A novel approach: Simulating multiple simultaneous encounters to assess multitasking ability in emergency medicine

Study objective The purpose of this feasibility study is to develop and validate a new assessment tool and scoring system for multitasking competency for physicians in-training in a timed simulated setting. The multitasking competency includes ability to appropriately prioritize and implement tasks for different patients who present simultaneously. Methods We designed three single task stations with different levels of difficulty and priority. These skill stations were then combined to create a multitasking simulation scenario. Skill checklists and the global rating scale were utilized to assess the participants’ performance. A multitasking score, multitasking index, and priority score were developed to measure the multitasking ability of participants. Results Thirty-three first-year postgraduate physicians were recruited for this prospective study. The total performance scores were significantly higher for the single-tasking stations than for the multitasking scenario. In terms of the time needed to complete the tasks, the participants spent more time on the multitasking scenario than on the single-tasking scenario. There were significant correlations between the global rating scale and the multitasking score (rho = 0.693, p < 0.001) and between the global rating scale and the multitasking index (rho = 0.515, p < 0.001). The multitasking score, multitasking index, and priority score did not have any significant correlations with the total single-tasking score. Conclusion We demonstrated that the use of a simulated multitasking scenario could be an effective method of assessing multitasking ability and allow assessors to offer better quality feedback.

Sexual counseling to patients with myocardial infarction: Nurses' performance, responsibility and confidence

Background & Aim: One of the main concerns in patients with myocardial infarction is that there is no return to sexual activities. Sexual counseling is an interaction between patient and nurse that requires appropriate performance, responsibility, and confidence. The present study aimed to determine nurses' performance, responsibility, and confidence in sexual counseling of myocardial infarction patients. Methods & Materials: This descriptive/analytical cross-sectional study was carried out on 180 nurses from the cardiac care unit (CCU) at the hospitals located in southeastern Iran in 2018. Sampling was performed with the census method; and the data collection tool was a demographic information form and questionnaire, involving nurses' performance, responsibility, and confidence in sexual counseling of cardiac patients. Information was analyzed using SPSS software (ver.18) through descriptive and inferential statistics, including t-test, ANOVA, and Pearson correlation coefficient. The significance level was considered as 0.05. Results: The mean of total performance scores in the nurses was 14.54 ± 4.4, indicating the average performance of nurses in the sexual counseling of myocardial infarction patients. The total mean score of responsibility was 14.32±2.7, indicating their average responsibility in sexual consultation. The total mean score of confidence was 12.86±2.35, indicating their average confidence in the sexual counseling of cardiac patients. Conclusion: The present research showed that nurses’ performance and confidence were not high or acceptable in the sexual counseling of patients with a myocardial infarction, which can lead to some dangerous events such as recurrent myocardial infarction or sudden death. Thus, holding some workshops or training related to the sexual counseling of the patients can assist nurses to be better in this case.

WAIS Results for Ss with Longstanding, Chronic, Lateralized and Diffuse Cerebral Dysfunction

Several studies utilizing W-B I results have shown differential impairment on verbal or performance tasks associated with lateralized cerebral dysfunction. Only modest differential impairment, however, has been found among patients with longstanding, chronic brain damage. Increased use of the newer scale, the WAIS, warrants evaluation of possible differential impairment of selected clinical samples on this scale. WAIS results were compared for 28 Ss with longstanding maximal cerebral damage of the left hemisphere, 24 with maximal damage of the right hemisphere, and 46 with diffuse damage. Significant differences between group means were rare. However, the mean intra-individual difference between total Verbal and total Performance scores was highly significant for the right-lesion group, moderately significant for the diffuse-lesion group, and non-significant for the left-lesion group. Further investigation with the instrument is needed on groups which differ from those in the present study with respect to variables such as duration of cerebral dysfunction, type of lesion, and age of onset, in order to improve our understanding of relationships between cerebral dysfunction and ability deficits.