Learning outcomes and cost-utility analysis of hybrid patient and mannequin-based simulation

Introduction: There is no clear evidence on the relationship between nursing student learning outcomes and the type of simulator used or its cost-effectiveness. Objectives: Compare nursing student learning outcomes using either the hybrid patient or mannequin and the cost-utility of both simulators. Method: A randomised experimental study with an experimental group (hybrid patient = 99) and a control group (mannequin = 97). A training intervention was carried out for polytrauma patients. Results: Statistically significant differences were found between the simulator used and the performance results for tourniquet (hybrid 5.37 ± 1.33, mannequin 4.95 ± 1.09; p = .008) and spinal board (hybrid 6.18 ± 2.02, mannequin 6.97 ± 20.2; p = .001) application. The cost-utility ratio was estimated to be 3.29 for the hybrid patient and 1.92 for the mannequin. Conclusion: The use of a hybrid patient or mannequin has not been shown to be a determinant of performance outcomes or student perceptions in training interventions in polytrauma patient care. However, as the cost per participant with a mannequin is almost twice as high, the hybrid patient has a better cost-utility ratio.This work was supported by the University of Alicante, within the Programa de Investigación en Docencia Universitaria (Research in University Teaching Programme) 2022 (approval number: 5766)

Programa de entrenamiento de habilidades de comunicación en situaciones críticas: análisis DAFO

Los programas de entrenamiento de habilidades clínicas permiten simular escenarios para la resolución de problemas, la toma de decisiones basadas en la evidencia, y el trabajo en equipo ofreciendo una retroalimentación inmediata sin poner en riesgo la seguridad del paciente o la calidad de la atención. Dada la escasez en la evidencia, el objetivo del presente estudio fue describir la implementación y valoración de un programa de entrenamiento de habilidades de comunicación en situaciones críticas dirigida a equipos de alto rendimiento mediante un diseño cualitativo bifásico: 1) implementación del programa y 2) valoración mediante matriz DAFO. Entre las fortalezas y oportunidades destacan la alta fidelidad, la adquisición de competencias clínicas, el debriefing y la experiencia, formación y compromiso de docentes, técnicos y actores. Deben atenderse las debilidades y amenazas externas para garantizar que el potencial de la metodología pueda aprovecharse por completo. Destacaron 9 de las 23 acciones de mejora propuestas relacionadas con la competitividad del máster y aspectos del briefing y el debriefing. Concluimos que un programa de estas características es una intervención educativa compleja que requiere una valoración continua de su efectividad para conseguir que sea competitivo y competente en la capacitación de profesionales de alto rendimiento

Protocolo de manejo ambulatorio de la paciente con sospecha de retención de restos ovulares tras parto/cesárea o aborto. Hospital Universitario Gregorio Marañón

Protocolo de manejo ambulatorio de la paciente con sospecha de retención de restos ovulares tras parto ó cesárea ó aborto que tiene como objetivo principal definir el circuito para el manejo ambulatorio de las pacientes con sospecha de retención de restos ovulares tras parto vaginal / cesárea ó tras aborto de 1º o 2º Trimestre. Objetivos específicos: Disminuir la morbilidad de este grupo de pacientes (especialmente vulnerable desde el punto de vista físico y psicológico) mediante el diagnóstico, seguimiento y tratamiento correcto. Estratificar el riesgo inicial de estas pacientes teniendo en cuenta su estado clínico y los hallazgos ecográficos, para decidir el tratamiento más adecuado (expectante, tratamiento médico, quirúrgico o embolización arterial pélvica). Mejorar la seguridad de las pacientes y profesionales en el manejo de esta patología. Fomentar el trabajo en equipo (entre obstetras, ginecólogos, radiólogos y radiólogos intervencionistas) mejorando la atención de las pacientes.Depto. de Salud Pública y Materno - InfantilFac. de Medicinaunpu

Workshop for Basic Gynaecological Examinations: Improving Medical Student Learning through Clinical Simulation

Introduction: This study was designed to evaluate whether the Workshop on Basic Principles for Clinical Gynaecological Exploration, offered to medical students, improves theoretical–practical knowledge, safety, confidence, global satisfaction and the achievement of the proposed objectives in the area of gynaecological clinical examinations. Materials and Methods: This was a quasi-experimental pre–post-learning study carried out at the Gynaecology and Obstetrics department of Gregorio Marañón Hospital in Madrid (Spain). The volunteer participants were 4th-year students earning a degree in Medicine during the 2020–2021 and 2021–2022 academic years. The study period was divided into the following stages: pre-workshop, intra-workshop and 2 weeks post-workshop. In the pre-workshop stage, students completed a brief online course to prepare for the workshop. The effectiveness of the workshop was evaluated through multiple-choice tests and self-administered questionnaires to assess self-assurance, self-confidence, self-satisfaction and the achievement of the objectives. Results: Of the 277 students invited in both academic years, 256 attended the workshop (92.4%), with a total participation in the different stages of the study greater than 70%. A total of 82.5% of the students in the 2020–2021 academic year and 80.6% of students in the 2021–2022 academic year did not have any type of experience performing gynaecological clinical examinations. Between the pre-workshop and 2 weeks post-workshop stages, there was significant improvement in theoretical–practical knowledge (improvement mean = 1.38 and 1.21 in 2020–2021 and 2021–2022 academic years, respectively). The security and confidence of the students prior to the workshop were low (average scores less than 5 points) in both academic years. However, post-workshop scores for satisfaction and the achievement of objectives were high in the two academic years; all the values approached or exceeded 8 points. Conclusions: Our students, after outstanding participation, evaluated the BPCGE, and improved their theoretical and practical knowledge, as well as their skills in a gynaecological clinical examination. Moreover, in their view, after the workshop, they felt very satisfied, far outreaching the proposed aims. In addition, excellent results were maintained over time, year after year