Increase In Self-reported Confidence Research Articles

Impact of Documented Fall-Risk, Self-Reported Health and Confidence to Prevent Falls on Concern About Falling Among Community-Dwelling Older Adults: Secondary Analysis of a Randomized Clinical Trial.

Individuals identified as high fall risk are expected to have high concern about falling. However, perception and individual factors that influence concern about falling have yet to be thoroughly studied. We aimed to understand factors that influence concern about falling among older adults with increased risk for falling. This was a secondary analysis of a clinical trial among community-dwelling older adults (age ≥65 years old) at high risk for falls (n = 178). Descriptive and regression analyses were used. We analyzed the relationship between participants' baseline concern about falling - categorized into three groups: low (7-8), moderate (9-13), and high (≥14) - and factors that may impact their concern. Exploratory factors included age, sex, self-reported health status and confidence to address fall risks, fall risk scores, and physical performance measures. Among these individuals, 15.2% reported low concern about falling. On average, individuals in higher concern about falling groups had higher fall risk scores (low [5.7], moderate [6.4], and high [8.0]; p < 0.001). Our regression model showed that the odds of being in a higher concern group increased by 21% for every one unit increase in fall risk score and increased by 67% for every one unit increase toward poorer health rating. Conversely, for every one unit increase in self-reported confidence, the odds of being in a higher concern group decreased by 27.5%. Knowledge of older adults' fall risk, health status, and concerns about falling can be used to assist in the personalization of fall prevention interventions for a more holistic approach.

Effects of an Experiential Learning Curriculum on Systems-Thinking.

Though health systems science (HSS) is referred to as the third pillar of medical education along with the pillars of basic science and clinical care, the effects of learning theories used to teach components of HSS including quality improvement/ patient safety (QI/PS), are poorly understood. Experiential learning theory is often referenced in QI/ PS education but its effects on QI/PS education are not well-described. To examine the effects of teaching QI using experiential learning theory on resident systems-thinking. Data was gathered from 30 resident participants in a 3-h QI workshop designed using experiential learning theory. Using a mixed-methods design, aspects of learner systems-thinking were analyzed both before and after the workshop. Learners were asked about their confidence in systems-thinking behaviors, and their QI plans were evaluated qualitatively for themes as well as quantitatively via the QIKAT-R. There was a significant increase in self-reported confidence in systems-thinking behaviors post-workshop. Odds ratio of the QI aim statement focusing on the systems-level of the problem after the workshop was 41.4 with a 95% CI of 8.9142 to 192.2721, p-value .0001. Thematic analysis of QI plans revealed a change in residents' thinking about healthcare problems. They shifted from attributing problems to individual actors to thinking about the problem as lying in the interaction between systems. Experiential learning theory can be an effective framework for QI to transform learners into systems-thinkers.

Empowering Future Physicians and Communities on Chicago's South Side through a 3-Arm Culinary Medicine Program.

The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in the study. Data were obtained using pre- and post-course surveys and qualitative interviews from September 2021-July 2023. Results show increased confidence in medical students' ability to provide nutrition counseling, with a high significance in their ability to provide counseling regarding chronic conditions. Participants managing chronic conditions demonstrated significant increases in self-reported confidence in their understanding of overall chronic disease management and care and in their kitchen skills, with participants who attended five or more classes having significantly higher means. Qualitative feedback from middle school students highlights their knowledge and willingness to try new foods after engaging with the curriculum. Findings add to the growing literature on culinary medicine and provide insight into the effectiveness of culinary medicine programming to increase knowledge and promote positive changes among future healthcare professionals and community members. However, more extensive research across a longer time span is needed to confirm the potential for sustained change.

Two Affordable, High-Fidelity Central Venous Models for Ultrasound-Guided Interventional Training.

