Barry Issenberg

• Doctor of Medicine
• Head of Faculty at University of Miami

Background Improving the resuscitation and teamwork skills of residents is key to better outcomes of in-hospital cardiac arrest events. This study aims to explore the effects of regular low-dose simulation combined with a booster workshop on the progression and retention of resuscitation skills and teamwork among residents. Methods This comparativ...

Introduction: Sharing mental models is essential for high-performance teams, and speaking up is key for exchanging critical insights, especially during medical errors. Understanding how health providers and trainees voice their concerns is crucial for improving speaking-up behavior. This study aims to fill a gap in the literature by examining how...

Purpose Transdisciplinarity has been described as a fusion of theories, methods, and expertise across disciplinary boundaries to address complex, global problems. This approach has coincided with an increase in US medical schools offering masters degrees along with an MD degree to equip medical students to practice in complex, interconnected health...

Introduction: Powerful medical education (PME) involves the use of new technologies informed by the science of expertise that are embedded in laboratories and organizations that value evidence-based education and support innovation. This contrasts with traditional medical education that relies on a dated apprenticeship model that yields uneven res...

Background Although reflective thinking is regarded as an important learning aspect of debriefing, the factors that can affect reflective thinking during simulation debriefing remain unclear. Purpose This study aimed to identify factors affecting reflective thinking during simulation debriefing among nursing students. Methods This study used a cr...

An effective prebriefing strategy is needed that can improve the learning outcomes of nurses in advanced life support education. This study aimed to identify the effects of prebriefing with online team-based learning on hospital nurses' knowledge, performance, and self-efficacy in advanced life support education. A nonequivalent control group prete...

Background There is a lack of research that identifies the status of implementing the debriefing best practice standards and training needs to enhance debriefer competency. Question This study aimed to identify the status of debriefing best practice standards implementation and training priorities in nursing simulation educators using importance-p...

Purpose Alignment of workplace-based assessments (WPBA) with core entrustable professional activities (EPAs) for entering residency may provide opportunities to monitor student progress across the continuum of undergraduate medical education. Core EPAs, however, reflect tasks of varying degrees of difficulty and faculty assessors are not accustomed...

Background: Tactical Combat Casualty Care (TCCC) is the standard of care for stabilization and treatment of military trauma patients. The DoD has mandated that all Service members receive role-based TCCC training and certification. Simulation education can increase procedural skills by providing opportunities for deliberate practice in safe, contr...

Background: As there is an increasing trend in the number of male-identifying learners in undergraduate nursing education, a need exists to identify the gender differences in learners' perceptions regarding simulation-based learning. Purpose: This study aimed to identify the gender differences in psychological safety, academic safety, cognitive...

Background Nurses should have the ability to interpret electrocardiograms (ECGs) quickly and accurately, but their ECG interpretation skills may be suboptimal. The best evidence for effective teaching methods is lacking. Objectives This study aimed to compare the effects of peer and self-directed individual learning methods on nursing students' le...

Psychological safety is valued in other high-risk industries as an essential element to ensure safety. Yet, in healthcare, psychological safety is not mandatorily measured, quantified, or reported as an independent measure of safety. All members of the healthcare team’s voice and safety are important. Calls for personal, physical or patient safety...

Despite calls from educators to re-engineer how faculty deliver medical student curricula with integrated basic science concepts, this content is still frequently disarticulated from other curricular components. We renewed our curriculum using evidence-based pedagogical and cognitive learning strategies to interleave basic science across the 4-year...

Background The mediating effect of psychological safety on the relationship between students’ perceptions of simulation design features and learning outcomes has not been addressed in simulation-based nursing education. Aim This study aimed to determine whether psychological safety mediates the relationship between students’ perceptions of simulat...

Objectives We estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak. Methods A cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-I...

Background: The competence of nurses who care for patients with finger replantation is critical for positive patient outcomes. This study sought to identify the effects of standardized patient (SP)-based training on surgical ward nurses' knowledge, clinical performance, and self-efficacy regarding finger replantation. Method: A wait-list control...

Background The expertise of the simulation instructor is a key factor in the success of simulation-based education. This study aimed to identify the perceived competence and training priorities of Korean nursing simulation instructors using importance-performance analysis. Methods A cross-sectional descriptive survey design was used. A Web-based s...

