scholarly journals Moving Forward from the “Boot Camp Method” To Learning-Curve Development in Simulation-Based Paracentesis Training For Undergraduate Medical Students

Author(s):  
Martin Inzunza ◽  
Rodrigo Tejos ◽  
Ignacio Villagrán ◽  
Eduardo Fuentes ◽  
Caterina Contreras ◽  
...  

Abstract Background: Abdominal paracentesis is an essential competence for physicians. Simulation-based mastery learning (SBML) programs lead to developing these skills for medical students. Most programs are structured as short boot-camps, without assessing skills' retention mid and long-term or learning curves.Aim: To assess the learning curve of paracentesis through an SBML program for medical students and compare this learning curve-based program with the boot-camp method.Methods: A prospective quasi-experimental study was conducted. A cohort of medical students participated in an SBML program with successive sessions until proficiency criteria were met while their learning curve was assessed (LC group). A control group received an SBML boot-camp intervention (BC group). As a proficient group, gastroenterology fellows (GF group) performed a paracentesis on the simulated model. The skills of the three groups were compared using technical/proficiency scores. Learning curves and cost analysis were performed.Results: 100% of the LC group achieved proficiency in the fourth session, with a flattening learning curve between third-fourth sessions. Comparing the initial and final sessions of LC group showed a significant improvement in their scores. When comparing the three groups, statistical differences were found in the skill scores, with the BC group having the lowest. The overall cost per participant was highest for the LC group.Conclusion: This study identifies a learning curve for paracentesis with an SBML program. The LC group significantly improved their skills, comparable with the GF group’s performance. SBML focused on a learning curve ensured better skills acquisition than the “boot-camp method.”

CJEM ◽  
2010 ◽  
Vol 12 (01) ◽  
pp. 27-32 ◽  
Author(s):  
Jeffrey Michael Franc-Law ◽  
Pier Luigi Ingrassia ◽  
Luca Ragazzoni ◽  
Francesco Della Corte

ABSTRACT Objective: Training in practical aspects of disaster medicine is often impossible, and simulation may offer an educational opportunity superior to traditional didactic methods. We sought to determine whether exposure to an electronic simulation tool would improve the ability of medical students to manage a simulated disaster. Methods: We stratified 22 students by year of education and randomly assigned 50% from each category to form the intervention group, with the remaining 50% forming the control group. Both groups received the same didactic training sessions. The intervention group received additional disaster medicine training on a patient simulator (disastermed.ca), and the control group spent equal time on the simulator in a nondisaster setting. We compared markers of patient flow during a simulated disaster, including mean differences in time and number of patients to reach triage, bed assignment, patient assessment and disposition. In addition, we compared triage accuracy and scores on a structured command-and-control instrument. We collected data on the students' evaluations of the course for secondary purposes. Results: Participants in the intervention group triaged their patients more quickly than participants in the control group (mean difference 43 s, 99.5% confidence interval [CI] 12 to 75 s). The score of performance indicators on a standardized scale was also significantly higher in the intervention group (18/18) when compared with the control group (8/18) (p < 0.001). All students indicated that they preferred the simulation-based curriculum to a lecture-based curriculum. When asked to rate the exercise overall, both groups gave a median score of 8 on a 10-point modified Likert scale. Conclusion: Participation in an electronic disaster simulation using the disastermed.ca software package appears to increase the speed at which medical students triage simulated patients and increase their score on a structured command-and-control performance indicator instrument. Participants indicated that the simulation-based curriculum in disaster medicine is preferable to a lecture-based curriculum. Overall student satisfaction with the simulation-based curriculum was high.


2017 ◽  
Vol 3 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Sinéad Lydon ◽  
Nadine Burns ◽  
Olive Healy ◽  
Paul O'Connor ◽  
Bronwyn Reid McDermott ◽  
...  