Ultrasound-guided vascular access is an increasingly popular technique due to its reduced complication and higher success rates. Commercially bought training phantoms allow providers to develop tactile skills in a low-risk setting, but are also expensive and poorly accessible. This study analyzes the efficacy of homemade, low-cost, gelatin-based central line vascular models to teach vascular anatomy and intravascular access techniques in training physicians. A gelatin mold was created using a mixture of unflavored gelatin, hot water, psyllium husk powder, and rubbing alcohol. Latex tubing, balloons, precooked hot dog, and tofu were inserted to simulate arteries, veins, nerves, and the sternocleidomastoid muscle, respectively. Medical students from a single institution participated in a 90-minute workshop led by interventional radiology residents. Participants completed presurveys and postsurveys that assessed knowledge acquisition and confidence levels related to acquiring central access. All images were obtained using a USB-C Butterfly iQ probe. Twenty medical students were analyzed after the workshop. There was a statistically significant increase in self-reported confidence in basic ultrasound use (adjusting gain, depth, probe manipulation), localizing major anatomical structures, using ultrasound for vessel access, and reported ease in identifying muscle, nerves, and major blood vessels under ultrasound. There was also a significant increase in correctly identified anatomical landmarks after the workshop, including the sternocleidomastoid muscle, internal jugular vein, carotid artery, femoral nerve, femoral artery, and femoral vein. Our findings suggest that our homemade, low-cost, gelatin-based models were effective in teaching vascular anatomy and ultrasound-guided vascular access techniques to training physicians.

A Student-Designed Multimodal Sex- and Gender-Based Women's Health Elective Program: Advocacy Curriculum for Medical Students.

The objective of this article is to describe the design and implementation of a multimodal, student-driven, sex- and gender-based women's health (SGBWH) elective with a curricular focus on patient and legislative advocacy. In this single arm, pre/post design, interventional study, we detail and evaluate the use of social media, newsletters, and round-table discussions in conjunction with a traditional lecture-based educational format to engage medical students in a virtual learning environment. We developed a 22-week SGBWH curriculum for pre-clinical and clinical medical students, which included a series of lectures on multi-specialty and gender-inclusive topics related to SGBWH, small group discussions with community leaders and legislators involved in women's health advocacy, and other self-directed resources such as social media, a website, and digital newsletters. Students were surveyed before and after completing the curriculum to assess for increases in self-reported confidence in advocating for their female and gender minority patients. One hundred and one students completed the anonymous pre- and post-elective surveys. There was statistically significant improvement in 8 of the 12 self-reported confidence measures. Eight (8%) participants identified their sex as male. Fifty-five (55%) participants stated future interest in primary care specialties (Internal Medicine, Family Medicine, Obstetrics and Gynecology, and Pediatrics). Our curriculum improved medical students' self-reported confidence in advocating for their female and gender minority patients when controlling for sex and specialty interest of participants. The success of our multimodal approach demonstrates the value in incorporating resources such as social media as tools for education and advocacy in the evolving landscape of medical education.

An Advanced, Risk-Driven Sexual Health Curriculum for First-Year Internal Medicine Residents.

Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often receive limited training in obtaining comprehensive, risk-based sexual histories, leading to less screening for sexually transmitted illnesses (STIs). Consequently, many internal medicine (IM) residents feel unprepared for advanced sexual history taking and site-specific STI testing based on sexual practices. We developed a case-based interactive didactic session for IM and med/peds residents. We focused on more advanced topics, such as comprehensive sexual history taking, secondary site testing for STIs, and patient counseling. Based on pre- and postcurriculum surveys, interns reported increases in comfort (scale: 1 = very low comfort, 5 = very high comfort) with counseling after positive STI results (Ms: pre = 2.9, post = 3.5, p < .01) and providing education on safe sex practices (Ms: pre = 3.0, post = 3.6, p < .01) and modest improvement in comfort with expedited partner therapy (EPT; Ms: pre = 2.1, post = 2.5, p = .06). An increase in self-reported confidence with collecting site-specific testing (composite Ms: pre = 2.7, post = 3.5, p < .01) was also seen. Percentage correct on knowledge questions increased from 48% to 78% postcurriculum (p = .01). This curriculum demonstrated improvement in knowledge and comfort with sexual history taking, STI screening, and counseling. Comfort also improved with EPT counseling, but not significantly, which could be addressed in future iterations of the curriculum.

A Game Changer: Adult-Geriatric Acute Care Nurse Practitioner Fellowship for the Veterans Health Administration.

