Learning Manual Skills in Anesthesiology

Konrad, Christoph; Schüpfer, G.; Wietlisbach, M; Gerber, Helmut

doi:10.1213/00000539-199803000-00037

Cited by 507 publications

(67 citation statements)

References 5 publications

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“…This could mean that for novice operators, AWS-ETI learning on manikin is achieved after the first attempts. By contrast, and as demonstrated in previous studies [4–6], 10 ETI attempts were found insufficient for novice operators to perform DLM-ETI with reliably. Finally, our results demonstrate that AWS-ETI acquisition may require less operator skill than the DLM.…”

Section: Discussionmentioning

confidence: 55%

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Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

Declercq

Bubenheim

Gelinotte

et al. 2016

Ann. Intensive Care

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BackgroundDifferent video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning.Methods We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL. Novices were assigned to start learning with DLM or AWS, and two sub-groups of 20 novices were formed. Experts group constituted the control group. Each participant performed 10 ETI attempts with each device on the same standard manikin. The primary endpoint was the ETI success probability. Secondary endpoints were ETI time, technical validity and qualitative evaluation for each technique. We also assessed the learning order and the successive attempts effects for these parameters.ResultsOverall, 1200 ETI attempts were performed. ETI success probability was higher with the AWS than with the DLM for all operators (98 vs. 81 %; p < 0.0001) and for experts compared to novices using devices in the same order (97 vs. 83 %; p = 0.0002). Overall ETI time was shorter with the AWS than with the DLM (13 vs. 20 s; p < 0.0001) and for experts compared to novices using devices in the same order (11 vs. 21 s; p < 0.0001). Among novices, those starting learning with AWS had higher ETI success probability (89 vs. 83 %; p = 0.03) and shorter ETI time (18 vs. 21 s; p = 0.02). Technical validity was found better with the AWS than DLM for all operators. Novices expressed global satisfaction and device preference for the AWS, whereas experts were indifferent.ConclusionsAWS-VDL permits faster, easier and more reliable ETI compared to the DLM whatever the previous airway ETI experience and could be a useful device for DLM-ETI learning.

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Section: Discussionmentioning

confidence: 55%

“…These risks are related to the critical setting as well as the underlying disease (hypoxemia, hemodynamic instability) and technical conditions of ETI [3]. Furthermore, learning and regular training are needed to sufficiently acquire skills and experience with the DLM technique [4–7]. …”

Section: Introductionmentioning

confidence: 99%

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

Declercq

Bubenheim

Gelinotte

et al. 2016

Ann. Intensive Care

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“…Currently, the College of Anaesthetists of Ireland is in the process of defining training competencies, which will include minimum numbers in relation to anaesthetic procedures performed and subspecialty caseload. These targets have been developed in other jurisdictions to provide specific and transparent objectives for both trainees and supervisors (Konrad C, Schupfer G, Wietlisbach M, Gerber H, 1998) (Australian and New Zealand College of Anaesthetists, 2012).…”

Section: Discussionmentioning

confidence: 99%

First Year Specialist Anaesthesia Training in Ireland: A Logbook Analysis

O'Shaughnessy

Skerritt

Fitzgerald

et al. 2017

IJHE

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Objective:Acquisition of a new range of skills occurs during first year anaesthesia training. The first twelve months of specialist anaesthesia training represent the steepest part of the learning curve, and thus large differences in performance should be apparent between the first and last quarters of this period.At present, no published quantitative logbook data exist for the Irish anaesthesia trainee. The aim of this study was to quantify the number of practical procedures performed and supervision required during first year anaesthesia training, in order to better understand the changes in skills occurring in trainees over this defining period. Methods:A retrospective analysis of prospectively maintained logbooks of three first year anaesthesia trainees was performed. Results:In the first three months, mean numbers of cases were 224, endotracheal tube (ETT) 64, laryngeal mask airway (LMA) 55, spinal anaesthetic 12, arterial lines 9.5, central lines 0.5, peripheral nerve blockade (PNB) 2, epidurals 0. There was 91.5% direct supervision and 8.5% indirect supervision.In the final three months, mean numbers of cases were 205.5, ETT 28, LMA 35, spinals 50, arterial line insertions 4.5, central line insertions 1.5, PNB 3.5, epidurals 80. There was 68.5% direct supervision and 31.5% indirect supervision. Conclusions:The use of logbooks to chart progress through training has many advantages. However, the number of procedures or cases logged should not be read in isolation, or compared with hard targets of "proficiency". Rather, logbooks need to be read with reference to the performance of peers in training. This snapshot of training provides a useful flavour of the experience of novice anaesthesia trainees, and their progress within their first year, and could be used as a benchmark for future logbook based assessments.

