scholarly journals P017: Impact of the use of a checklist for transcutaneous cardiac pacing on competency of junior residents undergoing an advanced cardiac life support course

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S69
Author(s):  
K. Chabot ◽  
J. Morris ◽  
R. Perron ◽  
C. Ranger ◽  
M. Paradis ◽  
...  

Introduction: Transcutaneous cardiac pacing (TCP) is recommended for the treatment of symptomatic bradycardia, a life-threatening condition. Although TCP is taught in ACLS (advanced cardiac life support) courses, it is a difficult skill to master for junior residents. The main objective of this study is to measure the impact of having access to a checklist on successful TCP implementation. Our hypothesis was that the availability of a CL would improve performance of junior residents in the management of symptomatic bradycardia by facilitating TCP. Methods: We conducted a prospective, randomized, single-site study. First-year residents entering postgraduate programs and taking a mandatory ACLS course were enrolled. Students had didactic sessions on the management of symptomatic bradycardia followed by hands-on teaching on a low-fidelity manikin (ALS® simulator, Laerdal) using a CL conceived for this project as a teaching tool. Study participants were then assessed with a simulation scenario requiring TCP. Participants were randomly assigned to groups with and without CL accessibility. Performances were graded on six critical tasks. The primary outcome was the successful use of TCP, defined as having completed all tasks. Participants then completed a post-test questionnaire. Sample size estimation was based on a previous project (Ranger et al., 2018). Accepting an alpha error of 0.05 and a power of 80%, 45 participants in each group would permit the detection of 26.5% in performance gain. Results: Of 250 residents completing the ACLS course in 2017, 85 voluntary participants were randomized to a control group (no CL available during testing, n = 42) or an experimental group (CL available during testing, n = 43). Six participants in the experimental group adequately used TCP compared to five participants in the control group (p = 0.81, chi-squared test). Out of the 43 participants who had access to the CL, only 2 (5%) used it. Reasons why the CL was infrequently used were stated as the following: 24 participants (56%) mentioned not realizing it was available, 8 (19%) considered it was of little to no utility and 5 (19%) forgot a CL existed. Conclusion: Availability of a checklist previously used during simulation teaching did not increase junior residents’ capacity to correctly apply TCP. Non-recognition of CL availability and decreased perceived need for it were the main reasons for marginal use. Our results suggest that there are many limiting factors to CL effectiveness.

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S114
Author(s):  
C. Ranger ◽  
M. Paradis ◽  
J. Morris ◽  
R. Perron ◽  
A. Cournoyer ◽  
...  

Introduction: Transcutaneous cardiac pacing (TCP), a skill taught in Advanced Cardiovascular Life Support (ACLS) courses, is recommended to treat unstable bradycardia. Training manikins currently available fail to reproduce key features of TCP and might be suboptimal to teach this procedure.The objective of this study was to measure the impact of a modified high-fidelity manikin on junior residents’ TCP competency during an ACLS course. We hypothesized that the use of this high-fidelity manikin improves junior residents’ performances. Methods: This prospective cohort study was conducted at the Université de Montréal in July 2015 and 2016. First-year residents undergoing their mandatory ACLS course were enrolled. The control group (2015) received the traditional curriculum, which includes hands-on teaching on Advanced Life Support manikins. The intervention group (2016) received a similar curriculum, but used a modified high-fidelity manikin that reproduces key features of TCP (e.g. use of multifunction pads, TCP induced patient twitching, ECG artifacts). Cohorts were tested with a simulation scenario requiring TCP. Performances were graded based on six critical tasks: turns on pacer function, applies multifunction pads, recognizes TCP is ineffective, achieves captures, verifies mechanical capture and prescribes sedation. Our primary outcome was successful use of TCP defined as having completed all tasks. Secondary outcomes were the success rates for each task. These were compared using Pearson’s chi-squared test. We anticipated that the success rate of TCP would increase from 20% to 50%. To obtain a power of more than 90%, 48 participants were needed in both cohorts. Results: A total of 50 residents were recruited in both cohorts. No resident that received the traditional curriculum was able to successfully establish TCP while 18 residents trained on the modified high-fidelity manikin succeeded (0 vs 36%, P<0.001). Furthermore, the latter were more likely to recognize when pacing was inefficient (12 vs 86%, P<0.001), obtain ventricular capture (2 vs 48%, P<0.001), and check for a pulse rate to confirm capture (0 vs 48%, P<0.001). Conclusion: Successful use of TCP is a difficult skill to master for junior residents. A modified high-fidelity manikin during ACLS training significantly improves their ability to establish effective pacing.


