A Comparison of the Effects of Simulation Training and Non-Simulation Training On Self-Efficacy in Providing Women\u27s Health Care

The Veterans Administration (VA) recognizes that proficiency in the core concepts of primary care women\u27s health is required to provide comprehensive primary care for women. A potentially superior form of training that has been recently used for care providers is simulation. The examination of the relationship between simulation training through the Mini-Residency Course and increased self-efficacy among Women\u27s Health Primary Care Providers (WH-PCP) is important, as the Mini-Residency Course is designed specifically to fill knowledge gaps and enhance the participant\u27s knowledge and skill. A single post-test only, two group design was used for this study. The experimental group included those who completed simulation training on how to provide effective, essential healthcare to women veterans. The simulation-based training occurred July, 2012. The study gathered survey data designed to determine the level of self-efficacy of practitioners from a sample who had participated in the Mini-Residency program (Part I, or Parts I and II) and compared the levels of self-efficacy to a sample of practitioners who did not participate in simulations. Limited by a low response rate, the study sample included 23 practitioners. A self-efficacy survey was constructed using Bandura\u27s self-efficacy theory. The self-efficacy score for this analysis used the mean of six discrete skill items. The reliability of this self-efficacy scale was examined using Cronbach\u27s alpha. Results indicated reliability at a = .71. The results failed to demonstrate any statistically significant differences between groups. However, it was noted that a significant result ( p = .10 level) was evident in the differences in mean self-efficacy scores based on standardized patient experience, which suggests the need for future research using a larger sample size

Adapting the Communication and Teamwork Skills Assessment to Assess Pre-licensure Health Care Student Team Performance in Simulation-Enhanced Interprofessional Education

Introduction: Literature demonstrates a lack of structured reporting of interprofessional (IPE) education activities and challenges objectively measuring team performance. The purposes of this article are: to provide a structured description of a simulation-enhanced IPE project focusing on pre-licensure health care student team performance; and, to describe how the Communication and Teamwork Skills (CATS) assessment was adapted to assess teamwork and communication skills during student team simulations. Methods: Simulated case scenarios were conducted with teams consisting of nursing, respiratory therapy, and medical students. The CATS tool was adapted for use in IPE simulations by adding two statements that globally assessed frequency and quality of teamwork. Individual items from the CATS tool guided assessment of overall team performance. Faculty assessors piloted the tool by discussing tool components and assessing several sample cases together. Faculty assessors then scored each simulation individually and the adapted CATS tool was assessed for inter-rater reliability. Results: The team assessed sixty-eight cases (n=68). Thirty-four (n=34) cases were rated by three of the faculty and thirty-four (n=34) were rated by two faculty. Inter-rater reliability for frequency of communication was .808 and .789 for quality of communication. Conclusion: This project suggests that an adapted version of the CATS assessment tool can be used to reliably assess communication performance of health care student teams during a simulated acute care case. In addition, the planning team hopes that the project can be replicated to develop a model of IPE that is sustainable and feasible within other academic or health care settings

A proposed method to investigate reliability throughout a questionnaire

<p>Abstract</p> <p>Background</p> <p>Questionnaires are used extensively in medical and health care research and depend on validity and reliability. However, participants may differ in interest and awareness throughout long questionnaires, which can affect reliability of their answers. A method is proposed for "screening" of systematic change in random error, which could assess changed reliability of answers.</p> <p>Methods</p> <p>A simulation study was conducted to explore whether systematic change in reliability, expressed as changed random error, could be assessed using unsupervised classification of subjects by cluster analysis (CA) and estimation of intraclass correlation coefficient (ICC). The method was also applied on a clinical dataset from 753 cardiac patients using the Jalowiec Coping Scale.</p> <p>Results</p> <p>The simulation study showed a relationship between the systematic change in random error throughout a questionnaire and the slope between the estimated ICC for subjects classified by CA and successive items in a questionnaire. This slope was proposed as an awareness measure - to assessing if respondents provide only a random answer or one based on a substantial cognitive effort. Scales from different factor structures of Jalowiec Coping Scale had different effect on this awareness measure.</p> <p>Conclusions</p> <p>Even though assumptions in the simulation study might be limited compared to real datasets, the approach is promising for assessing systematic change in reliability throughout long questionnaires. Results from a clinical dataset indicated that the awareness measure differed between scales.</p

The Effect of a Simulation-Based Education Program on NIHSS Accuracy and Inter-Rater Reliability Among Nursing Staff in the Neurological/Neurosurgical Intensive Care Unit

