High fidelity simulation as an alternative to traditional bedside teaching during COVID-19 and literature review (Preprint)

2021 ◽  
Author(s):  
Shereen Ajab ◽  
Emma Pearson ◽  
Steven Dumont ◽  
Alicia Mitchell ◽  
Jack Kastelik ◽  
...  

UNSTRUCTURED Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, it’s usage within medical education has been declining and additional challenges have been added during the COVID-19 pandemic. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the utilisation of online learning, social media platforms, virtual consultations, and simulation. Simulation based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with standardisation of cases. Several studies have been described in the literature, predominately using the Harvey simulator. The results demonstrate simulation-based training can increase student’s confidence, increase the rates of correct clinical diagnoses and improve retention of skills and knowledge when compared with traditional teaching methods. In order to mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School, a high-fidelity simulation based model of traditional bedside teaching was designed and implemented. The teaching sessions focused on asthma and aortic stenosis with all students having the opportunity to perform history taking and a focused cardiorespiratory clinical examination using SimMan 3G. Key aspects of the pathologies including epidemiology, differential diagnoses, investigation and management were summarised using an interactive powerpoint presentation, followed by a debriefing session. Overall feedback was highly positive with 91% of students feeling more confident in their clinical examination skills following the teaching session, all students recommending the session to a colleague and implementation of regular simulation being frequently requested amongst the responses.

2019 ◽  
Vol 133 (2) ◽  
pp. 115-118 ◽  
Author(s):  
E S Hogg ◽  
A J Kinshuck ◽  
N Littley ◽  
A Lau ◽  
S Tandon ◽  
...  

AbstractBackgroundSimulation-based training has a fundamental role in medical education as it allows the learner to gain experience managing emergencies in a safe, controlled environment.MethodsThis 1-day course consisted of eight high-fidelity simulation scenarios, followed by a video-assisted debrief focusing on the technical and non-technical (communication skills, teamwork, leadership and situational awareness) aspects of managing ENT and head and neck emergencies.ResultsEight courses have run since June 2014. Post-course questionnaires demonstrated that candidates’ confidence scores in managing airway and head and neck emergencies increased following completion of the course (p < 0.0001).ConclusionThis was the first fully immersive ENT simulation course developed in the region. The learning objectives for each scenario were mapped to the ENT Intercollegiate Surgical Curriculum Programme. Feedback from the course indicated a continued demand for this style of training, leading to its inclusion in the training calendar.


2020 ◽  
Author(s):  
Li TONG ◽  
Wen-jie HU ◽  
Yan-ping ZHU ◽  
Lu CAO ◽  
Ying-hui LI ◽  
...  

Abstract Background: This study aimed to design a suitable integrated extracorporeal membrane oxygenation (ECMO) curriculum and assessed the impact of this a high-fidelity simulation-based education module on novice learners. Methods: An ECMO training curriculum was developed by well-trained and experienced ECMO experts that incorporated simulation modules to train multidisciplinary health care professionals. Pre- and post-participation questionnaires were used to determine the effects on the knowledge, ability, and confidence level of the participants. A five-point Likert scale was used to assess the participants regarding the ECMO practical test. Results: The study enrolled 37 participants (10 doctors, 27nurses). 67.6% (25/37) of trainees didn’t have ECMO experience. All two questionnaires were completed by 37 participants. A five-point Likert scale on practical test was finished by 4 ECMO experts. All participants passed the written and practical tests. All the responding participants thought the curriculum was useful in improving their perception of their overall knowledge and their ability to perform the required critical performance criteria on simulated ECMO. 91.9% (34/37) trainees thought that they invested more in active learning during the whole course; 60% (22/37) of them achieved a good level of technical evaluation. On the other hand, 67.6% (25/37) of the trainees have shown a good self-confidence in the priming course; however, 43.2% (16/27) trainees still needed to strengthen their overall competence in ECMO management. Conclusions: The integration of traditional teaching and high-fidelity simulation teaching can effectively improve the ECMO monitoring level and management skills of novice learners, but whether this training mode can be successfully transferred to the clinical field needs further research and confirmation.


