scholarly journals Asthma Simulated Patient Simulation Team Learning Experience Using Hybrid Model Method

Author(s):  
Younsook Ju ◽  
◽  
MuyeongSeak Yang ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 576-584
Author(s):  
Richard Mary Akpan ◽  
Emmanuel Imo Udoh ◽  
Samuel Emediong Akpan ◽  
Chioma Cynthia Ozuluoha

Background: Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are dispensed only when necessary. Objective: To assess community pharmacists’ management of self-limiting infections. Methods: A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit. Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research Ethics Committee. Results: For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was ofered in 73% and 87% of the interactions, respectively. Conclusion: This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists. Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed. Keywords: Antibiotics; pharmacists; common cold; acute diarrhoea; community pharmacy; patient simulation.


2005 ◽  
Vol 36 (3) ◽  
pp. 355-363 ◽  
Author(s):  
Anna B. Kayes ◽  
D. Christopher Kayes ◽  
David A. Kolb

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20663-e20663
Author(s):  
Tara Herrmann ◽  
Martin Warters ◽  
Douglas Blevins ◽  
Panos Fidias

e20663 Background: In patients diagnosed with metastatic NSCLC it is now essential to identify targetable mutations and markers of treatment resistance in order to determine the appropriate therapy. A study was conducted to determine if simulation-based educational interventions to address clinical practice gaps could improve decisions of oncologists in the management of EGFR-mutated metastatic NSCLC. Methods: A cohort of US-oncologists who participated in a virtual patient simulation (VPS)-based education was evaluated. The VPS consisted of 2 cases that allowed oncologists to assess the patient and choose from a database of diagnostic possibilities matching the scope and depth of practice. Clinical decisions were analyzed using a decision engine, and instantaneous clinical guidance (CG) employing current evidence-based and expert faculty recommendations was provided after each decision. Oncologists were allowed a second chance at each decision point and decisions before and after CG were compared using a 2-tailed paired T-test to determine differences from pre- to post CG. P values are shown as a measure of significance; with P < .05 statistically significant. Results: 197 oncologists made clinical decisions within the simulation. As a result of CG, significant improvements were observed in: Ordering EGFR mutational testing (16%, P= 0.008) and making an accurate diagnosis (36%) Selecting an EGFR TKI in the first-line setting (24%, P< 0.001) Ordering a PET scan to assess disease progression (10%) and in diagnosing patients with EGFR T790M disease that is resistant (29% , P< 0.001) Evidence-based treatment selection for individuals whose disease progressed on first-line therapy (19%, P= .003) Number of oncologists who ordered adverse event education and counseling (23%, P< .001) Conclusions: This study showed improvements in evidence-based practices of oncologists in the diagnosis and management of EGFR-mutated NSCLC; demonstrating that VPS-based instruction that immerses and engages oncologists for an authentic, practical and16. consequence-free learning experience can result in an increase in appropriate clinical decisions. Therefore, VPS may have a role in improving the quality of patient care.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S146-S146
Author(s):  
Vimal Mannali ◽  
Paul Strickland ◽  
Craig laBuscagne ◽  
Joy Clift

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.


Biomolecules ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1703
Author(s):  
Laszlo Kiraly ◽  
Nishant C. Shah ◽  
Osama Abdullah ◽  
Oraib Al-Ketan ◽  
Reza Rowshan

Three-dimensional (3D) virtual modeling and printing advances individualized medicine and surgery. In congenital cardiac surgery, 3D virtual models and printed prototypes offer advantages of better understanding of complex anatomy, hands-on preoperative surgical planning and emulation, and improved communication within the multidisciplinary team and to patients. We report our single center team-learning experience about the realization and validation of possible clinical benefits of 3D-printed models in surgical planning of complex congenital cardiac surgery. CT-angiography raw data were segmented into 3D-virtual models of the heart-great vessels. Prototypes were 3D-printed as rigid “blood-volume” and flexible “hollow”. The accuracy of the models was evaluated intraoperatively. Production steps were realized in the framework of a clinical/research partnership. We produced 3D prototypes of the heart-great vessels for 15 case scenarios (nine males, median age: 11 months) undergoing complex intracardiac repairs. Parity between 3D models and intraoperative structures was within 1 mm range. Models refined diagnostics in 13/15, provided new anatomic information in 9/15. As a team-learning experience, all complex staged redo-operations (13/15; Aristotle-score mean: 10.64 ± 1.95) were rehearsed on the 3D models preoperatively. 3D-printed prototypes significantly contributed to an improved/alternative operative plan on the surgical approach, modification of intracardiac repair in 13/15. No operative morbidity/mortality occurred. Our clinical/research partnership provided coverage for the extra time/labor and material/machinery not financed by insurance. 3D-printed models provided a team-learning experience and contributed to the safety of complex congenital cardiac surgeries. A clinical/research partnership may open avenues for bioprinting of patient-specific implants.


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