Emergency Training Research Articles

EFFECTS OF OCCUPATIONAL SAFETY PRACTICE AND SUPERVISORY ENFORCEMENT ON THE SAFETY REPORTING: EXPLORATORY FACTOR ANALYSIS

This paper analyses the construct validity and reliability of a new developed questionnaire measuring the effects of the occupational safety practice and supervisory enforcement on the safety and health reporting among the oil palm labours. The exploratory factor analysis (EFA) was conducted to determine the underlying dimensions between variables and refine the proposed theory. The EFA was performed using the statistical analysis software SPSS. The questionnaire for all constructs was designed by adopting and customizing questionnaires from previous studies and reviewed by the language, content and statistical experts before it was administered on 100 oil palm Federal Land Development Authority (FELDA) labours. All of the variables passed the Bartlett’s Test of Sphericity (p-value < 0.05) and the measure of sampling adequacy using Kaiser-Meyer-Olkin (KMO > 0.60). The Cronbach’s Alpha value for the occupational safety practices for Organizational Safety Support (OSS), Safety Knowledge and Emergency Trainings (SKET), Compliance to Safety and Health Regulations (CSHR), and the Safety Procedures and Risk Management (SPRM) components were 0.957, 0.957, 0.940 and 0.936 respectively. The Cronbach’s Alpha for the supervisory enforcement construct was 0.930, while the value for safety reporting was 0.976 for component 1 and 0.936 for component 2. The validity and reliability of the questionnaires to assess the effect of occupational safety practice and the supervisory enforcement on the safety and health reporting among the Malaysian oil palm labours is confirmed.

Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees' performance.

Simulation-based obstetric team training focuses on building a system that will anticipate errors, improve patient outcomes and the performance of clinical care teams. Simulation-based obstetric team training has been proposed as a tool to improve the overall outcome of obstetric health care. To assess the effects of simulation-based obstetric team training on patient outcomes, performance of obstetric care teams in practice and educational settings, and trainees' experience. The Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) were searched (14 April 2020), together with references checking and hand searching the available proceedings of 2 international conferences. We included randomised controlled trials (RCTs) (including cluster-randomised trials) comparing simulation-based obstetric team training with no, or other type of training. We used standard methodological procedures expected by Cochrane, to identify articles, assess methodological quality and extract data. Data from three cluster-randomised trials could be used to perform generic inverse variance meta-analyses. The meta-analyses were based on risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). We used the GRADE approach to rate the certainty of the evidence. We used Kirkpatrick's model of training evaluation to categorise the outcomes of interest; we chose Level 3 (behavioural change) and Level 4 (patient outcome) to categorise the primary outcomes. We included eight RCTs, six of which were cluster-randomised trials, involving more than 1000 training participants and more than 200,000 pregnancies/births. Four studies reported on outcome measures on Kirkpatrick level 4 (patient outcome), three studies on Kirkpatrick level 3 (performance in practice), two studies on Kitkpatrick level 2 (performance in educational settings), and none on Kirkpatrick level 1 (trainees' experience). The included studies were from Mexico, the Netherlands, the UK and the USA, all middle- and high-income countries. Kirkpatrick level 4 (patient outcome) Simulation-based obstetric team training may make little or no difference for composite outcomes of maternal and/or perinatal adverse events compared with no training (3 studies; n = 28,731, low-certainty evidence, data not pooled due to different composite outcome definitions). We are uncertain whether simulation-based obstetric team training affects maternal mortality compared with no training (2 studies; 79,246 women; very low-certainty evidence). However, it may reduce neonatal mortality (RR 0.70, 95% CI 0.48 to 1.01; 2 studies, 79,246 pregnancies/births, low-certainty evidence). Simulation-based obstetric team training may have little to no effect on low Apgar score compared with no training (RR 0.99, 95% 0.85 to 1.15; 2 studies; 115,171 infants; low-certainty evidence), but it probably reduces trauma after shoulder dystocia (RR 0.50, 95% CI 0.25 to 0.99; 1 study; moderate-certainty evidence) and probably slightly reduces the number of caesarean deliveries (RR 0.79, 95% CI 0.67 to 0.93; 1 study; n = 50,589; moderate-certainty evidence) Kirkpatrick level 3 (performance in practice) We found that simulation-based obstetric team training probably improves the performance of the obstetric teams in practice, compared with no training (3 studies; 2398 obstetric staff members, moderate-certainty evidence, data not pooled due to different outcome definitions). Simulation-based obstetric team training may help to improve team performance of obstetric teams, and it might contribute to improvement of specific maternal and perinatal outcomes, compared with no training. However, high-certainty evidence is lacking due to serious risk of bias and imprecision, and the effect cannot be generalised for all outcomes. Future studies investigating simulation-based obstetric team training compared to training courses with a different instructional design should carefully consider how and when to measure outcomes. Particular attention should be paid to effect measurement at the level of patient outcome, taking into consideration the low incidence of adverse maternal and perinatal events.

