Development of Simulation Methods in Biomedical Sciences - From Phantoms to Virtual Patients

AbstractSimulation is an imitation of the operation of a real process or system over time that is applied for a variety of purposes, including entertainment, education, training, system evaluation, and research. Medical simulation is an artificial presentation of real clinical situations, which is applied in education. Medical simulation allows the acquisition of clinical skills without the risk of harming the patient. Medical simulations have been developed and refined over the years-simulation models, cadavers, actors and robots have found wide application in medical training. Of more sophisticated simulation technologies, Virtual and Augmented Realities are used. The presence of science in the digital world is necessary in order to market the proven knowledge acquired in an adequate manner. The traditional teaching process, despite serious and thorough research, seems non-inspirational, and it is important that educators and teachers keep up with the times and provide students with the latest teaching and work methods.

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Does simulation suffice? Teaching procedural skills in undergraduate medical students- observational quasi-experimental study.

10.21203/rs.2.18685/v1 ◽

2019 ◽

Author(s):

Katarzyna Naylor ◽

Kamil Torres

Keyword(s):

Medical Training ◽

Teaching Method ◽

Clinical Skills ◽

Early Years ◽

Medical Simulation ◽

Clinical Environment ◽

Undergraduate Medical Students ◽

Instructional Videos ◽

Simulation Techniques ◽

Quasi Experimental

Abstract Background. Medical simulation as a teaching method is concerned with close mirroring of the real clinical conditions, it is designed to develop skills from the clinical environment, under the guidance of experienced instructors, it allows standardization and repeatability of the skills taught. As a result, students acquire skills and competences, become acquainted with the medical equipment needed to perform a given procedure without endangering patients. The presented research attempts to evaluate the application of medical simulation techniques in the teaching of basic clinical skills using original instructional videos and the Peyton approach. Also, an attempt was made to assess how the applied interventions affect the assessment regarding the usefulness of the course by the students of medicine in comparison with the results of practical assessment in the form of OSCE. Materials. The research was conducted in the period from May 2015 to June 2017, among 750 students of the medical faculty of the Medical University in Lublin. The study used a self-reported questionnaire and documentation analysis with the results of practical assessment. The obtained results were statistically analyzed.Results. The overall students scored the BCS course high (good and very good). The highest values were assigned to Stage III of the research. The introduction of simulation techniques along with the original instructional videos and the Peyton approach positively reflected in the results obtained in the final assessment, OSCE, especially in case of invasive procedures: peripheral vein cannulation and urinary bladder catheterization. Conclusions. Consequently, obtained results allowed concluding that the use of medical simulation techniques in the teaching of basic clinical skills using modern methodologies and teaching interventions: original instructional videos and the Peyton approach affected the positive assessment of the usefulness of the simulation course by students, as well as improve and support the process of acquiring basic skills clinical in the early years of medical training.

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Outcomes of Using Heart Sound Simulator in Teaching Cardiac Auscultation

Canadian Medical Education Journal ◽

10.36834/cmej.36528 ◽

2010 ◽

Vol 1 (1) ◽

pp. e46-e50 ◽

Cited By ~ 1

Author(s):

Ralitsa Akins ◽

Hoi Ho

Keyword(s):

Curriculum Reform ◽

Heart Sound ◽

Medical Training ◽

Clinical Skills ◽

Training Session ◽

Resident Training ◽

Training System ◽

Heart Sounds ◽

Training Methods ◽

Significant Difference

Background - Despite continued curriculum reform, the clinical skills competencies of medical graduates at all levels are steadily declining within a training system, where bedside opportunities become a luxury and the laboratory tests prevail over the clinical skills. While high-fidelity expensive simulators are being embraced by high-procedure volume specialties, low-fidelity and relatively inexpensive simulators, such as the heart sounds simulators remain under-utilized in medical training. Methods - We used a commercially available heart sound synthesizer in 2-hour training sessions with students and residents. Pre-post testing was completed at the beginning of the training session and three weeks after the session; participant responses were recorded by audience interactive response system. Results - Data analysis was accomplished with statistical software SPSS 17.0 utilizing paired t-test, and showed a statistically significant difference in learners’ knowledge and skills attainment 3 weeks after completion of the simulation training (p<0.0001). Conclusions - Based on our findings and the review of literature, we recommend that heart sound simulation is introduced at medical student level as the standard for teaching cardiologic auscultation findings and as preparation for auscultation of live patients. We also suggest that training with digitally simulated heart sounds is similarly beneficial in resident training.

