Simulation Training Course Research Articles

Nursing and midwifery simulation training with a newly developed low-cost high-fidelity placenta simulator: a collaboration between Italy and Ethiopia

BackgroundSimulation training provides safe environment for skill acquisition and retention. This study addresses a critical challenge in Africa – umbilical cord and placenta management after childbirth – aiming to bridge theoretical learning with practical experiences through simulation. We realized a new low-cost high-fidelity simulator of placenta and umbilical cord. We conducted a needs-based training course for nursing and midwifery students at St. Luke Hospital of Wolisso, Ethiopia, to validate our new simulator and compare its acceptability and teaching effectiveness with other two simulators (conventional low-fidelity model and human placenta).MethodsWe surveyed St. Luke Hospital medical experts to obtain their feedback on the new simulator’s face, content, and usability. We carried out a simulation training course for 67 students who received theoretical lectures and simulation courses being divided into three groups according to the simulator used. We assessed the simulators’ user acceptability using the Technology Acceptance Model (TAM) and compared the final objective evaluations by tutors between groups.ResultsExperts confirmed the new simulator’s fidelity, material quality, and usability. Students training on the new simulator demonstrated higher objective scores and perceived it as more useful and user-friendly compared to human placenta, while there was no difference between conventional simulator and human placenta in the TAM items.ConclusionWe validated a new high-fidelity simulator developed by the Sant’Anna School of Advanced Studies in Pisa, Italy, using the TAM scale and robust statistical methods, thanks to a successful collaboration with St. Luke’s Hospital in a simulation training course where students achieved higher objective scores and perceived the simulator as more useful and easier to use than a real human placenta, suggesting significant educational benefits and potential for future research.

From FUSE to a hands-on electrosurgery course using a cadaveric model.

Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.

Analysis of Mixed Teaching Mode of Financial Accounting Comprehensive Simulation and Practical Training Courses in Colleges and Universities

Hybrid teaching has significant advantages in financial accounting courses in colleges and universities, which is conducive to improving students learning interest and promoting ability training. However, there are few studies on hybrid teaching in comprehensive simulation practical training courses of financial accounting. Therefore, this paper analyzes this and finds that it still has problems such as insufficient technical equipment. In order to better play the advantages of mixed teaching, improve the quality of teaching.

Rapid Production Nasal Osteotomy Simulators With Multi-Modality Manufacturing: 3D Printing, Casting, and Molding.

To expand and improve upon previously described nasal osteotomy models with the goals of decreasing cost and production time while ensuring model fidelity. To assess change in participant confidence in their understanding of and ability to perform nasal osteotomies following completion of the simulation course. Prospective study. Simulation training course for otolaryngology residents at West Virginia University. A combined methodology of 3D printing, silicone molding, and resin casting was used to design a nasal osteotomy model to address material issues such as print delamination. Multiple models were then used in a simulation lab on performing nasal osteotomies. Model utility and impact on participant confidence was assessed at baseline, postlecture, and postsimulation lab. Using a combined manufacturing methodology, we achieved a production time reduction of 97.71% and a cost reduction of 82.02% for this polyurethane resin nasal osteotomy model relative to a previously described osteotomy model. Participants in the simulation course were noted to have a significant improvement in confidence in their understanding of and ability to perform nasal osteotomies from baseline and postlecture and also from postlecture and postsimulation lab (P < .05 for all). By incorporating multiple manufacturing modalities (molding and casting) in addition to 3D printing, this study achieved a large reduction in both production time and cost in fabrication of a nasal osteotomy simulator and addressed material limitations imposed by fused deposition modelingprinters. This design methodology serves as an example on how these barriers may be addressed in unrelated simulation projects. Model fidelity was improved with addition of a silicone soft tissue midface. Improvement in participant confidence was noted following completion of the simulation lab.

Development and implementation of a high-fidelity simulation training course for medical and nursing collaboration based on the Fink integrated course design model.

