The effects of simulation training on learning of health information systems: A scoping review.

One of the most commonly used methods for training is simulation. It is important to examine the effects of simulation training of health information systems on the knowledge, attitude, and skill in trainees. This review provided a summary of relevant literature on how simulation training affects the learning of health information systems and determine the features and functional capabilities of existing simulators. Studies and websites using simulation training to teach health information systems were included. Studies were searched through Medline (via PubMed), Scopus, and ISI Web of Science and websites through Google search by the end of 2019. The characteristics of studies, features, and functional capabilities of simulators and effects on learning outcomes were extracted. The included studies and websites were categorized according to different characteristics including simulation types, learning outcome categories, and the effects of simulation training on learning outcomes. The learning outcomes were categorized into four groups: knowledge, attitude, skill, and satisfaction. The effects of interventions on outcomes were categorized into statistically significant positive, positive without statistical argument, no effect (not statistically significant), negative without statistical argument, or statistically significant negative. Ten studies and eight websites that used simulation training to teach health information systems (mainly electronic health record [EHR]) were included. EHR simulation was performed in 80% of the included studies and trainees in 70% of studies were physicians and nurses. All studies were conducted in three developed countries. In the included studies, four learning outcomes (i.e. skill, attitude, knowledge, and satisfaction) were assessed. Ninety percent of the included studies assessed skill-related outcomes, with more than half mentioning significant improvement. Thirty percent of the included studies assessed outcomes-related knowledge and attitude, all of which reported the positive effects of simulation training. The simulators offered a variety of functional capabilities, while all of which simulated the clinical data entry process. In teaching health information systems, especially EHRs, simulation training enhances skill, attitude, knowledge, and satisfaction of health-care providers and students.

Design, development, and evaluation of an interactive training simulator for teaching hospital information systems.

BACKGROUND: In their apprenticeship program, health information technology (HIT) students are deprived of the ample opportunity to work with the hospital information system (HIS). This study aimed to design an interactive simulator for the HIS training and evaluate its effects on the informatics skills of HIT students. MATERIALS AND METHODS: This study was conducted on 16 Bachelor of Science students of HIT at Kashan University of Medical Sciences in 2019. After the functionalities and features of the simulator were determined based on similar existing simulators, expert opinions were received to simulate eight important processes of admission, discharge, and transfer module in HIS. The scores of students' skills and time taken to perform the processes were recorded and analyzed before and after the educational intervention. After they were trained by the simulator, the students filled out a usability evaluation questionnaire. The data were then analyzed in SPSS version 21. RESULTS: The simulators of health information systems were characterized by interactivity, multimedia applications, practice exercises, tests, and feedback. After the students were trained by the developed simulator, their skills scores improved significantly in 75% (6/8) of the processes, and the timespans of all processes decreased significantly (P < 0.05). The usability evaluation indicated the usability of the simulator was at a "good" level. CONCLUSIONS: According to the study results, using the simulator improves the informatics skills of HIT students in working with HIS. It is recommended that this method also be used in other apprenticeship programs to teach health information systems.

Effectiveness of m-learning on knowledge and attitude of nurses about the prevention and control of MDR TB: A quasi-randomized study.

BACKGROUND: Multidrug-Resistant Tuberculosis is a fatal form because of high morbidity and poor recovery. Improper use of first line medicines and default treatment are the prime reasons of developing resistance of mycobacterium towards conventional anti- TB drugs. Nurses with refined knowledge, current evidence and positive attitude can prevent arising of MDR TB cases by ensuring adequate treatment, promoting treatment adherence and real time case monitoring. Because of paucity of data, present study was aimed to assess efficacy of m-learning in improving knowledge and attitude of nurses about the prevention and control of MDR-TB. METHODS: In this Quasi-randomized study, nurses working in the unit of pulmonary, emergency, respiratory ICU, general medicine of AIIMS Rishikesh during the months of August-October 2019 were involved. The number of participation was 190 (95 in each group; experimental and control) where m-learning intervention was available only for experimental group. There were structured questionnaire to measure knowledge and dichotomous checklist to evaluate attitude of nurses of both group before and one week after the provision of m-learning module. RESULTS: Both the group was homogeneous and m-learning intervention was effective to improve knowledge, when compared post-test knowledge score between experimental and control group (18.2 ± 5.4 vs 12.4 ± 4.4; P < 0.001); however, this one-time social media based intervention could not improve attitude of participants (10.3 ± 1.8 vs. 9.9 ± 1.8; P = 0.175). CONCLUSION: Hence, m-learning is useful for knowledge development among large number of nurses within limited resource setting but frequent provision of technology based module is recommended to acquire positive attitude among nurses.

