scholarly journals P039: Application of the Delphi method to refine key components in the iterative development of a mobile tele-simulation unit (MTU)

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S70-S71 ◽  
Author(s):  
C. Dunne ◽  
J. Jewer ◽  
M. Parsons
Keyword(s):  
Delphi Method ◽  
Practice Research ◽  
Iterative Development ◽  
Technical Requirements ◽  
Clinical Scenarios ◽  
Simulation Based ◽  
Technical Factors ◽  
Simulation Center ◽  
Simulation Unit ◽  
Research Studies

Introduction: Safe and efficient provision of quality healthcare requires maintenance of knowledge and skills relevant to daily practice. This is particularly relevant in rural and remote locations where high-acuity low-occurrence procedures and clinical scenarios present even less frequently. Simulation based training is widely used to supplement clinical exposure and practice but effective delivery of this approach to the rural/ remote practitioner must address barriers of time, cost and geographical separation. Mobile tele-simulation is an innovative approach that may help in bridging the gap through delivery of effective mentoring using telemedicine technologies and tailored educational content. Methods: To help direct the iterative design cycle for the mobile tele-simulation unit, input from potential future users was felt to be essential. The Delphi method was employed to reach consensus among study participants on four key questions: 1) What applications would the MTU be best suited for?, 2) What technical requirements and teaching tools would be needed to make the MTU successful?, 3) Which fields, besides EM/medical education, may benefit from partnerships with the final MTU?, 4) What research studies could be developed using the MTU? It was decided in advance that two rounds would be the maximum due to time constraints of the larger MTU projects. The first questionnaire focused on demographics and the four questions above. Independent reviewers analyzed, compiled and compared responses. Participants were sent the updated list, asked to confirm their responses and then to rank the responses highest to lowest priority. Results: Fifteen of 17 first round participants completed the questions, giving an 88.2% response rate. All shared a simulation background. 66% were physicians, 13.3% medical students, and 20% staff at Memorials Simulation Center. 66% had been involved with simulation-based education less than 5 years, and the others greater than 5 year. 13 of 15 (86.7%) responded in round 2. Consensus was not reached statistically using Kendalls W test for each of the four questions. However, there were several responses that showed higher median ranks than the others under each question. Application use: rural healthcare training, and medical professional training Technical factors: reliable learner-mentor connection, and competent technical support Non-technical factors: knowledgeable mentor and content relevant to locations practice, Research studies: training needs assessment from rural sites, and learners experience compared to stationary simulation center Conclusion: Input from a heterogeneous group of simulation users was sought to help prioritize key features in the development of the Mobile Tele-simulation Unit. Although statistically the study did not reach consensus, valuable feedback was compiled and pragmatically applied in the iterative development cycle.

Abstract TP240: Simulation-Based Learning Improves Neurology Resident Training in Acute Stroke Care

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Waimei Tai ◽  
J.j. Baumann ◽  
Esther Melamed ◽  
Nirali Vora ◽  
Neil Schwartz
Keyword(s):  
Acute Stroke ◽  
Training Session ◽  
Vital Signs ◽  
Stroke Care ◽  
Resident Training ◽  
Acute Stroke Care ◽  
Simulation Based ◽  
Overall Evaluation ◽  
Simulation Center

Introduction: Acute “stroke codes” are stressful for the new neurology resident who must lead a multi-disciplinary team and quickly integrate information to make high risk time-sensitive decisions. While other disciplines have used simulation technology for years for cardiac arrest codes, neurology has just begun utilizing this resource. Objective: To improve neurology trainees’ execution of a multi-disciplinary acute stroke code using simulation experience Methods: We identified three learning objectives for the simulation experience: assess tissue plasminogen activator (tPA) eligibility, utilize appropriate order sets, and communicate effectively. Scripts for two emergent scenarios were developed: ischemic stroke requiring i.v. tPA and warfarin-associated intracranial hemorrhage requiring coagulopathy reversal. A standardized patient (SP) was trained. Neurology residents in their first week of training were the learners. Six residents attended a four-hour training session in the Simulation Center at Stanford University. Half of the trainees participated in the scenario while the others observed through live video. The SP acted the part in a fully-equipped, mock emergency room. Monitors, controlled remotely, displayed vital signs which changed to reflect interventions performed. Screens also displayed radiologic data. Trainees communicated with the stroke fellow and nursing regarding the plan of care and placed orders through an electronic medical record in training mode. Debriefing occurred after each scenario. Evaluations were completed and collected. Results: Trainees had positive experiences and felt more comfortable with the stroke code after the training. On a 1-5 scale, learners rated quality of teaching (average 4.6); learning from the scenario (4.8); overall organization (4.2); facilities (5); and overall evaluation (4.6). Conclusions: Simulation training offers a valuable opportunity to enhance neurology resident’s comfort in running stroke codes. Additional studies are required to measure long-term retention of acquired skills and training effect on systems and clinical outcomes.

