Clinical Skills Centre Research Articles

The impact of simulated operating rooms in a clinical skill center on operating room students’ skills and satisfaction: A semi experimental study

The impact of simulated operating rooms in a clinical skill center on operating room students’ skills and satisfaction: A semi experimental study

The Impact of a Simulation-Based Learning Activity Using Actor Patients on Final Year Nursing Students’ Learning

Fundamental to clinical nursing is the ability to recognise patient deterioration and know what to do. These skills are vital for patient safety and yet remain a challenge to teach nursing students. Simulation provides a means for students to develop the necessary skills in a safe learning environment. This qualitative descriptive study investigated final-year nursing students’ perception of the effectiveness of a ward-based simulation learning activity using actor patients. The research question that underpinned this study is as follows: Does actor patient simulation help preparedness for clinical practice? The simulation setting was a mock medical-surgical ward in a tertiary education clinical skills centre. Focus group interviews were conducted in two parts: immediately after the simulation and then three months later when students had completed their clinical placements. Thematic analysis identified three main themes: decreasing the theory-practice gap; decision-making; and acting like a registered nurse. This study found that simulation with actor patients positively impacted nursing students’ learning, reinforcing other studies that support simulation as an effective learning strategy. Although the simulation was challenging, students valued the opportunity to role-play as a registered nurse, which provided insight into the skills and abilities needed for clinical practice. Te reo Māori translation Te pānga o tētahi ngohe akoranga ā-whakatakune mā te whakamahi i ngā tūroro kaiwhakaari, ki te akoranga tau whakamutunga o ētahi akonga tau tuatahi Ngā Ariā Matua He mea tino hira te kite wawe i te heke o te tūroro, waihoki te mōhio me aha te tapuhi, mō te haumarutanga tūroro, engari e noho ana hei mea uaua ki te whakaako ki ngā akonga tapuhi. Ko te whakatakune tētahi ara pai mō ngā ākonga hei whakawhanake i ngā pūkenga haumaru i roto i tētahi horopaki ako haumaru. I tūhura tēnei rangahau kounga whakaahua i ngā kitenga o ngā ākonga tapuhi tau whakamutunga mō te whāinga hua o tētahi ngohe ako i te wāhanga hōhipera nā te whakamahi i ngā tūroro kaiwhakaari. Ko te pātai rangahau i roto i tēnei mahi ko tēnei: Hei āwhina te whakatakune i te takatū mō te mahi i te taha o te tūroro? Ko te wāhi o te whakaritenga whakatakune ko tētahi wāhanga hōhipera taurima mate-hāparapara i tētahi pūtahi pūkenga tiaki turoro mātauranga matua. I kawea ētahi uiuinga rōpū arotahi i ētahi wā e rua: i muri tonu mai i te whakatakune; ā, e toru marama i muri i te whakatakune i te otinga o ngā whakanohonga tiaki tūroro o ngā ākonga. E toru ngā tāhuhu matua i tautohutia i roto i te tātaritanga tāhuhu: te whakaheke i te āputa ariā-mahi, te whakatau take, me te kawe i te mana o te tapuhi rēhita. I kitea e tēnei rangahau i whai hua te whakatakune me ngā tūroro kaiwhakaari ki te akoranga o ngā tapuhi, me tōna whakatūturu i ētahi atu rangahau e tautoko nei i te whakatakune hei rautaki ako whai hua. Ahakoa te uaua o te whakatakune, he mea hira ki ngā akonga te kawe i te tūranga o te tapuhi rēhita, i puta ai he māramatanga ki ngā pūkenga me ngā āheinga e hiahiatia ana mō te mahi tiaki tūroro tūturu. Ngā kupu matua: tūroro kaiwhakaari, akonga tapuhi, hekenga o te tūroro, te whakatakune, te tātari tāhuhu

Telesimulation for the Training of Medical Students in Neonatal Resuscitation.