PELATIHAN KEGAWAT DARURATAN PADA PETUGAS SATUAN PELAYANAN REHABILITASI SOSIAL LANJUT USIA (SPRSLU) KABUPATEN GARUT

First aid is very important as a prevention effort so that something worse doesn't happen. This first aid action in an emergency can be in the form of basic life support (BLS) which consists of several simple techniques that aim to maintain a person's life. The purpose of this training is to increase the knowledge and skills of officers to maintain the lives of the elderly. The method used is the workshop/training method in accordance with the problems faced by the elderly social rehabilitation service unit officers, namely they have not mastered the emergency guidelines correctly. The results obtained from this training are the knowledge of officers before receiving emergency training with a less category of 2 (two) people or 10%, enough for 12 people or 12% and knowledge of officers with good categories of 6 people or 30%. The conclusion of this training is that it is able to increase the knowledge of the Elderly Social Rehabilitation Service Unit officers on the concept of emergency victim assistance, able to improve the skills of youth youth groups in providing basic life support and emergency assistance and able to increase the mental readiness of participants in providing emergency assistance.

Gender Representation in Medical Emergency Training Videos. Perpetuating Bias.

Gender Representation in Medical Emergency Training Videos. Perpetuating Bias.

AN ANALYSIS OF CONTRIBUTING FACTORS IN NURSES’ ACCURACY WHILE CONDUCTING TRIAGE IN EMERGENCY ROOM

Triage is aimed to arrange treatment priority to patients with different levels of urgency.These nurses who are responsible for triage must conduct standardized procedure. Hence,these nurse must acquire certain competency required to conduct triage. The competencyincludes basic knowledge, skills and attitude. Besides that, there are several contributingfactors playing significant role in triage procedure implementation, which is intrinsicfactors. Regarding to those factors, this study aimed to analyze those contributing factorsaffecting nurses’ accuracy in doing triage procedure in emergency room. This studyemployed correlational analytic design accompanied with cross sectional approach. Thepopulation in this study was all nurses who worked actively in the Emergency Room atRSUD in Malang Regency and Blitar City and thirty two respondents are taken as thesamples using population total method. The data is collected using observation sheetand questionnaire. The data analyzed through Partial Least Squares (PLS). It is showedthat knowledge level (p-value 0.000), skill level (p-value 0.000), attitude (p-value 0.000),intrinsic factors (p-value 0.000) are related to nurses’ accuracy in implementing triageprocedure. Therefore, based on those findings, the hospital’s management is suggested toimprove their nurses’ competency in implementing triage, especially by recommendingthem to participate in advanced emergency training and triage course.

Instructional mechanisms in immersive virtual reality serious games: Earthquake emergency training for children

AbstractChildren are vulnerable in earthquakes, but they are also essential to foster earthquake‐resilient communities. It is critical to enhance the preparedness of children against earthquakes through effective education and training. Immersive virtual reality (IVR) and serious games (SGs) are innovative digital technologies that enable realistic and engaging training environments. However, little research has been made on the applications of IVR SGs for earthquake training targeting children. In order to fill this gap, this paper presents an IVR SG training system based on a problem‐based gaming framework. Three instructional mechanisms within the training system, namely prior instruction, immediate feedback, and post‐game assessment, were investigated to promote learning through effective reflection. A controlled experiment involving 125 secondary school students aged from 11 to 15 years old was undertaken, using leaflets as a traditional training approach for the control group and the IVR SG training system as the main intervention. Results revealed that the IVR SG training system with post‐game assessment was the most effective way to train children, with greater knowledge acquisition and self‐efficacy improvement observed. Possible improvements, such as increasing the time for reflection and differentiating the stimulation between positive and negative feedback, are suggested for further research.

