perioperative magnesium administration (magnesium groups) with no administration of magnesium (control group). The following outcomes were measured: postoperative pain intensity, analgesics administration, or other morbidities (laryngospasm, agitation, postoperative bleeding) in the postoperative 24 hours. Additionally, to evaluate the discrepancy of effects according to different administration routes, subgroup analyses regarding effects according to systemic or local administration of magnesium were performed. Results Nine prospective randomized controlled studies (n = 615) that evaluated the effect of magnesium in children having undergone tonsillectomy met inclusion criteria. Compared with control group, the time for first analgesic requirement was significantly delayed in magnesium groups (standardized mean difference = 0.75; 95% CI, 0.20-1.31; P = .0079). Laryngospasm (log odds ratio = −1.09; 95% CI,−2.11 to −0.07; P = .0362) and agitation score (standardized mean difference = −0.67; 95% CI, −0.97 to −0.36; P < .0001) in the recovery room also significantly decreased in magnesium groups. In subgroup analyses regarding pain and laryngospasm-related measurements, local administration of magnesium was shown to be more effective at reducing postoperative morbidities. Conclusions Perioperative magnesium regardless of route may offer pain, agitation, and laryngospasm relief without adverse effects in pediatric tonsillectomy. Based on the high heterogeneity of results within some parameters, further studies need to be performed to affirm these results.

scholarly journals The effect of unilateral and bilateral laparoscopic surgery for endometriosis on Anti-Mullerian Hormone (AMH) level after 3 and 6 months: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Anisodowleh Nankali ◽  
Mohsen Kazeminia ◽  
Parnian Kord Jamshidi ◽  
Shamarina Shohaimi ◽  
Nader Salari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laparoscopic Surgery ◽  
Growth Factors ◽  
Web Of Science ◽  
Meta Analysis ◽  
Research Work ◽  
Mean Difference ◽  
Transient Growth ◽  
Common Causes ◽  
Standardized Mean Difference

Abstract Background Endometriosis is one of the most common causes of infertility. The causes of the disease and its definitive treatments are still unclear. Moreover, Anti-Mullerian Hormone (AMH) is a glycoprotein dimer that is a member of the transient growth factors family. This research work aimed to identify the effect of unilateral and bilateral laparoscopic surgery for endometriosis on AMH levels after 3 months, and 6 months, using meta-analysis. Methods In this study, the articles published in national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were searched to find electronically published studies between 2010 and 2019. The heterogeneous index between studies was determined using the I2 index. Results In this meta-analysis and systematic review, 19 articles were eligible for inclusion in the study. The standardized mean difference was obtained in examining of unilateral laparoscopic surgery for endometriosis (before intervention 2.8 ± 0.11, and after 3 months 2.05 ± 0.13; and before intervention 3.1 ± 0.46 and after 6 months 2.08 ± 0.31), and in examining bilateral laparoscopic surgery for endometriosis examination (before intervention 2.0 ± 08.08, and after 3 months 1.1 ± 0.1; and before intervention 2.9 ± 0.23 and after 6 months 1.4 ± 0.19). Conclusion The results of this study demonstrate that unilateral and bilateral laparoscopic surgery for endometriosis is effective on AMH levels, and the level decreases in both comparisons.

The effectiveness of virtual reality-based technology on anatomy teaching: a meta-analysis of randomized controlled studies

2020 ◽  
Author(s):  
jingjie zhao ◽  
xinliang xu ◽  
Hualin Jiang ◽  
yi ding
Keyword(s):  
Virtual Reality ◽  
Meta Analysis ◽  
Mean Difference ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Subgroup Analyses ◽  
Degree Of Satisfaction ◽  
Meta Regression ◽  
Standardized Mean Difference ◽  
Anatomy Teaching

Abstract Virtual reality (VR) is an innovation that permits the individual to discover and operate three-dimensional (3D) environment to gain practical understanding instantly. Recently, VR has been advanced as an encouraging tool in the course of clinical college. This research aimed to examine the general efficiency of VR for teaching medical anatomy. We executed a meta-analysis of randomized regulated studies of the performance of VR anatomy education. We browsed 5 databases from the year 1990 to 2019. Ultimately, 15 randomized controlled trials with a teaching outcome measure analysis were included. Tow authors separately chosen studies, extracted information, and examined the risk of bias. The primary outcomes were examination scores of the students. Secondary outcomes were the degree of satisfaction of the students. Random-effects models were used for the pooled evaluations. Standardized mean difference (SMD) was applied to assess the systematic results. The heterogeneity was determined by I2 statistics, and then was investigated by meta-regression and subgroup analyses. In this review, we screened and included fifteen randomized controlled researches (816 students). The pooled analysis of primary outcomes showed that VR improves test scores comparing with other approaches (standardized mean difference [SMD]= 0.53; 95% CI 0.09–0.97; I2= 87.8%). The high homogeneity indicated that the studies were different from each other. Therefore, we carried out meta-regression as well as subgroup analyses using 7 variables (year, country, learners, course, intervention, comparator, and duration). We found that VR improves postintervention test score of anatomy comparing with other types of teaching methods. Although the findings have high internal validity and limited, because of that anatomy teaching in medical universities appears to becoming a dilemma, VR may act as an efficient way to improve the learners’ level of anatomy knowledge. Future research should assess other factors like degree of satisfaction, cost-effectiveness, and adverse reactions when evaluating the teaching effectiveness of VR in anatomy.

