scholarly journals 115 Multi-Disciplinary Simulation Training on Delirium

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
S Varma ◽  
D Alston ◽  
B Shah ◽  
S Long
Keyword(s):  
Learning Outcomes ◽  
Simulation Training ◽  
Discharge Planning ◽  
Geriatric Medicine ◽  
Early Discharge ◽  
Mental Capacity ◽  
Mandatory Training ◽  
Qualitative Feedback ◽  
Patient Scenario ◽  
Personal Skills

Abstract Introduction Delirium is still perceived as a “geriatric medicine competency”, despite its high prevalence across most specialties. Collective multi-disciplinary team performance in implementation of multi-component interventions is key. Simulation training incorporates the complex interplay of non-technical factors, specifically, role recognition and empowerment, inter-personal skills and teamwork that are pivotal in delivering effective delirium care. Methods Funding was approved by Health Education England. 2 pilot teaching sessions were arranged in the simulation ward. 3 scenarios were developed, each requiring a facilitator, an actor and three participants- a foundation-year doctor, a nurse/healthcare assistant and a therapist. Scenario 1 dealt with a patient with hypoactive delirium with focus on identification and multidisciplinary optimisation. Scenario 2 challenged participants with management of an agitated patient. Scenario 3 involved discharging a patient with resolving delirium and a reluctant relative, with emphasis on mental capacity assessment. Communication, patient risk assessment and challenging perceived role barriers were global themes. Participant feedback was captured using unstructured interviews and pre- and post-session 5-point Likert confidence scale in various learning outcomes. Results 16 participants were included- 4 foundation year doctors, 3 therapists, 2 healthcare assistants and 7 nurses. There was an average improvement in Likert confidence scales in all measured learning outcomes. All participants would recommend the course to their colleagues (average Likert scale 4.9). Qualitative feedback appraised the course for demonstration of de-escalation communication strategies, the application of mental capacity and recognition of early discharge planning. Conclusion Simulation training targeted at multi-disciplinary groups is an effective way to deliver teaching on delirium. It contextualises synergistic operation of different skills and personal accountability in influencing patient management. The challenge to its potential remains its adoption as mandatory training for various disciplines involved in care of older adults and its implementation at a wider-scale, to assure cost effectiveness.

scholarly journals What is meant by “frailty” in undergraduate medical education? A national survey of UK medical schools

2021 ◽  
Vol 12 (2) ◽  
pp. 355-362
Author(s):  
Rebecca Winter ◽  
Muna Al-Jawad ◽  
Juliet Wright ◽  
Duncan Shrewsbury ◽  
Harm Van Marwijk ◽  
...  
Keyword(s):  
Medical Education ◽  
Learning Outcomes ◽  
Undergraduate Medical Education ◽  
Geriatric Medicine ◽  
Treatment Decision ◽  
Medical Schools ◽  
Educational Strategies ◽  
Treatment Decision Making ◽  
Negative Perceptions ◽  
Common Learning

Abstract Purpose All UK medical schools are required to include frailty in their curriculum. The term is open to interpretation and associated with negative perceptions. Understanding and recognising frailty is a prerequisite for consideration of frailty in the treatment decision-making process across clinical specialities. The aim of this survey was to describe how frailty has been interpreted and approached in UK undergraduate medical education and provide examples of educational strategies employed. Methods All UK medical schools were invited to complete an electronic survey. Schools described educational strategies used to teach and assess frailty and provided frailty-related learning outcomes. Learning Outcomes were grouped into categories and mapped to the domains of Outcomes for Graduates (knowledge, skills and values). Results 25/34 Medical schools (74%) participated. The interpretation of what frailty is vary widely and the diversity of teaching strategies reflect this. The most common Learning outcomes included as “Frailty” are about the concept of frailty, Comprehensive Geriatric Assessments and Roles of the MDT. Frailty teaching is predominantly opportunistic and occurred within geriatric medicine rotations in all medical schools. Assessments focus on frailty syndromes such as falls and delirium. Conclusion There is variation regarding how frailty has been interpreted and approached by medical schools. Frailty is represented in an array of teaching and assessment methods, with a lack of constructive alignment to related learning outcomes. Consensus should be agreed as to what frailty means in medical education. Further research is required to explore which frailty-specific educational strategies in undergraduate medical education enhance learning.

scholarly journals Early discharge and rehabilitation in paediatric acquired brain and neurological injury: a transferable model