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“…Lo anterior permite que los estudiantes, a través de actividades muy simples en simulación de baja fidelidad, se relacionen con los distintos profesionales del equipo de salud, además de construir conocimiento enfermero fundamentado en las ciencias básicas. Sumado a esto, la inclusión de la simulación en el desarrollo de asignaturas pre clínicas y clínicas permite a través de la repetición de tareas, acortar la curva de aprendizaje y disminuir posibles errores cuando los estudiantes asisten a práctica clínica, aspectos fundamentales en el aprendizaje de temas relacionados con la valoración del paciente revisados en fisiología y fisiopatología, y la administración segura de medicación revisada en farmacología [15].…”

Section: /13unclassified

Clinical simulation and patient safety: integration into the nursing curriculum

Escudero¹,

Ben-Azul²,

Domínguez-Cancino³

2018

Sci Med

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Este artículo está licenciado bajo licencia Creative Commons Atribución 4.0 Internacional, que permite el uso sin restricciones, distribución y reproducción en cualquier medio, siempre y cuando la publicación original sea correctamente citada. RESUMENOBJETIVOS: Presentar la experiencia de la creación, desarrollo y resultados de un currículo de enfermería que integra la simulación clínica y la seguridad del paciente con sus desafíos y alcances después de cuatro generaciones egresadas. DESCRIPCIÓN DE LA EXPERIENCIA: La Escuela de Enfermería de la Universidad Finis Terrae es resultado de una solicitud directa de las autoridades de la institución en un momento en que el país requería el aumento de la oferta de los profesionales de enfermería. Esta parte con un proyecto que a través de su desarrollo y puesta en marcha requiere varios ajustes en términos programáticos. El proyecto tiene en consideración desde su generación la integración de la simulación y pone en el centro del desarrollo a la seguridad. Para esto, se trabajó en nuevos instrumentos que establecieron la forma de implementar el proceso educativo, generando un modelo propio de docencia basada en simulación, sumado al establecimiento de puntos de control que permitieran aplicar el modelo de mejora continua. A través de su desarrollo, se configuran elementos sellos que diferencian al estudiante de enfermería en el medio nacional. En la actualidad nos mantenemos trabajando en el cumplimiento de estándares internacionales, revisando periódicamente las estrategias implementadas y la forma de hacer docencia en beneficio de nuestros estudiantes. Nos planteamos como desafíos la generación de trabajo interprofesional, el fortalecimiento del cuerpo docente y la generación de investigaciones que evidencien los beneficios de tener un currículo para la seguridad basado en simulación considerando nuestra realidad local. CONCLUSIONES: La integración de la simulación y seguridad del paciente en el currículo de la carrera de enfermería es un desafío que requiere implementar procesos innovadores, movilizando recursos de todo tipo para el logro del objetivo. Fortalecer el liderazgo, el juicio clínico y la calidad de los profesionales enfermeros merece este tipo de cambios. Creemos que cambios como este en la educación de enfermería permitirán alcanzar mejores resultados de salud a nivel mundial.DESCRIPTORES: educación en enfermería; entrenamiento simulado; seguridad del paciente. ABSTRACTAIMS: To present the experience of creation, development and results of a nursing curriculum that integrates clinical simulation and patient safety with its challenges and achievements after four generations of graduates. EXPERIENCE DESCRIPTION: The School of Nursing at the Finis Terrae University is the result of a direct request from the authorities of the institution at a time when the country required an increase in the supply of nursing professionals. It started with a project that in the course of its development and implementation require several adjustments in programmatic terms. ...

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Learning Manual Skills in Anesthesiology

Cited by 507 publications

References 5 publications

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

First Year Specialist Anaesthesia Training in Ireland: A Logbook Analysis

Clinical simulation and patient safety: integration into the nursing curriculum

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