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Medical Simulation

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https://www.readbyqxmd.com/read/29341815/development-and-validation-of-simulated-virtual-patients-to-impart-early-clinical-exposure-in-endocrine-physiology
#1
Akriti Gupta, Satendra Singh, Farah Khaliq, Upreet Dhaliwal, S V Madhu
In the country presently, preclinical medical students are not routinely exposed to real patients. Thus, when they start clinical postings, they are found to have poor clinical reasoning skills. Simulated virtual patients (SVPs) can improve clinical skills without endangering real patients. This pilot study describes the development of two SVPs in endocrine physiology and their validation in terms of acquisition of clinical knowledge and student engagement. Two SVPs, Nandini Sharma (unintentional weight gain) and Sunil Yadav (polyuria), were created and published on the i-Human Patients platform through an iterative, interdisciplinary, and transdisciplinary collaborative process using the conceptual framework of Kim et al...
March 1, 2018: Advances in Physiology Education
https://www.readbyqxmd.com/read/29341340/bias-from-restricting-to-live-births-when-estimating-effects-of-prescription-drug-use-on-pregnancy-complications-a-simulation
#2
Elizabeth A Suarez, Suzanne N Landi, Mitchell C Conover, Michele Jonsson Funk
PURPOSE: Administrative claim databases are increasingly being used to study the safety of medication exposures during pregnancy. These studies are restricted to live births due to a reliance on algorithms for estimating gestational age that are based on codes associated with live delivery. Conditioning on live birth may induce selection bias when studying the effect of a drug on a pregnancy complication if fetal death is a competing risk for the complication or is caused by the complication...
January 17, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29341077/assessing-use-errors-related-to-the-interface-design-of-electrosurgical-units
#3
Jamie L Estock, Airan Li, Maureen C Casey, Matthew A Taylor, Monique Y Boudreaux-Kelly, Martin D Choma, Katrina Jacobs, David E Eibling
Medical device use errors, such as instrument connection errors made with electrosurgical units (ESUs), can lead to adverse events. Current device acquisition processes at health care facilities do not typically include a proactive evaluation of use-error risk before device purchase. We conducted an evaluation to identify ESU user interface design features that can help prevent or mitigate instrument connection errors during clinical care. Thirty-six current ESU users participated in the evaluation. We used a randomized crossover design in which each participant used two ESU models in a simulated OR scenario...
January 2018: AORN Journal
https://www.readbyqxmd.com/read/29340941/internal-medicine-residents-attitudes-toward-simulated-depressed-cardiac-patients-during-an-objective-structured-clinical-examination-a-randomized-study
#4
Kathleen Crapanzano, Dixie Fisher, Rebecca Hammarlund, Eric P Hsieh, Win May
BACKGROUND: Physician biases toward mental conditions such as depression have been shown to adversely affect medical outcomes. OBJECTIVE: To explore the relationship between residents' explicit bias toward depressed patients and their clinical skills on a cardiac case during an objective structured clinical exam (OSCE). DESIGN: Prospective parallel randomized controlled study. PARTICIPANTS: One hundred eighty-five internal medicine residents from three residency programs in two states...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29338304/investigation-of-the-use-of-external-aluminum-targets-for-portal-imaging-in-a-medical-accelerator-using-geant4-monte-carlo-simulation
#5
Hyungdong Kim, Byungyong Kim, Jonggeun Baek, Youngkee Oh, Hyunsoo Jang
OBJECTIVE: To install a low-Z target on the wedge tray mount of a medical linear accelerator to create a new image beam and to confirm image contrast enhancement. METHODS: Experimental low-energy photon beams were produced with the linac running in the 6 MeV electron mode and with a low-Z target installed on the wedge tray mount (denoted 6 MeV (low-Z target)). Geant4 Monte Carlo simulation (MCS) was performed to analyze the energy spectrum and image contrast of a 6 MeV (low-Z target) beam...
