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Medical scenario simulation

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https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#1
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28521380/-clinical-practical-examination-in-orthopaedic-teaching-who-is-the-ideal-examiner
#2
Peter Melcher, Andreas Roth, Mohamed Ghanem, Daisy Rotzoll
Background Medical curricula require an increasing amount of integrated clinical practical skills education. German medical faculties are increasingly implementing the OSCE (objective structured clinical examination) to test students' practical as well as communication skills. Teaching and assessment tools for practical skills include simulators and simulated patient scenarios, where peer-assisted teaching (PAT) is applied. Trained student tutors support this process. This study examines for the first time the use of PAT student tutors as examiners in an orthopaedic OSCE unit and the existence of possible differences in rating between faculty and PAT student tutors...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28505240/incidence-of-gonorrhea-and-chlamydia-following-hiv-preexposure-prophylaxis-among-men-who-have-sex-with-men-a-modeling-study
#3
Samuel M Jenness, Kevin M Weiss, Steven M Goodreau, Thomas Gift, Harrell Chesson, Karen W Hoover, Dawn K Smith, Albert Y Liu, Patrick S Sullivan, Eli S Rosenberg
Background: Preexposure prophylaxis (PrEP) is highly effective for preventing HIV, but risk compensation (RC) in men who have sex with men (MSM) raises concerns about increased sexually transmitted infections (STIs). CDC's PrEP guidelines recommend biannual STI screening, which may reduce incidence by treating STIs that would otherwise remain undiagnosed. We investigated the impact of these two potentially counteracting phenomena. Methods: With a stochastic network-based mathematical model of HIV and rectal/urogenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) transmission dynamics among MSM in the United States, we simulated PrEP uptake following the prescription indications and HIV/STI screening recommendations in the CDC guidelines...
May 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28504564/cinematic-rendering-in-ct-a-novel-lifelike-3d-visualization-technique
#4
Marwen Eid, Carlo N De Cecco, John W Nance, Damiano Caruso, Moritz H Albrecht, Adam J Spandorfer, Domenico De Santis, Akos Varga-Szemes, U Joseph Schoepf
OBJECTIVE: The purpose of this article is to present an overview of cinematic rendering, illustrating its potential advantages and applications. CONCLUSION: Volume-rendered reconstruction, obtaining 3D visualization from original CT datasets, is increasingly used by physicians and medical educators in various clinical and educational scenarios. Cinematic rendering is a novel 3D rendering algorithm that simulates the propagation and interaction of light rays as they pass through the volumetric data, showing a more photorealistic representation of 3D images than achieved with standard volume rendering...
May 15, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28503225/self-reported-and-actual-involvement-of-community-pharmacists-in-patient-counseling-a-cross-sectional-and-simulated-patient-study-in-gondar-ethiopia
#5
Abdrrahman S Surur, Eyob Getachew, Ebsa Teressa, Bisrat Hailemeskel, Nurahmed S Getaw, Daniel A Erku
BACKGROUND: Community pharmacists play a crucial role in reducing medication related health problems and improving the patient's overall wellbeing. Evidence suggests that community pharmacist led counseling services result in a better clinical and self-reported outcome, including a higher level of satisfaction and quality of life. OBJECTIVE: This study aims to document self-reported and actual levels of community pharmacists' involvement in the provision of patient counseling and barriers that limit their involvement in such services...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28503221/management-of-musculoskeletal-pain-in-retail-drug-outlets-within-a-nigerian-community-a-descriptive-study
#6
Samirah N Abdu-Aguye, Aishatu Shehu, Ubaidullah I Ahmad
OBJECTIVE: This work aimed to describe attitudes and practices of both community pharmacies and patent and proprietary medicine vendor (PPMV) outlets towards over-the-counter (OTC) analgesic use for musculoskeletal pain states within Zaria, Nigeria. METHODS: The study was carried out in 2 phases from May to August 2016. Phase one was a cross-sectional survey of 40 retail drug outlets (10 community pharmacies and 30 PPMVs). A simulated patient scenario of a young adult male complaining of acute onset back pain was used to collect data on the type and quality of analgesic recommended, duration of consultation, as well as nature of information provided during the drug dispensing process...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#7
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28497642/estimating-lifetime-medical-costs-from-censored-claims-data
#8
Jing-Shiang Hwang, Tsuey-Hwa Hu, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
Claims databases consisting of routinely collected longitudinal records of medical expenditures are increasingly utilized for estimating expected medical costs of patients with a specific condition. Survival data of the patients of interest are usually highly censored, and observed expenditures are incomplete. In this study, we propose a survival-adjusted estimator for estimating mean lifetime costs, which integrates the product of the survival function and the mean cost function over the lifetime horizon. The survival function is estimated by a new algorithm of rolling extrapolation, aided by external information of age- and sex-matched referents simulated from national vital statistics...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28493407/first-person-perspective-video-to-enhance-simulation
#9
Junaid Fukuta, Justin Morgan
BACKGROUND: Simulation training is increasingly being used as part of the undergraduate medical curriculum, but it remains time and faculty member intensive. To improve efficacy, videos have been used prior to the simulation of practical procedures; however, using videos prior to simulation training concerning the management of patients who are unwell has not been investigated. The aim of this project was to see whether clinical decision-making and non-technical skills can be improved if a video is used prior to simulation training, and uniquely to enhance the authenticity we filmed it using a first-person perspective...
