Simulation Training Session Research Articles

Quantitating skill acquisition with optical ultrasound simulation.

ObjectiveTo investigate and compare the effect of simulator training on quantitative scores for ultrasound‐related skills for trainees with novice level ultrasound experience and expert ultrasound operators.MethodsThree novice (comprising of 11, 32, 23 participants) and one expert (10 participants) subgroups undertook an ultrasound simulation training session. Pre‐ and post‐training test scores were collected for each subgroup. Outcome measures were as follows: mean accuracy score for obtaining the correct anatomical plane, percentage of correctly acquired target planes, mean number of movements, time to achieve image, distance travelled by probe and accumulated angling of the probe.ResultsThe novices showed improvement in image acquisition after completion of the simulation training session with an improvement in the rate of correctly acquired target planes from 28–57% to 39–83%. This was not replicated in the experts. The novice’s individual ratios based on pre‐ vs. post‐training metrics improved between 1.7‐ and 4.3‐fold for number of movements, 1.9‐ and 6.7‐fold for distance, 2.0‐ and 5.2‐fold for time taken and 1.8‐ and 7.3‐fold for accumulated angling. Among the experts, there was no relationship between pre‐training simulator metrics and years of ultrasound experience.ConclusionsThe individual simulation metrics suggest the sessions were delivered at an appropriate level for basic training as novice trainees were able to show demonstrable improvements in both efficiency and accuracy on the simulator. Experts did not improve after the simulation modules, and the novice scores post‐training were similar to those of experts, suggesting the exercises were valid in testing ultrasound skills at novice but not expert level.

Cadaveric Simulation Training Improves Residents’ Knowledge and Confidence in Performing Fluoroscopic Guided Joint Injections

Simulation training has been strongly encouraged to enhance radiology trainees' procedural competency. We aimed to assess whether a cadaveric simulation training session was effective in improving radiology residents' subjective technical ability, knowledge and confidence in performing fluoroscopic-guided joint injections. As part of the residency program's procedural training curriculum, first year radiology resident participated in a cadaveric, musculoskeletal injection training session including a didactic lecture followed by a practical hands-on component. Trainees performed fluoroscopic guided hip and shoulder injections on fresh cadavers, supervised by two fellowship-trained musculoskeletal radiologists. Trainees' knowledge on indications, contraindications, preprocedural care, complications, and technical ability in performing the procedures, as well as their rating of overall session experience were evaluated with pre- and post-session questionnaires (5 point Likert-scale). The mean residents' scores for pre- and post-session questionnaire items were calculated and compared using paired t-test. The magnitude of difference between mean pre- and post-session scores was compared between the items using analysis of variance. Results Over a 5-year period, 27 trainees participated in the joint injection simulation session. The mean pre- and post-session scores were significantly higher in the post session questionnaire for all five items pertaining to knowledge of indications, contraindications, preprocedural care, complications, and technical ability (all p < 0.0001). The magnitude of improvement was not different between the items (p = 0.45). Most of the participants rated the training facilities, contents, hands-on experience, teaching quality, and session organization as very good or excellent. Cadaveric joint injection simulation training significantly improved trainees' subjective knowledge, confidence, and technical ability in performing joint injections.

Strategies to Increase Peer Support Specialists' Capacity to Use Digital Technology in the Era of COVID-19: Pre-Post Study.

