scholarly journals Multi-source feedback following simulated resuscitation scenarios: a qualitative study

2022 ◽  
Author(s):  
Timothy Chaplin ◽  
Heather Braund ◽  
Adam Szulewski ◽  
Nancy Dalgarno ◽  
Rylan Egan ◽  
...  
Keyword(s):  
Registered Nurses ◽  
Qualitative Content Analysis ◽  
Comparative Method ◽  
Multisource Feedback ◽  
Medical Expert ◽  
Self Assessment ◽  
Narrative Assessment ◽  
Simulation Based ◽  
Attending Physicians ◽  
Narrative Comments

Background: The direct observation and assessment of learners’ resuscitation skills by an attending physician is challenging due to the unpredictable and time-sensitive nature of these events. Multisource feedback (MSF) may address this challenge and improve the quality of assessments provided to learners. We aimed to describe the similarities and differences in the assessment rationale of attending physicians, registered nurses, and resident peers in the context of a simulation-based resuscitation curriculum. Methods: We conducted a qualitative content analysis of narrative MSF of medical residents in their first postgraduate year of training who were participating in a simulation-based resuscitation course at two Canadian institutions. Assessments included an entrustment score and narrative comments from attending physicians, registered nurses, and resident peers in addition to self-assessment. Narrative comments were transcribed and analyzed thematically using a constant comparative method. Results: All 87 residents (100%) participating in the 2017-2018 course provided consent. A total of 223 assessments were included in our analysis. Four themes emerged from the narrative data: 1) Communication, 2) Leadership, 3) Demeanor, and 4) Medical Expert. Relative to other assessor groups, feedback from nurses focused on patient-centred care and communication while attending physicians focused on the medical expert theme. Peer feedback was the most positive. Self-assessments included comments within each of the four themes. Conclusions: In the context of a simulation-based resuscitation curriculum, MSF provided learners with different perspectives in their narrative assessment rationale and may offer a more holistic assessment of resuscitation skills within a competency-based medical education (CBME) program of assessment.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

scholarly journals A haptic laparoscopic trainer based on affine velocity analysis: engineering and preliminary results

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin De Witte ◽  
Charles Barnouin ◽  
Richard Moreau ◽  
Arnaud Lelevé ◽  
Xavier Martin ◽  
...  
Keyword(s):  
Motor Skills ◽  
Haptic Feedback ◽  
High Fidelity ◽  
Velocity Analysis ◽  
Self Assessment ◽  
Laparoscopic Skills ◽  
Effective Feedback ◽  
Simulation Based ◽  
Good Trade ◽  
Laparoscopic Techniques

Abstract Background There is a general agreement upon the importance of acquiring laparoscopic skills outside the operation room through simulation-based training. However, high-fidelity simulators are cost-prohibitive and elicit a high cognitive load, while low-fidelity simulators lack effective feedback. This paper describes a low-fidelity simulator bridging the existing gaps with affine velocity as a new assessment variable. Primary validation results are also presented. Methods Psycho-motor skills and engineering key features have been considered e.g. haptic feedback and complementary assessment variables. Seventy-seven participants tested the simulator (17 expert surgeons, 12 intermediates, 28 inexperienced interns, and 20 novices). The content validity was tested with a 10-point Likert scale and the discriminative power by comparing the four groups’ performance over two sessions. Results Participants rated the simulator positively, from 7.25 to 7.72 out of 10 (mean, 7.57). Experts and intermediates performed faster with fewer errors (collisions) than inexperienced interns and novices. The affine velocity brought additional differentiations, especially between interns and novices. Conclusion This affordable haptic simulator makes it possible to learn and train laparoscopic techniques. Self-assessment of basic skills was easily performed with slight additional cost compared to low-fidelity simulators. It could be a good trade-off among the products currently used for surgeons' training.

scholarly journals Registered nurses’ experiences of information technology use in home health care - from a sustainable development perspective