IntroductionA lack of preparedness for practice has been observed among new medical graduates. Simulation technology may offer one means of producing competency. This paper describes the application of a simulation-based intervention incorporating precision teaching (PT), a method of defining target skills, assessing individual progress and guiding instructional decisions, which is used to monitor learning and the development of behavioural fluency in other domains, to procedural skills training. Behavioural fluency refers to accurate and rapid responding that does not deteriorate with time, is resistant to distraction and can be adapted into new, more complex responses.MethodThis study used a between-groups design to evaluate the efficacy of a simulation-based intervention incorporating PT for teaching venepuncture among 11 medical students. The intervention consisted of timed learning trials during which participants carried out the skill in pairs and received corrective feedback. Two control groups of 11 untrained medical students and 11 junior doctors were also included in the study.ResultsIntervention group participants required an average of five trials and 21.9 min to reach the criterion for fluency. The intervention group demonstrated significantly higher accuracy in venepuncture performance than either control group. Improvements persisted over time, did not deteriorate during distraction, generalised to performance with patients and performance of an untargeted skill also improved.ConclusionsThe outcomes of this preliminary study support the application of PT within medical education. The implications of these data for clinical and procedural skills training are explored and suggestions are made for further research.


2020 ◽  
Author(s):  
Anne-Laure Philippon ◽  
Jennifer Truchot ◽  
Nathalie De Suremain ◽  
Marie-Christine Renaud ◽  
Arnaud Petit ◽  
...  

Abstract Background Simulation-based assessment is scarcely used for undergraduate medical students. We created a simulation-based assessment to validate medical students’ technical and psychometrics’ skills, during their emergency medicine and pediatric curriculum. The aim of our study was to collect medical students’ perception on this novel assessment.Methods This is a qualitative study that includes 9 focus groups among the 215 students who participated in either a pediatric or an emergency medicine simulation-based-course. These sessions ended by an assessment on a manikin. Among the 40 students who were randomly selected to participate in the focus groups, 30 agreed to participate. Data were analyzed using grounded theory and, data were coded the by two independent investigators.Results Seven major and two minor themes emerged from the focus groups. The importance of being certified by simulation to be more self-confident in hospital clerkships, the perception of simulation-based assessment as a high quality assessment, the contribution of the simulation-based assessment to change students’ practices and enhance their engagement in their curriculum and a disappointment because simulation-based assessment didn’t help student for the faculty high stakes assessments. Some students also found that simulation-based assessment was a stressful and unfair exercise. The last discussion was about practical issues of the assessment such as this normative way, and about the importance of the feedback.Conclusion The students reported positive aspects of the simulation-based assessment method such as helpful for their hospital clerkship, change of their practices and way of learning. However they also reported that it might be a biased and a stressful assessment method.


Author(s):  
Murilo Sabbag Moretti ◽  
Alex Sandro Gomes Pessoa

Abstract: Introduction: Assistance in health services is often the first possibility for the identification of cases of Violence Against Children and Teenagers (VACT). Therefore, the aim of this article was to evaluate the effectiveness of an intervention program developed to enable students and health professionals to recognize and report cases of VACT. Additionally, we sought to verify at what level of training (undergraduate, postgraduate or working professional) such intervention would show the greatest effect. Method: This is a quasi-experimental study, of which design was based on the analysis of a non-equivalent Control Group (CG). The research included undergraduate medical students, postgraduate medical students attending pediatric residency and professionals working in health institutions. A total of 105 people participated, of which 89% were women. The participants were subsequently subdivided between the Experimental Group - EG (n = 60) and Control Group - CG (n = 45). A training program on the topic, consisting of 10 sessions (20h in total), was developed and applied with an EG. To assess the effectiveness of the intervention, a questionnaire was applied at previously determined periods (pre-test and post-test). The data were submitted to statistical analysis (descriptive analyses, t test and Tukey’s multiple comparison test), using the software R. Results: The post-test showed statistically significant changes in all dimensions evaluated with the EG, which proves that the intervention resulted in changes regarding the previous conceptions that the participants had about VACT. Additionally, when comparing the responses obtained in the questionnaires between the three EG groups (undergraduate, postgraduate students and working professionals), it was verified that there were no statistical differences between the groups, suggesting that educational programs have positive effects on all levels of training. Conclusions: This study showed that training programs can qualify the conception of students and health professionals, as well as help them feel more prepared to deal with the demands related to VACT. However, a collective effort is needed so that these contents are purposefully incorporated into the training process at all levels, from undergraduate school to continuing education.