May 10, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28471581/training-physicians-toward-a-dignifying-approach-in-adolescents-health-care-a-promising-simulation-based-medical-education-program
#10
Daniel Hardoff, Assaf Gefen, Doron Sagi, Amitai Ziv
BACKGROUND: Human dignity has a pivotal role within the health care system. There is little experience using simulation-based medical education (SBME) programs that focus on human dignity issues in doctor-patient relationships. OBJECTIVES: To describe and assess a SBME program aimed at improving physicians' competence in a dignifying approach when encountering adolescents and their parents. METHODS: A total of 97 physicians participated in 8 one-day SMBE workshops that included 7 scenarios of typical adolescent health care dilemmas...
August 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28470678/learning-curve-estimation-in-medical-devices-and-procedures-hierarchical-modeling
#11
Usha S Govindarajulu, Marco Stillo, David Goldfarb, Michael E Matheny, Frederic S Resnic
In the use of medical device procedures, learning effects have been shown to be a critical component of medical device safety surveillance. To support their estimation of these effects, we evaluated multiple methods for modeling these rates within a complex simulated dataset representing patients treated by physicians clustered within institutions. We employed unique modeling for the learning curves to incorporate the learning hierarchy between institution and physicians and then modeled them within established methods that work with hierarchical data such as generalized estimating equations (GEE) and generalized linear mixed effect models...
May 3, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28463870/the-utility-of-point-of-care-testing-at-emergency-department-triage-by-nurses-in-simulated-scenarios
#12
Jesse M Pines, Mark S Zocchi, Mary Elizabeth Buchanan, Manish N Shah, Debbie Travers
We developed and tested simulated patient scenarios to assess how normal or abnormal point-of-care (POC) test results at triage change prioritization decisions. This was a cross-sectional study where our team developed simulated scenarios and presented them to triage nurses from 3 academic medical centers. Twenty-four scenarios were constructed on the basis of 12 clinical indications from a protocol previously developed by our team. In each scenario, nurses were presented with 2 patients with the same Emergency Severity Index Version 4 (ESI v...
April 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28455169/economic-impact-of-thermostable-vaccines
#13
Bruce Y Lee, Patrick T Wedlock, Leila A Haidari, Kate Elder, Julien Potet, Rachel Manring, Diana L Connor, Marie L Spiker, Kimberly Bonner, Arjun Rangarajan, Delphine Hunyh, Shawn T Brown
BACKGROUND: While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. METHODS: Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact...
April 25, 2017: Vaccine
https://www.readbyqxmd.com/read/28451810/human-thiel-embalmed-cadaveric-aortic-model-with-perfusion-for-endovascular-intervention-training-and-medical-device-evaluation
#14
Helen McLeod, Ben F Cox, James Robertson, Robyn Duncan, Shona Matthew, Raj Bhat, Avril Barclay, J Anwar, Tracey Wilkinson, Andreas Melzer, J Graeme Houston
PURPOSE: The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. MATERIALS AND METHODS: Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection...
April 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#15
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#16
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#17
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#18
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28409648/assessment-of-simulated-emergency-scenarios-are-trained-observers-necessary
#19
Juliane Noveanu, Felix Amsler, Wolfgang Ummenhofer, Thomas von Wyl, Mathias Zuercher
OBJECTIVES: Simulation-based medical training is associated with superior educational outcomes and improved cost efficiency. Self- and peer-assessment may be a cost-effective and flexible alternative to expert-led assessment. We compared accuracy of self- and peer-assessment of untrained raters using basic evaluation tools to expert assessment using advanced validation tools including validated questionnaires and post hoc video-based analysis. METHODS: Twenty-eight simulated emergency airway management scenarios were observed and video-recorded for further assessment...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28408272/successful-management-of-a-neck-hematoma-following-simulation-training
#20
Marie-Ève Bélanger, Issam Tanoubi, Mihai Georgescu, Roger Perron, Arnaud Robitaille, Marie-Pierre Charron, Pierre Drolet
Simulation-based education is gaining widespread acceptance in many medical specialties as an effective method to teach technical and non-technical skills. The ultimate goal of simulation is to improve health care and patient safety. Boet et al. [1] published a review on simulation-based crisis resources management (CRM) teaching, looking for evidence that it can lead to improved workplace practices and patient safety. Amongst hundreds of studies pertaining to CRM, he found only nine that were relevant, and only one that showed reduced mortality...
April 10, 2017: Anaesthesia, Critical Care & Pain Medicine
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