A Telesimulation Elective to Provide Medical Students With Pediatric Patient Care Experiences During the COVID Pandemic.

Objectives/IntroductionThe Association of American Medical Colleges suggested that medical students not be involved in direct patient care activities in the United States because of the COVID pandemic. Our objectives are to (1) describe the rapid creation and implementation of a fully online simulation-based pediatric emergency medicine training intervention for medical student learners using existing simulation center staff (faculty, technicians, actors) and resources (simulation technology, scenario files) and (2) report student and faculty feedback on the intervention.MethodsThe sessions involved the use of our existing simulation center faculty, staff, and resources. Feedbacks on the sessions were collected via a survey from faculty and students at the end of each session.ResultsSixteen simulation sessions were conducted (8 febrile infant, 8 anaphylactic toddler). Forty-eight students, 2 technicians, 2 actors, and 10 faculty participated. Ninety percent of the students agreed with the statements, “I am more comfortable with pediatrics after this session,” “participating improved my pediatric knowledge/skills,” “this session was more useful than other learning activities I am involved in at this time.” Seventy percent of the students agreed with the statement, “I learned as much from observing as when I was actively involved.” All faculty agreed with the statement, “this was an effective educational strategy compared to other distance learning.” Most faculty (60%) disagreed with the statement, “virtual simulation was equal to or superior to in-person simulation.” All students and faculty strongly agreed with the statement, “I would highly recommend this to others.”ConclusionsA telesimulation intervention involving all medical students, staff, and facilitators interacting remotely for pediatric emergency training during COVID was associated with high levels of satisfaction by the majority of learners and faculty.

Determinants of Nursing Campuses’ Readiness to Use a Computerised Training Tool

The Integrated Management of Childhood Illness Computerised Adaptation and Training Tool (ICATT) is an emergent training tool for improving the efficiency of the Integrated Management of Childhood Illness (IMCI) case management training in an in-service or pre-service context. This article reports on a study that explored nursing campuses’ readiness to use ICATT. A qualitative, exploratory, descriptive design was employed at 10 nursing campuses in KwaZulu-Natal (KZN), South Africa. Campus principals, nurse educators and learners were purposively sampled. The inclusion criteria were: for the campus principals – their willingness to participate; for the nurse educators – having received and facilitated IMCI case management training; and for the learners – being either second or third year trainees in the R425 training programme. In-depth semi-structured interviews were conducted to collect data from the seven campus principals, while eight focus group discussions (FGDs) were held with the nurse educators and learners. The interviews were audio-taped and transcribed verbatim. Data analysis was conducted manually, and trustworthiness was ensured. The determinants identified were: a positive attitude; enablers for ICATT implementation; and barriers to ICATT implementation. However, the barriers could have an impact on the adoption of an electronic tool for IMCI case management training. Recommendations include developing the infrastructure at nursing campuses; offering nurse educators training on the implementation of ICATT for teaching; and developing the learners’ computer skills. Nurse educators may use ICATT effectively in teaching IMCI case management, while also stimulating independent learning and creativity for the learners involved.

Developing a scenario-based video game generation framework for computer and virtual reality environments: a comparative usability study

Serious games—games that have additional purposes rather than only entertainment—aim to educate people, solve, and plan several real-life tasks and circumstances in an interactive, efficient, and user-friendly way. Emergency training and planning provide structured curricula, rule-based action items, and interdisciplinary collaborative entities to imitate and teach real-life tasks. This rule-based structure enables the curricula to be transferred into other systematic learning platforms. Although emergency training includes these highly structured and repetitive action responses, a general framework to map the training scenarios’ actions, roles, and collaborative structures to serious games’ game mechanics and game dialogues, is still not available. To address this issue, in this study, a scenario-based game generator, which maps domain-oriented tasks to game rules and game mechanics, was developed. Also, two serious games (i.e., Hospital game and BioGarden game) addressing the training mechanisms of Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNe) domain, were developed by both the game developers and the scenario-based game generator for comparative analysis. Finally, the outcomes of these games were mapped to the virtual reality environment to provide a thorough training program. To test the usability, immersion, presence, and technology acceptance aspects of the proposed game generator’s outcomes, 15 game developer participants tested a complete set of games and answered the questionnaires of the corresponding phenomenon. The results show that although the game generator has higher CPU time and memory usage, it highly outperforms the game development pipeline performance of the game developers and provides usable and immersive games. Thus, this study provides a promising game generator which bridges the CBRNe practitioners and game developers to transform real-life training scenarios into video games efficiently and quickly.

