Training Checklist Research Articles

271 Transesophageal Echocardiography in the Emergency Department: Development of a Validated Checklist for Training

271 Transesophageal Echocardiography in the Emergency Department: Development of a Validated Checklist for Training

Precursors of falls from height in two main contractor companies in the Chilean construction sector and their subcontractors: Shared vision and preventive prioritization.

Risk factors that can result in serious injuries or deaths are frequently not understood or prevented because of the traditional way in which organizations approach safety. This is especially true for falls from heights in the construction sector, which remain a leading safety hazard in construction globally. A theoretical framework derived from a thorough review of international evidence provided the foundation for the conduct of 50 structured focus groups with a total of 209 participants representing construction workers and supervisors in two main Chilean construction contractor companies and their subcontractors. A total of 627 precursors (risk factors), 56 taxonomies (work tasks/activities), and 622 defenses (prevention actions) were identified. These were classified in three macro dimensions and 13 subdimensions in total, providing a comprehensive framework for the origin, manifestation, and neutralization of such precursors. The findings provide a useful framework for understanding of the most critical risks to which workers are exposed and actions to prevent them. This framework should form the basis for the development of practical safety programs and tools such as management and training checklists, and data analysis for early warning signs.

Retraining transplant pharmacy staff to reduce Medicare Part B prescription billing errors post-transplant

BackgroundMedicare Part B (MedB) imposes penalties for certain errors in prescription billing of post-transplant medications, which can greatly affect pharmacy revenue. To prevent MedB billing fines, pharmacy staff must be cognizant of specific MedB requirements. ObjectiveThis quality improvement project aimed to retrain certified pharmacy technicians (CPhTs) on common billing errors and evaluate changes in error rates and potential fines after retraining. We aimed to determine whether retraining CPhTs minimizes MedB prescription billing errors and reduces potential fines owed by the Vanderbilt Transplant Pharmacy (VTP) to the Centers for Medicare and Medicaid Services (CMS). MethodsThis was a single-center, quality improvement study including post-transplant patients with at least one MedB prescription billing error who filled prescriptions through VTP. All CPhTs involved in MedB prescription billing received retraining focused on the top 3 errors in MedB billing identified at VTP: early refills, missing relationship of caller to patient and residence of patient on order documentation, or no day supply remaining recorded on the order file. Retraining consisted of developing a training checklist, testing current knowledge levels, individualized nonpunitive coaching based on technician specific errors, and retesting for knowledge retention. Outcomes included the number of prescriptions with at least one MedB prescription billing error and the projected amount of dollars fined owing to errors recorded during the 3 months before and 3 months after retraining. ResultsFourteen CPhTs received retraining. Average refill too soon errors decreased by 37.5% (10.7% vs. 6.7%), average missing relationship by 21.7% (7.7% vs. 6%), and day supply errors by 39.7% (1.7% vs. 1%). Error reductions equaled a 28.2% decrease (approximately $12,700) in potential fines. ConclusionRetraining focused on MedB billing error successfully reduced error frequency and fines from CMS. MedB billing error fines can be costly for pharmacies dispensing high-cost medications; therefore, identifying common errors and training staff can be useful and financially prudent.

A-179 Implementation of an Electronic Competency Evaluation System for Point of Care Testing

