Simulated video-based telehealth training for emergency physicians
Ontology highlight
ABSTRACT:
SUBMITTER: Hayden E
PROVIDER: S-EPMC10494251 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:PurposeRetinal implants (RIs) provide new vision for patients suffering from photoreceptor degeneration in the retina. The limited vision gained by RI, however, leaves room for improvement by training regimes.MethodsTwo groups of normal-sighted participants were respectively trained with videos or still images of daily objects in a labeling task. Object appearance was simulated to resemble RI perception. In Experiment 1, the training effect was measured as the change in performance during the training, and the same labeling task was conducted after 1 week to test the retention. In Experiment 2 with a different pool of participants, a reverse labeling task was included before (pre-test) and after the training (post-test) to show if the training effect could be generalized into a different task context.ResultsBoth groups showed improved object recognition through training that was maintained for a week, and the video group showed better improvement (Experiment 1). Both groups showed improved object recognition in a different task that was maintained for a week, but the video group did not show better retention than the image group (Experiment 2).ConclusionsTraining with video materials leads to more improvement than training with still images in simulated RI perception, but this better improvement was specific to the trained task.Translational relevanceWe recommend videos as better training materials than still images for patients with RIs to improve object recognition when the task-goal is highly specific. We also propose here that achieving highly specific training goals runs the risk of limiting the generalization of the training effects.
| S-EPMC8525839 | biostudies-literature
Project description:BackgroundTo overcome vast variations in Community Health Worker (CHW) training, investigators for the CHW Core Consensus Project (CCCP) derived three types of CHW (Category 1, 2, 3) and established competencies for each category. However, studies are needed that implement these competencies in real-world settings.ObjectiveUsing the six competency domains of the CCCP as a theoretical backbone, we developed and evaluated a training for Category 1 CHWs, individuals whose focus is on community outreach and advocacy.MethodsWe developed five telehealth-based, bilingual (Spanish/English) training sessions and implemented them among Category 1 Latino(a) CHWs. We measured the number of CHWs who achieved ≥70% correct on a domain-based posttest, attendance, and qualitative feedback.ResultsAll (18/18) CHWs achieved at least 70% on the posttest (mean: 93.7%; range 73.3-100%). Training attendance was 98.9%. Using a six-point scale, CHWs reported high levels of satisfaction overall (5.72 ± 0.57/6.0), with telehealth (5.72 ± 0.58/6.0), effectiveness of teaching strategies/methods (5.89 ± 0.32/6.0), achieving training objectives (5.96 ± 0.15/6.0), knowledge improvement (5.72 ± 0.57/6.0), and interest (5.78 ± 0.43/6.0).ConclusionWe successfully developed and evaluated a bilingual training program for Category 1 CHWs to address core competency gaps. High CHW attendance reinforces the value of telehealth modalities and their potential to increase the reach for CHW training. To overcome gaps in chronic disease training, investigations are needed to address additional CHW trainings.Trial registrationNCT04835493.
| S-EPMC10282968 | biostudies-literature
Project description:AbstractSurvey study of training and practice paradigms and job satisfaction of dual-boarded emergency medicine (EM) and sports medicine (SM) physicians. The REDCap survey was sent to 193 American Board of EM members who hold a Certificate of Added Qualification in SM. A total of 124 EM/SM physicians responded (67.5% male). More than 70% completed three-year residencies while only 28.5% had an EM/SM residency faculty. One-quarter delayed fellowship after residency 6.45 years on average. Regarding their first job after fellowship, 27.6% practiced only EM, 54.5% practiced both EM and SM, and 12.2% practiced only SM. Regarding their current job, 29.1% practice only EM. 47.3% practice both EM and SM, and 20.9% practice only SM. Only 13.9% and 9.9% indicated they are unhappy with their first job and current job, respectively. There is significant variability in practice settings for EM/SM physicians with the overwhelming majority being happy with their career choices.
