Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Comparative Study
Perception of realism during mock resuscitations by pediatric housestaff: the impact of simulated physical features.
Physical signs that can be seen, heard, and felt are one of the cardinal features that convey realism in patient simulations. In critically ill children, physical signs are relied on for clinical management despite their subjective nature. Current technology is limited in its ability to effectively simulate some of these subjective signs; at the same time, data supporting the educational benefit of simulated physical features as a distinct entity are lacking. We surveyed pediatric housestaff as to the realism of scenarios with and without simulated physical signs. ⋯ PALS scenarios were rated as highly realistic by pediatric residents. Slight differences existed between subjects exposed to simulated physical features and those not exposed to them; these differences were most pronounced in scenarios involving pulselessness. Specific physical features were rated as more important than others by subjects. Data from these surveys may be informative in designing future simulation technology.
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Randomized Controlled Trial
A training program for novice paramedics provides initial laryngeal mask airway insertion skill and improves skill retention at 6 months.
Major resuscitation councils endorse the use of the laryngeal mask airway (LMA) by paramedics for lifesaving airway interventions. Learning and maintaining adequate skill level is important for patient safety. The aim of this project was to develop a training program that provides student paramedics with initial knowledge and experience in LMA insertion skills but equally important to provide ongoing skill retention. ⋯ We devised a short intervention based on our training program using a video and practice in part task trainers. In an assessment using high-fidelity simulation, we demonstrated significant improvements in maintenance of LMA insertion skills in student paramedics at 6 months. Our model of just-in-time assessment and reinforcement of training prevents skill decay and has implications for healthcare skills training in general.
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Moderate capability simulators such as Laerdal's SimMan allow for the operator to control the vital signs presented on the monitor. However, the presence of the mannequin simulator may not always be needed to achieve specific teaching goals. In this report, we describe the use of the SimMan software to generate, control, and project vital signs on a projector screen, with an appearance identical to that of its normal companion monitor. ⋯ Laerdal SimMan software can be used to create a dynamic and interactive presentation tool for classroom learning.
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Crisis resource management (CRM) skills are a set of nonmedical skills required to manage medical emergencies. There is currently no gold standard for evaluation of CRM performance. A prior study examined the use of a global rating scale (GRS) to evaluate CRM performance. This current study compared the use of a GRS and a checklist as formal rating instruments to evaluate CRM performance during simulated emergencies. ⋯ Construct validity seems to be present when using both the Ottawa GRS and CRM checklist to evaluate CRM performance during simulated emergencies. Data also indicate the presence of moderate inter-rater reliability when using both the Ottawa GRS and CRM checklist.