The Development of a Cost-Effective Infant Intraosseous Infusion Simulator for Neonatal Resuscitation Program Training.

Simulation-based medical education (SBME) employs realistic simulators to allow physicians and medical students to learn and practice high acuity, low occurrence (HALO) skills such as the intraosseous (IO) infusion. Previous research was done to develop and evaluate a three-dimensional (3D)-printed adult proximal tibia IO simulator and was rated as a valuable and realistic medical education training tool. This report focuses on implementing this IO simulator for neonatal resuscitation program (NRP) training purposes, as well as to explain the process of redeveloping the previous adult IO simulator and the development of a stand, called the maxSIMbox, to hold the simulators, as well as the tools needed to perform an IO infusion. The feedback provided from stakeholders was helpful, with an emphasis on providing stability to both the infant IO simulator and the maxSIMbox. From this feedback, a functional and cost-effective simulator was developed to practice this HALO skill and is currently being used for NRP training.

Patient self-injection of methotrexate for inflammatory arthritis: a study evaluating the introduction of a new type of syringe and exploring patients' sense of empowerment.

OBJECTIVES: To evaluate the introduction of a new type of syringe for patients on a self-injection of methotrexate (MTX) programme and explore patients' sense of empowerment relating to the self-injection of MTX. METHODS: Data were collected using a postal questionnaire, which yielded quantitative and qualitative data. The questionnaire was sent to all eligible patients in the primary care setting who self-injected MTX (n=24). RESULTS: The response rate was 88% (n=21). Patients' responses illustrated numerous disadvantages of using the syringe, particularly difficulties with the syringe stopper, syringe handling and leakage potential of the mildly cytotoxic drug MTX. The advantages included the ease of syringe storage and longer use by date. Difficulties in using the syringe, and the amount of support and training from hospital staff were among the factors affecting patients' sense of empowerment. CONCLUSIONS: Although a small study, this work indicates that there may be benefits in a collaboration between hospital staff and the syringe manufacturer, to modify the new syringe to address the problems noted. The potential of cytotoxic MTX spillage being minimized is recognized, making the new syringe more suitable for use by patients with inflammatory arthritis. Patient training may help to alleviate difficulties in using a new syringe, which, in turn, may also increase patients' sense of empowerment.