Use Of Medical Simulation Research Articles

Exploring academic teachers perspectives regarding the impact of using medical simulation in dentistry pre- and post-COVID-19 pandemic: a qualitative study

BackgroundMedical simulation allows for the achievement of many educational goals and the continued education of some practical skills. The COVID-19 pandemic’s restrictions have led to a major increase in dental education simulations. The aim of this study was to analyse the perspectives of academic teachers towards dental simulation, their concerns and evaluation of this teaching method, as well as their opinion on the use of medical simulation during the COVID-19 pandemic.MethodA focus study was conducted in a group of 5 academic teachers, comprising 10% of academic teachers of a Dental Faculty using simulation techniques. Prior to and during the COVID-19 pandemic, the interviewed teachers had expertise with medical simulation in dentistry education methods. A facilitator used pre-planned, open-ended questions about the use of simulation in dentistry also with regard to the COVID-19 pandemic period. The group discussion has been managed, monitored, and recorded. The data analysis model was based on Braun and Clarke’s six phases of thematic analysis. Five thematic domains/fields were evaluated: (1) Simulation as a didactic method; (2) Simulation during COVID-19 pandemic; (3) General observations and expectations with regard to simulation; (4) Teachers in simulation; (5) Concerns in relation to simulation. Two researchers analysed the data.ResultsBased on interviewed teachers’ perspective the simulation allows students to learn basic and complex skills providing the repeatability of the procedures performed. During Covid-19 the simulation methods undoubtedly filled the gap in the training of future dentists. However, interviewed teachers pointed out the high cost of the methods dictated by the need to prepare the simulation environment at a high level, in order to reflect the real clinical situation.ConclusionsThe use of simulation methods requires adequate preparation of academic teachers, continuous education and updating of knowledge in the field of medical simulation. The COVID-19 pandemic significantly influenced the growth of dental education simulation techniques as well as staff knowledge of the usage of medical simulation.

A manikin or human simulator-development of a tool for measuring students' perception.

Education with the use of medical simulation may involve the use of two modalities: manikins or standardized patients (SPs) to meet specific learning objectives. We have collected students' opinions about the two modalities which can be helpful in planning and evaluating the curriculum process. Although reviews or comparisons of student opinions appear in the literature, it is difficult to find a scale that would be based on a comparison of specific effects that can be obtained in the educational process. In order to fill this gap, an attempt was made to construct a questionnaire. An experimental version of a questionnaire measuring the final-year students' (273) opinions about the effectiveness of both simulation techniques has been designed on the basis of semi-structured interviews. They were conducted with 14 final-year students excluded from the subsequently analyzed cohort. The scale has been completed, tested and validated. The authors developed a 33-statement questionnaire which contain two scales: teaching medicine with the manikins and with the SPs. Two factors were identified for each scale: Doctor-patient relationship and practical aspects. The scales can be used complementary or separately, as the article reports independent statistics for each scale. The Cronbach's alpha coefficient for the manikin scale is 0.721 and for the SP scale is 0.758. The questionnaire may be applied to medical students to identify their opinions about using manikins and SPs in teaching. It may have an important impact for planning curriculum and implementing particular modalities in accordance with the intended learning objectives.

Medical simulation as an educational tool in the opinion of nursing students

Abstract Introduction. Nursing education combined with medical simulation is currently a modern method of education, which, especially in the era of the SARS-COV-2 pandemic, is an essential form of preparing the student for professional tasks. Aim. The aim of the study was to find out the opinions of nursing students about the classes conducted in the Medical Simulation Center. Material and methods. A total of 186 undergraduate nursing students participated in the survey. It was conducted via the Internet. We used the method of diagnostic survey; surveying technique and the tool was the original questionnaire. The study was anonymous and voluntary and was conducted from February to May 2021. It is assumed that any relationship is statistically significant when p≤0.05. Results and conclusions. According to the respondents, medical simulation prepares to acquire practical skills, also consolidates theoretical knowledge, prepares to broaden social competence. For nursing students, its disadvantage is the lack of contact with the patient. Education realized with the use of medical simulation is an effective method of learning. Nursing students prefer to take classes in high fidelity rooms and with standardized patients because they are most similar to real life conditions.

Making Healthcare Safe: The Story of the Patient Safety Movement

Making Healthcare Safe: The Story of the Patient Safety Movement

Orientation of Healthcare Educators Towards Using an Effective Medical Simulation-Based Learning: A Q-Methodology Study.