Association between evidence-based training and clinician proficiency in electronic health record use.

OBJECTIVES: The purpose of the study was to determine if association exists between evidence-based provider training and clinician proficiency in electronic health record (EHR) use and if so, which EHR use metrics and vendor-defined indices exhibited association. MATERIALS AND METHODS: We studied ambulatory clinicians' EHR use data published in the Epic Systems Signal report to assess proficiency between training participants (n = 133) and nonparticipants (n = 14). Data were collected in May 2019 and November 2019 on nonsurgeon clinicians from 6 primary care, 7 urgent care, and 27 specialty care clinics. EHR use training occurred from August 5 to August 15, 2019, prior to EHR upgrade and organizational instance alignment. Analytics performed were descriptive statistics, paired t-tests, multivariate correlations, and hierarchal multiple regression. RESULTS: For number of appointments per 30-day reporting period, trained clinicians sustained an average increase of 16 appointments (P < .05), whereas nontrained clinicians incurred a decrease of 8 appointments. Only the trained clinician group achieved postevent improvement in the vendor-defined Proficiency score with an effect size characterized as moderate to large (dCohen = 0.625). DISCUSSION: Controversies exist on the return of investment from formal EHR training for clinician users. Previously published literature has mostly focused on qualitative data indicators of EHR training success. The findings of our EHR use training study identified EHR use metrics and vendor-defined indices with the capacity for translation into productivity and generated revenue measurements. CONCLUSIONS: One EHR use metric and 1 vendor-defined index indicated improved proficiency among trained clinicians.

Reducing electronic health record-related burnout in providers through a personalized efficiency improvement program.

OBJECTIVE: To give providers a better understanding of how to use the electronic health record (EHR), improve efficiency, and reduce burnout. MATERIALS AND METHODS: All ambulatory providers were offered at least 1 one-on-one session with an "optimizer" focusing on filling gaps in EHR knowledge and lack of customization. Success was measured using pre- and post-surveys that consisted of validated tools and homegrown questions. Only participants who returned both surveys were included in our calculations. RESULTS: Out of 1155 eligible providers, 1010 participated in optimization sessions. Pre-survey return rate was 90% (1034/1155) and post-survey was 54% (541/1010). 451 participants completed both surveys. After completing their optimization sessions, respondents reported a 26% improvement in mean knowledge of EHR functionality (P < .01), a 19% increase in the mean efficiency in the EHR (P < .01), and a 17% decrease in mean after-hours EHR usage (P < .01). Of the 401 providers asked to rate their burnout, 32% reported feelings of burnout in the pre-survey compared to 23% in the post-survey (P < .01). Providers were also likely to recommend colleagues participate in the program, with a Net Promoter Score of 41. DISCUSSION: It is possible to improve provider efficiency and feelings of burnout with a personalized optimization program. We ascribe these improvements to the one-on-one nature of our program which provides both training as well as addressing the feeling of isolation many providers feel after implementation. CONCLUSION: It is possible to reduce burnout in ambulatory providers with personalized retraining designed to improve efficiency and knowledge of the EHR.

Computerized attention training for visually impaired older adults with dementia: a case study.

Dementia causes disorders in multiple higher cortical functions. Visual impairment could further impact cognition in those with dementia. This study reports the results of a computerized attention training program in a patient with dementia and visual impairment. The case involves a 98-year-old woman with bilateral maculopathy and moderate dementia. The program consisted of pre- and post-assessments and training sessions. Assessments included the Cantonese version of the Mini-Mental State Examination, the digit span forward test, the Chinese version of the Verbal Learning Test (CVVLT), and the Test of Attentional Performance (TAP). Training sessions were conducted once to twice a week for a total of 8 45-minute sessions. The participant showed a decrease in the CVVLT score and improvements in TAP parameters. The results indicated that, in visually impaired older adults with dementia, attention and processing speed (measured by a sensitive test such as TAP) could potentially be improved with appropriate computerized training.