Application of the World Health Organization's Basic Emergency Care course in Zambia.

BackgroundIn 2013, the Zambian Ministry of Health identified action priorities for strengthening their emergency care system; one of these priorities was emergency care training for healthcare providers. To rapidly train the existing cadre of frontline providers, trainings were implemented in multiple provinces using the World Health Organization's Basic Emergency Care (BEC) course. The BEC course is open-access and emphasizes a practical syndrome-based approach to critical emergency conditions. This paper describes the first reported larger scale educational intervention of the BEC course in 7 provinces of Zambia.MethodsCourse delivery occurred at seven Zambian hospitals selected by the Ministry of Health over a 1 year period. Participant emergency care knowledge was assessed pre- and post-course with a 25-question multiple choice exam. Participant confidence levels related to emergency care provision and emergency care skills were assessed pre- and post-course using a Likert scale survey.ResultsOverall, 210 participants were trained at 7 sites. Participants demonstrated significant improvements in their multiple-choice exam scores; the overall pre-course mean was 61.47, and the post-course mean was 79.87 (p < 0.0001). Self-reported confidence in the care of ill and injured adults and children increased after taking the course, and participants generally agreed that the BEC course was highly valuable and applicable to local needs.ConclusionImplementation of the WHO's BEC course at seven hospitals throughout Zambia led to improvement in the participants' emergency care knowledge and confidence levels at all sites. The BEC course has the potential to be implemented in a nationwide initiative but would require allocation of significant human and physical resources. Additional work evaluating patient outcomes and long-term participant educational outcomes is needed.

Paramedicine and mental health: a qualitative analysis of limitations to education and practice in Ontario

Purpose Paramedics increasingly attend to mental health-related emergencies; however, there has been little evaluation of the mental health training for paramedics. This study aims to analyze the fit between paramedicine pedagogy, patient needs and the conditions for paramedics’ skill development. Design/methodology/approach Data were collected in a single, qualitative, critical ethnographic case study of pre-hospital mental health and psychosocial care in paramedicine in Ontario, Canada. Transcripts from interviews (n = 46), observation (n ∼ 90h) and document analysis were thematically analyzed using a constant comparative method. The study is theoretically grounded in a feminist political economy framework. Findings Tensions are explored in relation to the pedagogy of paramedicine and the conditions of work faced by paramedics. The paper presents challenges and insufficiencies with existing training, the ways in which certain work and training are valued and prioritized, increased emergency care and training needs and the limitations of training to improving care. Research limitations/implications Recommendations include more comprehensive didactic training, including the social determinants of health; scenario training; practicum placements in mental health or social services; collaboration with mental health and social services to further develop relevant curriculum and potential inclusion of service users. Originality/value This paper addresses the lack of mental health pedagogy in Ontario and internationally and the need for further training pre-certification and while in the workforce. It presents promising practices to ameliorate mental health training and education for paramedics.

Correlation of medical students' situational motivation and performance of non-technical skills during simulation-based emergency training

BackgroundNon-technical skills (NTS) are an indispensable element of emergency care and need to be prevalent alongside with good technical skills. Though, questions of how to teach (instructional design) and improve NTS effectively remain unresolved. One adjustment screw to enhance performance of NTS, which is detached from instructional designs and learning efforts might be motivation. Theoretical models and observational studies suggest that high levels of intrinsic (situational) motivation result in better performance and better learning. Therefore, this study analyzed the influence of motivation on performance of NTS, by exploring if high levels of intrinsic motivation lead to better performance of NTS in medical students.MethodsIn this prospective cross-sectional cohort study, the authors assessed the correlation of situational motivation and performance of NTS within a cohort of 449 undergraduates in their 1st to 4th year of medical studies, in a total of 101 emergency simulation trainings. Situational motivation was measured with the validated Situational Motivation Scale (SIMS), which was completed by every undergraduate directly before each simulation training. The NTS were evaluated with the Anesthesiology Students´ Non-Technical skills (AS-NTS) rating tool, a validated taxonomy, especially developed to rate NTS of undergraduates.ResultsStudent situational motivation was weakly correlated with their performance of NTS in simulation-based emergency trainings.ConclusionAlthough motivation has been emphasized as a determining factor, enhancing performance in different fields and in medicine in particular, in our study, student situational motivation was independent from their performance of NTS in simulation-based emergency trainings (SBET).

