An innovative model for teaching and learning clinical procedures

Kneebone, Roger; Kidd, Jane; Nestel, Debra; Asvall, Suzanne; Paraskeva, Paraskevas; Darzi, Ara

doi:10.1046/j.1365-2923.2002.01261.x

Cited by 249 publications

(204 citation statements)

References 14 publications

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“…Simulation education [3], identifies the importance of learners being able to practice according to their own learning needs. This method has been used successfully in the teaching of clinical skills to undergraduate medical students, however, predominantly in the context of medium sized groups (25-50 learners) [4,5]. Skills may be retained and transferred to the clinical environment [6].…”

Section: Resultsmentioning

confidence: 99%

Hybrid simulation for integrated skills teaching

Joekes¹,

Brown²,

Boardman³

et al. 2017

Clinical-Skills

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Background: Classroom teaching of communication and clinical skills in the pre-clinical years does not reflect authentic practice in the clinical workplace. This paper describes an innovative hybrid simulation teaching session on male urinary catheterisation to large cohorts of undergraduate medical students, which aims to achieve a holistic approach to integrated skills acquisition. Evaluation of the session is described.

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Section: Resultsmentioning

confidence: 99%

Hybrid simulation for integrated skills teaching

Joekes¹,

Brown²,

Boardman³

et al. 2017

Clinical-Skills

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“…Over the years, however, simulation has become an important education adjunct for evaluation of procedural tasks. 3 Simulation can be broadly defined as any system that replicates a real-life system. Advances in simulation technology have enabled the assessment of procedures in the simulation laboratory without causing potential harm to patients.…”

Section: Résumémentioning

confidence: 99%

“…6 Much of the research on contextualized simulation has focused on performing procedural tasks in a non-crisis situation, for example, the performance of an intravenous insertion on a mannequin arm that is integrated with an actor patient. 3,6,7 Nevertheless, little is known on the degree of realism needed to assess rare life-saving procedures that must be performed quickly and safely. Such knowledge is important since it is presumed that performance in a contextualized simulation closely reflects performance in a clinical situation.…”

Section: Résumémentioning

confidence: 99%

“…The simulation room included a fully computerized SimMan, full monitors (electrocardiogram, noninvasive blood pressure, pulse oximeter, end-tidal capnogram), alarms, and basic airway devices. The airway devices included a Macintosh laryngoscope blade (in sizes 3 and 4), a Miller laryngoscope blade, a gum elastic bougie, and a laryngeal maks (in sizes [3][4][5]. A GlideScope Ò video laryngoscope (Verathon, Burnaby, BC, Canada) and a fibreoptic bronchoscope were supplied on request.…”

Section: Test Scenarios: Cs and Ncsmentioning

confidence: 99%

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Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task

You-Ten

Wong

Arzola

et al. 2015

Can J Anesth/J Can Anesth

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Purpose Simulation is an important alternative to evaluate cricothyrotomy, a rare life-saving procedure. This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy procedural task. Methods Sixty-five anesthesia assistants and emergency medicine and anesthesia residents underwent a teaching session in surgical cricothyrotomy using one of two sets of cricothyrotomy kits: the Portex 6.0 and Melker 3.5 (n = 32) or the Portex 6.0 and Melker 5.0 (n = 33). Within six weeks following the session, the participants performed cricothyrotomies on a full-body patient mannequin simulator coupled with a porcine larynx (tissuemannequin simulator) using the assigned two kits in a ''cannot intubate, cannot ventilate'' (CICV) contextualized scenario (CS) and in a CICV verbalized non-contextualized scenario (NCS). Each participant performed a total of four cricothyrotomies using the two kits in the two scenarios. The primary outcome measure was insertion time, and secondary outcome measures were severity of injuries and failure rate. Outcome measures were compared between scenarios for each kit. Results Mean (SD) insertion time for a successful cricothyrotomy was not significantly different between NCS and CS for the Melker 3.5 [83.0 (45.0) sec vs 63.3 (36.1) sec, respectively; P = 0.96; mean difference (MD), 19.7 sec; 95% confidence interval (CI), -1.9 to 41.3], the Melker 5.0 [86.5 (36.8) sec vs 107.1 (55.6) sec, respectively; P = 0.11; MD, -20.6 sec; 95% CI, -44.9 to 3.7], and the Portex 6.0 [59.5 (35.5) sec vs 59.0 (35.0) sec, respectively; P = 0.95; MD, 0.5 sec; 95% CI, -13.2 to 14.2]. Failure rate and severity of injuries, measured as mean average injury score for each kit, were also similar between scenarios. Conclusions Contextualization of a crisis scenario did not affect the performance of a cricothyrotomy procedural task on a tissue-mannequin simulator. These findings may have implications when considering the feasibility and cost-effectiveness for assessing the performance of cricothyrotomy procedural tasks. RésuméObjectif La simulation est une alternative importante pour évaluer la cricothyrotomie, une intervention de sauvetage rare. Cette étude croisée avait pour objectif de déterminer si la mise en contexte d'un scénario de crise avait un impact sur la performance d'une tâche procédurale de cricothyrotomie.Author contributions Kong E. You-Ten designed the study, conducted the study, analyzed the data, and wrote the manuscript. Catherine Wong helped analyze the data and write the manuscript. Catherine Wong, Cristian Arzola, Jessica Cheung, and Naveed Siddiqui helped conduct the study. Catherine Wong, Cristian Arzola, Jessica Cheung, Naveed Siddiqui, Zeev Friedman, and Sev Perelman helped review the manuscript. Zeev Friedman and Sev Perelman helped design the study.