Background: Telesimulation may be an alternative to face-to-face simulation-based training. Therefore, we investigated the effect of a single telesimulation training in inexperienced providers. Methods: First-year medical students were recruited for this prospective observational study. Participants received a low-fidelity mannequin and medical equipment for training purposes. The one-hour telesimulation session was delivered by an experienced trainer and broadcast via a video conference tool, covering all elements of the neonatal resuscitation algorithm. After the telesimulation training, each student underwent a standardized simulated scenario at our Clinical Skills Center. Performance was video-recorded and evaluated by a single neonatologist, using a composite score (maximum: 10 points). Pre- and post-training knowledge was assessed using a 20-question questionnaire. Results: Seven telesimulation sessions were held, with a total of 25 students participating. The median performance score was 6 (5-8). The median time until the first effective ventilation breath was 30.0 s (24.5-41.0) and the median number of effective ventilation breaths out of the first five ventilation attempts was 5 (4-5). Neonatal resuscitation knowledge scores increased significantly. Conclusions: Following a one-hour telesimulation session, students were able to perform most of the initial steps of the neonatal resuscitation algorithm effectively while demonstrating notable mask ventilation skills.

Role of Clinical Skill Centers in Undergraduate Dental Education: Stakeholders View

Background: The clinical skill center (CSC) offers an opportunity for students and working clinicians to learn and acquire clinical skills by using artificially simulated process, which will subsequently improve patient care and safety. To promote skill-based dental education, a CSC might be considered to incorporate in undergraduate dental education. Objectives: To explore the views of the stakeholders about the role of clinical skill centers in undergraduate dental education. This study also identified the effect of clinical skill training in promoting and maintaining clinical teaching. Method: A cross sectional study was carried out among 637 dental persons in 11 dental colleges and units of medical colleges of Bangladesh; of which 5 were government and 6 were non-government. Study period was from January 2022 to December 2022. Data was collected by structured self-administered questionnaire, about the views of the stake holders (Dental teachers, interns and students of 3rd and 4th phases of BDS course). Results: With regard to advantages of CSC, 545 (80.4%) respondents agreed that CSC facilitate skill training before performing on real patient. More so, 544 (90.3%) respondents agreed that CSC increases scope of repeated practice, 360 (64.7%) respondents felt that CSC training helped in overcoming the resistance by the patients who were not interested to intervene them by the trainees and 531(88.5%) agreed that skill training in CSC will reduce medical error. Regarding limitations of CSC, 419 (69.6%) respondents opined that establishing and maintaining CSC are very costly. Total 548 (90.9%) respondents agreed that CSC requires formally trained trainer, 550 (91.6%) respondents felt that CSC needs formally trained supporting staffs, and 533 (89%) agreed that CSC requires well defined infrastructure. Conclusion: The study strongly suggests stakeholder’s positive perspective towards learning clinical skills in CSC. Medical educators, policy makers and curriculum designers can use the results of this study to incorporate clinical skill center based learning in undergraduate curriculum and establish CSC to train and enhance students’ clinical skills and maintain patients’ safety. Bangladesh Journal of Medical Education Vol.14(2) July 2023: 60-71

Detection Of Nematode Worm Eggs In The Feces Of Domestic Chicken (Gallus domesticus) In Karang Bongkot Village Labuapi District West Lombok Regency

Domestic chicken (Gallus domesticus) is one type of poultry that has experienced domestication and is spread throughout the archipelago. Chicken consumed by humans should be in a healthy condition and free from various types of parasites. Information about Domestic chicken infected with parasites is needed to maintain animal health and prevent the occurrence of zoonotic diseases. Research has been carried out on Domestic chicken in Karang Bongkot Village, Labuapi District, West Lombok Regency with the aim of detecting nematode worms in Domestic chicken. Samples were taken as many as 5 chicken feces and examined by the native and floating method in the Equine Clinical Skills Center (CSC) laboratory of the Faculty of Veterinary Medicine, Mandalika Universitas of Mataram, and then identified based on their morphology. Two samples were positive for nematode infection. The results of this study succeeded in detecting nematodes that infect native chickens as Heterakis gallinarum species.

