IntroductionSimulation-based learning affords participants the opportunity to practice high-acuity, low-incidence situations without risk to the patient. The realism of a simulated scenario is often referred to as fidelity. High levels of fidelity imply high levels of realism. One method of enhancing fidelity is the use of moulage. Commercially available moulage kits and professionally applied moulage are often expensive and therefore not practical in the resource-constrained environment. Cost-effective alternatives are required for the resource-constrained environment.MethodsStudents at a South African university used readily available, low cost materials to apply self-constructed, low cost moulage for a bandaging practical. A cross sectional design used a purpose-designed, validated questionnaire to gather data related to face and content validity of the self-constructed moulage. Frequency analysis formed the cornerstone of Likert-type quantitative data analysis. An open-ended question afforded participants the opportunity to express their own opinions related to the moulage experience.ResultsThe results revealed that there was both high face validity and high content validity of the self-constructed moulage. Participants found the activity enjoyable and a generally positive learning experience. The self-constructed moulage was realistic and added to the fidelity of the scenario. Participant confidence was improved and their engagement in the learning activity was enhanced. Participants found the self-constructed, low-cost moulage more realistic that commercial products that they had been exposed to.ConclusionThe use of low-cost, self-constructed moulage is a feasible and economically viable means of enhancing fidelity within the resource-constrained simulation setting. This technique is not necessarily limited to emergency medical care and can be used in other areas of healthcare simulation.
Introduction High-acuity patients are typically transported directly to the emergency centre via ambulance by trained prehospital care providers. As such, the emergency centre becomes the first of many physical transition points for patients, where a change of care provider (or handover) takes place. The aim of this study was to describe the variables perceived to be important during patient handover by a cohort of South African prehospital care providers. Methods A purpose-designed questionnaire was used to gather data related to prehospital emergency care provider opinions on the importance of certain patient variables. Results We collected 175 completed questionnaires from 75 (43%) BAA, 49 (28%) ANA, 15 (9%) ECT, 16 (9%) ANT and 20 (11%) ECP respondents. Within the ten handover variables perceived to be most important for inclusion in emergency centre handover, five were related to vital signs. Blood pressure was ranked most important, followed by type of major injuries, anatomical location of major injuries, pulse rate, respiration rate and patient history. These were followed by Glasgow Coma Score, injuries sustained, patient priority, oxygen saturations and patient allergies. Conclusion This study has provided some interesting results related to which handover elements prehospital care providers consider as most important to include in handover. More research is required to correlate these findings with the opinions of emergency centre staff.
This study did not identify any effect of 20 minutes of heavy exercise in highly fit volunteers wearing level C chemical and biological PPE on reaction time. Heart rate response and TM temperature were higher during exertion in PPE. These differences, along with other physiological alterations observed, were not of clinical relevance. Further studies using arterial blood gas analysis and a more accurate measure of core body temperature are needed to better assess the physiological effect of this level and duration of exercise on subjects wearing similar PPE. Other aspects of cognition also require investigation under these conditions, in order to assess their effect on patient and rescuer safety.
IntroductionThere is evidence to suggest that violence against paramedic personnel is increasing. Several authors report adverse effects linked to exposure to workplace violence. There remain gaps in the knowledge related to specific aspects of workplace violence experienced by paramedics in the prehospital setting.Methods and analysisThis scoping review will consider evidence relating to workplace violence against paramedic personnel. All types of evidence will be considered, including quantitative and qualitative studies, systematic reviews, opinion papers, grey literature, text and papers as well as unpublished materials. This scoping review will be designed and conducted in accordance with the JBI methodology for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews will guide the reporting process. Sources will include ERIC, Scopus, PubMed, CINAHL, Cochrane Library, ScienceDirect, Web of Science, Sabinet and the DOAJ as well as OpenGrey (https://opengrey.eu/). All sources published in English will be considered for inclusion and no date limit will be applied. The searching of the databases will begin 16 January 2023 and will be concluded by 30 January 2023. Three independent reviewers will conduct the study selection and data extraction process. In the event of disagreement related to a particular source, this will be resolved by discussion. The findings of the proposed review will be presented in a narrative style that uses diagrams and tables for reporting.Ethics and disseminationThis scoping review will use published literature available in the public domain and will involve no participants, meaning that ethical approval is not required. The findings of the proposed review will be published in topic relevant peer-reviewed journals and will be presented at associated conferences.
Context and Setting: The development of clinical competence remains a challenge in healthcare education. The reliable assessment of competence requires new approaches to address the perceived limitations of current assessment practices. The Simulation Assessment Tool Limiting Assessment Bias (SATLAB) seeks to provide a novel assessment strategy within the simulation environment. Concept: The SATLAB is a simulation assessment tool conceptualised by Andrew Makkink as a means to address many of the perceived issues prevalent in simulation assessment. Implementation: The SATLAB has been in use at the University of Johannesburg since its inception and is currently also used at several other institutions offering simulation-based learning and assessment in emergency medical care. Impact: The SATLAB was conceptualised as a potential solution to some of the inherent challenges in the assessment of simulation. The current use and ongoing evaluation of the SATLAB is providing exciting insights into the future of simulation assessment. Further research is required to determine the reliability and validity of the tool within the simulation assessment domain.
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