A study on the impact of simulation-based training, on retention of knowledge and skills of medical interns, for patient care, during the COVID-19 pandemic

BackgroundAs emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.MethodsThis was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.ResultsThirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.Discussion/ConclusionWe have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.

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Medical students as simulation educators: students’ experience of a 7-week simulation-based education rotation

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2020-000582 ◽

2020 ◽

pp. bmjstel-2020-000582 ◽

Cited By ~ 1

Author(s):

Victoria Brazil ◽

Melissah Caughley ◽

Lauren Middleton ◽

Georgia Powell ◽

Nemat Alsaba

Keyword(s):

Medical Students ◽

Role Models ◽

Practical Knowledge ◽

School Curriculum ◽

Lifelong Learners ◽

Knowledge And Skills ◽

Simulation Education ◽

Clinician Educators ◽

Simulation Based ◽

The Impact

Medical students will have future roles as clinician educators, and need to develop knowledge and skills for that role. Specific skills in simulation-based education (SBE) may be valuable in many educational settings. We aimed to understand the impact of a 7-week placement in SBE on the development of medical students’ knowledge, skills and perspectives as educators. We reviewed the experience of three graduated students (also coauthors of this article) who participated in the rotation in 2018. This case study includes analysis of the students’ electronic portfolios, rotation reports and subsequent reflections of the student coauthors. Five themes were identified:—‘Development as a professional’, ‘Active participation in an educator team’, ‘Diverse experience in simulation skills and techniques’, ‘Role models and mentoring’ and ‘Rethinking feedback’. Students describe the development of practical knowledge and skills, and more fundamental reflections on the nature of learning, feedback and their personal professional development. We suggest that integration of a simulation education elective within a medical school curriculum helps build capacity for effective SBE delivery, and has positive impacts on students for their future roles as doctors, educators and lifelong learners.

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The Power of Synergy: An Academic/Clinical Partnership for Transformational Change

Advances in Nursing ◽

10.1155/2014/605835 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Ann McKillop ◽

Cheryl Atherfold ◽

Gary Lees

Keyword(s):

Quality Improvement ◽

Critical Thinking ◽

New Zealand ◽

Focus Groups ◽

Patient Care ◽

Registered Nurses ◽

Outcome Evaluation ◽

Health Board ◽

Knowledge And Skills ◽

The Impact

Background. A programme of postgraduate study was developed in partnership between a health board and a university in New Zealand, having identified critical thinking and practice change as key determinants of good care delivery. Aim. To explore the impact after 12 months of a postgraduate programme for registered nurses on patient assessment and clinical reasoning, and the status of implementation plans for improved patient care. Design. Outcome evaluation using a survey and focus groups. Setting. On location at a hospital in a small city in New Zealand that provides healthcare services for 102,000 people across rural and urban areas. Participants. Registered nurses who had completed the programme (N=28) and seven clinical mentors. Methods. A survey, focus groups, and follow-up data about quality improvement projects were used to explore how the programme was experienced and its impact. Results. The survey revealed perceptions of improved knowledge and skills but a lack of confidence in communicating with medical staff. Of 28 quality improvement projects planned, all but three had been implemented and were still in use. Two themes were generated from focus group data: “new ways of thinking” and “doing things differently.” Conclusions. This academic/clinical partnership positively influenced nurses’ knowledge and skills, encouraged critical thinking and self-efficacy, and resulted in the sustained implementation of nurse-initiated projects intended to improve patient care.

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3317 Translating simulation-based team leadership training into patient-centered outcomes

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.136 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 57-58

Author(s):

Rosemarie Fernandez ◽

Elizabeth D. Rosenman ◽

Anne K. Chipman ◽

Sarah Brolliar ◽

Marie C. Vrablik ◽

...

