Factor Influencing Learning Outcome in Nursing Education Using Gamification: A Scoping Review / 기본간호학회지

Purpose@#This review explored trends in studies on learning outcomes in nursing education using gamification, to provide directions for future research. @*Methods@#This scoping review was conducted according to the Joanna Briggs Institute's guidelines. The literature search date was February 1, 2021. @*Results@#Thirty-two studies were included. The largest proportion of studies were quantitative descriptive studies, including qualitative mixed methods (34.4%). More studies applied gamification in practical classes (53.1%) than in theoretical classes. Virtual simulation games (37.9%) and simple quiz games (34.4%) were most often used. Commonly used gamification elements included scores/points, feedback, badges, countdowns, challenges, competitions, and levels. Two themes emerged regarding the impact of gamification on learning: learners’ experiences and achievement outcomes with cognitive, affective, and psychomotor subthemes. Nursing education using gamification improved engagement, motivation, and learning achievement. However, there was less evidence for affective and psychomotor outcomes than for cognitive outcomes. @*Conclusion@#Gamification can be an effective educational strategy if educator's have sufficient understanding and readiness and appropriate gamification elements are applied to nursing education. Further research should investigate knowledge retention in the cognitive domain, collaboration and empathy in the affective domain, and the improvement of nursing skills using new technologies in the psychomotor domain.

Laryngeal Mask Airway Insertion in Adults: Comparison between Fully Deflated and Partially Inflated Technique

PURPOSE: The laryngeal mask airway (LMA) is a supraglottic airway device designed to seal around the laryngeal inlet. A controlled study was designed to compare the effectiveness and complications in inserting the LMA when the cuff is fully deflated and partially inflated. MATERIALS AND METHODS: American Society of Anesthesiologists physical status I or II 172 female patients scheduled for gynecologic procedures were included in this study. Patients were randomly allocated into one of the two groups; fully deflated (n=86) and partially inflated group (n=86). A size #4 LMA was inserted. The number of attempts, time taken for successful insertion, grade of leak, grade of fiberoptic view, and complications were evaluated. RESULTS: All 172 patients completed the study protocol. The number of attempts, time taken for successful insertion, and grade of leak were not significantly different between the two groups. The grade of fiberoptic view and complications were lower in the fully deflated group. CONCLUSION: The fully deflated method is more accurate and safe because of better fiberoptic view and lesser complications than the partially inflated group.

Incidence of Venous Air Embolism during Myomectomy: The Effect of Patient Position

PURPOSE: Venous air embolism (VAE) is characterized by the entrainment of air or exogenous gases from broken venous vasculature into the central venous system. No study exists regarding the effect of patient positioning on the incidence of VAE during abdominal myomectomy. The purpose of this study was to assess the incidence and grade of VAE during abdominal myomectomy in the supine position in comparison to those in the head-up tilt position using transesophageal echocardiography. MATERIALS AND METHODS: In this study, 84 female patients of American Society of Anesthesiologist physical status I or II who were scheduled for myomectomy under general anesthesia were included. Patients were randomly divided into two groups: supine group and head-up tilt group. Transesophageal echocardiography images were videotaped throughout the surgery. The tapes were then reviewed for VAE grading. RESULTS: In the supine group, 10% of the patients showed no VAE. Moreover, 10% of the patients were classified as grade I VAE, while 50% were categorized as grade II, 22.5% as grade III, and 7.5% as grade IV. In the head-up tilt group, no VAE was detected in 43.2% of the patients. In addition, 18.2% of the patients were classified as grade I VAE, 31.8% as grade II, and 6.8% as grade III; no patients showed grade IV. VAE grade in the head-up tilt group was significantly lower than that in the supine group (p<0.001). CONCLUSION: The incidence and grade of VAE in the head-up tilt group were significantly lower than those in the supine group during abdominal myomectomy.

Management of cardiogenic shock during cardiac surgery with long-term use of percutaneous cardiopulmonary support: A case report / 대한마취과학회지

Percutaneous cardiopulmonary support (PCPS) provides hemodynamic and pulmonary support simultaneously and is increasingly used in medical practice. However, the presence of extracorporeal circulation and the use of heparin means it is not free of side effects, and use of PCPS for longer than 96 h is associated with poor prognosis. Therefore, along with the decision of when to apply or discontinue PCPS, an integrated team approach between the surgeon and the anesthesiologist to prevent and/ or manage PCPS-related complications is of paramount importance when the patient's physical status mandates prolonged use of PCPS. We hereby report 2 cases addressing successful management of postoperative cardiogenic shock, refractory to pharmacologic support, with early and prolonged application of PCPS in patients who underwent surgical anterior ventricular endocardial restoration and coronary artery bypass surgery.

Management of cardiogenic shock during cardiac surgery with long-term use of percutaneous cardiopulmonary support: A case report / 대한마취과학회지

Percutaneous cardiopulmonary support (PCPS) provides hemodynamic and pulmonary support simultaneously and is increasingly used in medical practice. However, the presence of extracorporeal circulation and the use of heparin means it is not free of side effects, and use of PCPS for longer than 96 h is associated with poor prognosis. Therefore, along with the decision of when to apply or discontinue PCPS, an integrated team approach between the surgeon and the anesthesiologist to prevent and/ or manage PCPS-related complications is of paramount importance when the patient's physical status mandates prolonged use of PCPS. We hereby report 2 cases addressing successful management of postoperative cardiogenic shock, refractory to pharmacologic support, with early and prolonged application of PCPS in patients who underwent surgical anterior ventricular endocardial restoration and coronary artery bypass surgery.

Changes in hemodynamic parameters and regional myocardial perfusion measured by thermal diffusion probe from the infusion of norepinephrine during displacement of porcine beating heart / 대한마취과학회지

BACKGROUND: This study was done to evaluate the sole effect of norepinephrine on the regional myocardial perfusion during displacement of the porcine beating heart using thermal diffusion method. METHODS: Thermal diffusion probe was inserted into the anterior myocardial wall during 20 procedures in 10 male pigs (30-35 kg). The measurements of regional myocardial perfusion and hemodynamic parameters were performed after complete instrumentation (baseline), after displacement of the beating heart anteriorly, and 5 and 15 minutes after norepinephrine infusion, titrated to restore baseline mean arterial pressure (MAP). RESULTS: Norepinephrine infusion reversed the decrease in MAP and myocardial perfusion, caused by displacement of the beating heart (62 +/- 3% to 115 +/- 4% of baseline, P < 0.01; 41 +/- 5% to 125 +/- 4% of baseline, P < 0.05, respectively). CONCLUSIONS: Restoration of MAP with norepinephrine infusion without any preload augmentation reversed deterioration in regional myocardial perfusion during displacement of the porcine beating heart.