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Mass trauma simulation design, demonstrating eight disaster clusters, each containing one facilitator, four simulated patients, from 12 to 16 attending students, and three differing types of resources to support student team working
Source publication
Background
There is little research on large-scale complex health care simulations designed to facilitate student learning of non-technical skills in a team-working environment. We evaluated the acceptability and effectiveness of a novel natural disaster simulation that enabled medical students to demonstrate their achievement of the non-technical...
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Citations
... Thus, research on training initiatives targeting NTS are rapidly emerging in medical education. Here, simulation-based training has been investigated in relation to promoting clinical confidence [9], knowledge [10], collaboration [11], or overall NTS [12]. Similarly, other methods such as team interventions' effect on team performance [13], and the effect of coaching on well-being and NTS [14] have also been investigated. ...
Introduction
Medical education often aims to improve either technical skills (TS) or ‘non-technical skills’ (NTS) and how these skills influence adverse events and patient safety. The two skill sets are often investigated independently, and little is known about how TS and NTS influence each other. In this scoping review, we therefore aim to investigate the association between TS and NTS.
Method
We conducted a scoping review of four databases in order to summarize, analyse, and collate findings from the included studies.
Results
In total, 203 of 2676 identified studies were included in the final analysis. The first study was published in 1991, but the majority of studies were published in the last decade. The majority were intervention studies including 41 randomized controlled trials. The the objective structured assessment of technical skills (OSATS) was the most common assessment tool with strong validity evidence within TS, but many variations without validity evidence were used. Conversely, Non-Technical Skills for Surgeons (NOTSS) was the most used tool with strong validity evidence for assessing NTS. However, the majority of studies used non-validated self-assessment tools to investigate NTS. The correlation between TS and NTS was assessed in 46 of 203 studies, whereof 40 found a positive correlation.
Discussion
Our findings echo previous literature suggesting that empirical literature investigating the interaction between TS and NTS lack methodological depth. In this review only a minority of the identified studies (n = 46) investigated this correlation. However, the results strongly indicate a correlation between TS and NTS skills, suggesting that physicians who are proficient in their NTS, also perform well on their TS. Thus, the distinction between them in learning designs may seem arbitrary. While this result is promising, the limited methodological rigour indicates a lack of proper understanding of NTS and how to properly assess them.
... There is a broad international consensus that health professional students should be prepared for collaborative practice through interprofessional education [3]. International health organizations promote this approach to address challenges like an aging population, limited resources, and the need for better interdisciplinary teamwork [1,4,5]. Universities are encouraged to develop inclusive interprofessional education programs [4], making it essential for dental and medical students to learn cooperation early in their careers and to appreciate each profession's unique contributions. ...
... International health organizations promote this approach to address challenges like an aging population, limited resources, and the need for better interdisciplinary teamwork [1,4,5]. Universities are encouraged to develop inclusive interprofessional education programs [4], making it essential for dental and medical students to learn cooperation early in their careers and to appreciate each profession's unique contributions. ...
The rapid advancements in biomedical sciences, including genomics, microbiome research, and bioinformatics, underscore the need for dental education to evolve to meet future challenges in public oral health and healthcare delivery. The integration of basic sciences into dental curricula is crucial to ensure that dental professionals are thoroughly prepared in these fundamental areas. Despite the widespread agreement on the necessity of including basic medical sciences in dental education, challenges such as curricular congestion, faculty economics, and infrastructural limits persist, complicating the integration of new scientific knowledge. Furthermore, there remains a significant lack of research concerning the optimal extent, timing, and focus of these subjects, whether biochemical, medical, or dental. Additionally, there is a need to address prevailing conceptions about the irrelevance of basic sciences to the field of dentistry, which necessitates a focus on teaching methodologies and pedagogical strategies. Therefore, it is essential to advance educational research that prepares future educators to integrate basic sciences into dental education through evidence-based teaching methods. The dental curriculum, which encompasses fundamental sciences, laboratory exercises, and clinical practice, must overcome considerable pedagogical challenges to effectively incorporate and balance these basic sciences within its educational structure.
... Designing and implementing authentic IPE activities for various university health educational programs is challenging (Jorm et al., 2016;Bogossian et al., 2023). IPC differs in all health systems, implying that IPE should be designed to fit the local context (WHO, 2010). ...
Purpose
This study explored students' perspectives on designing and implementing the new clinical interprofessional education (IPE) module for chronic disease management at the primary care level in the Vietnamese context.
Design/methodology/approach
Students from seven different university-level healthcare programmes participated in a cross-sectional survey Course Experience Questionnaire-based study. Additionally, two open-ended questions were presented to gather qualitative data, mapping student perspectives. Statistical analyses and thematic analyses were performed.
Findings
The results show that students agree with quality statements about IPE design features, such as good teaching, clear goals and standards, appropriate workload, appropriate assessment and a blended learning approach. Answers to the open-ended comments pointed out the strengths of the IPE module in providing opportunities for interprofessional learning, improving interprofessional collaboration competencies, real-life interprofessional collaboration practice and continuous feedback from tutors. Students also reported weaknesses in the IPE module, including a lack of feedback on the care plan and logistics of the IPE module.