Nurse practitioner (NP) fellowship programs assist the novice NP in transitioning to advanced practice while emphasizing building confidence and competence. The Veteran's Health Administration (VHA) offers an NP primary care fellowship program. The purpose of this project was to develop an acute care transition to practice fellowship program at a Midwestern VHA hospital. A prospective, descriptive design utilizing a convenience sample of senior adult-geriatric nurse practitioner (AGNP) students during a pilot study of an acute care fellowship program. Outcome measures included evaluation of skills interpreting electrocardiograms (ECG), chest x-rays (CXR), and self-reported confidence in performing these skills over the initial 6-week period of the 12-month program. There were three participants (N = 3, 100%). There was a 33% increase in self-reported confidence of readiness to practice at completion of the pilot. However, ECG scores decreased 66% and CXR interpretation scores decreased 33%. Despite training and targeted clinical experiences in ECG and CXR interpretations during an acute care fellowship, competence in these skills decreased while self-reported confidence increased at the end of 6 weeks. Continued education and training throughout the 12-month program is recommended to increase the novice NP's competence in these skills while transitioning to their new role. To provide an acute care fellowship to facilitate with transition into advanced practice while increasing confidence and competence in the novice NP. The novice NP may benefit from an NP fellowship program.

Building point-of-care ultrasound capacity in rural emergency departments: An educational innovation.

Point-of-care ultrasound (POCUS) use is the standard of care in emergency medicine (EM), but rural physicians face barriers to obtaining and retaining this skill and cite low confidence in their use of POCUS. Without access to high-quality educational opportunities, this important clinical tool may not be used to its full potential in rural hospitals. The Hands-On Ultrasound Education (HOUSE) programme, launched in 2015 by the University of British Columbia's (BC) Division of Rural Continuing Professional Development, is a rurally focused POCUS training and education programme that travels to rural and remote communities and aims to build a rural POCUS community of practice within BC. In this study, we present and evaluate the HOUSE programme. The HOUSE programme is described. A comprehensive qualitative evaluation of semi-structured interviews pertaining to HOUSE was conducted in the 4th year of the programme to assess participant experience and programme outcomes. Results from 52 semi-structured interviews indicate that there is a significant increase in self-reported confidence on specific POCUS applications and increased POCUS use after completion of the course, and we report positive experiences with the HOUSE programme. By providing a customizable, accessible, hands-on training opportunity, the HOUSE programme removes barriers to POCUS training and education for physicians in rural and remote BC. The rurally focused elements have contributed to education for rural participants that demonstrates increased confidence and the use of POCUS as a clinical tool.

The Genetic Code Kit: An Open-Source Cell-Free Platform for Biochemical and Biotechnology Education.

Teaching the processes of transcription and translation is challenging due to the intangibility of these concepts and a lack of instructional, laboratory-based, active learning modules. Harnessing the genetic code in vitro with cell-free protein synthesis (CFPS) provides an open platform that allows for the direct manipulation of reaction conditions and biological machinery to enable inquiry-based learning. Here, we report our efforts to transform the research-based CFPS biotechnology into a hands-on module called the “Genetic Code Kit” for implementation into teaching laboratories. The Genetic Code Kit includes all reagents necessary for CFPS, as well as a laboratory manual, student worksheet, and augmented reality activity. This module allows students to actively explore transcription and translation while gaining exposure to an emerging research technology. In our testing of this module, undergraduate students who used the Genetic Code Kit in a teaching laboratory showed significant score increases on transcription and translation questions in a post-lab questionnaire compared with students who did not participate in the activity. Students also demonstrated an increase in self-reported confidence in laboratory methods and comfort with CFPS, indicating that this module helps prepare students for careers in laboratory research. Importantly, the Genetic Code Kit can accommodate a variety of learning objectives beyond transcription and translation and enables hypothesis-driven science. This opens the possibility of developing Course-Based Undergraduate Research Experiences (CUREs) based on the Genetic Code Kit, as well as supporting next-generation science standards in 8–12th grade science courses.

Bridging the Gap: Using Interspecialty High-Fidelity Simulation to Improve Skills in Adolescent Emergency Medicine.