2020 ◽  
Author(s):  
Matthew E Miller ◽  
Gretchen Scholl ◽  
Sky Corby ◽  
Vishnu Mohan ◽  
Jeffrey Gold

BACKGROUND Accurate data retrieval is an essential part of patient care in ICU. The electronic health record (EHR) is the primary method of data storage and data review. We previously reported that residents participating in EHR based simulations have varied and nonstandard approaches to data finding in the ICU, with subsequent errors in recognition of patient safety issues. We hypothesized that a novel EHR simulation based training exercise would decrease variability in EHR use among intervention interns irrespective of prior EHR experience. OBJECTIVE To understand the impact of a novel, short, high-fidelity, simulation-based electronic health record learning activity on intern data gathering workflow and satisfaction. METHODS Seventy-two internal medicine interns across the 2018-19 academic years underwent a dedicated EHR training session as part of a week-long boot camp early in their training. We collected data on previous EHR and ICU experience for all subjects. Training consisted of an hour of guided review of a high-fidelity, simulated ICU patient chart focusing on best practices for navigation for data retrieval. Specifically, the activity focused on utilizing high and low yield data visualization screens determined by expert-consensus. Intervention group interns then had 20 minutes to review a new simulated patient chart before group review. EHR screen navigation was captured utilizing screen recording software and compared with data from existing ICU residents performing the same task on the same medical charts (N=62). Learners were surveyed immediately and 6-months after the activity to assess satisfaction as well as preferred EHR screen use. RESULTS Participants found the activity useful and enjoyable immediately and after six months. Intervention interns used more individual screens than reference residents (18 vs 20, p=0.008) but the total number of screens used were the same (35 vs 38, p=NS). Significantly more of the intervention interns used the ten most common screens (73% vs 45%, p=0.001). Intervention interns used high-yield screens more often and low-yield screens less often than the reference residents, which persistent on self-report 6 months later. CONCLUSIONS A short, high-fidelity, simulation-based learning activity focused on provider-specific data gathering was found to be enjoyable and to persistently modify navigation patterns. This suggests that workflow specific simulation-based EHR training throughout training is of educational benefit to residents. CLINICALTRIAL n/a


2020 ◽  
Author(s):  
Li TONG ◽  
Wen-jie HU ◽  
Yan-Ping ZHU ◽  
Lu CAO ◽  
Ying-Hui LI ◽  
...  

Abstract Background: This study aimed to design a suitable integrated extracorporeal membrane oxygenation (ECMO) curriculum and assessed the impact of this a high-fidelity simulation-based education module on novice learners.Methods: An ECMO training curriculum was developed by well-trained and experienced ECMO experts that incorporated simulation modules to train multidisciplinary health care professionals. Pre- and post-participation questionnaires were used to determine the effects on the knowledge, ability, and confidence level of the participants. A five-point Likert scale was used to assess the participants regarding the ECMO practical test.Results: The study enrolled 37 participants (10 doctors, 27nurses). 67.6% (25/37) of trainees didn’t have ECMO experience. All two questionnaires were completed by 37 participants. A five-point Likert scale on practical test was finished by 4 ECMO experts. All participants passed the written and practical tests. All the responding participants thought the curriculum was useful in improving their perception of their overall knowledge and their ability to perform the required critical performance criteria on simulated ECMO. 91.9% (34/37) trainees thought that they invested more in active learning during the whole course; 60% (22/37) of them achieved a good level of technical evaluation. On the other hand, 67.6% (25/37) of the trainees have shown a good self-confidence in the priming course; however, 43.2% (16/27) trainees still needed to strengthen their overall competence in ECMO management. Conclusions: The integration of traditional teaching and high-fidelity simulation teaching can effectively improve the ECMO monitoring level and management skills of novice learners, but whether this training mode can be successfully transferred to the clinical field needs further research and confirmation.


