Clinical Skills Centre Research Articles

Predictors of virtual reality simulation bronchoscopy performance among novice bronchoscopists.

IntroductionSimulation-based training is gradually replacing the classic “apprenticeship” training model. Predictors of better performance of virtual reality simulation bronchoscopy are not clear.ObjectiveWe aim to explore the predictors of performance of simulation bronchoscopy among novice bronchoscopists.Materials and methodsThis is a descriptive observational cohort study conducted at King Abdulaziz University Clinical Skills and Simulation Center, Jeddah, Saudi Arabia. All participants filled a demographic questionnaire and attended a pre-simulation orientation about the requested tasks. The Simbionix bronchoscopy simulator was used in this study. First, each resident performed three trails of basic scope manipulation task to test hand–eye coordination skills. Thereafter, each resident performed the guided anatomical navigation task to accurately examine as many lung segments as possible. Results and metrics were retrieved from the simulator, and statistical analysis was performed using t-test to measure statistically significant P-value (<0.05).ResultsFifty-three internal medicine residents participated in this study. Male residents significantly achieved higher score in the basic scope manipulation task than female residents (65% vs 46%, P<0.001). Furthermore, the percentage of time spent at mid lumen during the scope manipulation was significantly higher for males compared to female residents (48% vs 37%, P=0.003). Residents who were interested in pursuing procedure-based specialty training spent significantly less time in contact with wall (14.6% vs 20.3%, P=0.045). Smokers needed more time to finish the first task (mean 2.5 minutes vs mean 1.1 minutes, P=0.005).ConclusionSimulation bronchoscopy performance was different between genders, smoking status and future interest in pursuing a procedure-based career. Overall, male residents performed better than female residents in basic scope manipulation. Gender differences in performing simulation bronchoscopy need to be examined in future studies. Tailored educational programs may be needed to fit gender-specific skills and requirements as well as future career interests.

Establishing Clinical Skills Center in a Developing Country- LMDC Experience

Clinical skills centers have become an integral part of the curricular requirements in most modern medical schools and postgraduate centers; worldwide. There has also been a growing interest in the development of clinical skills laboratories in the developing countries in the past decade. Lahore Medical and Dental College, Lahore, Pakistan took the initiative of developing a low cost clinical skills lab in July 2010.The development of skills lab required a multi-step approach. A six steps approach of Syme-Drant (2005) was modified and used to develop clinical skills lab teaching and learning protocols. The objective of this study is to describe the stages involved in the development of a low cost, clinical skills training center in a medical college in a developing country.

Veterinary parasitology teaching at London – Meeting the ‘Day-One Competency’ needs of new veterinarians

Over the past four decades, there has been an exponential increase in veterinary parasitology knowledge, coinciding with the advent of molecular biology in research. Therefore, it is unrealistic for teachers to expect students to graduate with an encyclopaedic knowledge of the subject. As a result, a new curriculum was introduced at The Royal Veterinary College (University of London) in 2007, designed to meet the needs of our new graduates, i.e. RCVS Day-One Competences. The aims of this curriculum are, inter alia, to ensure that new graduates have an up-to-date body of core knowledge and are able to apply such knowledge and newly-acquired information to scientific and clinical problem-solving. Veterinary parasitology is taught primarily in Year 2, following a brief introduction in Year 1; clinical aspects are covered in Year 3, with original research projects undertaken in Years 4 and 5. Parasitology is taught in parallel with other subjects, enabling both horizontal and vertical integration. Core material is provided in lectures supplemented by directed learning (DL) in small groups and interactive, clinical scenario-based practical classes. Student learning is supported by Moodle 3.2 (Virtual Learning Environment [VLE], RVC Learn) which provides access to an on-line study guide (annotated using Adobe Reader), PowerPoint presentations with synchronized lecturer commentary (Echo Active Learning Platform [ALP]), detailed feedback for DL and practical classes, parasite ‘potcasts’ and CAL packages, and a Clinical Skills Centre. A parasitology textbook has also been published recently to support courses taught at the College. Assessment of student learning is achieved using a variety of written formats (essay, problem-solving questions [PSQ], multiple choice questions [MCQ] and extended matching questions [EMQ]), integrated oral examinations and objective structured clinical examinations (OSCEs).

