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Medical scenario simulation

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https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#1
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28706765/trauma-and-hypothermia-in-antarctica-an-emergency-medicine-marine-simulation-scenario
#2
Chrystal Horwood, Kerry-Lynn Williams, Tate Skinner, Robert Brown, Tia Renouf, Adam Dubrowski
Simulation has been shown to improve both learner knowledge and patient outcomes. Many emergency medicine training programs incorporate simulation into their curricula to provide learners with experiences that are rare to encounter in practice, yet performance with a high degree of competence is critical. One rare encounter, which is depicted in the report, is the management of a trauma patient who was hypothermic after falling from an expedition vessel into the cold Southern Ocean. The unique scenario presented in this technical report incorporates CanMEDS learning objectives including the communicator, health advocate, and collaborator roles...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28705158/-no-patient-should-die-of-pph-just-for-the-lack-of-training-experiences-from-multi-professional-simulation-training-on-postpartum-hemorrhage-in-northern-tanzania-a-qualitative-study
#3
Signe Egenberg, Bjørg Karlsen, Deodatus Massay, Happiness Kimaro, Lars Edvin Bru
BACKGROUND: Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. In Tanzania, PPH causes 25% of maternal deaths. Skilled attendance is crucial to saving the lives of mothers and their newborns during childbirth. This study is a follow-up after multi-professional simulation training on PPH in northern Tanzania. The purpose was to enhance understanding and gain knowledge of important learning features and outcomes related to multi-professional simulation training on PPH...
July 14, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28700249/simulation-based-evaluation-of-dose-titration-algorithms-for-rapid-acting-insulin-in-subjects-with-type-2-diabetes-mellitus-inadequately-controlled-on-basal-insulin-and-oral-antihyperglycemic-medications
#4
Xiaosu Ma, Jenny Y Chien, Jennal Johnson, James Malone, Vikram Sinha
BACKGROUND: The purpose of this prospective, model-based simulation approach was to evaluate the impact of various rapid-acting mealtime insulin dose-titration algorithms on glycemic control (hemoglobin A1c [HbA1c]). METHODS: Seven stepwise, glucose-driven insulin dose-titration algorithms were evaluated with a model-based simulation approach by using insulin lispro. Pre-meal blood glucose readings were used to adjust insulin lispro doses. Two control dosing algorithms were included for comparison: no insulin lispro (basal insulin+metformin only) or insulin lispro with fixed doses without titration...
July 12, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28684916/simulated-interprofessional-learning-activities-for-rural-health-care-services-perceptions-of-health-care-students
#5
Selina Taylor, Yaqoot Fatima, Navaratnam Lakshman, Helen Roberts
BACKGROUND: The literature on interprofessional learning (IPL) has limited empirical evidence on the impact of simulated IPL sessions in promoting collaborative health care services in rural settings. This study aims to explore health care students' perception of the relevance of simulated IPL for rural health care services. METHODS: Three focus group interviews were held with pre-registration medical, pharmacy, and allied health students (n=22). Students worked together to manage complex simulation scenarios in small interprofessional teams...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28680774/diabetic-ketoacidosis-an-emergency-medicine-simulation-scenario
#6
Reuben Addison, Tate Skinner, Felix Zhou, Michael Parsons
Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of undergraduate and postgraduate training. Similarly, effective professional development activities stand to benefit greatly from a more stringent integration of simulation and competency-based approaches...
May 29, 2017: Curēus
https://www.readbyqxmd.com/read/28680081/bioparr-a-software-system-for-estimating-the-rupture-potential-index-for-abdominal-aortic-aneurysms
#7
Grand Roman Joldes, Karol Miller, Adam Wittek, Rachael O Forsythe, David E Newby, Barry J Doyle
An abdominal aortic aneurysm (AAA) is a permanent and irreversible dilation of the lower region of the aorta. It is a symptomless condition that, if left untreated, can expand until rupture. Despite ongoing efforts, an efficient tool for accurate estimation of AAA rupture risk is still not available. Furthermore, a lack of standardisation across current approaches and specific obstacles within computational workflows limit the translation of existing methods to the clinic. This paper presents BioPARR (Biomechanics based Prediction of Aneurysm Rupture Risk), a software system to facilitate the analysis of AAA using a finite element analysis based approach...