The purpose of this study is to examine the design and implementation of a high-fidelity simulation training course for medical and nursing collaboration, based on the Fink integrated course design model. Additionally, the study aims to validate the teaching effectiveness of the course. Previous empirical studies have highlighted the effectiveness of collaborative healthcare education in institutional teaching and hospital training. However, the development of healthcare collaborative education in China has been slow to develop in China. In recent years, Chinese nursing educators and researchers have shown interest in utilizing high-fidelity simulators for healthcare collaborative education. These simulators help address the limitations of traditional nursing teaching and healthcare separation simulation. Nevertheless, a standardized simulation interprofessional education curriculum is still lacking. Therefore, nursing educators need to develop a standardized high-fidelity simulation training curriculum for healthcare collaboration, guided by established science curriculum development theories. A high-fidelity simulation training course on healthcare collaboration was designed based on the Fink integrated curriculum design model. The course was taught to 14 nursing students and 8 clinical medicine students from March to July 2022. To comprehensively evaluate the effectiveness of the healthcare collaboration high-fidelity simulation training course, several assessment tools were used. These included course grades, satisfaction and self-confidence scales, simulation teaching practice scales, healthcare collaboration attitude scales, critical thinking skills scales, and semi-structured interviews. After the course was implemented, students demonstrated high overall scores (79.19 ± 5.12) and reported high satisfaction ratings (4.44 ± 0.37). They also exhibited increased self-confidence (4.16 ± 0.33). Additionally, students evaluated all four dimensions of the course teaching practice scale positively. Furthermore, the study demonstrated significant improvements in various aspects, such as attitudes toward medical and nursing collaboration (t = -7.135, P < 0.01), shared education and teamwork (t = -3.247, P = 0.002), job autonomy for nurses (t = -1.782, P = 0.000), and reduced physician dominance (t = -6.768, P = 0.000). The critical thinking skills of the students showed significant improvement, with higher scores in truth-seeking (t = -3.052, P = 0.004), analytical ability (t = -2.561, P = 0.014), systematic ability (t = -3.491, P = 0.001), self-confidence in critical thinking (t = -4.024, P = 0.000), and curiosity (t = -5.318, P = 0.000) compared to their scores before the course (all P < 0.05). The interviews showed that the course's student-centered approach enabled active learning. Students suggested enhancing teaching cases and allocating more time for reflection and summarization. The study successfully designed a high-fidelity simulation training course for healthcare collaboration by utilizing the Fink integrated curriculum design model. The findings provide valuable insights for the development of standardized curricula and healthcare collaboration education in China. Moreover, the course adheres to best practice principles, fostering improved attitudes toward healthcare collaboration and enhancing students' healthcare collaboration and clinical thinking skills.

A comparison between the effects of simulation of basic CPR training and workshops on firefighters’ knowledge and skills: experimental study

BackgroundOne of the most common causes of death worldwide is cardiopulmonary arrest. Firefighters are among the first responders at the scenes of accidents and can, therefore, play a key part in performing basic cardiopulmonary resuscitation (CPR) for victims who need it. The present study was conducted to compare the effects of simulation training against workshops on the CPR knowledge and skills of firefighters in the south of Iran.MethodsThis experimental (Interventional) study was conducted on 60 firefighters of south of Fars province, Iran. The study was undertaken from March to July 2023. Through random allocation, the participants were divided into two groups: simulation-based training (30 members) and traditional workshop training (30 members). The participants’ CPR knowledge and practical skills were measured before, immediately after, and three months after intervention.ResultsThe findings of the study revealed a statistically significant difference between the pretest and posttest CPR knowledge and skill mean scores of the simulation groups as compared to the workshop group (p < 0.001). As measured three months after the intervention, the firefighters’ knowledge and skill mean scores were still significantly different from their pretest mean scores (p < 0.001); however, they had declined, which can be attributed to the fact that the study population did not frequently exercise CPR.ConclusionBased on the findings of the study, even though both methods of education were effective on enhancing the firefighters’ CPR knowledge and skill, simulation training had a far greater impact than training in workshops. In view of the decline in the participants’ knowledge and skill scores over time, it is recommended that short simulation training courses on CPR should be repeated on a regular basis.

Simulation training for medical emergencies: Evaluation of dentists' long-term learning skills and confidence.