| S-EPMC9830565 | biostudies-literature
Project description:BackgroundDespite the importance of Ultrasound-guided Regional Anaesthesia (UGRA) in Emergency Medicine (EM), there is significant variability in UGRA training among emergency physicians. We recently developed a one-day (8 h), simulation-based UGRA course, specifically tailored to help emergency physicians to integrate these skills into their clinical practice.MethodsIn this pre/post intervention study, emergency physicians attended a course consisting of a 4-hour teaching on background knowledge and a practical part structured as follows: a scanning session on a healthy individual; a needling station with an ex-vivo model (turkey thighs); a simulation-based learning experience on local anaesthetic toxicity (LAST); a session on the UGRA simulator BlockSim™. Participants rated their level of knowledge across several domains of UGRA practice; for this purpose, we used a 5-points Likert scale (from 0 to 4). Participants also rated the perceived utility of the practical sessions. We extrapolated baseline characteristics of participants, and we paired the answers of pre- and post-course questionnaires using Wilcoxon signed-rank test.ResultsSeventy-four emergency physicians across ten Italian regions and Switzerland completed the pre-and post- course questionnaire. Most of them were EM residents (75.68%) who had never performed UGRA. Median self-reported knowledge significantly improved from 1 to 3 in the following domains of UGRA indications: Knowledge of contraindications and UGRA techniques [pre-course 1 (IQR 1-2), post-course 3 (IQR 2-3)]; Equipment and drugs [pre-course 1(IQR 1-1), post-course 3 (IQR2-3)]; LAST recognition [pre-course 1 (IQR 1-2), post-course 3 (IQR 2-4)]; LAST management [pre-course 1 (IQR 1-1,75), post-course 3 (IQR 2-3)] (p < 0.001). A smaller improvement was observed in the domain Knowledge of "sonoanatomy" (from 1 to 2; p < 0.001); this might be due to the fact that a one-hour scanning session on a single healthy volunteer may be insufficient for learners to gain confidence with the relevant sonoanatomy. Most participants rated positively the utility of practical stations (100% for the scanning session; 100% for the ex-vivo station with turkey thigh; 91.8% for the BlockSim™).LimitationsThe main limitation of this study is that measurements are limited to learners' reaction to learning and self-assessment outcomes. We did not measure the impact of our course on participants' performance in simulated settings, or on their behavior in the clinical setting, or on patient outcomes. The sample size of participants was relatively small, although larger than most published similar studies.ConclusionsThis one-day simulation-based, UGRA course tailored for emergency physicians led to improved participants' self-reported knowledge across several domains of UGRA practice. The course represents an effective educational strategy and can be replicated in other settings for the initial training of emergency physicians in UGRA.
| S-EPMC11662541 | biostudies-literature
Project description:BackgroundOne of the primary goals of simulation-based education is to enable long-term retention of training gains. However, medical literature has poorly contributed to understanding the best timing for repetition of simulation sessions. There is heterogeneity in re-training recommendations.ObjectivesThis study assessed, through simulation-based training in different groups, the long-term retention of rare pediatric technical procedures.MethodsThis multicenter observational study included 107 emergency physicians and residents. Eighty-eight were divided into four groups that were specifically trained for pediatric emergency procedures at different points in time between 2010 and 2015 (< 0.5 year prior for G1, between 0.5 and 2 years prior for G2, between 2 and 4 years prior for G3, and ≥ 4 years prior for G4). An untrained control group (C) included 19 emergency physicians. Participants were asked to manage an unconscious infant using a low-fidelity mannequin. Assessment was based on the performance at 6 specific tasks corresponding to airway (A) and ventilation (B) skills. The performance (scored on 100) was evaluated by the TAPAS scale (Team Average Performance Assessment Scale). Correlation between performance and clinical level of experience was studied.ResultsThere was a significant difference in performance between groups (p < 0.0001). For G1, 89% of the expected tasks were completed but resulted in longer delays before initiating actions than for the other groups. There was no difference between G4 and C with less than half of the tasks performed (47 and 43% respectively, p = 0.57). There was no correlation between clinical level of experience and performance (p = 0.39).ConclusionPerformance decreased at 6 months after specific training for pediatric emergency skills, with total loss at 4 years after training, irrespective of experience. Repetition of simulation sessions should be implemented frequently after training to improve long-term retention and the optimal rate of refresher courses requires further research.
