Simulation-based procedure training (SBPT) in rarely performed procedures: a blueprint for theory-informed design considerations

Gent, David; Kainth, Ranjev

doi:10.1186/s41077-022-00205-4

Cited by 3 publications

(3 citation statements)

References 87 publications

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“…Alternatively, significant investment in training generalists could be considered. Given the infrequency of HALO procedures such as CTI, implementation of comprehensive simulation based procedural training curricula may support the traditional learning opportunities [ 21 , 22 ]. Indeed, HST perceived training improvements to be key to improving patient safety.…”

Section: Discussionmentioning

confidence: 99%

Training, experience, and perceptions of chest tube insertion by higher speciality trainees: implications for training, patient safety, and service delivery

Probyn,

Daneshvar,

Price

2024

BMC Med Educ

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Background Seldinger Chest Tube Insertion (CTI) is a high acuity low occurrence procedure and remains a core capability for UK physician higher speciality trainee’s (HST). A multitude of factors have emerged which may affect the opportunity of generalists to perform CTI. In view of which, this paper sought to establish the current experiences, attitudes, training, and knowledge of medical HST performing Seldinger CTI in acute care hospitals in the Peninsula deanery. Methods A Scoping review was performed to establish the UK medical HST experience of adult seldinger CTI. Synonymous terms for CTI training were searched across Cochrane, ERIC, Pubmed and British education index databases. Following which, a regional survey was constructed and completed by HST and pleural consultants from five hospitals within the Peninsula deanery between April–July 2022. Data collected included participants demographics, attitudes, training, experience, and clinical knowledge. Outcomes were collated and comparisons made across groups using SPSS. A p-value of < 0.05 was defined as significant. Results The scoping review returned six papers. Salient findings included low self-reported procedural confidence levels, poor interventional selection for patient cases, inadequate site selection for CTI and 1 paper reported only 25% of respondents able to achieve 5–10 CTI annually. However, all papers were limited by including grades other than HST in their responses. The regional survey was completed by 87 HST (12 respiratory, 63 non-respiratory medical HST and 12 intensivists/anaesthetists HST). An additional seven questionnaires were completed by pleural consultants. Respiratory HSTs performed significantly more Seldinger CTI than general and ICM/anaesthetic registrars (p < 0.05). The percentage of HST able to achieve a self-imposed annual CTI number were 81.8, 12.9 and 41.7% respectively. Self-reported transthoracic ultrasound competence was 100, 8 and 58% respectively (p < 0.001). The approach to clinical management significantly differed with national guidance with pleural consultants showing an agreement of 89%, respiratory HST 75%, general HST 52% and ICM/anaesthetic HST 54% (p = 0.002). Conclusion Compared to respiratory trainees, non-respiratory trainees perform lower numbers of Seldinger CTI, with lower confidence levels, limited knowledge, and a reduced perceived relevance of the skill set. This represents a significant training and service challenge, with notable patient safety implications.

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Section: Discussionmentioning

confidence: 99%

Training, experience, and perceptions of chest tube insertion by higher speciality trainees: implications for training, patient safety, and service delivery

Probyn,

Daneshvar,

Price

2024

BMC Med Educ

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“…The training protocol should incorporate an introduction to the clinical and surgical relevance, an adequate briefing on the task, explanation of the equipment and evaluation of the performance tool. 43,47 Creation of this training protocol will allow the release of this self-led training model to units with minimal cost.…”

Section: Next Stepsmentioning

confidence: 99%

A validated benchtop simulation model for flexor tendon repair

Robb¹,

Rust²

2023

J Surg Simul

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Background: The coronavirus disease 2019 pandemic has had an unprecedented impact on surgical training. Innovative approaches should be sought to aid the acquisition of technical skills to maximise intra-operative learning opportunities. This study evaluates the validity and reliability of low-cost low-fidelity flexor tendon repair simulators. Methods: Qualitative and quantitative data were gathered from participants working in a plastic surgery department through the performance of a simulation task and completion of a validation questionnaire. Results: Most of the participants (75%) agreed that the model accurately represents the intended procedure, demonstrating an overall high content validity. The three materials used in the model were found to have beneficial features. Participants, overall, did not have a clear preference for the material used, suggesting that the material itself is inconsequential. Conclusions:The skill acquisition of a flexor tendon repair is gained through repeated deliberate practice. Providing a vessel for practice is more important than replicating the biological tissue.

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“…However, simulation practice typically occurs for a fixed duration because of logistical challenges in scheduling trainees, facilities, and faculty for open-ended training with no time limit. 5,6 As a solution, we tested a strategy involving independent simulation practice for a variable duration based on each trainee’s pace and needs. It utilized a commercially available simulator that provided autonomous feedback on key ETI performance metrics for self-directed mastery learning.…”

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confidence: 99%

Enhancing Laryngoscopy Mastery: The Impact of Autonomous Practice with Feedback-Providing Simulators

Patel,

Rudolf,

Schwartz

et al. 2024

A&A Practice

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Mastery learning with fixed end points and variable training time leads to more consistent expertise but is difficult to implement. Here we piloted mastery learning of laryngoscopy with independent practice. 35 learners participated in independent mastery learning on a manikin that provides automated performance feedback. A pre- and postpractice assessment of intubation skills was completed. After an average of 21 minutes of open practice, the percentage of subjects that met mastery criteria improved from 24% to 89% (P < .05). Independent intubation practice with manikin feedback facilitated mastery learning, enhanced procedural education, and may impact clinical care.

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Simulation-based procedure training (SBPT) in rarely performed procedures: a blueprint for theory-informed design considerations

Cited by 3 publications

References 87 publications

Training, experience, and perceptions of chest tube insertion by higher speciality trainees: implications for training, patient safety, and service delivery

Training, experience, and perceptions of chest tube insertion by higher speciality trainees: implications for training, patient safety, and service delivery

A validated benchtop simulation model for flexor tendon repair

Enhancing Laryngoscopy Mastery: The Impact of Autonomous Practice with Feedback-Providing Simulators

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