As the population ages and more patients experience medical emergencies during dental treatments, dentists must competently and confidently manage these situations. We developed a simulation training course for medical emergencies in the dental setting using an inexpensive vital sign simulation app for smartphones/tablets without the need for an expensive simulator. However, the duration for which this effect is maintained is unclear. This study was performed to evaluate the long-term educational effect at 3, 6, and 12 months after taking the course. Thirty-nine dental residents participated in this course. Scenarios included vasovagal syncope, anaphylaxis, hyperventilation syndrome, and acute coronary syndrome, each of which the participants had to diagnose and treat. The participants were evaluated using a checklist for anaphylaxis diagnosis and treatment skills immediately after and 3, 6, and 12 months after the course. The participants were also surveyed about their confidence in diagnosing and treating these conditions by questionnaire before, immediately after, and 3, 6, and 12 months after the course. The checklist scores for anaphylaxis were significantly lower at 3, 6, and 12 months after the course than immediately after the course. The percentage of participants who provided a correct diagnosis and appropriate treatment for vasovagal syncope, hyperventilation syndrome, and acute coronary syndrome was lower at all reassessments than immediately after the course. Because medical emergency management skills and confidence declined within 3 months, it would be useful to introduce a refresher course approximately 3 months after the initial course to maintain skills and confidence.

Effect of virtual reality training to enhance laparoscopic assistance skills

BackgroundWhile laparoscopic assistance is often entrusted to less experienced individuals, such as residents, medical students, and operating room nurses, it is important to note that they typically receive little to no formal laparoscopic training. This deficiency can lead to poor visibility during minimally invasive surgery, thus increasing the risk of errors. Moreover, operating room nurses and medical students are currently not included as key users in structured laparoscopic training programs.ObjectivesThe aim of this study is to evaluate the laparoscopic skills of OR nurses, clinical medical postgraduate students, and residents before and after undergoing virtual reality training. Additionally, it aimed to compare the differences in the laparoscopic skills among different groups (OR nurses/Students/Residents) both before and after virtual reality training.MethodsOperating room nurses, clinical medical postgraduate students and residents from a tertiary Grade A hospital in China in March 2022 were selected as participants. All participants were required to complete a laparoscopic simulation training course in 6 consecutive weeks. One task from each of the four training modules was selected as an evaluation indicator. A before-and-after self-control study was used to compare the basic laparoscopic skills of participants, and laparoscopic skill competency was compared between the groups of operating room nurses, clinical medical postgraduate students, and residents.ResultsTwenty-seven operating room nurses, 31 clinical medical postgraduate students, and 16 residents were included. The training course scores for the navigation training module, task training module, coordination training module, and surgical skills training module between different groups (operating room nurses/clinical medical postgraduate/residents) before laparoscopic simulation training was statistically significant (p < 0.05). After laparoscopic simulation training, there was no statistically significant difference in the training course scores between the different groups. The surgical level scores before and after the training course were compared between the operating room nurses, clinical medical postgraduate students, and residents and showed significant increases (p < 0.05).ConclusionOur findings show a significant improvement in laparoscopic skills following virtual surgery simulation training across all participant groups. The integration of virtual surgery simulation technology in surgical training holds promise for bridging the gap in laparoscopic skill development among health care professionals.

Toward the design of a tailored training course for birth assistance: an Ethiopian experience.

Simulation in healthcare has already demonstrated extraordinary potential in high-income countries. However, to date, few authors have explored the possibility of applying simulation-based training in African settings, highlighting the necessity of need-based training protocols capable of addressing economic, social, and cultural aspects. In this framework, this research investigates the main features of a simulation training course on umbilical cord care and placenta management should be considered effective and sustainable in an African healthcare environment. Local facilitators were identified as the best resources for defining course contents and providing technical lectures to mitigate cultural, linguistic, and social issues. For the training program, the design of a new low-cost medium-fidelity simulator was explored and a preliminary evaluation was performed. Finally, the propensity of 25 students to attend a simulation training course was investigated using a questionnaire. The attitude of the enrolled students was positive, endorsing the future introduction of simulation training into the educational offers of Ethiopian colleges.

