Simulation in healthcare : journal of the Society for Simulation in Healthcare
-
The aim of this review was to identify the strengths and weaknesses of the roles of real and simulated patients in undergraduate medical education. The literature was reviewed in relation to four patient roles: real patients as educational "resource" (passive role), real patients as teachers (active role), and simulated patients as educational resource and teachers. ⋯ Disadvantages were their limited availability and the variability in learning experiences among students. Despite the considerable amount of literature we found, many gaps in knowledge about patient roles in medical education remain and should be addressed by future studies.
-
Comparative Study
Professionalism and communication in the intensive care unit: reliability and validity of a simulated family conference.
An Objective Structured Clinical Exam was designed to assess physician's ability to discuss end-of-life (EOL) and disclose iatrogenic complications (DOC) with family members of intensive care unit patients. The study explores reliability and validity based on scores from contrasting rater groups (clinicians, SPs, and examinees). ⋯ The Family Conference Objective Structured Clinical Exam is a reliable exam with high content validity. It seems unique in the literature for assessing surgical trainees' ability to discuss "bad news" with family members in intensive care.
-
Obstetric crises are unexpected and random. Traditionally, medical training for these acute events has included lectures combined with arbitrary clinical experiences. This educational paradigm has inherent limitations. During actual crises insufficient time exists for discussion and analysis of patient care. Our objective was to create a simulation program to fill this experiential gap. ⋯ Simulated obstetric crises training offers the opportunity for educators to identify specific performance deficits of their residents and the subsequent development of teaching modules to address these weaknesses.
-
Management of pediatric cardiopulmonary arrest (CPA) is challenging because of the low volume of experience of most pediatric health care providers. Use of cognitive aids may assist in making rapid decisions in these crises; however, there are no known published reports on whether these aids are actually used during arrest management and whether they impact quality of care. ⋯ Eighty-five percent of residents voluntarily used a cognitive aid to assist in managing simulated pediatric CPAs. The most commonly used aids were an American Heart Association Pediatric Advanced Life Support aid and an institutionally created aid. Forty-three of 51 (84.3%) and 23 of 46 (60.5%) residents used these aids for assistance with the pulseless ventricular tachycardia and pulseless electrical activity algorithm, respectively. Unfortunately, 13 of 51 (25.5%) residents chose the incorrect treatment algorithm, resulting in inappropriate management. CONCLUSION AND APPLICATION: Although the majority of residents chose to use cognitive aids for assistance, errors in management were common. Further study is required to determine whether these errors are associated with cognitive aid design flaws and whether improving their design through human factors research can help minimize errors in Basic and Advanced Life Support, ultimately improving patient outcomes.