Originality/value
Students positively recognise key design features of the IPE module, combining classroom activities with standardised patient simulations, clinical practice and home visits. Chronic disease management at the primary care level is a suitable context for training students to work interprofessionally. The strengths and weaknesses identified by students could help in the redesign and future implementation of the IPE module in the Vietnamese context. They could inspire practices in Southeast Asian medical education and beyond.
... NTS are gaining increasing attention within the medical field owing to their impact on both educational environments and clinical practice [22,23]. In disaster medicine, NTS are crucial, but their effective integration into real-world settings remains a challenge [10]. ...
Introduction
Disaster responders are an important part of disaster response. However, despite large efforts to train disaster responders, there is a limited scientific knowledge regarding which competences and skills such responders value and lack during a real mission. The aim of this study was to investigate used and needed skills among disaster responders responding to the earthquake in Türkiye and Syria 2023
Methods
A cross-sectional study using a non-randomized sample was conducted, collected between March and July, 2023. The participants were recruited through invitations distributed to international organizations, and the data were gathered through a web-based survey. The data were analyzed using descriptive and comparative statistics.
Results
A total of 525 participants involved in the disaster response in Türkiye or Syria in February 2023 were included. The most common valued skills were teamwork skills (n = 252, 59%), technical knowledge (n = 204, 48%), leadership skills (n = 105, 24%) and communication skills (n = 114, 17%). Women valued stress management (n = 33, 26%) more than leadership (n = 24, 19%) Technical knowledges were more valued among first-time responders (n = 168, 82%) compared to experienced responders (n = 108, 54%, p-value < 0.001). The most reported lacked skills were mental preparedness (n = 237, 53%), knowledge of the management system of international response (n = 132, 30%), stress management (n = 105, 24%) and leadership (n = 102, 23%).
Conclusion
The results showed slightly different needs in the various phases of a response, as well as some differences between men and women. Improving mental preparedness was not one of the most highly valued skills, but it was one of the skills that was most lacking; this discrepancy is an interesting finding. More in-depth analysis and additional studies are needed to further understand how best to prepare disaster responders and how their training can include the desirable skills. Further studies should be focused on the experience and knowledge of qualified disaster responders. This knowledge could also be of use when recruiting since several of the non-technical skills are not only gained solely through specific training.
... Implementing IPE courses in the curriculum can help medical students prepare for the healthcare workforce, where teamwork and collaboration are essential competencies (2,5). Many international health organizations encourage universities to develop IPE as part of healthcare system redesign to promote interprofessional teamwork, enhance patient care quality, and improve health outcomes (5,6). Educating students in IPE is essential to enhance interprofessional collaboration in the healthcare system (4,5). ...
... Seventeen studies noted the benefits of participating in full-scale exercises for identifying what knowledge and skills needed to be reinforced and allowing individuals to develop and practice using them to strengthen future disaster response [17,18,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. General post-exercise ratings for the learning utility of full-scale exercises varied from 60.8% [8] to 84.1% [50]. ...
... In 12 studies focus was also directed to identifying concrete benefits of participating in full-scale exercises [17,18,43,44,46,47,[49][50][51][52]56,57]. Qualitative findings highlight that full-scale exercises help to increase responders' confidence in managing future disasters by allowing them to practice new skills in environments that replicate many physical and psychological features and challenges of a real disaster, whilst also providing a safe space to learn from mistakes [17,46]. ...
... Qualitative findings highlight that full-scale exercises help to increase responders' confidence in managing future disasters by allowing them to practice new skills in environments that replicate many physical and psychological features and challenges of a real disaster, whilst also providing a safe space to learn from mistakes [17,46]. Findings from crosssectional surveys also demonstrate the value of full-scale exercises for reducing perceived stress, and improving critical thinking, decision making, intra-and inter-agency communication [18,43,[49][50][51]56,57], and understanding of how to implement emergency plans [52]. However, studies also consistently highlighted that participating in full-scale exercises did not improve knowledge about agency specific language and acronyms [17,18,43,44,47]. ...
... Perry, Jaffe, & Bitan (2022a) used quantitative data from MCI field simulations to explore the decision-making process of paramedic students at the end of their MCI management qualification harnessing the "dual-process" model (Kahneman, 2003;Norman, 2009). Because field simulations are known to improve communication skills (Gordon et al., 2016;Jorm et al., 2016), knowledge (Zinan, Puia, & Kinsley, 2015), clinical skills (Currie, Kourouche, Gordon, Jorm, & West, 2018), and performance (Bajow, Alassaf, & Cluntun, 2018), they provide the most realistic exposure to gain experience toward managing a real MCI (Gillett et al., 2008). ...