BackgroundPrior to the outbreak of coronavirus disease (COVID-19), telemental health to support mental health services was primarily designed for individuals with professional clinical degrees, such as psychologists, psychiatrists, registered nurses, and licensed clinical social workers. For the first the time in history, peer support specialists are offering Medicaid-reimbursable telemental health services during the COVID-19 crisis; however, little effort has been made to train peer support specialists on telehealth practice and delivery.ObjectiveThe aim of this study was to explore the impact of the Digital Peer Support Certification on peer support specialists’ capacity to use digital peer support technology.MethodsThe Digital Peer Support Certification was co-produced with peer support specialists and included an education and simulation training session, synchronous and asynchronous support services, and audit and feedback. Participants included 9 certified peer support specialists between the ages of 25 and 54 years (mean 39 years) who were employed as peer support specialists for 1 to 11 years (mean 4.25 years) and had access to a work-funded smartphone device and data plan. A pre-post design was implemented to examine the impact of the Digital Peer Support Certification on peer support specialists’ capacity to use technology over a 3-month timeframe. Data were collected at baseline, 1 month, 2 months, and 3 months.ResultsOverall, an upward trend in peer support specialists’ capacity to offer digital peer support occurred during the 3-month certification period.ConclusionsThe Digital Peer Support Certification shows promising evidence of increasing the capacity of peer support specialists to use specific digital peer support technology features. Our findings also highlighted that this capacity was less likely to increase with training alone and that a combinational knowledge translation approach that includes both training and management will be more successful.

An evaluation of an interprofessional simulation training session on end-of-life-care conversations in the intensive care unit

The purpose of this paper is to evaluate the influence of a simulation training program on interprofessional learners' confidence and self-efficacy in conducting family meetings focused on end-of-life care in an intensive care unit . Medical residents, nursing students, social work students, and spiritual care residents participated in a simulation training that involved the use of prework modules, scenarios with trained actors, and debriefing sessions. Pretest and posttest questionnaires measured changes in confidence and self-efficacy before and after the training, and open-ended questionnaire items gave insight into the program overall. Results indicated improvements in both confidence and self-efficacy for learners, and recommendations are given for future directions of the program and for future evaluations.

Simulation-based clinical learning for the third year medical student: Effectiveness of transabdominal and transvaginal ultrasound for elucidation of OB/GYN scenarios.

Point-of-care ultrasound (POCUS) is gaining recognition as a teaching modality that acts as an integrative learning tool during medical student transition to clinical rotations. This study aimed to determine if the use of ultrasound simulation enhances understanding of Obstetrical and Gynecological (Ob/Gyn) anatomy and pathology in third-year medical students (M3), and if M3 students found the simulator useful. M3 students taking the OB/Gyn clerkship were invited to participate. Baseline knowledge of pelvic ultrasound anatomy and pathology was assessed with a multiple-choice question test. Participants received a one-hour OB/Gyn ultrasound simulation training session. A post-test assessed knowledge after the intervention. Survey data was collected regarding learning styles and learner satisfaction. Following simulator-based training, the median correct number of responses to the knowledge questions increased from 11 of 18 to 14 of 18 correct (P < .001). Statistically significant increases were also observed in comfort level with OB/GYN ultrasound (P < .001). All 68 students answered that the ultrasound simulator was helpful and enjoyed using the simulator. This study suggests that ultrasound simulators are useful for improvement in knowledge, comfort level, and ability to identify pathology in Ob/Gyn scenarios in M3 students.

670-P: Effectiveness of Using Simulation to Train Nursing Students in Providing Preconception Counseling to Women with Diabetes

Nurses can be pivotal to providing diabetes education, including, preconception counseling (PC) to prevent pregnancy-related complications in women with diabetes. However, many health professionals, including nurses, have reported self-deficits in these areas due to a lack training or knowledge. Simulation is an effective educational strategy utilized in schools of nursing to enhance critical thinking, decision-making, skills building and increase knowledge. However, little is known about the effectiveness of using simulation to train nursing students in providing diabetes education and preconception counseling to patients. Therefore, this study examined the effectiveness of a newly developed diabetes education/PC simulation training program developed for nursing students. The sample was 30 junior level baccalaureate nursing students who completed pretest and posttest measures on their awareness and knowledge of diabetes, pregnancy and PC. We used the 45 min video of READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) PC program during the simulation training session because it is a validated evidenced-based, theory-driven program that targets female adolescents, and is endorsed by the American Diabetes Association. They also observed a live 10 minute simulation of actors portraying a diabetic educator and a diabetic female adolescent and their clinical interaction. Data were analyzed using a paired t-test. The mean pretest score was 9.33, while the mean posttest score was 15.00 with a statistically significant gain (t = 15.89; p = .000). Therefore, it appears that PC simulation may be an effective educational strategy to train nursing students on caring for women with diabetes. Disclosure J.L. Thurheimer-Cacciotti: None. D. Charron-Prochownik: None.