PURPOSE: The purpose of this Quasi-experimental study was to examine the effect of a simulation-based educational NIHSS workshop on nursing accuracy and inter-rater reliability upon use of the National Institutes of Health Stroke Scale (NIHSS). METHODS: This study was conducted in the Neurological/Neurosurgical Intensive Care Unit (ICU) at Baptist Health, a comprehensive stroke center located in Lexington, KY. The sample included 26 eligible nurses employed in the aforesaid unit. Nurses completed the NIHSS on a patient actor in a simulated scenario (this session was videotaped), a one-on-one debriefing with review of the videotape was conducted afterward, and then the nurse completed the NIHSS on a patient actor in a second scenario. RESULTS: Four participants scored the patient correctly in scenario one, and nineteen participants scored the patient correctly in scenario two. However, the results were not deemed statistically significant (P=.287, Fisher’s Exact Test). Variability of scoring did improve from scenario 1 to scenario 2 (SD=1.74 and 0.53, respectively). Inter-rater reliability among participants was also shown to increase in scenario 2, with noted differences in five items on the NIHSS. CONCLUSION: NIHSS simulation-based education was shown to improve accuracy of scoring (SD=1.74 pre-intervention and SD=0.53 post-intervention) and inter-rater reliability (significant results seen in five distinct scale items) of participants. More research is needed to determine if simulation-based NIHSS education has an effect on patient outcomes

Optimal scheduling of reliability development activities

Probabilistic Safety Assessment and Management is a collection of papers presented at the PSAM 7 - ESREL '04 Conference in June 2004. The joint Conference provided a forum for the presentation of the latest developments in methodology and application of probabilistic and reliability methods in various industries. Innovations in methodology as well as practical applications in the areas of probabilistic safety assessment and of reliability analysis are presented in this six volume set. The aim of these applications is the optimisation of technological systems and processes from the perspective of a risk-informed safety management while also taking economic and environmental aspects into account. The joint Conference in particular achieved an enhanced communication, the sharing of experience and integration of approaches not only among the various industries but also on a truly global basis by bringing together leading experts from all over the world. Over the last four decades, contemporary researchers have continuously been working to provide modern societies with a systematic, self-consistent and coherent framework for making decisions on at least one class of risks, those stemming from modern technological applications. Most of the effort has been spent in developing methods and techniques for assessing the dependability of technological systems, and assessing or estimating the levels of safety and associated risks. A wide spectrum of engineering, natural and economic sciences has been involved in this assessment effort. The developments have moved beyond research endeavours, they have been applied and utilised in real socio-technical environments and have become established - while modern technology continues to present new challenges and to raise new questions. Consequently, Probabilistic Safety Assessment and Management covers both well-established practices and open issues in the fields addressed by the Conference, identifying areas where maturity has been reached and those where more development is needed. The papers reflect a wide variety of disciplines, such as principles and theory of reliability and risk analysis, systems modelling and simulation, consequence assessment, human and organisational factors, structural reliability methods, software reliability and safety, insights and lessons from risk studies and management/decision making. A diverse range of application areas are represented including aviation and space, chemical processing, civil engineering, energy, environment, information technology, legal, manufacturing, health care, defence, transportation and waste management

Computerized adaptive testing and short form development for child and adolescent oral health patient-reported outcomes measurement.

ObjectivesTo develop computerized adaptive testing (CAT) and short forms of self-report oral health measures that are predictive of both the children's oral health status index (COHSI) and the children's oral health referral recommendation (COHRR) scales, for children and adolescents, ages 8-17.Material and methodsUsing final item calibration parameters (discrimination and difficulty parameters) from the item response theory analysis, we performed post hoc CAT simulation. Items most frequently administered in the simulation were incorporated for possible inclusion in final oral health assessment toolkits, to select the best performing eight items for COHSI and COHRR.ResultsTwo previously identified unidimensional sets of self-report items consisting of 19 items for the COHSI and 22 items for the COHRR were administered through CAT resulting in eight-item short forms for both the COHSI and COHRR. Correlations between the simulated CAT scores and the full item bank representing the latent trait are r = .94 for COHSI and r = .96 for COHRR, respectively, which demonstrated high reliability of the CAT and short form.ConclusionsUsing established rigorous measurement development standards, the CAT and corresponding eight-item short form items for COHSI and COHRR were developed to assess the oral health status of children and adolescents, ages 8-17. These measures demonstrated good psychometric properties and can have clinical utility in oral health screening and evaluation and clinical referral recommendations

Effect of Sequence of Simulated and Clinical Practicum Learning Experiences on Clinical Competency of Nursing Students

Two different sequences of blocks of simulated and clinical practicum learning experiences compared the clinical competency development of nursing students using a randomized crossover design. Competency was measured 3 times: after each block of simulated and clinical experiences and after a final simulated experience. No significant differences in competency scores between the 2 groups across the 3 time points were found. Using alternative models of clinical and simulation learning may help address barriers to the delivery of clinical education faced by schools of nursin