Abstract Background Management of training and competency evaluation for point of care testing personnel is essential to hospital operations. Typically, documentation for training and competency of point of care operators is a paper based manual process and managed by the POCT team. The responsibilities include maintaining these records for the duration of employment and thereafter and retrieving records for regulatory inspections. It is a challenge for any POCT team in a hospital system with a high volume of operators. In an effort to streamline this process, an electronic training and competency format for the operators of point of care glucose meter was developed and implemented in our hospital system. Method Initial training and competency requires in person delivery which must capture specific elements of competency and must be traceable to the trainer and trainee. Leveraging a survey based online training platform (Qualtrics) as the repository of the training record, the paper based training checklist was converted to an online format accessed via QR (Quick Response) code. Delivery of the training is performed by a certified trainer or preceptor under observation. The training checklist and competency quiz are documented directly in Qualtrics capturing all of the data required for traceability. The evaluation record of each new trainee is available to the POCT Team in real time. Results The online format of initial training and competency was validated by comparing the paper based version to the electronic version. Functionality of the electronic version was confirmed and accuracy of the checklist answers were validated. This electronic format was implemented for initial operator training and evaluation in January 2023. Over 150 trainees have successfully completed the electronic training checklist and competency quiz. Discussion and Conclusion The implementation of an electronic evaluation tool for operators of point of care blood glucose testing has streamlined the process of documentation management in a secure, reliable and transparent way. It also helps to standardize the training process and minimize errors related to a manual process. These documents are readily available and can be retrieved upon request. The implementation of the electronic training evaluation system through Qualtrics coupled with our existing electronic re-certification process will allow us to transition to a fully paperless evaluation/documentation workflow.

A-343 Provider Performed Microscopy Program Makeover: One Institution's Experience

Abstract Background Provider Performed Microscopy (PPM) is a subset of moderate complexity tests performed by physicians and midlevel practitioners. Regulatory bodies require PPM to meet specific accreditation standards. Many institutions face challenges with engaging providers to complete required training and ongoing assessments. Not immune to these challenges, we set out to improve PPM compliance. We reviewed guidelines to identify potential gaps in our PPM program. The existing PPM program practitioners were not aware of specific regulations and current learning systems were not robust enough to meet the regulations. The Point of Care Testing team (POCT) set out to establish a root cause for non-compliance, identify and collaborate with practitioners, and develop a sustainable training and competency system. Quality improvement must establish sustainable solutions to ensure compliance. Method POCT focused efforts on improving practitioner training, competency, and collaboration with practitioners. Over a period of 2 months, we identified and engaged key stakeholders in each department to review historical data from training, competency completion, and result audits revealing gaps. We clearly communicated the standards and how the current program was not meeting standards such as a lack of formalized training and competency documentation, observation of result documentation, and proper reporting of results. By identifying gaps in training, we utilized stakeholders to develop simple processes to enable compliance such as creation of a tip sheet to guide the resulting process, development of a specific training checklist requiring both provider and POC technical consultant (TC) signatures. In collaboration, a system was created to identify practitioner availability for direct observation of the specific elements of assessment. We leveraged our clinical consultant (CC) to assist in the conversations on a peer level with providers to bolster the importance of compliance. Every practitioner was re-trained by our TC along with the CC. With sustainability in mind, POCT collaborated with administrative assistants and department administrators to be notified of new practitioners. Ongoing monitoring involves POCT completing periodic check-ins with the departments as a second layer of assurance. POCT maintains the records of training and competency expiry dates and assigns critical thinking assessments. Results After 2 months, significant improvements were observed. Completed trainings improved from 50% to 100%, competency from 40% to 85%, and proper result documentation by practitioners from 25% to 70%. A 6-month review showed training was maintained at 100%, competency maintained at 85%, and result documentation improved to 90%. Sustainable improvements were observed at 1 year where training and result documentation achieved 100% compliance and competency completion reached 95%. Conclusion Sustainable quality improvement with PPM compliance was achieved by collaborating with practitioners, understanding obstacles to meeting standards, and developing simple solutions specific to practitioner workflows. In doing so, we were able to develop a robust yet succinct system for initiating and maintaining compliance with PPM regulatory standards.

Supervision of Surgical Trainees During Operative Procedures: Implementation of a Formal Preoperative Surgical Checklist.

