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1.
Am J Vet Res ; 83(11): 1-5, 2022 Sep 02.
Article in English | MEDLINE | ID: mdl-36074747

ABSTRACT

OBJECTIVE: To determine whether copper oxide wire particles (COWP) administered as an oral bolus effectively decrease fecal gastrointestinal nematode (GIN) egg counts in adult alpacas. ANIMALS: 57 adult alpacas. PROCEDURES: A double-blind clinical trial was performed during the months of April through August 2019. Adult alpacas enrolled in the trial were administered 2 g of COWP or a placebo control capsule PO on day 0 and day 45. On day 0 and at 15-day intervals, fecal samples were collected, and Modified McMaster fecal egg counts (FEC) were performed as well as physical examinations, including FAMACHA scoring and body condition scoring (BCS). Hematocrits were measured in 30-day intervals (days 0, 30, 60, and 90). Results were compared across groups. RESULTS: A significant decrease in mean FEC was observed in the COWP-treated group over time, compared with the placebo group. Mean BCS, FAMACHA score, and Hct did not differ significantly between groups. No clinical evidence of copper toxicosis was observed. CLINICAL RELEVANCE: Oral administration of COWP was determined to be a safe and effective method of reducing GIN FEC in adult alpacas.


Subject(s)
Camelids, New World , Nematoda , Sheep Diseases , Sheep , Animals , Parasite Egg Count/veterinary , Copper/therapeutic use , Sheep Diseases/drug therapy , Oxides/therapeutic use , Feces
2.
Anesth Analg ; 135(1): 143-151, 2022 07 01.
Article in English | MEDLINE | ID: mdl-35147576

ABSTRACT

BACKGROUND: Although included within the American Society of Anesthesiologists difficult airway algorithm, the use of "invasive airway access" is rarely needed clinically. In conjunction with highly associated morbidity and liability risks, it is a challenge for the average anesthesiologist to develop and maintain competency. The advancement of high-fidelity simulators allows for practice of rarely encountered clinical scenarios, specifically those requiring invasive subglottic airway techniques. METHODS: Sixty board-certified academic anesthesiologists were enrolled and trained in dyads in a simulation-based, mastery-based learning (MBL) course directed at 2 emergency airway subglottic techniques: transtracheal jet ventilation (TTJV) and bougie cricothyrotomy (BC). Performance metrics included: pretest, posttest, specific skill step error tracking, and 15-month period retest. All were pretested and trained once on the Melker cricothyrotomy (MC) kit. All pretest assessment, training, posttesting, and 15-month retesting were performed by a single expert clinical and educational airway management faculty member. RESULTS: Initial testing showed a success rate of 14.8% for TTJV, 19.7% for BC, and 25% for MC. After mastery-based practice, all anesthesiologists achieved successful invasive airway placement with TTJV, BC, and MC. Repeated performance of each skill improved speed with zero safety breaches. BC was noted to be the fastest performed technique. Fifteen months later, retesting showed that 80.4% and 82.6% performed successful airway securement for TTJV and BC, respectively. For safety, average placement time and costs, MC was discarded after initial training results. CONCLUSIONS: We discovered that only ~20% of practicing anesthesiologists were able to successfully place an invasive airway in a simulated life or death clinical setting. Using mobile simulation (training performed in department conference room) during a 2.5-hour session using mastery-based training pedagogy, we increased our success rate of invasive airway placement to 100%, while also increasing the successful speed to ventilation (TTJV, 32 seconds average; BC, 29 seconds average). Finally, we determined that there was a 15-month 80% retention rate of the airway skills learned, indicating that skills last at least a year before retraining is required using this training methodology.


Subject(s)
Anesthesiologists , Simulation Training , Clinical Competence , Computer Simulation , Humans , Intubation, Intratracheal/methods
3.
Article in English | MEDLINE | ID: mdl-34360274

ABSTRACT

Between March 2019 and February 2020, Asian long-horned ticks (Haemaphysalis longicornis Neumann, 1901) were discovered and collected for the first time in one middle and seven eastern Tennessee counties, facilitated by a newly developed passive and collaborative tick-surveillance network. Network collaborators included federal, state, county, university, and private resource personnel working with companion animals, livestock, and wildlife. Specimens were collected primarily from dogs and cattle, with initial detections of female adult stage ticks by stakeholders associated with parasitology positions (e.g., entomologists and veterinary parasitologists). Initial county tick detections were confirmed with morphological and molecular identifications, and then screened for the presence of animal-associated pathogens (Anaplasma marginale, Babesia species, Ehrlichia species, and Theileria orientalis), for which all tests were negative. Herein, we describe the identification and confirmation of these tick specimens as well as other results of the surveillance collaboration.


