Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Comparative Study
Comparison of expert and novice performance of a simulated transesophageal echocardiography examination.
Training in transesophageal echocardiography (TEE) requires a significant commitment of time and resources on behalf of the trainees and the instructors. Training opportunities may be limited in the busy clinical environment. Medical simulation has emerged as a complementary means by which to develop clinical skills. Transesophageal echocardiography simulators have been commercially available for several years, yet their ability to distinguish experts from novices has not been demonstrated. We used a standardized assessment tool to distinguish experts from novices using a commercially available TEE simulator. ⋯ A simulated transesophageal examination of normal cardiac anatomy in concert with a standardized assessment tool permits ample discrimination between expert and novice echocardiographers as defined for this investigation. Future research will examine in detail the role echocardiography simulators should play during echocardiography training including assessment of training level.
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Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. ⋯ Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.
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Central line-associated blood stream infection (CLABSI) is a preventable burden to our current health care system. Inconsistencies in knowledge and practice of central venous catheters (CVC) dressing change procedures are associated with CLABSI. We hypothesized that participation in a "just-in-time" and "just-in-place" CVC dressing change program would improve nurses' knowledge, confidence, and psychomotor performance on mannequins (eg, T1 outcomes). Moreover, this simulation program would be associated with improved procedural competence on real patients (T2 outcomes) and hospital CLABSI rate (T3 outcomes). ⋯ This program improved nurse's knowledge, self-confidence, and psychomotor skill performance on mannequins (eg, T1 outcomes). These improvements were associated with improved procedural competence on real patients (T2 outcomes) and a temporal association with decreased hospital CLABSI rates (T3 outcomes).
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Among the most powerful tools available to simulation instructors is a confederate. Although technical and logical realism is dictated by the simulation platform and setting, the quality of role playing by confederates strongly determines psychological or emotional fidelity of simulation. The highest level of realism, however, is achieved when the confederates are properly trained. ⋯ It aims to refine the practice of simulation by embracing the lessons of the theater community. Although the application of these approaches in healthcare education has been described in the literature, a systematic way of organizing, publicizing, or documenting the acting within healthcare simulation has never been completed. Therefore, we attempt, for the first time, to take on this challenge and create a resource, which infuses theater arts into the practice of healthcare simulation.
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Randomized Controlled Trial
A randomized trial of cardiopulmonary resuscitation training for medical students: voice advisory mannequin compared to guidance provided by an instructor.
Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. ⋯ In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.