Preparing Residents Effectively in Emergency Skills Training with a Serious Game

Introduction Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game. Methods This was a quasi-experimental study with residents preparing for a rotation in the emergency department. The "reading" group received a course manual before classroom training; the "reading and game" group received this manual plus the game as preparation for the same training. Emergency skills were assessed before training (with residents who agreed to participate in an extra pretraining assessment), using validated competency scales and a global performance scale. We also measur

Correction to: Putting genome-wide sequencing in neonates into perspective

The original version of this Article contained an error in the spelling of the author Pleuntje J. van der Sluijs, which was incorrectly given as Eline (P. J.) van der Sluijs. This has now been corrected in both the PDF and HTML versions of the Article

Thermal anemometric assessment of coronary flow reserve with a pressure-sensing guide wire : an in vitro evaluation

Assessment of coronary flow reserve (CFR) with a commercially available pressure-sensor-tipped guide wire using the principle of thermal anemometry could provide major clinical benefits both in determining and in distinguishing between epicardial and microvascular coronary artery disease. In constant-temperature thermal anemometry, the electrical power required to maintain an element at a constant temperature is a measure for the local shear rate. Here, the feasibility of applying this thermoconvection method to a pressure-sensing guide wire is investigated using an in vitro model. A theoretical relation between electrical power and steady shear rate based on boundary layer theory was tested in an experimental set-up. In steady flow, a reproducible relation between electrical power and shear rate was obtained with an overheat temperature of 20 K, which was in good agreement with theory. The relation between shear rate and flow, however, depends on geometry of the artery and position of the guide wire inside the vessel. Although this means that this thermoconvection method is less useful for absolute flow measurements, CFR could be assessed even for unsteady flow using the steady calibration curve with a mean relative difference of (3 ± 5)% compared to CFR derived from the golden standard using an ultrasonic flow measurement device

Neuroimaging in Breast Implant Illness, an fMRI Pilot Study

BACKGROUND: Some women with breast implants report systemic and cognitive symptoms known as breast implant illness (BII), which are very similar to those of fibromyalgia. Functional MRI has shown altered brain activity in fibromyalgia patients. OBJECTIVES: In this pilot study, we investigated whether brain alterations could be observed in BII patients using fMRI. METHODS: Women aged 18 to 76 with silicone breast implants for cosmetic reasons were recruited through a Dutch online BII support organization (MKS) and through Maastricht University Medical Center. Twelve women with BII and twelve women without symptoms were included. Participants completed questionnaires regarding demographic characteristics, medical history, psychosocial complaints (4DSQ), cognitive failure (MSSE), pain intensity and pain-related disability (CPGS). Subsequently, brain images of all participants were obtained using resting-state fMRI (rs-fMRI) and Diffusion Tensor Imaging (DTI) at a 3 Tesla MRI scanner (Siemens Medical System, Erlangen, Germany). RESULTS: Eleven BII patients and 12 healthy controls were included for analysis. Baseline characteristics were similar in the two groups and the mean silicone exposure was 15 years. Patients scored significantly higher on both pain intensity and disability than controls. Patients scored worse on depression, somatization, distress, and anxiety compared to asymptomatic women. MMSE scores were normal. However, the analyses of both functional connectivity and structural integrity showed no significant differences between the two groups. CONCLUSIONS: This pilot study showed no evidence of brain alterations in BII patients. However, patients scored significantly worse on psychosocial symptoms than controls. Psychological factors appear to play an important role in BII and should be further investigated

Preparing Residents Effectively in Emergency Skills Training With a Serious Game

INTRODUCTION: Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game. METHODS: This was a quasi-experimental study with residents preparing for a rotation in the emergency department. The “reading” group received a course manual before classroom training; the “reading and game” group received this manual plus the game as preparation for the same training. Emergency skills were assessed before training (with residents who agreed to participate in an extra pretraining assessment), using validated competency scales and a global performance scale. We also measured motivation. RESULTS: All groups had comparable important characteristics (eg, experience with acute care). Before training, the reading and game group felt motivated to play the game and spent more self-study time (+2.5 hours) than the reading group. Game-playing residents showed higher scores on objectively measured and self-assessed clinical competencies but equal scores on the global performance scale and were equally motivated for training, compared with the reading group. After the 2-week training, no differences between groups existed. CONCLUSIONS: After preparing training with an additional serious game, residents showed improved clinical competencies, compared with residents who only studied course material. After a 2-week training, this advantage disappeared. Future research should study the retention of game effects in blended designs