Using Simulation Training to Reduce Skill Decay Among Certified Registered Nurse Anesthetists.

Skill decay refers to the loss of skills and knowledge resulting from lack of consistent use. Among certified registered nurse anesthetists (CRNAs), skill decay can lead to negative results. One method that has been shown to mitigate skill decay is low-dose, high-frequency (LDHF) simulation. There is a gap in the LDHF simulation literature regarding CRNAs to determine its effectiveness in reducing skill decay or increasing confidence levels. This study used a quasi-experimental pretest-posttest follow-up design. The pretests and posttests were evaluated using a Wilcoxon signed rank test to determine CRNAs' proficiency and confidence in central venous catheter (CVC) insertion before and after a simulated refresher training course. The CRNAs showed a significant improvement in CVC insertion proficiency, from a 50% pretest average to a 94% posttest average (p < .0001), and they retained proficiency 6 months later (91%, p = .0109). There was no significant change in CRNAs' confidence level following the training (p = .4486). A program of LDHF simulation training is an important activity in meeting the continuing education/training needs of CRNAs in improving and retaining CVC insertion proficiency. This study demonstrates the efficacy of a LDHF simulation program for CRNAs and helps to bridge the gap in the literature on the use of LDHF simulation among CRNAs. [J Contin Educ Nurs. 2024;55(4):187-194.].

HPB O06 Strategy, evolution and outcomes of a ‘unit-wide’ approach to robotic surgical training – evaluation of the experience in a high-volume tertiary hepatopancreaticobiliary unit

Abstract Background Robotic surgery has been a 'slow-burning' technology in HPB Surgery in the UK, partly due to availability of robotic systems due to more rapid adoption in other subspecialties. It has also been seen as the preserve of one or two early adopters, both within units and more widely. In this study we evaluate an alternative approach to starting a robotic programme, with an a priori intent to train multiple members of the same unit following a structured process and continuous real-time outcome evaluation. Methods The training programme was structured in line with the Intuitive console surgeon training pathway consisting of online modules, simulation training and laboratory courses. Case acquisition was in line with the suggested escalation of difficulty laid out in the paper by Farrugia et al (J Robotic Surg 2022). Surgeons trained in pairs, with the order determined by robotic availability and previous minimally-invasive HPB experience. Regular robotic access was secured by agreement with other robotic specialties. A prospective database of cases was maintained and regularly interrogated to evaluate outcomes at a unit and surgeon level. Results 245 cases were performed in 18 months. Case acquisition rate was similar for all surgeons. Unit volume slowed from a peak of 21 cases/month until acquisition of a 3rd Xi system, facilitating 3 regular HPB robotic lists/week. Following this both number and complexity of cases increased. All surgeons experienced a decrease in total numbers of complex cases in the first month, which had returned to baseline at 6 months (mean 9.25 v 3.5, p&amp;lt;0.05). Overall length of stay, HDU stay and conversion rates were lower than surgeon- and case-matched historical data, with no significant increase in complication rates. Conclusions The introduction of a unit-wide robotic programme is feasible and results in better robotic utilisation. Case acquisition can be maintained for all surgeons. A possible further benefit is a greater acceptance of the need to share the caseload for open and laparoscopic cases during the learning curve. Robotic access is key to successful implementation and must be assessed before the programme begins. Outcomes at a unit- and surgeon- level can be maintained or improved regardless of the career stage of the surgeon prior to beginning robotics.

A1Interactive simulation training course for professionals working with children and adolescents with eating disorders