The long-term reactions, experiences and reflections of simulation educators have not been explored. In a semistructured, exploratory interview study, the experiences of simulation educators in either Advanced Life Support (ALS) or Crisis Resource Management (CRM) courses in Denmark, Norway and the USA were analyzed. Three overarching themes were i...

The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and...

Introduction: The Miami Emergency Neurologic Deficit (MEND) exam is a screening tool for identifying stroke patients in the field. It is rapid, and can detect both anterior and posterior circulation strokes. Recent developments in the care of ischemic stroke patients with large vessel occlusion (LVO) have highlighted the need to transport these pat...

Introduction: Early detection and rapid transport to a stroke center are essential in the care of stroke patients. The Miami Emergency Neurologic Deficit (MEND) exam, developed in 1998, incorporates the posterior circulation elements missed by the Cincinnati Prehospital Stroke Scale (CPSS). It has a max score of 22, and includes all three component...

Introduction: Comprehensive stroke education is necessary for rapid and effective diagnosis and treatment of stroke victims, especially in the prehospital and emergency department settings. Early acute stroke recognition and appropriate treatment lead to improved patient outcomes. Prehospital and hospital-based health care providers can make the di...

Background A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. Objectives The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. Design This study used a non-equi...

Objectives: With a continual shortage of geriatricians, adult-gerontology primary care nurse practitioners have assumed a greater role in the delivery of outpatient care for older adults. Given the long duration of physician training, the high cost of medical school, and the lower salaries compared with subspecialists, the financial advantage of a...

Introduction: In patients with acute ischemic stroke, significant time can elapse from symptom onset until initiation of thrombolytic therapy. Prehospital diagnosis can reduce time delays, and remote evaluation using telemedicine may help; especially in the context of rural areas where a decision to airlift the patient to a stroke center must be ma...

BACKGROUND: This study evaluates the effectiveness of integrated simulation-based resuscitation skills training combined with a clinical practicum by assessing nursing students' knowledge, psychomotor skills, and self-efficacy.

Physicians' career interest in geriatric medicine continues to wane at a time when the health care needs of older adults are increasing. Nurse practitioners have helped fill the U.S. physician gap by delivering outpatient care to older adults and can practice with full autonomy in many states. Nursing graduate school programs are preparing adult-ge...

Instructor-led simulation-based mastery learning of advanced cardiac life support (ACLS) skills is an effective and focused approach to competency-based education. Directed self-regulated learning (DSRL) may be an effective and less resource-intensive way to teach ACLS skills. Forty first-year internal medicine residents were randomized to either s...

Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time t...

Research demonstrates limitations in the ability of health care trainees/practitioners, including physician assistants (PAs), to identify important cardiopulmonary examination findings and diagnose corresponding conditions. Studies also show that simulation-based training leads to improved performance and that these skills can transfer to real pati...

Background: This study evaluates the effectiveness of integrated simulation-based resuscitation skills training combined with a clinical practicum by assessing nursing students' knowledge, psychomotor skills, and self-efficacy. Methods: In a pretest-posttest design, 255 second-year nursing students participated in an emergency nursing clinical c...

Background: This study explored individual, team, and setting factors associated with the quality of management of in-hospital emergency situations experienced by former Advanced Life Support (ALS) course participants. Methods: This study was a survey of former ALS course participants' long-term experience of management of in-hospital, emergency...

Objectives This article has two objectives. Firstly, we critically review simulation-based mastery learning (SBML) research in medical education, evaluate its implementation and immediate results, and document measured downstream translational outcomes in terms of improved patient care practices, better patient outcomes and collateral effects. Seco...

Residents perform invasive bedside procedures in most training programs. To date, there is no universal approach for determining competency and ensuring quality and safety of care. We developed and implemented an assessment of central venous catheter insertion competency for internal medicine and internal medicine-pediatrics residents, using measur...

Introduction/Background: The American Board of Internal Medicine modified its requirement for procedural training, eliminating the numerical threshold. Resident performance of procedures continues to be necessary in most training programs, however, there is no universal standard for determining competency. The aim of this project was to develop and...

