Do Different Roles of Anesthesia Residents Improve Knowledge Retention after Non-Technical Skills Workshop?

2021 ◽  
Vol 104 (9) ◽  
pp. 1519-1527
Keyword(s):  
Test Scores ◽  
Linear Regression Analysis ◽  
Technical Skills ◽  
Knowledge Retention ◽  
University Hospital ◽  
Multivariate Linear Regression Analysis ◽  
Simulation Based ◽  
Post Test ◽  
Anesthesia Residents ◽  
Predictors Of Change

Objective: The authors assessed whether anesthesia residents who acted as a scenario creators would have better knowledge retention than their juniors 90 days after participating in a simulation-based anesthetists’ non-technical skills (ANTS) workshop. Materials and Methods: A prospective observational study via simulation ANTS workshop was conducted at a university hospital in southern Thailand in November 2017. Seven third-year post-graduate (PGY-3) residents volunteered as scenario creators, while the remaining anesthesia residents were randomly selected to participate in or observe three case scenarios, which were cardiac arrest, hypotension, and difficult ventilation. Resident’s knowledge was assessed before, immediately after, and 90 days after the workshop using a 20-item multiple-choice questionnaire. Predictors of change in knowledge scores were analyzed using multivariate linear regression analysis and presented as beta coefficient (β) and 95% confidence limits (CL). Results: Twenty-four anesthesia residents were recruited in the present study and included eight PGY-1, seven PGY-2, and nine PGY-3. The roles consisted of seven scenario creators, seven participants, and 10 observers. The overall immediate post-test and 90-day post-test scores increased significantly compared to the pre-test scores with a mean of 15.5 and 13.2 versus 11.7 (p<0.001 and p=0.007, respectively). The predictors of change in 90-day scores were PGY-3 versus PGY-1 (β 95% CL 4.0 [0.5 to 7.6], p=0.039), and role of participants and observers versus scenario creator (β 95% CL 5.5 [2.2 to 8.8] and 6.7 [2.8 to 10.6], p=0.004, respectively). Conclusion: Anesthesia residents who were participants or observers could improve their knowledge 90 days after a simulation-based ANTS workshop without necessarily being a scenario creator. Keywords: Anesthetists’ non-technical skill; Knowledge retention; Scenario creator; Simulation workshop

scholarly journals Combatting with Challenges in Medical Education During COVID-19 Pandemic: A Mixed-Methods Study Identifying the Effectiveness of Using E-Learning in Pediatric Clinical Clerkship of A University Hospital, Pakistan

2020 ◽  
Author(s):  
Mahanoor Raza ◽  
Sidra Kaleem ◽  
Sonia Qureshi ◽  
Nadeem Aslam ◽  
Akber Madhwani ◽  
...  
Keyword(s):  
Medical Education ◽  
Test Scores ◽  
Qualitative Content Analysis ◽  
Statistical Significance ◽  
Positive Association ◽  
University Hospital ◽  
Live Streaming ◽  
Post Test ◽  
E Learning ◽  
The Impact

Abstract Background The emergence of COVID-19 raises the opportunity to reimagine medical education. One way of attempting this is online classes, also known as e-learning, through recordings and or live streaming. The purpose of this research is to ascertain the effectiveness of using the e-learning instructional methodology for a Pediatric module with the fourth year MBBS students at the Aga Khan University Hospital, Karachi. Methods It was a sequential (Quantitative-Qualitative) mixed-method study. The quantitative component of the study consisted of pre and post-tests, as well as feedback on each session. The qualitative component was composed of focused-group discussions to explore students' experiences. Statistical analysis was performed using SPSS 20.0. Mean ±SD was reported for quantitative variables, and frequency and percentages were calculated for nominal variables. The pre and post-test scores were compared using a paired t-test. Pre and post mean test scores were analyzed in comparison to the level of student groups (Experts, Semi-experts, and Novice) by one-way ANOVA. For qualitative content analysis, categories were clumped together to yield sub-themes that were further merged into themes.Results All students (n= 102) participated and enrolled in this study. Fifty-nine participants (68.8%) were female. Participants were stratified into three groups, Novice 41(40.2%), Semi-expert 21 (19.6%), and Expert 40 (39.2%). The majority of the students appreciated the session structure and facilitation. There was a significant effect (p<0.005) on knowledge enhancement during each session, depicted by the improvement in post-test scores. It was also supported by the positive association (r=0.242 to 0.595) between the gain in knowledge and each session held. The ANOVA yielded no statistical significance between the knowledge gained among the three group levels, denoting that our online module had been proven successful in achieving the same learning goals as an in-person rotation.Conclusion E-learning is an effective way of continuing the process of delivering medical education, especially in unprecedented times. Technological enhancements will help carry the impact forward as a blended-learning pedagogical approach in undergraduate medical education.

