Simulation-Based Learning for Pain Medicine: A Scoping Review of Undergraduate Education

Issues in Long-term Opioid Therapy: Unmet Needs, Risks, and Solutions

Beyond the needle: expanding the role of anesthesiologists in the management of chronic non-malignant pain.

For many years, simulation-based education (SBE) at Walsall Manor Hospital (WMH) was carried by a one-man simulation technician, with intermittent input from department facilitators. Inadvertently creating SBE dis-equality across departments. Studies have demonstrated that formalized SBE plans improve training [1] and clinical outcomes [2]. We aimed to create standardisation and equity in SBE across departments by formulating a SBE training and delivery plan and governance structure at WMH. In the Autumn 2021, WMH started standardising SBE across the Trust in order to improve both the undergraduate and postgraduate standard of education [3]. The team grew to incorporate five multidisciplinary members; SIM technician, SIM lead (consultant), SIM nurse, SIM project support, and SIM technician support. With further expansion to now include speciality simulation leads in emergency medicine (EM) and paediatrics. Currently there is active recruitment for speciality leads in other departments. The SIM staff were appointed already holding simulation education related qualifications and/or experience. In addition, staff attended the University of Stafford foundations in simulation and debriefing courses. The governance process has been developed and implemented around the appointment of simulation speciality staff, formation of simulation courses, and simulation delivery. Furthermore, collection of attendance, feedback forms, certificates of participation and attendance have been made mandatory element of simulation delivery. In addition, there has been internal and external investment in increasing simulation equipment, including paediatric manikins and immersive technology. In seven months, achievements have included: a range of simulation-based training events, the implementation of in-situ simulation in acute medicine, simulated sessions for final year medical students, the development of a simulation Foundation Year 1 and 2 curriculum, successful construction and running of mock royal college of physicians viva examination, multiple medical procedure courses, the re-introduction of Ill Medical Patients’ Acute Care Treatment (IMPACT) course, and simulation sessions for student nurses. SBE activities were delivered by and to a multidisciplinary team. Putting together a simulation team and formalizing the governance process around SBE delivery has increased the number of educational activities for both undergraduate medical/nursing students and postgraduate doctors and allied health care professionals. Feedback scores have been good to excellent and multidisciplinary work in EM has improved. The SIM team will continue to promote, implement, embed, and sustain SBE within the Trust to bigger and bolder activities. We would like to thank and acknowledge the Dinwoodie charitable company for their support. 1. Weaver SJ, Salas E, Lyons R, Lazzara EH, Rosen MA, DiazGranados D, Grim JG, Augenstein JS, Birnbach DJ, King H. Simulation-based team training at the sharp end: A qualitative study of simulation-based team training design, implementation, and evaluation in healthcare. Journal of Emergencies, Trauma and Shock. 2010;3(4):369–377. 2. Houzé-Cerfon CH, Boet S, Marhar F, Saint-Jean M, Geeraerts T. Simulation-based interprofessional education for critical care teams: Concept, implementation and assessment. Presse Medicale (Paris, France: 1983). 2019;48(7–8 Pt 1):780–787. 3. Irwin PM, Brown RA, Butler S. The undergraduate simulation framework: standardising design and delivery’. Higher Education, Skills and Work-Based Learning. 2020;11(2):576–586.