A demência causa distúrbios em várias funções corticais superiores. O comprometimento da visão pode impactar ainda mais a cognição em pessoas com demência. Este estudo relata os resultados de um programa de treinamento computadorizado de atenção em um paciente com demência e deficiência visual, uma mulher de 98 anos com maculopatia bilateral e demência moderada. O programa consistia em avaliações e pré- e pós-sessões de treinamento. As avaliações incluíram o Mini-Exame do Estado Mental em Cantonês, o teste de extensão de dígitos, a versão chinesa do Teste de Aprendizagem Verbal (CVVLT) e o Teste de Desempenho de Atenção (TAP). As sessões de treinamento foram realizadas uma a duas vezes por semana, com um total de 8 sessões de 45 minutos. A paciente apresentou diminuição no escore CVVLT e melhora nos parâmetros TAP. Os resultados indicaram que em idosos com deficiência visual com demência, a atenção e a velocidade de processamento (medida por um teste sensível como o TAP) poderiam ser melhoradas com a realização de treinamento computadorizado adequado.

Computerized attention training for visually impaired older adults with dementia: a case study / Treino de atenção computadorizado para idosos com comprometimento visual e demência: um estudo de caso

ABSTRACT. Dementia causes disorders in multiple higher cortical functions. Visual impairment could further impact cognition in those with dementia. This study reports the results of a computerized attention training program in a patient with dementia and visual impairment. The case involves a 98-year-old woman with bilateral maculopathy and moderate dementia. The program consisted of pre- and post-assessments and training sessions. Assessments included the Cantonese version of the Mini-Mental State Examination, the digit span forward test, the Chinese version of the Verbal Learning Test (CVVLT), and the Test of Attentional Performance (TAP). Training sessions were conducted once to twice a week for a total of 8 45-minute sessions. The participant showed a decrease in the CVVLT score and improvements in TAP parameters. The results indicated that, in visually impaired older adults with dementia, attention and processing speed (measured by a sensitive test such as TAP) could potentially be improved with appropriate computerized training.

RESUMO. A demência causa distúrbios em várias funções corticais superiores. O comprometimento da visão pode impactar ainda mais a cognição em pessoas com demência. Este estudo relata os resultados de um programa de treinamento computadorizado de atenção em um paciente com demência e deficiência visual, uma mulher de 98 anos com maculopatia bilateral e demência moderada. O programa consistia em avaliações e pré- e pós-sessões de treinamento. As avaliações incluíram o Mini-Exame do Estado Mental em Cantonês, o teste de extensão de dígitos, a versão chinesa do Teste de Aprendizagem Verbal (CVVLT) e o Teste de Desempenho de Atenção (TAP). As sessões de treinamento foram realizadas uma a duas vezes por semana, com um total de 8 sessões de 45 minutos. A paciente apresentou diminuição no escore CVVLT e melhora nos parâmetros TAP. Os resultados indicaram que em idosos com deficiência visual com demência, a atenção e a velocidade de processamento (medida por um teste sensível como o TAP) poderiam ser melhoradas com a realização de treinamento computadorizado adequado.

Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges.

The increasingly digitized healthcare system requires new skills from all those involved. In order to impart these competencies, appropriate courses must be developed at educational institutions. In view of the rapid development of new aspects of digitization, this presents a challenge; suitable teaching formats must be developed successively. The establishment of cross-location teaching networks is one way to better meet training needs and to make the necessary spectrum of educational content available. As part of the Medical Informatics Initiative, the HiGHmed consortium is establishing such a teaching network, in the field of medical informatics, which covers many topics related to the digitization of the health care system. Various problem areas in the German education system were identified that hinder the development of the teaching network. These problem areas were prioritized firstly according to the urgency of the solution from the point of view of the HiGHmed consortium and secondly according to existing competencies in the participating societies. A workshop on the four most relevant topics was organized with experts from the German Society for Medical Informatics, Biometry and Epidemiology (GMDS), the Society for Medical Education (GMA) and the HiGHmed consortium. These are: recognition of exam results from teaching modules that are offered digitally and across locations, and their integration into existing curricula; recognition of digital, cross-location teaching in the teachers' teaching load; nationwide uniform competencies for teachers, in order to be able to conduct digital teaching effectively and with comparable quality; technical infrastructure to efficiently and securely communicate and manage the recognition of exam results between educational institutions. For all subject areas, existing preliminary work was identified on the basis of working questions, and short- and long-term needs for action were formulated. Finally, a need for the redesign of a technologically supported syntactic and semantic interoperability of learning performance recording was identified.

Physician champions' perspectives and practices on electronic health records implementation: challenges and strategies.