PurposeThis study explores the healthcare educators’ orientations about medical simulation in clinical skills training —its benefits, needs, challenges, and implications for proper implementation and integration into curricula.MethodsThe study used a Q-sort technique, allowing quantitative and qualitative representation of the participants’ orientations and was conducted at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A total of 22 healthcare educators from different roles were included. Participants pre-sorted into three categories and then ranked statements related to medical simulation, by level of agreement, and they answered open-ended and demographic questions. Data was uploaded to Ken-Q Analysis application to conduct Q-factor analysis.ResultsA total of 22 healthcare educators participated in the study. Q-factor analysis was performed with principal component analysis and varimax rotation, identifying three factors. Most educators shared a similar orientation regarding the benefits of using simulation-based learning. Most participants considered medical simulation a simple, effortless, and beneficial method of learning. However, challenges in scheduling sessions and obtaining the necessary resources, such as human resources and funds, and lack of training had a negative impact on some participants’ motivation to use medical simulation.ConclusionHealthcare educators shed light on the influence of multiple factors on using medical simulation. The possibility for students to learn practical and clinical skills was a leading factor. Financial resources, funds, and faculty training were identified as challenges and needs. It is important for institutions and leaders to be aware of the variations in faculty perceptions and to provide resources and training to improve the current use of medical simulation.

Practical aspects of the use of medical simulation in the teaching of medical and communication skills

Practical aspects of the use of medical simulation in the teaching of medical and communication skills

Use of medical simulation for cancer education in Nigeria.

11011Background: Among the many limitations of cancer control in Nigeria are lower awareness/competence and poorer training of healthcare professionals (HCP). These manifest as deficiencies in advo...

Use of Live-Stream and Pre-recorded Simulation in the Individual Readiness Assessment Test During TBL, a Novel Approach

At the Alabama College of Osteopathic Medicine (ACOM), the use of medical simulation helps to teach basic pharmacology in a manner that can more easily integrate with clinical sciences. Our novel use of simulation involved using both pre-recorded and live streaming simulated scenes in a clinical vignette format during the independent readiness assurance test (iRAT) of team-based learning (TBL). The incorporation of simulation helped bridge basic science and clinical sciences in a manner that had basic and clinical faculty work together, leading to positive student feedback. Our results indicate that more students were satisfied than dissatisfied with this method and more agreed that this was a valuable use of their time. This paper describes our experience in developing these simulated cases and student satisfaction data on this method.

The Use of Medical Simulation in Cupping Therapy Training: A Novel Idea from the National Center for Complementary and Alternative Medicine

The Use of Medical Simulation in Cupping Therapy Training: A Novel Idea from the National Center for Complementary and Alternative Medicine

State-of-the-art usage of simulation in anesthesia: skills and teamwork.

This review describes the level of evidence for the use of medical simulation in anesthesia. It also discusses the topic of realism in simulation and its use for assessment. Medical simulation in anesthesia covers a variety of techniques used for training and assessment. The current level of evidence for the use of medical simulation strongly supports a shift from learning on patients to learning on simulators. Skill and multidisciplinary team training are effective modalities and improve (team) performance and patient outcome.Well defined learning objectives, not a high level of realism should be the main focus of a simulation activity. Simulation centers should focus on faculty development as emphasis on simulation facilities and simulator fidelity alone does not guarantee effective training.Formative and summative assessment can help identify the omissions in knowledge, skills, and the ability to work in a team for both residents and anesthesiologists. Not only does it help to obtain competence, it also helps to maintain it. Simulation for skill and team training should be a mandatory component for anesthesia residency programs and continuous medical education. The 'see one, do one, teach one' approach is obsolete and should be abandoned.

A Pilot Curriculum to Integrate Standardized Patient Simulation into Clinical Pastoral Education.

We describe a novel means of experiential learning for clinical pastoral care residents using standardized patient (SP) simulations. A prospective cohort study involving 7 clinical pastoral care residents was performed. All residents underwent 2 verbatim SP sessions and 2 simulation sessions. After all sessions, residents completed a self-evaluation. Faculty completed an evaluation and then provided a debriefing session to all residents. Performance ratings were globally higher on simulated scenarios when compared to the verbatim sessions. More research in the field of pastoral care is needed to validate the learned professional skills that enhance a comprehensive training program through the use of medical simulation, verbatim reports, and clinical pastoral education (CPE) competencies. Medical simulation provides a promising teaching methodology for the training of CPE residents.