Author(s):  
Laetitia Idier ◽  
Aurélie Untas ◽  
Nicole Rascle ◽  
Michèle Koleck ◽  
Maider Aguirrezabal ◽  
...  

Introduction:Psychological impact of Therapeutic Patient Education (TPE) for dialysis patients is rarely evaluated since the focus of many studies is on medical variables (i.e., adherence).Objectives:The aims of this study were: 1) to estimate the impact of a TPE program on knowledge, depression and anxiety, 2) to examine change in knowledge as a mediator of the effects of a TPE program on mental health.Method:This study was conducted in three hemodialysis units and comprised two groups: an experimental group with education and a control group with routine care. The program was based of 5 educative sessions. Knowledge, depressive and anxious symptoms were assessed with self-reported outcomes measured before and 3 months after the program.Results:The sample comprised 125 patients. Knowledge about vascular access and nutrition (p < 0.01) and depressive symptoms increased in the experimental group (p < 0.01). Analysis of mediation showed that changes in knowledge about vascular access were a significant mediator of the effects of the program on depressive symptoms (F = 4.90;p = 0.01).Discussion:Knowledge acquired during an educational program could lead to an emotional change. Improving knowledge often leads to an awareness of the risks that can modify the psychological state of patients by reminding them of their vulnerability. This study shows that it is required to be attentive to the way of transmitting knowledge. It’s necessary adapting this transmission to the needs of patients and promoting the acquisition of psychosocial competence too.Conclusion:This study shows that knowledge acquired during an educational program can lead to an emotional change in the short term. A long-term follow-up of the population should be interesting to observe these emotional effects.


2020 ◽  
pp. 15-18
Author(s):  
Inna R. Kilmetova ◽  
◽  
Igor A. Rodin ◽  
Nazira I. Khayrullina ◽  
Nikolay G. Fenchenko ◽  
...  

Summary. The disbalanced feeding and the uneven distribution of micro- and macroelements in the environment leads to a trace element, in particular hypomelanosis. To accelerate the growth and preservation of young farm animals include in the diet of various biological additives and drugs, which include selenium. For stimulation of weight gain in the livestock industry, as well as for the prevention and treatment of pathological processes in addition to micro - and macrouse amino acids, primarily methionine. The aim of this work was to study the influence of composition of DAFS-25+Polizon on morpho-biochemical parameters of blood and functional state of the liver in fattening bulls of black-motley breed in the conditions of the Republic of Bashkortostan. Experiments using were conducted on bull-calves of black-motley breed of the properties in the properties age from 6 to 15 months. The first experimental group during the experiment was additionally given the composition of DAFS-25+Polizon at a dose of 2 mg/kg, the animals of the control group received a standard diet. To assess the impact of the composition DAFS-25+Polizon on metabolism cattle studied morphological and biochemical indicators of blood and conducted histological examination of the liver. It is established that the use of the composition of DAFS-25+Polizon at a dose of 2 mg/kg increases the number of erythrocytes and hemoglobin in the experimental group and reduces the amount of white blood cells. The serum content of total protein, phosphorus and calcium increases in the group of experimental animals. Microscopic examination of the liver revealed no changes in the structure of the organ and hepatocytes in the experimental group, whereas in the control group hemodynamic disorders and dystrophic changes in liver cells were observed. Thus, the use of the composition DAFS-25+Polizon at a dose of 2 mg/kg of live weight in fattening bulls black-and-white breed contributes to the increase of redox processes in the body, stimulation of metabolism, prevent the development of liver disorders of cellular mechanisms of metabolism, optimizes the structure of the liver, which generally provides higher productivity.