scholarly journals P100: Iterative prototype development of a mobile tele-simulation unit for remote training: an update

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S112 ◽  
Author(s):  
M.H. Parsons ◽  
A. Smith ◽  
K.J. Hoover ◽  
J. Jewer ◽  
S. Noseworthy ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Mixed Methods ◽  
Learning Experience ◽  
Rural And Remote ◽  
Mixed Methods Approach ◽  
Technical Performance ◽  
Prototype Development ◽  
Simulation Based ◽  
Technical Issues ◽  
Simulation Unit

Introduction/Innovation Concept: Rural and remote practice of emergency medicine presents unique challenges, particularly when faced with infrequently encountered cases and procedures. Simulation-based training is a valuable tool in the acquisition and maintenance of knowledge and skills; however, simulators are often located in larger centers and they are not widely outside these centers due to geographic, cost and time constraints. Mobile tele-simulation has the potential to overcome barriers but challenges such as comfort, technical issues and ability to teach desired content via tele-simulation must be addressed. We are developing a mobile-tele-simulation unit (MTU) prototype that will enable emergency medicine practitioners and trainees to access simulation-based instruction in rural and remote settings. Methods: Through application of a mixed-methods approach with input of a multidisciplinary team we are iteratively developing an MTU prototype to assess key factors in design and function, including: technical issues, environmental features, and human factors. The Delphi method is being used to collect input from experts on key design components and feedback is also being collected from trainees after participating in trial deployments of the MTU in different educational and environmental settings. Curriculum, Tool, or Material: The effective application of the MTU in a variety of learning settings will be optimized through ongoing evaluation in the iterative design cycle. Feedback to ensure a quality learning experience in the MTU will direct features of physical design and technical performance that can be applied in deployment of the unit. In addition, challenges to the delivery of module content and instructional modality/ features of lessons to be executed will be important considerations as we move toward developing content that can effectively be taught using the MTU. Conclusion: To ensure effective use of tele-simulation in the delivery of a meaningful simulation experience to rural and remote trainees a number of important challenges must be overcome. We describe our evolving multidisciplinary mixed-methods approach to develop an effective mobile tele-simulation unit.

scholarly journals Medical students’ satisfaction with the Applied Basic Clinical Seminar with Scenarios for Students, a novel simulation-based learning method in Greece

2016 ◽  
Vol 13 ◽  
pp. 13 ◽  
Author(s):  
Panteleimon Pantelidis ◽  
Nikolaos Staikoglou ◽  
Georgios Paparoidamis ◽  
Christos Drosos ◽  
Stefanos Karamaroudis ◽  
...  
Keyword(s):  
Medical Students ◽  
Educational Environment ◽  
Undergraduate Medical Students ◽  
Clinical Scenarios ◽  
Feedback Questionnaire ◽  
Simulation Based ◽  
Post Test ◽  
Core Components ◽  
Lecture Session ◽  
Case Based

Purpose: The integration of simulation-based learning (SBL) methods holds promise for improving the medical education system in Greece. The Applied Basic Clinical Seminar with Scenarios for Students (ABCS3) is a novel two-day SBL course that was designed by the Scientific Society of Hellenic Medical Students. The ABCS3 targeted undergraduate medical students and consisted of three core components: the case-based lectures, the ABCDE hands-on station, and the simulation-based clinical scenarios. The purpose of this study was to evaluate the general educational environment of the course, as well as the skills and knowledge acquired by the participants. Methods: Two sets of questions were distributed to the participants: the Dundee Ready Educational Environment Measure (DREEM) questionnaire and an internally designed feedback questionnaire (InEv). A multiple-choice examination was also distributed prior to the course and following its completion. A total of 176 participants answered the DREEM questionnaire, 56 the InEv, and 60 the MCQs. Results: The overall DREEM score was 144.61(±28.05) out of 200. Delegates who participated in both the case-based lectures and the interactive scenarios core components scored higher than those who only completed the case-based lecture session (P=0.038). The mean overall feedback score was 4.12(±0.56) out of 5. Students scored significantly higher on the post-test than on the pre-test (P<0.001). Conclusion: The ABCS3 was found to be an effective SBL program, as medical students reported positive opinions about their experiences and exhibited improvements in their clinical knowledge and skills.

