Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Randomized Controlled Trial
Simulation Improves Procedural Protocol Adherence During Central Venous Catheter Placement: A Randomized Controlled Trial.
Simulation training may improve proficiency at and reduce complications from central venous catheter (CVC) placement, but the scope of simulation's effect remains unclear. This randomized controlled trial evaluated the effects of a pragmatic CVC simulation program on procedural protocol adherence, technical skill, and patient outcomes. ⋯ Simulation training added to standard training improved protocol adherence during CVC insertion by novice practitioners. This study may have been too small to detect meaningful differences in venous cannulation proficiency and other clinical outcomes, highlighting the difficulty of patient-centered simulation research in settings where poor outcomes are rare. For high-performing systems, where protocol deviations may provide an important proxy for rare procedural complications, simulation may improve CVC insertion quality and safety.
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Randomized Controlled Trial
Comparison of Chest Compressions Metrics Measured Using the Laerdal Skill Reporter and Q-CPR: A Simulation Study.
There has been an increased emphasis on the quality of chest compressions as a part of the cardiopulmonary resuscitation (CPR) bundle of care for recent times. During CPR training, chest compression quality parameters can be measured directly from sensors within a manikin or from external devices placed on the manikin chest that use accelerometer-based technology. The aim of this study was to compare external chest compression data from the manikin-based Laerdal Skill Reporter (LSR) and the accelerometer-based Q-CPR technology, incorporated into the Philips MRx defibrillator, during CPR on a single Resusci Anne Simulator manikin. ⋯ There was no significant difference in most chest compression quality metrics measured between the LSR and the Phillips Q-CPR devices when measured on a manikin. However, there were significant differences in the measurement of duty cycle and also the depth of compressions between the 2 devices with the Phillips Q-CPR device measuring lower depth of compression and duty cycle compared with the LSR device.
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Simulation-based education (SBE) has emerged as an effective and important tool for medical educators, but research about how to optimize training with simulators is in its infancy. It is often difficult to generalize results from experiments on instructional design issues in simulation because of the heterogeneity of learner groups, teaching methods, and rapidly changing technologies. ⋯ Herein, we briefly describe cognitive load theory, its grounding in our current understanding of cognitive architecture, and the evidence supporting it. We focus our discussion on a few well-established cognitive load effects with examples from simulation training and recommend some instructional applications with theoretical potential to improve learning outcomes.