scholarly journals Chemical and Radiation Training for Public Health and Nursing Students: An Under-Utilized Disaster Response Demographic

2019 ◽  
Vol 34 (s1) ◽  
pp. s107-s108
Author(s):  
Sukhi Atti ◽  
Emily Kiernan ◽  
Mark Layer ◽  
Aynur Sahin ◽  
Shaikhah Alotiabi ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Perception ◽  
Nursing Students ◽  
Test Scores ◽  
Disaster Response ◽  
Comfort Level ◽  
Convenience Sample ◽  
Mcnemar Test ◽  
Simulation Based ◽  
Post Test

Introduction:Public health (PH) and nursing students are an underutilized demographic in disaster response. Knowledge of the disaster response phase may enhance student understanding of preparedness, and provide response capabilities.Aim:A single four-hour simulation-based training session, with toxicologists as instructors, can effectively improve PH and nursing student knowledge and skills in chemical and radiation response, despite minimal prior experience.Methods:A convenience sample was used to test PH and nursing students in a response training program. An introductory lecture and simulation training reviewed: mass casualty care, triage, personal protective equipment, decontamination, and chemical and radiation exposure toxidromes. An examination was administered pre-training, and then post-training, to evaluate relevant training, knowledge, risk perception, and comfort in response capabilities to chemical and radiation incidents.Results:Forty-two students attended the course; 39 were included in the study. Seventy-two percent (n=28) of participants had no prior disaster training. Overall, there were significant differences between the pre-test and post-test scores for all students [95% CI: 5.4 (4.7-6.1); p<0.0001, paired t-test]; maximum score 15/15. Comparing scores of nursing and PH students, despite statistical difference in pre-test scores (median, IQR: 9.0 (7.5-10±2.0); 7.0 (5.7-9.0) respectively; p=0.048, Mann Whitney U-test), there were no statistical differences in post-test scores (median, IQR: 14.0 (13.0-14.0); 13.0 (12.0-14.0), respectively, Mann Whitney U-test). All students recognized nerve agent toxidrome and performed SALT triage after the training (p <0.0001, McNemar test). Subjectively, participant comfort level in responding to a chemical or radiological incident improved (p <0.0001, McNemar test). Individual risk perception for chemical or radiological disasters did not improve after training.Discussion:Improvement of knowledge and comfort was demonstrated, irrespective of previous experience. Simulation-based training of chemical and radiation disaster preparedness, led by medical toxicologists, is an effective means of educating PH and nursing students, with minimal prior fluency.

scholarly journals Association Between Cortisol and Left Ventricular Diastolic Dysfunction in Patients With Diabetes Mellitus: A Case Control Study

2021 ◽  
Author(s):  
RIKAKO SAGARA ◽  
Tomoaki Inoue ◽  
Noriyuki Sonoda ◽  
Chieko Yano ◽  
Misato Motoya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Linear Regression Analysis ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
University Hospital ◽  
Multivariate Linear Regression Analysis ◽  
Diastolic Velocity ◽  
Ventricular Diastolic Dysfunction ◽  
Patients With Diabetes

Abstract Introduction: Diabetes mellitus (DM) is a major risk factor for the development of cardiovascular diseases. Heart failure with preserved ejection fraction is characterized by left ventricular diastolic dysfunction (LVDD). It has been reported that excess cortisol found in patients with Cushing’s syndrome was associated with the development of LVDD. However, the relationship between cortisol concentration and LVDD in patients with DM has not been addressed. Research Design and Methods: We enrolled 109 patients with DM and 104 patients without DM who had undergone echocardiographic examination at Kyushu University Hospital, Japan, between November 2016 and March 2019. Left ventricular function was evaluated and the ratio of early diastolic velocity from transmitral inflow to early diastolic velocity (E/eʹ) was used as an index of diastolic function. Plasma cortisol concentrations, glycemic control, lipid profiles, treatment with anti-diabetic drugs, and other clinical characteristics were evaluated, and their associations with E/eʹ were determined using univariate and multivariate analyses. Results Multivariate linear regression analysis showed that log E/eʹ was positively correlated with age (p = 0.017), log systolic blood pressure (p = 0.004), and cortisol (p = 0.037) and negatively correlated with eGFR (p = 0.016) and the usage of SGLT2 inhibitors (p = 0.042) in patients with DM. Multivariate analysis showed that cortisol was positively correlated with age (p = 0.016) and HbA1c (p = 0.011). There was no association between E/eʹ and cortisol in patients without DM. Conclusions Increased cortisol levels may increase the risk of developing LVDD in DM patients.