scholarly journals End of Paediatric Posting Assessment of Medical Interns at a Teaching hospital from Coastal Karnataka

2019 ◽  
Vol 38 (2) ◽  
pp. 90-93
Author(s):  
K.S. Sahana ◽  
Ghulam Jeelani Qadiri ◽  
Prakash R.M. Saldanha
Keyword(s):  
Undergraduate Education ◽  
Critical Period ◽  
Standardized Patients ◽  
Equal Proportion ◽  
Model Driven ◽  
Medical Undergraduate ◽  
Simulation Based ◽  
Computer Based ◽  
Method Of Assessment ◽  
Medical Undergraduate Education

Introduction: Internship is very a critical period of a medical undergraduate education during which student evolves into a doctor. The objectives of this study were to assess the interns at the end of their paediatric postings. Materials and Methods. Interns knowledge and skills were assessed at the end of their postings in the must know areas. Assessment was conducted by the trained faculty and interns were given the orientation about it. Method of assessment included OSCE, simulation based using standardized patients and computer-based model driven simulators. Feedback was given to the students immediately at the end of their exam Results: Total 202 interns participated in the exam over the period of two years. New-borns assessment was done more frequently (22.7%) and interpretation of investigations was less frequently assessed (7.9%). Rest of other stations was assessed almost at the equal proportion. Highest score was observed in vaccines section (7.5) and lowest score was seen in procedures assessment (5.5). Conclusion. Interns were found to be weaker in procedural, communication and clinical scenario judgement skills which will help us in planning future training of the Interns.

Intra-articular Injection of Culture-Expanded Mesenchymal Stem Cells Without Adjuvant Surgery in Knee Osteoarthritis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (11) ◽  
pp. 2839-2849 ◽  
Author(s):  
Seong Hwan Kim ◽  
Yoshi Pratama Djaja ◽  
Yong-Beom Park ◽  
Jung-Gwan Park ◽  
Young-Bong Ko ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cartilage Repair ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Resonance Imaging ◽  
Adjuvant Surgery ◽  
Significant Difference ◽  
Standardized Mean Difference ◽  
And Cartilage

Background: Although many clinical studies have assessed the efficacy of mesenchymal stem cells (MSCs) in knee osteoarthritis, evidence on their efficacy remains unclear owing to heterogeneity of cell entity and concomitant procedures. Purpose: To determine the efficacy of culture-expanded MSCs in knee osteoarthritis in terms of clinical outcome and cartilage repair via meta-analysis of randomized controlled trials (RCTs) without adjuvant surgery. Study Design: Meta-analysis. Methods: PubMed, Embase, the Cochrane Library, CINAHL, and Scopus were searched from inception to December 31, 2018. RCTs with culture-expanded MSCs for treating knee osteoarthritis were included. Studies with adjuvant surgery or cell concentrate were excluded. Quality was assessed by the Cochrane Collaboration risk-of-bias tool. For meta-analysis, data on clinical outcomes were measured using a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and data on cartilage repair were measured using the Whole-Organ Magnetic Resonance Imaging Score (WORMS); categorization related to improvement was extracted. Results: Six RCTs (203 patients) were included. Two studies were deemed to have a low risk of bias. In pooled analysis, the only significant difference was in the VAS score (mean difference, –13.55; 95% CI, –22.19 to −4.9). In cumulative pain analysis with VAS and WOMAC pain scores, there was significant improvement after treatment (standardized mean difference, –0.54; 95% CI, –0.85 to −0.23). There was no significant difference in cartilage repair assessed by magnetic resonance imaging (standardized mean difference, 0.11; 95% CI, –0.51 to 0.73), WORMS (standardized mean difference, 1.68; 95% CI −14.84 to 18.21), or categorical results (odds ratio, 1.56; 95% CI, 0.32-7.59). Conclusion: Intra-articular injection of culture-expanded MSCs without adjuvant surgery can improve pain for patients experiencing knee osteoarthritis at short-term follow-up (6-12 months). However, evidence regarding function and cartilage repair remains limited.

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