Board #132 - Research Abstract Use of Medical Simulation to Enhance Compliance with a State Mandated Sepsis Protocol in Children (Submission #10293)

Hypothesis Sepsis is an important cause of morbidity and mortality in children. Early goal directed therapy (EGDT) has been shown to improve patient outcomes and its principles have been adopted into global best practice initiatives. The New York State Department of Health mandated that all hospitals develop and implement protocols incorporating EGDT. To fulfill this mandate, all health care providers have been required to complete a sepsis education program. The hypothesis of this study is simulation will improve knowledge and adherence to sepsis protocol. Methods This is a multicenter, prospective educational intervention study for the 2013-2015 academic years. Consenting pediatricians at two academic teaching hospitals will participate in a sepsis simulation exercise and complete 4 serial assessments of their knowledge of and adherence with the NY State mandated sepsis protocol. Three items were identified as key content: tachycardia as the most important sign of shock; the ability to list systemic inflammatory response syndrome (SIRS) criteria, and knowledge of antibiotic timing. Patient outcome measures include time to: IV access, collection of blood cultures, first dose of antibiotics, and first fluid bolus. Outcomes will be collected before and after protocol implementation and the simulation education intervention. Results At one hospital, 41 of 59 resident trainees were enrolled. The number of residents correctly identifying tachycardia as the most important sign of shock increased from baseline to pre-simulation (47% vs 82%; p<.01), and from baseline to post-simulation (47% vs 87%; p<0.001); however, there was no difference between pre- and post-simulation (82% vs 87%). The proportion of residents able to list three SIRS criteria was no different from baseline to pre-simulation (63% vs 66%) but increased post-simulation when compared to pre-simulation (95% vs 66%; p < .01). Similarly, knowledge of antibiotic timing did not change from baseline to pre-simulation (53% vs 55%) but increased post-simulation when compared to pre-simulation (76% vs 55%; p < .05) and baseline (76% vs 53%; p < .001). At baseline, only 21% of participants correctly answered all three key content questions, increasing to 33% (NS) pre-simulation, and 60% post-simulation (p<0.05). Conclusion Our results indicate the simulation-based education can be an effective tool for increasing knowledge surrounding SIRS and EGDT. Ongoing data collection is planned to evaluate knowledge retention over time, as well as the impact on quality of care as evidenced by adherence to state mandated sepsis protocol.

Teaching first-year medical students in basic clinical and procedural skills--a novel course concept at a medical school in Austria.

Introduction: Clerkships are still the main source for undergraduate medical students to acquire necessary skills. However, these educational experiences may not be sufficient, as there are significant deficiencies in the clinical experience and practical expertise of medical students.Project description: An innovative course teaching basic clinical and procedural skills to first-year medical students has been implemented at the Medical University of Graz, aiming at preparing students for clerkships and clinical electives. The course is based on several didactic elements: standardized and clinically relevant contents, dual (theoretical and virtual) pre-course preparation, student peer-teaching, small teaching groups, hands-on training, and the use of medical simulation. This is the first course of its kind at a medical school in Austria, and its conceptual design as well as the implementation process into the curriculum shall be described.Evaluation: Between November 2011 and January 2013, 418 students have successfully completed the course. Four online surveys among participating students have been performed, with 132 returned questionnaires. Students’ satisfaction with all four practical course parts was high, as well as the assessment of clinical relevance of contents. Most students (88.6%) strongly agreed/agreed that they had learned a lot throughout the course. Two thirds of the students were motivated by the course to train the acquired skills regularly at our skills laboratory. Narrative feedbacks revealed elements contributing most to course success.Conclusions: First-year medical students highly appreciate practical skills training. Hands-on practice, peer-teaching, clinically relevant contents, and the use of medical simulation are valued most.

Anesthesia Quality and Safety

Anesthesia Quality and Safety

Use of Medical Simulation to Teach Bioterrorism Preparedness

The 2001 anthrax bioterrorism attacks demonstrated vulnerability for future similar attacks. This article describes mechanisms that can be used to prepare the medical community and healthcare facilities for the diagnosis and management of a subsequent bioterrorism attack should such an event occur and the fundamentals of medical simulation and its use in teaching learners about the diagnosis of management of anthrax exposure.

Use of medical simulation in neonatal-perinatal fellowship training programs

Objective: Simulation-based training is being increasingly used in undergraduate and graduate medical education. There are no prior studies on the use of simulation-based training in Neonatal-Perinatal Medicine (NPM) fellowship programs in the U.S. We conducted this study to evaluate the current use of simulation-based training in these programs. Subjects and methods: An 18 question survey was sent to all NPM fellowship Program Directors in the U.S. The survey contained questions regarding the use of simulation-based training, details on how the training was accomplished and perceived barriers to its use. Results: 62% (60/97) of the programs surveyed responded. Eighty-one percent of responding programs reporting using simulation. Of those, 86% used mannequin-based high-fidelity simulation. The most common uses for simulation training included: neonatal resuscitation skills (86%), procedural skills (71%), airway management (69%), crisis resource management/team training (69%), and professionalism (47%). Most programs are still developing their curriculums and there was a wide range in the amount of time spent on simulation training. Common barriers included time and cost of equipment. Conclusions: The majority of NPM fellowship programs we surveyed used simulation as part of their training and most did so with the use of high-fidelity mannequins. The proportion of programs using simulation for crisis team management and professionalism suggest that these types of training are important components of simulation-based training in addition to the traditional use for resuscitation skills. Further research is needed to determine if simulation-based training in NPM fellowship provides important benefits over traditional teaching methods.