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“…For example, physical simulators can not change their visual appearance to express fear or pain, can not move or gesture in response to the user's input, and can not be comforted by the user. To simulate a more realistic patient experience, model-based simulators have been combined with standardized patients (actors trained to simulate a medical condition) [19]. However, using a trained human actor limits the availability of the simulation and the ability to simulate abnormal medical conditions.…”

Section: Physical Simulators For Medical Educationmentioning

confidence: 99%

Virtual Human + Tangible Interface = Mixed Reality Human An Initial Exploration with a Virtual Breast Exam Patient

Kotranza

Lok

2008

2008 IEEE Virtual Reality Conference

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Virtual human (VH) experiences are receiving increased attention for training real-world interpersonal scenarios. Communication in interpersonal scenarios consists of not only speech and gestures, but also relies heavily on haptic interactioninterpersonal touch. By adding haptic interaction to VH experiences, the bandwidth of human-VH communication can be increased to approach that of human-human communication.To afford haptic interaction, a new species of embodied agent is proposed -mixed reality humans (MRHs). A MRH is a virtual human embodied by a tangible interface that shares the same registered space. The tangible interface affords the haptic interaction that is critical to effective simulation of interpersonal scenarios. We applied MRHs to simulate a virtual patient requiring a breast cancer screening (medical interview and physical exam). The design of the MRH patient is presented. This paper also presents the results of a pilot study in which eight (n = 8) physician-assistant students performed a clinical breast exam on the MRH patient. Results show that when afforded haptic interaction with a MRH patient, users demonstrated interpersonal touch and social engagement similarly to interacting with a human patient. INTRODUCTIONVirtual human (VH) experiences are increasingly being used for training real-human interpersonal scenarios, for example, military leadership [13] and doctor-patient interviews [15]. These human-VH interactions simulate a human-human interaction by providing two-way verbal and gestural communication. Prior research using these systems has shown that the efficacy of a VH experience would be significantly enhanced by integrating the haptic component of interpersonal communication [15]. This would, in effect, increase the bandwidth of human-VH communication.We expand on current VH experiences by affording haptic interaction with the VH. This paper proposes a new species of embodied agent that affords haptic interaction by combining virtual and real spaces -mixed reality humans.A mixed reality human (MRH) is a virtual human with a physical embodiment in the form of a tangible interface. By merging virtual and real spaces, MRHs afford haptic interaction between human and VH (Figure 1).Mixed reality humans allow for: 1. Interpersonal touch between the human and VH.Interpersonal touch is a critical component of non-verbal communication which affects how people perceive those they communicate with, increases information flow, and aids in conveying empathy [11,7]. Affording haptic interaction with a VH will allow VH experiences to more accurately and effectively simulate interpersonal communication. 2. VH experiences to train interpersonal scenarios which require interpersonal touch. Without affording touch, the domain of current VH experiences is limited. By affording haptic interaction, VH experiences can simulate a wider range of real-human interpersonal scenarios, such as medical physical exams. This paper presents the design of a MRH breast exam patient and the results of a pilot...

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An innovative model for teaching and learning clinical procedures

Cited by 249 publications

References 14 publications

Hybrid simulation for integrated skills teaching

Hybrid simulation for integrated skills teaching

Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task

Virtual Human + Tangible Interface = Mixed Reality Human An Initial Exploration with a Virtual Breast Exam Patient

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