Adolescents are attending emergency departments (EDs) in increasing numbers, accounting for 21% attendances in the United Kingdom. A recent report by the Northern Ireland Commissioner for Children and Young People highlighted deficiencies in the support offered by EDs to adolescents. The aim of this study was to develop a high-fidelity simulation-based course focused on managing common adolescent presentations to the ED. A 1-day mixed-modality course comprising of simulations, lectures, and skill stations, mapped to the pediatric and emergency medicine curriculum, was designed. The faculty developed and delivered 8 high-fidelity simulations. Precourse and immediate postcourse questionnaires were used to assess confidence levels and gain qualitative data. Delayed feedback was collected at 3 months. There were 36 participants; 86% (n = 31) completed the precourse feedback, 96% (n = 34) completed the postcourse feedback, and 47% (n = 17) completed the delayed feedback. There was a statistically significant increase in self-reported confidence across all domains with a median increase of 21.25% immediately, sustained at 20% on delayed 3-month feedback. Qualitative feedback noted a change in practice, "I used (the knowledge) regularly while working in children's A + E." This was a feasible, high-fidelity simulation-based study day covering the key components of adolescent medicine. The sustained increase in confidence at 3 months and the positive qualitative and quantitative feedback are supportive of the use of simulation to improve adolescent emergency care.

Outcomes of an Online Virtual Boot Camp to Prepare Fourth-Year Medical Students for a Successful Transition to Internship.

IntroductionChanges in medical education and health care delivery have limited the ability of fourth-year medical students to perform the role of an intern prior to graduating from medical school. To address this issue, many schools have instituted residency preparation courses (sometimes referred to as boot camps) particularly for students entering surgical fields. Courses for students entering nonprocedural fields are less common and most assess increases in self-reported confidence without providing objective evidence of a gain in knowledge or skills improvement.Materials and MethodsWe used a Plan, Do, Study, Act (PDSA) model to develop and pilot cycle 1 of a nonprocedural internship preparation elective in 2019. Feedback was used to refine the course and map sessions to core competencies outlined by the Accreditation Council of Graduate Medical Education (ACGME) for PDSA cycle 2. The curriculum was adapted for remote synchronous delivery due to the coronavirus pandemic in spring 2020 using a combination of didactic lectures containing embedded polls and case-based role play responses using a chat box. Students completed anonymous surveys assessing self-perceived levels of confidence, as well as an objective comprehensive assessment after course completion.ResultsA total of 89 students participated in the course. Pre-session confidence was lowest for transfusion medicine, handling pages from nursing while on call, and knowledge of the role of a chief resident. A statistically significant increase in median scores for self-reported knowledge or confidence was seen in all sessions. The percentage of students reporting that they were either confident or extremely confident also increased significantly after each session (p<0.001 for all). All sessions analyzed were rated as useful or extremely useful by more than half of the students, and 94% of the students scored 70% or higher on the comprehensive course assessment.ConclusionsAn online virtual synchronous boot camp increased students’ confidence in handling common topics encountered during residency and demonstrated an appropriate gain in knowledge using a comprehensive assessment. We were able to adapt our curriculum to a remote model and will likely keep several sessions in an online format in the future.

Clinical Skills Simulation Complementing Core Content: Development of the Simulation Lab Integrated Curriculum Experience (SLICE).

Simulation is emerging as an essential component of the medical school curriculum. Simulation Lab Integrated Curriculum Experience (SLICE) is a student-organized program at the University of North Carolina School of Medicine (UNC SOM) for medical students that provides skills-based training sessions to augment didactic learning experiences. During its pilot year, SLICE conducted five events with respondents completing pre-and post-surveys evaluating participants' level of comfort with procedures. There was a significant increase in self-reported confidence after each session, with students providing overwhelmingly positive feedback regarding SLICE's ability to contextualize material presented in traditional lectures.

The Impact of Manuscript Learning vs. Video Learning on a Surgeon's Confidence in Performing a Difficult Procedure.