2018 ◽  
pp. edpract-2018-315096
Author(s):  
Rachel Keetley ◽  
Laura Kelly ◽  
William P Whitehouse ◽  
Sophie Thomas ◽  
Emily Bennett ◽  
...  
Keyword(s):  
Discharge Planning ◽  
Quality Care ◽  
Acquired Brain Injury ◽  
Early Discharge ◽  
Family Satisfaction ◽  
Neurological Injury ◽  
Children And Young People ◽  
Financial Gain ◽  
Lengths Of Stay ◽  
Improve Patient

Children and young people who require rehabilitation following sustaining an acquired brain injury often experience long lengths of stay (LOS) and potentially poorer recovery outcomes due to limited access to therapy and little proactive discharge planning. After stakeholder enquiry we launched a new team and pathway with a primary aim to reduce LOS. The secondary aims were to pilot an outreach model, reduce cost and improve patient and family satisfaction. We achieved a significantly improved change in quality care with a financial gain and increased patient and family satisfaction.

Abstract W P317: Pan-London Simulation Training for Hyperacute Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
J Birns ◽  
P Jaye ◽  
A Roots ◽  
G Reedy ◽  
Alastair Ross
Keyword(s):  
Learning Outcomes ◽  
Health Care Professionals ◽  
Simulation Training ◽  
Emergency Situation ◽  
Technical Skills ◽  
Stroke Care ◽  
Training Programme ◽  
Management Decision ◽  
Structured Interviews ◽  
Hyperacute Stroke

Background: City-wide re-organisation of stroke care in London, incorporating 8 hyperacute stroke units (HASUs), has improved thrombolysis rates and survival cost-effectively. Continued staffing of HASUs requires stroke-specialist training to develop competencies for managing neurological emergencies. Simulation training provides an education platform for health care professionals to become immersed in realistic scenarios where outcome is dependent upon technical and non-technical skills. Methods: A standardised, curriculum-mapped, high-fidelity, simulation-training programme was developed on 4 HASUs for city-wide staff to attend. Learning outcomes included technical (acute stroke assessment/management) and non-technical skills (including time management/decision-making/teamwork). A mixed-methods evaluation approach was used to evaluate data from participants before, during, and after training. Results: Over a 2 year period, 152 HASU staff (70 medical; 82 nursing) participated. Quantitative analysis showed a pre/post-course increase in candidates’ ability to manage emergency stroke situations (t=6.6, p<0.001), leadership skills (t=6.7, p<0.001) and communication skills (t=3.7, p<0.001), more so in junior compared with senior clinicians. Simulation training was enjoyable (mean (SD) rating 5.7(2) on 7 point Likert scale), with higher ratings from doctors compared with nurses (t=3; p<0.01). Enjoyment correlated positively (r=0.853; p<0.001) and previous experience of simulation correlated negatively (r=-0.228; p<0.05) with relevance to clinical practice. Thematic analysis of post-course semi-structured interviews demonstrated 5 important learning outcomes (assertiveness; calling for help; situational awareness; teamwork; verbalising thoughts) and 3 main responses for transference to practice (general enthusiasm with no particular practical change; immediate recognition of an emergency situation providing recall of the course; reflective change). Conclusion: Simulation training may be effective in helping achieve HASU-specific learning outcomes and may be delivered in a standardised manner across multiple sites.

Psychogeriatric Hospitalization: Terminable or Interminable?

1992 ◽  
Vol 37 (3) ◽  
pp. 157-162
Author(s):  
H.M.R. Meier ◽  
M. Besir ◽  
J.A. Sylph
Keyword(s):  
General Hospital ◽  
Discharge Planning ◽  
Early Discharge ◽  
Positive Outcome ◽  
Community Resources ◽  
Patient Assessment ◽  
Psychogeriatric Patients

This paper takes issue with the stereotype of psychogeriatric patients in the general hospital using beds unnecessarily. With appropriate organization of services involving integrated teamwork, comprehensive patient assessment, early discharge planning and liaison with community resources, a positive outcome and early discharge was achieved with the majority of a group of psychogeriatric patients.

scholarly journals Computer-based Simulation Training to Improve Learning Outcomes in Mannequin-based Simulation Exercises

2011 ◽  
Vol 75 (6) ◽  
pp. 113 ◽  
Author(s):  
Lindsay B. Curtin ◽  
Laura A. Finn ◽  
Quinn A. Czosnowski ◽  
Craig B. Whitman ◽  
Michael J. Cawley
Keyword(s):  
Learning Outcomes ◽  
Simulation Training ◽  
Computer Based ◽  
Simulation Exercises

scholarly journals Prediction of Disposition within 48-hours of Hospital Admission Using Patient Mobility Scores

