The validation and application of a novel colonic polypectomy trainer. The WIMAT colonoscopy suitcase

Summary Background and Aims The WIMAT colonoscopy suitcase is an ex-vivo, porcine, polypectomy simulator. This has been developed in response to the increasing demand for polypectomy training following the introduction of the National Bowel Cancer Screening Programme. The aims of this thesis are to establish if the simulator is a valid form of polypectomy skills training and to identify if this model can be used to develop objective parameters for polypectomy assessment. Materials and Methods A series of clinical trials were systematically conducted to test the validity of the WIMAT colonoscopy suitcase. This included evaluating its content, construct and concurrent validity and conducting a skills transfer study comparing the WIMAT colonoscopy suitcase with a virtual reality simulator. Objective assessment parameters were examined by measuring the accuracy of self-assessment and using video coding software to analyse the hand movements performed during simulated polypectomy tasks. Results Content validity was demonstrated by experts who scored the model’s anatomical, mechanical and visual realism favourably across multiple parameters (p=0.05). The ratio of rotational hand movements to endoscopic tip angulation (RoTA) was significantly different when comparing novices to experts (p=<0.05). Discussion The WIMAT colonoscopy suitcase is a valid form of polypectomy skills training. The simulator can be used to address the increasing demand for training in this procedure. Further work is needed to assess the reliability of the RoTA score at different stages of the polypectomy procedure before it is used as an assessment tool

Quality assurance of training in diagnostic and therapeutic gastrointestinal endoscopy

Previous evidence has shown that standards of performance in gastrointestinal endoscopy are variable and that there are disparities in training outcomes. Many changes have been made recently to both training and assessment of endoscopy in the UK. However, no prospective methods of evaluating their outcome have been put in place. The aims of this research were to evaluate current and new training processes and assessments in order to quality assure the outcomes and improve the training process. Two audits were undertaken demonstrating improvements in colonoscopy training over 5 years within a single region and in trainee perceptions of their training nationally. Two studies were done investigating a novel computer colonoscopy simulator for assessment of colonoscopic skills, demonstrating excellent construct validity. A multi-centre randomised controlled trial evaluated the use of this simulator in novice training, which was shown to be equivalent to standard bed-side training with a high degree of skills transfer to real-life colonoscopy. Assessment tools for therapeutic endoscopic procedures were developed, validated and used to quality assure a course in therapeutic endoscopy. This course resulted in significant improvements in practical skills for three of the four therapeutic procedures following training. Web-based training and assessment modules for lesion recognition at capsule endoscopy were developed, validated and piloted. This demonstrated the effectiveness of using new training methodologies for skills improvement in this area. A training course for radiographers in virtual colonoscopy was developed and the training evaluated. This demonstrated competence in practical performance and improvements in knowledge and interpretative skill. Finally, two qualitative studies on non-technical skills in endoscopy were undertaken in order to widen the assessment domains from purely knowledge and skill. An interview study provided the basis for development of a nontechnical skills taxonomy and a video-analysis study resulted in production of a marker system for professional behaviour within gastrointestinal endoscopy

