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

Comparison of Kinyoun's acid-fast and immunofluorescent methods detected an unprecedented occurrence of Cryptosporidium in the eastern region of Saudi Arabia

The aim of this study was to compare the diagnostic sensitivity and specificity of the modified Kinyoun's acid-fast test used widely in Saudi Arabia compared to the direct immunofluorscent assay [DFA] for monitoring the occurrence of Cryptosporidium spp. We compared the conventional, modified Kinyoun's acid-fast with the Merifluor direct immunofluorscent assay for the detection of Cryptosporidium oocysts in 100 stool samples, among patients who reported to King Fahad Military Medical Complex during April-May, 2012. The modified Kinyoun's method and the DFA revealed 49 and 66 Cryptosporidium oocyst positives, respectively. Sensitivity and specificity of acid-fast when compared to DFA, were 66.67% [95% CI: 53.99%-77.79%] and 88.24% [95% CI: 72.53%-96.63%], respectively, [Kappa = 0.487 and the 95% confidence interval was 0.328-0.645]. The positive and negative predictive values of the same method were 91.67% [95% CI: 80.00%-97.63% and 57.69% [95% CI: 43.21%-71.27%], respectively. The DFA was found to be simple to perform and has been demonstrated to have a higher sensitivity than traditional staining procedures. The current positivity rate of 66% of Cryptosporidium in this study is higher than indicated before by several studies. This disease remains underdiagnosed in current routine laboratory procedures. It is recommended that tests for Cryptosporidium be done as part of a general diarrhea screen during standard stool tests in diagnostic laboratories