Background Trainers in surgery have an educational obligation to train trainees in performing operative procedures. Objective We hypothesized that poor concordance manifests as discrepancies between the trainee and the trainer, with an associated reduction in satisfaction with the training experience, perception of training quality, and completion of workplace-based assessments (WBAs). This study also aimed to validate the novel Supervised Training Operative Procedure (STOP) online tool. Method We developed an online proforma (STOP online tool) and conducted a prospective, single-blinded study of 53 orthopedic operative procedures with 53 traineesbetween January 19, 2019, and August 27, 2019. Results Forty-four (82%) trainees were listed as the primary surgeon. The overall mean trainee satisfaction (on a 0-10 Likert scale) was 8.25 (range: 3-10), and the mean trainer satisfaction was 8.28 (range: 4-10). A preoperative discussion between the trainee and the trainer occurred in 96.2% of the cases. Forty-eight (91%) trainers preoperatively established trainees' objectives and 91% (n = 48) of the cases showed postoperative completion of objectives. Forty-four (83%) trainers anticipated workplace-based assessment(WBA) completion for trainees, and this translated into 41 (77%) completed WBAs. Overall, 47 (92.9%) trainees felt that the STOP tool would be useful as a surgical training checklist and in the completion of WBAs. Conclusion The STOP checklist is useful in understanding qualitative and quantitative measures of the overall trainee performance of an operative case. This holistic approach will enable us to establish a structured perioperative surgical training checklist, as trainee and trainer requirements are dependent on one another.

How Fast Can Nurses Learn Therapeutic Communication Skills? A Pilot Study on Brief Hypnotic Communication Training Conducted with Oncology Nurses

Objective: This project aimed to train nurses on an oncology unit in hypnotic communication to reduce treatment-related pain and anxiety in their patients. A pilot study was conducted to assess changes in hypnotic communication behaviors associated with the training. Methods: Nurses were recruited and their interactions during a simulated patient admission for treatment (before and after training) were recorded. Hypnotic communication skills were assessed by independent reviewers using a training checklist listing different hypnotic communication techniques and a validated assessment scale (Sainte-Justine Hypnotic Communication Assessment Scale, SJ-HCAS). Results: Seven nurses were evaluated. Wilcoxon paired-sample tests (pre–post) reported significant improvement with large effect sizes in the total score of the training grid (P = 0.034, r = 0.832) and significant improvement with large effect sizes in the relational (P = 0.018, r = 0.930) and total (P = 0.021, r = 0.903) scores of the SJ-HCAS. Conclusion: This pilot study shows promising results regarding the effectiveness of hypnotic communication training for nurses. These acquired skills could translate into improved treatment experience with patients and could be transferred to other professionals and settings in the health care system.

SP1.2.1 The Theatre Training Checklist (TTC): A toolkit to improve training within the operating theatre

Abstract Aims The operating theatre is a crucial learning environment for different trainees (nurses, anaesthetists, surgeons etc.) Equity of access is essential to achieve their individual training requirements. Traditionally, opportunities within a theatre list are informally discussed between trainers and trainees at some point during the list. Furthermore, there is currently limited discussion between different members of the full team. The Theatre Training Checklist (TTC) is a simple framework that aims to facilitate coordination of training for all team members. Methods The TTC was devised as an extension of the WHO checklist. It consists of four stages: Trainer/Trainee discussion before theatre brief regarding training goals for the list, formal identification of all trainees within the theatre brief, explanation to the team of what each trainee will undertake, followed by use of theatre debrief to reprise whether training goals were met. The TTC was piloted and outcomes measured using an anonymised structured questionnaire from across the entire team. Results 27 staff participated, including 7 trainees. Individuals’ understanding of trainees’ objectives improved as a result of the TTC (25/27, 92.6%) along with perceived improved theatre list efficiency (18/27, 66.6%). All trainees agreed that the checklist improved achievement of their training objectives. Qualitative feedback included: “This is a great way to identify what students and trainees want to achieve in theatre and how we can work together to overcome any difficulties” Conclusion Initial data suggests the checklist qualitatively improves training. The TTC Toolkit is available for use and consists of the checklist tool and an instructional video.

Teaching study skills to college students using checklist training

AbstractDeficits in the study skills of college students can lead to lower academic performance and disqualification. Although behavior analytic research has evaluated strategies for improving student performance in the classroom, no studies have evaluated methods for improving study skills outside of the classroom. We evaluated the effects of a training package that consisted of instructions, written checklists, picture models, and performance feedback using a multiple probe design across skill sets of college students. We taught four college students how to set up their study environment, take notes on readings, and self‐test using their notes from readings. All participants exhibited improvements in targeted study skills during training, and three of four participants achieved mastery within two training sessions per skill set. Acquisition of targeted skill sets corresponded with increased scores on quizzes that assessed learning from the readings. Moreover, participants found the goals and procedures acceptable and the outcomes satisfactory.

