14 research outputs found
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Improving decision-making and cognitive bias using innovative approaches to simulated scenario and debrief design
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Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees
Purpose: Mental health simulation is the educational practice of recreating clinical situations in safe environments using actors, followed by structured debriefing, to foster professional development and improve care. Although evidence outlines the benefits of simulation, few studies have examined the impact of interprofessional mental health simulation on healthcare trainees, which is more reflective of clinical care. The purpose of this paper is to evaluate the impact of mental health simulation training on studentsâ confidence, attitudes, knowledge and perceived professional development and anticipated clinical practice.
Design/methodology/approach: Participants (n=56) were medical (41 per cent) and mental health nursing students (41 per cent), and clinical psychology trainees (18 per cent). Six simulated scenarios, involving one to three trainees, were followed by structured debriefs with trained facilitators. Scenarios, using actors, reflected patient journeys through emergency, medical and psychiatric settings. Participantsâ confidence, knowledge and attitudes were measured quantitatively using pre- and post-course self-report questionnaires. Perceptions of impact on professional development and clinical practice were assessed using thematic analysis of post-course questionnaire responses.
Findings: Knowledge, confidence and attitudes scores showed statistically significant increases, with large effect sizes. Thematic analyses highlighted themes of: interprofessionalism, communication skills, reflective practice, personal resilience, clinical skills and confidence.
Research limitations/implications: Further research should clarify the impact of interprofessional simulation training on mental health practice in the context of other training received.
Practical implications: Simulation training may begin to influence participantsâ professional development and future clinical practice and subsequently care delivered, supporting its increased use in mental health.
Originality/value: This study adds to nascent understandings of the use and potential of interprofessional mental health simulation, outlining innovative training, its positive outcomes and implications
Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)
Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic