Jordan D Bohnen, Leah Demetri, Eva Fuentes, Kathryn Butler, Reza Askari, Rahul J Anand, Emil Petrusa, Haytham M A Kaafarani, D Dante Yeh, Noelle Saillant, David King, Susan Briggs, George C Velmahos, Marc de Moya
OBJECTIVE: Resuscitative Thoracotomy or Emergency Department Thoracotomy (EDT) is a time-sensitive and potentially life-saving procedure. Yet, trainee experience with this procedure is often limited in both clinical and simulation settings. We sought to develop a high-fidelity EDT simulation module and assessment tool to facilitate trainee education. DESIGN: Using the Kern model for curricular development, a group of expert trauma surgeons identified EDT as a high-stakes, low-frequency procedure...
September 2018: Journal of Surgical Education
M A Corvetto, J C Pedemonte, D Varas, C Fuentes, F R Altermatt
BACKGROUND: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. METHODS: Postgraduate year 1 (PGY-1) residents from anesthesiology, emergency medicine, cardiology, ICU, and nephrology specialties were trained in four deliberate practice sessions...
October 2017: Acta Anaesthesiologica Scandinavica
Andrew Petrosoniak, Agnes Ryzynski, Gerald Lebovic, Karen Woolfrey
INTRODUCTION: Technical skill acquisition for rare procedures can be challenging given the few real-life training opportunities. In situ simulation (ISS), a training technique that takes place in the actual workplace, is a promising method to promote environmental fidelity for rare procedures. This study evaluated a simulation-based technical skill curriculum for cricothyroidotomy using deliberate practice, followed by an ISS evaluation session. METHODS: Twenty emergency medicine residents participated in a two-part curriculum to improve cricothryoidotomy performance...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
Mrinalini Balki, David Hoppe, David Monks, Lynn Sharples, Mary Ellen Cooke, Lawrence Tsen, Rory Windrim
OBJECTIVE: The objective of this study was to establish the validity and reliability of a new interdisciplinary teamwork assessment scale, the Perinatal Emergency Team Response Assessment (PETRA), to assess team dynamics during a simulated obstetric crisis. METHODS: This observational cohort study was conducted using high-fidelity simulation and multidisciplinary obstetric teams in order to evaluate the validity and reliability of the previously developed PETRA scale for the assessment of teamwork in the management of obstetric crises...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC
Kaileigh A Byrne, Crina D Silasi-Mansat, Darrell A Worthy
The purpose of the present study was to examine whether the Big Five personality factors could predict who thrives or chokes under pressure during decision-making. The effects of the Big Five personality factors on decision-making ability and performance under social (Experiment 1) and combined social and time pressure (Experiment 2) were examined using the Big Five Personality Inventory and a dynamic decision-making task that required participants to learn an optimal strategy. In Experiment 1, a hierarchical multiple regression analysis showed an interaction between neuroticism and pressure condition...
February 2015: Personality and Individual Differences
Masoumeh Kordi, Fatemeh Erfanian, Farzaneh Rashidi Fakari, Fatemeh Dastfan, Keivan Shariati Nejad
INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012...
2017: Journal of Education and Health Promotion
Richard Amlôt, Holly Carter, Lorna Riddle, Joanne Larner, Robert P Chilcott
Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an "Initial Operational Response" by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads)...
2017: PloS One
Andrew J Davis, Lizveth Fierro, Mindi Guptill, Michael Kiemeney, Lance Brown, Dustin D Smith, Timothy P Young
No abstract text is available yet for this article.
September 2017: Annals of Emergency Medicine
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...
March 2017: 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)...
July 27, 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
2016-02-18 02:34:38
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