Factors Influencing Team and Task Performance in Intensive Care Teams in a Simulated Scenario.

Healthcare teams and their performance in a complex environment such as that of intensive care units (ICUs) are influenced by several factors. This study investigates the relationship between team background characteristics and team as well as task performance. This study included 105 professionals (26 teams), working at the ICUs of 2 hospitals in Northern Sweden. The team-based simulation training sessions were video recorded, and thereafter, team performance and task performance were analyzed based on ratings of the TEAM instrument and the ABCDE checklist. The final analyses showed that a higher age was significantly associated with better total team performance (β = 0.35, P = 0.04), teamwork (β = 0.04, P = 0.04), and task management (β = 0.04, P = 0.05) and with a higher overall rating for global team performance (β = 0.09, P = 0.02). The same pattern was found for the association between age and task performance (β = 0.02, P = 0.04). In addition, prior team training without video-facilitated reflection was significantly associated with better task performance (β = 0.35, P = 0.04). On the other hand, prior team training in communication was significantly associated with worse (β = -1.30, P = 0.02) leadership performance. This study reveals that a higher age is important for better team performance when caring for a severely ill patient in a simulation setting in the ICU. In addition, prior team training had a positive impact on task performance. Therefore, on a team level, this study indicates that age and, to some extent, prior team training without video-facilitated reflection have an impact on team performance in the care of critically ill patients.

Educational value of telementoring for a simulation-based fundamental use of surgical energy™ (FUSE) curriculum: a randomized controlled trial in surgical trainees.

The SAGES Fundamental Use of Surgical Energy (FUSE) program accompanied by a bench-top simulation has shown to improve knowledge of the safe use of energy devices. However, there are significant barriers and costs associated with delivering an effective structured simulation curriculum to a widespread international audience. The purpose of this study was to evaluate if bench-top simulation FUSE curriculum through telementoring is as effective as a live-in house proctor for electrosurgical training. A two-armed multi-institutional randomized controlled trial was designed, including a 1-h didactic electrosurgery course (FUSE curriculum), followed by a structured 1-h bench-top simulation training session. For the simulation, participants were randomized to either a live proctor who delivered the course on-site (LIVE group), or a proctor from a remote location using videoconferencing platform (TELEM group). Pre- and post-curriculum (immediate and 6months) knowledge and self-perceived comfort and competence were assessed. Data are expressed as median [interquartile range], *p < 0.05. Sixty-five (35 LIVE; 30 TELEM) surgical trainees from three institutions participated. Baseline characteristics were similar. Total score on the exam improved from 47% [40-54] to 78% [71-84]* amongst all participants, with similar immediate post-curriculum scores in the LIVE group compared to the TELEM group (77% [69-83] vs 80% [75-85]). At 6 months, performance on the exam declined significantly for both groups, but remained similar between the two (LIVE: 59% [51-71] vs TELEM: 71% [57-77]). Participants in both groups reported feeling greater comfort and competence post-curriculum (immediate and at 6months) compared to baseline, with no difference between the two groups. A bench-top simulation FUSE course delivered via a telementoring platform seems to improve surgical trainees' knowledge and comfort in the safe use of electrosurgical devices as effectively as when it is delivered by a live proctor, despite long-term decay for both methods.

