Serious game, lectures or simulation-based mastery learning course which is the best method for training students about cardiac arrest management?

2019 ◽  
Author(s):  
Giuliana Scarpati ◽  
Paolo Remondelli ◽  
Ornella Piazza
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Primary Outcome ◽  
Serious Game ◽  
Training Time ◽  
Simulation Based ◽  
Before And After ◽  
Second Year ◽  
Cpr Training ◽  
Passing Score

"Background and aim: This study aimed to compare a serious game and lectures for the pretraining of medical students before learning about simulation-based management of cardiac arrest. Methods: Participants were 150 volunteer second-year medical students between April and June 2018 randomly assigned to CPR training using either lectures (n = 75) or a serious game (n = 75). Each participant was evaluated on a scenario of cardiac arrest before and after exposure to the learning methods. The primary outcome measures were the median total training time needed for the student to reach the minimum passing score. This same outcome was also assessed three months later. Results: The median training time necessary for students to reach the minimum passing score was similar between the two groups (p=0,45). Achieving an appropriate degree of chest compression was the most difficult requirement to fulfill for students in both groups. Singing the refrain of the song ""staying alive"" significantly increased the number of compressions with the correct rate. Three months later, the median training time decreased significantly in both groups. However, students have remained interested in the serious game for a longer time showing a preference for using this method. Conclusions: The serious game was not superior to lectures to pretraining medical students in the management of a cardiac arrest."

scholarly journals Disaster Day: A Simulation-Based Disaster Medicine Curriculum for Novice Learners

2021 ◽  
Vol 8 ◽  
pp. 238212052110207
Author(s):  
Brad D Gable ◽  
Asit Misra ◽  
Devin M Doos ◽  
Patrick G Hughes ◽  
Lisa M Clayton ◽  
...  
Keyword(s):  
Medical Students ◽  
Disaster Management ◽  
Disaster Preparedness ◽  
Real Life ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Incident Command ◽  
Management Concepts ◽  
Simulation Based ◽  
Second Year

Background: Mass casualty and multi-victim incidents have increased in recent years due to a number of factors including natural disasters and terrorism. The Association of American Medical Colleges (AAMC) recommends that medical students be trained in disaster preparedness and response. However, a majority of United States medical students are not provided such education. Objective: The goal of this study was to evaluate the effectiveness of a 1 day, immersive, simulation-based Disaster Day curriculum. Settings and Design: Learners were first and second year medical students from a single institution. Materials and Methods: Our education provided learners with information on disaster management, allowed for application of this knowledge with hands-on skill stations, and culminated in near full-scale simulation where learners could evaluate the knowledge and skills they had acquired. Statistical analysis used: To study the effectiveness of our Disaster Day curriculum, we conducted a single-group pretest-posttest and paired analysis of self-reported confidence data. Results: A total of 40 first and second year medical students participated in Disaster Day as learners. Learners strongly agreed that this course provided new information or provided clarity on previous training, and they intended to use what they learned, 97.6% and 88.4%, respectively. Conclusions: Medical students’ self-reported confidence of key disaster management concepts including victim triage, tourniquet application, and incident command improved after a simulation-based disaster curriculum. This Disaster Day curriculum provides students the ability to apply concepts learned in the classroom and better understand the real-life difficulties experienced in a resource limited environment.

scholarly journals Simulation-based Training for Pelvic and Breast Physical Examination: Effect on the Anxiety and Self-confidence of Medical Students

2020 ◽  
Vol 42 (11) ◽  
pp. 739-745
Author(s):  
Talles Dias Orsi ◽  
Ana Lucia Ribeiro Valadares ◽  
Paula Miranda Esteves Orsi ◽  
Isabella Miranda Esteves Orsi ◽  
Alexandre Sampaio Moura
Keyword(s):  
Medical Students ◽  
Self Report ◽  
Student Anxiety ◽  
Factors Associated ◽  
Confidence Levels ◽  
Learning Satisfaction ◽  
Self Confidence ◽  
Breast Examination ◽  
Simulation Based ◽  
Before And After

Abstract Objective To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination. Methods A longitudinal study was conducted with 4th year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated. Results Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; p < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; p < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders. Conclusion The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.

