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Assessment procedure skills

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https://www.readbyqxmd.com/read/29157233/integrating-acute-stroke-telemedicine-consultations-into-specialists-usual-practice-a-qualitative-analysis-comparing-the-experience-of-australia-and-the-united-kingdom
#1
Kathleen L Bagot, Dominique A Cadilhac, Christopher F Bladin, Caroline L Watkins, Michelle Vu, Geoffrey A Donnan, Helen M Dewey, Hedley C A Emsley, D Paul Davies, Elaine Day, Gary A Ford, Christopher I Price, Carl R May, Alison S R McLoughlin, Josephine M E Gibson, Catherine E Lightbody
BACKGROUND: Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. METHODS: Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012)...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29152181/projecting-species-vulnerability-to-climate-change-which-uncertainty-sources-matter-most-and-extrapolate-best
#2
Valerie Steen, Helen R Sofaer, Susan K Skagen, Andrea J Ray, Barry R Noon
Species distribution models (SDMs) are commonly used to assess potential climate change impacts on biodiversity, but several critical methodological decisions are often made arbitrarily. We compare variability arising from these decisions to the uncertainty in future climate change itself. We also test whether certain choices offer improved skill for extrapolating to a changed climate and whether internal cross-validation skill indicates extrapolative skill. We compared projected vulnerability for 29 wetland-dependent bird species breeding in the climatically dynamic Prairie Pothole Region, USA...
November 2017: Ecology and Evolution
https://www.readbyqxmd.com/read/29145740/fair-or-square-experiences-of-introducing-a-new-method-for-assessing-general-work-ability-in-a-sickness-insurance-context
#3
Christian Ståhl, Ida Seing, Björn Gerdle, Jan Sandqvist
PURPOSE: To study social validity and perceived fairness of a new method for assessing general work ability in a sickness insurance context. Assessments are based on self-reports, combined with examinations by physicians, and, if needed, occupational therapists, physiotherapists and/or psychologists. MATERIALS AND METHODS: Interviews with 36 insurance officials, 10 physicians, and 36 sick-listed persons, which were analysed through a qualitative content analysis...
November 16, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29138033/randomized-trial-of-high-and-low-fidelity-simulation-to-teach-intrauterine-contraception-placement
#4
Siripanth Nippita, Miriam J Haviland, Sara F Voit, Judith Perez-Peralta, Michele R Hacker, Maureen E Paul
BACKGROUND: High fidelity simulation creates conditions that resemble real circumstances, and can help teach procedures such as intrauterine contraception placement. Its impact on skill retention has not been studied. OBJECTIVE: To evaluate novice learners' skills, attitudes, and knowledge on placement of intrauterine contraception when trained using a high-fidelity commercially available simulator compared with a low-fidelity simulator. STUDY DESIGN: We recruited senior nurse practitioner students and interns in obstetrics and gynecology and family medicine inexperienced with intrauterine contraception placement...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29137902/effects-of-opioid-medications-on-cognitive-skills-among-emergency-department-patients
#5
Catherine A Marco, Dennis Mann, Jordan Rasp, Michael Ballester, Oswald Perkins, Michael B Holbrook, Kyle Rako
INTRODUCTION: Treatment for pain and related conditions has been identified as the most common reason for Emergency Department (ED) visits. Concerns exist regarding the effects of opioid pain medications on cognition and patient ability to consent for procedures, hospital admission, or to refuse recommended medical interventions. This study was undertaken to identify cognitive skills before and after opioid pain medication in the ED setting. METHODS: This was a prospective study comparing performance on the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after administration of opioid pain medications...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29136003/longitudinal-acquisition-of-endotracheal-intubation-skills-in-novice-physicians
#6
Shinya Takeuchi, Takashi Shiga, Yasuaki Koyama, Taizo Nakanishi, Yosuke Honma, Hiroshi Morita, Tadahiro Goto
Little is known about the acquisition of intubation skills among novice physicians during their one-year clinical training. Our primary objective was to determine the changes in the intubation skills of novice physicians between prior to the clinical training and after completion of the clinical training. We used data of a prospective longitudinal multicenter data registry developed to investigate factors associated with the improvement of intubation skills among novice physicians. The study participants included 90 postgraduate year 1 physicians in 2015-2016...