Introduction: Operative surgical videos are a popular educational resource, not commonly a part of a peer-reviewed article. We wanted to evaluate the impact of either reading a peer-reviewed manuscript or watching an operative video on a surgeon's confidence in performing a complex case.Methods: Pediatric surgeons and fellows were asked to complete an initial questionnaire to assess their confidence (formulated as a score) in the diagnosis and operative repair of anal stenosis and rectal atresia.Results: Of 101 pediatric surgeons and fellows, 52 (51%) were randomized into a “manuscript” group and 49 (49%) into a “video” group. The mean confidence before the intervention was the same in the two groups (6.4 vs. 6.6). Attending surgeons started with more confidence than trainees (7.1 vs. 5.3, p < 0.001). In the manuscript group, the average confidence increased to 7.7 (p = 0.005), and in the video group the average confidence increased to 7.9 (p = 0.001) globally. Trainees in the video group significantly improved their confidence to a score of 6.6 (p = 0.035), as did attending surgeons to 8.5 (p = 0.01). In the manuscript group, only attendings significantly improved their confidence by 1.5–8.3 (p < 0.001), whereas trainees did not with a difference of 1.3 (p = 0.194). When considering experience level, physicians who reported never having performed this surgery improved only by reading the manuscript (3.9–6.2) (p = 0.004), not by watching the video (5.4–6.6) (p = 0.106). Surgeons with experience doing this operation (>5 times) did not improve their confidence by reading the manuscript (p = 0.10), nor by watching the video (p = 0.112).Conclusion: Reviewing either a detailed manuscript or operative video on the surgical management of rectal atresia and anal stenosis demonstrated a significant increase in self-reported confidence. Trainees benefitted the most from operative videos, whereas experienced surgeons did not improve their confidence by reading the manuscript nor watching the video.

The First‐year Research Advancement Program (FRAP): Fostering Persistence of Underrepresented Students in Biology and Chemistry

We co founded the First Year Research Advancement Program (FRAP) in 2014, based on a workshop we attended by the Council on Undergraduate Research. Our goal is to increase persistence in STEM of academically promising students who belong to groups that traditionally do not persist at the same rate as majority students, including first‐generation students, PELL‐eligible students, and underrepresented minority students. Based on research that suggests that early exposure to research experiences increases discipline identity and persistence, we established FRAP. Two first‐year students per lab are paired with a senior student mentor, and each are paid for eight hours a week such that the experience replaces other work‐study. Students spend six hours a week in the lab, one hour in lab meeting, and one hour in a meeting with the cohort of 8–16 students in which faculty and students discuss college and STEM issues and form an academic professional network. Mentors are trained in coaching and mentorship. We have assessed the program in collaboration with the College's Office of Assessment and Research and found increases in self‐reported confidence and engagement. As our number of participants increases, we will study the effect on four‐year persistence versus matched sets of non‐participants. Over the last four years, 30 first year students have participated in FRAP. Our first cohort of FRAP students are now seniors; two current student mentors started as FRAP students themselves. Six of the eight FRAP students that started in the Mills lab are still part of the research groupSupport or Funding InformationThis work was supported by the National Science Foundation (MCB‐1517138 to KVM) and a Henry Dreyfus Teacher‐Scholar Award (KVM).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

“Doctor, Will You Pray with Me?” A Quality Improvement Project to Overcome Discomfort in Discussing Patient Spirituality (QI801)