Abstract 12052: A Comprehensive Simulation-Based Training for E-CPR Improves the Neurological Outcome of Patients With Refractory Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Takaaki Toyofuku ◽  
Takashi Unoki ◽  
Junya Matsuura ◽  
Yutaka Konami ◽  
Hiroto Suzuyama ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Training Program ◽  
Neurological Outcome ◽  
Hazard Analysis ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Coronary Syndrome ◽  
Simulation Based ◽  
Favorable Neurological Outcome ◽  
Cpr Training ◽  
Refractory Cardiac Arrest

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) has been utilized as a rescue strategy for patients with refractory cardiac arrest (CA). To improve the outcome of E-CPR, we developed a comprehensive simulation-based E-CPR training program. In the present study we assessed whether the E-CPR training improved the mortality and the neurological outcome. Methods: We have implemented the comprehensive E-CPR simulation training program twice a year to the medical team, which consists of emergency physicians, cardiologists, nurses, clinical engineers, and radiographers using a mock vascular model for E-CPR (ECMO cannulation). We assessed collapse to ECMO time, cumulative 30-day survival and good neurological outcome at hospital discharge defined as the cerebral performance categories (CPC) of 1 or 2. Results: Fifty-three consecutive patients received E-CPR for OHCA from January 2012 to December 2020 in which 31 patients were prior to (until September 2017) and 22 were after (from October 2017) the initiation of the E-CPR training. No differences were found in age, rates of witnessed and bystander-CPR, shockable rhythms, or acute coronary syndrome (ACS). Intra-aortic balloon pump was used in 87% patients prior to and 27% patients after the training (p<0.001), and a microaxial Impella pump was used in 55% after the training. Collapse to ECMO time was significantly shorter after the training (p<0.001). Cumulative 30-day survival and the rate of favorable neurological outcome were significantly higher after the training (p<0.05). Multivariate cox proportional hazard analysis revealed that age (hazard ratio [HR], 1.38 (10 years increase), 95% confidence interval [CI], 1.12-1.73, p=0.002), Collapse to ECMO time (HR, 1.14, 95%CI, 1.04-1.23, p=0.006), and additional Impella use (HR, 0.23, 95% CI, 0.08-0.69, p=0.0009) were significantly associated with the 30-day survival. Conclusions: The E-CPR training significantly improved the collapse to ECMO time. The faster deployment of ECMO improves the neurological outcome and 30-day survival in patients with refractory CA. Additional use of Impella may improve the survival.

scholarly journals P134: Escape game as a theatre-based simulation for teamwork skills training in undergraduate medical education

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S104-S105
Author(s):  
A. V. Seto
Keyword(s):  
Medical Students ◽  
Acute Care ◽  
Medical Knowledge ◽  
Skills Training ◽  
Mutual Support ◽  
Training Time ◽  
University Of Calgary ◽  
Second Year ◽  
Teamwork Skills ◽  
Successes And Challenges

Introduction: Teamwork skills are essential in emergency presentations. When training medical students to manage acute care cases, simulation is frequently the educational tool. However, simulation content is often medically-focused, and post-simulation debriefs may not prioritize discussion of teamwork skills, as time is limited. Furthermore, debriefing both medical and teamwork aspects of a case may add to the learners cognitive load. This innovation uses an escape game as a non-clinical simulation to gamify teamwork skills training, with a focus on the collaborator CanMEDS role. In the entertainment industry, escape games are activities where teams solve a series of puzzles together to ultimately escape a room. Methods: 2 groups of 5 second-year medical students piloted the escape game, created within a simulation theatre, designed to surface teamwork competencies under the four University of Calgary Team Scheme domains (adapted from CIHCs National Interprofessional Competency Framework and TeamSTEPPS): Leadership/Membership, Communication, Situation Monitoring, and Collaborative Decision-Making/Mutual Support. During the game, facilitators noted examples of students strengths and challenges in demonstrating teamwork competencies. Post-game, a debrief and written reflective exercise enabled students to analyze successes and challenges in demonstrating teamwork competencies, propose solutions to teamwork challenges, and write 3 goals to improve teamwork skills. All competencies listed under each Team Scheme domain represented themes used in a thematic analysis to uncover students reported teamwork challenges. Results: Each escape game is a 30-minute teamwork activity where 5 students collaborate to complete 8 puzzles, which do not require medical knowledge, in order to win. Briefing is scheduled for 15-minutes, whereas post-game debriefing and reflection is 45-minutes. Conclusion: Escape games can highlight strengths and challenges in teamwork and collaboration amongst second-year medical students. Every competency under the Team Scheme domains was highlighted by the escape game pilots, touching on both strengths and challenges, for which students demonstrated, debriefed, and reflected upon. Students self-documented teamwork challenges include issues surrounding task-focused, closed-loop communication, and frequent reassessments. Advantages of this innovation include its use as a learning progression towards acute care simulations, portability and affordability, potential interprofessional use, and customizability. Additional training time may be required to orient facilitators to this atypical simulation. The escape game will launch in MDCN490 for second-year medical students and is scheduled prior to their acute care simulations. Further teamwork challenges identified at that time will help inform teamwork curriculum development for year 3.