Simulation is a teaching learning and assessment strategy used in medical education to prepare medical laboratory students for clinical practice. Simulation-based learning is aimed at bridging the gap between theory and practice through the use of innovative teaching strategies and thus it is considered the best alternative teaching, learning and assessment tool in preparing medical laboratory students for practical and professional life. Traditional methods of educating medical laboratory students are no longer sufficient in the present times largely influenced by the emergence of new infections, technology, and multimedia. In general, scarce literature supports the use of simulation to benefit medical laboratory student in areas of knowledge, value and realism. However, little emphasis has been placed to make application of the method. The aim of the study was to determine the extent of the application of innovative simulation-based medical teaching and learning among staff in selected Kenya medical training campuses offering medical laboratory sciences in Kenya, with a view of improving the application of the simulation strategy. The study employed the census sampling technique. Data collection tools were structured questionnaire, interview, checklist and observation which were used for data collection to obtain information from the respondents. Quantitative data analysis was conducted using the Statistical Package for Social Science (SPSS) software version 22 for windows. Qualitative data was analyzed using content analysis. Both descriptive and inferential statistics particularly the Chi-square test statistics were used in data analysis. P-value was used to test the normality of the spread of the ages. From the findings, majority of the lecturers, 39 (83.0%) indicated that they understood and defined simulated medical laboratory experiences both actual and anticipated. The respondents reported that simulation-based teaching and learning enables them to earn continuous professional development (CPD) points. All the lecturers 47(100%) agreed that educational validity of simulation-based teaching and learning was one among the factors that shaped their decision to implement simulations. The principals cited issues such as untrained simulator instructor staff in MLS, lack of adequate infrastructure, as part of challenges they encountered while implementing innovative simulation-based teaching and learning. From the study, it was concluded that simulation-based teaching and learning was not applied uniformly across the MLS department, indicating a lack of standardization in training hence the knowledge, attitudes as well as skills acquired by the students before they graduate were not in line with the public expectation. There is a need for Kenya Medical Training College (KMTC) management to ensure uniform application of innovative simulation-based teaching and learning across all MLS departments and hence standardization in training of medical laboratory sciences professionals.

Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine.

Medical Student Education

Pain Management Still a Pain

A persistent pain

BONUS: the National Oncology Network for Students and Junior Doctors

An effective airway management education program is a crucial part of the undergraduate medical education curriculum. Theoretical instructions and practical demonstrations are the major modalities of medical education in Nepal. Simulation-based education (SBE) programs have not yet been implemented effectively. The authors aimed to determine the effects of an SBE program on the knowledge, skills, and perceived confidence of medical interns regarding emergency airway management. This mixed methods study comprised both quantitative and qualitative components. The study participants were 47 medical interns who had participated in the SBE program. The mean age of the 47 participants was 24.74 years. There were 33 (70.21%) male and 14 (29.79%) female participants. The knowledge, skills, and perceived confidence scores of the participants for airway management preparation, basic airway management, endotracheal intubation, and laryngeal mask airway (LMA) insertion improved significantly following the SBE program (P<0.001). Analysis of the participants' feedback indicated that they largely approved of the SBE program. The majority of students and faculty expressed a willingness to include similar programs in the undergraduate medical education curriculum. This study demonstrated through quantitative and qualitative metrics that SBE can enhance the knowledge, skills, and perceived confidence in performing emergency airway management among medical interns. The authors recommend measures to include and effectively implement SBE in the undergraduate medical education curriculum of Nepal.

Background/AimsOphthalmology is an under-represented specialty in many medical school curriculums resulting in reduced confidence in medical students and clinicians when dealing with eye conditions. Our study evaluates the impact of a simulation-based education (SBE) workshop to train medical students in ophthalmology.MethodsSecond-year medical students were invited to participate in a two-day (eight-hour) simulation-based ophthalmology workshop. Standardised patients, free-to-use simulators, and low-cost eye models were used to teach eye anatomy, physiology, pathologies, skills (slit-lamp, ophthalmoscopy etc.), and eye procedures (cataract surgery, eye lasers etc.). Learners filled questionnaires to evaluate their ophthalmology interest, confidence, and knowledge before the workshop, immediately after the workshop, and three months later. They also answered a feedback survey on the workshop’s quality and usefulness immediately after the workshop.ResultsNine students, including six females and three males, participated in the workshop. Pre-workshop, learners’ mean self-reported confidence in dealing with ophthalmology patients was 1.8/5 and mean self-reported interest in pursuing an ophthalmology residency was 2.6/5 on a Likert-scale-based questionnaire (on a scale of 1–5). Learners scored a mean of 8.4/15 on an ophthalmology knowledge questionnaire with fifteen questions. Post-workshop (immediate), their mean self-reported confidence was 3.4/5 (p = 0.0001), interest in pursuing an ophthalmology residency was 3.2/5 (p = 0.022), and score on the ophthalmology questionnaire was 13/15 (p = 0.0001). Three months later, students’ self-reported mean confidence was 3.2/5 (p = 0.0001), the likelihood of choosing ophthalmology residency was 2.8/5 (p = 0.59), and score on the ophthalmology knowledge questionnaire was 11/15 (p = 0.006). The feedback survey showed that all students found the workshop relevant, comprehensive, easy to understand, and that they gained knowledge/skills applicable to their future clinical practice.ConclusionsA small group SBE ophthalmology workshop improves learners’ knowledge, skills, and confidence using an approach they find interesting, with low cost and time investment.Trial registrationNot applicable.