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Student Perceived Value of Anatomy Pedagogy, Part I: Prosection or Dissection?

Journal of Medical Education and Curricular Development ◽

10.4137/jmecd.s17496 ◽

2015 ◽

Vol 2 ◽

pp. JMECD.S17496 ◽

Cited By ~ 2

Author(s):

Jonathan J. Wisco ◽

Stephanie Young ◽

Paul Rabedeaux ◽

Seth D. Lerner ◽

Paul F. Wimmers ◽

...

Keyword(s):

Medical Education ◽

Medical School ◽

Student Perceptions ◽

Medical Curriculum ◽

Clinical Skills ◽

School Experience ◽

First Year ◽

Biomedical Sciences ◽

Medical Specialties ◽

Preclinical Medical Education

A series of three annual surveys of David Geffen School of Medicine (DGSOM) at UCLA students and UCR/UCLA Thomas Haider Program in Biomedical Sciences students were administered from 2010 to 2012 to ascertain student perceptions of which anatomy pedagogy—prosection or dissection—was most valuable to them during the first year of preclinical medical education and for the entire medical school experience in general. Students were asked, “What value does gross anatomy education have in preclinical medical education?” We further asked the students who participated in both prosection and dissection pedagogies, “Would you have preferred an anatomy curriculum like the Summer Anatomy Dissection during your first year in medical school instead of prosection?” All students who responded to the survey viewed anatomy as a highly valued part of the medical curriculum, specifically referring to four major themes: Anatomy is (1) the basis for medical understanding, (2) part of the overall medical school experience, (3) a bridge to understanding pathology and physiology, and (4) the foundation for clinical skills. Students who participated in both prosection and dissection pedagogies surprisingly and overwhelmingly advocated for a prosection curriculum for the first year of medical school, not a dissection curriculum. Time efficiency was the dominant theme in survey responses from students who learned anatomy through prosection and then dissection. Students, regardless of whether interested in surgery/radiology or not, appreciated both pedagogies but commented that prosection was sufficient for learning basic anatomy, while dissection was a necessary experience in preparation for the anatomical medical specialties. This suggests that anatomy instruction should be integrated into the clinical years of medical education.

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Simulation capacity building in rural Indian hospitals: a 1-year follow-up qualitative analysis

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2019-000577 ◽

2020 ◽

pp. bmjstel-2019-000577

Author(s):

Veena Sheshadri ◽

Isaac Wasserman ◽

Alexander W Peters ◽

Vatshalan Santhirapala ◽

Shivani Mitra ◽

...

Keyword(s):

Simulation Training ◽

Medical Training ◽

Rural Hospitals ◽

Medical Simulation ◽

Staff Members ◽

Context Sensitive ◽

Consultant Anaesthetist ◽

Time Required ◽

Training Programmes ◽

Simulator Program

IntroductionThe benefits of simulation-based medical training are well described. The most effective way to plant and scale simulation training in rural locations remains undescribed. We sought to plant simulation training programmes for anaesthesia emergencies in two rural Indian hospitals.MethodsTwo Indian consultant anaesthetists without experience in medical simulation underwent a 3-day course at the Boston Children’s Hospital’s (BCH) Simulator Program. They returned to their institutions and launched simulation programmes with an airway manikin and mock patient monitor. The 1-year experience was evaluated using individual, in-depth interviews of simulation facilitators. Three staff members (responsible for facilitating medical simulations over the prior year) at two rural hospitals in India were interviewed. None attended the BCH training; instead, they received on-the-job training from the BCH-trained, consultant anaesthetist colleagues.ResultsSuccesses included organisational adoption of simulation training with exercises 1 year after the initial BCH-training, increased interdisciplinary teamwork and improved clinical competency in managing emergencies. Barriers to effective, local implementation of simulation programmes fell into three categories: time required to run simulations, fixed and rigid roles, and variable resources. Thematic improvement requests were for standardised resources to help train simulation facilitators and demonstrate to participants a well-run simulation, in addition to context-sensitive scenarios.ConclusionAn in-person training of simulation facilitators to promote medical simulation programmes in rural hospitals produced ongoing simulation programmes 1 year later. In order to make these programmes sustainable, however, increased investment in developing simulation facilitators is required. In particular, simulation facilitators must be prepared to formally train other simulation facilitators, too.