Author(s):  
Panteleimon Pantelidis ◽  
Nikolaos Staikoglou ◽  
Georgios Paparoidamis ◽  
Christos Drosos ◽  
Stefanos Karamaroudis ◽  
...  

Purpose: The integration of simulation-based learning (SBL) methods holds promise for improving the medical education system in Greece. The Applied Basic Clinical Seminar with Scenarios for Students (ABCS3) is a novel two-day SBL course that was designed by the Scientific Society of Hellenic Medical Students. The ABCS3 targeted undergraduate medical students and consisted of three core components: the case-based lectures, the ABCDE hands-on station, and the simulation-based clinical scenarios. The purpose of this study was to evaluate the general educational environment of the course, as well as the skills and knowledge acquired by the participants. Methods: Two sets of questions were distributed to the participants: the Dundee Ready Educational Environment Measure (DREEM) questionnaire and an internally designed feedback questionnaire (InEv). A multiple-choice examination was also distributed prior to the course and following its completion. A total of 176 participants answered the DREEM questionnaire, 56 the InEv, and 60 the MCQs. Results: The overall DREEM score was 144.61(±28.05) out of 200. Delegates who participated in both the case-based lectures and the interactive scenarios core components scored higher than those who only completed the case-based lecture session (P=0.038). The mean overall feedback score was 4.12(±0.56) out of 5. Students scored significantly higher on the post-test than on the pre-test (P<0.001). Conclusion: The ABCS3 was found to be an effective SBL program, as medical students reported positive opinions about their experiences and exhibited improvements in their clinical knowledge and skills.


2021 ◽  
Vol 9 ◽  
Author(s):  
Liyuan Hu ◽  
Lan Zhang ◽  
Rong Yin ◽  
Zhihua Li ◽  
Jianqing Shen ◽  
...  

Background: Serious games are potential alternatives for supplementing traditional simulation-based education for neonatal resuscitation training. However, evidence regarding the benefits of using serious games to improve long-term knowledge retention of neonatal resuscitation in undergraduate medical students is lacking.Objective: We designed a serious computer game “NEOGAMES” to train undergraduate medical students in neonatal resuscitation in a cost-friendly and accessible way and to examine whether serious game-based training improves long-term knowledge retention in medical students.Methods: “NEOGAMES” consists of a screen with images of an incubator, a baby, visual objects, anatomy, action cards, monitors, real-time feedback, and emotional components. Undergraduate medical students from Shanghai Medical College of Fudan University were invited to participate and were allocated to a game group or a control group. Participants in the game group played the game before the training. All the participants completed three written tests, pre- and post-training knowledge tests and a follow-up test after 6 months.Results: Eighty-one medical students participated in the study. The student demographic characteristics of the groups were comparable, including sex, age, and grade point average (GPA). Significant short-term knowledge improvement was noticed only for male students in the game group based on their 5.2-point higher test scores than those of the controls (p = 0.006). However, long-term knowledge improvement at 6 months was identified for both male and female students in the game group, with test scores 21.8 and 20 points higher, respectively, than those of the controls (P &lt; 0.001). The long-term knowledge retention in the game group was almost 3 times higher than that in the control group.Conclusions: Long-term knowledge retention was nearly 3 times higher for the game group than for the control group. The improvement in knowledge supports the use of serious games for undergraduate medical education.


2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Guanchao Jiang ◽  
Hong Chen ◽  
Shan Wang ◽  
Qinghuan Zhou ◽  
Xiao Li ◽  
...  

Author(s):  
Rabi R. Datta ◽  
Sebastian Schönhage ◽  
Thomas Dratsch ◽  
Justus Toader ◽  
Dolores T. Müller ◽  
...  