Development and learning efficacy of a simulation rubric in childhood pneumonia for nursing students: A mixed methods study

BackgroundNursing students often lack knowledge, skills, and appropriate attitudes toward chest physiotherapy, which affects the quality of care provided to children with pneumonia in clinical practice. Helping students learn about the effectiveness of simulations can improve their nursing ability. ObjectivesTo develop a rubric associated with the simulation of childhood pneumonia and to examine the learning efficacy of students using the rubric to assess the knowledge, skills, and attitudes in the simulation. DesignA mixed methods study using a post-test survey and a descriptive qualitative analysis of students' reflective journals. SettingsA paediatric simulation classroom at the University Clinical Skills Centre in Northern Taiwan. Participants214 third-year students enrolled in a four-year nursing programme. MethodsQuantitative and qualitative data were collected after the course to obtain a comprehensive understanding of its effects. Quantitative data from the questionnaire were analysed using descriptive statistics. Qualitative data were analysed using content analysis. ResultsThe quantitative results showed that mean knowledge and nursing students' attitudes were moderate. Of the six sub-indices, chest percussion technique and communication with family and children had the highest mean with 3.32 ± 0.67 and 3.01 ± 0.68, respectively. The students discovered that they often focused on performing technical steps without pre-analysing patient information. Most students also indicated difficulty showing emotional caring behaviours toward patients. The qualitative results revealed that students reflected on their learning post-self-evaluation of the rubric, particularly regarding knowledge of systemic assessments, patient-centred nursing skills, and caring attitudes. ConclusionsThe knowledge, skills, and attitude rubric can help students develop their learning process in a more organised manner, promote the development of their caring performances toward children, and assist them in their future clinical care practices.

A needs assessment for designing and establishing a Center for Clinical Skills Center

Background: Due to the limitations of clinical learning and the consideration of patients’ rights, the emphasis on educating clinical and communication skills and creating attitudes in students has received much attention, which requires an appropriate educational environment. Methods: In a descriptive study, we examined challenges and proposed solutions in a clinical skills center in 2017. The study participants were 60 medical students and 29 faculty members at the Tabriz University of Medical Sciences who were selected randomly and followed for 12 months, from October 2016 to October 2017. The classical modified Delphi technique was used to collect data and study execution in three rounds. Results: From the perspectives of academic board members, the most critical weaknesses included "small and limited educational environment of workshops" (weight of consensus=212.5), "severe lack of educational facilities such as simulators" (weight of consensus=158.9), and "lack of adequate facilities for assessing students’ skills" (weight of consensus=140.9) based on the results. From the perspectives of academic board members, the most crucial weaknesses in the field of management and execution were "lack of adequate constructional infrastructure" (weight of consensus=239.2), "lack of adequate funding for the clinical skills center" (weight of consensus=200.1) and "lack of approved organizational chart for clinical skills center" (weight of consensus=200.1). Conclusion: The main challenges of the Clinical Skills Center of Tabriz University of Medical Sciences included the lack of definition of an organizational chart, lack of sufficient funding to provide educational facilities, lack of standard educational space, and clinical skills evaluation, which the Center for Clinical Skills developed. Most of the center’s problems were resolved by allocating sufficient funds to provide educational facilities and cultivate a culture of interdisciplinary collaboration supported by university authorities.

Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses

BackgroundPatients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education.MethodsExcept for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors.ResultsAll 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice.ConclusionSimulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.

Development of an Objective Structured Clinical Examination Station for Pediatric Occupational Therapy and an Evaluation of Its Quality.

The Objective Structured Clinical Examination (OSCE) is a highly valued measure of students' clinical competencies in medical education. However, few studies have reported on the administration of the OSCE in pediatric occupational therapy education. To describe the development of a pediatric occupational therapy OSCE station to evaluate students' use of a standardized assessment and examine its standard setting, failure rates, and psychometric properties. Prospective, cross-sectional, observational study design. Three OSCE stations in a university clinical skills center. Five experienced occupational therapists, 60 examinees, 44 child standardized patients, 44 chaperones, and 15 examiners. The sum of the rating scale and the global performance scores were used. The rating scale measured the examinee's clinical competences in administering a standardized assessment. The 5-point global performance score was used to evaluate the examinee's whole performance. The OCSE station's expert validity was acceptable (item-level content validity index [CVI] = 0.8-1.0; scale-level CVI = 0.98). Passing scores according to the Angoff method (passing score = 14) and the contrasting-groups M-SD method (passing score = 13) were similar. Failure rates were high (61.7%-73.3%). Internal consistency was acceptable (Cronbach's α = .78). No significant examiner effect was found (p = .554), and interexaminer reliability was acceptable (item score = 0.58-1.00; sum of the rating scale score = 0.97; global performance score = 0.79). The OSCE station for using a standardized assessment is a reliable and valid measure of students' interpersonal communication skills and assessment skills. What This Article Adds: The OSCE for education in pediatric occupational therapy is both effective and rigorous.