Background and aim: Research suggests that eating disorders (ED) in children and adolescents are on the rise [1]. One study found that the incidence of anorexia nervosa in young girls aged 10–14 years increased by 50% between 1980 and 2000 [2]. Another study reported a 119% increase in the number of hospitalizations for eating disorders in children aged 12 and under between 1999 and 2006 [3]. These statistics highlight the urgent need for improved prevention, early intervention and treatment of eating disorders in young people. This 1-day interactive simulation training course is designed to enhance the knowledge, confidence and skills of medical doctors, psychiatrists, RMNs, physical health nurses, dieticians, general practitioners and family therapists who are working with children and young people (CYP) with eating disorders. Methods: This 1-day simulation course was delivered online. The course focuses on the assessment and management of CYP with ED, understanding the challenges faced by professionals in engaging CYP with ED in different settings, thinking about dynamics within family systems and in wider systems, and gaining a better understanding of capacity, consent and other conundrums. The course includes simulated scenarios played by trained actors to support the development of effective communication skills and Maudsley debrief model is employed to give participants feedback on their contributions and assist them in learning positively and constructively from their experience. Participants completed a pre- and post-course questionnaire measuring their confidence in course-specific skills and human factors skills, as well as collecting qualitative feedback on their experience of the course and intention to apply the learning. Results: Participants were asked to complete a pre-course and post-course questionnaire rating their knowledge, confidence and skills related to working with patients with eating disorders. Paired samples t-tests were conducted to analyse the difference in ratings between the pre- and post-course questionnaires. Results demonstrated a significant difference in the scores for course-specific questions between the pre-course (M =25.48, SD = 4.50) and post-course (M = 32.44, SD = 3.53), t(12) = 46 p &lt; .001, 95% CI [−8.11, −5.80]. 100% of the participants reported that they would recommend the course. Conclusion: The course was effective at improving participants’ knowledge, confidence and skills in working with CYP with ED. The participants found the course useful for their clinical practice. Ethics statement: Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A39Managing transitions from CAMHS for people with autism spectrum disorder (ASD) – interactive simulation training course

Transitions from CAMHS services to adult mental health care present a challenge to patients, carers, and professionals alike and are often managed poorly by services, leading to avoidable anxiety and adverse experiences for service users [1]. For patients with autism, transitions can be extremely distressing and require careful consideration and planning to ensure continuity of care. There is a lack of clarity for professionals and services users about what resources are available and appropriate for people with autism. This course is designed to provide professionals working in both CAMHS and adult mental health with a better understanding of autism and introduce strategies to improve the management of transitions and care of individuals with autism. Maudsley Learning, in collaboration with the ESTIA Centre, offered an online simulation training program on two occasions. The course aimed to provide participants with a clinical understanding of autism and autistic persons’ lived experiences, to equip participants with person-centred strategies to support individuals with autism, address the challenges faced by autistic individuals during child-to-adult transitions, and implement strategies to improve the care of individuals with autism who have co-morbid mental and physical illnesses. The training began with group icebreakers and a didactic introduction to simulation training to establish psychological safety followed by five scenarios covering different aspects of ASD and the challenges faced by individuals with ASD during transition. To add higher fidelity and better learning experience, we involved actors with autism and intellectual disability. The Maudsley debrief model was used to provide constructive feedback to participants on their contributions and facilitate positive learning experiences. Participants completed a questionnaire before and after the course assessing their confidence in skills related to the course. They also provided qualitative feedback on their experience and their willingness to apply their learning. Paired samples t-tests did not find a significant difference in scores for course-specific questions between pre-course (M =16.75 SD = 2.50) and post-course (M = 20.25, SD =.50), t(2.64)=3 p &gt;.0.05, 95% CI [-7.70,.70]. 100% of the participants reported that they would recommend the course. This course was co-produced and involved actors with autism and intellectual disability for better learning. The score improved slightly, but not significantly due to a small number of participants. All participants found the course helpful for their clinical practice and would recommend it. The course is best conducted in-person for optimal learning experiences. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Introduction to the Program of the Simulation Training Course on Stress Resistance and the Ability to Self-Regulate the Emotions of a Medical Specialist

The article touches upon the analysis of stress resistance and the ability to self-regulate emotions as determining factors in building effective professional communication in medical practice. The relevance of the possession of these competencies involves the introduction of thematic training into the training program, which can be most effectively implemented within the framework of a simulation course using, respectively, simulation technologies.