175TF Design and Integration of an Emergency Medicine Focused Interpersonal Skills Simulation Curriculum

Simulation is one of the most powerful tools for emergency medicine (EM) resident education and training. Standardized patients (SPs) are frequently used to help further create the near-realistic environment, adding to the experiential learning for trainees. Simulation with SPs have also been shown to be an excellent tool, both well-established and well-studied for teaching and evaluating communication skills, an ACGME core competency. To improve training in communication and interpersonal skills, we have created a simulation curriculum with an EM focus, utilizing SPs and cases that go beyond medical management. Upon completion of the Interpersonal Skills Simulation Curriculum participants will: 1) recognize the importance and relevance of having communication skills for all patient and family encounters, 2) demonstrate excellent communication skills and apply learned strategies in all patient care scenarios, and 3) express greater confidence and comfort in challenging patient encounters. The curriculum spans over 4 years. At the start of each academic year, each residency class will have 2 designated cases for each resident to run. Prior to the simulations, residents will fill out pre-evaluations on confidence and comfort levels. Post-evaluations will be done by the SP and an observing attending with immediate feedback given during debrief. Following each debrief, the residents will run through a mirror case to allow for incorporation of feedback received and learned strategies. For example, a pediatric blunt traumatic code requiring the delivery of bad news to highly emotional parents would be mirrored by a case of Sudden Infant Death Syndrome requiring similar delivery of bad news. There would be a graded experience of cases each year, concordant with training level, with cases ranging from delivering bad news, to managing difficult consultants, withholding confidential pediatric patient history from demanding parents, and caring for the transsex patient. Excellent communication skills are absolutely necessary for physicians. Despite the need, a 2018 CORD survey found that EM residents are uncomfortable in several communication scenarios and that training is lacking. At our institution, a survey of graduating residents demonstrated that they felt there was not enough formal education in regards to communication skills, especially in the setting of challenging patient encounters. They also felt particularly less confident in managing difficult pediatric scenarios. This curriculum was piloted amongst a focus group of chief residents and simulation faculty in coordination with our institutional simulation center to assure feasibility of this longitudinal curriculum and will begin over the upcoming years. To our knowledge, no other EM-based, longitudinal simulation curriculum with a focus on interpersonal skills and communication exists. Training in communication is essential and overall appears to be lacking in many EM residencies, including our own institution. After completion of our longitudinal simulation curriculum, residents will be able to display excellent communication skills and feel more confident and comfortable with the variety of challenging patient care scenarios that we face in EM.

Emergency evacuation model assuming leakage of toxic substances in a chemical plant

Preparedness of emergency evacuation for the leakage of toxic substances in chemical plants is very important in order to reduce damage. In order to implement an emergency evacuation properly, it is necessary to comprehensively and concretely determine the conditions of the leakage and atmospheric conditions and predict the consequences of the dispersed gases. Repeated training for emergencies is also essential. In order to realize effective evacuation, a prediction model of the evacuation area that anyone can use to obtain the same results both accurately and promptly is developed in the present study. The prediction model is designed such that the wind speed and atmospheric conditions are automatically set, and the leakage rate is the only input parameter, so that anyone can use the model easily. In addition, the model can also predict the atmospheric parameters for up to 3 h and can calculate the evacuation distance so that smooth evacuation can be achieved for changing atmospheric conditions. Finally, the evacuation area is defined by statistically analysed wind fluctuations, and a series of emergency evacuation measures is implemented.