January 17, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29338143/anesthesiology-residents-induction-month-a-pilot-study-showing-an-effective-and-safe-way-to-train-novice-residents-through-simulation
#6
Federico L Barra, Luca Carenzo, Jeffrey Franc, Claudia Montagnini, Flavia Petrini, Francesco Della Corte, Pier L Ingrassia
BACKGROUND: The transition of new residents from medical school to the post-graduate clinical environment remains challenging. We hypothesized that an introductory simulation course could improve new residents' performance in anesthesiology. METHODS: "Anesthesiology Residents Induction Month" (ARIM) was designed as a non-clinical simulation training program aiming at providing the theoretical and practical skills to safely approach, as junior anesthesiologists, the operating rooms...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336338/training-in-urological-robotic-surgery-future-perspectives
#7
Ahmed El Sherbiny, Ahmed Eissa, Ahmed Ghaith, Elena Morini, Lucilla Marzotta, Maria Chiara Sighinolfi, Salvatore Micali, Giampaolo Bianchi, Bernardo Rocco
As robotics are becoming more integrated into the medical field, robotic training is becoming more crucial in order to overcome the lack of experienced robotic surgeons. However, there are several obstacles facing the development of robotic training programs like the high cost of training and the increased operative time during the initial period of the learning curve, which, in turn increase the operative cost. Robotic-assisted laparoscopic prostatectomy is the most commonly performed robotic surgery. Moreover, robotic surgery is becoming more popular among urologic oncologists and pediatric urologists...
January 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29336327/current-status-of-urological-training-in-europe
#8
Diego M Carrion, Juan Gómez Rivas, Francesco Esperto, Giulio Patruno, Juan L Vasquez
Modern urological training has changed drastically in the past years, due to the global surgical training trends, advances in technology, subspecialization of the field and, working hour regulations for doctors. The lack of a standardized curriculum across Europe, puts in evidence the great difference in the requirements in every country, from the start of the residency, to obtaining the accreditation. We sought to identify problems related to medical, scientific and surgical activity during urological training, and summarize data obtained from surveys realized during the European Urology Residents Education Programme (EUREP) in 2013, and from countries such as Germany, Italy and Spain...
January 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29334925/implementing-blended-learning-in-emergency-airway-management-training-a-randomized-controlled-trial
#9
Madeleine Huei Tze Kho, Keng Sheng Chew, Muhaimin Noor Azhar, Mohd Lotfi Hamzah, Kee Man Chuah, Aida Bustam, Hiang Chuan Chan
BACKGROUND: While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training...
January 15, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#10
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333113/grating-oriented-line-wise-filtration-golf-for-dual-energy-x-ray-ct
#11
Yan Xi, Wenxiang Cong, Daniel Harrison, Ge Wang
In medical X-ray Computed Tomography (CT), the use of two distinct X-ray source spectra (energies) allows dose-reduction and material discrimination relative to that achieved with only one source spectrum. Existing dual-energy CT methods include source kVp-switching, double-layer detection, dual-source gantry, and two-pass scanning. Each method suffers either from strong spectral correlation or patient-motion artifacts. To simultaneously address these problems, we propose to improve CT data acquisition with the Grating Oriented Line-wise Filtration (GOLF) method, a novel X-ray filter that is placed between the source and patient...
December 2017: Sensing and Imaging
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#12
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332775/development-and-testing-of-a-neonatal-intubation-checklist-for-an-air-medical-transport-team
#13
Lisa A Davidson, Richard B Utarnachitt, Andrew Mason, Taylor Sawyer
OBJECTIVE: We developed a Neonatal Intubation Checklist for Airlift Northwest. Our goal was to improve the preparation, technical proficiency, and safety of neonatal intubation without increasing the time required to perform the procedure. METHODS: The Neonatal Intubation Checklist, a "call and response" checklist for neonatal intubation, was developed. Its effectiveness was evaluated during a baseline assessment and 2 practice sessions after a checklist orientation...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332616/addressing-children-s-needs-in-disasters-a-regional-pediatric-tabletop-exercise
#14
Sarita Chung, Aaron H Gardner, David J Schonfeld, Jessica L Franks, Marvin So, Eric J Dziuban, Georgina Peacock
OBJECTIVE: Preparing and responding to the needs of children during public health emergencies continues to be challenging. The purpose of this study was to assess the usefulness of a tabletop exercise in initiating pediatric preparedness strategies and assessing the impact of the exercise on participants' understanding of and confidence in their roles during pediatric public health emergencies. METHODS: A tabletop exercise was developed to simulate a public health emergency scenario involving smallpox in a child, with subsequent spread to multiple states...