Online and Remote Training Experience in the Engine Room Simulator Training Courses using the IMO Model Course 2.07 Exercises

In the age of technology, changes are experienced in many areas such as globalization, information society, new basic technology, the spread of the Internet, and the realization of competition on a global scale. New methods used in education and training have been developed and kept up with technological developments. With the widespread use of the Internet, online and remote training has become more possible than ever. Technology was ready for online education and training for the past decades, yet the COVID-19 pandemic caused the traditional training to be disrupted and training institutions had to carry out studies for traditional training to be conducted online and remotely. This caused a paradigm change in the training methods. Online or remote education, even in training using the engine room simulator (ERS), has become more popular as an alternative to traditional classroom teachings, even though the pandemic is disappearing. Additionally, the progress in autonomous ships and recent regulatory studies indicates the importance of a better understanding of the engineering data in remote or autonomous ship operations. The authors have been offering Engine Room Simulator (ERS) training courses using online methods since the first semester of 2020, totaling six semesters of online training so far. This paper presents the online training process used in courses including the technological setup and method of teaching and assessment. Experiences and lessons learned by the lecturers in providing operational and management level ERS courses and feedback from students are examined and presented. The use of IMO Model Course 2017 Edition became helpful as it describes exercises for each training objective in accordance with IMO STCW 2010. An Engine Room Simulator (ERS) called Ship ERS or SERS™ was utilized as the remote training tool in the pilot implementation of these courses that were spread over two semesters. The advantages and disadvantages of online ERS training was presented and discussed. A particular and interesting observation has been that the students could have longer duration of exercise opportunities when using SERS™ in the remote training than in traditional ones.

Hand Dominance Is Not of Significance in Performing Fundamental Arthroscopic Skills Simulation Training Tasks

To compare the performance of the dominant and nondominant hand during fundamental arthroscopic simulator training. Surgical trainees who participated in a 2-day simulator training course between 2021 and 2023 were classified, according to their arthroscopic experience in beginners and competents. Only right-handed individuals with complete data sets were included in the study. Ambidexterity was trained using a box trainer (Fundamentals of Arthroscopic Surgery Training, Virtamed AG, Schlieren, Switzerland).Two tasks, periscoping for learning camera guidance and triangulation for additional instrument handling, were performed 4 times with the camera in the dominant hand and then in the nondominant hand. For each task, exercise time, camera path length, and instrument path length were recorded and analyzed. Out of 94 participants 74 right-handed individuals (22 females, 52 males) were classified to novices (n= 43, less than 10 independently performed arthroscopies) and competents (n= 31, more than 10 independently performed arthroscopies). Competents performed significantly better than novices. No significant difference was found after changing the guiding hand for the camera from the dominant to the nondominant hand regarding the camera path length and the instrument path length. Notably, tasks were performed even faster when using the camera in the nondominant hand. Our data demonstrate that the learned manual skills during basic arthroscopic training are quickly transferred to the contralateral side. In consequence, additional fundamental skills training for camera guidance and instrument handling of the nondominant hand are not necessary. For skillful arthroscopy, camera guidance and instrument handing must be equally mastered with both hands. It is important to understand how hand dominance may affect learning during arthroscopic simulator training.

Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training

IntroductionThe influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. MethodsParticipants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. ResultsForty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], p = <0.001; [137.3 (108.9) sec] versus [51.3 (37.9)], p = <0.001; and [218.5 (105.8) sec] versus [110.8 (87.1) sec], p = <0.001; respectively. These improvements were maintained following the Vital Anaesthesia Simulation Training Course, and at 3-month retention testing. Qualitative analysis highlighted five key themes: ability to initiate cardiopulmonary resuscitation; team coordination for task allocation; empowerment; desire for training and mentorship; and advocacy for system improvement. ConclusionA modified 2-day Advanced Cardiac Life Support course improved resuscitation time indicators with retention 3-months later. Combining the Vital Anaesthesia Simulation Training Course and Advanced Cardiac Life Support led to better team coordination, empowerment to act, and advocacy for system improvement. This pairing of courses has promise for improving Advanced Cardiac Life Support skills amongst healthcare workers in low-resource settings.ClinicalTrials.gov Identifier: NCT05278884.

The number of arthroscopies performed by trainees does not deduce the level of their arthroscopic proficiency.

