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Medical scenario simulation

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https://www.readbyqxmd.com/read/28813636/using-systems-science-to-inform-population-health-strategies-in-local-health-departments-a-case-study-in-san-antonio-texas
#1
Yan Li, Norma A Padrón, Anil T Mangla, Pamela G Russo, Thomas Schlenker, José A Pagán
OBJECTIVES: Because of state and federal health care reform, local health departments play an increasingly prominent role leading and coordinating disease prevention programs in the United States. This case study shows how a local health department working in chronic disease prevention and management can use systems science and evidence-based decision making to inform program selection, implementation, and assessment; enhance engagement with local health systems and organizations; and possibly optimize health care delivery and population health...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28802910/inter-rater-reliability-of-physical-abuse-determinations-in-young-children-with-fractures
#2
Katherine E Buesser, John M Leventhal, Julie R Gaither, Victoria Tate, Daniel R Cooperman, Rebecca L Moles, Cicero T Silva, Lauren J Ehrlich, Melinda S Sharkey
As there is no "gold standard" in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from 551 children <36months of age presenting to a pediatric emergency department, we examined the extent of agreement between specialists who evaluate children with fractures for suspected abuse. To simulate clinical scenarios, two pediatric orthopaedists and two child abuse pediatricians (CAPs) reviewed the full abstraction and imaging, whereas the two pediatric radiologists reviewed a brief history and imaging...
August 10, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28802837/development-of-simulation-optimization-methods-for-solving-patient-referral-problems-in-the-hospital-collaboration-environment
#3
Ping-Shun Chen, Ming-Han Lin
This research studied a patient referral problem among multiple cooperative hospitals for sharing imaging services' referrals. The proposed problem consisted of many types of patients and the uncertainty associated with the number of patients of each type, patients' arrival time, and patients' medical operation time, leading to a difficulty in finding solutions due to the uncertain environment. This research used system simulation to construct a model and develop a simulation optimization method, combining the heuristic algorithm (patient referral mechanism) with the particle swarm optimization (PSO) method, to determine a better way to refer patients from one hospital (referring hospital) to another (recipient hospital) to receive certain imaging services...
August 9, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28800439/a-simplified-parametrised-model-for-lung-microstructures-capable-of-mimicking-realistic-geometrical-and-mechanical-properties
#4
Christian J Roth, Lena Yoshihara, Wolfgang A Wall
The respiratory zone of mammalian lungs contains several millions of so-called alveoli. The geometrical and mechanical properties of this microstructure are crucial for respiration and influence the macroscopic behaviour of the entire organ in health and disease. Hence, if computational models are sought to gain more insight into lung behaviour, predict lung states in certain scenarios or suggest better treatment options in early stages of respiratory dysfunction, an adequate representation of this microstructure is essential...
August 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28799196/combining-evidence-from-multiple-electronic-health-care-databases-performances-of-one-stage-and-two-stage-meta-analysis-in-matched-case-control-studies
#5
Fabiola La Gamba, Giovanni Corrao, Silvana Romio, Miriam Sturkenboom, Gianluca Trifirò, Tania Schink, Maria de Ridder
PURPOSE: Clustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. METHODS: First, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates...
August 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28789739/teamstepps-virtual-teams-interactive-virtual-team-training-and-practice-for-health-professional-learners
#6
Rachel A Umoren, Julie A Poore, Linda Sweigart, Natalia Rybas, Evalyn Gossett, Miles Johnson, Martina Allen, Patricia J Scott, Barbara Truman, Rohit Das
Medical errors because of communication failure are common in health care settings. Teamwork training, such as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), improves team performance and patient outcomes. Academic institutions seek high-quality, low-cost curricula for interprofessional education (IPE) to prepare learners for clinical experiences before and after graduation; however, most IPE curricula involve lectures, simple tabletop exercises, and in-person simulations and are not readily accessible to geographically distributed and asynchronously engaged learners...
