Background: Healthcare education models have recently shifted from the traditional reliance on the apprenticeship model, where trainees learn on real patients in actual clinical settings, to one based on simulation mo...Background: Healthcare education models have recently shifted from the traditional reliance on the apprenticeship model, where trainees learn on real patients in actual clinical settings, to one based on simulation models. Education in airway management is a fundamental component of anesthetic training programs, and airway modification to simulate difficult airways increases the fidelity of airway management training. Objective: The study goal was to determine the feasibility of simulating difficult airways such as mandibular fracture and post-tonsillectomy bleed in cadaver models by surgical modification for the use in enhanced experiential learning of difficult airway management. Methods: Two cadaver heads were modified surgically to simulate a mandibular fracture and post-tonsillectomy bleed. Workshop facilitators conducted directed one-to-one learning and provided feedback to participants. A paper-based feedback was obtained from the participants on their confidence level, and the realism, attractiveness, beneficial levels, and difficulty levels of the simulation models used. Results: The modified cadavers were reliable in simulating difficult airways. The majority of participants (83.3% for fractured mandible and 87.1% for post-tonsillectomy bleed) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers, and found both models realistic, attractive, and beneficial for difficult airway training. Conclusions: Surgical modifications of cadavers to simulate difficult airways such as fractured mandible and post-tonsillectomy bleed may be incorporated into advanced airway management courses to enhance experiential learning.展开更多
Background: Student test scores in the pediatric portion were at a national percentile rank of 30, which was concerning. It was theorized that the main contributor to this dilemma was that the majority of students wer...Background: Student test scores in the pediatric portion were at a national percentile rank of 30, which was concerning. It was theorized that the main contributor to this dilemma was that the majority of students were not able to have a pediatric clinical experience. Objective: The purpose of this project was to determine if the addition of pediatric simulation scenarios would have an impact on student learning as evidenced by end of level test scores. Method: A convenience sample (n = 100) of first year nursing students attending a university in the western United States participated in this project. This was a mixed methods study. A quasi-experimental design was used to compare test scores of both a non-intervention group and an intervention group of students. A 5 point Likert scale questionnaire was also using post-intervention to assess for changes in perceptions of self-confidence. Results: After implementation of the pediatric focused scenarios, students’ test scores increased to the 95th percentile. This 65 percentile increase is a significant change that suggests that pediatric simulation is effective in improving student exam performance. In addition, 81% of students also reported perceptions of increased levels of self-confidence after implementation of simulation scenarios. Conclusion: The findings suggest that simulation is an effective way to create alternative pediatric clinical experiences which can, in turn, increase student comprehension, test scores, and self-confidence.展开更多
目的:系统评价体验式分娩模拟教学对初产妇的影响。方法:计算机检索PubMed、Web of Science、Cochrane Library、CBM、CNKI和WanFang Data等数据库中自建库至2020年7月10日所有关于体验式分娩模拟教学对初产妇影响的随机对照试验(RCT)...目的:系统评价体验式分娩模拟教学对初产妇的影响。方法:计算机检索PubMed、Web of Science、Cochrane Library、CBM、CNKI和WanFang Data等数据库中自建库至2020年7月10日所有关于体验式分娩模拟教学对初产妇影响的随机对照试验(RCT)。采用RevMan 5.3行Meta分析。结果:共纳入26篇文献,包括5957例初产妇。Meta分析结果显示,体验式分娩模拟教学能够提高初产妇的自然分娩率(OR=2.71,95%CI:2.40~3.05,P<0.01),降低产后出血率(OR=0.11,95%CI:0.04~0.33,P<0.01)和新生儿窒息率(OR=0.23,95%CI:0.12~0.44,P<0.01),改善初产妇的焦虑(SMD=-1.68,95%CI:-2.01~-1.35,P<0.01)和抑郁(SMD=-1.37,95%CI:-1.58~-1.15,P<0.01),提高其自我效能(MD=5.60,95%CI:2.92~8.28,P<0.01)。结论:体验式分娩模拟教学能够提高初产妇自然分娩率,降低产后出血、新生儿窒息等不良分娩结局的发生,改善初产妇的焦虑、抑郁情绪,提高其自我效能。受纳入研究质量和数量限制,上述结论仍需开展更多高质量研究加以验证。展开更多
文摘Background: Healthcare education models have recently shifted from the traditional reliance on the apprenticeship model, where trainees learn on real patients in actual clinical settings, to one based on simulation models. Education in airway management is a fundamental component of anesthetic training programs, and airway modification to simulate difficult airways increases the fidelity of airway management training. Objective: The study goal was to determine the feasibility of simulating difficult airways such as mandibular fracture and post-tonsillectomy bleed in cadaver models by surgical modification for the use in enhanced experiential learning of difficult airway management. Methods: Two cadaver heads were modified surgically to simulate a mandibular fracture and post-tonsillectomy bleed. Workshop facilitators conducted directed one-to-one learning and provided feedback to participants. A paper-based feedback was obtained from the participants on their confidence level, and the realism, attractiveness, beneficial levels, and difficulty levels of the simulation models used. Results: The modified cadavers were reliable in simulating difficult airways. The majority of participants (83.3% for fractured mandible and 87.1% for post-tonsillectomy bleed) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers, and found both models realistic, attractive, and beneficial for difficult airway training. Conclusions: Surgical modifications of cadavers to simulate difficult airways such as fractured mandible and post-tonsillectomy bleed may be incorporated into advanced airway management courses to enhance experiential learning.
文摘Background: Student test scores in the pediatric portion were at a national percentile rank of 30, which was concerning. It was theorized that the main contributor to this dilemma was that the majority of students were not able to have a pediatric clinical experience. Objective: The purpose of this project was to determine if the addition of pediatric simulation scenarios would have an impact on student learning as evidenced by end of level test scores. Method: A convenience sample (n = 100) of first year nursing students attending a university in the western United States participated in this project. This was a mixed methods study. A quasi-experimental design was used to compare test scores of both a non-intervention group and an intervention group of students. A 5 point Likert scale questionnaire was also using post-intervention to assess for changes in perceptions of self-confidence. Results: After implementation of the pediatric focused scenarios, students’ test scores increased to the 95th percentile. This 65 percentile increase is a significant change that suggests that pediatric simulation is effective in improving student exam performance. In addition, 81% of students also reported perceptions of increased levels of self-confidence after implementation of simulation scenarios. Conclusion: The findings suggest that simulation is an effective way to create alternative pediatric clinical experiences which can, in turn, increase student comprehension, test scores, and self-confidence.