Subject(s)
Ixodidae , Theileria , Tick-Borne Diseases , Ticks , Anaplasma , Animals , Cattle , Dogs , Female
4.
Front Vet Sci ; 8: 651672, 2021.
Article in English | MEDLINE | ID: mdl-33829053

ABSTRACT

Old World Camelids (OWC) represent two species (Camelus bactrianus and Camelus dromedarius) with increasing numbers in North America. Gastrointestinal (GI) parasitism is a major cause of clinical disease in camelids and leads to significant economic impacts. Literature reporting on clinical parasitism of camels is localized to India, Africa, and the Middle East, with limited information available on OWCs in North America. Objectives of this study were to report on clinical presentation and diagnostic findings in Camelus bactrianus and Camelus dromedarius with GI parasitism and provide a comparative analysis between geographic regions. Medical records of OWCs presenting to two veterinary teaching hospitals (of the University of Tennessee and University of Wisconsin) were evaluated. Thirty-one camels including 11 Bactrians and six dromedaries (14 species not recorded) were included for the clinical component of this study, reporting on signalment, presenting complaint, and clinical pathology. Anorexia, weight loss, and diarrhea were the most common presenting complaint. Clinical pathology findings included eosinophilia, hypoproteinemia, and hyponatremia. For the second component of this study, a total of 77 fecal parasite examination results were evaluated for parasite identification and regional variation. Trichuris, Capillaria, Strongyloides, Nematodirus, Dictyocaulus, Moniezia, and protozoan parasites (Eimeria, Cryptosporidium, Giardia) were recorded. Strongyle-type eggs predominated, followed by Trichuris and Eimeria spp. There was a statistically significant variation in prevalence of coccidia between the two regions, with fecal examinations from Tennessee more likely to contain Eimeria (P = 0.0193). Clinicians treating camels in North America should recognize anorexia, weight loss, and diarrhea combined with clinical pathologic changes of hypoproteinemia, eosinophilia and hyponatremia as possible indications of GI parasitism. Clinicians should also consider the potential for regional variation to exist for GI parasites of camels in different areas of North America.

5.
Augment Altern Commun ; 37(1): 1-13, 2021 03.
Article in English | MEDLINE | ID: mdl-33840318

ABSTRACT

Special education teachers are often responsible for training their staff how to support children with autism spectrum disorder in their classrooms. In addition to academic and behavioral interventions, paraeducators also need to be prepared to support students with complex communication needs. This study was designed to investigate the effects of a paraeducator-implemented communication intervention in a public school. A multiple probe design across participants was used to evaluate a communication intervention that included providing opportunities to initiate with least-to-most prompting for a 10-year-old student with autism who used an augmentative and alternative communication (AAC) device. Prior to the intervention, the student was rarely observed initiating interactions with her AAC device, and paraeducators were rarely observed offering opportunities to initiate or providing supports to help the student initiate. Following training, data from each paraeducator indicated an increased rate when providing the communication intervention and as a result, the student displayed an increase in the targeted intervention, initiation. Findings from the intervention highlight the need for explicit teaching when promoting initiation among students with autism who use AAC.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Communication Aids for Disabled , Child , Communication , Female , Humans , Students
6.
Behav Modif ; 45(6): 887-910, 2021 11.
Article in English | MEDLINE | ID: mdl-32436391

ABSTRACT

The authors of this systematic review identified 20 individual single-subject studies examining the efficacy of Behavior Skills Training (BST) implemented with parents. Findings indicate that researchers have used BST to successfully train parents to implement a range of evidence-based practices (EBP) with their own children. Parents of children with autism or intellectual disability made up the large majority of participants in these studies. Applying the methodological quality standards set by What Works Clearinghouse (WWC), the authors detail the evidence from 67 individual cases provided by single-subject design research. Practitioners looking to train parents of children with disabilities to implement EBPs can be confident that BST is an effective training practice.