Developing Effective Supervisors of Teaching Rounds: Consensus, Entrustment and Deliberate Practice.

The Accreditation Council for Graduate Medical Education considers developing residents into effective clinical supervisors as a critical area in residency training. 1 Edgar L Sydney McLean C Sean Hogan MO et al. The Milestones Guidebook. Accreditation Council for Graduate Medical Education; Published online, 2020: 1-41https://www.acgme.org/What-We-Do/Accreditation/Milestones/Resources Google Scholar Defining and assessing optimal resident performance as clinical supervisors must consider competence in patient safety and quality care, as well as residents’ roles in educating other physician trainees in these same domains. In “Using the Modified Delphi Method to Develop a Tool to Assess Pediatric Residents Supervising on Inpatient Rounds,” we generated consensus on essential supervisory behaviors demonstrated by pediatric residents leading inpatient teaching rounds. This consensus serves as a checklist for training and assessing residents in the realm of clinical supervision. 2 Miller KA Collada B Tolliver D et al. Using the modified Delphi method to develop a tool to assess pediatric residents supervising on inpatient rounds. Acad Pediatr. 2020; 20: 89-96https://doi.org/10.1016/J.ACAP.2019.07.012 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar In this progress report, we revisit our study in the context of what has been published since July 29, 2019, the date that our manuscript was accepted for publication, to highlight common supervisory criteria identified across other specialties and professional levels and identify new emphases on trust and entrustment. We also offer recommendations on applications of our checklist and similar tools.

Preventive effects of Spirulina platensis on exercise-induced muscle damage, oxidative stress and inflammation in taekwondo athletes: a randomized cross-over trial

Abstract Background: Spirulina is an interesting nutritional supplement that has attracted a lot of attention. The aim of the present study was to examine the effect of spirulina supplementation on oxidative stress, inflammatory factors and plasma markers of exercise-induced muscle damage in male taekwondo athletes. Results: A total of 18 trained taekwondo male athletes took part in a double-blind, placebo-controlled crossover study. Each subject received either spirulina (8 g/day) or placebo for 3 weeks. The study had two periods separated by a 14-day washout. Blood samples were taken after finishing a training checklist program (4 times in total). There were no significant carryover effects; therefore, the two-week washout period was adequate. Compared to the placebo, a dose of 8 g / d of spirulina supplement over 21 days resulted in a significant decrease in plasma levels of lactate dehydrogenase (LDH), creatine kinase (CK) and interleukin 6 (IL6) and a significant increase in plasma levels of total antioxidant capacity (TAC), superoxide dismutase (SOD) and glutathione peroxidase (GPX) (p<0.05). There was not any statistically significant change in the plasma malondialdehyde (MDA) (p>0.05). Conclusion: Due to the improvement of antioxidant and anti-inflammatory conditions as well as an appropriate protein content, spirulina supplementation can produce a preventive effect on exercise-induced muscle damage in taekwondo athletes. Trial registration: Iranian Registry of Clinical Trials, IRCT20121110011421N4. Registered 12 July 2021 - Retrospectively registered, https://irct.ir/trial/11692.