Introduction/Background: Simulation-based mastery learning of Advanced Cardiac Life Support (ACLS) skills has proven to be effective.1 Traditional ACLS courses incorporate instructor-regulated learning (IRL). Directed self-regulated learning (DSRL), where an educator designs the self-regulated learning,2 may provide an effective and less resource i...

Introduction/Background: United States Department of State healthcare providers deployed in remote international settings face challenges in meeting the educational requirements for maintaining their professional certifications and proficiency. To meet this need, we leveraged an existing telemedicine consultation program with a large academic medic...

Effective cardiopulmonary resuscitation (CPR) skills are essential for better patient survival, but whether these skills are associated with knowledge of and self-efficacy in CPR is not well known. The purpose of this study was to assess the quality of CPR skills and identify the association of the psychomotor skills with knowledge and self-efficac...

Abstract Healthcare reform has led to an increased emphasis on interprofessional healthcare models for older adults. Unfortunately, best practice education that focuses on the interprofessional healthcare of the elderly does not yet exist. As a prelude to implementing interprofessional geriatric educational initiatives, we developed a survey to ide...

Over the past two decades, there has been an exponential and enthusiastic adoption of simulation in healthcare education internationally. Medicine has learned much from professions that have established programs in simulation for training, such as aviation, the military and space exploration. Increased demands on training hours, limited patient enc...

Summary statement: Debriefing plays a critical role in facilitated reflection of simulation after the experiential component of simulation-based learning. The concept of framing and reflective learning in a debriefing session has emanated primarily from Western cultures. However, non-Western cultures have significant characteristics that manifest...

Background: Effective training is needed for high-quality performance of staff nurses, who are often the first responders in initiating resuscitation. There is insufficient evidence to identify specific educational strategies that improve outcomes, including early recognition and rescue of the critical patient. This study was conducted to identify...

Context: Simulation-based medical education allows trainees to engage in self-regulated learning (SRL), yet research aimed at elucidating the mechanisms of SRL in this context is relatively absent. We compared 'unguided' SRL with 'directed' SRL (DSRL), wherein learners followed an expert-designed booklet. Methods: Year 1 medical students (n = 37...

The purpose of this study was to develop and evaluate psychometric properties of the instrument, Resuscitation Self-Efficacy Scale for nurses. This was a methodological study for instrument development and psychometric testing. The initial item pool derived from literature review and experts resulted in 30 items linked to resuscitation self-efficac...

Countries that are less experienced with simulation-based healthcare education (SBHE) often import Western programs to initiate their efforts to deliver effective simulation training. Acknowledging cultural differences, we sought to determine whether faculty development program on SBHE in the United States could be transported successfully to train...

Little is known about the current training and barriers in resuscitation skills among practicing ward nurses. A convenience sample of 459 ward nurses, recruited from 11 academic teaching hospitals in Korea, were surveyed to assess current training and barriers to optimal resuscitation performance on the wards. The Perceived Barriers scale was devel...

Medical education research contributes to translational science (TS) when its outcomes not only impact educational settings, but also downstream results, including better patient-care practices and improved patient outcomes. Simulation-based medical education (SBME) has demonstrated its role in achieving such distal results. Effective TS also encom...

Aim: Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended and unintended learner reactions, experience...

Purpose: Countries that are less experienced with simulation-based healthcare education (SBHE) often import Western programs to initiate their efforts to deliver effective simulation training. Acknowledging cultural differences, we sought to determine whether faculty development program on SBHE in the United States could be transported successfully...

Introduction Early recognition and rapid transport to a stroke center by prehospital providers is essential in the care of stroke patients. In this study, prehospital providers were trained to perform the Miami Emergency Neurologic Deficit (MEND) exam as part of an 8-hour comprehensive course, Advanced Stroke Life Support (ASLS ® ). The MEND exam w...

This report reviews and critically evaluates the development of 3 movements in healthcare that have had a profound impact on changes occurring at all levels of medical education: patient safety, healthcare simulation, and competency-based education (exemplified by the Accreditation Council for Graduate Medical Education). The authors performed a cr...

In this article, we describe the preparation and execution of the first Research Consensus Summit (Summit) of the Society for Simulation in Healthcare (SSH) held in January 2011 in New Orleans, Louisiana. The goals of the Summit were to provide guidance for better simulation-related research, to broaden the scope of topics investigated, and to high...