Subject(s)
Autistic Disorder , Intellectual Disability , Child , Evidence-Based Practice , Humans , Parents
7.
Educ Health (Abingdon) ; 33(2): 37-45, 2020.
Article in English | MEDLINE | ID: mdl-33318452

ABSTRACT

Background: Highly infectious but rare diseases require rapid dissemination of safety critical skills to health-care workers (HCWs). Simulation is an effective method of education; however, it requires competent instructors. We evaluated the efficacy of an internet-delivered train-the-trainer course to prepare HCWs to care for patients with Ebola virus disease (EVD). Methods: Twenty-four individuals without prior EVD training were recruited and divided into two groups. Group A included nine trainees taught by three experienced trainers with previous EVD training. Group B included 15 trainees taught by five novice trainers without previous EVD training who completed the train-the-trainer course. We compared the efficacy of the train-the-trainer course by examining subject performance, measured by time to complete 13 tasks and the proportion of steps per task flagged for critical errors and risky and positive actions. Trainees' confidence in their ability to safely care for EVD patients was compared with a self-reported survey after training. Results: Overall trainees' confidence in ability to safely care for EVD patients did not differ by group. Participants trained by the novice trainers were statistically significantly faster at waste bagging (P = 0.002), lab specimen bagging (P = 0.004), spill clean-up (P = 0.01), and the body bagging (P = 0.008) scenarios compared to those trained by experienced trainers. There were no significant differences in the completion time in the remaining nine training tasks. Participants trained by novice and experienced trainers did not differ significantly with regard to the proportion of steps in a task flagged for critical errors, risky actions, or positive actions with the exception of the task "Man Down in Gown" (12.5% of steps graded by experienced trainers compared to 0 graded by novice trainers, P = 0.007). Discussion: The online train-the-trainer EVD course is effective at teaching novices to train HCWs in protective measures and can be accomplished swiftly.


Subject(s)
Health Personnel/education , Hemorrhagic Fever, Ebola/prevention & control , Simulation Training/methods , Female , Humans , Infection Control/methods , Internet-Based Intervention , Male , Pilot Projects , Program Evaluation
8.
Parasit Vectors ; 12(1): 576, 2019 Dec 09.
Article in English | MEDLINE | ID: mdl-31818311

ABSTRACT

BACKGROUND: The canine hookworm, Ancylostoma caninum is the most prevalent and important intestinal nematode parasite of dogs in the USA. Hookworms are typically well controlled by treatment with all commonly used anthelmintics that are approved for this use in dogs. However, in the past few years, cases of recurrent/persistent canine hookworm infections appear to have dramatically increased, suggesting that anthelmintic resistance (AR) may have evolved in this parasite. These cases are highly overrepresented by greyhounds, but multiple other breeds are also represented. The aim of this study was to characterize several of these suspected resistant isolates using in vitro, genetic and clinical testing to determine if these cases represent true anthelmintic resistance in A. caninum. METHODS: Fecal samples containing hookworm eggs from three cases of persistent hookworm infections; one from a greyhound, one from a miniature schnauzer and one from a hound-mix, were received by our laboratory. These were then used to establish infections in laboratory dogs and to perform egg hatch assays (EHA) and larval development assays (LDA) for detecting resistance to benzimidazoles and macrocyclic lactones, respectively. Additional EHA and LDA were performed on eggs recovered from the laboratory-induced infections. Fecal egg count reduction tests were performed to detect resistance to pyrantel. Deep amplicon sequencing assays were developed to measure the frequency of non-synonymous single nucleotide polymorphisms (SNP) at codons 167, 198 and 200 of the A. caninum isotype-1 ß-tubulin gene. RESULTS: Resistance ratios for the three A. caninum isolates tested ranged from 6.0 to > 100 and 5.5 to 69.8 for the EHA and LDA, respectively. Following treatment with pyrantel, reduction in faecal egg counts was negative or 0%. Deep amplicon sequencing of the isotype-1 ß-tubulin gene identified a high frequency of resistance-associated SNPs at codon 167 in all three resistant isolates and in two additional clinical cases. CONCLUSIONS: These data conclusively demonstrate multiple anthelmintic resistance in multiple independent isolates of A. caninum, strongly suggesting that this is an emerging problem in the USA. Furthermore, evidence suggest that these resistant hookworms originate from racing greyhound farms and kennels, though additional research is needed to confirm this.