scholarly journals Effectiveness of Bi-lingual Multidisciplinary Simulation-based Training in Improving Communication and Breaking Bad-News Skills

2022 ◽  
Vol 2 (1) ◽  
pp. 76-82
Author(s):  
Baraa Tayeb ◽  
Jameel Abuelenain ◽  
Wadeeah Bahaziq ◽  
Loui Alsulimani ◽  
Abeer Arab ◽  
...  
Keyword(s):  
Communication Skills ◽  
Test Scores ◽  
Positive Impact ◽  
Essential Element ◽  
Improve Patient Care ◽  
Good Communication ◽  
Simulation Based ◽  
Post Test ◽  
Instructor Performance ◽  
Performance Satisfaction

Background: Healthcare worker (HCW)-patient communication is an essential element of every patient’s journey, and evidence links good communication with favourable patient experiences and outcomes. Simulation-based training (SBT) is a promising and effective tool to improve such communication. Aim: To develop a bilingual SBT programme in communication skills for all HCWs in an academic tertiary hospital, to improve patient care, experiences and outcomes. Methods: This was a quasi-experimental design, conducted in 2018 at King Abdulaziz University (KAU). We designed and delivered a bilingual, simulation-based, full-day course for HCWs (both clinical and administrative), and measured its impact by comparing pre- and post-course test scores, participant feedback, and instructor performance satisfaction indices. Results: We trained 318 HCWs over 15 days, using 10 instructors. Post-test scores showed individual and overall improvement. The average scores were 26.6% (14-40%) for the pre-test and 55.8% (37-70%) for the post-test, with an average improvement of 29% (P<0.005). Participant feedback was 77% positive and in favour of more training. The average instructor performance satisfaction score was 96.2% (92-99%). Conclusion: We demonstrated the positive impact of SBT on communication skills for both clinical and administrative HCWs. We also demonstrated the sustainability and scalability of this course.

scholarly journals Short-term gains in histology knowledge: A veterinary gaming application

2017 ◽  
Author(s):  
Eric B. Bauman ◽  
Gregory E Gilbert ◽  
Greg Vaughan
Keyword(s):  
Test Scores ◽  
Knowledge Retention ◽  
Rank Test ◽  
Short Term ◽  
Veterinary Students ◽  
Discrimination Ability ◽  
Post Test ◽  
Signed Rank Test ◽  
Matching Game ◽  
Group 2

Outcomes research exists incorporating non-digital games in veterinary education; however, little research examines outcomes from digital applications. Bauman’s Layered-Learning Model was applied to investigate whether a digital matching game produced short-term knowledge gains in veterinary students. Two groups of students (n1=67; n2=55) practiced the matching game for an hour. A Wilcoxon signed rank test tested for a statistically significant improvement in pre-test/post-test scores. All statistical analyses were done using R. Mean and median pre-test scores were 15 (SD=1.88; IQR: 2) and post-test scores 16 (SD=1.80; IQR: 2). Mean and median pre-test score for Group 2 were 13 (SD=2.30; IQR=2.5) and post-test scores 15 (SD=1.93; IQR=2.5). Both groups increased significantly in post-test scores (P value<.0001). Statistically significant short-term increases of marginal importance in histology knowledge was seen. A greater increase might be seen with quiz revision increasing difficulty and discrimination ability. Further directions should investigate long-term knowledge retention.