LO76: Effect of task interruptions training on the quality of simulated ALS

Introduction: Task interruptions are reportedly frequent disturbances for emergency physicians performing advanced life support (ALS). The aim of this study was to evaluate the benefit of adding task interruptions in ALS simulated training session. Methods: We conducted a multi centered randomized controlled trial in four emergency departments of a university hospital in Paris, France. Each emergency team included one resident, one nurse and one emergency physician. The teams were randomized for the nature of their training session: control (without interruption) or realistic (with interruptions). The interruption consisted of an interfering family member speaking a foreign language, and of repetitive phone calls during ALS. After the first training session, teams were evaluated on a second realistic session with task interruptions. The primary outcome was non-technical skills assessed with the TEAM score during this evaluation session. We also measured the no flow time, and the Cardiff score, which reflects the quality of ALS: including chest compression depth and rate, no flow time. Results: On a total of 23 included teams, 12 had a control training session and 11 with task interruptions. Baseline characteristics and TEAM score were similar between the two groups (Mean difference: 3,3 [-2,2; 8,9]; p = 0,26). During the evaluation session, the TEAM score was lower for “realistic” teams (mean difference -8 [95% confidence interval -13; -3]). We also report a higher no flow time and similar overall Cardiff score. Conclusion: In this simulated ALS study, the presence of disturbances during simulation seemed to worsen the quality of training. This study highlights the negative consequences of task interruptions in emergency medicine.

The Impacts of Obstetrical Simulation Training for Emergency Medical Service Providers [40G

INTRODUCTION: Obstetrical emergencies in the field require coordinated time-sensitive teamwork between emergency medical services (EMS) and hospital-based teams. Simulation is effective at preparation for emergencies. The study objective was to determine the educational and clinical impacts of simulation training sessions for emergency medical service personnel by obstetrical teams within the same communities. METHODS: A multi-center prospective pre/post educational study design was used to assess the effectiveness of a curriculum designed for emergency medical service providers on obstetrical emergencies. Instructional strategies included team-based checklist review and skills coaching using low-fidelity task trainers, taught by interdisciplinary teams. Outcomes were measured using pre/post educational tests, team performance assessments, course evaluations and clinical impacts. Internal review board exemption was obtained. Paired t-tests were used for data analysis. RESULTS: Over 18 months, 185 EMS personnel participated in the curriculum taught at 2 community hospitals. Instructors included obstetricians, emergency physicians, nurses, and medical students. Significant improvement in knowledge was achieved (pre 47.8%, post 89.6%, P&lt;.0001). Confidence (1=high, 5=low) improved in managing precipitous delivery (pre 3.77, post 1.52, P&lt;.0001), shoulder dystocia (pre 4.0, post 1.48, P&lt;.0001), eclampsia (pre 2.68, post 1.29, P&lt;.0001), breech (pre 4.68, post 2.21, P&lt;.0001), and PPH (pre 3.68, post 1.33, P&lt;.0001). Team performance assessments demonstrated significant improvement (pre 68.54%, post 93.54%, P&lt;.0001). Qualitative clinical impacts included improvements to EMS protocols, transfer of care and communication between teams. CONCLUSION: Simulation training in obstetrical emergencies for emergency medical service providers improves knowledge, skills, and performance. Instruction by obstetrical teams in the same communities enhances communication and collaborative care.

Impact of Simulation Training on Undergraduate Clinical Decision-making in Emergencies: A Non-blinded, Single-centre, Randomised Pilot Study.