126 The Theatre Training Checklist: A Toolkit to Improve Operative Training

Abstract Aim The operating theatre is expensive, costing approximately £1200 per hour to run. It is a crucial learning environment for many different trainees: anaesthetists, surgeons, operation department practitioners, etc. For individuals to achieve their training requirements, the operating theatre as a training environment must be shared between all trainees, requiring excellent teamwork and leadership. This could be improved by the adoption of innovative training strategies. Method The Theatre Training Checklist is a simple framework that aims to facilitate awareness, understanding, coordination and cooperation of training for all team members. It is a practical strategy that can be adopted in any setting. Usually, trainers discuss informally with their trainees about their individual skills, experience, expectations and what is achievable in a theatre list. However, there is currently limited opportunity to discuss this between different disciplines and the wider team. This tool aims to refine communication, optimize training, manage expectations, and ensure equity across the board. Results The checklist is completed at the start of the list during the theatre brief. It identifies all trainees and their specific needs within the operating theatre session to the whole team. An agreed strategy is developed on how to achieve identified training goals. Feedback undertaken from the MDT after local trailing of the checklist has been positive. Conclusions The toolkit is available for use and consists of the checklist tool and an instructional video. The checklist is being piloted in some centres and we hope to have the opportunity to present some early findings to the ASiT Innovation Summit.

Implementation of a Rapid Sequence Intubation Checklist Improves First Pass Success and Reduces Peri-Intubation Hypoxia in Critical Care Transport

<h3>Objectives</h3> We measured the impact of a rapid sequence intubation checklist (RSIC) on first pass success (FPS) during endotracheal intubation by US flight crews, taking into consideration human factors of checklist utilization. We also examined the effects of the RSIC on definitive airway sans hypoxia or hypotension on first pass among adult patients (abbreviated as DASH1a). <h3>Methods</h3> This is a before-and-after observational study within a helicopter ambulance company. The RSIC was used by the crews (Flight Paramedic and Flight Nurse) over a three-year period. Data were evaluated for 8 quarters before- and 8 quarters after- checklist implementation, spanning December 2014 to March 2019. Data included: reason for intubation, use of checklist during intubation, and correlation with the prehospital difficult airway prediction tool, HEAVEN (Hypoxemia, Extremes of size, Anatomic disruption, Vomit, Exsanguination, Neck mobility/Neurological injury) compared with airway management prior to implementation of the checklist. The primary outcome was FPS, and this was compared among those who received RSI before the checklist, versus those who received RSI with the checklist. Also, definitive airway sans hypoxia on first pass among adult patients (DASH1a) was measured before and after RSI checklist implementation. Outcome scenarios were recorded to analyze effectiveness of the checklist. <h3>Results</h3> A total of 10,405 intubations were attempted during the study. First pass success was achieved in 90.9% of patients prior to RSIC, and 93.3% achieved FPS post-implementation (p=<0.001). In the epoch prior to the RSI checklist, there were 4015 (91.9%) of intubations that met the DASH1a metric. After RSI checklist implementation, DASH1a success improved to 94% (p<0.001). Reasons for intubation were similar between the cohorts, although there were more HEAVEN criteria, indicating more difficult airway characteristics, among the post-checklist cohort. It is also noteworthy that overall intubation success without hypoxia improved between the study timeframes, with 89.5% prior versus 93.1% of patients intubated without hypoxia after RSI checklist training, p<0.001. <h3>Conclusion</h3> Implementation of a standardized Rapid Sequence Intubation checklist is a best practice to optimize DASH1a and thereby prevent adverse events related to hypotension or hypoxia in the peri-intubation period. Data suggest that these observations held true even with more objectively difficult EMS airways, based on the higher prevalence of one or more HEAVEN criteria after the checklist implementation.

Listening to Clinical Teams: Developing Strategies to Support Sustained STAR-VA Implementation

Feedback obtained from program evaluations and interviews with CLC team members who participated in STAR-VA helped to inform the development of sustained implementation strategies guided by the CFIR-ERIC Mapping Tool. A CLC readiness assessment was developed to guide selection of new champions and assess for local team readiness to implement STAR-VA. Virtual training materials were developed along with a champion training checklist to prepare additional champions and support team training. We identified key implementation steps and optional strategies to support sustained implementation, developed a sustained implementation guide, associated sustained implementation checklist, and sustainability toolkit. We are piloting a regional community of practice model, encouraging development of and building on relationship networks to promote use of program tools, collaborative problem-solving, feedback, and a shared vision for implementation. We will discuss the importance of tailored strategies for integrating new practices into usual care.