The construction of clinical skills center under the mode of informatization

Taking an actual case as an example, this paper discusses how to integrate the informa-tization concept into the actual construction of the clinical skill center, and introduces the two aspects of the construction and management of the site and the daily business management. The design concept of multimedia standard has been proposed, and the necessary teaching auxiliary facilities are chosen according to local conditions, all of which ensure the versatility and high cost performance of teaching units. Through the concept of information remote management, the problem of multimedia teaching terminal management is solved. Besides, through the information process reengineering, the daily business problems such as room management, multi-station examination and asset management have been solved, and syn-chronously a multimedia network learning platform has been built. The scheme has highlighted the charac-teristics of practical, efficient and management science and has achieved remarkable results, so it has cer-tain reference and promotion value. Key words: Informatization; Mode; Clinical skills training center; Construction

Comparison of the Effects of Concept Mapping and Conventional Teaching Methods on Critical Thinking of Nursing Students

Introduction: Development of critical thinking and Procedural skills has remained a serious and considerable challenge throughout the nursing educational system in Iran. Conventional methods of teaching such as lecture, as the dominant method used in higher educational systems, is a passive style which ignores critical thinking. Therefore, the aim of this study was to compare the effects of instruction by concept-mapping and conventional methods in fundamentals of nursing on critical thinking skills in Tehran nursing students in 2014. Methods: This quasi-experimental study was carried out on 70 nursing students, who were selected through convenient sampling method, then divided randomly into two equal experimental and control groups, in the Clinical Skills Center of Tehran Nursing and Midwifery School. Educational content was presented in the forms of concept-mapping for the experimental group and lecture in the control group. Data collection included a demographic information and California Critical Thinking Skills (form B) questionnaire; They were filled at the beginning and end of the fourth week of the Instructional period. Data were analyzed using SPSS software (v. 21), using descriptive and analytical statistics, at the significance level of 0.05. Results: Before the intervention, the mean of the total critical thinking skill score was 9.71 ± 2.66 in the concept mapping group and 9.64 ± 2.14 in the lecture group, and the difference was not significant (P = 0.121); but, after the intervention, the critical thinking skill score was 15.20 ± 2.71 in the intervention group and 10.25 ± 2.06 in the control group, which had a significant difference (P = 0.003). Conclusions: Using concept mapping strategy in the education of nursing students may lead to developing critical thinking skills as one of the important missions of higher level education. Therefore, it is recommended to employ this method in clinical nursing education. Keywords: Concept mapping, Critical Thinking Skills, Fundamentals of Nursing, Nursing Students

Does video feedback analysis improve CPR performance in phase 5 medical students?

BackgroundThe use of simulation in medical education is increasing, with students taught and assessed using simulated patients and manikins. Medical students at Queen’s University of Belfast are taught advanced life support cardiopulmonary resuscitation as part of the undergraduate curriculum. Teaching and feedback in these skills have been developed in Queen’s University with high-fidelity manikins. This study aimed to evaluate the effectiveness of video compared to verbal feedback in assessment of student cardiopulmonary resuscitation performance.MethodsFinal year students participated in this study using a high-fidelity manikin, in the Clinical Skills Centre, Queen’s University Belfast. Cohort A received verbal feedback only on their performance and cohort B received video feedback only. Video analysis using ‘StudioCode’ software was distributed to students. Each group returned for a second scenario and evaluation 4 weeks later. An assessment tool was created for performance assessment, which included individual skill and global score evaluation.ResultsOne hundred thirty eight final year medical students completed the study. 62 % were female and the mean age was 23.9 years. Students having video feedback had significantly greater improvement in overall scores compared to those receiving verbal feedback (p = 0.006, 95 % CI: 2.8–15.8). Individual skills, including ventilation quality and global score were significantly better with video feedback (p = 0.002 and p < 0.001, respectively) when compared with cohort A. There was a positive change in overall score for cohort B from session one to session two (p < 0.001, 95 % CI: 6.3–15.8) indicating video feedback significantly benefited skill retention. In addition, using video feedback showed a significant improvement in the global score (p < 0.001, 95 % CI: 3.3–7.2) and drug administration timing (p = 0.004, 95 % CI: 0.7–3.8) of cohort B participants, from session one to session two.ConclusionsThere is increased use of simulation in medicine but a paucity of published data comparing feedback methods in cardiopulmonary resuscitation training. Our study shows the use of video feedback when teaching cardiopulmonary resuscitation is more effective than verbal feedback, and enhances skill retention. This is one of the first studies to demonstrate the benefit of video feedback in cardiopulmonary resuscitation teaching.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0726-x) contains supplementary material, which is available to authorized users.