Subject(s)
Ancylostoma/drug effects , Ancylostoma/genetics , Ancylostomiasis/veterinary , Anthelmintics/pharmacology , Drug Resistance, Multiple/genetics , Parasite Egg Count/veterinary , Ancylostomiasis/parasitology , Animals , Breeding , Dog Diseases , Dogs , Feces/parasitology , Polymorphism, Single Nucleotide , Pyrantel/pharmacology , United States
9.
J Vet Intern Med ; 33(5): 2336-2342, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31454105

ABSTRACT

BACKGROUND: Mycoplasma haemolamae (Mhl) and gastrointestinal nematodes can cause anemia in camelids. Control programs aim to suppress parasitism without promoting anthelminthic resistance, but few evidence-based guidelines define acceptable parasite loads in camelids. HYPOTHESIS/OBJECTIVES: In clinically healthy nonanemic camelids, compare erythrocyte variables to Mhl real-time PCR status and to fecal egg count (FEC). Determine the FEC threshold above which erythrocyte variables are consistently below reference interval medians. ANIMALS: One hundred fourteen client-owned adult alpacas and llamas. METHODS: In a cross-sectional study, whole blood in ethylenediaminetetraacetic acid (EDTA) was assessed for packed cell volume (PCV) by centrifugation, erythrocyte count (RBC), and hemoglobin concentration (HGB) using an ADVIA120 analyzer, and Mhl using real-time PCR. Trichostrongyle eggs per gram (epg) were counted by modified McMaster test on freshly collected feces. Significant differences in erythrocyte variables based on Mhl status and FEC thresholds were assessed by independent t test and one-way ANOVA, respectively. RESULTS: Packed cell volume, RBC, and HGB were not significantly different between Mhl-positive and Mhl-negative animals, but were significantly lower in animals with FEC >1000 epg compared to those with <500 epg. All animals with FEC >600 epg had RBC and HGB below the reference interval median. All animals with FEC >750 epg had PCV below the reference interval median. CONCLUSIONS AND CLINICAL IMPORTANCE: In healthy nonanemic camelids, positive Mhl PCR is not associated with lower erythrocyte variables and such animals may not warrant treatment. Fecal egg count >600-750 epg has a negative effect on erythrocyte variables, and may be a guide for deworming protocols.


Subject(s)
Camelids, New World/microbiology , Camelids, New World/parasitology , Mycoplasma Infections/veterinary , Trichostrongyloidiasis/veterinary , Animals , Camelids, New World/blood , Cross-Sectional Studies , Erythrocyte Count/veterinary , Female , Hematocrit/veterinary , Hemoglobins/analysis , Male , Mycoplasma/isolation & purification , Mycoplasma Infections/blood , Mycoplasma Infections/epidemiology , Parasite Egg Count/veterinary , Real-Time Polymerase Chain Reaction/veterinary , Tennessee/epidemiology , Trichostrongyloidea/isolation & purification
10.
J Med Educ Curric Dev ; 6: 2382120519834327, 2019.
Article in English | MEDLINE | ID: mdl-30937387

ABSTRACT

OBJECTIVE: Bag mask ventilation (BMV) is fundamental to airway management. Simulation is effective in airway management training, but its effectiveness for difficult BMV training is less clear. We evaluated the difference between type of training (simulation vs on patients) and the pass rate on a post-test on patients. DESIGN: A single center pilot study was performed with 32 medical students randomized to participate in difficult BMV training on simulators or patients. Pre- and post-training tests on the simulator and on patients were recorded. Surveys of trainee confidence level were collected. The primary goal was to estimate the difference between type of training (simulation vs on patients) and the pass rate on the post-test on patients with an improvement of 10% or more in passing rate considered as a meaningful improvement. Secondary outcomes included whether or not participants passed the simulator post-test, post-test on patient confidence, and pre- and post-test confidence. MEASUREMENTS AND MAIN RESULTS: Participants trained on the simulator had 13% higher passing rate on the post-test on patients compared to participants trained on patients (88% vs 75%). In addition, subjects that passed the simulator post-test had 11 times the odds of passing a post-test on patients relative to subjects that did not pass the simulator post-test (P = 0.023, odds ratio = 11.0, 95% confidence interval [CI] = 1.48-81.6). Post-training confidence levels were higher among those who passed the simulator pre-test and post-test and received simulator training. CONCLUSIONS: Simulation training for difficult BMV led to a higher passing rate on a post-test on patients compared to those trained on patients. This finding will need to be confirmed in larger randomized controlled trials. Successfully completing difficult BMV training on a simulator with a passing grade correlated with passing a test on difficult BMV on patients.