P-EGS11 The Theatre Training Checklist: A Toolkit to Revive Post Pandemic Operative Training

BackgroundThe COVID-19 pandemic has had a significant negative impact on operative surgical training, with trainee logbook numbers reduced by more than 50% compared to 2019. The operating theatre is expensive, costing approximately £1200 per hour to run. It is a crucial learning environment for many different trainees: anaesthetists, surgeons, operation department practitioners and surgical first assistants. For individuals to achieve their training requirements, the operating theatre as a training environment must be shared between all trainees. This requires excellent teamwork and leadership. The recovery phase of the COVID-19 pandemic is a unique opportunity to adopt novel training strategies. MethodsThe Theatre Training Checklist is a simple framework that aims to facilitate awareness, understanding, coordination and cooperation of training for all members of the team (Figure 1). It is a practical strategy that can be adopted in any setting. Usually, trainers discuss informally with their trainees about their individual Skills, Experience, Expectationsand what is Achievable in a planned theatre list (SEEA). However, there currently is limited opportunity to discuss this between different disciplines and the wider team. This tool aims to refine communication, optimize training, manage expectations and ensure equity across the board. The checklist has been introduced and trialed locally. ResultsThe checklist is completed at the start of the list during the theatre brief. It identifies all trainees and their specific needs within the operating theatre session to the whole team. An agreed strategy is developed on how to achieve identified training goals (figure 2). Sometimes it may not be possible to allow a trainee to perform a particular procedure. However, other opportunities for training in theatre exist, such as: patient positioning, choice of equipment, types of techniques, discussions around consenting and complications etc. Feedback undertaken from the multiprofessional team after local trialing of the checklist has been positive. ConclusionsThe Theatre Training Checklist aims to create dialogue and shared understanding of training needs among all parties within the operating theatre. The Theatre Training Checklist Toolkit is available for use and consists of the checklist tool and an instructional video. The Theatre Training checklist is being piloted in some centers and we hope to have the opportunity to present some early findings at AUGIS 2021.P-EGS11 Figure 1P-EGS11 Figure 2

Building Entrustable Professional Activities In Residency Training: Peripheral Blood Smear And Body Fluid Analysis

Abstract Introduction/Objective Entrustable professional activities (EPAs) are defined as specialty-specific tasks representing a unit of professional practice that can be entrusted to unsupervised performance by a trainee following attainment of sufficient task-specific competence. EPAs and periodic competency assessments also provide a framework for evaluating relevant ACGME milestones. We describe our experience creating EPAs for peripheral blood smear (PBS) and body fluid (BF) analysis through which residents became qualified to act as laboratory testing personnel. Methods Training occurred during a 6 week “boot camp” for PGY2 and PGY4 residents in July-August 2018 and July-August 2019. Training for PBS included didactic lectures in automated hematology and RBC morphology (2 hr) and WBC and platelet morphology (2 hr); faculty-guided microscope reviews of RBC (2 hr) and WBC morphology (2 hr) using a training checklist; completion of RBC and WBC self-assessment quizzes; and a 40 question graded exam that covered cell identification, lab protocols, and case scenarios. Training for BF included didactic lectures (2 hr); faculty-guided microscope review of BF slides using a training checklist; completion of a BF self-assessment quiz; and a 40 question graded exam that covered cell identification, lab protocol, and case scenarios. Following successful completion of the graded exam residents were deemed competent to perform unsupervised review of cases initially flagged as abnormal by laboratory technologists; they were required to obtain attending review prior to release of results in defined situations. Formal competency assessments according to CLIA standards were done at 6 and 12 months after initial training. Impact on laboratory workflow and turnaround time was assessed before and after training. Conclusion We successfully created EPAs for PBS and BF analysis through which residents became qualified to act as laboratory testing personnel. There was no adverse impact on laboratory turnaroud time, and the number of PBS and BF cases requiring attending pathologist review decreased. Residents appreciated this tangible opportunity to gain graduated responsibility that prepared them for future practice. Periodic competency assessments provide an opportunity to evaluate relevant ACGME milestones. Our training and assessment program and EPAs can serve as a template for other residency programs.

