Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Multicenter Study
Qualitative evaluation of just-in-time simulation-based learning: the learners' perspective.
Just-in-time training (JITT) is an educational strategy where training occurs in close temporal proximity to a clinical encounter. A multicenter study evaluated the impact of simulation-based JITT on interns' infant lumbar puncture (LP) success rates. Concurrent with this multicenter study, we conducted a qualitative evaluation to describe learner perceptions of this modality of skills training. ⋯ Just-in-time training improved procedural confidence with infant LP, but work place busyness and instructor lack of support or unawareness were barriers to JITT performance. Optimal LP JITT would occur with improved contextual fidelity. More research is needed to determine optimal training strategies that are effective for the learner and maximize clinical outcomes for the patient.
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Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. ⋯ Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.
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The past decade has witnessed the increased use of patient simulation in medical training as a method to teach complex bedside skills. Although effective bag-mask ventilation (BMV) is a critical part of airway management, the quality of training in this skill has been questioned. ⋯ This study suggests that this computerized patient simulator was validated as a simulation model for teaching difficult BMV and differentiating skill levels in BMV. Using the simulator with brief training on difficult BMV allowed new internal medicine house staff to successfully ventilate a simulated difficult patient.
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Perimortem cesarean section is a rare, time-critical, and potentially life-saving procedure for both the fetus and mother. This makes perimortem cesarean section an ideal and recommended subject for simulation learning and practice. ⋯ We present here an inexpensive, easy to make, and portable model, which can be used to simulate an emergency caesarian section.