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Simulation in Emergency Medicine

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197 papers 25 to 100 followers
Luciana Garbayo, James Stahl
Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued...
August 6, 2016: Medicine, Health Care, and Philosophy
Dustin Smith, Daniel G Miller, Jeffrey Cukor
INTRODUCTION: Work interruptions during patient care have been correlated with error. Task-switching is identified by the Accreditation Council for Graduate Medical Education (ACGME) as a core competency for emergency medicine (EM). Simulation has been suggested as a means of assessing EM core competencies. We assumed that senior EM residents had better task-switching abilities than junior EM residents. We hypothesized that this difference could be measured by observing the execution of patient care tasks in the simulation environment when a patient with a ST-elevation myocardial infarction (STEMI) interrupted the ongoing management of a septic shock case...
March 2016: Western Journal of Emergency Medicine
Simon Cooper, Robyn Cant, Cliff Connell, Lyndall Sims, Joanne E Porter, Mark Symmons, Debra Nestel, Sok Ying Liaw
AIM: To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). BACKGROUND: Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes. METHODS: A quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED...
April 2016: Resuscitation
Peter F Kemper, Martine de Bruijne, Cathy van Dyck, Ralph L So, Peter Tangkau, Cordula Wagner
INTRODUCTION: There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. METHODS: Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months)...
August 2016: BMJ Quality & Safety
Z Friedman, M A Hayter, T C Everett, C T Matava, L M K Noble, M D Bould
A key factor that may contribute to communication failures is status asymmetry between team members. We examined the effect of a consultant anaesthetist's interpersonal behaviour on trainees' ability to effectively challenge clearly incorrect clinical decisions. Thirty-four trainees were recruited to participate in a video-recorded scenario of an airway crisis. They were randomised to a group in which a confederate consultant anaesthetist's interpersonal behaviour was scripted to recreate either a strict/exclusive or an open/inclusive communication dynamic...
October 2015: Anaesthesia
Robert W Frengley, Jennifer M Weller, Jane Torrie, Peter Dzendrowskyj, Bevan Yee, Adam M Paul, Boaz Shulruf, Kaylene M Henderson
OBJECTIVE: We evaluated the effectiveness of a simulation-based intervention on improving teamwork in multidisciplinary critical care teams managing airway and cardiac crises and compared simulation-based learning and case-based learning on scores for performance. DESIGN: Self-controlled randomized crossover study design with blinded assessors. SETTING: A simulated critical care ward, using a high-fidelity patient simulator, in a university simulation center...
December 2011: Critical Care Medicine
Vicki R Leblanc, Cheryl Regehr, Walter Tavares, Aristathemos K Scott, Russell Macdonald, Kevin King
OBJECTIVES: Substantial research demonstrates that the stressors accompanying the profession of paramedicine can lead to mental health concerns. In contrast, little is known about the effects of stress on paramedics' ability to care for patients during stressful events. In this study, we examined paramedics' acute stress responses and performance during simulated high-stress scenarios. METHODS: Twenty-two advanced care paramedics participated in simulated low-stress and high-stress clinical scenarios...
August 2012: Prehospital and Disaster Medicine
Bradley Davis, Katherine Welch, Sharon Walsh-Hart, Dennis Hanseman, Michael Petro, Travis Gerlach, Warren Dorlac, Jocelyn Collins, Timothy Pritts
BACKGROUND: Critical Care Air Transport Teams (CCATTs) are a critical component of the United States Air Force evacuation paradigm. This study was conducted to assess the incidence of task saturation in simulated CCATT missions and to determine if there are predictable performance domains. METHODS: Sixteen CCATTs were studied over a 6-month period. Performance was scored using a tool assessing eight domains of performance. Teams were also assessed during critical events to determine the presence or absence of task saturation and its impact on patient care...
August 2014: Military Medicine
Samuel Clarke, Timothy Horeczko, Dale Cotton, Aaron Bair
BACKGROUND: High-fidelity patient simulation has been praised for its ability to recreate lifelike training conditions. The degree to which high fidelity simulation elicits acute emotional and physiologic stress among participants - and the influence of acute stress on clinical performance in the simulation setting - remain areas of active exploration. We examined the relationship between residents' self-reported anxiety and a proxy of physiologic stress (heart rate) as well as their clinical performance in a simulation exam using a validated assessment of non-technical skills, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS)...
2014: BMC Medical Education
Donald Byars, Bruce Lo, Jeff Yates
INTRODUCTION: Successful oxygenation and ventilation can mean the difference between life and death in the prehospital setting. While airway challenges can be numerous within the confines of the emergency department, there are many additional confounding difficulties in the prehospital setting, which include limited access to equipment, poor lighting, extreme environments, limited personnel to assist, no immediate backup, and limited rescue airway options. The concept of an easy, reliable, and rapidly deployable alternative rescue airway device is critical, especially when considering the addition of rapid sequence intubation protocols in the prehospital setting...
December 2013: Prehospital and Disaster Medicine
Imri Amiel, Daniel Simon, Ofer Merin, Amitai Ziv
BACKGROUND: Medical simulation is an increasingly recognized tool for teaching, coaching, training, and examining practitioners in the medical field. For many years, simulation has been used to improve trauma care and teamwork. Despite technological advances in trauma simulators, including better means of mobilization and control, most reported simulation-based trauma training has been conducted inside simulation centers, and the practice of mobile simulation in hospitals' trauma rooms has not been investigated fully...