Patient safety is the number one priority for the NHS and evidence suggests that greater experience leads to greater patient safety. 1 Increasingly medical students spend more time in scheduled teaching and less time on the wards. When they are on the wards there are many potential barriers to gaining clinical experience such as a time-pressured environment, patients being too unwell or unwilling. 2 So is there a role for using simulation-based education to increase experiential learning opportunities with medical students? Simulation has been shown to promote competence in clinical and non-technical skills. 3 However most of this evidence comes from postgraduate training. The aims of this pilot project were firstly to introduce the students to both the modality of simulation-based teaching and the concept of non-technical skills. Both of these are likely to increasingly feature in their future training and by introducing them early on it would allow them to build on them in future years. Secondly we wanted to see how we could incorporate the 3rd year curriculum in to simulation based-teaching. Finally we aimed to establish if simulation-based teaching actually improves 3rd year medical students’ clinical and non-technical skills as measured by their own self-assessment. Based on this we have developed and ran 5 one day simulation-based teaching programme, with multi-disciplinary faculty, for a total of 52 3rd year medical students. Students were asked to complete a self-assessment of four clinical and four non-technical skills before and after the programme. Analysis of these results supports the use simulation-based teaching for 3rd year medical students. References McGaghie WC et al . Effect of practice on standardised learning outcomes in simulation-based medical education. Med Educ 2006; 40 :792–7 Olson LG, Hill SR, Newby DA. Barrier to student access to patients in a group of teaching hospitals. Med J Aust 2005; 183 :461–3 Aggarwal R et al . Training and simulation for patient safety. Qual Saf Health Care 2010; 19 (2):34–43

Pain control in chronic and acute disease conditions such as cancer pain or post-operative pain is often adequate with the help of appropriate pharmacological agent. A&nbsp;comprehensive&nbsp;review of numerous studies conducted to evaluate the efficacy of hydromorphone (OROS) for the management of acute and chronic pain was performed. Data from 17 controlled trials were reviewed, taking into consideration the usefulness of hydromorphone for the management of chronic and acute pain. Heterogeneity of the studies and the small number of patients involved made the conclusion difficult. Overall the studies found that osmotic-controlled released oral delivery system (OROS) hydromorphone that is effective in the management of chronic pain. But comparative studies with other opioid analgesics find little difference in efficacy and side effect profile. OROS hydromorphone is effective in the management of chronic pain, but it&rsquo;s usefulness in acute pain is less conclusive. &nbsp; Key words:&nbsp;Hydromorphone, osmotic-controlled released oral delivery system (OROS), chronic pain, acute pain.

Opioids for the treatment of acute pain and the pain of malignancy have been strongly encouraged for more than 25 years.1 In the past 2 decades, the treatment of chronic noncancer pain using long-term opioid therapy has become more common. However, recent studies have revealed the astonishing rapidi

Racism in Pain Medicine: We Can and Should Do More