Dataset Information

A pilot study to assess the utility of a freely downloadable mobile application simulator for undergraduate clinical skills training: a single-blinded, randomised controlled trial.

ABSTRACT:

Background

Medical simulators offer an invaluable educational resource for medical trainees. However, owing to cost and portability restrictions, they have traditionally been limited to simulation centres. With the advent of sophisticated mobile technology, simulators have become cheaper and more accessible. Touch Surgery is one such freely downloadable mobile application simulator (MAS) used by over one million healthcare professionals worldwide. Nevertheless, to date, it has never been formally validated as an adjunct in undergraduate medical education.

Methods

Medical students in the final 3 years of their programme were recruited and randomised to one of three revision interventions: 1) no formal revision resources, 2) traditional revision resources, or 3) MAS. Students completed pre-test questionnaires and were then assessed on their ability to complete an undisclosed male urinary catheterisation scenario. Following a one-hour quarantined revision period, all students repeated the scenario. Both attempts were scored by allocation-blinded examiners against an objective 46-point mark scheme.

Results

A total of 27 medical students were randomised (n = 9 per group). Mean scores improved between baseline and post-revision attempts by 8.7% (p = 0.003), 19.8% (p = 0.0001), and 15.9% (p = 0.001) for no resources, traditional resources, and MAS, respectively. However, when comparing mean score improvements between groups there were no significant differences.

Conclusions

Mobile simulators offer an unconventional, yet potentially useful adjunct to enhance undergraduate clinical skills education. Our results indicate that MAS's perform comparably to current gold-standard revision resources; however, they may confer significant advantages in terms of cost-effectiveness and practice flexibility.

Trial registration

Not applicable.

SUBMITTER: Bartlett RD

PROVIDER: S-EPMC5725819 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Publications

A pilot study to assess the utility of a freely downloadable mobile application simulator for undergraduate clinical skills training: a single-blinded, randomised controlled trial.

Bartlett Richard D RD Radenkovic Dina D Mitrasinovic Stefan S Cole Andrew A Pavkovic Iva I Denn Peyton Cheong Phey PCP Hussain Mahrukh M Kogler Magdalena M Koutsopodioti Natalia N Uddin Wasima W Beckley Ivan I Abubakar Hana H Gill Deborah D Smith Daron D

BMC medical education 20171211 1

<h4>Background</h4>Medical simulators offer an invaluable educational resource for medical trainees. However, owing to cost and portability restrictions, they have traditionally been limited to simulation centres. With the advent of sophisticated mobile technology, simulators have become cheaper and more accessible. Touch Surgery is one such freely downloadable mobile application simulator (MAS) used by over one million healthcare professionals worldwide. Nevertheless, to date, it has never been ...[more]

PMID: 29228934

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Project description:BackgroundIn this research paper we report on the quality of feedback provided in the logbooks of pre-clinical undergraduate students based on a model of 'actionable feedback'. Feedback to clinical learners about their performance is crucial to their learning, which ultimately impacts on their development into competent clinicians. Due to students' concerns regarding the inconsistency and quality of feedback provided by clinicians, a structured feedback improvement strategy to move feedback forward was added to the clinical skills logbook. The instrument was also extended for peer assessment. This study aims to assess the quality of feedback using the deliberate practice framework.MethodsA feedback scoring system was used to retrospectively assess the quality of tutor and peer logbook feedback provided to second and third year medical students to identify deliberate practice components i.e. task, performance gap and action plan. The sample consisted of 425 second year and 600 third year feedback responses over a year.ResultsAll three deliberate practice components were observed in the majority of the written feedback for both classes. The frequency was higher in peer (83%, 89%) than tutor logbook assessments (51%, 67%) in both classes respectively. Average tutor and peer task, gap and action feedback scores ranged from 1.84-2.07 and 1.93-2.21 respectively. The overall quality of feedback provided by the tutor and peer was moderate and less specific (average score < or = 2). The absence of the three components was noted in only 1% of the feedback responses in both 2nd and 3rd year.ConclusionThis study found that adding in a feed-forward strategy to the logbooks increased the overall quality of tutor and peer feedback as the task, gap and action plans were described. Deliberate practice framework provides an objective assessment of tutor and peer feedback quality and can be used for faculty development and training. The findings from our study suggest that the ratings from the tool can also be used as guidelines to provide feedback providers with feedback on the quality of feedback they provided. This includes specifically describing a task, performance gap and providing a learning plan as feed-forward to enhance feedback given.

