Authors:
Wyres, M; Taylor, N. Pages: 317 - 319 Abstract: Introduction Covid-19 has changed the way we live, move and connect in the UK and this includes education settings. There are only four reasons that the government advises people to currently leave home.1 These are: Shopping for essential food or medicine. Exercise or walking a pet but only with members of one’s own household. Medical appointments or as a carer for a vulnerable person. Travel to and from work, if unable to work from home. At all times people must follow social distancing rules when outside the home, so must remain at least 2 m apart, except when with those in the same household.1 This presents a unique challenge generally, but especially in healthcare educational institutions and settings across the country. This is particularly true for universities that provide healthcare-related courses, who traditionally gather learners together in face-to-face settings... PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2020-000642 Issue No:Vol. 6, No. 6 (2020)
Authors:
Woodhead, N. J; Mahmud, A, Clark, J. Pages: 320 - 331 Abstract: IntroductionSimulation is a potentially promising solution to some of the challenges in delivering ultrasound training, and in the last decade, research in simulation-based education has rapidly expanded. There have been no prior focused systematic reviews on the effects of simulation on gynaecological ultrasound scan training. The aim of this review was to summarise and critically appraise the available evidence.MethodsMedline, EMBASE, CINHAL, BNI, PubMed, ERIC, Cochrane Library and ISRCTN Register of Clinical Trials were searched using selected terminology. No language restrictions were applied. The selection criteria were studies of all types that investigated the use of a simulator to teach gynaecological ultrasound. Data evaluating study outcomes, along with methodological details, were extracted in duplicate. The outcomes were classified according to the Kirkpatrick hierarchy and included: patient-related outcomes, such as discomfort; organisational efficiency outcomes, such as examination times; and trainee-related outcomes, such as competence, skill and confidence.ResultsFourteen studies with 573 participants were included: seven randomised controlled trials, three controlled observational studies and four uncontrolled observational studies. The use of simulation practice in gynaecological ultrasound in addition to standard approaches for teaching is associated with significant improvements in competence, skill and confidence of trainees and reduced patient discomfort, increased perceived patient safety and enhanced confidence in the trainee.ConclusionOur findings suggest that simulation in the early stages of training in gynaecological ultrasound is beneficial for the trainee, patients and has organisational benefits through reduced examinations times and need for supervision. Future research needs to confirm these findings in the different settings. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000482 Issue No:Vol. 6, No. 6 (2020)
Authors:
Richardson, C. L; White, S, Chapman, S. Pages: 332 - 338 Abstract: BackgroundVirtual patients (VPs) are a sub-type of healthcare simulation that have been underutilised in health education. Their use is increasing, but applications are varied, as are designs, definitions and evaluations. Previous reviews have been broad, spanning multiple professions not accounting for design differences.ObjectivesThe objective was to undertake a systematic narrative review to establish and evaluate VP use in pharmacy. This included VPs that were used to develop or contribute to communication or counselling skills in pharmacy undergraduates, pre-registration pharmacists and qualified pharmacists.Study selectionEight studies were identified using EBSCO and were quality assessed. The eligibility criteria did not discriminate between study design or outcomes but focused on the design and purpose of the VP. All the included studies used different VP applications and outcomes.FindingsFour themes were identified from the studies: knowledge and skills, confidence, engagement with learning, and satisfaction. Results favoured the VPs but not all studies demonstrated this statistically due to the methods. VP potential and usability are advantageous, but technological problems can limit use. VPs can help transition knowledge to practice.ConclusionsVPs are an additional valuable resource to develop communication and counselling skills for pharmacy students; use in other pharmacy populations could not be established. Individual applications require evaluation to demonstrate value due to different designs and technologies; quality standards may help to contribute to standardised development and implementation in varied professions. Many studies are small scale without robust findings; consequently, further quality research is required. This should focus on implementation and user perspectives. Keywords: Open access PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000514 Issue No:Vol. 6, No. 6 (2020)
Authors:
Fleming, M; McMullen, M, Beesley, T, Egan, R, Field, S. Pages: 339 - 343 Abstract: IntroductionSimulation training in anaesthesiology bridges the gap between theory and practice by allowing trainees to engage in high-stakes clinical training without jeopardising patient safety. However, implementing simulation-based assessments within an academic programme is highly resource intensive, and the optimal number of scenarios and faculty required for accurate competency-based assessment remains to be determined. Using a generalisability study methodology, we examine the structure of simulation-based assessment in regard to the minimal number of scenarios and faculty assessors required for optimal competency-based assessments.MethodsSeventeen anaesthesiology residents each performed four simulations which were assessed by two expert raters. Generalisability analysis (G-analysis) was used to estimate the extent of variance attributable to (1) the scenarios, (2) the assessors and (3) the participants. The D-coefficient and the G-coefficient were used to determine accuracy targets and to predict the impact of adjusting the number of scenarios or faculty assessors.ResultsWe showed that multivariate G-analysis can be used to estimate the number of simulations and raters required to optimise assessment. In this study, the optimal balance was obtained when four scenarios were assessed by two simulation experts.ConclusionSimulation-based assessment is becoming an increasingly important tool for assessing the competency of medical residents in conjunction with other assessment methods. G-analysis can be used to assist in planning for optimal resource use and cost-efficacy. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000504 Issue No:Vol. 6, No. 6 (2020)
Authors:
Hernandez, J; Frallicciardi, A, Nadir, N.-A, Gothard, M. D, Ahmed, R. A. Pages: 344 - 350 Abstract: IntroductionOne critical aspect of successful simulation facilitation is development of written scenarios. However, there are no validated assessment tools dedicated to the evaluation of written simulation scenarios available. Our aim was to develop a tool to evaluate the quality of written simulation demonstrating content validity.MethodsA comprehensive literature search did not yield a validated assessment tool dedicated for the evaluation of written simulation scenarios. A subsequent search yielded six templates published for written simulation scenario design. From these templates, critical scenario elements were identified to create an evaluation instrument with six components of scenario quality with corresponding anchors and rating scale. Subsequently, a national group of simulation experts were engaged via survey methodology to rate the content of the proposed instrument. Ultimately, a modified two-round Delphi approach was implemented to demonstrate consensus of the final assessment tool.Results38 responses were obtained in round 1, while 22 complete responses were obtained in round 2. Round 1 kappa values ranged from 0.44 to 1.0, indicating moderate to almost perfect rater agreement for inclusion of the six proposed components. Kappa values specifically regarding scale and anchors ranged from 0 to 0.49. After revisions, there was a significant level of agreement (p PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000521 Issue No:Vol. 6, No. 6 (2020)
Authors:
E J, S. K; Purva, M, Chander M, S, Parameswari, A. Pages: 351 - 355 Abstract: BackgroundLittle is known about the learning curve characteristics of residents undertaking simulation-based education. It is important to understand the time for acquisition and decay of knowledge and skills needed to manage rare and difficult clinical situations.MethodTen anaesthesiology residents underwent simulation-based education to manage a cannot intubate cannot ventilate scenario during general anaesthesia for caesarean section. Their performance was measured using an assessment tool and debriefed by two experienced anaesthesiologists. The parameters against which the performance was judged were grouped into preoperative assessment, preoperative patient care, equipment availability, induction sequence, communication and adherence to airway algorithm protocol. The scenario was repeated at 6 and 12 months thereafter. The residents’ acquisition of knowledge, technical and non-technical skills were assessed and compared at baseline, 6 months and end of 12 months.ResultThe skills of preoperative assessment, preoperative care and communication quickly improved but the specific skill of managing a difficult airway as measured by adherence to an airway algorithm required more than 6 months (CI at 6 vs 12 months: –3.4 to –0.81, p=0.016). The skills of preoperative assessment and preoperative care improved to a higher level quickly and were retained at this improved level. Communication (CI at 0 vs 6 months: –3.78 to –0.22, p=0.045 and at 6 vs 12 months : –3.39 to –1.49, p=0.007) and difficult airway management skill were slower to improve but continued to do so over the 12 months. The compliance to machine check was more gradual and showed an improvement at 12 months.ConclusionOur study is unique in analysing the learning curve characteristics of different components of a failed obstetric airway management skill. Repeated simulations over a longer period of time help in better reinforcement, retention of knowledge, recapitulation and implementation of technical and non-technical skills. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000496 Issue No:Vol. 6, No. 6 (2020)
Authors:
Pollard, C; McKendrick-Calder, L. A, Shumka, C, McDonald, M, Carlson, S. Pages: 356 - 359 Abstract: BackgroundSimulation places multiple simultaneous demands on participants. It is well documented in the literature that many participants feel performance stress, anxiety or other emotions while participating in simulation activities. These feelings and other stressors or distractions may impact participant ability to engage in simulation. The use of mindfulness has been proven to enhance performance in other contexts and we wondered if including a mindful moments activity in the traditional prebrief would change the participants perceived workload demands.MethodUsing a fourth-year undergraduate nursing course with an intense simulation requirement we were able to compare a control group to an intervention group who was exposed to this mindful moment activity. All participants completed the same simulations. Postsimulation event, all participants completed the National Aeronautics and Space Administration Task Learning Index which measures mental demands, physical demands, temporal demands, effort, performance and frustration. Our convenience sample consisted of 107 nursing students (86 treatment group, 21 control group) who participated in 411 simulations for this study.ResultsThe control group experienced significantly different perceived workload demands in two domains (temporal and effort).ConclusionIt is possible to manipulate participants’ perceived workload in simulation learning experiences. More research is needed to determine optimal participant demand levels. We continue in our practices to use this technique and are currently expanding it to use in other high stress situations such as before examinations. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000499 Issue No:Vol. 6, No. 6 (2020)
Authors:
Taylor, N; Wyres, M, Bollard, M, Kneafsey, R. Pages: 360 - 364 Abstract: BackgroundThe use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional near-infrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events.MethodsThis study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-to-face and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12.ResultsIn this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load.ConclusionOverall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000517 Issue No:Vol. 6, No. 6 (2020)
Authors:
Park, C. S; Clark, L, Gephardt, G, Robertson, J. M, Miller, J, Downing, D. K, Koh, B. L. S, Bryant, K. D, Grant, D, Pai, D. R, Gavilanes, J. S, Herrera Bastida, E. I, Li, L, Littlewood, K, Escudero, E, Kelly, M. A, Nestel, D, Rethans, J.-J. Pages: 365 - 368 Abstract: A pandemic has sent the world into chaos. It has not only upended our lives; hundreds of thousands of lives have already been tragically lost. The global crisis has been disruptive, even a threat, to healthcare simulation, affecting all aspects of operations from education to employment. While simulationists around the world have responded to this crisis, it has also provided a stimulus for the continued evolution of simulation. We have crafted a manifesto for action, incorporating a more comprehensive understanding of healthcare simulation, beyond tool, technique or experience, to understanding it now as a professional practice. Healthcare simulation as a practice forms the foundation for the three tenets comprising the manifesto: safety, advocacy and leadership. Using these three tenets, we can powerfully shape the resilience of healthcare simulation practice for now and for the future. Our call to action for all simulationists is to adopt a commitment to comprehensive safety, to advocate collaboratively and to lead ethically. Keywords: Editor's choice PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2020-000712 Issue No:Vol. 6, No. 6 (2020)
Authors:
Nakamura, K; Sakai, T, Abe, T, Saitoh, T, Coffey, F, MacKenzie, A, Taneichi, A, Tsuchiya, K. Pages: 369 - 370 Abstract: Introduction The advanced technology of eye-tracking enables us to analyse healthcare professionals’ (HCPs) gaze behaviours. Gaze analysis has great potential to capture HCPs’ non-technical skills, especially situational awareness (SA).1 The SA framework has three levels. Level 1 involves perceiving an event, level 2 understanding what is being perceived importantly and level 3 being able to make predictions. How to analyse HCPs’ utterances and gaze in an integrative manner may provide insights into higher-order cognitive skills such as level 3 SA. This study aims to establish a method to describe HCPs’ gaze and utterances in emergency care interactions, focusing on a leader’s gaze at team members’ faces and bodies when making requests. Methods One simulated training session (about 16 min) was analysed, applying a multimodal corpus approach. The recording took place in the resuscitation area at Yokohama City University Medical Center. The team comprised a senior... PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000561 Issue No:Vol. 6, No. 6 (2020)
Authors:
Saunders, A; Brooks, J, El Alami, W, Jabur, Z, Laws-Chapman, C, Schilderman, M, Tooley, C, Attoe, C. Pages: 371 - 373 Abstract: Introduction In the UK, 10% of trainee doctors are out of clinical practice at any given time, for reasons including personal health, carer duties, further education, research and parental leave.1 Doctors report that leaving work often invokes feelings of isolation and sadness, as well as concerns around a lack of support from colleagues and organisations, and even negative views from their families.1 Self-stigmatisation sees doctors internalise negative views about themselves, promoting self-esteem issues and a lack of help-seeking behaviour, which also relates to the constructs of personal and professional identity.2 Addressing and tackling the barriers related to returning to work is not only beneficial for a doctor’s well-being but for patient care too. One systematic review found that doctors with higher occupational well-being adhere more to treatment guidelines, are more optimistic and helpful, and direct more attention to patient’s psychosocial health. PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2019-000566 Issue No:Vol. 6, No. 6 (2020)
Authors:
Brown, C. W; Morse, J. C, Cooper, A. Pages: 374 - 375 Abstract: Introduction In this report, we describe the design and delivery of an interprofessional simulation–based education (SBE) course with a novel debriefing strategy designed to facilitate the simultaneous debrief of a larger than normal number of interprofessional participants and observers. The participants and the observers were separated into two groups, with each having a facilitated learning conversation. Following on from these initial separate debriefings, the participant and observer groups were then once again combined for a successive learning conversation, in which facilitators shared and discussed approximately three key points derived from each of the groups. Description Recently across Scotland, a trauma network (Scottish Trauma Network (STN)) has been developed with the aim of improving and optimising the health and well-being of the seriously injured patient, as well as pioneering in clinical excellence and education. With Aberdeen Royal Infirmary and the Royal Aberdeen Children’s Hospital becoming the first... PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2020-000598 Issue No:Vol. 6, No. 6 (2020)
Authors:
Major, S; Sawan, L, Vognsen, J, Jabre, M. Pages: 376 - 377 Abstract: Introduction Web-Objective Structured Clinical Examination (OSCEs) were piloted for the Clinical Skills Assessment (CSA) exams in the USA two decades ago and were shown to be an acceptable way to conduct OSCEs remotely. The learners valued the process yet expressed numerous limitations.1 In response to the COVID-19 outbreak in Qatar, medical schools stopped in-person teaching creating a hiatus in clinical instruction. The Clinical Skills and Simulation Lab (CSSL) team devised and piloted a Web-OSCE to determine its feasibility in this setting, and to evaluate stakeholders’ experiences. We describe the steps taken to create a Web-OSCE built on women’s reproductive and sexual health which is part of the third year Obstetrics and Gynecology Clerkship curriculum, using Zoom teleconferencing. It mirrored the steps taken when conducting this activity in person; however, all communication relied on emails before the event, Zoom during the event with WhatsApp as a backup... Keywords: Open access PubDate: 2020-11-03T06:00:37-08:00 DOI: 10.1136/bmjstel-2020-000629 Issue No:Vol. 6, No. 6 (2020)
Pages: 378 - 378 Abstract: Sunga K, Sandefur B, Asirvatham U, Cabrera D. LIVE. DIE. REPEAT: a novel instructional method incorporating recursive objective-based gameplay in an emergency medicine simulation curriculum. BMJ Simul Technol Enhanc Learn 2016; 2: 124-6; DOI : 10.1136/bmjstel-2016-000128 Brazil V, Shaghaghi S, Alsaba N. ‘Live Die Repeat’ simulation for medical students. BMJ Simul Technol Enhanc Learn 2020; 6: 247-9. DOI : 10.1136/bmjstel-2019-000485 The Editor and Publisher of BMJ STEL wish to highlight that both of these papers reference an outdated version of the Simulation Effectiveness Tool (SET), published in 2012 by Elfrink et al. (https://doi.org/10.1016/j.ecns.2011.12.001). In the 2016 BMJ STEL paper by Sunga et al., the 2012 SET was modified by the authors without attribution, and renamed as mSET. The 2020 paper by Brazil et al. built on the 2016 paper and referenced the mSET. The authors of the original SET published a modified version of their tool (SET-M)... PubDate: 2020-11-03T06:00:37-08:00 Issue No:Vol. 6, No. 6 (2020)
Pages: 379 - 379 Abstract: Brazil V, Shaghaghi S, Alsaba N. ‘Live Die Repeat’ simulation for medical students. BMJ Simul Technol Enhanc Learn 2020; 6: 247-9. DOI : 10.1136/bmjstel-2019-000485 Sunga K, Sandefur B, Asirvatham U, Cabrera D. LIVE. DIE. REPEAT: a novel instructional method incorporating recursive objective-based gameplay in an emergency medicine simulation curriculum. BMJ Simul Technol Enhanc Learn 2016; 2: 124-6; DOI : 10.1136/bmjstel-2016-000128 The Editor and Publisher of BMJ STEL wish to highlight that both of these papers reference an outdated version of the Simulation Effectiveness Tool (SET), published in 2012 by Elfrink et al. (https://doi.org/10.1016/j.ecns.2011.12.001). In the 2016 BMJ STEL paper by Sunga et al., the 2012 SET was modified by the authors without attribution, and renamed as mSET. The 2020 paper by Brazil et al. built on the 2016 paper and referenced the mSET. The authors of the original SET published a modified version of their tool (SET-M)... PubDate: 2020-11-03T06:00:37-08:00 Issue No:Vol. 6, No. 6 (2020)
Hybrid journal (It can contain Open Access articles)
[68 journals]
