BACKGROUND: The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment. METHODS: The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council. A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios. The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured. RESULTS: The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR = 1.17, 95% CI: 1.02 to 1.35, p = 0.023) which were significantly more frequently performed in proper order (220: 338; OR = 1.68, 95% CI: 1.40 to 2.02, p < 0.0001). The use of ABCDE CAT did not prolong the time of patient assessment. CONCLUSION: The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.
- MeSH
- delfská metoda MeSH
- kognice * MeSH
- kontrolní seznam normy MeSH
- kurikulum MeSH
- lidé MeSH
- mladý dospělý MeSH
- osoby simulující pacienta ve výuce MeSH
- pilotní projekty MeSH
- pomocný zdravotnický personál výchova MeSH
- resuscitační péče normy MeSH
- směrnice jako téma MeSH
- třídění pacientů normy MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- validační studie MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: A lack of physician training is a major obstacle for effective tobacco dependence treatment. This study assessed the feasibility of an active learning training program and its effects on smoking cessation counselling skills of medical residents in Armenia, an Eastern European country with high smoking prevalence. STUDY DESIGN: The study used a pre-post assessment of smoking cessation counselling activities and a course evaluation survey to assess the feasibility of the intervention in a different environment. METHODS: We adapted an active learning training model developed in Switzerland. Residents were trained in Yerevan, Armenia, using video-taped counselling sessions, role plays, standardized patients (actors), group discussions and immediate feedback. The training evaluation was done using a semi-structured anonymous questionnaire. The study assessed the physicians' self-reported smoking cessation counselling activities before and 6 months after the training. A non-parametric Mann-Whitney test was used to assess pre-post differences in physicians' counselling skills measured on ordinal scale. RESULTS: Of the 37 residents trained, 75% were female, 89% aged 20-29 years and 83% were never-smokers. Twenty-eight trainees (76%) returned the course evaluation survey and 32 (86%) answered a questionnaire on skills self-assessment at 6 months follow-up. The majority agreed the course was successful in achieving its learning objectives (64%-96%) and increased their confidence in assisting their patients to quit (74%). After 6 months, the physicians were more likely than at baseline to adhere to evidence-based counselling strategies, including assessing the smoking status and dependence and matching the advice to the patient motivation. The training did not, however, improve the prescription of tobacco dependence medications. CONCLUSIONS: Six months after the training, several self-reported smoking cessation counselling activities had significantly improved compared to baseline. This training model is acceptable for medical residents in Yerevan, Armenia and offers a promising approach in addressing the lack of physician counselling skills in similar settings and populations.
- MeSH
- dospělí MeSH
- hodnocení programu MeSH
- kontinuální vzdělávání lékařů metody organizace a řízení statistika a číselné údaje MeSH
- kuřáci psychologie MeSH
- lékaři statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- odvykání kouření metody MeSH
- osoby simulující pacienta ve výuce MeSH
- poradenství výchova statistika a číselné údaje MeSH
- poruchy vyvolané užíváním tabáku diagnóza terapie MeSH
- problémově orientovaná výuka metody organizace a řízení statistika a číselné údaje MeSH
- průzkumy a dotazníky statistika a číselné údaje MeSH
- studie proveditelnosti MeSH
- vzdělávací modely MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Arménie MeSH
This paper presents the domain of information sciences, applied informatics and biomedical engineering, proposing to develop methods for an automated detection of similarities between two particular virtual learning environments - virtual patients at Akutne.cz and the OPTIMED curriculum management system - in order to provide support to clinically oriented stages of medical and healthcare studies. For this purpose, the authors used large amounts of text-based data collected by the system for mapping medical curricula and through the system for virtual patient authoring and delivery. The proposed text-mining algorithm for an automated detection of links between content entities of these systems has been successfully implemented by the means of a web-based toolbox.
- MeSH
- algoritmy MeSH
- kurikulum * MeSH
- lidé MeSH
- osoby simulující pacienta ve výuce * MeSH
- software * MeSH
- studium lékařství * MeSH
- učení MeSH
- virtuální realita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Background: The problems and difficulties in students' education that arise from the existing undergraduate curriculum at the medical school of Aristotle University of Thessaloniki (AUTH) urged the academic staff members to the pursuance of new pedagogic approaches that could revitalize medical education practice. The educational programs "mEducator", "ePBLnet" and "Ariadne" that run at AUTH laid the foundations for the development of a plenty of virtual patient (VP) cases. A VP is an innovative computer simulation method that can motivate students to occupy themselves with their studies and perfect their skills. Unfortunately, despite the indisputable advantages of embedding VPs to the lessons, their utilization is neglected during the educational process at AUTH. Objective: The purpose of this study was to explore the reasons for which VP authors do not use their own VP cases. Why even VP authors avoid VPs' exploitation and in this way they forsake the insistent efforts they made through the rigorous process of VPs' creation? Methods: After study' s authorization, 35 academic staff members, who had previously developed their own VPs, signed an informed consent and fulfilled a specially designed questionnaire, mainly consisted of closed questions (answer: yes/ no) about the possible causes of VPs' dereliction. Results: Some 77% of participants granted that they do not utilize their own VP cases. Almost 56% of them admitted that the lack of proper infrastructures (computers, projectors) and Internet connection in the lecture rooms impede VPs' use. Specifically, some 33% acknowledged the absence of access to the Internet as the only reason of VPs' abandonment. Almost 52% claimed that they do not have enough time in the courses for covering the great curriculum. Moreover, almost 30% sustained that the great number of students in the lessons enables all of them to conduct a fruitful discussion. Almost 15% asserted that they do not exploit VPs due to the combination of the above two reasons. Conclusions:Undoubtedly, VPs' embracement can upgrade medical education practice. According to this study, infrastructural in conjunction with organizational problems subvert VPs' utilization during the pedagogic process. The institutions should strive for these problems' resolution in order to facilitate medical education modernization and complete future curriculum transformation.