IntroductionThere is an increasing evidence base for the use of simulation-based medical education. Simulation is superior to more didactic methods for teaching a range of technical and non-technical skills, and students report they often derive more educational value from it compared with other teaching methods. There is currently limited evidence that simulation training improves clinical decision-making and, therefore, this pilot study sought to explore this further.MethodsStudents were randomised to take part in either five classroom tutorials and simulation training sessions or five classroom tutorials and an online e-learning module. On completion of the teaching, students all undertook an unseen assessment scenario (managing a simulated patient with anaphylaxis), where they were scored using a weighted marking scheme. The time taken to make decisions and student-reported confidence in decisions were also measured.Results14/14 simulation-group participants and 12/14 e-learning-group participants completed the post-learning assessment. The simulation group identified anaphylaxis and gave adrenaline more quickly (p 0.008 and 0.005, respectively), and this cohort was more confident in making the diagnosis (p 0.044). There was no statistically significant difference between weighted global assessment scores for each group (p 0.705). The e-learning group called for help more quickly (p.0.049), although fewer students in this group called for help (five vs. nine). There was no statistical difference in confidence in decisions to administer adrenaline or call for help (p 0.539 and 0.364 respectively).ConclusionsParticipants who undertook simulation training were able to more confidently and quickly identify the diagnosis and initiate emergency treatment. However, there was not a statistically significant difference between groups using an overall weighted score. Using simulation to train students to perform better in emergencies and improve their decision-making shows promise but a further quantitative study is required.

A team leader's gaze before and after making requests in emergency care simulation: a case study with eye-tracking glasses.

The advanced technology of eye-tracking enables us to analyse healthcare professionals’ (HCPs) gaze behaviours. Gaze analysis has great potential to capture HCPs’ non-technical skills, especially situational awareness (SA).1 The SA framework has three levels. Level 1 involves perceiving an event, level 2 understanding what is being perceived importantly and level 3 being able to make predictions. How to analyse HCPs’ utterances and gaze in an integrative manner may provide insights into higher-order cognitive skills such as level 3 SA. This study aims to establish a method to describe HCPs’ gaze and utterances in emergency care interactions, focusing on a leader’s gaze at team members’ faces and bodies when making requests. One simulated training session (about 16 min) was analysed, applying a multimodal corpus approach. The recording took place in the resuscitation area at Yokohama City University Medical Center. The team comprised a senior consultant as a team leader (Leader) with an eye-tracker, Tobii Pro Glasses 2, another two doctors (a senior doctor (SD) and a junior doctor (JD)), a foundation doctor and two nurses, and a simulated patient (male, …

How to apply Simulation-Based Learning in Medical Education?

Simulation-Based Learning is considered the best alternative teaching and assessment tool that able to make the change in education, training, improving the quality and assessing the performance of the medical students. It helps students for acquiring many skills such as professionalism, communication, self-evaluation, time management, and teamwork. In addition, the use of simulation in medical education is based on many noble goals and ethical rules; it provides the best standards for patient care and safety, patient autonomy, and social justice. However, assessment of the application of simulation appropriateness depends on validity, reliability, and utility. Simulation has many types and classifications; it may be classified into human simulation such as role-play and standardized patient or non-human simulation such as manikin and the based computer simulation. It may be also classified according to the type or the fidelity. According to the type, it is classified into compiler-driven and event-driven, or according to the fidelity as a low, medium, and high-fidelity. There are specific criteria and steps that should be applied when designing a simulation course or operation a simulation training session as well as designing a skill checklist for ensuring a successful simulation application in medical education. However, many challenges and obstacles are still facing simulation implementation in medical education in different medical schools.

The impact of tiredness on virtual reality robotic surgical skills.

IntroductionThe effect of tiredness has been proved for the surgeons’ musculature performing laparoscopic or robotic procedures (physical stress). Mental stress after robotic surgery has been reported as well. It is still unclear how much the surgical skills are altered and which types of skills are more affected at the final steps of long, complex robotic surgical procedures.AimTo evaluate to what extent the surgeon’s skills are influenced by long procedures, using the objective assessment of different surgical skills by a virtual reality robotic simulator.Material and methodsFifteen surgeons were asked to perform a continuous 4 h virtual robotic surgical simulator training session. At the beginning of simulator training and at the end of each of the 4 h of training, three exercises of increasing difficulty were selected to be performed in order to assess the surgeons’ skills.ResultsThere were statistically significant differences between the initial and final overall scores for all the three exercises, the final outcomes being inferior. The specific metrics for each exercise slightly improved within 1 h from the beginning and thereafter decreased to a statistically significantly inferior value.ConclusionsThe specific metrics on the virtual reality robotic surgical simulator were altered after a 4-hour console training period. Further larger and more complex studies are necessary to evaluate the translation from the simulator to real-life robotic surgery.

