Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Second trimester surgical termination of pregnancy by dilation and evacuation (D&E) is a procedure that the Obstetrics and Gynecology (OB/GYN) Residency Review Committee requires training programs to offer to their residents and that many residents desire to learn. However, because of limited numbers of credentialed providers, clinical training opportunities may be limited or not available at their training institutions. Simulated procedures may allow for residents and other learners to be more prepared and capable at the time of their first clinical procedures or advanced skill acquisition. ⋯ The task trainer for ultrasound-guided second trimester uterine evacuation showed excellent face validity. This low-cost task trainer provides residents and other trainees with a tool to practice ultrasound-guided fetal extraction skills and improve proficiency with D&E outside the operating room. In addition, it increases their confidence in being able to perform the procedure on patients.
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Although many methods have been proposed to assess clinical performance during resuscitation, robust and generalizable metrics are still lacking. Further research is necessary to develop validated clinical performance assessment tools and show an improvement in outcomes after training. We aimed to establish evidence for validity of a previously published scoring instrument--the Clinical Performance Tool (CPT)--designed to evaluate clinical performance during simulated pediatric resuscitations. ⋯ Pediatric residents improved scores on CPT after completion of a PALS course. Clinical Performance Tool scores are sensitive to the increase in skills and knowledge resulting from such a course but not to learners' levels. Validity evidence from scores for the CPT confirms implementation in new contexts and partially supports internal structure. More evidence is required to further support internal structure and especially to support relations with other variables and consequence evidence. Additional modifications should be made to the CPT before considering its use for high-stakes certification such as PALS.
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Iatrogenic complications associated with chest tube insertion (CTI) could be related to the gaps in the procedural fidelity of the current CTI training models and their insufficiency to support training of procedural mastery. A CTI bench model simulation developed with reference to preexisting curriculum increases trainees' exposure and practice of this clinical skill. Newly developed training models need to be recognized by trainees as a usable learning device. In this report, we describe the development of a novel CTI model, based on curriculum, and survey its usability as a training model among pediatric trainees. ⋯ A PCTITT is an easy to create and feasible bench top task trainer to teach CTI skills, which integrates with other simulations currently in use the process of teaching CTI. Trainees recognized it as usable and superior to previous models. Future work needs to focus on the improvement of model fidelity, skills transferability, and tool validation.
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Few valid and reliable grading checklists have been published for the evaluation of performance during simulated high-stakes perioperative event management. As such, the purposes of this study were to construct valid scoring checklists for a variety of perioperative emergencies and to determine the reliability of scores produced by these checklists during continuous video review. ⋯ The findings indicate that the grading checklists described are valid, are reliable, and could be used in perioperative crisis management assessment.
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Randomized Controlled Trial
Immediate and 1-year chest compression quality: effect of instantaneous feedback in simulated cardiac arrest.
Several studies have demonstrated subpar chest compression (CC) performance by trained health care professionals. The objective of this study was to determine the immediate and sustained effect of instantaneous audiovisual feedback on CC quality. ⋯ Instantaneous audiovisual feedback training on CC quality produces immediate improvements in compression rate, hand placement, as well as depth and recoil compliance. These improvements, however, are not retained 1 year later. Improved depth performance may be correlated to an increased training frequency.