2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Viola Janse van Vuuren ◽  
Eunice Seekoe ◽  
Daniel Ter Goon

Although nurse educators are aware of the advantages of simulation-based training, some still feel uncomfortable to use technology or lack the motivation to learn how to use the technology. The aging population of nurse educators causes frustration and anxiety. They struggle with how to include these tools particularly in the light of faculty shortages. Nursing education programmes are increasingly adopting simulation in both undergraduate and graduate curricula. The aim of this study was to determine the perceptions of nurse educators regarding the use of high fidelity simulation (HFS) in nursing education at a South African private nursing college. A national survey of nurse educators and clinical training specialists was completed with 118 participants; however, only 79 completed the survey. The findings indicate that everyone is at the same level as far as technology readiness is concerned, however, it does not play a significant role in the use of HFS. These findings support the educators’ need for training to adequately prepare them to use simulation equipment. There is a need for further research to determine what other factors play a role in the use of HFS; and if the benefits of HFS are superior to other teaching strategies warranting the time and financial commitment. The findings of this study can be used as guidelines for other institutions to prepare their teaching staff in the use of HFS.


2018 ◽  
Vol 32 (6) ◽  
pp. 727-738
Author(s):  
Cindy Chamberland ◽  
Helen M. Hodgetts ◽  
Chelsea Kramer ◽  
Esther Breton ◽  
Gilles Chiniara ◽  
...  

2021 ◽  
Vol 113 (1) ◽  
pp. 101-110
Author(s):  
Juan I. Cobián ◽  
◽  
Federico Ferrero ◽  
Martín P. Alonso ◽  
Alberto M. Fontana

Background: Learning complex tasks in surgical requires the coordination and integration of technical and non-technical skills have an impact on the performance of work teams. Objective: The aim of this study is to report the results of a simulation-based educational strategy for training in complex surgical skills considering the participants’ perceptions. Material and methods: In 2019, 10 healthcare professionals participated in a 20-hour course divided in 6 hours of online training and 14 hours of onsite training. The strategy designed included the integration of case resolution activities, role-playing, practice with synthetic and virtual simulators and high-fidelity simulation. At the end of the course, a questionnaire was administered to explore participants’ perceptions on what they had learned and on their attitude changes. Results: Fifty percent of the participants perceived their skills and knowledge improved at the end of the course compared with their perception at the beginning of the course while 80% perceived the impact of the course on their professional activity was good or excellent. All the participants agreed with the need for improving non-technical skills. The experience was rated as positive or very positive by all participants, who were eager to repeat it. Conclusion: The participants’ perceptions of this educational program demonstrates that this method is highly accepted. Raising awareness of non-technical skills during the reflection stage suggests the need for changes in attitude and in self-perception of efficacy. We believe that simulation-based training offers the possibility of improving the overall performance of the surgical team. Future studies should focus on this goal.


Author(s):  
Thomas E. Doyle ◽  
David Musson ◽  
Jon-Michael J Booth

The skill of visualization is fundamental to the teaching and learning of engineering design and graphics. Implicit in any skill is the ability to improve with training and practice. This study examines visualization performance using three teaching modalities of a Freshmen Design and Graphics course: 1) Traditional, 2) Project based Dissection, and 3) Simulation based Design. The first and second modalities focused assessment on the part/assembly form, whereas the third modality transitioned the outcome expectations to understanding and function of mechanism design. A shift of focus from Traditional (Form) to Simulation (Function) was expected to positively effect visualization performance. Analogously, medical education and practice also require visualization and high-fidelity simulation has provided numerous positive outcomes for the practice of medicine. Comparison of a random population of 375 from each year indicated a decline in the average visualization scores. Further analysis revealed that highest 100 and 250 exam score populations show improvement in average scores with consistent variance. This paper will examine simulation based learning in medicine and engineering, present our findings on the comparison between teaching modalities, and discuss the reasons for the unexpected bifurcation of results.


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