Investigation of protective exposure risk events in nurses against corona virus disease 2019 in Wuhan

Objective To investigate the current situation of virus exposure risk incidents of nurses against corona virus disease 2019 (COVID-19) in Wuhan, and to provide reference evidence for nursing managers to protect nursing staff who were working in the isolation ward. Methods In the study, 308 nursing staff against COVID-19 working in the isolation ward in Wuhan were conveniently selected to participate in the investigation. The designed questionnaires including 7 kinds of protective exposure risk events were made by the team of researchers on the basis of literature review and interview with the nurses in Wuhan. All the participants recalled their working experience in the status of dressing in personal protective equipment and filled in the questionnaires online by WeChat according to the same instruction. Results The questionnaires were filled in validly by a total of 304 nursing staff, of whom 88.8% received emergency training on the prevention and dealing measurement of exposure risk events. The incidence of shoe cover contamination, falling off or torn was relatively high, about 53.6%. Due to the protection of gloves, the incidence of hand or skin contamination was relatively low, about 14.1%. The most nervousness of protective exposure risk event for nurses was N95 mask contamination, falling off or shifting, with a score of 8.2±2.3, showing a higher psychiatric burden. Single factor analysis found that the number of days in Wuhan was different, the number of the types of protective risk events occurred was different (χ2=14.562, P=0.024), orderly multivariate Logistic regression found that men were the independent protective factor for the number of the types of protective exposure risk events that occurred (P=0.019). Conclusion Protective exposure risk events may occur in the work of nursing staff working in the isolation ward in Wuhan. It is necessary to guide nurses to prevent the occurrence of protective exposure risk events and effectively deal with them, so as to prevent virus exposure and reduce psycholo-gical burden.

Experiences of clinical first-line nurses treating patients with COVID-19: A qualitative study.

AimTo explore the work experience of clinical first‐line nurses treating patients with coronavirus disease 2019 (COVID‐19).BackgroundCOVID‐19 has been listed as an international public health emergency. Clinical first‐line nurses are at a high risk of infection, and they face a lack of experience and inadequate preparation for COVID‐19, leading to physical and psychological disorders.MethodsA qualitative study was conducted from January to February 2020 at a COVID‐19‐designated hospital in Wuhan, China. Thirty nurses were selected for the study using a purposive sampling method. Data were collected by semi‐structured interviews and analysed using content analysis.ResultsTwo main categories were defined in the study from the perspective of nurses: negative experiences during clinical first‐line work and positive impacts of clinical first‐line work. Under the first category, two subcategories were included: psychological experiences of clinical first‐line work and difficulties faced during clinical first‐line work. The analysis further yielded two subcategories for the second category: the needs of clinical first‐line work and the impact of clinical first‐line work on professional attitudes.ConclusionsThe results demonstrate that success depends upon strengthening emergency training and knowledge of infectious diseases for nurses, providing adequate protective equipment and improving the emergency response plans of hospitals for public health emergencies.Implications for Nursing ManagementIt is believed that our findings will guide hospital managers to make improvements in personal, administrative and institutional areas and that they will provide a reference and inspiration for nurses with regard to public health emergencies in the future.

The impact of supply-side and demand-side interventions on use of antenatal and maternal services in western Kenya: a qualitative study

BackgroundAntenatal care (ANC) and delivery by skilled providers have been well recognized as effective strategies to prevent maternal and neonatal mortality. ANC and delivery services at health facilities, however, have been underutilized in Kenya. One potential strategy to increase the demand for ANC services is to provide health interventions as incentives for pregnant women. In 2013, an integrated ANC program was implemented in western Kenya to promote ANC visits by addressing both supply- and demand-side factors. Supply-side interventions included nurse training and supplies for obstetric emergencies and neonatal resuscitation. Demand-side interventions included SMS text messages with appointment reminders and educational contents, group education sessions, and vouchers to purchase health products.MethodsTo explore pregnant mothers’ experiences with the intervention, ANC visits, and delivery, we conducted focus group discussions (FGDs) at pre- and post-intervention. A total of 19 FGDs were held with pregnant mothers, nurses, and community health workers (CHWs) during the two assessment periods. We performed thematic analyses to highlight study participants’ perceptions and experiences.ResultsFGD data revealed that pregnant women perceived the risks of home-based delivery, recognized the benefits of facility-based delivery, and were motivated by the incentives to seek care despite barriers to care that included poverty, lack of transport, and poor treatment by nurses. Nurses also perceived the value of incentives to attract women to care but described obstacles to providing health care such as overwork, low pay, inadequate supplies and equipment, and insufficient staff. CHWs identified the utility and limitations of text messages for health education.ConclusionsFuture interventions should ensure that adequate workforce, training, and supplies are in place to respond to increased demand for maternal and child health services stimulated by incentive programs.