January 15, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29331902/the-use-of-interprofessional-learning-and-simulation-in-undergraduate-nursing-programs-to-address-interprofessional-communication-and-collaboration-an-integrative-review-of-the-literature
#15
REVIEW
Benedikte M Granheim, Julie M Shaw, Martha Mansah
OBJECTIVE: To identify how simulation and interprofessional learning are used together in undergraduate nursing programs and undertaken in schools of nursing to address interprofessional communication and collaboration. DESIGN: An integrative literature review. DATA SOURCES: The databases CINAHL, ProQuest, PubMed, Scopus, PsycInfo and Science Direct were searched to identify articles from 2006 to 2016 that reported on the use of IPL and simulation together in undergraduate nursing education...
December 29, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29331226/a-low-complexity-minimum-variance-beamformer-for-ultrasound-imaging-using-dominant-mode-rejection
#16
Babak Mohammadzadeh Asl, Ali Mohades Deylami
In recent years, high resolution adaptive minimum variance-based beamformers have been successfully applied to medical ultrasound imaging to improve its resolution and contrast, simultaneously. However, these improvements come at the cost of much more computational complexity in comparison to the non-adaptive delay-and-sum beamformer. The computational overhead mainly results from the L×L covariance matrix inversion needed for computation of the adaptive weights, the complexity of which is cubic with the subarray size, O(L3)...
January 4, 2018: Ultrasonics
https://www.readbyqxmd.com/read/29329996/to-prep-or-not-to-prep-that-is-the-question-a-randomized-trial-on-the-use-of-antiflatulent-medication-as-part-of-bowel-preparation-for-patients-having-image-guided-external-beam-radiation-therapy-to-the-prostate
#17
Merrylee McGuffin, Naila Devji, Lyann Kehoe, Anne Carty, Steve Russell, Lisa Di Prospero, Carlo DeAngelis, Alex Kiss, Danny Vesprini, Andrew Loblaw, Laura D'Alimonte
INTRODUCTION: Radiation therapy is a standard treatment option for prostate cancer. With growing use of escalated doses and tighter margins, procedures to limit rectal size variation are needed to reduce prostate motion, increase treatment accuracy, and minimize rectal toxicity. This prospective study was done to determine whether the introduction of an antiflatulent medication would decrease rectal distention at computed tomography (CT) simulation and throughout a course of radiation therapy...
November 4, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29327991/a-clinical-librarian-embedded-in-medical-education-patient-centered-encounters-for-preclinical-medical-students
#18
Lindsay Blake, Frances M Yang, Hutton Brandon, Benjamin Wilson, Renee Page
Adding patient encounters and simulation to the preclinical years of medical school is becoming increasingly popular. This article describes the creation of active learning opportunities by a clinical librarian that are aimed at training preclinical students through the use of simulated patient scenarios. Scenarios for second-year students walk them through the evidence-based resources needed in clinical years and beyond through a standardized patient encounter. Scenarios for first-year students involve role-play of cases where the patient and physician bring contrasting ideas to the outpatient interaction...
January 2018: Medical Reference Services Quarterly
https://www.readbyqxmd.com/read/29327220/patient-perceptions-and-preferences-for-a-mealtime-insulin-delivery-patch
#19
Mark Peyrot, Darlene Dreon, Vivien Zraick, Brett Cross, Meng H Tan
INTRODUCTION: A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient...
January 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29325812/transcatheter-mitral-valve-replacement-in-mitral-annulus-calcification-the-art-of-computer-simulation
#20
Júlia Karády, Ioannis Ntalas, Bernard Prendergast, Christopher Blauth, Steven Niederer, Pál Maurovich-Horvat, Ronak Rajani
There is considerable interest in transcatheter prosthetic valve treatment for mitral valve disease in high-risk individuals. Although the presence of mitral annular calcium (MAC) may provide an anchoring zone for such devices, results to date have been modest with reported technical failure rates approaching 30% in specialist centers. This in part relates to the risk of left ventricular outflow tract obstruction and device dislodgment but also to the lack of specific imaging guidelines to plan for such procedures...
January 4, 2018: Journal of Cardiovascular Computed Tomography
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