scholarly journals Effect of Facial Skin Temperature on the Perception of Anxiety: A Pilot Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 206
Author(s):  
Elba Mauriz ◽  
Sandra Caloca-Amber ◽  
Ana M. Vázquez-Casares
Keyword(s):  
Nursing Students ◽  
Skin Temperature ◽  
Clinical Performance ◽  
Quality Parameters ◽  
Performance Parameters ◽  
Simulation Based ◽  
Scale Scores ◽  
Before And After ◽  
Specific Temperature ◽  
Cpr Training

The extent of anxiety and psychological stress can impact upon the optimal performance of simulation-based practices. The current study investigates the association between differences in skin temperature and perceived anxiety by under- (n = 21) and post-graduate (n = 19) nursing students undertaking a cardiopulmonary resuscitation (CPR) training. Thermal facial gradients from selected facial regions were correlated with the scores assessed by the State-Trait Anxiety Inventory (STAI) and the chest compression quality parameters measured using mannequin-integrated accelerometer sensors. A specific temperature profile was obtained depending on thermal facial variations before and after the simulation event. Statistically significant correlations were found between STAI scale scores and the temperature facial recordings in the forehead (r = 0.579; p < 0.000), periorbital (r = 0.394; p < 0.006), maxillary (r = 0.328; p < 0.019) and neck areas (r = 0.284; p < 0.038). Significant associations were also observed by correlating CPR performance parameters with the facial temperature values in the forehead (r = 0.447; p < 0.002), periorbital (r = 0.446; p < 0.002) and maxillary areas (r = 0.422; p < 0.003). These preliminary findings suggest that higher anxiety levels result in poorer clinical performance and can be correlated to temperature variations in certain facial regions.

scholarly journals The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Adam Cheng ◽  
Yiqun Lin ◽  
Vinay Nadkarni ◽  
Brandi Wan ◽  
Jonathan Duff ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Visual Feedback ◽  
Just In Time ◽  
Average Height ◽  
Compression Depth ◽  
Simulation Based ◽  
Cpr Quality ◽  
Cpr Training ◽  
Gender Specific

AbstractObjectivesWe aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality.MethodsWe analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use.ResultsOne hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth.ConclusionsStep stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

scholarly journals Effectiveness of simulation-based interprofessional education for medical and nursing students in South Korea: a pre-post survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jihye Yu ◽  
woosuck Lee ◽  
Miran Kim ◽  
Sangcheon Choi ◽  
Sungeun Lee ◽  
...  
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Interprofessional Education ◽  
Continuous Exposure ◽  
Interprofessional Practice ◽  
Interprofessional Learning ◽  
Simulation Based ◽  
Before And After ◽  
Effective Collaboration

Abstract Background Effective collaboration and communication among health care team members are critical for providing safe medical care. Interprofessional education aims to instruct healthcare students how to learn with, from, and about healthcare professionals from different occupations to encourage effective collaboration to provide safe and high-quality patient care. The purpose of this study is to confirm the effectiveness of Interprofessional education by comparing students’ attitudes toward interprofessional learning before and after simulation-based interprofessional education, the perception of teamwork and collaboration between physicians and nurses, and the self-reported competency differences among students in interprofessional practice. Methods The survey responses from 37 5th-year medical students and 38 4th-year nursing students who participated in an interprofessional education program were analyzed. The Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation scale, the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration, and the Interprofessional Education Collaborative competency scale were used for this study. The demographic distribution of the study participants was obtained, and the perception differences before and after participation in interprofessional education between medical and nursing students were analyzed. Results After interprofessional education, student awareness of interprofessional learning and self-competency in interprofessional practice improved. Total scores for the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration did not change significantly among medical students but increased significantly among nursing students. Additionally, there was no significant change in the perception of the role of other professions among either medical or nursing students. Conclusions We observed an effect of interprofessional education on cultivating self-confidence and recognizing the importance of interprofessional collaboration between medical professions. It can be inferred that exposure to collaboration situations through Interprofessional education leads to a positive perception of interprofessional learning. However, even after their interprofessional education experience, existing perceptions of the role of other professional groups in the collaboration situation did not change, which shows the limitations of a one-time short-term program. This suggests that efforts should be made to ensure continuous exposure to social interaction experiences with other professions.

