Translational Educational Research

McGaghie, William C.; Issenberg, S. Barry; Cohen, Elaine; Barsuk, Jeffrey H.; Wayne, Diane B.

doi:10.1378/chest.12-0148

Cited by 79 publications

(22 citation statements)

References 53 publications

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“…Additional work includes longitudinal data collection of staff attitudes over longer time periods, comparison of different methods of training and curriculum design, as well as a higher level of evaluation in the definitions of translational educational research to include patient outcomes or direct indices of care safety and quality. 18 , 25 Finally, validation studies of our interprofessional curriculum across different clinical sites may expand the applicability of the training methodology used in our study to a wider spectrum of institutions and departments.…”

Section: Impactmentioning

confidence: 91%

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

Wong¹,

Wing²,

Weiss³

et al. 2015

WestJEM

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IntroductionWhile treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design.MethodsFormal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs.ResultsOne hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys. Constructs for internal/biomedical factors, external/staff factors and situational/interactional perspectives on patient aggression significantly improved (p<0.0001, p<0.002, p<0.0001 respectively). Staff attitudes toward management of patient aggression did not significantly change (p=0.542). Multiple quality improvement initiatives were successfully implemented, including the creation of an interprofessional crisis management alert and response protocol. Staff members described appreciation for our simulation-based curriculum and welcomed the interaction with SPs during their training.ConclusionA structured simulation-enhanced interprofessional intervention was successful in improving multiple facets of ED staff attitudes toward behavioral emergency care.

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Section: Impactmentioning

confidence: 91%

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

Wong¹,

Wing²,

Weiss³

et al. 2015

WestJEM

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“…Several studies have demonstrated the efficiency of simulation for knowledge acquisition and for technical (6)(7)(8) and non-technical (9,10) skills training in healthcare. Training healthcare professionals to manage rare or critical events in a standardized manner and without risk for the patient has become a major challenge (11) .…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality Simulation in Nontechnical Skills Training for Healthcare Professionals

Bracq¹,

Michinov²,

Jannin³

2019

Sim Healthcare

205

136

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This systematic review, conducted in accordance with PRISMA guidelines, is aimed to review current research in virtual reality for healthcare training, specifically pertaining to nontechnical skills. PsycInfo and Medline databases were queried for relevant articles published through December 2017. Of the 1377 publications identified, 80 were assessed for eligibility and 26 were finally included in the qualitative synthesis. Overall, the use of virtual training for non-technical skills is recent in healthcare education, and has increased since 2010. Screen-based VR simulators or virtual worlds are the most frequently used systems. The nontechnical skills addressed in VR simulation include mainly teamwork, communication and situation awareness. The majority of studies evaluate the usability and acceptability of VR simulation, and few studies have measured the effects of VR simulation on non-technical skills development.

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“…We believe that this is the way that we can address what have been called complex service interactions in the clinical arena where multi-person teams are interacting around real patients in dynamic and complex care settings that have constant change. 37 Goldhaber-Fiebert and colleagues recently summarized this implementation schema of any cognitive aid as: Create, Familiarize, Use, Integrate. 29 In addition, payors, professors, and private practitioners should now join forces to ensure that a culture obtains where these tools, having been created, are ones that all members of our care teams become familiar with, use, and integrate into healthcare systems so that we are better prepared when the rare event occurs.…”

Section: Discussionmentioning

confidence: 99%

Adherence to Guidelines for the Management of Local Anesthetic Systemic Toxicity Is Improved by an Electronic Decision Support Tool and Designated “Reader”

McEvoy

Hand

Stoll

et al. 2014

Regional Anesthesia and Pain Medicine

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Background and Objectives A hardcopy or paper cognitive aid has been shown to improve performance during the management of simulated local anesthetic systemic toxicity (LAST) when given to the team leader. However, there remains room for improvement in order to ensure a system that can achieve perfect adherence to the published guidelines for LAST management. Recent research has shown that implementing a checklist via a designated reader may be of benefit. Accordingly, we sought to investigate the effect of an electronic decision support tool (DST) and designated ‘Reader’ role on team performance during an in-situ simulation of LAST. Methods Participants were randomized to Reader+DST (N = 16, rDST) and Control (N = 15, memory alone). The rDST group received the assistance of a dedicated Reader on the response team who was equipped with an electronic DST. The primary outcome measure was adherence to guidelines. Results For overall and critical percent correct scores, the rDST group scored higher than Control (99.3% vs 72.2%, P < 0.0001; 99.5% vs 70%, P < 0.0001, respectively). In the LAST scenario, 0 of 15 (0%) in the control group performed 100% of critical management steps, while 15 of 16 (93.8%) in the rDST group did so (P < 0.0001). Conclusions In a prospective, randomized single-blinded study, a designated Reader with an electronic DST improved adherence to guidelines in the management of an in-situ simulation of LAST. Such tools are promising in the future of medicine, but further research is needed to ensure the best methods for implementing them in the clinical arena.

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Translational Educational Research

Cited by 79 publications

References 53 publications

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

Virtual Reality Simulation in Nontechnical Skills Training for Healthcare Professionals

Adherence to Guidelines for the Management of Local Anesthetic Systemic Toxicity Is Improved by an Electronic Decision Support Tool and Designated “Reader”

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