Innovation in training for totally implanted port insertion.

This article discusses the use of fresh frozen cadavers as an innovative way to teach the procedure of totally implanted port insertion. In an attempt to increase the number of competent medical and nursing practitioners able to insert these devices, workshops have been devised and delivered at a university clinical anatomy skills centre. This method of teaching has had positive feedback from practitioners.

Simulation in healthcare education: is it only about money?

Editorial No musician would give a concert without having trained to perfection. No actor or actress would ever go on stage without knowing his or her role. Indeed, artist’s training is really tough! Every movement during and even every bow at the end of their performance are trained to perfection. They invest plenty of time to achieve their one and only goal: to thrill their audience. Imagine a theatre employing untrained musicians and actors! How long would this theatre survive? As in the world of art economic survival has always been also a matter of staff training, many theatres all over the world run well-equipped training facilities. So-called “rehearsal stages” provide the safe environment needed to try out new things, to gain self-confidence and to bring any performance to perfection. Training in the world of art is more than a successful concept – it is a successful culture. What about this culture in healthcare? Do healthcare systems or hospital operators provide comparable safe environments? Are today’s healthcare professionals fully enabled to train their skills before treating real patients? Are there enough facilities and programmes available to meet their needs for simulation-based skills training? And if not: Why is that? From the perspective of critically ill or perhaps even incurable persons all these questions reach a new dimension. Nowadays more and more patients rightly refuse being used as a “learning object” [1]. Using simulation as an educational tool reduces risks for patients as well as for learners, allows repeated skills training and facilitates the transfer of classroom-knowledge to real situations [2]. But simulation is not only about technical skills performance. Simulation-based training paves the way for medical crews working together as medical teams even in critical situations. Simulation has the power to sensitize all people involved in patient care to the impact of human factors on care quality. Structured approaches and tools e.g., the life-saving ‘10-seconds-for-10 minutes” principle [3] might be given a better chance to be put into daily practice by using simulation training and structured debriefing rather than using so-called “traditional” teaching methods. Although significance and benefits of simulation-based training in the wide field of healthcare education have been undisputable for decades, in some respects even for centuries [2, 4], there are still blank spots in the core curricula of medical and paramedical educational institutions. Simulation-based programmes in undergraduate education are often electives, reaching not all students. Moreover compulsory simulation-based training programmes are still very rare in postgraduate education. Nevertheless strong efforts are made all over the world to promote simulation-based training as a vital part of patient-safety-training programmes. In 2009 the World Health Organization (WHO) published a Patient Safety Curriculum Guide for Medical Schools [5] followed by a Multi-professional Edition in 2011 [6]. Both documents emphasize the relevance of multiprofessional training using simulation to enhance patient safety [5, 6]. Although those responsible are mostly aware of the wide range of learning and teaching opportunities of simulation and its positive effects on patient safety, many educational institutions as well as hospital operators tend to show more hidden restraint than support. Correspondence: thomas.wegscheider@medunigraz.at Department of Anesthesiology and Intensive Care Medicine, Division of Special Anesthesiology, Pain-and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria Clinical Skills Center, Medical University of Graz, Graz, Austria

Comparison of the effect of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume on midwifery students: A randomized clinical trial.

