High Fidelity Simulation of the Impact of Pressure Conditions on Liquid Jet in Crossflow Atomization

Author(s):  
Xiaoyi Li ◽  
Marios C. Soteriou
2018 ◽  
Vol 4 (4) ◽  
pp. 190-195 ◽  
Author(s):  
Owain Michael Leng ◽  
Charlotte Rothwell ◽  
Annamarie Buckton ◽  
Catherine Elmer ◽  
Jan Illing ◽  
...  

BackgroundThe patient safety agenda has propelled the rise of simulation education, but relatively few evaluations of simulation-based educational interventions have focused on patient outcomes.ObjectiveTo evaluate the impact of an in situ, high-fidelity simulation teaching intervention on the management of community-acquired pneumonia in the ambulatory care unit of a district general hospital.MethodsThis study used a mixed-methods approach to evaluate the impact of a programme of 10 in situ high-fidelity simulation education sessions delivered to a total of 10 junior doctors, nine nurses and seven healthcare assistants. Participants were tasked with managing a manikin simulating a patient with pneumonia in real time in a working clinical area. Subsequent structured debrief emphasised key themes from the national guidelines on pneumonia management. The intervention was evaluated through an immediate feedback form, follow-up semistructured interviews by independent qualitative researchers that underwent content analysis and triangulation with audit data on compliance with national pneumonia guidelines before and after the simulation intervention.ResultsThe in situ simulation intervention was valued by participants both in immediate written feedback and in follow-up semistructured interviews. In these interviews, 17 of 18 participants were able to identify a self-reported change in practice following the simulation intervention. Furthermore, most participants reported observing a change in the clinical practice of their colleagues following the training. Collected audit data did not show a statistically significant change in compliance with the guidelines for the management of pneumonia.ConclusionThis study found evidence of a change in both self-reported and observed clinical practice following a simulation intervention, supporting expert opinion that simulation education can impact clinician behaviours and patient outcomes in complex clinical scenarios. Furthermore, this feasibility study provides a transferrable method to evaluate the real-world impact of simulation education that merits further investigation through an appropriately powered study.


2019 ◽  
Vol 75 (11) ◽  
pp. 2673-2682
Author(s):  
Kristine Haddeland ◽  
Åshild Slettebø ◽  
Elisabeth Svensson ◽  
Patricia Carstens ◽  
Mariann Fossum

2018 ◽  
Vol 4 (4) ◽  
pp. 179-183
Author(s):  
Selin Tuysuzoglu Sagalowsky ◽  
Kimball A Prentiss ◽  
Robert J Vinci

IntroductionRepetitive paediatric simulation (scenario-debrief-scenario; RPS) is an instructional design that allows immediate application of learner-directed feedback, in contrast to standard simulation (scenario-debrief; STN). Our aim was to examine the impact of RPS embedded within a paediatric resident simulation curriculum, comparing it to STN.MethodsIn this prospective educational cohort study, paediatric residents were enrolled in STN (n=18) or RPS (n=15) groups from August 2012 through June 2013. Each group performed an initial high-fidelity simulation and another after 1–2 weeks. Attitudes, confidence and knowledge were assessed using anonymous surveys with each scenario and at 4–6 months. Skills were assessed in real time with a modified Tool for Resuscitation Assessment Using Computerised Simulation (TRACS). Two blinded reviewers assessed a subset of videotaped scenarios for TRACS inter-rater reliability.ResultsBoth STN and RPS designs were rated highly. The curriculum led to significant short-term and long-term improvements in confidence, knowledge and performance, with no significant differences between groups. All final respondents reported that they would prefer RPS to STN (n=6 STN, 4 RPS). TRACS intraclass correlation was 0.87 among all reviewers.ConclusionsPaediatric residents reported preference for RPS over STN, with comparable impacts on confidence, knowledge and performance. The modified TRACS was a reliable tool to assess individual resident performance. Further research is needed to determine whether RPS is a more effective instructional design for teaching resuscitation skills to paediatric residents.


Author(s):  
Joseph W. Hendricks ◽  
S. Camille Peres ◽  
Stefan V. Dumlao ◽  
Cara A. Armstrong ◽  
Timothy J. Neville

Objective The objective of these studies was to identify hazard statement (HS) design elements in procedures that affected whether both workers and lab participants performed the associated hazard mitigation. Background Many of the incidents in high-risk industries are the result of issues with procedures (e.g., standard operating procedures; SOPs) workers use to support their performance. HSs in these procedures are meant to communicate potential work hazards and methods of mitigating those hazards. However, there is little empirical research regarding whether current hazard design guidelines for consumer products translate to procedures. Method Two experimental studies—(1) a laboratory study and (2) a high-fidelity simulation—manipulated the HS design elements present in procedures participants used while performing tasks. Participants’ adherence to the mitigation of the hazard was compared for the HS designs. Results The guidelines for HSs from consumer products did not translate to procedures. Specifically, the presence of an alert icon, a box around the statement, and highlighting the statement did not improve adherence to HSs. Indeed, the only consistent finding was for the Icon, with its presence reliably predicting nonadherence in both studies. Additionally, the total number of design elements did not have a positive effect on adherence. Conclusion These findings indicate that more fundamental procedure HSs research is needed to identify effective designs as well as to understand the potential attentional mechanisms associated with these findings. Application The findings from these studies indicate that current regulations and guidelines should be revisited regarding hazard presentation in procedures.


2012 ◽  
Vol 17 (4) ◽  
pp. 329-345 ◽  
Author(s):  
Mary Gobbi ◽  
Eloise Monger ◽  
Mark J. Weal ◽  
John W. McDonald ◽  
Danius Michaelides ◽  
...  

Demonstrating the impact and effectiveness of educational interventions, including medium and high-fidelity simulation, has long been fraught with methodological challenges and ambiguities. This is particularly the case when there are several confounding factors and variables operating in situations where control trials are inappropriate, and investigative costs can be high. Current theoretical and empirical evidence, while emerging, is parsimonious and fails to take account of the characteristics of different modes of simulation, their contested theoretical models of learning and the opportunities presented by cutting edge computer science. Medium and high-fidelity simulations, situated within technology-rich environments, generate new forms of complex data that have the potential to provide insights into ‘real-world’ practices. Drawing on a range of locally based studies, we argue that until the methodological questions and data management systems can be addressed, the evidence to determine the judicious and optimal use of simulation to improve student and practitioner performance and patient outcomes will remain primarily reliant on proxy measures of self-efficacy and competence.


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