2017: PloS One
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#7
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29122599/impact-of-experience-on-self-assessment-accuracy-of-clinical-colonoscopy-competence
#8
Michael A Scaffidi, Samir C Grover, Heather Carnahan, Rishad Khan, Jennifer M Amadio, Jeffrey J Yu, Callum Dargavel, Nitin Khanna, Simon C Ling, Elaine Yong, Geoffrey C Nguyen, Catharine M Walsh
BACKGROUND AND AIMS: Self-assessment is important for life-long learning and a recommended assessment method for endoscopy skills. Prior literature has not investigated self-assessment accuracy of colonoscopic competence in the clinical setting. This study aimed to determine the self-assessment accuracy of novice, intermediate, and experienced endoscopists. METHODS: Novice (performed <50 previous colonoscopies), intermediate (50-500), and experienced (>1000) endoscopists from 5 hospitals each performed a clinical colonoscopy...
November 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29122537/a-coil-placement-technique-to-treat-intracranial-aneurysm-with-incorporated-artery
#9
Chao-Bao Luo, Feng-Chi Chang, Chung-Jung Lin, Wan-Yuo Guo
BACKGROUND: Endovascular coil embolization is an accepted treatment option for intracranial aneurysms. However, the coiling of aneurysms with an incorporated artery (IA) poses a high risk of IA occlusion. Here we report our experience of endovascular coil placement using a technique that avoids IA occlusion in aneurysms with IAs. METHODS: Over a 6-year period, 185 patients harboring 206 intracranial aneurysms underwent endosaccular coiling. Forty-two of these patients with 45 aneurysms were treated by coil placement to avoid IAs occlusion...
November 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#10
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29115073/assessment-of-competence-in-emergency-medicine-among-healthcare-professionals-in-cameroon
#11
Sang Chul Kim, Young Sun Ro, Sang Do Shin, Dae Han Wi, Joongsik Jeong, Ju Ok Park, Kyong Min Sun, Kwangsoo Bae
Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29113003/-comparison-of-safety-insertion-techniques-of-percutaneous-endoscopic-gastrostomy-in-nurses-and-physicians-a-non-randomized-interventional-pilot-study-on-a-simulation-model
#12
Monika Engelke, Karl-Ernst Grund, Dieter Schilling, Ulrike Beilenhoff, Elisabeth Kern-Waechter, Olaf Engelke, Ferdinand Stebner, Christiane Kugler
Percutaneous endoscopic gastrostomy (PEG) insertion represents a standardized procedure for enteral nutrition in patients with long-term eating difficulties for various reasons. In a clinical setting, delegation of stomach puncture and placement of a PEG tube, within the context of percutaneous endoscopic gastrostomy amongst nurses, occurs. In Germany, there are no studies yet showing the differences between physicians and nurses regarding the safety of percutaneous stomach puncture.In a non-randomized quasi-experimental interventional study on a simulation model, the safety of stomach puncture within the context of percutaneous endoscopic gastrostomy between physicians and nurses with special training was compared...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29111113/understanding-the-relationship-between-brain-and-upper-limb-function-in-children-with-unilateral-motor-impairments-a-multimodal-approach
#13
Maya Weinstein, Dido Green, Julian Rudisch, Ingar M Zielinski, Marta Benthem-Muñiz, Marijtje L A Jongsma, Verity McClelland, Bert Steenbergen, Shelly Shiran, Dafna Ben Bashat, Gareth J Barker
Atypical brain development and early brain injury have profound and long lasting impact on the development, skill acquisition, and subsequent independence of a child. Heterogeneity is present at the brain level and at the motor level; particularly with respect to phenomena of bilateral activation and mirrored movements (MMs). In this multiple case study we consider the feasibility of using several modalities to explore the relationship between brain structure and/or activity and hand function: Electroencephalography (EEG), both structural and functional Magnetic Resonance Imaging (sMRI, fMRI), diffusion tensor imaging (DTI), transcranial magnetic stimulation (TMS), Electromyography (EMG) and hand function assessments...
October 12, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29110695/unifying-interdisciplinary-education-designing-and-implementing-an-intern-simulation-educational-curriculum-to-increase-confidence-in-critical-care-from-pgy1-to-pgy2
#14
Mark J Bullard, Jo Anna Leuck, Lisa D Howley
BACKGROUND: A longitudinal, multidisciplinary critical care simulation curriculum was developed and implemented within a teaching hospital to address the need for consistent, safe, efficient, and unified critical care training within graduate medical education. Primary goals were to increase learner confidence in critical care topics and procedural skills across all specialties. Secondary goals included improving communication skills and obtaining a high level of learner satisfaction...