•Recognize the importance of religious care in whole-person palliative care and its underutilization in clinical practice.•Describe at least three common barriers that palliative clinicians encounter when addressing patients’ religious needs.•Discuss a model for increasing quality and quantity of religious care implemented at one institution and identify potential ways this model can be adapted to other institutions or care settings. Inadequate exploration of religious needs may lead to unaddressed suffering. Nearly 90% of patients prefer that their clinicians understand their religious beliefs and how these impact medical decisions. While guidelines for discussing patients’ religious concerns are available, clinical implementation is lagging. We were interested in improving palliative care clinicians’ assessment of religion. The aim of this quality improvement (QI) project was to determine clinician barriers to addressing hospitalized patients’ religious needs and measure the quality and quantity of clinician conversations following an educational intervention targeting identified barriers. This IRB-approved QI project targeted palliative care clinicians at the University of Pittsburgh Medical Center between September 2016 and May 2017. Baseline religious assessment data was obtained by reviewing 105 charts and surveying 21 clinicians. Review of free-text comments elucidated common barriers to religious history taking. With chaplains, these results were used to develop a one-hour educational intervention. We incorporated established palliative care communication strategies for addressing two identified challenges – when a clinician is questioned regarding their religious beliefs and when a patient is questioning personal faith. Additionally, instruction on a validated religious history tool was provided. A post-intervention chart review and survey were conducted. The post-intervention survey demonstrated a 43% to 75% increase in self-reported confidence, including an over 10% increase in five of six aspects of religious care. Perceived barriers changed from procedure-focused, including uncertainty on how to respond to religious distress, to time-focused, concerned about insufficient time to explore distress. The post-intervention review of 103 charts showed a significant increase in religious history documentation. The number of charts documenting two or more religious history questions increased from 13% pre-intervention to 36% post-intervention. Post-intervention charts also documented a broader range of questions. This project demonstrates that a one-hour intervention focusing on barriers and how to use a common religious history improved both quality and quantity of conversations.

The development and evaluation of mini-GEMs – short, focused, online e-learning videos in geriatric medicine

ABSTRACTMini Geriatric E-Learning Modules (Mini-GEMs) are short, focused, e-learning videos on geriatric medicine topics, hosted on YouTube, which are targeted at junior doctors working with older people. This study aimed to explore how these resources are accessed and used. The authors analyzed the viewing data from 22 videos published over the first 18 months of the Mini-GEM project. We conducted a focus group of U.K. junior doctors considering their experiences with Mini-GEMS. The Mini-GEMs were viewed 10,291 times over 18 months, equating to 38,435 minutes of total viewing time. The average viewing time for each video was 3.85 minutes. Learners valued the brevity and focused nature of the Mini-GEMs and reported that they watched them in a variety of settings to supplement clinical experiences and consolidate learning. Watching the videos led to an increase in self-reported confidence in managing older patients. Mini-GEMs can effectively disseminate clinical teaching material to a wide audience. The videos are valued by junior doctors due to their accessibility and ease of use.

A Mixed-Methods Analysis of Changing Student Confidence in an Online Shelter Medicine Course.

Maddie's Shelter Medicine Program at the University of Florida College of Veterinary Medicine offers comprehensive training in shelter medicine to veterinary students based on a set of core job skills identified by the Association of Shelter Veterinarians. In 2012, this program began teaching online distance education courses to students and practicing veterinarians worldwide who sought additional training in this newly recognized specialty area. Distance learning is a novel educational strategy in veterinary medicine; most instruction at veterinary medical schools is classroom based. No previous studies have shown whether online courses can prepare veterinarians to practice shelter medicine. In this study, we investigated how an online, graduate-level course titled "Shelter Animal Physical Health" changed student self-reported confidence. First, we compared pre-course confidence regarding eight specific shelter medical practice scenarios to post-course confidence through statistical analysis. Quantitative analysis showed a significant (p<.001) increase in self-reported confidence for all eight scenarios. Next, we used open coding to identify themes within reflection papers that students were asked to write during the course and used those findings to corroborate or refute the quantitative results. Qualitative analysis of students' reflection papers identified six themes: confidence, communication, population management, outbreak management, medical care, and application. The results of this study show that distance education can be an effective method of preparing veterinarians and veterinary students to practice shelter medicine.

Developing Skills for Developmental Disabilities: Assessing Efficacy in An Innovative Preclinical Elective