Introduction:Delay in diagnosis of bleeding can be due to underestimation of the actual amount of blood loss during delivery. Therefore, this research aimed to compare the efficacy of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume.Materials and Methods:This three-group randomized clinical trial study was performed on 105 midwifery students in Mashhad School of Nursing and Midwifery in 2013. The samples were selected by the convenience method and were randomly divided into three groups of web-based, simulation-based, and conventional training. The three groups participated before and 1 week after the training course in eight station practical tests, then, the students of the web-based group were trained on-line for 1 week, the students of the simulation-based group were trained in the Clinical Skills Centre for 4 h, and the students of the conventional group were trained for 4 h presentation by researchers. The data gathering tool was a demographic questionnaire designed by the researchers and objective structured clinical examination. Data were analyzed by software version 11.5.Results:The accuracy of visual estimation of postpartum hemorrhage volume after training increased significantly in the three groups at all stations (1, 2, 4, 5, 6 and 7 (P = 0.001), 8 (P = 0.027)) except station 3 (blood loss of 20 cc, P = 0.095), but the mean score of blood loss estimation after training did not significantly different between the three groups (P = 0.95).Conclusion:Training increased the accuracy of estimation of postpartum hemorrhage, but no significant difference was found among the three training groups. We can use web-based training as a substitute or supplement of training along with two other more common simulation and conventional methods.

Teaching percutaneous renal biopsy using unfixed human cadavers.

BackgroundPercutaneous renal biopsy (PRB) is an important diagnostic procedure. Despite advances in its safety profile there remains a small but significant risk of bleeding complications. Traditionally, operators train to perform PRB through tutor instruction and directly supervised PRB attempts on real patients. We describe an approach to teaching operators to perform PRB using cadaveric simulation.MethodsWe devised a full day course hosted in the Clinical Anatomy Skills Centre, with places for nine candidates. Course faculty consisted of two Consultant Nephrologists, two Nephrology trainees experienced in PRB, and one Radiologist.Classroom instruction included discussion of PRB indications, risk minimisation, and management of complications. Two faculty members acted as models for the demonstration of kidney localisation using real-time ultrasound scanning. PRB was demonstrated using a cadaveric model, and candidates then practised PRB using each cadaver model.ResultsWritten candidate feedback was universally positive. Faculty considered the cadaveric model a realistic representation of live patients, while the use of multiple cadavers introduced anatomical variation.ConclusionsOur model facilitates safe simulation of a high risk procedure. This might reduce serious harm associated with PRB and improve patient safety, benefiting trainee operators and patients alike.

Introducing simulation-based education to healthcare professionals: exploring the challenge of integrating theory into educational practice.

Introducing simulation-based education to the curricular programme of healthcare professionals can be challenging. This study explored the early experiences of healthcare professionals in the use of simulation. This was in the context of the Kuwait-Scotland transformational health innovation network programme. Two cohorts of healthcare professionals undertook a simulation module as part of faculty development programme in Kuwait. Participants' initial perceptions of simulators were gathered using a structured questionnaire in the clinical skills centre. Their subsequent ability to demonstrate the application of simulation was evaluated through analyses of the video-recordings of teaching sessions they undertook and written reflections of their experiences of using simulation. In theory, participants were able to identify simulators' classification and fidelity. They also recognised some of the challenges of using simulators. In their teaching sessions, most participants focused on using part-task trainers to teach procedural skills. In their written reflections, they did not articulate a justification for their choice of simulator or its limitations. This study demonstrated a theory-to-practice gap in the early use of simulation by healthcare educators. The findings highlight the need for deliberate practice and adequate mentorship for educators to develop confidence and competence in the use of simulation as part of their educational practice.

Exploring the black box of practical skill learning in the clinical skills center

Background: Learning in skills centers has a long tradition in nursing education. Nurse educators struggle to substantiate their opinions on the efficacy of simulation technologies over traditional methods of instruction and it is suggested that they should re-evaluate their methods when teaching psychomotor skills. A necessary step before evaluation is to unravel what the students are actually doing in the skills center. Purpose: The purpose of this study was to explore nursing students’ practical skills training in the skills center to label and define generic learning actions used during the learning of two specific skills; wound care and dressing, and sterile gloving. Methods: A qualitative observational study of nursing students’ practical skill training in the skills center was developed. Students across three cohorts were video recorded while practicing wound cleaning and dressing, and donning and removing sterile gloves. Verbal interaction on the video recordings was transcribed. The core analytical process was the joint listening to and watching of videos with following discussions of interpretations and development of categories. Results: Seven categories of learning actions were developed: Parallel action and self-instruction, watch and copy, collaborating to find solutions, giving support, seeking support, recontextualising the skill, and humorous enactment with the equipment. The categories are exemplified and discussed in light of learning theory and research on aspects of scaffolding. Conclusions: The learning actions described in this study are a starting point in detailing students learning actions during skills training. Students’ learning in other practical nursing skills should be studied to accumulate more knowledge about students’ learning actions and how peer interaction supports or hampers learning. The relevance of the learning actions should be explored in the clinical setting. A goal is to lay the groundwork for better design of learning in skills centers in nursing education.

