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Effect of vascular simulation training on practice performance in residents: a retrospective cohort study.

ABSTRACT: OBJECTIVE:This study aims to investigate the teaching effect of vascular simulation training (ST) in rotating vascular residents. DESIGN:Retrospective cohort study. SETTING AND PARTICIPANTS:A total of 95 vascular residents were included from 2015 to 2018 in a university affiliated centre western China, and divided into an ST group and a conventional training (CT) group. The ST group received ST and CT, and the CT group only received CT. PRIMARY OUTCOME MEASURES:Theoretical scores were assessed, and the technique parameters, complications and radiation damage of the procedures were analysed. RESULTS:The mean scores (8.74±1.09 vs 8.13±1.31) and the rate of willingness for retraining (93.62% vs 79.17%) in residents were higher in the ST group than in the conventional training (CT) group (p<0.05). The success rate of arterial puncture was significantly higher in the ST group (78.72% vs 58.33%, p=0.03); however, the incidence of complications was similar between the two groups (p>0.05). The time of the puncture procedure was significantly lower (9.56±5.24 vs 12.15±6.87?min), and the comfort score of the patient (5.49±1.72 vs 4.71±1.57) was higher in the ST group than in the CT group (p<0.05). At the end of the assessment, the learning time for angiography (3.65±0.64 vs 4.07±0.77 months) and the complete procedure time (33.81±10.11 vs 41.32±12.56?min) were lower in the ST group than in the CT group (p<0.01). The fluo time for angiography (489.33±237.13 vs 631.47±243.65?s) and the cumulative air kerma (401.30±149.06 vs 461.16±134.14?mGy) were significantly decreased in ST group (p<0.05). CONCLUSION:The application of a vascular simulation system can significantly improve the clinical performance of residents and reduce the radiation damage from a single intervention procedure in patients.

SUBMITTER: Yang L

PROVIDER: S-EPMC7507846 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Effect of vascular simulation training on practice performance in residents: a retrospective cohort study.

Yang Lin L Li Yanzi Y Liu Jianlin J Liu Yamin Y

BMJ open 20200921 9

<h4>Objective</h4>This study aims to investigate the teaching effect of vascular simulation training (ST) in rotating vascular residents.<h4>Design</h4>Retrospective cohort study.<h4>Setting and participants</h4>A total of 95 vascular residents were included from 2015 to 2018 in a university affiliated centre western China, and divided into an ST group and a conventional training (CT) group. The ST group received ST and CT, and the CT group only received CT.<h4>Primary outcome measures</h4>Theor ...[more]

PMID: 32958489

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Project description:Simulation stands to serve an important role in modern competency-based programs of assessment in postgraduate medical education. Our objective was to compare the performance of individual emergency medicine (EM) residents in a simulation-based resuscitation objective structured clinical examination (OSCE) using the Queen's Simulation Assessment Tool (QSAT), with portfolio assessment of clinical encounters using a modified in-training evaluation report (ITER) to understand in greater detail the inferences that may be drawn from a simulation-based OSCE assessment.A prospective observational study was employed to explore the use of a multicenter simulation-based OSCE for evaluation of resuscitation competence. EM residents from five Canadian academic sites participated in the OSCE. Video-recorded performances were scored by blinded raters using the scenario-specific QSATs with domain-specific anchored scores (primary assessment, diagnostic actions, therapeutic actions, communication) and a global assessment score (GAS). Residents' portfolios were evaluated using a modified ITER subdivided by CanMEDS roles (medical expert, communicator, collaborator, leader, health advocate, scholar, and professional) and a GAS. Correlational and regression analyses were performed comparing components of each of the assessment methods.Portfolio review and ITER scoring was performed for 79 residents participating in the simulation-based OSCE. There was a significant positive correlation between total OSCE and ITER scores (r = 0.341). The strongest correlations were found between ITER medical expert score and each of the OSCE GAS (r = 0.420), communication (r = 0.443), and therapeutic action (r = 0.484) domains. ITER medical expert was a significant predictor of OSCE total (p = 0.002). OSCE therapeutic action was a significant predictor of ITER total (p = 0.02).Simulation-based resuscitation OSCEs and portfolio assessment captured by ITERs appear to measure differing aspects of competence, with weak to moderate correlation between those measures of conceptually similar constructs. In a program of competency-based assessment of EM residents, a simulation-based OSCE using the QSAT shows promise as a tool for assessing medical expert and communicator roles.

Project description:BackgroundA prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity. However, residents are rarely exposed to real emergency situations. Simulation-based medical training (SBMT) offers the opportunity to improve medical and non-technical skills in a controlled setting. This survey describes the availability and current use of SBMT by paediatric residents in Italy with the purpose of understanding residents' expectations regarding neonatal and paediatric emergency training, and identifying gaps and potential areas for future implementation.MethodsA survey was developed and distributed to Italian residents. SBMT was defined as any kind of training with a mannequin in a contextualised clinically realistic scenario.ResultsThe response rate was 14.4%, covering the 71% of Italian paediatric residency programmes. Among them, 88% stated that Out of the 274 residents, 88% stated that they received less than 5 h of SBMT during the past training year, with 66% not participating in any kind of simulation activity. In 62% of the programmes no simulation training facility was available to residents. Among those who received SBMT, 46% used it for procedures and skills, 30% for clinical scenarios, but only 24% of them reported a regular use for debriefing. Of the overall respondents, 93% were interested in receiving SBMT to improve decision-making abilities in complex medical situations, to improve technical/procedural skills, and to improve overall competency in neonatal and paediatric emergencies, including non-technical skills. The main barriers to the implementation of SBMT programmes in Italian paediatric residencies were: the lack of experts (57%), the lack of support from the school director (56%), the lack of organisation in planning simulation centre courses (42%) and the lack of teaching materials (42%).ConclusionsThis survey shows the scarce use of SBMT during paediatric training programmes in Italy and points out the main limitations to its diffusion. This is a call to action to develop organised SBMT during paediatric residency programs, to train qualified personnel, and to improve the quality of education and care in this field.

Dataset Information

Effect of vascular simulation training on practice performance in residents: a retrospective cohort study.

Publications

Effect of vascular simulation training on practice performance in residents: a retrospective cohort study.

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