Live lecture versus video podcast in undergraduate medical education: A randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Information technology is finding an increasing role in the training of medical students. We compared information recall and student experience and preference after live lectures and video podcasts in undergraduate medical education.</p> <p>Methods</p> <p>We performed a crossover randomised controlled trial. 100 students were randomised to live lecture or video podcast for one clinical topic. Live lectures were given by the same instructor as the narrator of the video podcasts. The video podcasts comprised Powerpoint™ slides narrated using the same script as the lecture. They were then switched to the other group for a second clinical topic. Knowledge was assessed using multiple choice questions and qualitative information was collected using a questionnaire.</p> <p>Results</p> <p>No significant difference was found on multiple choice questioning immediately after the session. The subjects enjoyed the convenience of the video podcast and the ability to stop, review and repeat it, but found it less engaging as a teaching method. They expressed a clear preference for the live lecture format.</p> <p>Conclusions</p> <p>We suggest that video podcasts are not ready to replace traditional teaching methods, but may have an important role in reinforcing learning and aiding revision.</p

Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment

<p>Abstract</p> <p>Background</p> <p>This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration.</p> <p>Methods</p> <p>Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis.</p> <p>Results</p> <p>The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error.</p> <p>Conclusions</p> <p>The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development.</p

ParaVR: A Virtual Reality Training Simulator for Paramedic Skills maintenance

This document is the Accepted Manuscript version of a Published Work that appeared in final form in Journal of Paramedic Practice, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://www.paramedicpractice.com/features/article/paravr-a-virtual-reality-training-simulator-for-paramedic-skills-maintenance.Background, Virtual Reality (VR) technology is emerging as a powerful educational tool which is used in medical training and has potential benefits for paramedic practice education. Aim The aim of this paper is to report development of ParaVR, which utilises VR to address skills maintenance for paramedics. Methods Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust (WAST) developed ParaVR in four stages: 1. Identifying requirements and specifications 2. Alpha version development, 3. Beta version development 4. Management: Development of software, further funding and commercialisation. Results Needle Cricothyrotomy and Needle Thoracostomy emerged as candidates for the prototype ParaVR. The Oculus Rift head mounted display (HMD) combined with Novint Falcon haptic device was used, and a virtual environment crafted using 3D modelling software, ported (a computing term meaning transfer (software) from one system or machine to another) onto Oculus Go and Google cardboard VR platform. Conclusion VR is an emerging educational tool with the potential to enhance paramedic skills development and maintenance. The ParaVR program is the first step in our development, testing, and scaling up of this technology

An overview of realist evaluation for simulation-based education

This article describes the key features of realist (realistic) evaluation and illustrates their application using, as an example, a simulation-based course for final year medical students. The use of simulation-based education (SBE) is increasing and so too is the evidence supporting its value as a powerful technique which can lead to substantial educational benefits. Accompanying these changes is a call for research into its use to be more theory-driven and to investigate both 'Did it work?' and as importantly 'Why did it work (or not)?' An evaluation methodology that is capable of answering both questions is realist evaluation. Realist evaluation is an emerging methodology that is suited to evaluating complex interventions such as SBE. The realist philosophy positions itself between positivist and constructivist paradigms and seeks to answer the question 'What works for whom, in what circumstances and why?' In seeking to answer this question, realist evaluation sets out to identify three fundamental components of an intervention, namely context, mechanism and outcome. Educational programmes work (successful outcomes) when theory-driven interventions (mechanisms) are applied to groups under appropriate conditions (context). Realist research uses a mixed methods (qualitative and quantitative) approach to gathering data in order to test the proposed context-mechanism-outcome (CMO) configurations of the intervention under investigation. Realist evaluation offers a valuable methodology for researchers investigating interventions utilising simulation-based education. By investigating and understanding the context, mechanisms and outcomes of SBE interventions, realist evaluation can provide the deeper level of understanding being called for

Training interval in cardiopulmonary resuscitation.

AIM:Although evidence supports brief, frequent CPR training, optimal training intervals have not been established. The purpose of this study was to compare nursing students' CPR skills (compressions and ventilations) with 4 different spaced training intervals: daily, weekly, monthly, and quarterly, each for 4 times in a row. METHODS:Participants were nursing students (n = 475) in the first year of their prelicensure program in 10 schools of nursing across the United States. They were randomly assigned into the 4 training intervals in each of the schools. Students were trained in CPR on a Laerdal Resusci Anne adult manikin on the Resuscitation Quality Improvement (RQI) mobile simulation station. The outcome measures were quality of compressions and ventilations as measured by the RQI program. RESULTS:Although students were all certified in Basic Life Support prior to the study, they were not able to adequately perform compressions and ventilations at pretest. Overall compression scores improved from sessions 1 to 4 in all training intervals (all p < .001), but shorter intervals (daily training) resulted in larger increases in compression scores by session 4. There were similar findings for ventilation skills, but at session 4, both daily and weekly intervals led to better skill performance. CONCLUSION:For students and other novices learning to perform CPR, the opportunity to train on consecutive days or weeks may be beneficial: if learners are aware of specific errors in performance, it may be easier for them to correct performance and refine skills when there is less time in between practice sessions

The first Research Consensus Summit of the Society for Simulation in Healthcare: conduction and a synthesis of the results

In this article, we describe the preparation and execution of the first Research Consensus Summit (Summit) of the Society for Simulation in Healthcare (SSH) held in January 2011 in New Orleans, Louisiana. The goals of the Summit were to provide guidance for better simulation-related research, to broaden the scope of topics investigated, and to highlight the importance of simulation-related research. An international Core Group (the authors of this article) worked with the SSH Research Committee to identify 10 topic areas relevant for future research that would be examined by the 10 Topic Groups composed of Topic Chairs and Topic Group Members. Each Topic Group prepared a monograph and slide presentation on their topic which was presented at the 2-day Summit. The audience provided feedback on each presentation. Based on this feedback, the Topic Groups revised their presentations and monographs for publication in this supplement to Simulation in Healthcare. The Core Group has synthesized an overview of the key Summit themes in this article. In some groups, the agreement was that there is currently no consensus about the state of the science in certain topic aspects. Some key themes emerged from the Topic Groups. The conceptual and theoretical bases of simulation-related research, as well as the methods used and their methodological foundations, need to be more explicitly described in future publications. Although no single method is inherently better, the mix of research methods chosen should match the goal of each study. The impact of simulation, whether direct or indirect, needs to be assessed across different levels of training, and larger, more complex contexts need to be taken into account. When interpreting simulation-related research, the ecological validity of the results needs to be taken into consideration. The scope of simulation-related research can be widened from having simulation as the focus of research (research about simulation), to using simulation to investigate other research questions (research with simulation). Simulation-related research can benefit from an improved understanding of structural differences and similarities with other domains. The development of simulation equipment and concepts will benefit from applying known and available science-based design frameworks. Overall, the context of simulation-related research needs to be better understood. The progress of research depends on building overarching and sustainable research programs that relate individual studies with each other. The Summit was successful in taking a snapshot of the state of the science. Future summits might explore these topics further, monitor progress, and address new topics