Describing the effect of a first aid training program on the first aid knowledge and attitudes of female secondary school students in Jeddah – Saudi Arabia

Objectives: to explore the effect of a first aid training program on knowledge and practice of female secondary school students in Jeddah- Saudi Arabia. Sample the study was applied at one Secondary female School in Jeddah and the data were collected from 100 Saudi female students who attended the first aid training programmed. Method: to achieve the target of this article,the researcher applied pre-post quasi-experimental approach. Data entry and statistical analysis was done using SPSS 20.0 statistical software package. Data were presented using descriptive statistics in the form of frequencies and percentages for quantitative variables and means and standard deviations for variables. Findings: The study shows that First-aid training is essential to develop female secondary school with first aid skills and to extend their input to health emergency situations. On the other hand, students should have sufficient practice and knowledge in first aid to be able to manage injuries and illness that commonly take place at the school sitting. Novelty: By Introducing, acquainting and sustaining the lifesaving skills and first aid practices among female students increase the students’ confidence in responding to any contingency. Conclusions: It is agreed that nurses at schools could play a key role in the provision of lifesaving skills and basic emergency training for the students; this might be very important addition for investigating the effectiveness of future health education programs at females Saudi schools. Keywords: first aid; female secondary school; Saudi Arabia

Research on the individualized short-term training model of nurses in emergency isolation wards during the outbreak of COVID-19.

AimTo explore an effective personalized training model for nurses working in emergency isolation wards of COVID‐19 in a short period.DesignThis study is a longitudinal study from 24 January 2020 to 28 February 2020.MethodsThere are 71 nursing staff working in the emergency isolation wards of Sichuan Provincial People's Hospital that participated in this study. The questionnaires were conducted with Likert scale. The operation assessment teachers have received standardized training. The self‐rating anxiety scale (SAS) and self‐rating depression Scale (SDS) were applied to assess the mental state of nurses.ResultsAfter short‐term training, these nurses can handle the emergency tasks in a timely manner. The pass rate of nurse theory and operation assessment is 100%. The 111 suspected patients admitted to the emergency isolation ward have been scientifically diagnosed and treated, the three confirmed patients have received appropriate treatment. No nurses have been infected.ConclusionsIn this study, the personalized emergency training mode was feasible in the emergency isolation ward during the COVID‐19 epidemic, which rapidly improved the rescue ability of nurses and effectively avoid the occurrence of cross‐infection. This mode can provide a valuable reference for the emergency training of nurses in the future.

An Immersive Multi-User Virtual Reality for Emergency Simulation Training: Usability Study.

BackgroundVirtual reality (VR) is increasingly used as simulation technology in emergency medicine education and training, in particular for training nontechnical skills. Experimental studies comparing teaching and learning in VR with traditional training media often demonstrate the equivalence or even superiority regarding particular variables of learning or training effectiveness.ObjectiveIn the EPICSAVE (Enhanced Paramedic Vocational Training with Serious Games and Virtual Environments) project, a highly immersive room-scaled multi-user 3-dimensional VR simulation environment was developed. In this feasibility study, we wanted to gain initial insights into the training effectiveness and media use factors influencing learning and training in VR.MethodsThe virtual emergency scenario was anaphylaxis grade III with shock, swelling of the upper and lower respiratory tract, as well as skin symptoms in a 5-year-old girl (virtual patient) visiting an indoor family amusement park with her grandfather (virtual agent). A cross-sectional, one-group pretest and posttest design was used to evaluate the training effectiveness and quality of the training execution. The sample included 18 active emergency physicians.ResultsThe 18 participants rated the VR simulation training positive in terms of training effectiveness and quality of the training execution. A strong, significant correlation (r=.53, P=.01) between experiencing presence and assessing training effectiveness was observed. Perceived limitations in usability and a relatively high extraneous cognitive load reduced this positive effect.ConclusionsThe training within the virtual simulation environment was rated as an effective educational approach. Specific media use factors appear to modulate training effectiveness (ie, improvement through “experience of presence” or reduction through perceived limitations in usability). These factors should be specific targets in the further development of this VR simulation training.