PWE-407 Scottish surgical boot camp: an induction to a community of practice

<h3>Introduction</h3> A reduction in hours of “apprentice style” training, has led to increased interest in alternative pedagogic paradigms. Intensive “Boot Camps” have been found to accelerate the acquisition of key surgical skills.¹A 4 day residential Scottish Surgical Boot Camp in the Inverness Clinical Skills Centre is now adopted by 2 Royal Colleges and recommended for 1^styear Core Surgical Trainees in Scotland. It is simulation-rich and includes technical and non-technical skills, e.g. wet labs, simulated ward rounds, etc. Evaluation of other Boot Camp models have been from the quantitative perspective of efficacy of training,²usually limited to Kirkpatrick levels 1 and 2. We take a qualitative perspective to explore the development and delivery of this Boot Camp. <h3>Method</h3> Grounded in social constructivism and consistent with the theoretical lens of cultural-historical activity theory,³we used a rapid ethnographic approach⁴involving observations, semi-structured formal interviews with faculty and field interviews with students and faculty to understand the relationships and processes of the SSBC. <h3>Results</h3> Kirkpatrick level one feedback was positive. Further, our empirical data showed the important factors shaping the design, aims, objectives, development and positioning of SSBC within national training programmes, and a surgical community of practice. Interviews with faculty provided a picture of how the content of SSBC had changed over time in response to the trainee needs, curricular changes and growing faculty expertise. Within the SSBC, there were clear rules and expectations, division of labour, and social and skills-focused learning objectives. <h3>Conclusion</h3> This theory-grounded case study gives a unique insight into the complexity of interacting influences shaping a Boot Camp, which we believe enables a better description and understanding of the SSBC. Further data illustrating the usefulness of CHAT as a means of developing and evaluating this educational activity will be presented on the day. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Cohen ER, Barsuk JH, Moazed F, Caprio T, Didwania A, McGaghie WC. Making July Safer: Simulation-Based Mastery Learning During Intern Boot Camp. Acad Med. 2013;88:233–239 Parent RJ, Plerhoples TA, Long EE, <i>et al</i>. Early, intermediate, and late effects of a surgical skills “Boot Camp” on an objective structured assessment of technical skills: a randomized controlled study. J Am Coll Surg. 2010;210: 984–989 Engestrom Y, Miettinen R, Punamaki R. Activity Theory and Individual and Social Transformation. Perspectives on Activity Theory. Cambridge: Cambridge University Press 1999 Savage J. Ethnography and healthcare. BMJ 2000;321:1400

Evaluation of the effect of hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center.

Hand hygiene is a critical element of patient care, which needs to be learned and reinforced to become an autonomous behavior. Previous studies have explored aspects of hand hygiene behavior in the clinical workplace, but not in controlled learning environments with health professional students. Development of good hand hygiene behavior requires a multi-faceted approach, including education, reinforcement, feedback and audit. Our study aimed to identify the effect of unannounced hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center. Year 2 MBChB students received practical learning regarding hand hygiene in their clinical skills sessions. Baseline hand gel use was measured using before and after weighing of the bottles. An A5 sign was created to remind the students to hand cleanse and was used as an unannounced intervention. In semester 2 (2012), the student groups were randomly allocated as intervention (signs) or control (no signs). Hand gel use at all sessions was measured. Data were compared between groups and over time. In total, 237 students attended the skills sessions twice during the study. Hand gel use was not significantly different between the two study arms. Overall use was low, typically 1-2 hand gel pumps per student per session. In addition, hand gel use fell over time. A visual reminder to cleanse hands did not appear to have any effect on behavior. These findings may have implications for their value in a clinical setting. Low overall use of hand gel may be context-dependent. Students are in a simulated environment and examine 'healthy' peers or actors. There may have been inconsistent tutor role-modeling or problems with the educational approach to the skill. Analysis at the level of the group, and not the individual, may have also limited our study.