2020 ◽  
Author(s):  
Qing Zhao ◽  
Pei Chen ◽  
Yu Zhang ◽  
Haining Liu ◽  
Xianwen Li

BACKGROUND Mobile health application has become an important tool for healthcare systems. One such tool is the delivery of assisting in people with cognitive impairment and their caregivers. OBJECTIVE This scoping review aims to explore and evaluate the existing evidence and challenges on the use of mHealth applications that assisting in people with cognitive impairment and their caregivers. METHODS Nine databases, including PubMed, EMBASE, Cochrane, PsycARTICLES, CINAHL, Web of Science, Applied Science & Technology Source, IEEE Xplore and the ACM Digital Library were searched from inception through June 2020 for the studies of mHealth applications on people with cognitive impairment and their caregivers. Two reviewers independently extracted, checked synthesized data independently. RESULTS Of the 6101 studies retrieved, 64 studies met the inclusion criteria. Three categories emerged from this scoping review. These categories are ‘application functionality’, ‘evaluation strategies’, ‘barriers and challenges’. All the included studies were categorized into 7 groups based on functionality: (1) cognitive assessment; (2) cognitive training; (3) life support; (4) caregiver support; (5) symptom management; (6) reminiscence therapy; (7) exercise intervention. The included studies were broadly categorized into four types: (1) Usability testing; (2) Pilot and feasibility studies; (3) Validation studies; and (4) Efficacy or Effectiveness design. These studies had many defects in research design such as: (1) small sample size; (2) deficiency in active control group; (3) deficiency in analyzing the effectiveness of intervention components; (4) lack of adverse reactions and economic evaluation; (5) lack of consideration about the education level, electronic health literacy and smartphone proficiency of the participants; (6) deficiency in assessment tool; (7) lack of rating the quality of mHealth application. Some progress should be improved in the design of smartphone application functionality, such as: (1) the design of cognitive measurements and training game need to be differentiated; (2) reduce the impact of the learning effect. Besides this, few studies used health behavior theory and performed with standardized reporting. CONCLUSIONS Preliminary results show that mobile technologies facilitate the assistance in people with cognitive impairment and their caregivers. The majority of mHealth application interventions incorporated usability outcome and health outcomes. However, these studies have many defects in research design that limit the extrapolation of research. The content of mHealth application is urgently improved to adapt to demonstrate the real effect. In addition, further research with strong methodological rigor and adequate sample size are needed to examine the feasibility, effectiveness, and cost-effectiveness of mHealth applications for people with cognitive impairment and their caregivers.


SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402110035
Author(s):  
Aziz İlhan

The present study aimed to investigate the effects of geometry instruction activities conducted in nature based on modeling, game-based, and cooperative learning methods on achievement, mathematical motivation, and visual mathematical literacy perceptions of third-grade elementary school students. The present study is a quantitative study conducted with a pre-test/post-test experimental design with a control group. The study was conducted with 61 students (35 students in the experimental group and 26 students in the control group). Modeling-, game-, and collaborative learning-based activities were conducted with the students in the experimental group. It was determined that the achievements of students who were instructed with modeling-based activities in geometry were high when compared to that of the students instructed with collaborative learning- and game-based methods, and those in the control group where no intervention was applied. This group was followed by the game-based and collaborative learning groups. Based on the variable of motivation, the mean motivation of the students in the modeling group was higher when compared to that of the students in the collaborative learning, game-based, and conventional instruction groups. This group was followed by the collaborative and game-based learning groups. Also, based on the visual mathematical literacy perception variable, the mean visual mathematics literacy perception of the students in the collaborative learning group was higher when compared to that of the students in the groups where the modeling, game-based, and conventional instruction methods were used. This group was followed by the modeling and game-based learning groups.


SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402110071
Author(s):  
Saleh Alharthi

Writing is an intricate process that encompasses various factors and is a key skill for English as a Foreign Language (EFL) students. Thus, writing assignments are vital for any curriculum. One of the essential aspects of effective writing includes good grammar knowledge. Advocates of process writing argue that a free-writing journal is a practical approach to teaching EFL students writing. This study is intended to examine the impact of the free-writing journal on EFL learners. This study was conducted on 80 students from a writing course at the University. Thirty-five students were randomly selected to join the free-writing program—the experimental group—and 45 students were kept in their regular structured writing program—the control group. The experimental group selected topics of interest to them and was encouraged to write in English freely without concern for errors, whereas the control group followed a regular structured writing program where the topics were selected for them and they wrote following a clear guideline. Five major areas were investigated to evaluate students’ progress: the number of words written, spelling, capitalization, subject-verb agreement, and punctuation. The researcher conducted semi-structured interviews with 10 students of the experimental group to elicit their perception of the free-writing program. According to the analysis, students in the free-writing program acquired better grammar acquisition than the control group. The researcher also observed students’ perception of free-writing at the end of the study and found that free-writing improved their writing skills.


