Faculty Opinions recommendation of Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac surgery.

2010 ◽  
Author(s):  
Markus Schneider ◽  
Thierry Girard
Keyword(s):  
Cardiac Surgery ◽  
Patient Care ◽  
Clinical Setting ◽  
High Stakes ◽  
Simulation Based

scholarly journals Simulation-based Training Improves Physicians' Performance in Patient Care in High-stakes Clinical Setting of Cardiac Surgery

2010 ◽  
Vol 112 (4) ◽  
pp. 985-992 ◽  
Author(s):  
Heinz R. Bruppacher ◽  
Syed K. Alam ◽  
Vicki R. LeBlanc ◽  
David Latter ◽  
Viren N. Naik ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Setting ◽  
Retention Test ◽  
Rating Scale ◽  
Training Session ◽  
Global Rating Scale ◽  
Global Rating ◽  
High Stakes ◽  
Randomized Controlled ◽  
Simulation Based

Background Simulation-based training is useful in improving physicians' skills. However, no randomized controlled trials have been able to demonstrate the effects of simulation teaching in real-life patient care. This study aimed to determine whether simulation-based training or an interactive seminar resulted in better patient care during weaning from cardiopulmonary bypass (CPB)-a high stakes clinical setting. Methods This study was conducted as a prospective, single-blinded, randomized controlled trial. After institutional research board approval, 20 anesthesiology trainees, postgraduate year 4 or higher, inexperienced in CPB weaning, and 60 patients scheduled for elective coronary artery bypass grafting were recruited. Each trainee received a teaching syllabus for CPB weaning 1 week before attempting to wean a patient from CPB (pretest). One week later, each trainee received a 2-h training session with either high-fidelity simulation-based training or a 2-h interactive seminar. Each trainee then weaned patients from CPB within 2 weeks (posttest) and 5 weeks (retention test) from the intervention. Clinical performance was measured using the validated Anesthesiologists' Nontechnical Skills Global Rating Scale and a checklist of expected clinical actions. Results Pretest Global Rating Scale and checklist performances were similar. The simulation group scored significantly higher than the seminar group at both posttest (Global Rating Scale [mean +/- standard error]: 14.3 +/- 0.41 vs. 11.8 +/- 0.41, P < 0.001; checklist: 89.9 +/- 3.0% vs. 75.4 +/- 3.0%, P = 0.003) and retention test (Global Rating Scale: 14.1 +/- 0.41 vs. 11.7 +/- 0.41, P < 0.001; checklist: 93.2 +/- 2.4% vs. 77.0 +/- 2.4%, P < 0.001). Conclusion Skills required to wean a patient from CPB can be acquired through simulation-based training. Compared with traditional interactive seminars, simulation-based training leads to improved performance in patient care by senior trainees in anesthesiology.

scholarly journals ‘Decisions and Consequences: Validation of High-Stakes Simulation-Based Assessments in Gynecologic Surgery’

2021 ◽  
Author(s):  
Edgar L. LECLAIRE ◽  
Christopher C. DESTEPHANO ◽  
Veronica T. LERNER ◽  
Chi Chiung Grace CHEN
Keyword(s):  
Gynecologic Surgery ◽  
High Stakes ◽  
Simulation Based

scholarly journals Effects of high-fidelity simulation education on medical students’ anxiety and confidence

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251078
Author(s):  
Ji Hye Yu ◽  
Hye Jin Chang ◽  
Soon Sun Kim ◽  
Ji Eun Park ◽  
Wou Young Chung ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Medical Students ◽  
Patient Care ◽  
Clinical Setting ◽  
Clinical Performance ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Simulation Education ◽  
Before And After ◽  
Care Situation

Introduction Psychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students. Materials and methods This study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students’ level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience. Results Students had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience. Conclusions We confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

scholarly journals IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

2019 ◽  
Vol 8 (3) ◽  
pp. 153
Author(s):  
Rachmadya Nur Hidayah
Keyword(s):  
Medical Education ◽  
Quality Assurance ◽  
Patient Safety ◽  
Focus Groups ◽  
Patient Care ◽  
Medical Schools ◽  
Theory Approach ◽  
High Stakes ◽  
Teachers And Students ◽  
The Impact