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicki Koltsida ◽  
Lise-Lotte Jonasson
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Sustainable Development ◽  
Registered Nurses ◽  
Home Health Care ◽  
Technology Use ◽  
Qualitative Content Analysis ◽  
Well Being ◽  
Home Health ◽  
It Use

Abstract Background The work of registered nurses in home health care is complicated and extensive, and information technology (IT) is used in everyday activities. Coordination between care and resource efficiency is important. There is a wealth of information that supports the notion of sustainable development, but what sustainable development means from the perspective of the registered nurse in home health care when using IT is limited. The term “sustainable development” is not clearly defined and is poorly researched in nursing. Sustainable development in this study includes the ecological, economic, social, technical and ethical dimensions. The aim of this study was to describe registered nurses’ experience of IT use in home health care through a sustainable development model. Methods This study was conducted using ten semi-structured lifeworld interviews with registered nurses. The method employed was a qualitative content analysis with a deductive approach. The deductive approach consisted of a model of sustainable development. Results Analysis of the interviews and the model of sustainable development provided categories: using IT from an ecological dimension, the registered nurses experienced reduced consumption and damage to the environment; using IT in the economical dimension, saving of time and resources was experienced; the use of IT affected social aspects such as the work environment and patient safety, and positive consequences, such as accessibility, were also mentioned; using IT from a technical dimension was characterized by the nurse’s attitude towards it – the registered nurses felt it improved the quality of care and gave users an overview of the organization; and from an ethical dimension, the registered nurses expressed the need for IT to be adaptable to the patient’s well-being and indicated that more awareness of risks in the care meeting may be needed. Conclusion The findings are discussed based on the synergies and conflicts that arise between the different dimensions of sustainable development. IT intertwines and overlaps with, and within, the environment, economy, society, technology and ethics. Registered nurses in home health care want to conduct good and safe care, while using IT could benefit patients.

Transformation Through Health Teaching for Adults with Intellectual and Developmental Disabilities: A Qualitative Study

2012 ◽  
Vol 50 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Ginny Focht-New
Keyword(s):  
Developmental Disabilities ◽  
Qualitative Study ◽  
Registered Nurses ◽  
Developmental Process ◽  
Comparative Method ◽  
Intellectual And Developmental Disabilities ◽  
Naturalistic Inquiry ◽  
Teaching Activities ◽  
Increased Risk ◽  
Health Teaching

Abstract Adults with intellectual and developmental disabilities have medical conditions similar to those among the general population but with more complex presentation, a extended life expectancy, and increased risk of morbidity and mortality. These adults' health education has been inadequate. In this qualitative study, the author describes the experiences of 23 registered nurses who provide health teaching to adults with intellectual and developmental disabilities, selection of and health topics taught, and teaching activities put into practice. The author used a rigorous descriptive, naturalistic inquiry design with purposive (n  =  22) and snowball (n  =  1) sampling. Data were gathered through individual interviews, focus groups, and nonparticipant observations, and analyzed with a constant comparative method. Findings concerned the educators' developmental process, use of a social context to teach, and health-teaching activities. Registered nurses s described their transformation from insecure, novice health educators to confident and passionate educators of adults with intellectual and developmental disabilities. Findings apply to multiple disciplines.

New home warranty schemes: developing a theoretical comparative framework using qualitative content analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sebastien Royal ◽  
Nadia Lehoux ◽  
Pierre Blanchet
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Comparative Method ◽  
Developed Countries ◽  
Comparative Case Study ◽  
Flexible Tool ◽  
Content Type ◽  
Comparative Framework ◽  
Government Documents ◽  
Content Analysis Method