Aim: To outline the purpose and meaning of using simulation methods in education in nursing study program. Background: The transformation of university education is becoming mandatory in medical and paramedical sciences. This transformation is due to the progressive development of health care and medicine informatics, an increase of new knowledge, and advanced diagnostic and therapeutic procedures and well. Methodology: Content analysis of selected studies published in EBSCO databases for the period 2005-2015 and synthesis of collected data. Results: Application of simulation methods (SM) in the learning process in nursing improves cognitive skills of students (knowledge, critical thinking, clinical judgment, and communication skills), psychomotor skills and affective abilities (increased confidence and motivation, improving satisfaction, relieve anxiety) and it has positive impact on outcomes in patients. Conclusion: The groups exposed to simulation demonstrated positive transformation of cognitive and affective abilities and motor skills in clinical practice. Education based on simulations is an effective teaching strategy in nursing.
- MeSH
- klinické kompetence MeSH
- lidé MeSH
- osoby simulující pacienta ve výuce * MeSH
- studium ošetřovatelství * metody MeSH
- tréninková simulace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Aim: The aim of this study is to analyze the available research evidence on the effectiveness of training methods used in communication and interpersonal skills enhancement in midwifery practice and study. Design: Review. Methods: A systematic search in SCOPUS and PubMed databases was performed, with the following selection criteria for studies: quantitative studies in English between the years 2006–2016, using the key words: communication enhancement, communication training, and midwifery in their abstract or title. Theoretical analyses of the problem and review articles were excluded. The search process resulted in the discovery of nine studies focusing on communication skills enhancement in midwifery. Results: All of the available studies confirmed positive effects on communication skills in general, particularly on self-confidence, selfawareness, subjective feelings of competency, and communication within the team. Roleplay with patient-actors proved to be more effective than patient simulators. Conclusion: Although positive effects of the communication training programs were reported in the articles reviewed, there was a high level of heterogeneity in the intervention methods, length and outcome measures used within the training programs. Research studies comparing the effectiveness of the different training methods, using objective outcome measures, and with good quality methodological background, are needed in this area in order to formulate clear recommendations for practice regarding effective interventions.
- MeSH
- babictví * výchova MeSH
- klinické kompetence MeSH
- komunikace MeSH
- lidé MeSH
- osoby simulující pacienta ve výuce MeSH
- porodní asistentky * výchova MeSH
- problémově orientovaná výuka MeSH
- studium ošetřovatelství - výzkum * MeSH
- studium ošetřovatelství metody MeSH
- výuka - hodnocení MeSH
- vztahy mezi ošetřovatelkou a pacientem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Nácvik správného řešení kritických stavů v pregraduální výuce medicíny patří do náplně předmětů První pomoc, Intenzivní medicína, Urgentní medicína a Anesteziologie a léčba bolesti. Cílem sdělení je představit přehled možností interaktivní výuky, které nabízíme studentům medicíny na Lékařské fakultě Masarykovy univerzity (LF MU): využití virtuálního pacienta (interaktivní algoritmy, klinické scénáře), simulovaného pacienta, nácvik technik zajištění pa-cienta na modelech, simulátory s implementovaným fyziologickým modelem anebo videokonferenční přenosy dění z operačních sálů. Tyto metody výuky se staly součástí výše zmíněných předmětů v pregraduální výuce studentů Všeobecného lékařství, Zubního lékařství a nelékařských zdravotnických oborů. Od roku 2007 bylo na LF MU vytvořeno 43 interaktivních výukových algoritmů v české a anglické jazykové verzi. Proces tvorby počínaje studiem literatury, tvorbou textu jednotlivých uzlů a získání multimediálních materiálů probíhá ve skupině 2–3 studentů medicíny pod vedením lékaře a trvá 2 semestry. Vzniklý algoritmus je ve formě Flash objektu volně přístupný online na portálu AKUTNE.CZ (www.akutne.cz). Klinické scénáře představují skutečné případy pacientů v těžké sepsi, hospitalizovaných na pracovišti intenzivní medicíny, jejichž data se stala součástí registru EPOSS (eposs.registry.cz; Data-based evaluation and prediction of outcome in severe sepsis). Videokonferenční přenosy z operačních sálů do výukové místnosti umožní shlédnout raritní operační výkony velkému počtu studentů naráz bez narušení provozu operačních sálů. Pokročilý pacientský simulátor firmy CAE Healthcare? je na LF MU již čtvrtým rokem využíván k nácviku řešení týmové spolupráce u akutních situací v rámci předmětů První pomoc, Intenzivní medicína a Urgentní medicína. Přinesli jsme přehled metod, kterými lze obohatit pregraduální výuku akutních stavů v medicíně, spolu s návody na jejich implementaci do kurikula.
