ABSTRACT
BACKGROUND: Adequate training and preparation of medical first responders (MFRs) are essential for an optimal performance in highly demanding situations like disasters (e.g., mass accidents, natural catastrophes). The training needs to be as effective as possible, because precise and effective behavior of MFRs under stress is central for ensuring patients' survival and recovery. This systematic review offers an overview of scientifically evaluated training methods used to prepare MFRs for disasters. It identifies different effectiveness indicators and provides an additional analysis of how and to what extent the innovative training technologies virtual (VR) and mixed reality (MR) are included in disaster training research. METHODS: The systematic review was conducted according to the PRISMA guidelines and focused specifically on (quasi-)experimental studies published between January 2010 and September 2021. The literature search was conducted via Web of Science and PubMed and led to the inclusion of 55 articles. RESULTS: The search identified several types of training, including traditional (e.g., lectures, real-life scenario training) and technology-based training (e.g., computer-based learning, educational videos). Most trainings consisted of more than one method. The effectiveness of the trainings was mainly assessed through pre-post comparisons of knowledge tests or self-reported measures although some studies also used behavioral performance measures (e.g., triage accuracy). While all methods demonstrated effectiveness, the literature indicates that technology-based methods often lead to similar or greater training outcomes than traditional trainings. Currently, few studies systematically evaluated immersive VR and MR training. CONCLUSION: To determine the success of a training, proper and scientifically sound evaluation is necessary. Of the effectiveness indicators found, performance assessments in simulated scenarios are closest to the target behavior during real disasters. For valid yet inexpensive evaluations, objectively assessible performance measures, such as accuracy, time, and order of actions could be used. However, performance assessments have not been applied often. Furthermore, we found that technology-based training methods represent a promising approach to train many MFRs repeatedly and efficiently. These technologies offer great potential to supplement or partially replace traditional training. Further research is needed on those methods that have been underrepresented, especially serious gaming, immersive VR, and MR.
Subject(s)
Disasters , Emergency Responders , Humans , Clinical Competence , TriageABSTRACT
Promoting Self-Regulation of Adolescents in School Through Mindfulness. Evaluation of the Mindfulness Training "8-sam" Mindfulness describes the psychological process of purposely bringing one's attention to the present experiences with an accepting, non-judgmental attitude. As such, it has attracted increasing interest in educational institutions. The present study aims to evaluate a mindfulness training for adolescents in a German high school. For this purpose, the program "8-sam" has been developed. Feasibility, acceptance and efficacy of this four-week training were examined in a sample of 48 ninth-grade students. Self-ratings of mindfulness, chronic stress, emotion regulation and health, as well as behavioral measures of attention and mind-wandering of the intervention group (n = 22) were compared to the wait control group (n = 24) before, immediately and 6 weeks after the training. As indicated by self-designed evaluation questionnaires, the training proved to be well accepted and implementable at school. The intervention group showed less mind-wandering after the training than the control group. The findings offer implications for future research and the application of mindfulness trainings in schools. Implementing mindfulness in the daily school routine promises to support self-regulatory processes and thus, strengthen the resilience of children and adolescents.
Subject(s)
Mindfulness , Psychology, Adolescent , School Mental Health Services , Self-Control , Students/psychology , Adolescent , Feasibility Studies , Germany , Humans , Patient Compliance , Schools , Self Report , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To determine whether mental practice of wrist movements during forearm immobilization maintains range of motion. DESIGN: Randomized controlled trial. PARTICIPANTS: Eighteen healthy young men aged between 20 and 30 years were assigned to either a control or a mental practice group. Both groups were immobilized with a circular forearm cast for 3 weeks to simulate a distal radial fracture. METHODS: The mental practice group received 1 × 60-min, followed by 3 × 30-min, sessions of supervised mental practice. Consecutively, they were asked to perform 15 min/day of self-guided imagery sessions, during which they mentally exercised motion sequences of the immobilized joint. The training program followed the Mental Gait Training procedure. The control group did no training. Wrist movement was measured with a goniometer before and after immobilization. RESULTS: Mental practice preserved dorsal extension and ulnar abduction. The sedentary control group showed due to this variables a significant decrease after cast removal. There was no significant change in palmar flexion and radial abduction in either group. CONCLUSION: Despite the study limitations, these results suggest that mental practice may be useful in preventing loss of hand function associated with mid-term immobilization. Because of the expected clinical benefits, the low cost and simple application of the intervention, the effects of mental practice in orthopedic rehabilitation of the upper extremity warrant further study.