January 2016: Journal of Surgical Education
Adam R Parks, Glenn Verheul, Denise LeBlanc-Duchin, Paul Atkinson
BACKGROUND: Goal-directed point-of-care ultrasound (PoCUS) protocols have been shown to improve the diagnostic accuracy of the initial clinical assessment of the critically ill patient. The diagnostic impact of the Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol was assessed in simulated emergency medical scenarios. METHODS: Following a focused PoCUS training program, the diagnostic accuracy, confidence, and precision of 12 medical learners participating in standardized scenarios were tested using high-fidelity clinical and ultrasound simulators...
May 2015: CJEM
Matthew Edward Smith, Annakan Navaratnam, Lily Jablenska, Panagiotis A Dimitriadis, Rishi Sharma
OBJECTIVES/HYPOTHESIS: Life-threatening ear, nose, and throat (ENT) emergencies are uncommon but require immediate skilled management. We investigated if traditional lecture-based teaching can be improved by a simulation and lecture hybrid approach. STUDY DESIGN: A single-blinded, prospective, randomized controlled trial. METHODS: Two groups of interns with no previous ENT experience were randomized to one of two training groups: a simulation/lecture hybrid group or a lecture-only control group...
August 2015: Laryngoscope
Maxime Maignan, François-Xavier Koch, Jordane Chaix, Pierre Phellouzat, Gery Binauld, Roselyne Collomb Muret, Simon J Cooper, José Labarère, Vincent Danel, Damien Viglino, Guillaume Debaty
AIM: Evaluation of team performances during medical simulation must rely on validated and reproducible tools. Our aim was to build and validate a French version of the Team Emergency Assessment Measure (TEAM) score, which was developed for the assessment of team performance and non-technical skills during resuscitation. METHODS: A forward and backward translation of the initial TEAM score was made, with the agreement and the final validation by the original author...
April 2016: Resuscitation
Allistair Paul McRobert, Joe Causer, John Vassiliadis, Leonie Watterson, James Kwan, Mark A Williams
BACKGROUND: It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. METHOD: Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions...
June 2013: BMJ Quality & Safety
Pin-Tarng Chen, Hung-Wei Cheng, Chia-Rong Yen, I-Wen Yin, Ying-Che Huang, Chao-Chun Wang, Mei-Yung Tsou, Wen-Kuei Chang, Huey-Wen Yien, Cheng-Deng Kuo, Kwok-Hon Chan
BACKGROUND: We integrated lecture, real-time multimedia display and medical simulation into a new renewal airway management training protocol for experienced nurse anesthetists. METHODS: Trainees of the Taiwan Association of Nurse Anesthetists from northern Taiwan and junior residents from our department were enrolled into the training program. A 4-hour renewal curriculum in the management of airway emergencies was developed, which consisted of a 2-hour general lecture (including 4 divided sections) and a 2-hour instructor-based real-time multimedia medical simulation of 4 specific techniques...
April 2008: Journal of the Chinese Medical Association: JCMA
Leonore Bourgeon, Mourad Bensalah, Anthony Vacher, Jean-Claude Ardouin, Bruno Debien
OBJECTIVE: Emergency situations can generate negative affect in medical personnel, which can negatively impact on the quality of care. Several studies have demonstrated a positive influence of emotional competence (EC) on negative affect. The goal of this study was to test the effect of EC level on simulated emergency care situation in medical residents. METHODS: The sample included 21 medical residents caring for a simulated seriously wounded person whose condition suddenly deteriorated...
May 2016: BMJ Quality & Safety
Leo Kobayashi, Marc J Shapiro, Andrew Sucov, Robert Woolard, Robert M Boss, Jennifer Dunbar, Ronald Sciamacco, Kelly Karpik, Gregory Jay
OBJECTIVES: Efforts to mitigate unexpected problems during transition of an active emergency department (ED) to a new physical plant are imperative to ensure effective health care delivery and patient safety. The authors used advanced medical simulation (SIM) to evaluate the capacity of a new ED for emergent resuscitative processes and assist facility orientation before opening day. METHODS: Operational readiness testing and orientation to the new ED of a large academic center were arranged through a Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing (TESTPILOT) project...
June 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Molly Zirkle, Richard Blum, Daniel B Raemer, Gerald Healy, David W Roberson
OBJECTIVE: Simulation is a tool that has been used successfully in many high performance fields to permit training in rare and hazardous events. Our goal was to develop and evaluate a program to teach airway crisis management to otolaryngology trainees using medical simulation. METHODS: A full-day curriculum in the management of airway emergencies was developed. The program consists of three airway emergency scenarios, developed in collaboration between attending otolaryngologists and faculty from the Center for Medical Simulation...
March 2005: Laryngoscope
Chih-Huang Li, Win-Sen Kuan, Malcolm Mahadevan, Lynda Daniel-Underwood, Te-Fa Chiu, H Bryant Nguyen
BACKGROUND: Medical simulation has been used to teach critical illness in a variety of settings. This study examined the effect of didactic lectures compared with simulated case scenario in a medical simulation course on the early management of severe sepsis. METHODS: A prospective multicentre randomised study was performed enrolling resident physicians in emergency medicine from four hospitals in Asia. Participants were randomly assigned to a course that included didactic lectures followed by a skills workshop and simulated case scenario (lecture-first) or to a course that included a skills workshop and simulated case scenario followed by didactic lectures (simulation-first)...
July 2012: Emergency Medicine Journal: EMJ
2016-02-18 02:25:26
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