11.
J Vet Diagn Invest ; 31(1): 128-132, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30453850

ABSTRACT

Nine of 23 (39%) research ewes with severe diarrhea and weight loss had histologic lesions consistent with Eimeria gilruthi infection in their abomasa. Gross anatomic lesions included hundreds of opaque 1-mm nodules in abomasal mucosa that corresponded microscopically to 200-300 µm diameter organisms surrounded by areas of necrosis. Analysis of fecal samples from 4 ewes demonstrated oocysts from typical ovine Eimeria species, none of which were E. gilruthi. Two separate PCR reactions were performed on abomasal tissue from 4 sheep to amplify the 18S ribosomal DNA (rDNA) and internal transcribed spacer (ITS) region of the rDNA, respectively. The resultant 18S rDNA nucleotide sequences shared 99% homology with multiple Eimeria species in GenBank. The ITS region shared 77% homology with E. ellipsoidalis in GenBank. Further studies are needed to understand the life cycle and pathogenicity of E. gilruthi. Our results underscore the inclusion of E. gilruthi in the differential diagnosis of diarrhea and weight loss in sheep.


Subject(s)
Abomasum/parasitology , Coccidiosis/veterinary , Diarrhea/veterinary , Eimeria/isolation & purification , Sheep Diseases/diagnosis , Animals , Coccidiosis/diagnosis , Coccidiosis/parasitology , DNA, Protozoan/analysis , Diarrhea/diagnosis , Diarrhea/parasitology , Eimeria/classification , Eimeria/genetics , Phylogeny , RNA, Ribosomal, 18S/analysis , Sequence Analysis, DNA/veterinary , Sheep , Sheep Diseases/parasitology , Sheep, Domestic , Weight Loss
12.
Health Secur ; 16(6): 391-401, 2018.
Article in English | MEDLINE | ID: mdl-30489171

ABSTRACT

This article describes a pilot trial of an internet-distributable online software package that provides course materials and built-in evaluation tools to train healthcare workers in high-risk infectious disease response. It includes (1) an online self-study component, (2) a "hands-on" simulation workshop, and (3) a data-driven performance assessment toolset to support debriefing and course reporting. This study describes a pilot trial of the software package using a course designed to provide education in Ebola response to prepare healthcare workers to safely function as a measurable, high-reliability team in an Ebola simulated environment. Eighteen adult volunteer healthcare workers, including 9 novices and 9 experienced participants, completed an online curriculum with pre- and posttest, 13 programmed simulation training scenarios with a companion assessment tool, and a confidence survey. Both groups increased their knowledge test scores after completing the online curriculum. Simulation scenario outcomes were similar between groups. The confidence survey revealed participants had a high degree of confidence after the course, with a median confidence level of 4.5 out of 5.0 (IQR = 0.5). This study demonstrated the feasibility of using the online software package for the creation and application of an Ebola response course. Future studies could advance knowledge gained from this pilot trial by assessing timely distribution and multi-site effectiveness with standard education.

13.
Oral Maxillofac Surg Clin North Am ; 30(2): 195-206, 2018 May.
Article in English | MEDLINE | ID: mdl-29622313

ABSTRACT

Patient safety in dental anesthesia has been called into question in recent years. Simulation training has been proposed and developed as one possibility for increasing preparedness and training in cases of adverse events in dental anesthesia. This article presents an overview of the challenges of patient safety in dental anesthesia and how to address them with simulation training. The American Association of Oral and Maxillofacial Surgeons simulation program is unique in its potential to become a standardized, validated competency course with objective grading criteria, mastery-based cooperative learning model, and low facilitator-to-participant ratio, leading to a practical delivery cost structure.


