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Objective:To explore a type of teaching teeth that can highly simulate natural teeth, and to investigate its application in the practice teaching of crown preparations.Methods:A total of 44 senior students majoring in stomatology Fourth Military Medical University were selected, and each student received the training of crown preparations using interpenetrating polymer network (IPN) enamel-like teaching teeth, extracted natural teeth, and traditional composite resin teeth. Operation assessment was performed, and the operation time of each crown preparation was recorded. According to the requirements for crown preparations, scores were determined from the five aspects of axial converging, space for repair, line angle, shoulder quality, and posture, with 10 points for each aspect and 50 points in total, and the total score was calculated. A questionnaire survey on IPN enamel-like teeth was performed for each student after assessment, and SPSS 23.0 was used to perform the least significant difference t-test and the Tambane's T2 test. Results:There was no significant difference in total assessment score between the IPN enamel-like teeth group and the natural teeth group (37.15±1.17 vs. 37.20±1.20, P>0.05), and both groups had a significantly higher total score than the resin teeth group (31.53±1.41) ( P<0.05). The IPN enamel-like teeth group and the natural teeth group had significantly higher scores than the traditional composite resin teeth group in terms of axial converging, space for repair, and shoulder quality ( P<0.05). The questionnaire survey of the students showed a relatively high score of 3.7-4.9 for each item. Conclusion:Compared with traditional composite resin teeth, IPN enamel-like teeth can more comprehensively and effectively simulate the operation and experience of natural teeth for crown preparations and thus have potential advantages in the practice teaching of crown preparations.
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@#AIM: To evaluate the practical teaching effect of the doctor-patient communication ability training combined with Simulation-based Medical Education(SBME)pedagogy in the standardized training for ophthalmology residents through Mini-Clinical Evaluation Exercise(Mini-CEX). <p>METHODS: From September 2015 to July 2017, sixteen residents from the Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University were selected as research subjects. Before and after the conventional teaching or SBME teaching with standardized patients(SP), real doctor-patient communications were completed respectively, which were evaluated through Mini-CEX.<p>RESULTS: As to the Mini-CEX assessment of the standard training residents for the pre-intervention doctor-patient communication about the three common diseases of age-related cataract, primary open-angle glaucoma, and acute bacterial conjunctivitis, there was no significant difference in the average score of the seven items between the trainees in the control group and the experimental group(<i>P</i>>0.05). After the demonstration teaching and comment revision, the control group directly performed the post-intervention doctor-patient communication and Mini-CEX evaluation, and the experimental group performed the further SBME teaching and then the post-intervention doctor-patient communication and Mini-CEX evaluation. The scores of the seven items in the two groups after the intervention were significantly higher than those before the intervention(<i>P</i><0.05). The excellent rates of the trainees in the control group and the experimental group with an average score of 7 or more increased from 37.5%(3/8)and 37.5%(3/8)to 87.5%(7/8)and 100%(8/8), respectively. After the intervention, in addition to physical examination skills and clinical judgment, the scores of other five items such as medical interview skills, humanistic care and professionalism, psychological counseling skills, organizational effectiveness and overall clinical competence, were significantly higher in the experimental group than the ones in the control group(<i>P</i><0.05).<p>CONCLUSION: SBME pedagogy with SP can improve the effectiveness of the doctor-patient communication training for ophthalmology residents. Mini-CEX can be used to evaluate the teaching efficiency easily, quickly and standardly. The combination of Mini-CEX and SBME can be widely used in the practice of the doctor-patient communication training for ophthalmology residents.
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Simulation-based medical education can ensure medical safety, reduce medical errors and improve students' clinical skills. At present, the main problems in medical teaching are the conflict between doctors and patients, the contradiction between medical teaching and ethics, the shortage of teaching resources and the lack of a universal assessment standard. The advantages of simulation-based medical education are its safety, repeatability, standardization, controllability, relative authenticity, and the cultivation of humanistic spirit and teamwork for students. Simulation-based medical education has two major limits. First, its teaching effect relies on the function and quality of each model. Second, simulation cannot replace clinical practice. This article proposes the following ways and means for promoting the simulation-based medical education: training of faculty is the core, establishment of courses is the focus, cooperation and communication is an important way to promote development, and phased and refined development is the future direction.
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We have conducted a nationwide survey on faculty development for simulation-based medical education in Japan. The response rate was 90%. Forty-seven (68%) schools have implemented faculty development programs for simulation-based education. The most commonly implemented contents were standardized patient development, task trainer, high fidelity manikin operation, and student evaluation, which were related to objective structured clinical examination objective clinical skill assessment. Only 15 percent of medical schools implemented topics on reflective practice, and scientific writing. A constraint on faculty time was the most commonly perceived barrier to simulation use (mentioned by 62 schools; 90%).
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With the development of science and technology,medical simulation has been applied extensively.The application of simulation technique in teaching hospitals has become a new choice in modern medical education.As the most basic and important clinical ability,airway management has become a popular training program in China's teaching hospitals.This paper summarizes the current situation of the simulation training of airway management in teaching hospitals at home and abroad,concludesthe existing problems in the simulation teaching of airway management of teaching hospitals in China,such as narrow range of training objects,lack of professional teaching staff,unscientific curriculum design and outdated training model,etc.Then puts forward the countermeasures of expanding the training coverage,establishing the professional teaching team,designing the curriculum design of science,and introducing advanced simulation equipment to improve the quality of simulated teaching.