Modelos de simulação clínica virtual : revisão de escopo

Orientador: Prof. Dr. Jorge Vinícius Cestari FelixCoorientador: Profª Drª Shirley BollerDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Defesa : Curitiba, 25/03/2022Inclui referências: p. 90-100Área de concentração: Prática Profissional de EnfermagemResumo: O objetivo deste presente estudo foi identificar quais modelos de simulação clínica virtual descritos na literatura científica são utilizados como estratégia de ensino em estudantes e profissionais de enfermagem. A simulação clínica, é uma técnica que substitui as experiências reais por experiências guiadas replicáveis permitindo aos estudantes e profissionais de enfermagem vivenciarem a representação de um acontecimento real. Uma vez que a simulação clínica virtual utiliza um computador de alto nível, fazendo com que essa técnica viabilize condições de maior segurança e autoconfiança do estudante durante sua formação teórica e prática, consolidando seus conhecimentos, habilidades e competências. Método: Revisão sistematizada do tipo Scoping Review, que consiste nas cinco etapas: (1) formulação da questão de pesquisa (2) identificação dos estudos relevantes; (3) seleção de estudos; (4) mapeamento de evidências científicas; (5) apresentação e interpretação dos resultados. As bibliotecas digitais e bases de dados escolhidas para este estudo foram: PubMed, Medline, Scielo, Scopus, BvS, Web of Science, Lilacs, Embase, Ebsco. Os descritores utilizados foram: Simulação/ Simulação clínica/ Simulação clínica virtual/ Realidade virtual /Treinamento por Simulação/ Treinamento com Simulação de Alta Fidelidade/ Simulação por Computador/ Estudante de Enfermagem/ Estratégias de ensino/ Educação. A coleta de dados ocorreu no período de 1° de maio até 1° de novembro do ano de 2020. Foram descritos os seguintes critérios de seleção: trabalhos de qualquer natureza que retratam estudos sob simulação clínica virtual em estudantes de enfermagem da graduação e pós-graduação; artigos publicados na literatura nacional e internacional nos idiomas português, inglês e espanhol dos últimos 20 anos, desde janeiro 2000 até agosto 2020, todos estes disponíveis online nas bases de dados consultados e aqueles que respondem ao problema ou questão de revisão. Os dados extraídos foram analisados e sintetizados narrativamente. Resultados: Dos 711 artigos recuperadas na busca, foram salvas para revisão e conteúdo, onde apenas 52 artigos duplicados e excluídas por não contribuírem com elementos para a análise temática desta revisão, 507 estudos foram excluídos com base no título e resumo, dos quais 152 foram selecionados, assim 99 estudos foram excluídos com base no conteúdo. Apenas 53 estudos atenderam os critérios de seleção para o estudo. Destes, 16 foram selecionados no Scopus, 17 no Medline/PubMed, 1 no Embase, 11 no Ebesco, 1 no BvS, 7 no Web Of Science e 5 no PubMed Central. Conclusão: Esta revisão de escopo fornece uma avaliação abrangente do uso de diferentes modelos de simulação clínica virtual no ensino de enfermagem, esses modelos podem melhorar o conhecimento de estudantes e profissionais de enfermagem. Em geral, o uso da simulação de realidade virtual deve ser considerado para aprimorar o conhecimento e como complemento a outras estratégias de simulação para melhorar a qualidade e a segurança da prática clínica. No entanto, a heterogeneidade e o risco de viés entre os estudos incluídos devem ser levados em consideração. Estudos de grande escala rigorosamente desenhados são necessários para confirmar ainda mais os resultados desta revisão.Abstract: The objective of this present study was to identify which virtual clinical simulation models described in the scientific literature are used as a teaching strategy for nursing students and professionals. Clinical simulation is a technique that replaces real experiences with replicable guided experiences, allowing nursing students and professionals to experience the representation of a real event. Since the virtual clinical simulation uses a high-level computer, making this technique possible conditions of greater security and self-confidence of the student during their theoretical and practical training, consolidating their knowledge, skills and competences. Method: Systematized review of the Scoping Review type, which consists of five steps: (1) formulation of the research question (2) identification of relevant studies; (3) selection of studies; (4) mapping of scientific evidence; (5) presentation and interpretation of results. The digital libraries and databases chosen for this study were: PubMed, Medline, Scielo, Scopus, BvS, Web of Science, Lilacs, Embase, Ebesco. The descriptors used were: Simulation / Clinical Simulation / Virtual Clinical Simulation / Virtual Reality / Training by Simulation / Training with High Fidelity Simulation / Computer Simulation / Nursing Student / Teaching Strategies / Education. Data collection took place from May 1st to November 1st, 2020. The following selection criteria were described: works of any nature that portray studies under virtual clinical simulation in undergraduate and graduate nursing students graduation; articles published in national and international literature in Portuguese, English and Spanish for the last 20 years, from January 2000 to August 2020, all of which are available online in the consulted databases and those that respond to the problem or review question. The extracted data were analyzed and synthesized narratively. Results: Of the 711 articles retrieved in the search, they were saved for review and content, where only 52 articles were duplicated and excluded for not contributing elements to the thematic analysis of this review, 507 studies were excluded based on title and abstract, of which 152 were selected, thus 99 studies were excluded based on content. Only 53 studies met the selection criteria for the study. Of these, 16 were selected from Scopus, 17 from Medline/PubMed, 1 from Embase, 11 from Ebesco, 1 from BvS, 7 from Web Of Science and 5 from PubMed Central. Conclusion: This scoping review provides a comprehensive assessment of the use of different virtual clinical simulation models in nursing education, these models can improve the knowledge of nursing students and professionals. In general, the use of virtual reality simulation should be considered to enhance knowledge and as a complement to other simulation strategies to improve the quality and safety of clinical practice. However, heterogeneity and risk of bias among included studies must be taken into account. Large-scale rigorously designed studies are needed to further confirm the results of this review

