Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review

Issenberg, S. Barry; McGaghie, William C.; Petrusa, Emil; Gordon, David; Scalese, Ross J.

doi:10.1080/01421590500046924

Cited by 2,997 publications

(2,346 citation statements)

References 7 publications

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“…Despite virtual reality simulators being introduced more than a decade ago, evidence on the effect of simulators on performance in the operating theatre is still sparse 13. To date no published studies on the transfer of technical surgical skills from simulator to real operations had exceeded grade 2a evidence; in our study the level of evidence is 1b.…”

Section: Discussionmentioning

confidence: 54%

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Larsen

Soerensen²,

Grantcharov

et al. 2009

BMJ

495

335

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Objective To assess the effect of virtual reality training on an actual laparoscopic operation.Design Prospective randomised controlled and blinded trial.Setting Seven gynaecological departments in the Zeeland region of Denmark.Participants 24 first and second year registrars specialising in gynaecology and obstetrics.Interventions Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls).Main outcome measure The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes.Results The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers’ inter-rater agreement was 0.79.Conclusion Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.Trial registration ClinicalTrials.gov NCT00311792.

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Section: Discussionmentioning

confidence: 54%

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Larsen

Soerensen²,

Grantcharov

et al. 2009

BMJ

495

335

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“…Furthermore, the introduction of debriefings as a learning tool during simulations, as well as after a serious clinical event, will help improve performance. Debriefing is a process in which people who have had a certain experience are led through a purposive discussion regarding the experience [36,37]. Unlike audits, debriefing helps the providers to learn and reflect on what they have experienced immediately after an actual or a simulated event, giving them a chance to learn from their experience.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania

Moshiro

Ersdal

Mdoe

et al. 2018

Global Health Action

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Background: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. Objective: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania. Methods: Eight midwives, each with more than one year’s working experience in the labour ward, were interviewed individually at Haydom Lutheran Hospital, Tanzania. The audio recordings were transcribed and translated into English and analysed using qualitative content analysis. Results: Midwives reported the ability to monitor labour properly, preparing resuscitation equipment before delivery, teamwork and frequent ventilation training as the most effective factors in improving actual ventilation practices and promoting the survival of newborns. They thought that their anxiety and fear due to stress of ventilating a non-breathing baby often led to poor resuscitation performance. Additionally, they experienced difficulties assessing the baby’s condition and providing appropriate clinical responses to initial interventions at birth; hence, further necessary actions and timely initiation of ventilation were delayed. Conclusions: Efforts should be focused on improving labour monitoring, birth preparedness and accurate assessment immediately after birth, to decrease intrapartum-related hypoxia. Midwives should be well prepared to treat a non-breathing baby through high-quality and frequent simulation training with an emphasis on teamwork training.

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“…• They provide immediate feedback to the trainee based on these metrics, as well as keeping an updated versión of his/her learning curve, which enhances the learning process [81].…”

Section: Tracking Systems In Virtual Reality Simulatorsmentioning

confidence: 99%

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review

Abstract: While research in this field needs improvement in terms of rigor and quality, high-fidelity medical simulations are educationally effective and simulation-based education complements medical education in patient care settings.

Cited by 2,997 publications

References 7 publications

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

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