CREW RESOURCE MANAGEMENT IN THE PICU AND NICU
SIMULATE OR NOT SIMULATE: THAT'S THE QUESTION
Abstract
Background
Medical simulation is a tool, device or environment with which the learner experiences a representation of a real event for the purpose of practice and learning.Objectives
Several studies suggest that delayed or aggressive treatments, poor team dynamics and certain human factors are among the most important drivers of poor outcomes during hospitalization.Moreover, especially in acute care, the healthcare professional faces to complex situations and treatments that are also potentially harmful for the patient. The opportunity to learn in a safe environment remains one of the focal points of improvement in healthcare delivery, especially in pediatrics.
Methods
The field of pediatric simulation has grown rapidly in the last years and simulation-based interventions has been conducted for many purposes: education and training assessment, improvement in the quality of care, designing of new equipment, learn crisis resource management (CRM), unit risk assessment, check situation readiness, implement new protocols, improve interdepartmental coordination, learn new concepts or procedural skills.Results
Simulation-based research (SBR) is mainly oriented to assess the effectiveness of simulation as an educational intervention or as an investigative methodology. It provides several opportunities like an easier standardization (patients, environment and intervention) compared to clinical trials but also challenges like a clear and consistently measurable outcome selection, as far as a plausible association to the intervention.Conclusion
Another important remark is the strengthening of educational networks and a common research program for the pediatric simulation community, in order to ensure high-quality SBR and to point out the most meaningful questions in pediatrics simulation research.CROSSOVER RANDOMIZED CONTROLLED TRIAL OF HIGH-FIDELITY SIMULATION-BASED TRAINING COMPARE TO CASE DISCUSSION FOR TEACHING PEDIATRIC RESIDENTS IN PEDIATRIC CRITICAL CARE MEDICINE
Abstract
Background
Simulation based training was increasing popularity over the decade. Simulation training was used to enhanced learner experience and concerted with adult type learning theory.
Objectives
To assess the effectiveness of high-fidelity simulation-based training (SIM) compare to case-based discussion (CBD) for teaching pediatrics resident in Pediatric Critical Care Medicine topics.
Methods
This study was a prospective, stratified randomized, crossover study of 27 pediatric residents in a single center. Pediatric residents were stratified randomized to 2 groups (A and B). In the first session, residents in group A was experienced to simulation training in pediatric septic shock and pediatric acute respiratory distress syndrome in the group B. During a second session, the residents crossed over and participated case discussion in a different scenario. The primary outcome was written examination scores and the satisfactory of each type of learning.
Results
Of 27 eligible pediatric residents in the academic year of 2018, all of them participated in this study. There was no significant difference of mean examination scores in both groups (42.4±9.0 vs 43.5 ±11.2, p =0.7) In the same direction, the satisfactory from the evaluations were same in both groups in all domains.
Conclusion
There was no significant different in written scores and satisfactory among between 2 types of learning in pediatric critical care medicine topics.
HOW TO INCREASE OF CONFIDENCE IN PROFESSIONAL CARING FOR CHILD
Abstract
Background
Insufficient nursing manpower, high nursing turnover rate, and an increase in influx of new graduate nurses with little experiences at the hospital affect lack of confidence in caring for pediatric patients and their parents expectation. The Project increases awareness to develop a nursing practice to promote a high quality, effective nursing care and to emphasize on knowledge and effective nursing skills in order to increase the confidence in professional caring for the patients.
Objectives
For development of nursing management system to develop knowledge and nursing skills. Promote the status of excellence in nursing practice, through development of nursing practice, ask effective questions and use of simulation in the workplace to promote satisfaction among patients and parents, the measurement by randomly asking the patients on a monthly basis for overall patient satisfactions assessment, ability of nurse to inspire trust and confidence in patients by HCAHP. A yearly questionnaire to evaluate staff’s confidence reflected through staff engagement score and RN turnover rate.
Methods
Using a framework of professional practice model and professional nurse development committee, who will work together as a team to develop competency in nursing practice,training and implementation program as progressive communication, ask effective questions and reflect, use of simulations for promotes active learning and participation to enhance clinical judgment and critical thinking, evaluation and improvement program
Results
shown results in the table.
Conclusion
According to the patient's feedback,The nurses are confident in working professionally. Simulations scenario with multidisciplinary team and effective questions can encourage critical thinking to optimize benefits for patients and families.
CUMULATIVE EVALUATION DATA: SIMULATION BASED LEARNING COURSES FOR PEDIATRIC R1 RESIDENTS
Abstract
Background
Medical simulations aim to imitate real patients, anatomic regions, clinical tasks and virtual reality devices. Benefits includes safe environment, mistake forgiving, trainee focused vs. patient focused, controlled, structured, proactive clinical exposure, reproducible, standardized, debriefing, deliberate and repetitive practice.
