Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Transition of a Neonatal Intensive Care Unit (NICU) to a new physical plant incurs many challenges. These are amplified when the culture of care is changing from traditional cohort-based care to the single-family room model. Altered healthcare delivery systems can be tested in situ with TESTPILOT: Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing. The aims of the study included promoting translation of existing processes and identifying staff orientation material. We hypothesized that (1) numerous process gaps would be discovered and resolved, and (2) participants would feel better prepared. ⋯ Simulation is very effective for identifying process gaps before major institutional change. TESTPILOT generated iterative workflow enhancements and staff orientation toward improving patient care at transition and beyond. The extensive coordination required to implement such large-scale simulations is well worth the benefit for systems refinement and patient safety.
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Randomized Controlled Trial Multicenter Study
Team communication with patient actors: findings from a multisite simulation study.
Patient satisfaction is an important healthcare outcome and communication with clinical staff is an important determinant. Simulation could identify problems and inform corrective action to improve patient experience. ⋯ Some aspects of staff-patient interaction and teamwork during management of a simulated emergency varied significantly and were often inadequate in this study, indicating a need for better training of individuals and teams.
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: To inform further development of a personal computer-based Pediatric Advanced Life Support (PALS) simulator, we wished to understand users' perceptions of this new technology. Specifically, we sought to determine whether the simulator was perceived as an effective training tool, whether it filled a gap in the users' current training regimen, and whether these perceptions were impacted by professional affiliation and PALS training history. ⋯ : Hospital-based pediatric providers are open to using personal computer-based simulation to provide on-demand refresher training in the cognitive aspects of PALS. Through its capacity to reach a large number of health care workers without the need for instructor presence, this technology could be used to help develop a more targeted role for mannequin simulation.
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Randomized Controlled Trial
Leadership in medical emergencies depends on gender and personality.
Leadership is an important predictor of team performance in medical emergencies. There are no data on why some healthcare workers take the lead in emergencies while others do not. Accordingly, the aim of the study was to determine predictors of leadership in a medical emergency. ⋯ During the initial phase of a medical emergency, there is a substantial interindividual variation in the amount of leadership. Leadership behavior as assessed by the number of leadership statements is determined by gender and personality and not by knowledge or experience.
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Randomized Controlled Trial
Comparison of checklist and anchored global rating instruments for performance rating of simulated pediatric emergencies.
To compare the psychometric performance of two rating instruments used to assess trainee performance in three clinical scenarios. ⋯ We demonstrate that our checklist and anchored global rating instrument performed in a psychometrically similar fashion with high reliability. As long as proper attention is given to instrument design and testing and rater training, checklists and anchored assessment scales can produce reproducible data for a given population of subjects. The validity of the data arising for either instrument type must be assessed rigorously and with a focus, when practicable, on patient care outcomes.