The Surgical Skills competition

RCS England hosted this year's final at the new clinical skills centre in our recently reburbished flagship headquarters. Which of this year's finalists will make the cut?

Deteksi Cacing Capillaria hepatica pada Organ Hati Tikus

Capillaria hepatica is a zoonotic parasitic agent that has been reported in various parts of the world. The presence of C. hepatica in an area is closely related to the presence of a rat population. Considering the life cycle of C. hepatica which is easily transmitted to humans, one of the most vulnerable places for transmission of C. hepatica to humans is the market area. This study aims to detect the presence of C. hepatica worms in the rat population in Public Market Kebon Roek, Ampenan District, Mataram City. This type of research is descriptive research with a cross sectional study design (cross-sectional study). To determine the number of samples, an accidental study approach was used, namely the number of rat samples used was the number of rats caught during the study period (set for 2 traps). 10 samples of rat liver were collected. The liver was then preserved in 10% formalin solution at the Microanatomy Laboratory, Department of Anatomy, Faculty of Veterinary Medicine, Gadjah Mada University. Meanwhile, histology preparations and GI fluid examination were carried out at the Clinical Skill Center (CSC) Laboratory, Faculty of Veterinary Medicine, Mandalika University of Education. Data in the form of images of worm eggs and histopathology of liver tissue were analyzed descriptively and presented in the form of figures and tables. The results of the examination of 10 samples of rat liver histology preparations showed that 4 positive samples contained eggs and adult worms of C. hepatica. Where the 3 histological preparations observed showed that the rat liver was severely damaged, and 1 sample appeared to have minor damage. For examination of gastrointestinal fluids, there were no samples containing C. hepatica worm eggs.

Design, Implementation and Evaluation of Clinical Pharmacology Simulation Training Method for Nursing Students of Tehran School of Nursing and Midwifery

Introduction: Educating students in a safe environment such as simulated centers can be effective in providing educational services and preparation for clinical work. Accordingly, the present study was conducted with the aim of designing, implementing and evaluating clinical pharmacology simulation training method for nursing students. Methods: This study was performed in 2019-2021 in three main phases of design, implementation and evaluation of Pharmaceutical Skills Center in Clinical Skills Center of Tehran School of Nursing and Midwifery. First, the design phase was accomplished by preparing the space and the desired drugs. Due to the prevalence of Covid-19 disease, part of the implementation and evaluation phase was carried out in the virtual context. Before and after the internship, students' knowledge, skills, satisfaction and clinical reasoning were measured using relevant questionnaires and analyzed using descriptive and analytical statistics. Result: The mean scores of the three variables in terms of pharmacology knowledge, drug calculation skills and clinical reasoning of pharmacology of nursing students before and after the internship were examined. The results demonstrated that all three means were significantly improved compared to that of before the intervention (P &lt;0.001 and P = 0.001). The mean of total students' satisfaction with pharmacology internship course turned out to be 30.57 (3.2), which indicated the relative satisfaction with the training course. Conclusion: In general, the results of the study indicated an improvement at the level of pharmacological knowledge, clinical reasoning of pharmacology and a significant improvement in pharmacological skills. Despite the limitations of Covid 19, this training method seems to augment the performance of nursing students in pharmacology.

Objective Measurement of Impact of Bench Laparoscopic Training in Novices

Background: We are currently in the era of laparoscopic surgery. It has gained popularity in the last few decades because of its well- known advantages. Laparoscopy requires different skills from those of open surgery. In a paradigm shift, learning basic surgical skills is now performed more in the skills laboratory than in the operation theater. However, there is a lack of reliable training and assessment tools for laparoscopic surgical skills. This study aimed to objectively assess the effect of bench laparoscopic training in novices.&#x0D; Methods: This prospective study was conducted at the Clinical Skills Centre of Bangalore Medical College and Research Institute (BMCRI) in Bangalore, India. Sixty interns with no previous experience in laparoscopy were included. They underwent supervised training on the box trainer for 3 days, 2 hours a day, in basic surgical tasks, including pointing dots, joining straight lines, joining curved lines, picking objects, peg transfer, and circle cut. All participants were assessed objectively in a virtual reality (VR) simulator before and after training. The objective outcomes measured were time taken, distance traveled, and error scores given by the VR simulator metrics.&#x0D; Results: The novices showed statistically significant improvement in all the tasks after the training compared with their skill levels before the training.&#x0D; Conclusion: Structured short-term training significantly improves basic laparoscopic surgery skills.

