Stress among medical students during simulation training at King Saud bin Abdulaziz University for Health Sciences

Background: Simulation training is increasingly being used as a safe format to instruct students and trainees in different skills and procedures in the field of medicine. In this study, we recorded stress levels among medical students during simulation training for a lumbar puncture [LP] procedure performed on a mannequin and investigated the association between stress and performance

Methodology: This study was conducted on 39 fourth year female medical students. Students wore a galvanic skin response [GSR] sensor on their wrist before being asked to attempt the LP procedure on the mannequin on two separate occasions. Students' performance was assessed using a validated LP checklist on each attempt. Data were compared across all simulation attempts and for each student

Results: Collectively, mean wrist GSR levels increased from the mental rehearsal phase 0.31 mS +/- 0.40, during the first attempt 0.48 mS +/- 0.62 and continued to increase significantly [P = 0.007] during the second attempt 0.60 mS +/- 0.80. There were no significant differences [P = 0.32] between the checklist scores of the first and second attempts

Conclusion: The results of our study support the previous evidence that linked simulation training with emotional and physiological stress. Performing highly intense procedures such as LP is considered to be a potential source of stress. Our findings showed that there was a continuous increase in the level of stress associated with repeated attempts during the LP simulation that had no significant impact on clinical performance. As the practice of medicine involves exposure to a remarkable number of stressors and critical conditions, we emphasize the importance of training medical students in ways to cope more effectively with these situations

Reliability and validity of an Arabic version of the dyspnea-12 questionnaire for Saudi nationals with chronic obstructive pulmonary disease

Dyspnea is a distressing symptom experienced by people with chronic obstructive pulmonary disease [COPD]. The dyspnea-12 [D-12] questionnaire comprises of 12 items and assesses the quality of this symptom, its severity and the emotional response. The original [English] version of the D-12 is reliable and valid for the measurement of dyspnea in pulmonary diseases. To translate the D-12 into Arabic and determine whether this version is reliable and valid in Saudi nationals with COPD. The D-12 was translated into Arabic version and reviewed by an expert panel before being back-translated into English. The Arabic version was administered to five patients with COPD to test whether it was easily understood after which a final Arabic version was produced. Thereafter, 40 patients with COPD [aged 63 +/- 9 years; 33 [82.5%] males; forced expiratory volume in one second [FEV[1]] 47 +/- 16% predicted] completed the D-12, the COPD Assessment Test [CAT] and the Chronic Respiratory Disease Questionnaire [CRDQ]. Lung function and 6-minute walk distance were also measured. The D-12 was re-administered two weeks later. The Arabic version of the D-12 demonstrated good reliability over the two administration [intraclass correlation coefficient = 0.94, P= 0.01]. Strong associations were demonstrated between the [1] total score for the D-12 and the CAT, [2] quality sub-score of the D-12 and the CAT and [3] emotional response sub-score of the D-12 and emotional function domain of the CRDQ [r

Low- versus high-fidelity simulations in teaching and assessing clinical skills

Simulation has been widely used in the education of healthcare workers. In simulation training, there is an approximation to reality in which trainees are supposed to react to problems or conditions as they would under genuine circumstances. The educational value of simulations has been determined to be valuable. Simulation has a significant impact on health care education across the disciplines and in both undergraduate and postgraduate studies. Recent development in technologies permits the reproduction of real-life scenarios with acceptable fidelity, thus profoundly enhancing the learning environment. However, the educational outcomes of high- versus low fidelity simulations remain controversial. This article aims to review the effectiveness of low- and high-fidelity simulations in teaching and assessing clinical skills

Establishing a clinical simulation centre: recommendations from an expert panel from the international conference on advanced clinical simulation, Dhahran, Saudi Arabia

Establishing a simulation centre remains a real challenge for many experts in the field of clinical simulation. A panel of experts presented some guidelines during the International Conference on Advanced Clinical Simulation that was held in Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia, in October 2014. The round table discussion addressed eight themes: The planning stage, stakeholders' involvement, strategic planning, centre design, partnership development, faculty development, curriculum development and establishing a research strategy. The conclusions are presented in this paper

Outcomes of premature and very-low-birth-weight infants from 1991 to 2002

Intensive care nursery [ICN] survival rates reflect the efficacy of the perinatal management achieved in each institution. It became of great importance to compare outcome data of individual hospitals to international numbers, taking into consideration the dramatic changes in medical care for very-low-birth weight [VLBW] infants and their mothers that occurred during the past decade worldwide. Evaluate the neonatal outcome [mortality and morbidity] of VLBW and premature infants born at Makassed General Hospital [MGH] and admitted to ICN and compare it to the international rates. Detailed data were collected for all VLBW [<1500 g] and /or premature infants [<30 weeks] born at MGH and admitted to ICN from Jan 1, 1991, through May 31, 2002, retrospectively. Three study periods were defined according to the emergence of new treatment modalities, namely antenatal steroid use and surfactant treatment. Outcome measures were the survival rates at day 28 and on discharge. Secondary outcomes were morbidity rates for patents ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, and nosocomial and maternofetal infections. We studied the effect of antenatal steroids, surfactant, and new respiratory support modes as well as the effect of birth weight, etiology of pre-term labor, mode of delivery, Apgar score, etiology of pre-term labor, mode of delivery, Apgar score, gender, multiple gestation, and intrauterine growth retardation on both survival and morbidity. There were 207 VLBW [