Apport de l’apprentissage par la simulation dans l’enseignement de la pneumologie

Simulation maintains patient safety by limiting the risk of errors. In the medical field, simulation is a method of learning that is developing more and more in the acute specialties but it is still not widespread in the field of respiratory medicine. To evaluate the efficacy of high fidelity simulation as a teaching tool in respiratory medicine. This was a prospective and descriptive study including students who had high fidelity simulation training sessions during their traineeship in respiratory medicine. Simulation learning took the form of four teaching sessions. The included students were assessed at the beginning and end of each session by a pre-test and post-test. Student satisfaction was assessed at the end of each session. Comparing the average student score before and after the simulation session showed an improvement in post-test scores. This improvement was statistically significant for all four scenarios. The majority of students, 60% (N=13), were satisfied with the progress of their internship in the Respiratory Department. High fidelity simulation is a teaching method that allows the acquisition and/or optimization of several skills. Nevertheless, this method remains undeveloped in respiratory medicine.

A Novel Low-Cost Surgical Simulation Tool for Pinning Supracondylar Humerus Fractures.

Simulation-based training is one way to improve basic competence for surgical trainees and thus improve patient safety. Closed reduction and percutaneous pinning of a supracondylar humerus fracture is a common procedure that encompasses many basic orthopaedic skills and has been identified as a residency milestone. Despite this, no quantitative tools exist to help learners attain this basic skill. This study seeks to validate a quantitative, low-cost simulation-based training tool for teaching orthopaedic surgery trainees the fundamentals of fracture stabilization with pins. Two low-cost models were developed with simulated cancellous bone blocks and cortical bone sheets: a pinning agility tool to teach pin placement and redirection, and a low-cost construct stability tool to replicate pinning. A high-cost construct stability tool was cut using a pediatric supracondylar humerus model to simulate pinning a real fracture. Construct stability was assessed by adding weight until ∼1.6 mm of displacement was observed. Participants were tested naively on all 3 models and then completed a training session using only the low-cost models. Performance following training was then assessed and compared with fellowship-trained pediatric orthopaedic surgeons. Participants also rated their preintervention and postintervention confidence, skill, and knowledgeability. A total of 18 novice trainees participated (10 PGY1 and PGY2 orthopaedic surgery residents and 8 medical student members of the orthopaedic surgery interest club), whereas the reference group consisted of 7 orthopaedic surgery attendings. The subjects significantly improved their scores on both the low-cost (P=0.002) and high-cost (P<0.001) construct stability tools after the training with only the low-cost tools. Compared with the attending benchmark, trainee scores improved on the high-fidelity model from 31% preintervention to 86% postintervention and their pinning times decreased by 38%. Trainees reported increased knowledge, skill, and confidence after the intervention (P<0.001). A novel, low-cost simulation model and training session for supracondylar humerus fracture pinning resulted in improved performance in stabilizing a supracondylar humerus model and increased trainee knowledgeability, confidence, and skill. Level II-economic.