Management of the critical patient in the undergraduate teaching of medicine is an important part of first aid, intensive care medicine and anaesthesiology. The aim of this paper is to present an overview of the interactive learning opportunities which are offered to students at the Medical Faculty of Masaryk University (MF MU): the use of the virtual patient (interactive algorithms, clinical scenarios), the standardised patient, skills training on patient models, simulators with an embedded computer model or videoconference streaming from operating theatres. These teaching methods have become part of undergraduate teaching of medicine, dentistry and nursing. Since the year 2007, 43 interactive learning algorithms have been created at MF MU in the Czech-English version. The process of creation takes two semesters and is performed by groups of 2–3 students of medicine under the supervision of a physician. The created algorithm is in the form of a Flash object freely accessible online through the AKUTNE.CZ portal (www.akutne.eu). The clinical scenarios represent real cases of patients with severe sepsis hospitalized on ICUs participating in EPOSS (eposs.registry.cz; Data-based evaluation and prediction of outcome in severe sepsis). Videoconference streaming from operating theatres to teaching rooms enables a large number of students to watch a rare surgical procedure without entering the operating theatre. Advanced patient simulator by CAE Healthcare? has been used for four years at MF MU to practice team leadership and communication skills in the subjects of first aid, intensive care medicine and emergency medicine. We present an overview of methods that can enrich undergraduate education of acute medicine, along with instructions for their implementation into the curriculum.
- MeSH
- akutní nemoc MeSH
- algoritmy MeSH
- anesteziologie * výchova MeSH
- audiovizuální pomůcky MeSH
- lékařská informatika MeSH
- lidé MeSH
- on-line systémy MeSH
- osoby simulující pacienta ve výuce MeSH
- počítačem řízená výuka MeSH
- problémově orientovaná výuka * metody MeSH
- programovaná výuka jako téma * MeSH
- rozhodování organizační MeSH
- skupinové procesy MeSH
- studium lékařství MeSH
- studium ošetřovatelství MeSH
- urgentní lékařství výchova MeSH
- vyučování metody MeSH
- vzdělávací modely MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Faculty of Medicine of the Masaryk University (MU), and especially its departments focusing on acute medicine, make an active effort to find and to support extra motivated students by organising courses and congresses with simulation-based learning sessions for them. 4th Emergency Medicine Course (EMC) and 6th AKUTNĚ.CZ Congress were organised during 2014. EMC was held during a weekend in mid-April for 80 medical students. The congress was held on 22nd November 2014. A group of more than 700 enthusiastic professionals including physicians, nursing staff and medical students interested in acute medicine met again in Brno at the University Campus Bohunice. We also report the evaluation of effectiveness of different types of sessions, as well as its influence on practical skills and the fixation of memory footprint. The website AKUTNĚ.CZ (www.akutne.cz) is freely accessible, and anyone can find and watch all the videos and presentations there.
OBJECTIVES: We set to measure the interatrial pressure gradient during simulated obstructive sleep apnea (OSA). BACKGROUND: OSA occurs when a sleeping patient attempts to inhale against an obstructed airway. How this event affects the interatrial pressure gradient has not been defined. We hypothesized that simulated OSA in a conscious subject (Mueller maneuver [MM], inspiration against obstruction) would promote increased right-to-left pressure gradient, and then the substrate for right-to-left atrial shunting. METHODS: Selected patients underwent simultaneous measurement of airway and atrial pressures (both left and right atrium [LA, RA]) using high-fidelity micromanometry at rest, during MM, and during VM, during right heart catheterization. RESULTS: Ten patients (age 55 ± 11 years, two women) were successfully studied. During the onset of MM, RA pressure transiently but consistently exceeded LA pressure in response to the steep decline in intrathoracic pressure (maximum RA-LA pressure gradient increased from 0.1 ± 1.4 mm Hg at baseline to 7.0 ± 4.3 mm Hg during MM, P < 0.001). The maximum right-to-left atrial pressure gradient during Mueller maneuver was higher than that achieved during the Valsalva maneuver release (P < 0.007). CONCLUSIONS: The onset of MM increased right-to-left pressure gradient across the atrial septum, likely as a result of greater blood return to the RA from extrathoracic veins. The RA-LA pressure gradient achieved during MM was greater than that observed during VM. These findings delineate the hemodynamic substrate for right to left shunting during OSA.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- manometrie metody MeSH
- následné studie MeSH
- obstrukční spánková apnoe patofyziologie MeSH
- osoby simulující pacienta ve výuce * MeSH
- prospektivní studie MeSH
- síňový tlak fyziologie MeSH
- srdce - funkce pravé síně fyziologie MeSH
- srdeční katetrizace metody MeSH
- srdeční síně patofyziologie MeSH
- Valsalvův manévr MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