This article presents a comparison of the effectiveness of traditional clinical education toward skill acquisition goals versus simulation-based medical education (SBME) with deliberate practice (DP). This is a quantitative meta-analysis that spans 20 years, 1990 to 2010. A search strategy involving three literature databases, 12 search terms, and...

Simulation-based research is still a relatively new field, where it can play an important role in the analysis of the interplay between humans, technology, and the healthcare organization. Simulation is a complex service intervention that operates in a complex social system58 and often involves a needs analysis to identify learning objectives and t...

The use of learning objects (LOs), small chunks of learning stored digitally and reused or referenced to support learning, was described as a promising approach to the creation of e-learning modules or programmes. In practice, however, the early enthusiasm has waned and the approach has not been widely adopted. It is argued that this was due, at le...

This study assessed the impact of a blended, standardized curriculum for invasive bedside procedural training on medical knowledge and technical skills for Internal Medicine residents. The investigators developed a curriculum in procedural instruction and performance for Internal Medicine house staff, and implemented the program at a tertiary care...

Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an i...

Despite extensive educational efforts, many medical students still have negative attitudes toward the field of geriatric medicine and the care of older adult patients. This article describes a fourth-year geriatric clerkship that addressed this issue by providing opportunities for students to actively discuss many of the negative stereotypes that e...

This article reviews and critically evaluates historical and contemporary research on simulation-based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. This qualitative synthesis of SBME research and...

Responding to acts of terrorism requires the effective use of public-safety and medical-response resources. The knowledge, skills and attitudes necessary to respond to future threats is unfamiliar to most emergency responders. The purpose of this report to describe the development, implementation and evaluation of a multidisciplinary, interactive a...

Objective outcome measures for use with simulator-based assessments of cardiac physical examination competence are lacking. The current study describes the development and validation of an approach to scoring performance using a cardiac findings checklist. A cardiac findings checklist was developed and implemented for use with a simulator-based ass...

High-stakes assessments of doctors' physical examination skills often employ standardised patients (SPs) who lack physical abnormalities. Simulation technology provides additional opportunities to assess these skills by mimicking physical abnormalities. The current study examined the relationship between internists' cardiac physical examination com...

During the past 15 years there has been widespread adoption of simulation in health care education as a method to train and assess learners. Multiple factors have contributed to this movement, including reduced patient availability, limited faculty teaching time, technological advances in diagnosis and treatment that require a new skills set, great...

Medical education during the past decade has witnessed a significant increase in the use of simulation technology for teaching and assessment. Contributing factors include: changes in health care delivery and academic environments that limit patient availability as educational opportunities; worldwide attention focused on the problem of medical err...

Many standardized patient (SP) encounters employ SPs without physical findings and, thus, assess physical examination technique. The relationship between technique, accurate bedside diagnosis, and global competence in physical examination remains unclear. Twenty-eight internists undertook a cardiac physical examination objective structured clinical...

Assessment of residents’ physical examination skills often involves the use of standardized patients lacking physical abnormalities. Simulation technology offers the potential benefit of mimicking physical abnormalities. The current study was undertaken to examine the relationship between physicians’ competence in cardiac physical examination as as...

To examine the relationship between a physician's ability to examine a standardized patient (SP) and their ability to correctly identify related clinical findings created with simulation technology. The authors conducted an observational study of 347 candidates during a Canadian national specialty examination at the end of post-graduate internal me...

Following up his best-selling Board Stiff TEE & Too manuals for the oral boards in anesthesiology, Dr. Gallagher has produced a step-by-step how-to guide on conducting an anesthesia simulation. Topics include which equipment to use as well as suggestions for simulation scenarios that will help train your staff with a theoretical basis for handling...

A learning object (LO) is a grouping of instructional materials structured to meet a specified educational objective. Digital LOs, which can be stored electronically, allow a new approach to instructional activity, making medical education more efficient, and potentially more cost-effective. They are reusable and can incorporate text, graphics, ani...

To assess the individual and team skills acquired from an interactive training program to prepare emergency personnel to respond to terrorist acts. We developed a 16-hour, two-day, multimedia- and simulation-enhanced course that places learners in realistic situations using the equipment required to respond to various chemical, biologic, radiologic...