OBJECTIVE: Physician champions are "boots on the ground" physician leaders who facilitate the implementation of, and transition to, new health information technology (HIT) systems within an organization. They are commonly cited as key personnel in HIT implementations, yet little research has focused on their practices and perspectives. MATERIALS AND METHODS: We addressed this research gap through a qualitative study of physician champions that aimed to capture their challenges and strategies during a large-scale HIT implementation. Email interviews were conducted with 45 physician champions from diverse clinical areas 5 months after a new electronic health record (EHR) system went live in a large academic medical center. We adopted a grounded theory approach to analyze the data. RESULTS: Our physician champion participants reported multiple challenges, including insufficient training, limited at-the-elbow support, unreliable communication with leadership and the EHR vendor, as well as flawed system design. To overcome these challenges, physician champions developed their own personalized training programs in a simulated context or in the live environment, sought and obtained more at-the-elbow support both internally and externally, and adapted their departmental sociotechnical context to make the system work better. DISCUSSION AND CONCLUSIONS: This study identified the challenges physician champions faced and the strategies they developed to overcome these challenges. Our findings suggest factors that are crucial to the successful involvement of physician champions in HIT implementations, including the availability of instrumental (eg, reward for efforts), emotional (eg, mechanisms for expressing frustrations), and peer support; ongoing engagement with the champions; and appropriate training and customization planning.

Identification of Factors Influencing the Adoption of Health Information Technology by Nurses Who Are Digitally Lagging: In-Depth Interview Study.

BACKGROUND: The introduction of health information technology (HIT) has drastically changed health care organizations and the way health care professionals work. Some health care professionals have trouble coping efficiently with the demands of HIT and the personal and professional changes it requires. Lagging in digital knowledge and skills hampers health care professionals from adhering to professional standards regarding the use of HIT and may cause professional performance problems, especially in the older professional population. It is important to gain more insight into the reasons and motivations behind the technology issues experienced by these professionals, as well as to explore what could be done to solve them. OBJECTIVE: Our primary research objective was to identify factors that influence the adoption of HIT in a sample of nurses who describe themselves as digitally lagging behind the majority of their colleagues in their workplaces. Furthermore, we aimed to formulate recommendations for practice and leadership on how to help and guide these nurses through ongoing digital transformations in their health care work settings. METHODS: In a Dutch university medical center, 10 face-to-face semi-structured interviews were performed with registered nurses (RN). Ammenwerth's FITT-framework (fit between the Individual, Task, and Technology) was used to guide the interview topic list and to formulate themes to explore. Thematic analysis was used to analyze the interview data. The FITT-framework was also used to further interpret and clarify the interview findings. RESULTS: Analyses of the interview data uncovered 5 main categories and 12 subthemes. The main categories were: (1) experience with digital working, (2) perception and meaning, (3) barriers, (4) facilitators, and (5) future perspectives. All participants used electronic devices and digital systems, including the electronic health record. The latter was experienced by some as user-unfriendly, time-consuming, and not supportive in daily professional practice. Most of the interviewees described digital working as "no fun at all," "working in a fake world," "stressful," and "annoying." There was a lack of general digital knowledge and little or no formal basic digital training or education. A negative attitude toward computer use and a lack of digital skills contributed to feelings of increased incompetency and postponement or avoidance of the use of HIT, both privately and professionally. Learning conditions of digital training and education did not meet personal learning needs and learning styles. A positive impact was seen in the work environment when colleagues and nurse managers were aware and sensitive to the difficulties participants experienced in developing digital skills, and when there was continuous training on the job and peer support from digitally savvy colleagues. The availability of a digital play environment combined with learning on the job and support of knowledgeable peers was experienced as helpful and motivating by participants. CONCLUSIONS: Nurses who are digitally lagging often have had insufficient and ineffective digital education. This leads to stress, frustration, feelings of incompetency, and postponement or avoidance of HIT use. A digital training approach tailored to the learning needs and styles of these nurses is needed, as well as an on-the-job training structure and adequate peer support. Hospital management and nurse leadership should be informed about the importance of the fit between technology, task, and the individual for adequate adoption of HIT.

