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Medical scenario simulation

Marc Auerbach, Joanne Cole, Pina Violano, Linda Roney, Catherine Doherty, Michael Shepherd, Ralph MacKinnon
OBJECTIVES: Thousands of head-injured children are cared for by interprofessional teams in emergency departments every day. Teams must balance performing time-consuming interventions with safe transport for neuroimaging. This study aims to describe and compare providers' perspectives on the transfer of head-injured children to neuroimaging and factors contributing to delays. METHODS: Participants were interprofessional health care providers involved in the care of head-injured children at sites in the United Kingdom, the United States, and New Zealand...
October 8, 2016: Pediatric Emergency Care
Daniel S Lemke, Elaine K Fielder, Deborah C Hsu, Cara B Doughty
INTRODUCTION: Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods. OBJECTIVE: The aim of the study was to compare traditional and RCDP SBME...
October 6, 2016: Pediatric Emergency Care
Vicent Giménez-Alventosa, Javier Vijande, Facundo Ballester, Jose Perez-Calatayud
The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) (60)Co sources along a transfer tube as compared to (192)Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom...
October 14, 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Kai-Cheng Hsu, Feng-Sheng Wang
Model-based optimization approaches are valuable in developing new drugs for human metabolic disorders. The core objective in most optimal drug designs is positive therapeutic effects. In this study, we considered the effects of therapeutic, adverse, and target variation simultaneously. A fuzzy optimization method was applied to formulate a multiobjective drug design problem for detecting enzyme targets in the presynaptic dopamine metabolic network to remedy two types of enzymopathies caused by deficiencies of vesicular monoamine transporter 2 (VMAT2) and tyrosine hydroxylase (TH)...
2016: PloS One
M Ruesseler, J Sterz, B Bender, S Hoefer, F Walcher
PURPOSE: Feedback can significantly improve future performance. Reviewing one's performance by video is discussed as useful adjunct to debriefing, particularly for non-technical skills. Communicative competencies are an essential part of daily clinical practice; thus should be taught and assessed during undergraduate training. The aim of this study was to compare the educational value of video-assisted feedback versus oral feedback in communicative competencies in the surgical context...
October 11, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
Fatemeh Keshmiri, Sari Ponzer, AmirAli Sohrabpour, Shervin Farahmand, Farhad Shahi, Shahram Bagheri-Hariri, Kamran Soltani-Arabshahi, Mandana Shirazi, Italo Masiello
BACKGROUND: Simulation can be used for educating, evaluating and assessing psychometric properties of an instrument. The aim of this study was to contextualize and assess the validity and reliability of the Interprofessional Collaborative Assessment tool (ICAR) in an Iranian context using simulation. METHODS: In this descriptive study, contextualization of the ICAR was assessed through several steps. Firstly, validity assessment was approved through expert panels and Delphi rounds...
2016: Medical Journal of the Islamic Republic of Iran
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
September 27, 2016: Der Anaesthesist
Javad Salimi Sartakhti, Mohammad Hossein Manshaei, Mehdi Sadeghi
One of the main step in solid cancers to invade surrounding tissues is degradation of tissue barriers in the extracellular matrix. This operation that leads to initiate, angiogenesis and metastasis to other organs, is essentially consequence of collapsing dynamic balance between matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP). In this work, we model the MMP-TIMP interaction in both normal tissue and invasive cancer using evolutionary game theory. Our model explains how invasive cancer cells get the upper hand in MMP-TIMP imbalance scenarios...
September 23, 2016: Journal of Theoretical Biology
Jeffrey D Ho, Donald M Dawes, Evan M McKay, Jeremy J Taliercio, Scott D White, Blair J Woodbury, Mark A Sandefur, James R Miner
INTRODUCTION: Current Emergency Medical Services (EMS) documentation practices usually occur from memory after an event is over. While this practice is fairly standard, it is unclear if it can introduce significant error. Modern technology has seen the increased use of recorded video by society to more objectively document notable events. Stationary mounted cameras, cell-phone cameras, and law enforcement officer Body-Worn Cameras (BWCs) are increasingly used by society for this purpose...
September 16, 2016: Prehospital Emergency Care
Deirdre Holly, Vivien Swanson, Philip Cachia, Beverley Beasant, Colville Laird
BACKGROUND: Remote and Rural pre-hospital care practitioners manage serious illness and injury on an unplanned basis, necessitating technical and non-technical skills (NTS). However, no behaviour rating systems currently address NTS within these settings. Informed by health psychology theory, a NTS-specific behaviour rating system was developed for use within pre-hospital care training for remote and rural practitioners. METHOD: The Immediate Medical Care Behaviour Rating System (IMCBRS), was informed by literature, expert advice and review and observation of an Immediate Medical Care (IMC) course...
