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Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal
BACKGROUND: Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation is restricted due to the financial burden in resource-limited settings like ours...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712774/ https://www.ncbi.nlm.nih.gov/pubmed/31455223 http://dx.doi.org/10.1186/s12245-019-0235-x |
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author | Shrestha, Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Basnet, Samjhana Pradhan, Alok |
author_facet | Shrestha, Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Basnet, Samjhana Pradhan, Alok |
author_sort | Shrestha, Roshana |
collection | PubMed |
description | BACKGROUND: Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation is restricted due to the financial burden in resource-limited settings like ours. We therefore pursued to introduce cost-effective in situ simulation (ISS) in the emergency department (ED) to explore its impact on perception and learning experience among multidisciplinary health care professionals and to identify and remediate the latent safety threats (LST). METHODS: This is a prospective cross-sectional study with a mixed method research design, which was conducted in the ED of Dhulikhel Hospital-Kathmandu University Hospital. The pretest questionnaire was used to determine baseline knowledge, attitude, and confidence of the staff. The ISS with minimal added cost was conducted involving multidisciplinary healthcare workers. The LSTs were recorded and appropriate remediation was performed. Voluntary post simulation feedback was collected after the sessions. RESULTS: Overall 56 staff participated in at least one of the 35 simulation sessions, among which 45 (80%) responded to the questionnaires`. Twenty participants (45.5%) were reluctant to use the defibrillator. The self-reported confidence level of using defibrillator was low 29 (64.6%). The knowledge score ranged from 0 to 8 with the median score of 3 and a mean of 3.29 ± 1.8. There was no statistically significant difference in knowledge scores among participants of different occupational backgrounds, previous training, duration of work experience, and previous use of a defibrillator. A total of 366 LSTs {individual (43%), medication (17%), equipment (4%), and system/team (36%)} were identified (10.45 LST per ISS). The overall feedback from the participants was positive. Eighty percent of participants reported increased skills to use a defibrillator, and 82% reported increased confidence for managing such cases. They also agreed upon the need and continuity of such type of simulation in their workplace. CONCLUSIONS: The baseline knowledge score and the confidence level of the staff were low. Self-reported feedback suggested increased confidence level and teamwork skills after ISS. It promoted identification and remediation of latent safety threats. ISS serves as a cost-effective powerful educational model that can be implemented even in settings where finances and space are limited. |
format | Online Article Text |
id | pubmed-6712774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-67127742019-09-04 Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal Shrestha, Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Basnet, Samjhana Pradhan, Alok Int J Emerg Med Educational Advances in Emergency Medicine BACKGROUND: Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation is restricted due to the financial burden in resource-limited settings like ours. We therefore pursued to introduce cost-effective in situ simulation (ISS) in the emergency department (ED) to explore its impact on perception and learning experience among multidisciplinary health care professionals and to identify and remediate the latent safety threats (LST). METHODS: This is a prospective cross-sectional study with a mixed method research design, which was conducted in the ED of Dhulikhel Hospital-Kathmandu University Hospital. The pretest questionnaire was used to determine baseline knowledge, attitude, and confidence of the staff. The ISS with minimal added cost was conducted involving multidisciplinary healthcare workers. The LSTs were recorded and appropriate remediation was performed. Voluntary post simulation feedback was collected after the sessions. RESULTS: Overall 56 staff participated in at least one of the 35 simulation sessions, among which 45 (80%) responded to the questionnaires`. Twenty participants (45.5%) were reluctant to use the defibrillator. The self-reported confidence level of using defibrillator was low 29 (64.6%). The knowledge score ranged from 0 to 8 with the median score of 3 and a mean of 3.29 ± 1.8. There was no statistically significant difference in knowledge scores among participants of different occupational backgrounds, previous training, duration of work experience, and previous use of a defibrillator. A total of 366 LSTs {individual (43%), medication (17%), equipment (4%), and system/team (36%)} were identified (10.45 LST per ISS). The overall feedback from the participants was positive. Eighty percent of participants reported increased skills to use a defibrillator, and 82% reported increased confidence for managing such cases. They also agreed upon the need and continuity of such type of simulation in their workplace. CONCLUSIONS: The baseline knowledge score and the confidence level of the staff were low. Self-reported feedback suggested increased confidence level and teamwork skills after ISS. It promoted identification and remediation of latent safety threats. ISS serves as a cost-effective powerful educational model that can be implemented even in settings where finances and space are limited. Springer Berlin Heidelberg 2019-08-27 /pmc/articles/PMC6712774/ /pubmed/31455223 http://dx.doi.org/10.1186/s12245-019-0235-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Educational Advances in Emergency Medicine Shrestha, Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Basnet, Samjhana Pradhan, Alok Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title | Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title_full | Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title_fullStr | Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title_full_unstemmed | Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title_short | Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal |
title_sort | interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in nepal |
topic | Educational Advances in Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712774/ https://www.ncbi.nlm.nih.gov/pubmed/31455223 http://dx.doi.org/10.1186/s12245-019-0235-x |
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