Simulation training to improve aseptic non-touch technique and success during intravenous cannulation—effect on hospital-acquired blood stream infection and knowledge retention after 6 months: The snowball effect theory

2020 ◽  
pp. 112972982093820
Author(s):  
Bharathi Balachander ◽  
Deepa Rajesh ◽  
Bonita Viona Pinto ◽  
Sofia Stevens ◽  
Suman Rao PN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Knowledge Retention ◽  
Blood Stream ◽  
Simulation Based ◽  
Post Test ◽  
The Mean ◽  
Hospital Acquired

Background: Intravenous cannulation is a common procedure and a valuable skill in the neonatal intensive care unit. Standardized procedure and personnel training are needed in the unit to prevent hospital-acquired blood stream infections. Hence, we evaluated the effect of training using a low-fidelity simulation on the improvement of the aseptic non-touch technique during intravenous cannulation and knowledge retention after 6 months. Methods: The study was conducted in a tertiary care neonatal unit from June 2017 to July 2018. All the staff nurses and junior resident doctors posted in the neonatal intensive care were included in the study. A protocol and checklist score sheet was developed. The score sheet consisted of 23 items with a total score of 46. Participants were expected to obtain a minimum of 80%. A pre-test was conducted initially, followed by a formal training and then a post-test. The NITA newborn venous access mannequin was used to facilitate the training. A re-training for new nurses was conducted after 6 months. Data were analyzed using paired t-test. Results: A total of 29 doctors and nurses were enrolled in the training. The mean pre-test score was 29.93 compared to 42.66 in the post-test scores (mean difference 12.24(95% confidence interval: 9.39–16.05), p < 0.01. The mean scores were higher when the simulation was conducted after 6 months. There was a significant decline in blood stream infection rates from 5.5 to 1.65 per 1000 patient days (p = 0.05). Conclusion: Simulation-based training of health care personnel is a good modality to improve aseptic non-touch technique during intravenous cannulation in the neonatal intensive care unit. Simulation-based training also helps in knowledge retention and standardization of training procedures.

scholarly journals Time course of lymphocyte repopulation after dimethyl fumarate-induced grade 3 lymphopenia: contribution of patient age

2019 ◽  
Vol 12 ◽  
pp. 175628641984345 ◽  
Author(s):  
Myriam Briner ◽  
Maud Bagnoud ◽  
Andrei Miclea ◽  
Christoph Friedli ◽  
Lara Diem ◽  
...  
Keyword(s):  
Time Course ◽  
Opportunistic Infections ◽  
Linear Regression Analysis ◽  
Dimethyl Fumarate ◽  
University Hospital ◽  
Multivariate Linear Regression Analysis ◽  
Retrospective Data Analysis ◽  
Relapsing Remitting ◽  
Grade 3 ◽  
Relapsing Remitting Multiple Sclerosis

Background: Dimethyl fumarate (DMF) is licensed for treatment of relapsing–remitting multiple sclerosis (RRMS). DMF can induce lymphopenia, which is assumed to increase the risk for opportunistic infections like progressive multifocal leukoencephalopathy. Our goal for this work was to estimate the frequency of grade 3 lymphopenia in DMF-treated patients with RRMS and to characterize patient-sided factors influencing the time course of lymphocyte repopulation after DMF withdrawal. Material and methods: A single-center retrospective data analysis was performed at University Hospital Bern, Switzerland. Patients with DMF treatment were analyzed for lymphocyte counts. Demographic factors were statistically analyzed in grade 3 lymphopenic patients. Results: We estimated a grade 3 lymphopenia frequency of 11/246 (4.5%), corroborating previous studies. In all patients, lymphocytes recovered to values ⩾800/µl within 0.5 years. Multivariate linear regression analysis unmasked older age as being associated with a longer duration of repopulation. Conclusion: Considering the aging population, our findings warrant further investigations of DMF-induced lymphopenia.

A gamified mobile application for first-year student orientation to promote library services

2021 ◽  
pp. 096100062110672
Author(s):  
Bhornchanit Leenaraj ◽  
Watsaporn Arayaphan ◽  
Kannikar Intawong ◽  
Kitti Puritat
Keyword(s):  
Intrinsic Motivation ◽  
Test Scores ◽  
Mobile Application ◽  
Knowledge Retention ◽  
Control Group ◽  
First Year ◽  
Library Services ◽  
Student Orientation ◽  
Post Test ◽  
First Year Student

This study proposes a mobile application as a new approach for first-year student orientation to promote knowledge of library services using the gamification concept. The application is based on mobile devices with GPS to locate students, allowing them to catch, collect, and battle monsters around the library with questions on library service instructions. To evaluate the learning effectiveness of the approach, we performed a comparative experiment in which the control group used e-learning, while the experimental group used the mobile application of the CMU Journey. We evaluated the pre-and post-test scores, delayed 1-month post-test scores, and intrinsic motivation based on the IMI questionnaire. The results demonstrated that the preference for gamified experience among students can enhance knowledge retention and intrinsic motivation compared to other groups.