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A Cloud-Based Architecture for Interactive E-Training

Cloud Security ◽

10.4018/978-1-5225-8176-5.ch070 ◽

2019 ◽

pp. 1379-1392 ◽

Cited By ~ 1

Author(s):

Halima E. Samra ◽

Alice S. Li ◽

Ben Soh ◽

Mohammed A. AlZain

Keyword(s):

Positive Impact ◽

Clinical Skills ◽

Skills Training ◽

Training System ◽

Cloud Services ◽

Technology Enhanced Learning ◽

Clinical Skills Training ◽

Intensive Training ◽

Training Resources ◽

Cloud Technologies

Cloud-based technologies play a significant role in the technology-enhanced learning domain. The adoption of cloud technologies in the educational environment has a positive impact on the learning process by offering new tools and services to improve and support the learning life cycle, including interactivity. In specific fields, such as clinical skills training, that involve computer-intensive training scenarios, there is an increased demand to deliver training services to a larger number of learners, therefore the need for cloud services. However, to date there has been a lack of a formalized framework relating to the use of cloud computing for on-demand interactive e-training resources. This paper is to formalize a theoretical framework for an interactive e-training system particularly for clinical skills training, taking into consideration e-training system requirements and with a focus on applying cloud technologies to ensure the dynamic scalability of services and computing power while maintaining QoS and security

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Experiences of a Student Elective at McGill University

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2012010104 ◽

2012 ◽

Vol 2 (1) ◽

pp. 29-32

Author(s):

Mohsin Bin Mushtaq

Keyword(s):

South Asian ◽

Medical Training ◽

Tertiary Care Hospital ◽

Clinical Skills ◽

Tertiary Care ◽

Care Hospital ◽

Online Forums ◽

Undergraduate Training ◽

School Of Medicine ◽

Mcgill University

It is often debated if medical electives are beneficial for students. While medical electives are not mandatory for students in the developing world, they are an important part of medical training in some Western universities (UCSD School of Medicine, n.d.) and have been part of UK undergraduate training since the 1970s (Cruikshank & Walsh, 1980). In the West medical schools form committees to guide, counsel, and help students plan their electives during vacations. In South Asia, the concept of electives is minimally encouraged; however, the students themselves share their elective experience and encourage other students to take electives, mostly through online forums. Electives often provide students a chance to work in a different setup, with different disease prevalence patterns, hospital management protocols, and learning experiences under various doctors with diverse problem solving approaches. It is also a two pronged tool whereby students can enhance their clinical skills and find opportunities to obtain a research project under the mentorship of research oriented academic consultants. This article is a brief sketch of experiences encountered by a South Asian medical student on a clerkship elective rotation in cardiology at a tertiary care hospital in Canada.

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Perceptions of Internal Medicine Residency Program Candidates on the Use of Simulation in the Selection Process

Journal of Graduate Medical Education ◽

10.4300/jgme-d-13-00276.1 ◽

2014 ◽

Vol 6 (2) ◽

pp. 338-340 ◽

Cited By ~ 1

Author(s):

Keith Cannon ◽

Zachary Hartsell ◽

Ilko Ivanov ◽

Joseph Charles ◽

Harshad Joshi ◽

...

