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      Unifying interdisciplinary education: designing and implementing an intern simulation educational curriculum to increase confidence in critical care from PGY1 to PGY2

      research-article
      1 , , 2 , 3
      BMC Research Notes
      BioMed Central
      Critical care, Simulation, Communication, Confidence, Skills

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          Abstract

          Background

          A longitudinal, multidisciplinary critical care simulation curriculum was developed and implemented within a teaching hospital to address the need for consistent, safe, efficient, and unified critical care training within graduate medical education. Primary goals were to increase learner confidence in critical care topics and procedural skills across all specialties. Secondary goals included improving communication skills and obtaining a high level of learner satisfaction. All interns caring for adult patients within our hospital participated in three 4-h simulation-based sessions scheduled over the second half of their intern year. Pre- and postcurricular surveys evaluated self-confidence in critical care topics, procedures, and communication skills. The Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV) Short Form was used to evaluate facilitator debriefing. Data were compared with Wilcoxon rank sum and signed rank test.

          Results

          Pre- and postcurricular surveys were collected from 51 of 52 interns (98% response rate) in curricular year 1 and 59 of 59 interns (100% response rate) in curricular year 2 in six programs within the hospital. Resident confidence significantly improved in all areas ( p < .05). DASH-SV demonstrated overall effective facilitator debriefing and > 75% of interns in both curricular years 1 and 2 expressed a desire for future educational sessions.

          Conclusions

          The implemented curriculum increased learner confidence in select critical care topics, procedures, and communication skills and demonstrated a high level of learner satisfaction. The curriculum has expanded to learners from three other teaching hospitals within our system to unify critical care education for all interns caring for adult patients.

          Electronic supplementary material

          The online version of this article (10.1186/s13104-017-2905-1) contains supplementary material, which is available to authorized users.

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          Most cited references5

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          To Err Is Human : Building a Safer Health System

          (2000)
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            Breaking bad news education for emergency medicine residents: A novel training module using simulation with the SPIKES protocol

            Breaking bad news (BBN) in the emergency department (ED) is a common occurrence. This is especially true for an emergency physician (EP) as there is little time to prepare for the event and likely little or no knowledge of the patients or family background information. At our institution, there is no formal training for EP residents in delivering bad news. We felt teaching emergency medicine residents these communication skills should be an important part of their educational curriculum. We describe our experience with a defined educational program designed to educate and improve physician’s confidence and competence in bad news and death notification. A regularly scheduled 5-h grand rounds conference time frame was dedicated to the education of EM residents about BBN. A multidisciplinary approach was taken to broaden the prospective of the participants. The course included lectures from different specialties, role playing for three short scenarios in different capacities, and hi-fidelity simulation cases with volatile psychosocial issues and stressors. Participants were asked to fill out a self-efficacy form and evaluation sheets. Fourteen emergency residents participated and all thought that this education is necessary. The mean score of usefulness is 4.73 on a Likert Scale from 1 to 5. The simulation part was thought to be the most useful (43%), with role play 14%, and lecture 7%. We believe that teaching physicians to BBN in a controlled environment is a good use of educational time and an important procedure that EP must learn.
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              Teaching medical error disclosure to physicians-in-training: a scoping review.

              This scoping review identified published studies of error disclosure curricula targeting physicians-in-training (residents or medical students). In 2011, the authors searched electronic databases (e.g., MEDLINE, EMBASE, ERIC) for eligible studies published between 1960 and July 2011. From the studies that met their inclusion criteria, they extracted and summarized key aspects of each curriculum (e.g., level of learner, program discipline) and educational features (e.g., curriculum design, teaching and assessment methods, and learner outcomes). The authors identified 21 studies that met their inclusion criteria. These studies described 19 error disclosure curricula, which were either a stand-alone educational activity, part of a larger curriculum in patient safety or communication skills, or part of simulation training. Most curricula consisted of a brief, single encounter, combining didactic lectures or small-group discussions with role-play. Fourteen studies described learners' self-reported improvements in knowledge, skills, and attitudes. Five studies used a structured assessment and reported that learners' error disclosure skills improved after completing the curriculum; however, these studies were limited by their small to medium sample size and lack of assessment of skills retention. Attempts to assess the change in learners' error disclosure behavior in the clinical context were limited. Studies of existing error disclosure curricula demonstrate improvements in learners' knowledge, skills, and attitudes. A greater emphasis is needed on the more rigorous assessment of skills acquisition and behavior change to determine whether formal training leads to long-term effects on learner outcomes that translate into real-world clinical practice.
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                Author and article information

                Contributors
                704-355-4212 , Mark.Bullard@carolinashealthcare.org
                jleuck@jpshealth.org
                lhowley@aamc.org
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                6 November 2017
                6 November 2017
                2017
                : 10
                : 563
                Affiliations
                [1 ]ISNI 0000 0000 9553 6721, GRID grid.239494.1, Department of Emergency Medicine, Carolinas Simulation Center, , Carolinas Medical Center, Carolinas HealthCare System, ; 1000 Blythe Blvd., 3rd Floor MEB, Charlotte, NC 28203 USA
                [2 ]Department of Emergency Medicine, John Peter Smith Health System, Dallas, TX USA
                [3 ]ISNI 0000 0000 8652 9597, GRID grid.414000.1, Association of American Medical Colleges, ; Washington, DC USA
                Article
                2905
                10.1186/s13104-017-2905-1
                5674682
                29110695
                8aa8b616-e673-42db-995a-b27a33a201f6
                © The Author(s) 2017

                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. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 August 2016
                : 1 November 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Medicine
                critical care,simulation,communication,confidence,skills
                Medicine
                critical care, simulation, communication, confidence, skills

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