Caring for People with a Learning Disability or Complex Care Needs: An Evaluation of a Student Selected Component for Medical Students

AbstractThe Simulated Patient Bank Team within the Clinical Skills Centre at the University of Dundee has for some time been interested in devising an educational programme on the subject of learning disability (LD) for undergraduate medical students. Both local and national major adverse events involving people with a learning disability in acute hospitals, prompted by personal and professional interest, motivated the team to develop a student selected component (SSC) for medical students to orientate them to the special needs of people with LD and complex care needs in the acute hospital setting.Developed in collaboration with colleagues from the School of Nursing and Midwifery at the University of Dundee, PAMIS (a national organisation supporting people with complex needs), the local authority Education Department and NHS Tayside, the SSC has now run for three years.The innovation in this SSC derives from the close involvement of students with disabled people. The students engage with children, adults,...

Keyboard Data Entry Use Among Osteopathic Medical Students and Residents

Candidates taking the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) are currently evaluated on their ability to document clinical findings using a handwritten postencounter note. However, keyboard data entry is increasingly used for medical documentation. To determine the use and perception of keyboard data entry among osteopathic medical students and residents in educational and clinical settings. A Web-based survey regarding frequency of and preference for keyboard data entry was distributed to 9801 osteopathic medical students, 17,268 osteopathic residents, and 34 clinical deans of colleges of osteopathic medicine (COMs). In addition, 31 COMs' clinical skills center directors were contacted to participate in a telephone survey about the use of keyboard data entry in their centers. A total of 1711 students, 1198 residents, 14 clinical deans, and 17 clinical skills center directors responded to the surveys. The majority of students (872 [51%]) reported using electronic keyboard data entry at their COM's clinical skills center for postencounter notes. Among respondents, 379 students (23%), 77 residents (9%), and 1 clinical dean reported that electronic keyboard data entry is never or rarely used during clinical rotations. Most trainees (1592 students [93%], 864 residents [94%]) reported that they were either comfortable or very comfortable with typing. Given the option of recording methods for SOAP (subjective, objective, assessment, plan) note findings on the COMLEX-USA Level 2-PE, 7 clinical deans were unsure of their students' preferences, while the remaining favored keyboard data entry (5) over handwriting (2). The majority of student and resident respondents would choose keyboard data entry (1009 [60%] and 511 [55%], respectively). Osteopathic medical students and residents are comfortable with typing; they are exposed to and would prefer using an electronic form of entry for medical documentation. These results support a conversion from written postencounter notes to keyboard data entry of notes on the COMLEX-USA Level 2-PE.

Evaluation of a Computer-Based Educational Intervention to Improve Medical Teamwork and Performance During Simulated Patient Resuscitations

To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams. A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011. This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine. Participants (n = 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (nteams = 45). Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module. Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (e.g., "chest radiograph findings communicated to team" and "team member assists with intubation preparation") were standardized before combining to create overall teamwork scores. Similarly, patient care items ("chest radiograph correctly interpreted"; "time to start of compressions") were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity. When controlling for team members' medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42] = 4.81, p < 0.05; ηp = 10%) and patient care (F [1, 42] = 4.66, p < 0.05; ηp = 10%) than did teams in the placebo condition. Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.

