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Simulation obstetric

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https://www.readbyqxmd.com/read/29694344/elective-induction-of-labor-at-39-weeks-among-nulliparous-women-the-impact-on-maternal-and-neonatal-risk
#1
Rachel G Sinkey, Jasmin Lacevic, Tea Reljic, Iztok Hozo, Kelly S Gibson, Anthony O Odibo, Benjamin Djulbegovic, Charles J Lockwood
OBJECTIVE: Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among nulliparous women with non-anomalous singleton, vertex fetuses as compared to expectant management (EM) which included IOL for medical or obstetric indications or at 41 weeks in undelivered mothers. MATERIALS AND METHODS: A Monte Carlo micro-simulation model was constructed modeling two mutually exclusive health states: eIOL at 39 weeks, or EM with IOL for standard medical or obstetrical indications or at 41 weeks if undelivered...
2018: PloS One
https://www.readbyqxmd.com/read/29667240/use-of-simulators-for-the-assessment-of-trainees-competence-trendy-toys-or-valuable-instruments
#2
EDITORIAL
Martin G Tolsgaard, Gihad E Chalouhi
Over the past decade, ultrasound simulators have been increasingly used as an adjunct to clinical training in Obstetrics and Gynaecology. Studies have shown that providing initial simulation-based ultrasound training leads to sustained improvements in clinical performances1 including improved diagnostic accuracy,2 reduced need for supervised practice, and decreased patient discomfort.3 .
April 17, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29663275/a-multiple-perspective-approach-for-the-assessment-and-learning-of-ultrasound-skills
#3
Martin Grønnebæk Tolsgaard
Ultrasound has become a core skill in many specialties. We evaluated the learning and assessment of ultrasound skills in Obstetrics-Gynaecology in a series of eight studies. In the clinical setting, we found that trainees as well as experienced clinicians struggle with technical aspects of performance such as image optimization. We examined how to improve these aspects of performance in the simulated setting by determining mastery learning levels and exploring learning curves for novices. We then examined how to improve the efficiency of training as well as transfer of learning through the use of dyad practice as compared with single practice...
April 16, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29644465/impact-of-one-to-one-tutoring-on-fundamentals-of-laparoscopic-surgery-fls-passing-rate-in-a-single-center-experience-outside-the-united-states-a-randomized-controlled-trial
#4
Federico Gheza, Paolo Raimondi, Leonardo Solaini, Federico Coccolini, Gian Luca Baiocchi, Nazario Portolani, Guido Alberto Massimo Tiberio
BACKGROUND: Outside the US, FLS certification is not required and its teaching methods are not well standardized. Even if the FLS was designed as "stand alone" training system, most of Academic Institution offer support to residents during training. We present the first systematic application of FLS in Italy. Our aim was to evaluate the role of mentoring/coaching on FLS training in terms of the passing rate and global performance in the search for resource optimization. METHODS: Sixty residents in general surgery, obstetrics & gynecology, and urology were selected to be enrolled in a randomized controlled trial, practicing FLS with the goal of passing a simulated final exam...
April 11, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29581094/prenatal-remote-monitoring-of-women-with-gestational-hypertensive-diseases-cost-analysis
#5
Dorien Lanssens, Thijs Vandenberk, Christophe Jp Smeets, Hélène De Cannière, Sharona Vonck, Jade Claessens, Yenthel Heyrman, Dominique Vandijck, Valerie Storms, Inge M Thijs, Lars Grieten, Wilfried Gyselaers
BACKGROUND: Remote monitoring in obstetrics is relatively new; some studies have shown its effectiveness for both mother and child. However, few studies have evaluated the economic impact compared to conventional care, and no cost analysis of a remote monitoring prenatal follow-up program for women diagnosed with gestational hypertensive diseases (GHD) has been published. OBJECTIVE: The aim of this study was to assess the costs of remote monitoring versus conventional care relative to reported benefits...
March 26, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29580444/medical-simulation-as-a-vital-adjunct-to-identifying-clinical-life-threatening-gaps-in-austere-environments
#6
Adaora M Chima, Rahul Koka, Benjamin Lee, Tina Tran, Onyebuchi U Ogbuagu, Howard Nelson-Williams, Michael Rosen, Michael Koroma, John B Sampson
BACKGROUND: Maternal mortality and morbidity are major causes of death in low-resource countries, especially those in Sub-Saharan Africa. Healthcare workforce scarcities present in these locations result in poor perioperative care access and quality. These scarcities also limit the capacity for progressive development and enhancement of workforce training, and skills through continuing medical education. Newly available low-cost, in-situ simulation systems make it possible for a small cadre of trainers to use simulation to identify areas needing improvement and to rehearse best practice approaches, relevant to the context of target environments...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29560809/mbrrace-in-simulation-an-evaluation-of-a-multi-disciplinary-simulation-training-for-medical-emergencies-in-obstetrics-memo
#7
Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29547424/education-the-heart-of-the-matter
#8
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29524725/validation-of-the-simulated-vaginal-hysterectomy-trainer-simvaht
#9
Monique H Vaughan, Shunaha Kim-Fine, Kathie L Hullfish, Tovia M Smith, Nazema Y Siddiqui, Elisa R Trowbridge
STUDY OBJECTIVE: To establish construct validity of the simulated vaginal hysterectomy trainer (SimVaHT). DESIGN: Cross-sectional validation study (Canadian Task Force classification II-2). SETTING: Single academic medical center in the United States. SUBJECTS: Fourteen residents in Obstetrics and Gynecology (four PGY-1, four PGY-2, three PGY-3 and three PGY-4). PGY-1 and PGY-2 residents were grouped to form the "junior level" cohort, while PGY-3 and PGY-4 residents comprised the "senior level" cohort...