Introduction: Managing a mass-casualty incident (MCI) challenges commanders in the pre-hospital phase. Exploring the differences between the decision-making processes of novice and expert commanders can reveal how to improve training. This study aims to compare the decision-making processes between paramedic students and veteran paramedics. Methods: Data from eight MCI field simulations of paramedic students with no experience, and one simulation of a veteran paramedic were collected. Results: In the first phase of the simulation, both the students and the veteran paramedic followed the MCI protocol. From the second phase, the paramedic students mostly responded to received cues, while the veteran paramedic initiated actions without preliminary cues. Discussion: The veteran paramedic initiates actions and utilizes "considered" decision-making process earlier than the students, that frequently acted in response to cues. Although these results are based on a small sample, this study indicates a difference between novice and expert commanders’ decision-making processes.
... Medical simulation classes have a beneficial effect on the development of non-technical students' competences. This is consistent with the results of other studies in which classes, such as medical simulations, allow teachers and students to assess their skills and identify further educational needs in this field (Jorm et al., 2016;Pearson & McLafferty, 2011). These types of courses force students to be actively engaged in the lessons which can also help stimulate further learning, which have been supported by other studies in the teaching NTS competencies (Brown et al., 2016;Kr€ uger et al., 2009;Lewis et al., 2012). ...
Non-technical skills (NTS) are important skills in emergency medicine and should be a necessity even at the stage of medical studies. The aim of this study was to assess how increasing the number of non-technical skills hours influenced the results of non-technical competences among medical students. In this investigation, 296 Polish medical students in the sixth year at Medical College in Krakow, Poland were included in the study. The students were divided into two research groups: I in 2018 and II in 2019. The groups differed in the number of total hours that focused on non-technical skills, in 2018: 60 hr, and 2019: 120 total hours. Non-technical competencies were assessed at the Crisis Resource Management station using sudden cardiac arrest scenarios. In 2018, the median was 20 points and the average of the points obtained in this group was 19.53 points (SD 5.39 points). In 2019, the median was 26 points and the average of points was 25.07 points (SD 5.23 points). Students who had more non-technical skills classes (120 hr) scored more points on the OSCE exam than group I (60 hr) ( p < .001). The median of points in non-technical competences depended on the number of teaching hours in which the main emphasis was on the development of these skills. This investigation demonstrates that more teaching hours dedicated to improving the non-technical skills of students corresponded to better results on the cardiopulmonary resuscitation scenarios.
... Perry, Jaffe, & Bitan (2022a) used quantitative data from MCI field simulations to explore the decision-making process of paramedic students at the end of their MCI management qualification harnessing the "dual-process" model (Kahneman, 2003;Norman, 2009). Because field simulations are known to improve communication skills (Gordon et al., 2016;Jorm et al., 2016), knowledge (Zinan, Puia, & Kinsley, 2015), clinical skills (Currie, Kourouche, Gordon, Jorm, & West, 2018), and performance (Bajow, Alassaf, & Cluntun, 2018), they provide the most realistic exposure to gain experience toward managing a real MCI (Gillett et al., 2008). ...
Introduction: Managing a mass-casualty incident (MCI) challenges commanders in the pre-hospital phase. Exploring the differences between the decision-making processes of novice and expert commanders can reveal how to improve training. This study aims to compare the decision-making processes between paramedic students and veteran paramedics. Methods: Data from eight MCI field simulations of paramedic students with no experience, and one simulation of a veteran paramedic were collected. Results: In the first phase of the simulation, both the students and the veteran paramedic followed the MCI protocol. From the second phase, the paramedic students mostly responded to received cues, while the veteran paramedic initiated actions without preliminary cues. Discussion: The veteran paramedic initiates actions and utilizes "considered" decision-making process earlier than the students, that frequently acted in response to cues. Although these results are based on a small sample, this study indicates a difference between novice and expert commanders’ decision-making processes.
... Evidências apontam que a utilização de SR em IMV constitui uma estratégia facilitadora para que sejam trabalhadas competências, atitudes e habilidades dos agentes envolvidos na resposta ao IMV, resultando em melhores níveis de desempenho profissional individual e em equipe, o que contribui diretamente no gerenciamento de futuras situações que demandem resposta rápida de equipe multiprofissional e interdisciplinar 8,12,13 . ...
O presente estudo visa descrever a experiência da Força Nacional do Sistema Único de Saúde (FN-SUS) no apoio aos estados para a organização da simulação realística (SR) em diferentes cenários envolvendo múltiplas vítimas, no âmbito da Capacitação “Preparo da Resposta a Incidente com Múltiplas Vítimas". Trata-se de um estudo crítico-reflexivo do tipo relato de experiência referente ao período de outubro de 2021 a setembro de 2022, envolvendo em média 150 profissionais representados por técnicos da FN-SUS, Secretarias Estaduais de Saúde, integrantes da Rede de Atenção às Urgências e demais agências atuantes na resposta em incidentes com múltiplas vítimas. Os resultados confluíram em três categorias temáticas: contextualização da capacitação, aproximação com o estado e planejamento e construção do cenário. Um dos maiores legados da construção dessa capacitação com SR consiste na percepção de que ao passo que essa metodologia promove um espaço de interação entre os diferentes agentes respondedores, também lança em cena os principais desafios encontrados na estrutura da rede local, agregando assim, diferentes profissionais na busca das melhores estratégias à luz do objetivo soberano de salvar o maior número de vidas.
