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Marshall S.,Medical Simulation
Anesthesia and Analgesia | Year: 2013

Cognitive aids are prompts designed to help users complete a task or series of tasks. They may take the form of posters, flowcharts, checklists, or even mnemonics. It has been suggested that the use of cognitive aids improves performance and patient outcomes during anesthetic emergencies; however, a systematic assessment of the evidence is lacking. The aim of this literature review was to determine (1) whether cognitive aids improve performance of individuals and teams and (2) whether recommendations can be made for future cognitive aid design, testing, and implementation. Medical, nursing, and psychology databases were searched using broad criteria to find cognitive aids that have been reported in the literature for use in anesthetic emergencies. The reference lists of the articles selected for review were also screened to identify additional studies. Selected articles that described the evaluation of cognitive aids used in anesthetic emergencies were reviewed to determine how the content of the aid was derived, how the design was evaluated, and the success of the aid in improving technical and team performance. The search yielded 22 cognitive aids developed to support clinicians during anesthetic emergencies that had been evaluated in 23 studies. Ten studies using simulation suggested that technical performance improves with the use of cognitive aids in some anesthetic emergencies such as malignant hyperthermia, cardiopulmonary resuscitation, and airway management. However, in 3 of the simulator-based evaluations, participants had either no improvement or took longer to diagnose and treat and made more incorrect diagnoses. Four studies investigated the effect of the aids on teamwork with differing conclusions. One study suggested improved participants' coordination patterns and one found aids improved their decision-making scores, but 2 other studies indicated that there was no improvement and even provided evidence of reduced levels of team communication when teams used a cognitive aid in simulated conditions. The designs of cognitive aids were rarely considered. Education may compensate for a poorly designed aid, but only by ingraining correct actions for situations in which the aid provides little or no guidance. Cognitive aids should continue to be developed from established clinical guidelines where guidelines exist. They would also benefit from more extensive simulation-based usability testing before use. Further evidence is required to explore the effects of cognitive aids in anesthetic emergencies, how they affect team function, and their design considerations. Copyright © 2013 International Anesthesia Research Society. Source

Dieckmann P.,Medical Simulation
Simulation in Healthcare | Year: 2012

Debriefing is important in simulation-based education but rarely studied empirically. In this article, I describe an experience-based workshop concept that was tested with approximately 80 participants during the Annual Meeting of the Society in Europe for Simulation Applied to Medicine (SESAM), June 2 to 4, 2011, in Granada, Spain. On a metalevel, the goal of the workshop was to raise the awareness of debriefing as an important part of simulation-based learning and to increase the awareness about different styles of debriefing-possibly stimulating further investigations of debriefings. © 2012 by the Society for Simulation in Healthcare. Source

Stefanidis D.,Medical Simulation | Sevdalis N.,Imperial College London | Paige J.,The New School | Zevin B.,University of Toronto | And 3 more authors.
Annals of Surgery | Year: 2015

Objective: To review the current state of simulation use in surgery and to offer direction for future research and implementation of evidence-based findings. Background: Simulation-based training (SBT) in surgery has surged in recent years. Although several new simulators and curricula have become available, their optimization and implementation into surgical training has been lagging. Methods: Members of the Association for Surgical Education Simulation Committee with expertise in surgical simulation review and interpret the literature and describe the current status of the use of simulation in surgery, identify the challenges to its widespread adoption, and offer potential solutions to these challenges. The review focuses on simulation research and implementation of existing knowledge and explores possible future directions for the field. Results: Skill acquired on simulators has repeatedly and consistently been demonstrated to transfer to the operating room, and proficiency-based training maximizes this benefit. Several simulation-based curricula have been developed by national organizations to support resident training, but their implementation is lagging because of inadequate human resources, difficult integration of SBT into educational strategy, and logistical barriers. In research, lack of coordinated effort, flaws in study design, changes in simulator-validation concepts, limited attention to skill retention, and other areas are in need of improvement. Conclusions: Future research in surgical simulation should focus on demonstrating the cost-effectiveness of SBT and its impact on patient outcomes. Furthermore, to enable the more widespread incorporation of best practices and existing simulation curricula in surgery, effective implementation strategies need to be developed. © 2014 Wolters Kluwer Health, Inc. All rights reserved. Source

Hardoff D.,Medical Simulation
Georgian medical news | Year: 2013

The Internet has turned during the past decade into a major information resource in various domains of life and a communication venue among adolescents who seek health information via the net. The increasing availability of computers in homes, as well as wireless Internet access, means that adolescents today can go online anywhere, at any time. The media are not the leading cause of any major health problem, but they do contribute significantly to a variety of adolescent health problems, including aggressive behavior, sexual activity, drug use, obesity, sleep disorders, eating disorders, depression, suicide and self harm. This paper focuses on 3 major health issues in adolescents' Internet use: Body image and eating behaviors; sexuality and reproductive health behaviors; and self harm and suicidal behavior. This paper also demonstrates Internet venues where reliable health information is provided to young people by health professionals. Health professionals need to recognize the hazards of adolescents Internet use, and to address potential Internet abuse when encountering adolescents in clinical settings. Source

Stefanidis D.,University of North Carolina at Charlotte | Stefanidis D.,Medical Simulation
Surgical Clinics of North America | Year: 2010

Increasingly, trainees are being exposed to simulators for the purpose of acquiring surgical skills. This article addresses the theoretical framework behind surgical skill acquisition and explores the factors that optimize learning on simulators. Furthermore, this article evaluates the role of currently used performance metrics for documentation of skills proficiency and provides suggestions for the incorporation of additional, more sensitive performance metrics that may lead to improved transfer of simulator-acquired skill. © 2010 Elsevier Inc. Source

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