Abstract Background Minimally invasive single-port surgery is always associated with large incisions up to 2–3 cm, complicated handling due to the lack of triangulation, and instrument crossing. The aim of this prospective study was to report how medical students without any laparoscopic experience perform several laparoscopic tasks (rope pass, paper cut, peg transfer, recapping, and needle threading) with the new SymphonX single-port platform and to examine the learning curves in comparison to the laparoscopic multi-port technique. Methods A set of 5 laparoscopic skill tests (Rope Pass, Paper cut, Peg Transfer, Recapping, Needle Thread) were performed with 3 repetitions. Medical students performed all tests with both standard laparoscopic instruments and the new platform. Time and errors were recorded. Results A total of 114 medical students (61 females) with a median age of 23 years completed the study. All subjects were able to perform the skill tests with both standard laparoscopic multi-port and the single-port laparoscopic system and were able to significantly improve their performance over the three trials for all five tasks—rope pass (p < 0.001), paper cut (p < 0.001), peg transfer (p < 0.001), needle threading (p < 0.001), and recapping (p < 0.001). In 3 out of 5 tasks, medical students performed the tasks faster using the standard multi-port system—rope pass (p < 0.001), paper cut (p < 0.001), and peg transfer (p < 0.001). In the task recapping, medical students performed the task faster using the new single-port system (p = 0.003). In the task needle threading, there was no significant difference between the standard multi-port system and the new single-port system (p > 0.05). Conclusion This is the first study analyzing learning curves of the commercially available SymphonX platform for abdominal laparoscopic surgery when used by novices. The learning curve and the error rate are promising.


Author(s):  
Murilo Sabbag Moretti ◽  
Alex Sandro Gomes Pessoa

Abstract: Introduction: Assistance in health services is often the first possibility for the identification of cases of Violence Against Children and Teenagers (VACT). Therefore, the aim of this article was to evaluate the effectiveness of an intervention program developed to enable students and health professionals to recognize and report cases of VACT. Additionally, we sought to verify at what level of training (undergraduate, postgraduate or working professional) such intervention would show the greatest effect. Method: This is a quasi-experimental study, of which design was based on the analysis of a non-equivalent Control Group (CG). The research included undergraduate medical students, postgraduate medical students attending pediatric residency and professionals working in health institutions. A total of 105 people participated, of which 89% were women. The participants were subsequently subdivided between the Experimental Group - EG (n = 60) and Control Group - CG (n = 45). A training program on the topic, consisting of 10 sessions (20h in total), was developed and applied with an EG. To assess the effectiveness of the intervention, a questionnaire was applied at previously determined periods (pre-test and post-test). The data were submitted to statistical analysis (descriptive analyses, t test and Tukey’s multiple comparison test), using the software R. Results: The post-test showed statistically significant changes in all dimensions evaluated with the EG, which proves that the intervention resulted in changes regarding the previous conceptions that the participants had about VACT. Additionally, when comparing the responses obtained in the questionnaires between the three EG groups (undergraduate, postgraduate students and working professionals), it was verified that there were no statistical differences between the groups, suggesting that educational programs have positive effects on all levels of training. Conclusions: This study showed that training programs can qualify the conception of students and health professionals, as well as help them feel more prepared to deal with the demands related to VACT. However, a collective effort is needed so that these contents are purposefully incorporated into the training process at all levels, from undergraduate school to continuing education.


2021 ◽  
Author(s):  
Kay Wu ◽  
Alex Chan ◽  
Avinash Pandey ◽  
Puru Panchal ◽  
Maroof Khalid ◽  
...  

Background: The COVID-19 pandemic has restricted in-person clinical training for medical students. Simulation-based teaching is a promising tool to introduce learners to the clinical environment. MacSim is a student-led simulation workshop for learners to develop clinical competencies. The objective of this study was to assess the impacts of MacSim and participants' perspectives regarding simulation-based teaching. Methods: A comprehensive simulation, representative of a virtual care scenario, was delivered to 42 pre-clerkship medical students via video conferencing. In pairs, participants obtained histories and carried out management plans for simulated patients. Participants were surveyed and interviewed. Survey data were analyzed using the Wilcoxon signed-ranks test. Interview transcript data were thematically analyzed. Results: Post-simulation, participants (n=24) felt more prepared to make clinical decisions, collaborate, and communicate in a virtual setting. 92% of respondents agreed MacSim was a valuable learning experience and 96% agreed more simulation-based learning should be integrated into curricula. Emergent themes from interviews (n=12) included: 1) value of simulation fidelity, 2) value of physician feedback, and 3) effectiveness of MacSim in improving virtual clinical skills. Conclusion: Simulation-based teaching is of importance and educational value to medical students. It may play an increasingly prevalent role in education as virtual care is likely to become more prevalent.


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