Simulation Centers and Simulation-Based Education during the Time of COVID 19: A Multi-Center Best Practice Position Paper by the World Academic Council of Emergency Medicine.

COVID 19 struck us all like a bolt of lightning and for the past 10 months, it has tested our resilience, agility, creativity, and adaptability in all aspects of our lives and work. Simulation centers and simulation-based educational programs have not been spared. Rather than wait for the pandemic to be over before commencing operations and training, we have been actively looking at programs, reviewing alternative methods such as e-learning, use of virtual learning platforms, decentralization of training using in situ simulation (ISS) modeling, partnerships with relevant clinical departments, cross-training of staff to attain useful secondary skills, and many other alternatives and substitutes. It has been an eye-opening journey as we maximize our staff's talent and potential in new adoptions and stretching our goals beyond what we deemed was possible. This paper shares perspectives from simulation centers; The SingHealth Duke NUS Institute of Medical Simulation which is integrated with an Academic Medical Center in Singapore, The Robert and Dorothy Rector Clinical Skills and Simulation Center, which is integrated with Thomas Jefferson University, Oakhill Emergency Department, Florida State University Emergency Medicine Program, Florida, USA and The Wellington Regional Simulation and skills center. It describes the experiences from the time when COVID 19 first struck countries around the world to the current state whereby the simulation centers have stWWarting functioning in their “new norm.” These centers were representative examples of those in countries which had extremely heavy (USA), moderate (Singapore) as well as light (New Zealand) load of COVID 19 cases in the nation. Whichever categories these centers were in, they all faced disruption and had to make the necessary adjustments, aligning with national policies and advisories. As there is no existing tried and tested model for the running of a simulation center during an infectious disease pandemic, this can serve as a landmark reference paper, as we continue to fine-tune and prepare for the next new, emerging infectious disease or crisis.

Howard University College of Medicine.

Howard University College of Medicine.

Rutgers Robert Wood Johnson Medical School.

Rutgers Robert Wood Johnson Medical School.

McGovern Medical School at The University of Texas Health Science Center at Houston.

McGovern Medical School at The University of Texas Health Science Center at Houston.

The George Washington University School of Medicine and Health Sciences.

The George Washington University School of Medicine and Health Sciences.

COVID-19 and anatomy: Stimulus and initial response.

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world.

Training Medical Student Facilitators of Peer-Assisted Study Sessions Using an Objective Standardized Teaching Exercise.

IntroductionPeer-assisted study sessions (P.A.S.S.) are medical student–facilitated small-group sessions that aim to improve students’ knowledge and performance in preclinical courses. Peer teaching has been shown to have a positive impact on academic performance of both learners and peer teachers. For peer teaching to be more effective, there is a need for training of peer teachers. We developed a facilitator training workshop to help to improve medical students’ confidence in serving as P.A.S.S. facilitators.MethodsParticipants were first-year medical students who were approved to become P.A.S.S. facilitators. We recruited facilitators to attend a training workshop and provided them with a training manual to use during the training session and as a resource after the session. We recruited five standardized students to participate in an objective standardized teaching exercise (OSTE). We asked facilitators to complete pre/post surveys before and after the workshop to indicate their level of confidence in facilitating the sessions and provide feedback on the workshop.ResultsNine P.A.S.S. facilitators participated in the training session. Analysis of pre- and postworkshop survey data showed a statistically significant increase in student confidence (p ≤ .02).DiscussionDeveloping and implementing a formalized P.A.S.S. facilitator training manual and workshop with an OSTE helped improve students’ confidence in facilitating an organized, effective, and interactive peer teaching session. Students’ positive feedback on the OSTE suggests that OSTEs can be useful tools to help peer teachers learn skills to cope with challenging situations with students.