Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Randomized Controlled Trial
Improving patient safety with ultrasonography guidance during internal jugular central venous catheter placement by novice practitioners.
This study compared ultrasonography-guided (USG) placement with anatomic placement during internal jugular (IJ) central venous catheter (CVC) insertion by novice practitioners using a simulation model. ⋯ The USG during IJ CVC placement by novice practitioners is essential to improve patient safety. If these data are extrapolated to impact on patient care, an arterial stick may be avoided in one of every two IJ CVCs placed by novice practitioners. The USG technology should be made available to novice practitioners needing to place CVCs.
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Randomized Controlled Trial
Simulation training improves medical students' learning experiences when performing real vaginal deliveries.
To determine the relationship between simulation training for vaginal delivery maneuvers and subsequent participation in live deliveries during the clinical rotation and to assess medical students' performance and confidence in vaginal delivery maneuvers with and without simulation training. ⋯ Students who receive simulation training participate more actively in the clinical environment during the course of the clerkship. Student simulation training is beneficial to learn obstetric skills in a minimal risk environment, demonstrate competency with maneuvers, and translate this competence into increased clinical participation and confidence.
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Given the emphasis on early vascular access via the umbilical vein in neonatal resuscitation it is essential that participants in neonatal resuscitation simulation training be given the opportunity to practice both the placement and use of an emergency umbilical venous catheter. By integrating available parts from the Laerdal catalog, combined with a few other inexpensive components, into a Laerdal SimBaby we were able to create a single, integrated neonatal simulator that could be used to practice both the placement and use of an emergent umbilical vein catheter. ⋯ We have developed a modification to the Laerdal SimBaby involving the integration of a usable umbilical cannulation task trainer. The modification was easily accomplished using available parts from the Laerdal catalog and a few other inexpensive components. Given the emphasis on early vascular access via the umbilical vein and the complexities involved with the administration of medications and fluids via this route we believe that a usable umbilical cannulation task trainer is essential to neonatal resuscitation simulation training. When modified as described the Laerdal SimBaby can act as a high-fidelity newborn simulator that allows participants to practice both the placement and use of an emergency umbilical vessel catheter. Given our positive experience we think others could apply the above modification to their own SimBaby.
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Educational opportunities with simulation are now available to teach endoscopic skills outside the clinical setting. The goal of this study is to assess the learning curve and subjective impressions of cystoscopic tasks performed by untrained subjects on a computer-based simulator using a standardized curriculum. ⋯ In this study a computer-based simulator was successfully incorporated into a training curriculum for cystoscopy education. For simulated tasks performed with rigid and flexible cystoscopes, a median of six training sessions was necessary. Objectively, performance on the testing scenarios significantly increased with experience. Subjectively based on nonvalidated criteria, comfort level, and perceived competency increased significantly from the pre- to postcourse evaluations.