PurposeThe housing construction industry is one of the most lucrative sectors for developed countries. However, homebuyers are often vulnerable when left with latent building defects in their new-build house. Many nations have thus implemented new home warranty schemes to protect consumers and stimulate residential production. These warranty programs vary excessively from state to state given the distinct nature of environments. Previous studies have attempted to compare one with another but did not apply a consistent comparative method when doing so. Therefore, the purpose of this study is to identify the characteristics defining a new home warranty and to develop a standardised comparative framework.Design/methodology/approachAfter evaluating the characteristics outlined in multiple home warranty programs, a qualitative content analysis method was used to establish coding, categories and themes in order to create the framework. The methodology relied mostly on cross-referencing from academic papers, methodical reviews, government documents and professional consultant reports.FindingsThis paper reviewed warranty schemes from six countries: Canada, United Kingdom, Australia, Japan, France and Malaysia. The findings suggest that home warranty programs are defined by five main themes: political involvement; homeowner protection; financial sustainability; quality management; and dispute resolution. At the end, the research created a comparative framework of 101 codes that could be used to accurately measure the efficiency of a home warranty scheme.Originality/valueGathering all defining characteristics of new housing warranties into a unique comparative framework rectifies a gap in the literature. Such a flexible tool will aid future practitioners in the field to undertake comparative case study analysis through qualitative research methods.

scholarly journals Coping with adequate and inadequate self-assessment of older people’s risk of falling: a mixed-methods study in Germany.

2019 ◽  
Author(s):  
Nicole Strutz ◽  
Hanna Brodowski ◽  
Sandra Mümken ◽  
Ursula Müller-Werdan ◽  
Jörn Kiselev
Keyword(s):  
Older People ◽  
Coping Strategies ◽  
Fall Risk ◽  
Qualitative Content Analysis ◽  
Self Awareness ◽  
Risk Of Falling ◽  
Self Assessment ◽  
Functional Changes ◽  
Positive Coping ◽  
Increased Risk

Abstract Background: Older people are exposed to an increased risk of falling due to a multitude of physiological and functional changes and fear of falling. The risk of falling is assessed and managed differently. It should be found out whether the coping strategies of older people differ with regard to their activities in daily life depending on the adequacy of their self-assessed fall risk. Methods: Adequacy of the perceived fall risk was evaluated with the de Morton Mobility Index and the Activities-specific Balance Confidence Scale among 100 older people. Additionally, semi-structured interviews were conducted in 16 participants with an identified fall risk. Coding techniques, based on structuring qualitative content analysis and the half-split method were applied. Results: Six out of 16 interviewees assessed their fall risk adequately. Interviews with the seniors resulted in topics such as coping strategies and awareness and several sub-topics in each category. Participants who adequately assessed their own fall risk reported an “active/positive” coping behavior and awareness of themselves. In contrast, those who assessed their own risk of falling inadequately covered all identified categories with no identifiable pattern. Conclusion: An adequate self-assessment of fall risks is accompanied by positive coping strategies to maintain an active lifestyle. In contrast, a lack of an adequate self-awareness seems to lead to arbitrary coping strategies. Assisting older people in their self-awareness regarding their own fall risk should be emphasized in order to adopt positive coping strategies. Future studies are necessary to better understand the underlying mechanisms that lead to an adequate or inadequate self-assessment in older people fall risk.

Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops

2016 ◽  
Vol 35 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Crystal E. Brown ◽  
Anthony L. Back ◽  
Dee W. Ford ◽  
Erin K. Kross ◽  
Lois Downey ◽  
...  
Keyword(s):  
Palliative Care ◽  
South Carolina ◽  
Randomized Trial ◽  
Communication Skills ◽  
Communication Skill ◽  
Linear Regression Models ◽  
Care Needs ◽  
Self Assessment ◽  
Simulation Based ◽  
Self Assessments

Background: We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees’ self-assessments. Aim: To examine whether Codetalk resulted in improved self-assessed communication competence by trainees. Design: Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency. Results: We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee’s overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators—expressing empathy, discussing spiritual issues, and eliciting goals of care. Conclusion: Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.

