Military medicine
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Randomized Controlled Trial
Effects of simulation-based practice on focused assessment with sonography for trauma (FAST) window identification, acquisition, and diagnosis.
We compared the effects of simulator-based virtual ultrasound scanning practice with classroom-based ultrasound scanning practice on participants' knowledge of focused assessment with sonography for trauma (FAST) window quadrants and interpretation, and on participants' performance on live patient FAST examinations. Novices with little or no ultrasound training experience received simulation-based practice (n = 24) or classroom-based practice (n = 24). Participants who received simulation-based practice scored significantly higher on interpreting static images of FAST windows. ⋯ Overall, classroom-based practice appeared to promote physical acquisition skills and simulator-based practice appeared to promote window interpretation skills. Accurate window interpretation is critical to identification of blunt abdominal trauma injuries. The simulator used (SonoSimulator) appears promising as a training tool to increase probe time and to increase exposure to FAST windows reflecting various anatomy and disease states.
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The development of more effective medical simulators requires a collaborative team effort where three kinds of expertise are carefully coordinated: (1) exceptional medical expertise focused on providing complete and accurate information about the medical challenges (i.e., critical skills and knowledge) to be simulated; (2) instructional expertise focused on the design of simulation-based training and assessment methods that produce maximum learning and transfer to patient care; and (3) software development expertise that permits the efficient design and development of the software required to capture expertise, present it in an engaging way, and assess student interactions with the simulator. In this discussion, we describe a method of capturing more complete and accurate medical information for simulators and combine it with new instructional design strategies that emphasize the learning of complex knowledge. Finally, we describe three different types of software support (Development/Authoring, Run Time, and Post Run Time) required at different stages in the development of medical simulations and the instructional design elements of the software required at each stage. We describe the contributions expected of each kind of software and the different instructional control authoring support required.
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Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. ⋯ FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research.