Keyword(s):

Internal Medicine ◽

Medical School ◽

Residency Program ◽

Situational Awareness ◽

Clinical Skills ◽

Selection Process ◽

Internal Medicine Residency ◽

Medical Simulation ◽

Internal Medicine Residency Program ◽

Interview Process

Abstract Background The recruitment of skilled candidates into internal medicine residency programs has relied on traditional interviewing techniques with varying degrees of success. The development of simulated medical technology has provided a new arena in which to assess candidates' clinical skills, knowledge base, situational awareness, and problem-solving dexterities within a standardized environment for educational and assessment purposes. Objective The purpose of this study was to investigate the interest of program candidates in incorporating simulation medicine into the internal medicine residency interview process. Methods As a prospective, survey-based analysis, potential candidates who completed an interview between October 2012 and January 2013 with an accredited internal medicine residency program were sent a postmatch survey that incorporated 3 additional questions relating to their prior experience with medical simulation and their views on incorporating the technology into the interview format. Results Of the 88 candidates who completed an interview, 92% (n = 81) were scheduled to graduate medical school in 2013 and were graduates of a US medical school. All survey responders described previous experience with medical simulation. Fifty-eight percent (n = 51) of responders described being “less likely” to interview with or join a residency program if they were required to participate in a 10-minute medical simulation during the interview process. Conclusions The results of this study suggest that despite the increasing role of technology in medical education, its role in high-stakes evaluations (such as residency interviews) requires further maturation before general acceptance by residency candidates can be expected.

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Education, education, education: postgraduate assessments and the consultant contract

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363509x403320 ◽

2009 ◽

Vol 91 (2) ◽

pp. 44-45 ◽

Cited By ~ 1

Author(s):

S Mukhtar ◽

J Compson

Keyword(s):

Medical Training ◽

Training System ◽

Assessment Process ◽

Correct Number

Recent changes in medical training have involved the introduction of a number of different tools for the assessment of trainees at all levels. These are completed by all doctors ranging from the level of foundation year 1 (FY1) trainees (previously pre-registration house officers) to final year specialty trainees (STs). While consultants are required to be an integral part of this assessment process, no formal time has been set aside and protected for these sessions. We propose the correct number of sessions for this activity be part of a new consultant contract, especially given the significant increase in the quantity of assessment and appraisals in the current training system. But how many hours are required?

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Oxygenator change-out times: the value of a written protocol and simulation exercises

Perfusion ◽

10.1177/0267659110369854 ◽

2010 ◽

Vol 25 (3) ◽

pp. 141-143 ◽

Cited By ~ 5

Author(s):

Edward Darling ◽

Bruce Searles

Keyword(s):

New York ◽

New England ◽

Clinical Skills ◽

Improve Patient Care ◽

Medical Emergency ◽

P Value ◽

Emergent Change ◽

Emergency Events ◽

Student’S T ◽

The Times

A survey by our department revealed that most of the institutions in New England and New York have written protocols for low-volume, high-risk, emergency events but few of these centers formally practice these protocols through simulation. We hypothesized that hands-on experience with medical emergency protocols will significantly improve clinician performance. Two groups (n = 24 each) of third semester perfusion students with comparable clinical skills were enrolled in this study. The first group was surprised with an emergent oxygenator change-out drill during a simulation exercise, with no prior warning and without the benefit of a written protocol. The second group was asked to develop a written protocol before they were challenged with the change-out drill. Subsequently, both groups were given a week to practice a protocol for emergent change-out before re-testing. The times for all change-out drills were recorded and the groups were compared with a Student’s t-test. A p-value < 0.05 was considered significant. The group without a written protocol (NP) had the longer time (559.7 ± 84.9 sec) while the group with the written protocol (P) performed better (461.8 ± 57.5 sec, p < 0.05). However, both groups achieved significantly better performance following repeated practice (NP = 167.8 ± 34.8; P = 170.9±32.5 sec, p < 0 .05). While written protocols for emergent events will improve patient care, simulation and practice of emergency protocols is the most significant way to protect our patients. Based on this, we advocate for all perfusion groups to simulate emergency events and practice their crisis protocols.

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