Simulators for use in anaesthesia

Cumin, David; Merry, Alan

doi:10.1111/j.1365-2044.2006.04902.x

Cited by 77 publications

(61 citation statements)

References 81 publications

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“…This may not be surprising but it is still worthy of comment as it helps to validate simulation against another widely accepted practical test. The value of simulation has a narrow evidence base, with no studies in medicine, aviation or any other industry to show that simulation reduces morbidity and mortalityyet the high staff requirements and capital expenditure required to maintain a high fidelity simulation centre require justification [12,13]. The finding that perfor- A box and whisker plot of the intensity of drug administration teaching (as described in Table 2) against the indexed mean of the marks obtained in the four unrelated OSPE stations.…”

Section: Discussionmentioning

confidence: 99%

Retention of drug administration skills after intensive teaching

Wheeler¹,

Degnan

Murray³

et al. 2008

Anaesthesia

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We have identified deficiencies in medical students' drug administration skills, and we attempted to address them with interactive online teaching modules and simulated critical incident scenarios. Short-term improvements have been evident with this intensive effort, but medium-term retention of skills has not been measured. A drug administration lecture, an online module and a simulated emergency scenario were offered to final year clinical students. None of the teaching was compulsory but participation was recorded, along with students' simulator performances and marks in an objective structured practical examination 9 months later. A poor simulator score predicted a poor performance in the later examination. Participation in the simulated scenario only significantly improved examination scores when supplemented by online teaching (p = 0.002). Intensive drug administration teaching using an online module and high fidelity simulation improves drug administration skills in the medium term. Students found simulation much more engaging than online teaching. Our research focuses on drug administration skills, originating from our observation that medical students and doctors are confused by expressing the concentration of drug solutions as ratios and percentages rather than mass concentration [1][2][3]. These findings concur with other researchers [4][5][6][7] and, despite calls for ampoule labelling to be standardised [8], drugs are still presented in packaging that is potentially confusing.Our findings have also suggested that a lack of education about drug administration can lead to drug dosing errors, and served to highlight that drug administration skills in our university were taught on an entirely ad hoc basis [1]. We sought to improve drug administration teaching for our medical students by ensuring that drug dose calculation was included in formal teaching for all students. Traditional teaching was complemented by an interactive online teaching module, which improved students' performances in drug administration questions in end of attachment assessments and final examinations [9]. We went on to examine how better teaching might influence the acquisition of practical skills using students' performance in a simulated critical incident as an outcome measure.We conducted a randomised, controlled trial in a high fidelity patient simulator that showed that additional online teaching also improved medical students' practical skills in a simulated emergency scenario [10]. Students were randomly allocated into two groups: one group was invited to view the additional teaching before their simulated scenario, the other group received the invitation afterwards. Students who had viewed the teaching beforehand were found to have performed significantly

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Section: Discussionmentioning

confidence: 99%

Retention of drug administration skills after intensive teaching

Wheeler¹,

Degnan

Murray³

et al. 2008

Anaesthesia

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“…However, unless the learner follows the workshop with ongoing deliberate practice, the benefits may be short-lived; providing airway laboratories in the workplace may be an effective way of facilitating this. There is considerable interest in taking simulation to the clinical environment [72].…”

Section: ó 2011 the Authorsmentioning

confidence: 99%

Education in airway management

et al. 2011

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SummaryIn airway management, poor judgment, education and training are leading causes of patient morbidity and mortality. The traditional model of medical education, which relies on experiential learning in the clinical environment, is inconsistent and often inadequate. Curriculum change is underway in many medical organisations in an effort to correct these problems, and airway management is likely to be explicitly addressed as a clinical fundamental within any new anaesthetic curriculum. Competency‐based medical education with regular assessment of clinical ability is likely to be introduced for all anaesthetists engaged in airway management. Essential clinical competencies need to be defined and improvements in training techniques can be expected based on medical education research. Practitioners need to understand their equipment and diversify their airway skills to cope with a variety of clinical presentations. Expertise stems from deliberate practice and a desire constantly to improve performance with a career‐long commitment to education.

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“…54 It is widely known that the use of simulators need not be restricted to undergraduates and should be extended to medical professionals in lato sensu graduate education programs and medical residency, 54,55 as well as recent graduates from medical schools. 56,57 Some hypothesize that simulators would aid learning for various reasons: 58 (1) students may practice as much as they need; (2) mistakes can be spotted and corrected; (3) no individuals (patients) are disturbed or harmed. We can also see that students in training believe it is better that a technique be learned before it is applied to patients, so the use of simulators is an excellent way of having large numbers of students practicing skills in sufficient number.…”

Section: The Context Of Practical Training In Medicinementioning

confidence: 99%

Análise bioética do uso de recém-cadáveres na aprendizagem prática em medicina

Gomes¹,

Rêgo²,

Palácios³

et al. 2010

Rev. Assoc. Med. Bras.

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Bioethical analysis of the use of the newly deceased in medical training. Objective. The objective of this study is to carry out, a discussion on the subject of bioethics and cadavers based upon a critic review of literature. MethOds. Literature review based on a survey of articles published between 1977 and 2007 on websites Biblioteca Virtual de Saúde, PubMed and SciElo, using the following keywords: newly deceased patients, newly dead patients, simulators. The review was complemented by books on ethics and bioethics, as well as a critical evaluation of the subject. Results. The utilization of the newly deceased to learn invasive procedures is very common and seldom admitted. Procedures are usually carried out secretly, without family knowledge or consent, often without proper supervision from professors. In Brazil, moral and legal regulations do not back these practices, and their ethical aspects should be more widely discussed in undergraduate medical training. cOnclusiOn. It essential that the ethics of using the newly deceased to learn invasive procedures be discussed in academia (by professors and students alike) and be extended to practices as well. Performance of these procedures by students should always require authorization from family members. Simulators should be the first step in medical training.

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Simulators for use in anaesthesia

Cited by 77 publications

References 81 publications

Retention of drug administration skills after intensive teaching

Retention of drug administration skills after intensive teaching

Education in airway management

Análise bioética do uso de recém-cadáveres na aprendizagem prática em medicina

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