ABSTRACT
BACKGROUND: Opportunities to practice procedural skills in the clinical learning environment are decreasing, and faculty time to coach skills is limited, even in simulation-based training. Self-directed learning with hands-on practice early in a procedural skill course might help maximize the benefit of later faculty coaching and clinical experience. However, it may also lead to well-learned errors if learners lack critical guidance. The present study sought to investigate the effects of a hands-on, self-directed "study hall" for central line insertion among first-year residents. METHODS: Learner cohorts before vs. after introduction of the study hall (n = 49) were compared on their pre- and post-test performance of key procedural behaviors that were comparable across cohorts, with all learners receiving traditional instructor-led training between tests. RESULTS: Study hall participants spent a median of 116 min in hands-on practice (range 57-175). They scored higher at pre-test (44% vs. 27%, p = .00; Cohen's d = 0.95) and at post-test (80% vs. 72%, p = .02; Cohen's d = 0.69). A dose-response relationship was found, such that 2 h of study hall were roughly equivalent to the performance improvement seen with four clinical observations or supervised insertions of central lines. CONCLUSIONS: Self-directed, hands-on "study hall" supported improved procedural skill learning in the context of limited faculty availability. Potential additional benefits make the approach worth further experimentation and evaluation.
ABSTRACT
(1) We aimed to systematically search available data on the prevalence of frailty among community-dwelling elders in Middle Eastern countries. The results from available studies are cumulated to provide comprehensive evidence for the prevalence of frailty. (2) Methods: A meta-analysis was done. A literature search was carried out using PRISMA guidelines in PubMed, Web of Science, and SCOPUS websites for studies up to 2020. Inclusion criteria entailed all primary studies conducted in Middle Eastern countries on frailty in community-dwelling older adults aged 60 years and older. (3) Results: A total of 10 studies were selected for this study. Random-effects meta-analysis of nine studies indicated there was a pooled prevalence rate of 0.3924 with a standard error of 0.037. This pooled prevalence point estimate of 0.3924 was statistically significant (p < 0.001). The Egger's regression test and the trim-fill method for detecting publication bias did not detect any evidence of publication bias in the sample of included studies. The Egger's regression test was not statistically significant. The trim-fill method indicated zero studies were missing on either side; (4) Conclusions: The study's findings indicate that the prevalence of frailty is higher in Middle Eastern nations. Despite indications that many of these nations' populations are rapidly ageing, we presently lack information on the incidence of frailty in these populations; this information is essential to health, policymakers, and social care planning.