Design Methodology of a Toy to Improve Manual Abilities on Medicine Students

2020 ◽  
Author(s):  
Jessica Daniela Vega Bello ◽  
Yesica Escalera Matamoros ◽  
Arturo Treviño Arizmendi ◽  
Daniel Haro Mendoza ◽  
Vicente Borja ◽  
...  
Keyword(s):  
Medical Students ◽  
Execution Time ◽  
Design Methodology ◽  
Practical Knowledge ◽  
Measured Variable ◽  
Before And After ◽  
Manual Skills ◽  
Second Year ◽  
The Individual ◽  
Precision Test

Abstract Theoretical knowledge is important in all disciplines, but practical knowledge is of utmost importance in many of them, such is the case in engineering, medicine, and architecture. In most of these majors’ instructors focus more on the theoretical area and set aside the practical one. That is why it is important to develop educational tools to improve students’ practice. Medical students at the Universidad Nacional Autónoma de México were our case of study since we noticed a lack of practical knowledge during their second year at University. In this paper, we present a design methodology of a toy for the students of medicine to exercise and improve their manual precise movements and motor sequencing skills, in order to improve their practical abilities by using it. This methodology emphasizes the importance of specific movements that surgeons do while they perform basic surgical procedures, intending to imitate them when they use the toy. Therefore, procedures like cutting, suturing, exposure, among others were performed by a surgeon, recorded, and analyzed. As a result, it was observed that some movements were repeated in most of the procedures. Based on this, a device was designed so that the user may be able to repeat the movements following a series of audiovisual instructions as a game. To validate its efficiency manual precision tests were used to compare the individual students’ improvement before and after using it. Once the device was built as a toy, 12 second-year medical students took the precision tests, the measured variable was the time they used to complete both tests. Furthermore, they practiced with the toy for 10 days, 6 minutes per day. On the last day, after using it, each student performed the precision tests once again to obtain a quantitative value of their improvement. The time spent by each student to perform the first precision tests were compared to the last after using the toy. The results showed that the execution time was reduced by an average of 53.75 seconds in the first precision test and 45 seconds in the second. This indicates that the use of the toy allows students to improve their manual precision skills, affecting the execution time of tasks that require accurate manual precision. Also, it was observed that the methodology developed could be applied and extrapolated to other disciplines such as engineering, in order to develop similar toys or devices that could enhance manual skills.

Abstract 356: Skill Retention in Medical Students Trained in Cardiac Arrest Care

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Miguel A Moretti ◽  
Adriana O Camboim ◽  
Caroline A Ferrandez ◽  
Isabela C Etcheverria ◽  
Iaggo B Costa ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Training Program ◽  
Life Support ◽  
Categorical Variables ◽  
First Year ◽  
Chi Square ◽  
Hands On ◽  
Before And After ◽  
First Year Medical Students

Background: Morbidity and mortality reduction in cardiac arrest depends upon early and effective care. Basic life support (BLS) measures encompass a series of procedures to be started outside the hospital usually by trained lay people. Therefore, it is key that lay caregivers retain knowledge and skills late after instruction. However, studies demonstrate loss of cardiopulmonary resuscitation (CPR) skills as early as 30 days after training, pending mostly on the caregiver professional background. In this study, we evaluated medical students’ retention skills at 6 months. Methods: Prospective case-control observational study. Medical students underwent a 40-hour BLS training program. CPR skills were evaluated immediately and 6 months after the course based on individual scores before and after training as well as on categorical stratification as excellent, good or poor. Data were compared using F-test, paired t-test and chi-square for categorical variables. A 95% confidence interval was used with a level of significance of 0.05. Results: Fifty first-year medical students (54% female) aged between 18 and 24 years were enrolled in the BLS training program. Total number of CPR steps accurately performed decreased after 6 months of training (10.8 vs . 12.5; p<0.001). Sex and age were not associated with performance. Categorical evaluation was considered excellent in 78% of the students immediately after training but decreased to 40% in 6 months (p<0.01). Hands-on basic skills were mostly lost within the period. Conclusion: First-year medical students lost hands-on skills after 6 months of training decreasing the efficacy of CPR measures which might affect outcomes of patients in cardiac arrest.

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