August 1, 2017: Creative Nursing
https://www.readbyqxmd.com/read/28775221/in-situ-medical-simulation-for-pre-implementation-testing-of-clinical-service-in-a-regional-hospital-in-hong-kong
#7
P P Chen, N Tk Tsui, A Sw Fung, A Hf Chiu, W Cw Wong, H T Leong, P Sf Lee, J Yw Lau
The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service...
August 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28768700/randomised-clinical-simulation-designed-to-evaluate-the-effect-of-telemedicine-using-google-glass-on-cardiopulmonary-resuscitation-cpr
#8
Nuria Pérez Alonso, Manuel Pardo Rios, Laura Juguera Rodriguez, Tomas Vera Catalan, Francisca Segura Melgarejo, Belen Lopez Ayuso, Carolina Martínez Riquelme, Joaquin Lasheras Velasco
AIM: Through a clinical simulation, this study aims to assess the effect of telematics support through Google Glass (GG) from an expert physician on performance of cardiopulmonary resuscitation (CPR) performed by a group of nurses, as compared with a control group of nurses receiving no assistance. METHODS: This was a randomised study carried out at the Catholic University of Murcia (November 2014-February 2015). Nursing professionals from the Emergency Medical Services in Murcia (Spain) were asked to perform in a clinical simulation of cardiac arrest...
August 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28768335/simulation-of-lipid-lowering-therapy-intensification-in-a-population-with-atherosclerotic-cardiovascular-disease
#9
Christopher P Cannon, Irfan Khan, Alexa C Klimchak, Matthew R Reynolds, Robert J Sanchez, William J Sasiela
Importance: In patients with atherosclerotic cardiovascular disease (ASCVD), guidelines recommend optimizing statin treatment, and consensus pathways suggest use of ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with persistently elevated low-density lipoprotein cholesterol (LDL-C) levels despite use of statins. Recent trials have provided evidence of benefit in reduction of cardiovascular events with these agents. Objective: To estimate the percentage of patients with ASCVD who would require a PCSK9 inhibitor when oral lipid-lowering therapy (LLT) is intensified first...
August 2, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28767561/mixed-reality-in-visceral-surgery-development-of-a-suitable-workflow-and-evaluation-of-intraoperative-use-cases
#10
Igor M Sauer, Moritz Queisner, Peter Tang, Simon Moosburner, Ole Hoepfner, Rosa Horner, Rudiger Lohmann, Johann Pratschke
OBJECTIVE: The paper evaluates the application of a mixed reality (MR) headmounted display (HMD) for the visualization of anatomical structures in complex visceral-surgical interventions. A workflow was developed and technical feasibility was evaluated. SUMMARY OF BACKGROUND DATA: Medical images are still not seamlessly integrated into surgical interventions and, thus, remain separated from the surgical procedure.Surgeons need to cognitively relate 2-dimensional sectional images to the 3-dimensional (3D) during the actual intervention...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28765717/assessing-the-performance-and-satisfaction-of-medical-residents-utilizing-standardized-patient-versus-mannequin-simulated-training
#11
Ali A Alsaad, Swetha Davuluri, Vandana Y Bhide, Amy M Lannen, Michael J Maniaci
BACKGROUND: Conducting simulations of rapidly decompensating patients are a key part of internal medicine (IM) residency training. Traditionally, mannequins have been the simulation tool used in these scenarios. OBJECTIVE: To compare IM residents' performance and assess realism in specific-simulated decompensating patient scenarios using standardized patients (SPs) as compared to mannequin. METHODS: Nineteen IM residents were randomized to undergo simulations using either a mannequin or an SP...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28763738/cost-effectiveness-of-simulation-based-team-training-in-obstetric-emergencies-tosti-study
#12
J van de Ven, G J van Baaren, A F Fransen, P J van Runnard Heimel, B W Mol, S G Oei
OBJECTIVE: Team training is frequently applied in obstetrics. We aimed to evaluate the cost-effectiveness of obstetric multi-professional team training in a medical simulation centre. STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate four strategies for obstetric team training from a hospital perspective (no training, training without on-site repetition and training with 6 month or 3-6-9 month repetition). Data were retrieved from the TOSTI study, a randomised controlled trial evaluating team training in a medical simulation centre...