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum 

Simulated airway drills as a tool to measure and guide improvements in endotracheal intubation preparation in the paediatric emergency department

2021 ◽  
pp. bmjstel-2020-000810
Author(s):  
Kei U Wong ◽  
Isabel Gross ◽  
Beth L Emerson ◽  
Michael P Goldman
Keyword(s):  
Emergency Department ◽  
Endotracheal Intubation ◽  
Preparation Process ◽  
High Stakes ◽  
Paediatric Emergency Department ◽  
Staff Members ◽  
Paediatric Emergency ◽  
Simulation Based ◽  
Airway Equipment

IntroductionEmergent paediatric intubation is an infrequent but high-stakes procedure in the paediatric emergency department (PED). Successful intubations depend on efficient and accurate preparation. The aim of this study was to use airway drills (brief in-situ simulations) to identify gaps in our paediatric endotracheal intubation preparation process, to improve on our process and to demonstrate sustainability of these improvements over time in a new staff cohort.MethodThis was a single-centre, simulation-based improvement study. Baseline simulated airway drills were used to identify barriers in our airway preparation process. Drills were scored for time and accuracy on an iteratively developed 16-item rubric. Interventions were identified and their impact was measured using simulated airway drills. Statistical analysis was performed using unpaired t-tests between the three data collection periods.ResultsTwenty-five simulated airway drills identified gaps in our airway preparation process and served as our baseline performance. The main problem identified was that staff members had difficulty locating essential airway equipment. Therefore, we optimised and implemented a weight-based airway cart. We demonstrated significant improvement and sustainability in the accuracy of obtaining essential airway equipment from baseline to postintervention (62% vs 74%; p=0.014), and postintervention to sustainability periods (74% vs 77%; p=0.573). Similarly, we decreased and sustained the time (in seconds) required to prepare for a paediatric intubation from baseline to postintervention (173 vs 109; p=0.001) and postintervention to sustainability (109 vs 103; p=0.576).ConclusionsSimulated airway drills can be used as a tool to identify process gaps, measure and improve paediatric intubation readiness.

Commentary: Diagnostic devices in clinical trials have high stakes for patient care

BMJ ◽  
2016 ◽  
pp. i5197 ◽  
Author(s):  
Vinay K Rathi ◽  
Harlan M Krumholz ◽  
Joseph S Ross
Keyword(s):  
Clinical Trials ◽  
Patient Care ◽  
High Stakes

scholarly journals Iso-osmolar hyponatremia from polyethylene glycol

2020 ◽  
Author(s):  
Bryan M Tucker ◽  
James L Pirkle ◽  
Erinda Stefi ◽  
David Sheikh-Hamad ◽  
Thomas DuBose
Keyword(s):  
Differential Diagnosis ◽  
Polyethylene Glycol ◽  
Gastrointestinal Tract ◽  
Patient Care ◽  
Clinical Setting ◽  
Laboratory Data ◽  
Accurate Diagnosis ◽  
Therapeutic Interventions ◽  
Pathophysiological Mechanisms

Abstract Understanding and applying pathophysiological concepts to patient care is an important skill for physicians in the clinical setting. Here, we present a case that demonstrates how the application of common physiological concepts relating to the widely accepted hyponatremia algorithm led to an accurate diagnosis of hyponatremia. This case documents iso-osmolar hyponatremia caused by orally administered polyethylene glycol absorption in the gastrointestinal tract. Herein, we discuss the workup and differential diagnosis for iso-osmolar hyponatremia in juxtaposition with the pathophysiological mechanisms unique to this case. We discuss these pathophysiological mechanisms based on the patients’ laboratory data and responses to therapeutic interventions.

Patient care in cardiac surgery, second edtion

1978 ◽  
Vol 95 (3) ◽  
pp. 414
Keyword(s):  
Cardiac Surgery ◽  
Patient Care

Patient Care in Cardiac Surgery.

1973 ◽  
Vol 107 (3) ◽  
pp. 494
Author(s):  
WALLY S. BUCH
Keyword(s):  
Cardiac Surgery ◽  
Patient Care
Sign in / Sign up

Export Citation Format

Share Document