Subject(s)
Anesthesia, Dental/standards , Anesthesiology/education , Oral and Maxillofacial Surgeons/education , Simulation Training , Airway Management , Ambulatory Care , Humans , Patient Care Team/organization & administration , Patient Safety , Societies, Dental , United States
14.
Dev Neurorehabil ; 21(1): 40-47, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28727477

ABSTRACT

PURPOSE: Research literature has yet to quantify and describe how students with complex communication needs are supported in the classroom and how special educators are being prepared to offer support. This study sought out special educators to complete a survey about their students with complex communication needs. METHOD: Over 4,000 teachers representing 50 states reported on the communicative and behavioral characteristics of 15,643 students. Teachers described the training they have received and instructional approaches they used. RESULTS: The majority of students were reported to use speech as their primary communication mode. Over half of students utilizing alternative and augmentative communication (AAC) were reported to have non-proficient communication. Teacher training varied across respondents as well as the supports they used to support these students in the classroom. CONCLUSION: The majority of students with disabilities using AAC when communicating across the nation are not proficiently communicating. Implications and recommendations will be discussed.


Subject(s)
Communication Aids for Disabled/statistics & numerical data , Communication Disorders/epidemiology , Education, Special/statistics & numerical data , Students/statistics & numerical data , Adolescent , Child , Communication Disorders/rehabilitation , Female , Humans , Male , Surveys and Questionnaires , United States , Young Adult
15.
Vet Parasitol Reg Stud Reports ; 10: 20-24, 2017 12.
Article in English | MEDLINE | ID: mdl-31014592

ABSTRACT

Free-roaming cat population estimates within the United States currently range from 10 to 114million individual cats. Zoonotic parasites of free-roaming cats are public health concerns; therefore, it is important to investigate the parasite prevalence in these populations. Seventy-six fecal samples from shelter cats in Citrus County, FL were surveyed for parasites using the Sheather's sugar centrifugal flotation method. The objective was to determine the prevalence of patent gastrointestinal parasitism in the sampled shelter cats as a proxy for parasite prevalence in the free-roaming cat populations in the area. Parasites identified with zoonotic potential include Toxocara cati, Ancylostoma sp., Spirometra sp., Mesocestoides sp., Cryptosporidium sp., and Giardia sp. Both tapeworms detected can infect humans, but are not directly transmissible from cats to people. Other parasite diagnostic stages found included Aonchotheca putorii eggs, Cystoisospora felis and Cystoisospora rivolta oocysts, and Sarcocystis sp. sporocysts. The mites Lynxacarus radovskyi and Notoedres cati were detected in feces likely from ingestion while grooming.


Subject(s)
Cat Diseases/parasitology , Parasitic Diseases, Animal/epidemiology , Animals , Cat Diseases/epidemiology , Cats , Florida/epidemiology , Housing, Animal , Prevalence , Zoonoses
16.
Anim Health Res Rev ; 16(2): 150-62, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26568360

ABSTRACT

Toxoplasma gondii is a protozoa that causes toxoplasmosis in people and other animals. It is considered one of the most common parasitic infections in the world due to its impressive range of hosts, widespread environmental contamination and the diverse means by which animals can be infected. Despite its ubiquity and numerous ongoing research efforts into both its basic biology and clinical management, many aspects of diagnosis and management of this disease are poorly understood. The range of diagnostic options that is available for veterinary diagnostic investigators are notably more limited than those available to medical diagnosticians, making accurate interpretation of each test result critical. The current review joins other reviews on the parasite with a particular emphasis on the history and continued development of diagnostic tests that are useful for veterinary diagnostic investigations. An understanding of the strengths and shortcomings of current diagnostic techniques will assist veterinary and public health officials in formulating effective treatment and control strategies in diverse animal populations.