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Objective To evaluate the educational effectiveness of feedback debriefing in clinical training.Methods Forty medical students and fifteen teachers were enrolled in the 2015 after-internship clinical training,which was newly designed to obtain the debriefing part.The test scores and single technical practices were collected and analyzed,before and after the training.DASH scoring system was used to evaluate the effect of debriefing in the team simulation.Results were statistically analyzed by SAS 9.2(SAS institute Inc).Quantitative data were described by x ± s,while qualitative data were described by number and/or constituent ratio.Student's t test and Wilcoxon rank sum test were applied as needed.A P-value ＜ 0.05 was considered to be significant.Results The scores of the students before and after the assessment were (41.88 ± 8.54) vs.(65.06 ± 13.83),and the difference was statistically significant(P=0.000).Individual skills before and after the course had a different degree of improvement.The average DASH-scores evaluated by the students,teachers and supervisors were (39.3 ± 2.12) (very good),(35.1 ± 4.18) (good) and (37.2 ± 3.03)(very good),separately.Conclusions Potent debriefing helps to improve the effectiveness of simulationbased clinical training.
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<p> To encourage the broad use of simulation-based medical education and establish partnerships to promote objective structured clinical examinations after clinical clerkship among medical teachers, we hosted the first team-based clinical skills competition event for medical students in Japan, named ‘Medical Students' Simlympic Games 2014'. Thirty-six (12 teams of three) open-recruited 5th or 6th grade medical students participated in this event. Student teams performed clinical tasks at 6 stations, which actively utilized the strengths of simulators or simulated patients. Contents, composition, difficulty level, and validity were tested by trainee doctors and examined by committee members in advance. In this report, we describe our concept, executive committee formation, a variety of arrangements, the outline on the day of the event, and the results of a questionnaire targeting participants. (126 words)</p>
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Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.
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Objective To explore an effective method for enhancing basic clinical skill of students.Methods Selective course of basic clinical skill was launched for the fourth grade clinical medicine students by using simulation-based medical education (SBME).Elective courses have 21 class hours,involving 15 items of basic clinical skills in internal medicine,surgery and nursing.Training methods include preparation,explanation,demonstration,operation,group competition,examination and questionnaire.Selective course examination includes class activation and final examination,accounting for 20％ and 80％ of the final scores,respectively.Scores were classified into A (excellent),B (good) and C (moderate) levels.Scores and questionnaire data were processed by Microsoft Office Excel 2007 software and percentages of score and questionnaire feedback were calculated.Results Results suggested that the scores of 70％ students were more than 90.Results of questionnaire indicated that the basic clinical skills of 76.6％ of the students were improved a lot.79.2％ considered that it was useful for their clinical practices.Conclusion Clinical-skill course based on SBME is conducive to enhancing basic clinical skills of students.
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Objective To investigate the effect of formative assessment on skill acquisition of basic life support (BLS) among medical students. Methods Totally 206 undergraduates were ran-domized into control group (C group) and interventional group (F group). A BLS lecture was given in both groups. And then, 45 min BLS training and BLS skill assessment (after training) were given in C group. Undergraduates in F group received BLS skill assessment (formative assessment) before training, and 15 min feedback was delivered based on the assessment, then 30 min BLS training was conducted. Skills assessment was conducted again in F group after the training. Student's-t-test was used to compare the difference of skills between the two groups and P<0.05 signifies statistically sig-nificant differences. Results Score of F group (85.2±7.3) were higher than that in C group (68.2± 13.2), with statistical difference. Conclusion A formative assessment could significantly improve skill acquisition of BLS among medical students.
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Las restricciones éticas impuestas al entrenamiento en cirugía laparoscópica en seres humanos y animales han impulsado la tendencia a utilizar, con mayor frecuencia, dispositivos de simulación. Los simuladores comerciales en cirugía laparoscópica, disponibles en el mercado, pueden mejorarse en virtud de la necesidad específica de los profesionales. La línea de simuladores biomecatrónicos del grupo de investigación en ingeniería biomédica GIBEC, ha desarrollado varios prototipos de simulación para cirugía laparoscópica, los cuales han evolucionado con base en las recomendaciones de los profesionales de la salud de la Universidad CES. En este artículo se presenta un resumen de cómo se han construido las bases de esta línea y cómo se han observado las necesidades que la escuela de medicina tiene para el desarrollo de simuladores, en donde la ingeniería juega un papel protagónico.
The ethical constraints imposed on the training in laparoscopic surgery in humans and animals have led to the increasingly common trend of using simulation devices. Commercially available simulators for laparoscopic surgery can be improved if tailored to the specific needs of professionals. The line of Biomechatronics Simulators of the biomedical engineering research group GIBEC, has developed several prototypes of simulation for laparoscopic surgery, which have evolved based on the recommendations from health professionals at the CES University. The results presented here demonstrate the group's progress in developing those devices.
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1) The central venous catheterization (CVC) training program for 2 trainees involves an instructor, a CVC insertion simulator (Kyoto Kagaku Co., Ltd), and a simulated patient.<br>2) The questionnaire filled out by trainees after the program showed favorable opinions, particularly the method of learning after the practice.<br>3) It is important that effective simulation programs for trainees are designed to develop practical procedures and professional attitudes as a physician using both a simulator and a simulated patient.