The Influence of Diabetic Foot Exercise in Sensory Peripheral Neuropathy with Monofilament Test on Diabetes Mellitus Clients

Background: Peripheral neuropathy is a long-term complication that attacks the nerves and loses the sensation of protection which affects about 50% of people with diabetes mellitus (DM). Diabetic foot exercises can help blood circulation, especially in the legs or lower limbs. This researched aimed to analyze the effect of diabetic foot exercise on sensory peripheral neuropathy in DM clients.Method: The study design used quasi-experimental pre-post test with control group. Samples were 28 respondents using purposive sampling and divided into two groups of 14 respondents each. The independent variable is diabetic foot training, and the dependent variable is peripheral sensory neuropathy. Interventions are carried out 3 times a week for 4 weeks. The research instrument was Weinstein Monofilament 10 g Semmes and a diabetic foot training checklist. Data analysis using the Wilcoxon-signed rank test and Mann Whitney test with α≤0.05.Result: The Wilcoxon-signed rank test in the treatment group showed differences in sensory peripheral neuropathy after treatment (p=0,000) and no difference in the control group (p=0.564). The Mann Whitney test results showed differences in sensory peripheral neuropathy between the treatment group and the control group after treatment p=0.039.Conclusion: Diabetic foot exercises can be used as an alternative measure to improve sensory peripheral neuropathy.

An effective snakebite first aid training method for medics in the Chinese troops: a RCT

BackgroundSnakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide. However, few Chinese military medics know the proper first aid procedures for snakebites. Therefore, this study aimed to explore the impact of the Standard Operation Procedure (SOP) and checklist on Chinese military medics’ ability to manage snakebite first aid.MethodsThis study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017. A questionnaire-based survey was performed to collect the participants’ socio-demographic profiles before the baseline measurement. During the baseline measurement, participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the SPs (standardized patients) and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table. After the baseline measurement, they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores: group A received a self-learning course with textbooks (n = 27), group B received a self-learning training on the SOP and checklist (n = 27) and group C was engaged in an interactive discussion panel regarding the SOP and checklist (n = 26). After the interventions, participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error. The reviewers were blinded about the grouping in the trial.ResultsThe baseline measurement yielded no significant difference (H = 1.647, P = 0.439) among the three groups. The post-intervention scores were higher than the pre-intervention scores for all three (A, B and C) groups (P = 0.008, P < 0.001 and P < 0.001, respectively). There was significant difference of the post-intervention scores among the three groups (F = 8.841, P < 0.001). Both post-intervention scores of group B and group C were higher than that of group A (P < 0.001 and P = 0.001, respectively), but no difference was found between group B and C (P = 0.695). The acceptance questionnaire score of SOP and checklist was mostly very satisfied, as the final scores of group B and group C were 4.62 ± 0.61 and 4.82 ± 0.45, respectively.ConclusionsIn this study, the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics. These intervention methods played an important role in improving the medics’ cognition and understanding of snakebite first aid. Therefore, this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.

WHO surgical safety checklist training: An alternative approach to training in local safety standards for invasive procedures.

Despite efforts to promote the effective use of the WHO surgical safety checklist, wrong tooth extractions have continued to occur within dentistry. A training initiative combined methods of teaching comprising of a presentation, video and simulation to deliver LocSSIP training at an Oral Surgery Department of a UK dental hospital. Participant feedback was analysed to determine their perception of using combined methods to deliver the training. Overall feedback was very positive with regard to relevance of the training, and its ability to meet the learning needs of all participants. Participants advocated that there should be regular re-training and incorporation of this training into the local induction programme. AlmostAbout 94% of staff members Strongly Agreed or Agreed that they would recommend this format of training to other departments. Effective training is essential to maintain safe clinical practice within health care, and training methods that are inclusive of various learning styles are well received.

Development of Novel Cloud-Based Clinical Credentialing and Training Checklist System to Improve Volunteer On-Boarding and Certification Tracking in a Student-Run Free Clinic

Development of Novel Cloud-Based Clinical Credentialing and Training Checklist System to Improve Volunteer On-Boarding and Certification Tracking in a Student-Run Free Clinic