Keyword(s):

Patient Care ◽

Trauma Patient ◽

Leadership Training ◽

Leadership Effectiveness ◽

Team Leadership ◽

Secondary Outcome ◽

Team Leaders ◽

Simulation Based ◽

Complex Skills ◽

The Impact

OBJECTIVES/SPECIFIC AIMS: The objective of this research was to assess the clinical impact of simulation-based team leadership training on team leadership effectiveness and patient care during actual trauma resuscitations. This translational work addresses an important gap in simulation research and medical education research. METHODS/STUDY POPULATION: Eligible trauma team leaders were randomized to the intervention (4-hour simulation-based leadership training) or control (standard training) condition. Subject-led actual trauma patient resuscitations were video recorded and coded for leadership behaviors (primary outcome) and patient care (secondary outcome) using novel leadership and trauma patient care metrics. Patient outcomes for trauma resuscitations were obtained through the Harborview Medical Center Trauma Registry and analyzed descriptively. A one-way ANCOVA analysis was conducted to test the effectiveness of our training intervention versus a control group for each outcome (leadership effectiveness and patient care) while accounting for pre-training performance, injury severity score, postgraduate training year, and days since training occurred. Association between leadership effectiveness and patient care was evaluated using random coefficient modeling. RESULTS/ANTICIPATED RESULTS: Sixty team leaders, 30 in each condition, completed the study. There was a significant difference in post-training leadership effectiveness [F(1,54)=30.19, p<.001, η2=.36] between the experimental and control conditions. There was no direct impact of training on patient care [F(1,54)=1.0, p=0.33, η2=.02]; however, leadership effectiveness mediated an indirect effect of training on patient care. Across all trauma resuscitations team leader effectiveness correlated with patient care (p<0.05) as predicted by team leadership conceptual models. DISCUSSION/SIGNIFICANCE OF IMPACT: This work represents a critical step in advancing translational simulation-based research (TSR). While there are several examples of high quality translational research programs, they primarily focus on procedural tasks and do not evaluate highly complex skills such as leadership. Complex skills present significant measurement challenges because individuals and processes are interrelated, with multiple components and emergent nature of tasks and related behaviors. We provide evidence that simulation-based training of a complex skill (team leadership behavior) transfers to a complex clinical setting (emergency department) with highly variable clinical tasks (trauma resuscitations). Our novel team leadership training significantly improved overall leadership performance and partially mediated the positive effect between leadership and patient care. This represents the first rigorous, randomized, controlled trial of a leadership or teamwork-focused training that systematically evaluates the impact on process (leadership) and performance (patient care).

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Assessment of a massive open online course (MOOC) incorporating interactive simulation videos on residents’ knowledge retention regarding mechanical ventilation

BMC Medical Education ◽

10.1186/s12909-021-03025-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tài Pham ◽

François Beloncle ◽

Lise Piquilloud ◽

Stephan Ehrmann ◽

Damien Roux ◽

...

Keyword(s):

Mechanical Ventilation ◽

Knowledge Retention ◽

Respiratory Physiology ◽

Medical Residents ◽

Interactive Simulation ◽

Knowledge And Skills ◽

Course Assessment ◽

Simulation Based ◽

The Impact

Abstract Background Understanding respiratory physiology and mechanical ventilation is a challenge for healthcare workers, particularly, medical residents. A team of French-speaking experts developed an innovative MOOC incorporating interactive simulation-based videos and serious games aiming at improving knowledge and skills in mechanical ventilation. Our objective was to evaluate the long-term knowledge retention regarding key concepts presented in this MOOC. Methods French residents registered for the MOOC 2020’s winter session were invited to participate in a two-step study. The first step consisted in evaluating students’ pre-course knowledge of respiratory physiology and mechanical ventilation fusing a 20 five-item multiple choice questions test with a total score ranging from 0 to 100. For the second step, the same students answered the same test (after shuffling the questions) six months after the completion of the course. We assessed the impact of this MOOC on the students’ knowledge retention by comparing pre-course and post-course scores. Result Of the 102 residents who agreed to participate in the study, 80 completed the course and their mean ± SD pre-course score was 76.0 ± 8.0. Fifty-one respondents also completed the second and their post-course score was significantly higher than the baseline one (83.1 ± 7.3 vs. 77.5 ± 7.6, p < 0.001). Scores of the first and second rounds did not differ upon comparing respondents’ background specialty or number of years of residency. For the vast majority of individual questions (96%), the success rate was higher at the post-course than at the pre-course assessment. Conclusion An innovative MOOC incorporating simulation-based videos was effective in teaching medical residents basic mechanical ventilation knowledge and skills, especially in the field of respiratory physiology and ventilatory modes. We observed effective long-term knowledge retention with a higher score at the post-course assessment six months after the completion of the course compared with the pre-course score.

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