July 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28760696/simulation-training-to-improve-9-1-1-dispatcher-identification-of-cardiac-arrest-a-randomized-controlled-trial
#13
Hendrika Meischke, Ian S Painter, Scott R Stangenes, Marcia R Weaver, Carol E Fahrenbruch, Tom Rea, Anne M Turner
BACKGROUND: The objective of this study was to test the effectiveness of simulation training, using actors to make mock calls, on improving Emergency Medical Dispatchers' (EMDs) ability to recognize the need for, and reduce the time to, telephone-assisted CPR (T-CPR) in simulated and real cardiac arrest 9-1-1 calls. METHODS: We conducted a parallel prospective randomized controlled trial with n=157 EMDs from thirteen 9-1-1 call centers. Study participants were randomized within each center to intervention (i...
July 29, 2017: Resuscitation
https://www.readbyqxmd.com/read/28756146/two-year-experience-implementing-a-curriculum-to-improve-residents-patient-centered-communication-skills
#14
Amber W Trickey, Anna B Newcomb, Melissa Porrey, Franco Piscitani, Jeffrey Wright, Paula Graling, Jonathan Dort
OBJECTIVES: Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. DESIGN: Eight quarterly modules were conducted on various communication topics. Former patient volunteers served as simulation participants (SP) who completed annual assessments using the Communication Assessment Tool (CAT)...
July 26, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28745098/analysis-of-the-accuracy-and-performance-of-a-continuous-glucose-monitoring-sensor-prototype-an-in-silico-study-using-the-uva-padova-type-1-diabetes-simulator
#15
Marc D Breton, Rolf Hinzmann, Enrique Campos-Nañez, Susan Riddle, Michael Schoemaker, Guenther Schmelzeisen-Redeker
BACKGROUND: Computer simulation has been shown over the past decade to be a powerful tool to study the impact of medical devices characteristics on clinical outcomes. Specifically, in type 1 diabetes (T1D), computer simulation platforms have all but replaced preclinical studies and are commonly used to study the impact of measurement errors on glycemia. METHOD: We use complex mathematical models to represent the characteristics of 3 continuous glucose monitoring systems using previously acquired data...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28739455/decision-making-in-critical-limb-ischemia-a-markov-simulation
#16
Aaron J Deutsch, C Charles Jain, Kimberly G Blumenthal, Mark W Dickinson, Anne M Neilan
BACKGROUND: Critical limb ischemia (CLI) is a feared complication of peripheral vascular disease that often requires surgical management and may require amputation of the affected limb. OBJECTIVE: To use a decision model to inform clinical management for a 63-year-old woman with CLI and multiple medical comorbidities, including advanced heart failure and diabetes. METHODS: Markov decision model evaluating four strategies: amputation, surgical bypass, endovascular therapy (e...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28731928/serious-game-versus-online-course-for-pretraining-medical-students-before-a-simulation-based-mastery-learning-course-on-cardiopulmonary-resuscitation-a-randomised-controlled-study
#17
David Drummond, Paul Delval, Sonia Abdenouri, Jennifer Truchot, Pierre-François Ceccaldi, Patrick Plaisance, Alice Hadchouel, Antoine Tesnière
BACKGROUND: Although both recorded lectures and serious games have been used to pretrain health professionals before simulation training on cardiopulmonary resuscitation, they have never been compared. OBJECTIVE: The aim of this study was to compare an online course and a serious game for pretraining medical students before simulation-based mastery learning on the management of sudden cardiac arrest. DESIGN: A randomised controlled trial. Participants were pretrained using the online course or the serious game on day 1 and day 7...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#18
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
#19
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
#20
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
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