2018 ◽  
Vol 48 ◽  
pp. 01060
Author(s):  
Sibel Demir Kaçan ◽  
Fatma Şahin

The research aims to determine “the Impact of Scientific Creative Thinking Skills on Scientific Process Skills”. Thus, the research was performed with 24 teacher candidates in the control group and 24 teacher candidates in the experimental group in the second class of the Department of Science Teaching in a university in Istanbul Province. In the experimental group of the research, the laboratory program to be designed by the researchers on the basis of scientific discussion and research; and in the control group, the conventionally designed laboratory program were applied for an academic semester. The research data was gained through “Scientific Creativity Test” to be developed by Hu and Adey [14] and adapted by Kadayıfçı [16]; “Scientific Process Skills Test” to be developed by Okey, Wise and Burns, and adapted by Geban, Aşkar and Özkan into Turkish. The conclusions to be reached by the research are in favour of the experimental group and the last application, and it has positive impact on the opinions of the teacher candidates related with the development of the scientific creativity skills.


Author(s):  
Laleh Khojasteh ◽  
Seyyed Ali Hosseini ◽  
Elham Nasiri

AbstractWriting as a multiple-step process is one of the most complex and demanding skills for graduate students to master. Foreign or second language learners who are required to write for academic purposes at the university level may even find it more demanding to master. One of the ways of decreasing the burden of mastering this skill for learners is mediation, using scaffolding techniques to teach writing. Hence, having a good understanding of the impact(s) of adopting mediating or scaffolding techniques in writing classes is absolutely indispensable. To this end, the present study employed an experimental research design to investigate the impact of mediation in the flipped writing classrooms of the students of medicine. To peruse this goal, 47 medical students were selected through purposive sampling and put into control and treatment groups. Medical students in the treatment group watched teacher-made video content(s) before their writing classes. The students in this group experienced organized-interactive writing group activities in their classes. Unlike the experimental group, the students in the control group received all the instructions in the classroom and were assigned homework. The findings obtained through the ANOVA and t-test indicated that the students in the experimental group significantly outperformed their counterparts in the control group in terms of their writing. A probable conclusion could be that by requiring students to study in advance and take responsibility for their learning, flipped classroom can provide the opportunity for learners to actively construct knowledge rather than receive the information passively in the classroom. Flipped classroom can also cultivate interactive class time for teachers and enable them to invest in more fruitful academic practices, instead of asking students to spend a substantial amount of time each week doing homework independently.


2016 ◽  
Vol 24 (3) ◽  
pp. 414-437 ◽  
Author(s):  
Satoshi Sugahara ◽  
Hisayo Sugao ◽  
Steven Dellaportas ◽  
Takahiro Masaoka

Purpose This research applies a quasi-experimental research method to investigate the impact of an innovative resource titled “Accounting Exercise” (teaching intervention using physical movement and lyrics) on learning motivation and performance on a group of students enrolled in a first-year undergraduate accounting course in Japan. Design/methodology/approach Five classes were randomly assigned to either an experimental group (two classes) or a control group (three classes). In the experimental group, 90 students participated in a 15-min “Accounting Exercise” at the commencement of lectures over three consecutive weeks. The remaining 133 students assigned to the control group did not participate in the Accounting Exercise. Findings The findings indicate that the Accounting Exercise provided stimuli in maintaining students’ learning motivation. This finding is important for entry-level students where learning motivation has the potential to influence students’ future decisions on major areas of study and career choices. Originality/value This finding is important for entry-level students where future career options are decided. This effect is also believed to contribute to reducing the declining numbers of students in accounting majors.


Author(s):  
Mojtaba Maghsoudi ◽  
Sahar Saeedi

This study presents the findings of an investigation of the impact of teacher error corrective feedback on 180 field-dependent/ field-independent (FD/FI) male and female pre-intermediate and advanced Iranian EFL learners writing skill. The participants were separated into two experimental groups and one control group and were asked to write three paragraphs of about 100-150 words around three different topics, each in odd days of a week; then they received direct (in experimental group 1), indirect (in experimental group 2) and no correction feedback (in control group). The results based on Mean Scores, Standard Deviation, Multivariate Analyses and 1-way ANOVA showed that there was not any significant difference between the FD/FI learners' writing skill scores who had received corrective feedback on their errors; however, as indicated by the second finding of the present study it would be better to feedback field-dependent/-independent EFL learners indirectly. It was also indicated that, learners' learning styles had made a significant change in their writing skill scores.


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