Project description:Objective: The objective of this article is a description of the longitudinal communication curriculum in the Model Medicine Curriculum (MSM) at Charité - Universitätsmedizin Berlin. The authors describe the planning and integration of the curriculum into the study program, outline how communicative competence is taught and evaluated in the MSM, and identify which challenges need to be mastered in the process. Project description: Starting with the introduction of the MSM in 2010, students have been spending 102 class hours, spread out over seven semesters, practicing social and communicative competences in the interactive small group format "Communication, Interaction & Teamwork (KIT)". The course contents are closely linked to the topics covered each semester and increase in complexity over the course of their studies. The contents are selected by the KIT planning group whose members continually check the curriculum's timeliness and determine any changes. Students as well as instructors have opportunities for evaluating KIT throughout, and their evaluations are taken into consideration as KIT continues to be updated. Instructors from different disciplines teach KIT courses. They participate in mandatory didactic trainings that prepare them to teach KIT. During their 4th and 9th semesters, respectively, students take summative exams that test their communicative competence. Results: According to the semester evaluations by students and instructors, students participating in KIT improved their conversation management skills (students: M=2.2, SD=1.1, instructors: M=1.9, SD=0.7, on a scale of 1-5). In addition, students and graduates rate KIT to be (very) relevant, consider the degree to which it is taught in the MSM to be (very) high, and consider KIT to be a meaningful part of the curriculum. Students taking the summative exams in their 4th and 9th semesters achieve a mean score of 75.9%, respectively 76.9%, in the purely communicative stations and 82.6%, respectively 83.3%, in the global evaluation of communicative competence in clinical-practical stations. Discussion: Survey and exam results alike indicate that the communication training is well accepted by students and instructors and that the training led to an improvement in general and specific communicative skills. Due to a lack of control groups or a pre-post design, it has thus far not been possible to unequivocally demonstrate a causal relationship between communicative competence trainings and good test results. Quality control measures, such as trainings for instructors and regular course evaluations, have been designed to address any challenges in the implementation of the communication curriculum at the faculty level. Conclusion: Building on the experience with the Charité's Reformed Medical Curriculum, a longitudinal, competence-based communication curriculum was integrated into the MSM's overall curriculum. This measure remedied a gap in the medical training that many graduates of regular study programs had previously bemoaned (Jansen 2010 [1]).

Project description:PurposeTo prospectively evaluate the transferability of skills acquired on a low-cost, at-home, nonanatomic triangulation simulation system to cadaveric models.MethodsWe randomized 28 medical students into either a simulator-training group (n = 14) or group with no training (control, n = 14). All subjects were pretested using a standardized checklist of arthroscopic skills on cadaveric knees and shoulders. Training-group subjects practiced on the triangulation simulator for 90 minutes per week for 4 consecutive weeks. Control subjects received no training. All subjects completed a post-test checklist of arthroscopic skills on cadaveric knees and shoulders, as well as 4 training tasks on the simulator. A blinded orthopaedic surgeon evaluated the arthroscopic videos using the Arthroscopic Surgical Skill Evaluation Tool (ASSET) score.ResultsTraining-group knee and shoulder ASSET scores increased from 12.2 ± 1.85 to 14.6 ± 2.76 (P = .02) and from 14.6 ± 3.5 to 17.9 ± 4.5 (P = .29), respectively. In the control group, knee and shoulder ASSET scores increased from 14.3 ± 3.12 to 14.25 ± 4.67 (P = .99) and from 14.2 ± 2.7 to 17.07 ± 6.7 (P = .58), respectively. There were no significant differences in the mean post-test ASSET scores between the training group and control group for either knee or shoulder arthroscopy. The post-test ASSET safety subscore during knee arthroscopy was significantly higher in the training group (P = .03). The training group was able to complete significantly more simulator tasks compared with controls (P = .003) at post-testing. A significant positive correlation was found between knee arthroscopy performance and the number of tasks completed during simulation post-testing (P = .043). There was no significant correlation between shoulder arthroscopy performance and simulation performance (P = .532).ConclusionsBasic triangulation skills may be acquired by training on a low-cost, at-home, nonanatomic triangulation simulation system, although the degree of transferability and universal joint applicability, as well as the existence of an early ceiling effect in skill development, could not be shown.Level of evidenceLevel II, randomized controlled trial.