It is reasonable to question whether the case volume is a suitable proxy for the manual competence of an arthroscopic surgeon. The aim of this study was to evaluate the correlation between the number of arthroscopies previously performed and the arthroscopic skills acquired using a standardized simulator test. A total of 97 resident and early orthopaedic surgeons who participated in arthroscopic simulator training courses were divided into five groups based on their self-reported number of arthroscopic surgeries: (1) none, (2) < 10, (3) 10 to 19, (4) 20 to 39 and (5) 40 to 100. Arthroscopic manual skills were evaluated with a simulator by means of the diagnostic arthroscopy skill score (DASS) before and after training. Seventy-five points out of 100 must be achieved to pass the test. In the pretest, only three trainees in group 5 passed the arthroscopic skill test, and all other participants failed. Group 5 (57 ± 17 points; n = 17) scored significantly higher than the other groups (group 1: 30 ± 14, n = 20; group 2: 35 ± 14, n = 24; group 3: 35 ± 18, n = 23; and group 4: 33 ± 17, n = 13). After a two-day simulator training, trainees showed a significant increase in performance. In group 5, participants scored 81 ± 17 points, which was significantly higher than the other groups (group 1: 75 ± 16; group 2: 75 ± 14; group 3: 69 ± 15; and group 4: 73 ± 13). While self-reported arthroscopic procedures were n.s. associated with higher log odds of passing the test (p = 0.423), the points scored in the pretest were found to be a good predictor of whether a trainee would pass the test (p < 0.05). A positive correlation was observed between the points scored in the pretest and the posttest (p < 0.05, r = 0.59, r2 = 0.34). The number of previously performed arthroscopies is not a reliable indicator of the skills level of orthopaedic residents. A reasonable alternative in the future would be to verify arthroscopic proficiency on the simulator by means of a score as a pass-fail examination. III.

Low-Cost Ear Procedure Simulator With Syringe andTuning Fork: Training Course andResults.

Medical simulation is a continuously expanding field. In surgical specialties, in particular, simulation can provide an alternative avenue for learning. The objective of this process improvement project was to evaluate the effectiveness and practicality of adding simulation-based training to our educational curriculum regarding common otologic procedures. A low-cost, novel ear procedure simulator was designed and constructed from readily available clinic supplies. Participants were asked to fill out a pre-simulator survey to assess their own comfort and skill level before undergoing the simulation course. A pre-simulation PowerPoint training course was then administered to participants. The participants then underwent the simulation training course and were again asked to fill out a post-simulator training exercise survey to reassess their own comfort and skill level. Institutional review board approval was not required by Tripler Army Medical Center. A total of 15 participants consisting of junior residents in otolaryngology, third- and fourth-year medical students rotating on an otolaryngology clinical clerkship, and one physician assistant in otolaryngology were included in the study. There was a significant improvement in both provider comfort with the procedure and clinical performance of the procedure among participants after training on the simulation-based model. Simulation-based training provides a safe, effective, and cost-friendly alternative to clinical medical education. Future studies are needed to address the wide-scale applicability of these results to other forms of surgical training.

Ultrasound simulation training to meet the 2021 Royal College of Radiologists' curriculum for radiology trainees: South East London experience

To enhance ultrasound teaching delivery to radiology trainees using a simulation course matched to the 2021 Royal College of Radiologists (RCR) curriculum. An ultrasound simulation training course was designed for specialty trainees (ST) 1 in radiology, which was based on the 2021 RCR curriculum and covered the top ultrasound training priorities. The course was piloted initially on two occasions in a 1-day format to the August 2021 and the March 2022 ST1 intake trainees. Based on the feedback, a comprehensive 4-day course was developed and delivered between October and December 2022 for the August 2022 ST1 intake, funded by Health Education England. The outcomes measured were subjective trainee feedback using numerical scores and free text. All King's College Hospital NHS Foundation Trust radiology ST1 trainees from the August 2021 to the August 2022 intake participated in ultrasound simulation training. The training matched the RCR curriculum and increased the trainees' confidence and competency in medical ultrasound. Ultrasound simulation training can be successfully delivered to ST1 trainees to match the 2021 RCR curriculum and enhance training in medical ultrasound for radiologists.