| S-EPMC6739955 | biostudies-literature
Project description:BackgroundDespite expanded access to telehealth services for Medicare beneficiaries in nursing homes (NHs) during the COVID-19 public health emergency, information on physicians' perspectives on the feasibility and challenges of telehealth provision for NH residents is lacking.ObjectiveTo examine physicians' perspectives on the appropriateness and challenges of providing telehealth in NHs.ParticipantsMedical directors or attending physicians in NHs.ApproachWe conducted 35 semistructured interviews with members of the American Medical Directors Association from January 18 through January 29, 2021. Outcomes of the thematic analysis reflected perspectives of physicians experienced in NH care on telehealth use.Main measuresThe extent to which participants used telehealth in NHs, the perceived value of telehealth for NH residents, and barriers to telehealth provision.Key resultsParticipants included 7 (20.0%) internists, 8 (22.9%) family physicians, and 18 (51.4%) geriatricians. Five common themes emerged: (1) direct care is needed to adequately care for residents in NHs; (2) telehealth may allow physicians to reach NH residents more flexibly during offsite hours and other scenarios when physicians cannot easily reach patients; (3) NH staff and other organizational resources are critical to the success of telehealth, but staff time is a major barrier to telehealth provision; (4) appropriateness of telehealth in NHs may be limited to certain resident populations and/or services; (5) conflicting views about whether telehealth use will be sustained over time in NHs. Subthemes included the role of resident-physician relationships in facilitating telehealth and the appropriateness of telehealth for residents with cognitive impairment.ConclusionsParticipants had mixed views on the effectiveness of telehealth in NHs. Staff resources to facilitate telehealth and the limitations of telehealth for NH residents were the most raised issues. These findings suggest that physicians in NHs may not view telehealth as a suitable substitute for most in-person services.
| S-EPMC10010241 | biostudies-literature
Project description:ObjectivesThe objectives were to describe the current procedural skill practices, attitudes toward procedural skill competency, and the role for educational skills training sessions among emergency medicine (EM) physicians within a geographic health zone.MethodsThis is a multicenter descriptive cross-sectional survey of all EM physicians working at 12 emergency departments (EDs) within the Edmonton Zone in 2019. Survey items addressed current procedural skill performance frequency; perceived importance and confidence; current methods to maintain competence; barriers and facilitating factors to participation in a curriculum; preferred teaching methods; and desired frequency of practice for each procedural skill.ResultsSurvey response rate was 53.6%. Variability in frequency of performed procedures was seen across the type of hospital sites. For the majority of skills, there was a significantly positive correlation between the frequency at which a skill was performed and the perceived confidence performing said skill. There was inconsistency and no significant correlation with perceived importance, perceived confidence or frequency performing a given skill, and the desired frequency of training for that skill. Course availability (76.2%) and time (72.8%) are the most common identified barriers to participation in procedural skills training.ConclusionsThis study summarized the current ED procedural skill practices among EM physicians in the Edmonton Zone and attitudes toward an educational curriculum for procedural skill competency. This represents a step toward targeted continuing professional development in staff physicians.
| S-EPMC8019211 | biostudies-literature
Project description:BackgroundFeeding and eating disorders present with a variety of medical complications, some of which may be life-threatening. Emergency Medicine (EM) physicians may interact with patients with eating disorders, however, EM physicians' knowledge and perceptions of resources for treating patients with eating disorders have not been examined. The purpose of this study was to explore previous training/education, perceptions of available resources, and educational needs in treating eating disorders in practicing EM physicians.MethodsAn investigator-developed survey was used in this cross-sectional pilot study, distributed to EM Residency Program Coordinators in the United States to distribute to EM physicians and residents. The survey assessed EM physicians' previous training and education in treating and diagnosing eating disorders. The primary outcomes assessed were participants' previous training/education in eating disorders, knowledge of local resources for patients, and educational needs on a variety of topics related to adult and adolescent eating disorders. Data were described descriptively and SAS 9.4 was used to analyze data.ResultsOf the 162 participants, just 1.9% completed a rotation on eating disorders during residency. Ninety-three percent were unfamiliar with the American Psychiatric Association's Practice Guideline for the Treatment of Patients with Eating Disorders; 95% were unfamiliar with the publication, "Emergency Department management of patients with eating disorders" by Trent et al. The majority were not aware of resources for patients with eating disorders including community and online support groups, the National Eating Disorders Association, and local treatment programs. At least 50% agreed additional education on 15 of the 19 topics examined would be useful; 85% agreed to wanting education on the assessment of patients with eating disorders in the Emergency Department.ConclusionsMost EM physicians lack training in eating disorders and knowledge of resources available for patients post-Emergency Department discharge. EM physicians agree additional education on a number of topics would be beneficial, particularly assessment of eating disorders in the Emergency Department, medical complications of eating disorders, and hospital admission criteria for those with eating disorders.