July 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28671912/errors-during-resuscitation-the-impact-of-perceived-authority-on-delivery-of-care
#8
Nicole Jane Delaloye, Kathy Tobler, Thomas OʼNeill, Afrothite Kotsakis, Jessica Cooper, Ilana Bank, Elaine Gilfoyle
OBJECTIVE: The aim of this study was to determine the influence of perceived authority on pediatric resuscitation teams' response to an incorrect order given by a medical superior. METHODS: As part of a larger multicenter prospective interventional study, interprofessional pediatric resuscitation teams (n = 48) participated in a video-recorded simulated resuscitation scenario with an infant in unstable, refractory supraventricular tachycardia. A confederate actor playing a senior physician entered the scenario partway through and ordered the incorrect dose and delivery method of the antiarrhythmic, procainamide...
June 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28671903/simulation-based-assessment-of-the-management-of-critical-events-by-board-certified-anesthesiologists
#9
Matthew B Weinger, Arna Banerjee, Amanda R Burden, William R McIvor, John Boulet, Jeffrey B Cooper, Randolph Steadman, Matthew S Shotwell, Jason M Slagle, Samuel DeMaria, Laurence Torsher, Elizabeth Sinz, Adam I Levine, John Rask, Fred Davis, Christine Park, David M Gaba
BACKGROUND: We sought to determine whether mannequin-based simulation can reliably characterize how board-certified anesthesiologists manage simulated medical emergencies. Our primary focus was to identify gaps in performance and to establish psychometric properties of the assessment methods. METHODS: A total of 263 consenting board-certified anesthesiologists participating in existing simulation-based maintenance of certification courses at one of eight simulation centers were video recorded performing simulated emergency scenarios...
July 3, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28669460/boot-camps-preparing-for-residency
#10
REVIEW
David H Yeh, Kevin Fung, Sonya Malekzadeh
Simulation-based boot camps are growing in popularity and are effective in onboarding novice residents with new knowledge, skills, and behaviors. These intensive and immersive courses may be used to train residents and allied health professionals in specific procedures, teamwork, and management of rare clinical scenarios. A needs assessment of learners determines the course curriculum. Boot camps are designed to encourage active and hands-on participation with deliberate practice and immediate feedback. As surgical education shifts toward competency-based medical education, there may be an even greater role for simulation-based boot camps as a training and assessment tool...
June 29, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28666771/physicians-psychophysiological-stress-reaction-in-medical-communication-of-bad-news-a-critical-literature-review
#11
REVIEW
Regina Katharina Studer, Brigitta Danuser, Patrick Gomez
INTRODUCTION: Stress is a common phenomenon in medical professions. Breaking bad news (BBN) is reported to be a particularly distressing activity for physicians. Traditionally, the stress experienced by physicians when BBN was assessed exclusively using self-reporting. Only recently, the field of difficult physician-patient communication has used physiological assessments to better understand physicians' stress reactions. METHOD: This paper's goals are to (a) review current knowledge about the physicians' psychophysiological stress reactions in BBN situations, (b) discuss methodological aspects of these studies and (c) suggest directions for future research...
June 27, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28664355/using-multiple-pharmacovigilance-models-improves-the-timeliness-of-signal-detection-in-simulated-prospective-surveillance
#12
Rolina D van Gaalen, Michal Abrahamowicz, David L Buckeridge
INTRODUCTION: Prospective pharmacovigilance aims to rapidly detect safety concerns related to medical products. The exposure model selected for pharmacovigilance impacts the timeliness of signal detection. However, in most real-life pharmacovigilance studies, little is known about which model correctly represents the association and there is no evidence to guide the selection of an exposure model. Different exposure models reflect different aspects of exposure history, and their relevance varies across studies...
June 29, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28659172/what-will-make-a-difference-assessing-the-impact-of-policy-and-non-policy-scenarios-on-estimations-of-the-future-gp-workforce
#13
Caroline O M Laurence, Jonathan Karnon
BACKGROUND: Health workforce planning is based on estimates of future needs for and supply of health care services. Given the pipeline time lag for the training of health professionals, inappropriate workforce planning or policies can lead to extended periods of over- or under-supply of health care providers. Often these policy interventions focus on one determinant of supply and do not incorporate other determinants such as changes in population health which impact the need for services...