Medical simulation for professional development—science and practice

From the earliest days of medical practice, when surgeons used cadavers to explore the possibilities of surgical intervention, simulation has been employed to advance the practice of health care. In the last 10 years, technological advances have allowed for a wider availability and greater realism of simulation, and this has encouraged a great expansion in its use. Simulation aims to create a virtuous cycle of professional development to improve patient outcomes. Although it seems eminently logical to believe that simulation will result in better outcomes, there is a need to test these new training interventions rigorously to be sure of their worth and to understand any limitations. The purpose of this BJOG supplement is to examine in depth several paradigms of medical simulation within maternity care and gynaecology, in different settings, looking at what can be achieved and how. In this opening review, we look at the potential use of medical simulation in broad terms and describe the types of evidence that can be employed to support its use.

Simulation in Medical School Education: Review for Emergency Medicine

Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

Use of Medical Simulation to Explore Equipment Failures and Human-Machine Interactions in Anesthesia Machine Pipeline Supply Crossover

High-fidelity medical simulation can be used to explore failure modes of technology and equipment and human-machine interactions. We present the use of an equipment malfunction simulation scenario, oxygen (O(2))/nitrous oxide (N(2)O) pipeline crossover, to probe residents' knowledge and their use of anesthetic equipment in a rapidly escalating crisis. In this descriptive study, 20 third-year anesthesia residents were paired into 10 two-member teams. The scenario involved an Ohmeda Modulus SE 7500 anesthetic machine with a Datex AS/3 monitor that provided vital signs and gas monitoring. Before the scenario started, we switched pipeline connections so that N(2)O entered through the O(2) pipeline and vice versa. Because of the switched pipeline, the auxiliary O(2) flowmeter delivered N(2)O instead of O(2). Two expert, independent raters reviewed videotaped scenarios and recorded the alarms explicitly noted by participants and methods of ventilation. Nine pairs became aware of the low fraction of inspired O(2) (Fio(2)) alarm. Only 3 pairs recognized the high fraction of inspired N(2)O (Fin(2)o) alarm. One group failed to recognize both the low Fio(2) and the high Fin(2)o alarms. Nine groups took 3 or more steps before instigating a definitive route of oxygenation. Seven groups used the auxiliary O(2) flowmeter at some point during the management steps. The fact that so many participants used the auxiliary O(2) flowmeter may expose machine factors and related human-machine interactions during an equipment crisis. Use of the auxiliary O(2) flowmeter as a presumed external source of O(2) contributed to delays in definitive treatment. Many participants also failed to notice the presence of high N(2)O. This may have been, in part, attributable to 2 facts that we uncovered during our video review: (a) the transitory nature of the "high N(2)O" alert, and (b) the dominance of the low Fio(2) alarm, which many chose to mute. We suggest that the use of high-fidelity simulations may be a promising avenue to further examine hypotheses related to failure modes of equipment and possible management response strategies of clinicians.

National Growth in Simulation Training within Emergency Medicine Residency Programs, 2003–2008

The use of medical simulation has grown dramatically over the past decade, yet national data on the prevalence and growth of use among individual specialty training programs are lacking. The objectives of this study were to describe the current role of simulation training in emergency medicine (EM) residency programs and to quantify growth in use of the technology over the past 5 years. In follow-up of a 2006 study (2003 data), the authors distributed an updated survey to program directors (PDs) of all 179 EM residency programs operating in early 2008 (140 Accreditation Council on Graduate Medical Education [ACGME]-approved allopathic programs and 39 American Osteopathic Association [AOA]-accredited osteopathic programs). The brief survey borrowed from the prior instrument, was edited and revised, and then distributed at a national PDs meeting. Subsequent follow-up was conducted by e-mail and telephone. The survey concentrated on technology-enhanced simulation modalities beyond routine static trainers or standardized patient-actors (high-fidelity mannequin simulation, part-task/procedural simulation, and dynamic screen-based simulation). A total of 134 EM residency programs completed the updated survey, yielding an overall response rate of 75%. A total of 122 (91%) use some form of simulation in their residency training. One-hundred fourteen (85%) specifically use mannequin-simulators, compared to 33 (29%) in 2003 (p < 0.001). Mannequin-simulators are now owned by 58 (43%) of the programs, whereas only 9 (8%) had primary responsibility for such equipment in 2003 (p < 0.001). Fifty-eight (43%) of the programs reported that annual resident simulation use now averages more than 10 hours per year. Use of medical simulation has grown significantly in EM residency programs in the past 5 years and is now widespread among training programs across the country.