Design revolutions: IASDR 2019 Conference Proceedings. Volume 3: People

In September 2019 Manchester School of Art at Manchester Metropolitan University was honoured to host the bi-annual conference of the International Association of Societies of Design Research (IASDR) under the unifying theme of DESIGN REVOLUTIONS. This was the first time the conference had been held in the UK. Through key research themes across nine conference tracks – Change, Learning, Living, Making, People, Technology, Thinking, Value and Voices – the conference opened up compelling, meaningful and radical dialogue of the role of design in addressing societal and organisational challenges. This Volume 3 includes papers from People track of the conference

[¹⁸F]fluorination of biorelevant arylboronic acid pinacol ester scaffolds synthesized by convergence techniques

Aim: The development of small molecules through convergent multicomponent reactions (MCR) has been boosted during the last decade due to the ability to synthesize, virtually without any side-products, numerous small drug-like molecules with several degrees of structural diversity.(1) The association of positron emission tomography (PET) labeling techniques in line with the “one-pot” development of biologically active compounds has the potential to become relevant not only for the evaluation and characterization of those MCR products through molecular imaging, but also to increase the library of radiotracers available. Therefore, since the [18F]fluorination of arylboronic acid pinacol ester derivatives tolerates electron-poor and electro-rich arenes and various functional groups,(2) the main goal of this research work was to achieve the 18F-radiolabeling of several different molecules synthesized through MCR. Materials and Methods: [18F]Fluorination of boronic acid pinacol esters was first extensively optimized using a benzaldehyde derivative in relation to the ideal amount of Cu(II) catalyst and precursor to be used, as well as the reaction solvent. Radiochemical conversion (RCC) yields were assessed by TLC-SG. The optimized radiolabeling conditions were subsequently applied to several structurally different MCR scaffolds comprising biologically relevant pharmacophores (e.g. β-lactam, morpholine, tetrazole, oxazole) that were synthesized to specifically contain a boronic acid pinacol ester group. Results: Radiolabeling with fluorine-18 was achieved with volumes (800 μl) and activities (≤ 2 GBq) compatible with most radiochemistry techniques and modules. In summary, an increase in the quantities of precursor or Cu(II) catalyst lead to higher conversion yields. An optimal amount of precursor (0.06 mmol) and Cu(OTf)2(py)4 (0.04 mmol) was defined for further reactions, with DMA being a preferential solvent over DMF. RCC yields from 15% to 76%, depending on the scaffold, were reproducibly achieved. Interestingly, it was noticed that the structure of the scaffolds, beyond the arylboronic acid, exerts some influence in the final RCC, with electron-withdrawing groups in the para position apparently enhancing the radiolabeling yield. Conclusion: The developed method with high RCC and reproducibility has the potential to be applied in line with MCR and also has a possibility to be incorporated in a later stage of this convergent “one-pot” synthesis strategy. Further studies are currently ongoing to apply this radiolabeling concept to fluorine-containing approved drugs whose boronic acid pinacol ester precursors can be synthesized through MCR (e.g. atorvastatin)