June 28, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28658657/acute-stress-in-residents-playing-different-roles-during-emergency-simulations-a-preliminary-study
#14
Roger Daglius Dias, Augusto Scalabrini-Neto
Objectives: To investigate acute stress response in residents playing nurse and physician roles during emergency simulations. Methods: Sixteen second-year internal medicine residents participated in teams of four (two playing physician roles and two playing nurse roles). Stress markers were assessed in 24 simulations at baseline (T1) and immediately after the scenario (T2), using heart rate, systolic and diastolic blood pressure, salivary α-amylase, salivary cortisol and salivary interleukin-1β...
June 19, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/28653554/the-role-of-simulation-to-support-donation-after-circulatory-death-with-extracorporeal-membrane-oxygenation-dcd-ecmo
#15
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Maciej Sip, Sebastian Stefaniak, Tomasz Kłosiewicz, Łukasz Gąsiorowski, Marek Karczewski, Tomasz Małkiewicz, Małgorzata Ładzińska, Marcin Zieliński, Aleksander Pawlak, Bartłomiej Perek, Michael Czekajlo, Marek Jemielity
Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland's first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28644782/how-should-resident-physicians-respond-to-patients-discomfort-and-students-moral-distress-when-learning-procedures-in-academic-medical-settings
#16
Bonnie M Miller
In this scenario, a medical student, Lauren, experiences moral distress because she feels that learning to perform a procedure on a patient who requested not to be used for "practice" puts her own interests above the patient's. Lauren might also worry that the resident physician is misrepresenting her abilities. The resident physician could help alleviate Lauren's distress and align her interests with the patient's by more clearly explaining the training situation to the patient and seeking the patient's approval...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28626175/characteristics-and-gender-differences-in-the-medical-interview-skills-of-japanese-medical-students
#17
Akiko Sugawara, Kazunobu Ishikawa, Ryo Motoya, Gen Kobayashi, Yoko Moroi, Tetsuhito Fukushima
Objective To examine the characteristics of the communication skills of medical students, we observed their performance during introductory medical interview training with simulated patients (SPs). Methods The subjects of the present study included fifth-year medical students (male, n=180, female, n=99) who were undergoing clinical training in Japan from 2012 to 2014. Each student was assigned to one of four 10-minute clinical scenarios, which was conducted with an SP. Three or four teachers observed and assessed the performance of each of the students...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28621586/the-cooler-code-a-novel-analytical-approach-to-calculate-subcellular-energy-deposition-by-internal-electron-emitters
#18
Mattia Siragusa, Giorgio Baiocco, Pil M Fredericia, Werner Friedland, Torsten Groesser, Andrea Ottolenghi, Mikael Jensen
COmputation of Local Electron Release (COOLER), a software program designed for dosimetry assessment at the cellular/subcellular scale, with a given distribution of administered low-energy electron-emitting radionuclides in cellular compartments, which remains a critical step in risk/benefit analysis for advancements in internal radiotherapy. The software is intended to overcome the main limitations of the medical internal radiation dose (MIRD) formalism for calculations of cellular S-values (i.e., dose to a target region in the cell per decay in a given source region), namely, the use of the continuous slowing down approximation (CSDA) and the assumption of a spherical cell geometry...
June 16, 2017: Radiation Research
https://www.readbyqxmd.com/read/28616430/training-and-validation-of-standardized-patients-for-assessing-communication-and-counseling-skills-of-pharmacy-students-a-pilot-study
#19
Mahboobeh Khabaz Mafinejad, Mansoor Rastegarpanah, Fereshteh Moosavi, Mandana Shirazi
OBJECTIVE: The objective of this study is to describe the process of training valid simulated patients (SPs) for assessing communication and counseling skills of pharmacy students' performance. METHODS: This is a cross-sectional and correlational study. Psychometric properties of checklist and SPs' portrayals and their filling of the checklist regarding assessing pharmacy students were assessed. Five SPs who were working in the simulated patient's pool were volunteered to take part in the project, which one of the SPs failed...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28600218/systematic-review-of-patient-specific-surgical-simulation-toward-advancing-medical-education-%C3%A2
#20
Won Hyung A Ryu, Navjit Dharampal, Ahmed E Mostafa, Ehud Sharlin, Gail Kopp, William Bradley Jacobs, Robin John Hurlbert, Sonny Chan, Garnette R Sutherland
OBJECTIVE: Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training...
June 6, 2017: Journal of Surgical Education
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