How to interpret a single cortisol measurement

2020 ◽  
Vol 105 (6) ◽  
pp. 347-351
Author(s):  
Meera Shaunak ◽  
Joanne C Blair ◽  
Justin Huw Davies
Keyword(s):  
Adrenal Insufficiency ◽  
Clinical Features ◽  
Diagnostic Utility ◽  
Factors Affecting ◽  
Clinical Scenarios ◽  
Technical Factors ◽  
Work Up ◽  
Result Interpretation

Adrenal insufficiency can present with non-specific clinical features. Therefore, a single cortisol measurement is often included in the biochemical work-up of an unwell child. This article aims to review the diagnostic utility of a single cortisol measurement by outlining the physiological, clinical and technical factors affecting result interpretation. Clinical scenarios are used to illustrate how this test may be used in different commonly encountered situations in general paediatrics, with the aim of minimising the frequency of inconclusive results.

Simulation Study on the Sports Biomechanical Characteristics of Long Jumpers’ Take-off Techniques

2021 ◽  
Vol 7 (5) ◽  
pp. 4963-4975
Author(s):  
Chao Zhou
Keyword(s):  
Reference Data ◽  
Factors Affecting ◽  
Advantages And Disadvantages ◽  
Technical Requirements ◽  
Long Jump ◽  
Technical Factors ◽  
Research Objects ◽  
Run Up ◽  
The Stability ◽  
Factors Affecting Performance

Objectives: Based on the principles of sports biomechanics and long jump technical requirements, the technical factors affecting performance are discussed. Provide reference for the teaching, training and scientific research of the long jump project in China, improve and perfect the special sports technology and quality. Methods: In this study, the excellent men’s long jump athletes at home and abroad in recent years are taken as research objects, and the sports biomechanical method is used on the basis of collecting and compiling large amounts of data in previous studies. Results: This paper makes a comparative analysis of the characteristics of run-up and Take-off Techniques of Chinese and foreign elite male long jumpers, in order to find out the advantages and disadvantages of Chinese athletes and provide reference data for the training of Chinese long jumpers. Conclusion: The research shows that the take-off technique is the key in the whole long jump. The take-off angle is an important factor that restricts the performance of long jumpers, and the stability of the brake point when the board is attached is more important.

scholarly journals A Delphi survey of practitioner’s understanding of mental capacity

2018 ◽  
Vol 20 (5/6) ◽  
pp. 174-186
Author(s):  
George Clerk ◽  
Jason Schaub ◽  
David Hancock ◽  
Colin Martin
Keyword(s):  
Delphi Method ◽  
Design Methodology ◽  
Occupational Therapists ◽  
Mental Capacity ◽  
Capacity Assessment ◽  
Content Type ◽  
Professional Groups ◽  
Clinical Scenarios ◽  
Clinical Responses ◽  
Mental Capacity Act

Purpose The purpose of this paper is to present the findings of a study considering the application of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Practitioners from a range of professions were recruited to provide their views of how to respond to a variety of scenarios. GPs, nurses, social workers, physio/occupational therapists and care assistants were recruited to participate. Design/methodology/approach This study used the Delphi method to elicit participant views and generate consensus of opinion. The Delphi method recommends a large sample for heterogeneous groups, and round one had 98 participants from six different professional groups. Findings Participants did not respond consistently to the scenarios, but disagreed most significantly when patient decisions conflicted with clinical advice, and when to conduct a capacity assessment. These responses suggest that clinical responses vary significantly between individuals (even within settings or professions), and that the application of Mental Capacity Act (MCA) is complicated and nuanced, requiring time for reflection to avoid paternalistic clinical interventions. Originality/value Previous studies have not used a Delphi method to consider the application of MCA/DoLS. Because of this methods focus on developing consensus, it is uniquely suited to considering this practice issue. As a result, these findings present more developed understanding of the complexity and challenges for practitioner responses to some relatively common clinical scenarios, suggesting the need for greater clarity for practitioners.