Project description:PurposeTo compare the effectiveness, in comparison to a control group (C), of module-based training (MBT) and traditional learning (TL) as a means of acquiring arthroscopic skills on an arthroscopic surgery simulator.MethodsThirty health sciences students with no previous arthroscopy experience were recruited and randomized into 1 of 3 groups: MBT, TL, or C (1:1:1 ratio). Participants in MBT were required to independently practice on a VirtaMed ArthroS simulator (VirtaMed AG, Zurich, Switzerland) for a minimum of 2 hours per week, whereas TL received one-on-one coaching by a senior orthopaedic resident for 15 minutes per week. The control group received no training. All groups were assessed at baseline and at 4 weeks based on objective measures generated by the surgical simulator (procedure time, camera path length, meniscus cutting score, detailed visualization, safety score and total score), and subjective ratings scales (Objective Assessment of Arthroscopic Skill [OAAS] global assessment form, and Competency-Based Assessment form).ResultsParticipants in the MBT group trained on average 113 min/week whereas the TL group trained on average 24 min/week. Three-way repeated-measures analysis of variance showed significant group by time interactions for procedure time (P = .006), camera path length (P = .008), safety score (P = .013), total score (P = .003), OAAS form (P < .001), and Competency-Based Assessment form (P < .001). MBT group was superior to C group for procedure time (P = .02), camera path length (P = .003), total score (P = .004), and OAAS form (P = .021), but there were no significant post-hoc differences between MBT and TL groups, or TL and C groups after Bonferroni correction. Total practice time explained 37.5% of the final simulator total score variance.ConclusionsKnee arthroscopy simulation training with self-learning modules can improve skills in areas such as procedure time, camera path length, and total score in untrained participants compared with a control group.Clinical relevanceModule-based simulation training provides additional training time and improves technical skills in naive health science students. It is hoped that this effect can be preserved and applied to junior resident developing in a busy residency program.

Project description:BackgroundThe goal of this study was to assess the value and acceptance of Standardized or Simulated Patients (SPs) for training clinically inexperienced undergraduate medical students in psychiatric history taking, psychopathological assessment, and communication with psychiatric patients.MethodsAs part of a newly developed introductory course to psychiatry, pairs of 3rd year medical students conducted psychiatric assessments of SPs, including history and psychopathological state, under the supervision of a clinical lecturer. Prior to the assessment, students attended introductory lectures to communication in psychiatry and psychopathology but were clinically inexperienced. After the interview, the students' summary of their findings was discussed with other students and the lecturer. Students, lecturers, and actors were invited to a survey after the course. Questions for the students included self-reports about perceived learning success and authenticity of the interviews.Results41 students, 6 actors and 8 lecturers completed the survey (response rates of 48%, 50%, and 100%, respectively). The survey results indicated that, despite their lack of clinical experience, students learned how to conduct a psychiatric interview, communicate in a non-judgmental and empathetic manner, take a psychiatric history and perform a psychopathological examination. SPs were perceived as authentic. The survey results suggested that this setting allowed for an enjoyable, non-distressful and motivating learning experience within a restricted time frame of just two afternoons.ConclusionThe results indicated that the SP approach presented is useful for teaching clinical skills in psychiatry to students with limited previous clinical experience and knowledge of psychiatry. We argue that SPs can be used to teach practical psychiatric skills already during an early phase of the curriculum. Limitations of our study include a limited sample size, a temporal gap between the course and the survey, reliance on self-reports, and lack of comparison to alternative interventions.

Dataset Information

A pilot study to assess the utility of a freely downloadable mobile application simulator for undergraduate clinical skills training: a single-blinded, randomised controlled trial.

Background

Methods

Results

Conclusions

Trial registration

Publications

A pilot study to assess the utility of a freely downloadable mobile application simulator for undergraduate clinical skills training: a single-blinded, randomised controlled trial.

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