A Simulation Curriculum for Teaching Obstetrics and Gynecology Residents the Management of Asherman's Syndrome

Study Objective To describe a simulation-based curriculum and evaluate its effect on OBGYN residents’ knowledge and confidence about the management of Asherman's Syndrome. Design A prospective cohort study. Setting A Canadian OBGYN residency program. Patients or Participants Twenty OBGYN residents. Interventions OBGYN residents participated in three targeted simulation-training sessions on the management of Asherman's Syndrome in the following sequence: didactic teaching with surgical videos and demonstration of safe dissection techniques; hysteroscopic dissection of intrauterine adhesions; insertion of intrauterine balloon to prevent adhesion reformation. Participants completed a pre-simulation and post-simulation survey assessing knowledge level of Asherman's Syndrome using a 20-point questionnaire and their self-reported confidence level in each of the simulation components using a Likert scale. (Component 1: Overall knowledge of Asherman's Syndrome; Component 2: Dissection of intrauterine adhesions; Component 3: Identifying the severity of intrauterine adhesions; Component 4: Insertion of a Cook's catheter.) Additional qualitative feedback was used to evaluate the strengths and weaknesses of the simulation curriculum. Measurements and Main Results Twenty OBGYN residents at the University of Saskatchewan participated in the study. The mean percentage of correct answers was 54.5% (+/- 18.3%) on the pre-simulation survey compared with 84.5% (+/- 12.5%) post-simulation (p Conclusion Simulation teaching is an effective method of increasing OBGYN residents’ knowledge and confidence about the management of Asherman's Syndrome.

Simulación versus exposición convencional en la enseñanza de preeclampsia severa

Objetivo. Determinar si la simulación es más efectiva que la exposición convencional en la mejora cognitiva de enfermeras en preeclampsia severa. Métodos. Investigación transversal cuasiexperimental realizada en dos clínicas de Cajamarca, Perú. Se comparó las mejoras cognitivas de enfermeras sobre la preeclampsia severa: 13 fueron sometidas a exposición convencional sobre preeclampsia severa (Exconv) y 16, asignadas al grupo experimental, tuvieron una exposición y 4 sesiones de simulación (Sim). Ambos grupos respondieron un pretest y, luego de las sesiones, un postest de 20 preguntas de opción múltiple, previamente validado por expertos y con confiabilidad de Spearman-Brown de 0,76. Todas las sesiones de simulación fueron guardadas en vídeo y evaluadas por un experto, con lista de verificación adaptada del American College of Obstetricians and Gynecologists. Los datos fueron procesados con el programa SPSS 20.0. Se usaron las pruebas Spearman-Brown de correlación, t de student para muestras relacionadas para comparar los puntajes obtenidos en pretest y postest, con p&lt; 0,05. Resultados. Los puntajes del grupo control (Exconv) en el pretest y postest fueron: 11,69 ± 2,53 y 13,85 ± 2,27, p=0,02, con ganancia pedagógica de 2,15 ± 2,88. Los puntajes de pretest y postest del grupo experimental (Sim) fueron 10,25 ± 2,79 y 14,69 ± 1,89, con ganancia pedagógica de 4,44 ± 2,22 con p=0,000. Las ganancias pedagógicas del grupo experimental fueron mayores que las del grupo control, con p=0,002. Conclusión. La enseñanza de preeclampsia severa con simulación obtuvo mejoras cognitivas mayores que con la exposición convencional.

Compuflo®-Assisted Training vs Conventional Training for the Identification of the Ligamentum Flavum with an Epidural Simulator: A Brief Report.

The ability of recognizing the ligamentum flavum is the first, crucial, important skill to teach novices when they are learning the epidural technique. The aim of this preliminary prospective study was to evaluate whether the Compuflo® Epidural instrument may help inexperienced trainees to better identify the ligamentum flavum during an epidural simulator training session. Compuflo® reduced the total number of attempts to identify the ligamentum flavum and increased three fold the chance to identify it at the first attempt during a simulator-assisted training module, making this identification easier for inexperienced trainees. This trial is registered with NCT03812926.

Reliability of instruments that measure situation awareness, team performance and task performance in a simulation setting with medical students

ObjectivesThe assessment of situation awareness (SA), team performance and task performance in a simulation training session requires reliable and feasible measurement techniques. The objectives of this study were to test...