| S-EPMC7789763 | biostudies-literature
Project description:IntroductionIncreasing prevalence of neurologic disorders with an aging global population and limited availability of neurologists may lead to worse patient outcomes. As a result of the COVID-19 pandemic, telehealth services surged, and despite easing public health measures, the demand has remained. Telehealth technology has the potential to close the physical gaps in expanding the reach of care. This academic half-day workshop sought to provide a learning opportunity in response to these concerns.MethodsThe workshop consisted of small- and large-group case discussions among pediatric resident physicians (PGY 1-PGY 3) moderated by two child neurology faculty physicians over Zoom. Participants received a learner document with prereading articles and questions for each case. PowerPoint presentations with video demonstrations were used to introduce the cases and guide discussions.ResultsOf the 25 attendees, 14 (56% response rate) answered a nonmandatory postsession survey. Eighty-six percent of the respondents were very or extremely satisfied with the content covered and were similarly satisfied with the effectiveness of content delivery. Seventy-nine percent of the respondents found the content helpful or very helpful in preparation for the board, and 93% anticipated applying the content covered occasionally or frequently in their clinical practice.DiscussionSmall-group discussions with video demonstrations are helpful in increasing proficiency with telehealth technology and in examining board-relevant cases on pediatric patients. There is strong interest in subsequent telehealth half-day workshops that incorporate teaching through group discussions on relevant patient case scenarios.
| S-EPMC10450098 | biostudies-literature
Project description:ObjectiveSuccessful completion of life-saving procedures may benefit from a concise just-in-time (JIT) intervention. Video is an optimal medium for JIT training, but currently available video-based references are not optimized for a JIT format, especially in time-pressured situations prior to high-risk clinical contexts. We aimed to create and evaluate the efficacy of a brief video review of emergent Sengstaken-Blakemore tube (SBT) insertion for acutely decompensating variceal hemorrhage when used just prior to clinical performance in a simulated setting.MethodsWe created a less than 3-minute audio-optional JIT training video on SBT insertion. We recruited emergency medicine resident physicians to participate in a simulation scenario in which they had to quickly place an SBT. Participants were randomized to either a 3-minute procedure review by any media they chose (control) or review of the JIT video (intervention). Performance on a checklist created by a multidisciplinary group of SBT experts (passing score > 18 and maximum = 28) served as the primary outcome. We analyzed performance in checklist scores controlling level of training through a one-way analysis of covariance (ANCOVA). We analyzed rates of passing scores via a chi-square analysis.ResultsWe randomized 32 participants to media review (control) or JIT video (intervention). The intervention group had an overall mean (±SD) performance of 19.8 (±9.0) and the control group had a mean (±SD) score of 6.6 (±7.4). After adjusting for postgraduate year, we found a significant difference in final checklist scores between the two groups (mean difference = 12.8, 95% confidence interval [CI] = 7.6 to 18.0). Percentages of participants reaching a minimum passing score were two of 16 (12.5%) in the control group and 10 of 16 (62.5%) in the intervention group (odds ratio = 11.7, 95% CI = 9.9 to 13.5). Cohen's kappa indicated substantial agreement (κ = 0.714) between reviewer scores.ConclusionsA readily available, focused, audio-optional JIT video increased performance for SBT insertion in a simulated setting. Future work may include testing of this format for more commonly performed emergency procedures and determination of effect on bedside performance in the clinical setting.
| S-EPMC8171783 | biostudies-literature