Abstract BACKGROUND: Many medical students feel they are not trained with adequate skills and knowledge regarding cognitive and physical disability. Because of this, students may have poor clinical skills in assessing developmental delays and discomfort when interacting with these patients. “Developing Skills for Developmental Disabilities (DSDD)” is a 12-hour preclinical (years 1 and 2) elective developed collaboratively by a group of medical students and developmental pedi-atric faculty. This elective provides training in disability, behaviour, family challenges, and available interventions via faculty presentations, peer teaching, simulation sessions, and observation of a clinical developmental intervention program. OBJECTIVES: Our objective is to assess the efficacy of this new elective-which aims to assist students in correctly and comfortably identifying pediatric patients with, or at risk for, developmental delays and ininterac-tions withfamily members. DESIGN/METHODS: Participating students completed a 10-question survey (responses administered on a 5 point Likert scale) at the start and end of the elective, whereby they self-assessed confidence and knowledge when engagingchildren with developmental disabilities. This questionnaire was adapted from confidence surveys used for other curriculum assessments. RESULTS: 22 preclinical students enrolled in DSDD. Of these, 20 completed the elective and both surveys. Out ofthe 20 participants, 8 (40%) had previous work experience with disability, and 11 (55%) had personal experience (family or friend related). A significant (p0.001, CI 95%) increase in self-reported confidence was seen in 8 of10 survey questions. CONCLUSION: Overall, DSSD increased preclinical students' self-reported confidence and knowledge regarding pediatric patients with developmental disabilities. Future plans include arepeatsurveycomparing students who opt to take the elective with a control group, randomly selected from the remainder of the class. This willaddress any potential self-selection bias. Because this brief form of intervention was significant in increasing student confidence and skill, aspects of this approach may be adapted into teaching tools for office practice (e.g. assessing development and/ordiscussing care with parents) when medical students are working alongside general pediatricians seeing children with chronic developmental disabilities.

Mechanical Ventilation Boot Camp: A Simulation-Based Pilot Study.

Objectives. Management of mechanically ventilated patients may pose a challenge to novice residents, many of which may not have received formal dedicated critical care instruction prior to starting their residency training. There is a paucity of data regarding simulation and mechanical ventilation training in the medical education literature. The purpose of this study was to develop a curriculum to educate first-year residents on addressing and troubleshooting ventilator alarms. Methods. Prospective evaluation was conducted of seventeen residents undergoing a twelve-hour three-day curriculum. Residents were assessed using a predetermined critical action checklist for each case, as well as pre- and postcurriculum multiple-choice cognitive knowledge questionnaires and confidence surveys. Results. Significant improvements in cognitive knowledge, critical actions, and self-reported confidence were demonstrated. The mean change in test score from before to after intervention was +26.8%, and a median score increase of 25% was noted. The ARDS and the mucus plugging cases had statistically significant improvements in critical actions, p < 0.001. A mean increase in self-reported confidence was realized (1.55 to 3.64), p = 0.049. Conclusions. A three-day simulation curriculum for residents was effective in increasing competency, knowledge, and confidence with ventilator management.

G192(P) ‘the day the simulator died’– a pilot

Aims We wanted to evaluate the educational value of a new inter-professional simulation day – ‘The Day the Simulator Died’ . Methods This day comprised introductory lectures, 2 high fidelity simulations of unsuccessful resuscitations including a simulated parent and communication skills sessions addressing breaking bad news and unexpected child death procedures. Immediate feedback was sought and a follow up questionnaire was sent 4 months later. Results The pilot day had 9 participants – 8 answered the follow up questionnaire. View this table: The group had varied prior experience. 50% had no previous formal training on child death procedures or breaking bad news. A significant proportion (5 of 8) had either no experience or had only been the primary deliverer of bad news on fewer than 5 occassions. Limited exposure to informal training opportunities including observation of such encounters and feedback within the work place were also reported. The graphs highlight the positive impact of this training with an increase in self-reported confidence ([Figures 1][1] and [2][2]). ![Abstract G192(P) Figure 1][3] Abstract G192(P) Figure 1 Pre-simulation day confidence ![Abstract G192(P) Figure 2][3] Abstract G192(P) Figure 2 Post-simulation day confidence Simulated parents were rated as being very useful and being immersed in high fidelity simulation prior to these difficult discussions was viewed as helpful; increasing the realism. Conclusion We have highlighted an area of practice where self-reported confidence is low as a result of limited opportunities for training and feedback that stem from unexpected child death being an infrequent event. This pilot simulation day was well received and resulted in an increased confidence amongst participants. Plans are in place to further this training and to widen the multi disciplinary team involvement. [1]: #F1 [2]: #F2 [3]: pending:yes