Abstract WMP87: Simulation Based Medical Education Improves Door to Needle Times in Acute Ischemic Stroke Management

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Tapan V Mehta ◽  
Sara Strauss ◽  
Dawn Beland ◽  
Ilene Staff ◽  
Gilbert Fortunato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Education ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Simulation Training ◽  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Simulation Based ◽  
Iv Tpa

Introduction: Literature on the effectiveness of simulation based medical education programs used in acute ischemic stroke (AIS) care is scant. In an effort to improve coordination and door to needle time (DNT) for AIS care, a stroke simulation education training program for neurology nursing staff and neurology residents was implemented in a comprehensive stroke center. Methods: Hospital stroke registry was used for retrospective analysis. The study population was defined as all patients treated with IV-tPA for AIS in the emergency room from October 2008 to September 2014. Simulation training was implemented yearly, for a three month period starting from July 2011. All neurology residents and a group of nurses trained to respond to all AIS cases participated. Simulations were standardized, using deliberate practice with a trained live actor portraying stroke vignettes in the presence of a board certified vascular neurologist. During the period of study, there were no changes in Emergency Department stroke triage protocol, or changes in first provider response to AIS. The data was analyzed using IBM SPSS24 software. Results: We identified 448 patients admitted with AIS who were treated with IV-tPA. The average DNT on univariate analysis before and after intervention was 67.9 and 58.3 minutes [p <0.001]. A multivariate linear regression analysis was performed controlling for age, night/day shift, weekday/weekend, and blood pressure at presentation (>185/110). After controlling for confounders we found that simulation training independently reduced the DNT by 9.64 minutes [95% confidence interval (CI) 4.01 - 15.28, p=0.001]. Amongst other co-variates, only the systolic blood pressure >185 was associated with 14.27 minutes of delay in DNT [95% CI 3.36 - 25.191, p=0.011]. Conclusion: Time to thrombolysis from symptom onset is a critical factor in AIS management and evidence shows improving the DNT could improve patient outcomes. In our six year study, integration of simulation based medical education for AIS reduced the average DNT by 9.64 minutes in multivariate analysis. Simulation based medical education therefore should be considered as a standard process for providers involved in the care of AIS patients receiving thrombolytic treatment.

scholarly journals SIMULATION BASED TRAINING IMPROVES LAPAROSCOPIC SURGICAL SKILLS IN TRAINEE SURGEONS

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S186-92
Author(s):  
Abdul Razaque Shaikh ◽  
Tanwir Khaliq
Keyword(s):  
Test Scores ◽  
Technical Skills ◽  
Surgical Skills ◽  
Control Group ◽  
Skill Sets ◽  
Minimally Invasive Surgical ◽  
Surgical Trainees ◽  
Post Test ◽  
The Impact ◽  
Better Than

Objective: To assess the impact of laparoscopic simulation training on surgical skills of trainee surgeons. Study Design: Comparative prospective study. Place and Duration of Study: Jinnah Sindh Medical University Karachi, for one month October 2019. Methodology: Total thirty surgical trainees of FCPS year four (R4) were studied. The cases group (fifteen trainees) were given one month laparoscopy training on a LAP Simulator (LAPSim), surgical science Sweden) and the control group (fifteen trainees) were not trained. Their laparoscopic skills were then compared. Objective Structured Assessment of Technical Skills (OSATS) specific and general was used to assess their performance. Data was entered and analyzed using SPSS-23. Results: On LAP Sim Scoring, post-test scores were significantly better than pre-test for all skills in the trainedresidents (p<0.01 for all subscales) and total post-test score was also significantly better for trained surgeonsas compared to untrained (77.45 ± 7.78 vs. 31.70 ± 2.48; p<0.01). On Objective Structured Assessment of Technical Skills for specific tasks, post-test scores were significantly better than pre-test for all tasks in the cases (p<0.01 for all subscales) and for none in the controls. On Objective Structured Assessment of Technical Skills general, posttest scores were significantly better than pre-test for all tasks in the cases (p<0.01 for all subscales) and for clip application (p<0.01) and suturing with intracorporeal knot tying (p<0.01) in the controls. Conclusion: This study demonstrated significantly improved levels of performance for all skill sets for novicesurgical residents trained on LAP Sim for minimally invasive surgical procedures.

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