Simulation-Based Assessment of Graduate Neurology Trainees’ Performance Managing Acute Ischemic Stroke

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012972
Author(s):  
Melissa B Pergakis ◽  
Wan-Tsu W Chang ◽  
Ali Tabatabai ◽  
Michael S. Phipps ◽  
Benjamin Neustein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Management ◽  
Delphi Approach ◽  
Cerebral Herniation ◽  
Sum Score ◽  
Simulation Based ◽  
Critical Action ◽  
Attending Physicians

Background and ObjectivesMultidisciplinary acute stroke teams improve acute ischemic stroke management but may hinder trainees’ education which in turn may contribute to poorer outcomes in community hospitals upon graduation. Our goal was to assess graduate neurology trainee performance independent of a multi-disciplinary stroke team in the management of acute ischemic stroke, tissue plasminogen activator (tPA)-related hemorrhage, and cerebral herniation syndrome.MethodsIn this prospective, observational, single-center simulation-based study, participants (sub-interns to attending physicians) managed a patient with acute ischemic stroke followed by tPA-related hemorrhagic conversion leading to cerebral herniation. Critical actions were developed by a modified Delphi approach based on relevant American Heart Association guidelines and the Neurocritical Care Society’s Emergency Neurological Life Support protocols. The primary outcome measure was graduate neurology trainees’ critical action item sum score. We sought validity evidence to support our findings by comparing trainees’ performance across four levels of training.ResultsFifty-three trainees (including 31 graduate neurology trainees) and five attending physicians completed the simulation. The mean sum of critical actions completed by graduate neurology trainees was 15/22 (68%). Ninety percent of graduate neurology trainees properly administered tPA, 84% immediately stopped tPA infusion following patient deterioration, but only 55% reversed tPA according to guidelines. There was a moderately strong effect of level of training on critical action sum score (level 1 mean score [standard deviation (SD)] = 7.2 (2.8) vs. level 2 mean score (SD) = 12.3 (2.6) vs. level 3 mean score (SD) = 13.3 (2.2) vs. level 4 mean score (SD) = 16.3 (2.4), p < .001, R2 = 0.54).DiscussionGraduate neurology trainees reassuringly perform well in initial management of acute ischemic stroke, but frequently make errors in the treatment of hemorrhagic transformation after thrombolysis, suggesting the need for more education surrounding this low frequency, high-acuity event. High-fidelity simulation holds promise as an assessment tool for acute stroke management performance.

scholarly journals Postcolonial theory and its Impact upon modern historical-anthropological research of Latin America

2021 ◽  
pp. 61-69
Author(s):  
Irina Veselova
Keyword(s):  
Latin America ◽  
Latin American ◽  
Postcolonial Theory ◽  
Qualitative Content Analysis ◽  
Comparative Method ◽  
Wide Range ◽  
Anthropological Research ◽  
Special Challenge ◽  
The Subject ◽  
Latin Americanism

The object of this research is the postcolonial theory, while the subject is its impact upon the historical, and namely, historical-anthropological research of Latin America. The author examines such peculiarities of post-colonialism as the problem of identification, the &ldquo;oppressed&rdquo;, the importance of linguistic component of scientific description, as well as the political bias of this direction. Attention is turned to the process of adaptation of postcolonial theory to Latin American scientific foundation; emphasis is placed on the fact that the region has its own tradition of interpretation of the colonial past that results in occurrence of the so-called phenomenon of decolonial turn within the Latin American humanities. Based on the comparative method and qualitative content analysis of the works dedicated to postcolonial theory, the author demonstrates the presence of a wide range of opinions of Latin American researchers on such concepts as &ldquo;colonialism: and &ldquo;Latin Americanism&rdquo;. The conclusion is made that the intense discussion on the theoretical aspects of colonial and decolonial theory may underlie the new vector in the historical studies of Latin America. &nbsp;At the same time, decolonial turn alongside postcolonial theory, raise a number of questions, the solution of which is vital for the development of accurate methodology for further scientific research. For the Russian Latin American scholars, the new trends turn into a special challenge that should be considered in carrying out historical and anthropological research.

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