Designing a simulation center: an experiential guide

2020 ◽  
Vol 18 (5) ◽  
pp. 487-504
Author(s):  
Carla Talal Dleikan ◽  
Zavi Lakissian ◽  
Selim Hani ◽  
Rana Sharara-Chami
Keyword(s):  
Thematic Analysis ◽  
Structured Interviews ◽  
Learning Space ◽  
Content Type ◽  
Qualitative Thematic Analysis ◽  
Depth Analysis ◽  
Simulation Based ◽  
Simulation Center ◽  
And Training ◽  
Practical Implications

Purpose Health-care simulation has evolved rapidly in the past few decades; it has become an integral component of education and training to improve the efficacy of both individuals and teams. Designing an optimal simulation-based learning space is a multitiered and multidisciplinary process involving architects, engineers and simulation educators. The purpose of this paper is to present the experience of designing a simulation center for a tertiary academic hospital. Design/methodology/approach The study is based on an in-depth analysis of the final structural blueprint of the center and qualitative thematic analysis of semi-structured interviews with persons involved in the design process Findings Thematic analysis led to three thematic categories, namely, organization of space, equipment and administrative and staff requirements. Research limitations/implications The paper describes the experience of designing one center within an academic tertiary setting. This experience may lack external validity and generalizability. Moreover, the operationality and functionality of the center have not been studied yet. Finally, the interviewees were interviewed post-design, which may pose as recall bias. Practical implications For future simulationists or educators attempting to undertake a simulation center design, this paper will help guide them to anticipate the needed human and technical resources and potential challenges. Originality/value The study offers recommendations meant to guide others attempting to design a simulation center within an academic institution.

The Analysis and Research of EPC Process Engineering

2014 ◽  
Vol 644-650 ◽  
pp. 4788-4791
Author(s):  
Tao Ping Yan
Keyword(s):  
Process Design ◽  
Solution Process ◽  
Casting Process ◽  
Design Principles ◽  
Production Volume ◽  
Process Technology ◽  
Technical Requirements ◽  
Volume Production ◽  
Technical Factors ◽  
Die Casting Process

EPC process, based on the casting structure, technical requirements, production volume, production conditions determines the casting solution, process planning. In this paper, the author from three aspects , the analysis of die casting process design principles, design principles and infiltration technology, makes a deeper understanding on the EPC process, and put forward some standards and requirements of the EPC process technology, which avoid the casting defects and waste caused by technical factors.

Simulation-Based Medical Training and Assessment in the Medical Physics Lab-Simulation Center

2016 ◽  
Vol 73 (6) ◽  
pp. 1081-1084 ◽  
Author(s):  
Constantinos Loukas ◽  
Nikolaos Nikiteas ◽  
Evangelos Georgiou
Keyword(s):  
Medical Training ◽  
Medical Physics ◽  
Simulation Based ◽  
Simulation Center

scholarly journals Development of a Simulation-Based Interprofessional Teamwork Assessment Tool

2019 ◽  
Vol 11 (2) ◽  
pp. 168-176
Author(s):  
Zia Bismilla ◽  
Tehnaz Boyle ◽  
Karen Mangold ◽  
Wendy Van Ittersum ◽  
Marjorie Lee White ◽  
...  
Keyword(s):  
Delphi Method ◽  
Rating Scale ◽  
Assessment Tool ◽  
Ease Of Use ◽  
Validity Evidence ◽  
Interprofessional Teamwork ◽  
Point Rating Scale ◽  
Simulation Based ◽  
Competency Based ◽  
Trainee Competence

ABSTRACT Background  The Accreditation Council for Graduate Medical Education (ACGME) Milestone projects required each specialty to identify essential skills and develop means of assessment with supporting validity evidence for trainees. Several specialties rate trainees on a milestone subcompetency related to working in interprofessional teams. A tool to assess trainee competence in any role on an interprofessional team in a variety of scenarios would be valuable and suitable for simulation-based assessment. Objective  We developed a tool for simulation settings that assesses interprofessional teamwork in trainees. Methods  In 2015, existing tools that assess teamwork or interprofessionalism using direct observation were systematically reviewed for appropriateness, generalizability, adaptability, ease of use, and resources required. Items from these tools were included in a Delphi method with multidisciplinary pediatrics experts using an iterative process from June 2016 to January 2017 to develop an assessment tool. Results  Thirty-one unique tools were identified. A 2-stage review narrowed this list to 5 tools, and 81 items were extracted. Twenty-two pediatrics experts participated in 4 rounds of Delphi surveys, with response rates ranging from 82% to 100%. Sixteen items reached consensus for inclusion in the final tool. A global 4-point rating scale from novice to proficient was developed. Conclusions  A novel tool to assess interprofessional teamwork for individual trainees in a simulated setting was developed using a systematic review and Delphi methodology. This is the first step to establish the validity evidence necessary to use this tool for competency-based assessment.

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