Development of simulation scene teaching of cardio-pulmonary resuscitation in emergency teaching center

Objective To construct a method for simulation scene teaching of cardio-pulmonary resuscitation (CPR).Methods Rescue processes for different cardiac arrest types were programmed by taking XinJiang Medical University clinical skill center as the backing and by using Norway production of CPR SIMMAN.Forty students were divided into 2 groups to do the practice and self-made questionnaire survey was conducted after the practice.Data of questionnaires were descriptively analyzed by SPSS15.0.Results A hierarchical training program combined with simulation scene teaching can most effectively control key points of CPR (75.56％).Searching for references,group discussion and report under the guidance of teachers and based on clinical case were the best way to teach CPR (97.78％).Case study under the guidance of teachers was the most fruitful way (73.33％).CPR simulation scene teaching and hierarchical teaching were combined well (75.56％).Conclusions Construction of CPR simulation scene teaching fully embodies the continuity and sustainability of emergency teaching.It can effectively improve teaching methods and teaching quality of emergency medicine as well as enhance students' problem-solving abilities. Key words: Emergency medicine; Cardiopulmonary resuscitation; Simulation scene; Teaching reform

Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment

PurposeTo compare the internal computer-based scoring with human-based video scoring of cataract modules in the Eyesi virtual reality intraocular surgical simulator, a comparative case series was conducted at the Department of Clinical Sciences – Ophthalmology, Lund University, Skåne University Hospital, Malmö, Sweden.MethodsSeven cataract surgeons and 17 medical students performed one video-recorded trial with each of the capsulorhexis, hydromaneuvers, and phacoemulsification divide-and-conquer modules. For each module, the simulator calculated an overall score for the performance ranging from 0 to 100. Two experienced masked cataract surgeons analyzed each video using the Objective Structured Assessment of Cataract Surgical Skill (OSACSS) for individual models and modified Objective Structured Assessment of Surgical Skills (OSATS) for all three modules together. The average of the two assessors’ scores for each tool was used as the video-based performance score. The ability to discriminate surgeons from naïve individuals using the simulator score and the video score, respectively, was compared using receiver operating characteristic (ROC) curves.ResultsThe ROC areas for simulator score did not differ from 0.5 (random) for hydromaneuvers and phacoemulsification modules, yielding unacceptably poor discrimination. OSACSS video scores all showed good ROC areas significantly different from 0.5. The OSACSS video score was also superior compared to the simulator score for the phacoemulsification procedure: ROC area 0.945 vs 0.664 for simulator score (P = 0.010). Corresponding values for capsulorhexis were 0.887 vs 0.761 (P = 0.056) and for hydromaneuvers 0.817 vs 0.571 (P = 0.052) for the video scores and simulator scores, respectively. The ROC area for the combined procedure was 0.938 for OSATS video score and 0.799 for simulator score (P=0.072).ConclusionVideo-based scoring of the phacoemulsification procedure was superior to the innate simulator scoring system in distinguishing cataract surgical skills. Simulator scoring rendered unacceptably poor discrimination for both the hydromaneuvers and the phacoemulsification divide-and-conquer module. Our results indicate a potential for improvement in Eyesi internal computer-based scoring.

Interprofessional Student Education: Exchange Program Between Albert Einstein College of Medicine and Pacific College of Oriental Medicine

The growing popularity of complementary and alternative medicine (CAM), of which estimated 38% of adults in the United States used in 2007, has engendered changes in medical school curricula to increase students' awareness of it. Exchange programs between conventional medical schools and CAM institutions are recognized as an effective method of interprofessional education. The exchange program between Albert Einstein College of Medicine (Einstein, Yeshiva University) and Pacific College of Oriental Medicine, New York campus (PCOM-NY) is in its fifth year and is part of a broader relationship between the schools encompassing research, clinical training, interinstitutional faculty and board appointments, and several educational activities. The Einstein/PCOM-NY student education exchange program is part of the Einstein Introduction to Clinical Medicine Program and involves students from Einstein learning about Chinese medicine through a lecture, the experience of having acupuncture, and a four-hour preceptorship at the PCOM outpatient clinic. The students from PCOM learn about allopathic medicine training through an orientation lecture, a two-and-a-half-hour dissection laboratory session along side Einstein student hosts, and a tour of the clinical skills center at the Einstein campus. In the 2011/2012 offering of the exchange program, the participating Einstein and PCOM students were surveyed to assess the educational outcomes. The data indicate that the exchange program was highly valued by all students and provided a unique learning experience. Survey responses from the Einstein students indicated the need for greater emphasis on referral information, which has been highlighted in the literature as an important medical curriculum integrative medicine competency.