Objectives
To utilize cumulative evaluation data of the Intensive pediatric simulation-based learning course on knowledge and practical skills of pediatric R1 residents at Saudi Commission for Health Speciality in order to measure its efficacy and areas for improvement.
Methods
It is a retrospective cohort study that compares pre- post- and retention test 6 months later (knowledge and skills) of an intensive pediatric R1 simulation course. The five-day bundle courses has been conducted once per month at CRESENT and is comprised of airway management with crew resource management, central line insertion under ultrasound guidance, thoracocentesis and chest tube insertion, chest X-ray interpretation and lung ultrasound, lumbar puncture and bone marrow aspiration and biopsy and cardiac simulation course. Our evaluation data includes all pediatric R1 residents who attended the course between September 2017 and May 2018.
Results
Results: A total number of 43 trainees, 23 residents (43.5%) are males and 20 (46.5%) are females.18 (41.9%) are KfMC residents and 25 (58.1%) non-KFMC residents(Table 1). Overall, there is statistically significant improvement between the pretest and post-test knowledge and practical skills scores for all the courses with P-value <0.001.similar result for retension test. Majority enjoyed training in simulation environment
Conclusion
The intensive pediatric simulation courses at CRESENT is effective in improving the knowledge and practical skills of pediatric residents.
APPROACH TO THE DESIGN AND DEVELOPMENT OF COMPUTER-SIMULATED NEONATAL RESUSCITATION ASSESSMENT GAME
Abstract
Background
The Singapore Neonatal Resuscitation Course (SNRC) curriculum is comprised of online e-learning modules, and 1-day instructor facilitated performance and integrated skills training, simulation and debriefing. Current institutional policies require local healthcare professionals to undergo training once every 2 years. However, evidence suggests that knowledge and skills in neonatal resuscitation decay with time as early as 6 months post-training.
SNRC in collaboration with Serious Games Association, Singapore (SGA) designed and developed a computer-simulated neonatal resuscitation assessment game.
Objectives
To develop and implement an unguided, web-based simulation game for re-training and assessment of knowledge and technical skills in neonatal resuscitation.
Methods
A single-player, unguided, time-constrained web-based simulation game was built. The player is the team leader, with 1-3 non-player characters (NPC) in a scenario-based neonatal resuscitation. To promote situated learning, the 2015 newborn resuscitation algorithm was formalized. Learning content is embodied within the game design by recreating accurate simulation environment, including gameplay features and teaching strategies.
Results
Resuscitation scenarios under 3 main categories (Term, Preterm, Extreme Preterm) with graduated levels of difficulties (Easy, Moderate, Challenging) were developed. At the end of every game session, a detailed feedback is available to the user for self-assessment and monitor user’s progress. User's performance data are stored for program evaluation.
Conclusion
Neonatal Resuscitation Training Game (link: https://youtu.be/0aDzjJTWUsc) is a model of learning that facilitates learning on a continuous basis with a focus on competency rather than compliance to institutional policy. It empower learners to take control of their own education and has the potential to impact re-training and competency maintenance in other resuscitation programmes.
EFFECT OF TWO DIFFERENT DEBRIEFING METHODS APPLIED DURING SIMULATION-BASED EDUCATION ON STUDENT SATISFACTION AND SELF-CONFIDENCE IN LEARNING
Abstract
Background
Debriefing session, which is one of the simulation practice stages, is an important step to maximize the information and to make a behavior change possible both individually and systematically.
Objectives
In this study, it was aimed to determine the effect of two different debriefing methods applied to the nursing students who received the neonatal intensive care course, during the simulation based education on the student satisfaction and self-confidence in learning.
Methods
This study was designed as a quasi-experimental study and designed as a two-period, two-treatment cross-over design. In the research, participants were randomly divided into two groups as A and B. Simulation practices “Nutrition for Risky Newborns” and “Hyperbilirubinemia in Newborn” were performed. PEARLS method was used during the debriefing session. Two different debriefing methods (video assisted debriefing and debriefing using only facilitator without video) were applied to groups. The data were obtained by using the Student Satisfaction and Self-Confidence in Learning Scale (SCLS), pre- post test and checklists.
Results
Total average score of the students for the SCLS is 54.51 ± 5.27. There was no statistically significant difference between the total scores of the students for the SCLS, pre-test and post-test, and the level of increase in the post-test as compared to the pre-test (p>0,05). The Cronbach's alpha internal consistency coefficient for the scale was determined as 0.929.
Conclusion
It is concluded that the use of a video assisted debriefing and debriefing using only facilitator without video in the Simulation Based Neonatal Intensive Care Nursing Education has not an effect on the SCLS.