March 7, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29523995/the-role-of-simulation-training-in-anesthesiology-resident-education
#10
REVIEW
Kazuma Yunoki, Tetsuro Sakai
An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology...
March 9, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29510491/crisis-resource-management-in-the-delivery-room-development-of-behavioral-markers-for-team-performance-in-emergency-simulation
#11
Fabrizio Bracco, Gabriele de Tonetti, Michele Masini, Marcello Passarelli, Francesca Geretto, Danilo Celleno
Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room...
March 3, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29493898/measuring-movement-towards-improved-emergency-obstetric-care-in-rural-kenya-with-implementation-of-the-pronto-simulation-and-team-training-program
#12
Julia C Dettinger, Stephen Kamau, Kimberly Calkins, Susanna R Cohen, John Cranmer, Minnie Kibore, Onesmus Gachuno, Dilys Walker
As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO International (PRONTO) simulation-based training as part of the Linda Afya ya Mama na Mtoto (LAMMP, Protect the Health of mother and child) in Kenya...
February 2018: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/29474294/surgical-anatomy-of-vaginal-hysterectomy-impact-of-a-resident-constructed-simulation-model
#13
Mallika Anand, Conor P Duffy, Olivera Vragovic, Wafaa Abbasi, Shannon L Bell
OBJECTIVES: Obstetrics and gynecology residents are less prepared to perform vaginal hysterectomy (VH), despite its advantages over other hysterectomy routes. The American Congress of Obstetricians and Gynecologists and Council on Resident Education in Obstetrics and Gynecology have prioritized simulation training in VH. Our objective was to improve residents' understanding of surgical anatomy of VH using a resident-constructed, low-cost, low-fidelity model. METHODS: A single simulation session was held in November 2016...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29455162/evaluation-of-learning-from-practical-obstetric-multi-professional-training-and-its-impact-on-patient-outcomes-in-australia-using-kirkpatrick-s-framework-a-mixed-methods-study
#14
Arunaz Kumar, Sam Sturrock, Euan M Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, Philip Dekoninck
OBJECTIVES: The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. STUDY DESIGN: Mixed methods approach with a pre-test/post-test design...
February 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29433368/teaching-childbirth-with-high-fidelity-simulation-is-it-better-observing-the-scenario-during-the-briefing-session
#15
Marcos J Cuerva, Carlos S Piñel, Lourdes Martin, Jose A Espinosa, Octavio J Corral, Nicolás Mendoza
The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29422404/new-challenges-for-a-core-procedure-development-of-a-faculty-workshop-for-skills-maintenance-for-abdominal-hysterectomy
#16
Lori R Berkowitz, Kaitlyn James, Emil Petrusa, Carey York-Best, Anjali J Kaimal
OBJECTIVE: To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. DESIGN: After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH...
February 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29393042/assessment-and-learning-of-ultrasound-skills-in-obstetrics-gynecology%C3%A2
#17
Martin Grønnebæk Tolsgaard
Ultrasound is a core skill in obstetrics-gynecology, but is highly operator-dependent. The evidence supporting the use of different methods for assessment and training of ultrasound skills was examined from different perspectives through a series of explorative and experimental studies.
We found that ultrasound performance of trainees in obstetrics-gynecology depended on a combination of motor skills, visual skills, and cognitive skills. We then established international multispecialty consensus on an assessment instrument designed to evaluate ultrasound skills...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29386989/cadaveric-surgery-in-core-gynaecology-training-a-feasibility-study
#18
Chou Phay Lim, Mark Roberts, Tony Chalhoub, Jason Waugh, Laura Delegate
Background: Fresh frozen cadaver training has been proposed as a better model than virtual reality simulators in laparoscopy training. We aimed to explore the relationship between cadaveric surgical training and increased surgical confidence.To determine feasibility, we devised two 1-day cadaveric surgical training days targeted at trainees in obstetrics and gynaecology. Seven defined surgical skills were covered during the course of the day. The relationship between surgical training and surgical confidence was explored using both quantitative (confidence scores) and qualitative tools (questionnaires)...
2018: Gynecological Surgery
https://www.readbyqxmd.com/read/29383061/training-in-emergency-obstetrics-a-needs-assessment-of-u-s-emergency-medicine-program-directors
#19
Daniel W Robinson, Michael Anana, Mary A Edens, Marc Kanter, Sorabh Khandelwal, Kaushal Shah, Todd Peterson
Introduction: Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods: We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH), shoulder dystocia, and breech presentation) through email invitations to all program directors (PD) of U...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29381590/simulation-of-shoulder-dystocia-for-skill-acquisition-and-competency-assessment-a-systematic-review-and-gap-analysis
#20
Edith D Gurewitsch Allen
Mastery of shoulder dystocia management skills acquired via simulation training can reduce neonatal brachial plexus injury by 66% to 90%. However, the correlation between simulation drills and reduction in clinical injuries has been inconsistently replicated, and establishing a causal relationship between simulation training and reduction of adverse clinical events from shoulder dystocia is infeasible due to ethical limitations. Nevertheless, professional liability insurance carriers increasingly are mandating simulation-based rehearsal and competency assessment of their covered obstetric providers' shoulder dystocia management skills-a high-stakes demand that will require rapid scaling up of access to quality shoulder dystocia simulation...
January 29, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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