January 2017: Applied Ergonomics
Yoshito Zamami, Toru Imai, Masaki Imanishi, Kenshi Takechi, Naoko Shiraishi, Toshihiro Koyama, Hidenori Sagara, Yasukazu Shiino, Toshiaki Sendo, Keisuke Ishizawa
BACKGROUND: Many pharmacists are participating in team-based medical care in emergency hospitals. Therefore, there is a desperate need to improve the education system. In the present study, we provided a "pharmaceutical lifesaving skills training" to the students in their fifth and sixth year of the pharmaceutical school and evaluated the program's impact on the students' learning and confidence in their ability to perform pharmaceutical interventions for emergency patients. METHODS: We conducted a pharmaceutical lifesaving skills training program with 12 participants who were in their fifth and six year of pharmaceutical school...
2016: Journal of Pharmaceutical Health Care and Sciences
Mário Amorim Lopes, Álvaro Santos Almeida, Bernardo Almada-Lobo
Starting in the 50s, healthcare workforce planning became a major concern for researchers and policy makers, since an imbalance of health professionals may create a serious insufficiency in the health system, and eventually lead to avoidable patient deaths. As such, methodologies and techniques have evolved significantly throughout the years, and simulation, in particular system dynamics, has been used broadly. However, tools such as stochastic agent-based simulation offer additional advantages for conducting forecasts, making it straightforward to incorporate microeconomic foundations and behavior rules into the agents...
September 3, 2016: Health Care Management Science
Olga Laszczyńska, Milton Severo, Ana Azevedo
Patients with acute kidney injury (AKI) are at risk for increased morbidity and mortality. Lack of specific treatment has meant that efforts have focused on early diagnosis and timely treatment. Advanced algorithms for clinical assistance including AKI prediction models have potential to provide accurate risk estimates. In this project, we aim to provide a clinical decision supporting system (CDSS) based on a self-learning predictive model for AKI in patients of an acute care hospital. Data of all in-patient episodes in adults admitted will be analysed using "data mining" techniques to build a prediction model...
2016: Studies in Health Technology and Informatics
Danko Relić
Development of a model for simulation of the needed number of specialists of different specialties in the Republic of Croatia by the year 2035 based on the expected changes in size and age structure of population and experts' estimates of the needs. The model will be implemented in the form of a computer program based on the estimated most potent predictors. The developed model will be used as a tool for the simulation of different scenarios for specialist education combined with other factors like migration flows, changes in retirement age and skill mixing in order to compare different possibilities and options for the renewal of the Croatian healthcare personnel...
2016: Studies in Health Technology and Informatics
Andreas Bietenbeck
BACKGROUND: In health care, exchange of data is becoming increasingly important. However, it is still unclear how to interpret measurements of the same parameter from diverse data sources. In clinical chemistry point-of-care testing (POCT), e.g. for blood glucose, complements the analytical spectrum of central laboratories. Available data from "central laboratory", "professional POCT" and "non-professional" blood glucose measurements can be used to realistically simulate errors in different environments...
2016: Studies in Health Technology and Informatics
Stefanie Beck, Vivian Meier-Klages, Maria Michaelis, Susanne Sehner, Sigrid Harendza, Christian Zöllner, Jens Christian Kubitz
BACKGROUND: The "kids save lives" joint-statement highlights the effectiveness of training all school children worldwide in cardiopulmonary resuscitation (CPR) to improve survival after cardiac arrest. The personnel requirement to implement this statement is high. Until now, no randomised controlled trial investigated if medical students benefit from their engagement in the BLS-education of school children regarding their later roles as physicians. The objective of the present study is to evaluate if medical students improve their teaching behaviour and CPR-skills by teaching school children in basic life support...
August 27, 2016: Resuscitation
Shaowen Hu
In radiation accidents, determining the radiation dose the victim received is a key step for medical decision making and patient prognosis. To reconstruct and evaluate the absorbed dose, researchers have developed many physical devices and biological techniques during the last decades. However, using the physical parameter "absorbed dose" alone is not sufficient to predict the clinical development of the various organs injured in an individual patient. In operational situations for radiation accidents, medical responders need more urgently to classify the severity of the radiation injury based on the signs and symptoms of the patient...
October 2016: Health Physics
Philippa Moore, María Inés Leighton, Constanza Alvarado, Cecilia Bralic
Simulated patients (SP) are now used in the majority of the institutions that train health care professionals in patient-centered care. This article summarizes the information about the use of SP in health education using information from the literature and from the 15 years’ experience in the medical school of the Pontificia Universidad Católica de Chile. It describes the different definitions in use, the roles and scenarios that can be used when teaching with SP and the organization that any institution working with SP should have in order to promote the optimal use of SP...
May 2016: Revista Médica de Chile
Mohammed S Alqahtani, John E Lees, Sarah L Bugby, Layal K Jambi, Alan C Perkins
OBJECTIVE: The hybrid gamma camera (HGC) has been developed to enhance the localization of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. To assess the capability of the HGC, a lymph node contrast (LNC) phantom was constructed to simulate medical scenarios of varying radioactivity concentrations and SLN size. METHODS: The phantom was constructed using two clear acrylic glass plates. The SLNs were simulated by circular wells of diameters ranging from 10 to 2...
October 2016: British Journal of Radiology
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