2019 ◽  
Vol 15 (9) ◽  
pp. 540-543 ◽  
Author(s):  
Daniel L Young ◽  
Elizabeth Colantuoni ◽  
Lisa Aronson Friedman ◽  
Jason Seltzer ◽  
Kelly Daley ◽  
...  
Keyword(s):  
Decision Tree ◽  
Hospital Admission ◽  
Discharge Planning ◽  
Classification Tree ◽  
Care Facility ◽  
Predictive Ability ◽  
Early Discharge ◽  
Final Decision ◽  
Patient Mobility ◽  
Machine Learning Classification

Delayed hospital discharges for patients needing rehabilitation in a postacute setting can exacerbate hospital-acquired mobility loss, prolong functional recovery, and increase costs. Systematic measurement of patient mobility by nurses early during hospitalization has the potential to help identify which patients are likely to be discharged to a postacute care facility versus home. To test the predictive ability of this approach, a machine learning classification tree method was applied retrospectively to a diverse sample of hospitalized patients (N = 805) using training and validation sets. Compared with patients discharged to home, patients discharged to a postacute facility were older (median, 64 vs 56 years old) and had lower mobility scores at hospital admission (median, 32 vs 41). The final decision tree accurately classified the discharge location for 73% (95%CI:67%-78%) of patients. This study emphasizes the value of systematically measuring mobility in the hospital and provides a simple decision tree to facilitate early discharge planning.

scholarly journals Collaborative Work and the Future of Humanities Teaching

2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Michael Ullyot ◽  
Kate E. O'Neill
Keyword(s):  
Learning Outcomes ◽  
Collaborative Research ◽  
Learning Experience ◽  
Collaborative Work ◽  
Writing Assignments ◽  
Course Materials ◽  
Qualitative Feedback ◽  
Premier Cycle ◽  
Disciplinary Expertise ◽  
Sciences Humaines

This article explores the degree to which student collaborations on research and writing assignments can effectively realize learning outcomes. The assignment, in this case, encouraged students to contribute discrete parts of a research project in order to develop their complementary abilities: researching, consulting, drafting, and revising. The outcomes for students included appreciation for their individual expertise, and experience combining discrete contributions into a result that surpasses the sum of its parts. In the course, we gave students preliminary guidance for establishing team objectives and roles for the duration of this assignment and asked them to evaluate their learning experience at the end. In this paper, we analyze the students’ quantitative and qualitative feedback, and suggest ways to structure and supervise collaborative assignments so that students develop their expertise and complementary skills. We suggest that collaborative work such as this is essential for advanced undergraduates in the humanities, where collaborations are less common than in other disciplines. Moreover, we conclude that future humanities instructors should be open to the benefits of collaborative research and writing. This article will be of interest to instructors who wish to develop collaborative assignments that improve students’ disciplinary expertise, engagement with course materials, and outreach to audiences beyond the academy. Cet article explore la mesure dans laquelle le travail en collaboration des étudiants en matière de recherche et de rédaction de devoirs peut aboutir à des résultats d’apprentissage efficaces. Dans le cas présent, le devoir demandé devait encourager les étudiants à contribuer à des sections distinctes d’un projet de recherche afin de développer leurs compétences complémentaires : mener à bien la recherche, consulter, préparer un brouillon et réviser. Pour les étudiants, les résultats comprenaient l’appréciation de leur expertise individuelle et l’expérience d’incorporer des contributions distinctes à un résultat qui dépassait la somme de ses parties. Dans le cours, nous avons fourni aux étudiants une orientation préliminaire pour établir les objectifs et les rôles du groupe pour la durée de ce devoir et nous leur avons demandé à la fin d’évaluer leur expérience d’apprentissage. Dans cet article, nous analysons la rétroaction qualitative et quantitative des étudiants et suggérons des manières de structurer et de superviser les devoirs en collaboration afin de permettre aux étudiants de développer leur expertise et leurs compétences complémentaires. Nous suggérons que le travail en collaboration tel que celui présenté ici est essentiel pour les étudiants de niveau avancé au premier cycle en sciences humaines, où le travail en collaboration est moins commun que dans d’autres disciplines. De plus, nous concluons que les futurs instructeurs en sciences humaines devraient se montrer ouverts aux avantages de la recherche et de la rédaction en collaboration. Cet article intéressera les instructeurs qui désirent créer des devoirs en collaboration pour améliorer l’expertise disciplinaire des étudiants, leur intérêt dans la matière enseignée et les activités de rayonnement pour des auditoires au-delà de l’université.

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