Subject(s)
Diagnostic Tests, Routine/methods , Toxoplasma/physiology , Toxoplasmosis, Animal/diagnosis , Animals , Animals, Wild/parasitology , Antibodies/chemistry , Cats/parasitology , Cattle/parasitology , Dogs/parasitology , Goats/parasitology , Humans , Parasitology/methods , Polymerase Chain Reaction , Sheep/parasitology , Toxoplasmosis/diagnosis , Veterinary Medicine/methods
18.
J Nurs Educ ; 54(3 Suppl): S47-51, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25692824

ABSTRACT

Traditionally, psychomotor skills training for nursing students involves didactic instruction followed by procedural review and practice with a task trainer, manikin, or classmates. This article describes a novel method of teaching psychomotor skills to associate degree and baccalaureate nursing students, Cooperative Learning Simulation Skills Training (CLSST), in the context of nasogastric tube insertion using a deliberate practice-to-mastery learning model. Student dyads served as operator and student learner. Automatic scoring was recorded in the debriefing log. Student pairs alternated roles until they achieved mastery, after which they were assessed individually. Median checklist scores of 100% were achieved by students in both programs after one practice session and through evaluation. Students and faculty provided positive feedback regarding this educational innovation. CLSST in a deliberate practice-to-mastery learning paradigm offers a novel way to teach psychomotor skills in nursing curricula and decreases the instructor-to-student ratio.


Subject(s)
Competency-Based Education/organization & administration , Education, Nursing, Baccalaureate , Intubation, Gastrointestinal , Motor Skills , Practice, Psychological , Simulation Training/organization & administration , Adult , Clinical Competence , Female , Humans , Male , Manikins , Middle Aged , Patient-Specific Modeling
19.
Simul Healthc ; 8(2): 114-23, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23299051

ABSTRACT

INTRODUCTION: Each year millions of patients undergo procedures that require moderate sedation. These patients are at risk of complications from oversedation that can progress to respiratory depression or even death. This article describes the creation of a simulation-based medical education course for nonanesthesiologists who use sedation in their specialty practice and preliminary data from our precourse and postcourse assessments. METHODS: Our course combined online and lecture-based didactics with simulation education to teach moderate sedation and basic emergency airway management to nonanesthesiologists. After online precourse materials were reviewed, participants attended an 8-hour simulation-based training course focused on the recognition of different levels of sedation, medication titration, sedation reversal, and airway support and rescue. To evaluate the course, precourse, and postcourse educational impacts, cognitive and simulation tests were administered. Participants completed a postcourse survey. RESULTS: To date, 45 physicians have participated in the course. We have cognitive performance data on 19 participants and survey data for 45 participants. Postcourse simulation tests results were improved compared with precourse tests. Our course was rated "better" or "much better" in comparison to courses using lecture-only format by 100% of the participants. CONCLUSIONS: A course using a combination of didactic and simulation education to teach moderate sedation is described. Our initial data demonstrated a significant increase in knowledge, skills, and clinical judgment. Future research efforts should focus on examining the validity and reliability of scenario scoring and the impact of training on clinical practice.


Subject(s)
Clinical Competence , Computer Simulation , Conscious Sedation , Education, Medical/methods , Airway Management , Humans
20.
Simul Healthc ; 8(1): 20-4, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22902607

ABSTRACT

INTRODUCTION: The past decade has witnessed the increased use of patient simulation in medical training as a method to teach complex bedside skills. Although effective bag-mask ventilation (BMV) is a critical part of airway management, the quality of training in this skill has been questioned. METHODS: First-year internal medicine house staff (novices) were used to evaluate a computerized patient simulator as a tool to teach difficult BMV. A novice group and an expert group (certified registered nurse anesthetists and anesthesiologists) were tested to validate the simulator's ability to distinguish between these 2 skill levels. RESULTS: The difference between the novice and expert groups in the ability to perform difficult BMV was statistically significant (P < 0.0001). Brief training for novices led to a 100% pass rate and competence as measured by the simulator. Simulation training was effective in increasing the ability to ventilate a simulated difficult-to-ventilate patient (P < 0.0001). CONCLUSIONS: This study suggests that this computerized patient simulator was validated as a simulation model for teaching difficult BMV and differentiating skill levels in BMV. Using the simulator with brief training on difficult BMV allowed new internal medicine house staff to successfully ventilate a simulated difficult patient.


Subject(s)
Computer Simulation , Internal Medicine/education , Intubation, Intratracheal/methods , Masks , Medical Staff, Hospital/education , Anesthesiology/education , Education, Medical, Undergraduate , Educational Measurement/methods , Humans , South Carolina
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