November 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29106861/laryngotracheal-reconstruction-and-swallowing-a-review
#15
REVIEW
Jennifer F Ha, Lynn Driver, David A Zopf
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29105689/-feasibility-and-safety-of-right-subclavian-access-for-edwards-sapien-3-balloon-expandable-transcatheter-aortic-valve-implantation
#16
Alessandro Iadanza, Marco Solari, Enrico Tucci, Carlo Pierli
Despite the technical advancements in transcatheter aortic valve implantation (TAVI), this procedure in patients with peripheral artery disease remains challenging and requires a patient-tailored management by the Heart Team. In-depth assessment of the patient's vascular anatomy is of utmost importance for the management of TAVI procedures with the aim to use the less invasive approach according to the specific patient characteristics. The trans-subclavian approach should be the preferred option in patients with femoral arterial disease undergoing TAVI; however, self-expandable valves have potential limitations, as in case of ascending aorta dilation and high implantation...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29104028/effectiveness-of-immersive-virtual-reality-in-surgical-training-a-randomized-control-trial
#17
Yeshwanth Pulijala, Minhua Ma, Matthew Pears, David Peebles, Ashraf Ayoub
PURPOSE: Surgical training methods are evolving with the technological advancements, including the application of virtual reality (VR) and augmented reality. However, 28 to 40% of novice residents are not confident in performing a major surgical procedure. VR surgery, an immersive VR (iVR) experience, was developed using Oculus Rift and Leap Motion devices (Leap Motion, Inc, San Francisco, CA) to address this challenge. Our iVR is a multisensory, holistic surgical training application that demonstrates a maxillofacial surgical technique, the Le Fort I osteotomy...
October 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29099299/perfusion-based-human-cadaveric-specimen-as-a-simulation-training-model-in-repairing-cerebrospinal-fluid-leaks-during-endoscopic-endonasal-skull-base-surgery
#18
Eisha A Christian, Joshua Bakhsheshian, Ben A Strickland, Vance L Fredrickson, Ian A Buchanan, Martin H Pham, Andrew Cervantes, Michael Minneti, Bozena B Wrobel, Steven Giannotta, Gabriel Zada
OBJECTIVE Competency in endoscopic endonasal approaches (EEAs) to repair high-flow cerebrospinal fluid (CSF) leaks is an essential component of the neurosurgical training process. The objective of this study was to demonstrate the feasibility of a simulation model for EEA repair of anterior skull base CSF leaks. METHODS Human cadaveric specimens were utilized with a perfusion system to simulate a high-flow CSF leak. Neurological surgery residents (postgraduate year 3 or greater) performed a standard EEA to repair a CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29093149/developing-prosthodontic-residents-communication-strategies-with-edentulous-patients-a-pilot-study
#19
Varsha Murthy, K R Sethuraman, Sunayana Choudhury, P Shakila
The aim of this study was to investigate whether prosthodontic residents' attitudes toward provider-client communication would be shaped by a tailor-made communications skills course. In 2016, the pre-intervention attitudes of all six second- and third-year prosthodontic residents in a three-year residency at an academic dental institution in India were assessed using the Communication Skills Attitude Scale (CSAS). The residents' performance was then video-recorded while they treated complete denture patients and was analyzed using the Kalamazoo scale, a validated scale for communication skills assessment...
November 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/29090731/human-cadavers-preserved-using-thiel-s-method-for-the-teaching-of-fibreoptically-guided-intubation-of-the-trachea-a-laboratory-investigation
#20
C J László, Z Szűcs, Á Nemeskéri, G Baksa, A Szuák, M Varga, E Tassonyi
We assessed the suitability of human cadavers preserved using Thiel's method for teaching flexible fibreoptic tracheal intubation. Thirty-one anaesthetists unacquainted with this technique received didactic teaching followed by handling of the fibrescope on the Oxford teaching box. They then carried out fibreoptic intubations in two cadavers to establish a baseline sample of their intubation skills. Thereafter, we randomly assigned the trainees to two groups to practice fibreoptic intubation either on two distinct cadavers or on two airway manikins...
November 1, 2017: Anaesthesia
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