Modelo de capacitação para realização do processo de enfermagem em sistema informatizado / Training model for carrying out the nursing process in a computerized system

Resumo: O Processo de Enfermagem na prática assistencial, é um importante método de organização do trabalho de enfermagem, pois permite organizar e planejar as ações de enfermagem a partir da tomada de decisão do enfermeiro. Neste estudo, o Processo de Enfermagem enfatiza o processo de enfermagem informatizado. Desse modo, elaborou-se a seguinte questão norteadora: Como construir um modelo de capacitação para enfermeiros para a realização do processo de enfermagem informatizado? Objetivo geral: Propor um modelo para a capacitação de enfermeiros das unidades assistenciais do Estado do Paraná para realização do processo de enfermagem com auxílio de sistema informatizado. Metodologia: A pesquisa é descritiva e faz parte de um estudo de métodos mistos, descritivo exploratório, desenvolvido junto à Superintendência das Unidades Próprias do Estado do Paraná (SUP), no período de setembro de 2019 a novembro de 2019. Os participantes da pesquisa foram agrupados em dois grupos distintos, nominados de grupo "A" e grupo "B". O "A" foram reunidos 19 enfermeiros e demais membros da equipe Servidores que participaram ativamente do planejamento, desenvolvimento, implementação e capacitação do módulo da SAE do GSUS nos hospitais próprios da SESA, neste grupo os dados foram coletados mediante a realização de Grupo Focal. O grupo "B" foi composto por 47 enfermeiros assistenciais das unidades de Terapia Intensiva, com experiência no uso do Módulo da SAE do Sistema de Gestão da Assistência de Saúde do Sistema Único de Saúde - GSUS. A coleta de dados foi realizada mediante questionário online autodirigido, que abrangeu as experiências positivas e as dificuldades que o GSUS oferece para implementação do Processo de Enfermagem. Resultados: Após análise dos dados do grupo "A" pelo IRAMUTEC, foram identificadas duas classes distintas: os pontos positivos sobre a capacitação e os desafios sobre a capacitação. No grupo "B" ressalta-se as respostas ao questionário que remetem a necessidade da implementação total e capacitação continuada para o entendimento do módulo GSUS. Com base nos dados coletados nos grupos "A" e "B" foi elaborada uma proposta de modelo de capacitação, como produto final deste estudo. Conclusão: Ciente dos desafios que o enfermeiro tem no seu dia a dia na elaboração e compreensão do Processo de Enfermagem, a proposição de um modelo de capacitação informatizado, permeada de sugestões facilitadoras, surge como uma alternativa de ensino-aprendizagem para a utilização plena do módulo GSUS.

Abstract: The Nursing Process in care practice is an important method of organizing nursing work, as it allows the organization and planning of nursing actions based on the nurse's decision making. In this study, the Nursing Process emphasizes the computerized nursing process. Thus, the following guiding question was elaborated: How to build a training model for nurses to carry out the computerized nursing process? General objective: To propose a model for the training of nurses of the care units of the State of Paraná to perform the nursing process with the aid of a computerized system. Methodology: The research is descriptive and is part of a study of mixed methods, exploratory descriptive, developed with the Superintendence of the Paraná State Own Units (SUP), from April 2018 to November 2019. The research participants were grouped in two distinct groups, named group "A" and group "B". The "A" consisted of 19 nurses and other Servers team members who actively participated in the planning, development, implementation and training of the GSUS SAE module in SESA's own hospitals. In this group the data were collected through the Focus Group. Group "B" consisted of 47 intensive care unit nurses with experience in using the SAE Module of the Health Care Management System of the Unified Health System - GSUS. Data collection was performed through a self-directed online questionnaire, which covered the positive experiences and difficulties that GSUS offers to implement the Nursing Process. Results: After analysis of the data from group "A" by IRAMUTEC, two distinct classes were identified: the strengths on training and the challenges on training. In group "B", the answers to the questionnaire highlighting the need for full implementation and continued training for understanding the GSUS module. Based on the data collected in groups "A" and "B", a training model proposal was elaborated as the final product of this study. Conclusion: Aware of the challenges that nurses have in their daily life in the elaboration and understanding of the Nursing Process, the proposition of a computerized training model, permeated by facilitating suggestions, emerges as an alternative of teaching and learning for the full use of the Nursing Process. GSUS module.

Blended learning: An effective methodology for teaching radiology to medical students / Aprendizaje mixto: una metodología efectiva para la enseñanza de radiología a estudiantes de medicina

Abstract Introduction: The combination of online learning environments and classroom education is known as blended learning. Objective: To design, implement and evaluate the blended learning method for teaching radiology to medical students. Materials and methods: Five online modules were designed as part of the Introduction to diagnostic imaging course for medical students. The blended learning method was implemented during the classes given in the terms 2016-II and 2017-I. Academic performance was measured using standardized tests, while the effect of the intervention was obtained by comparing the sample with a control group from the 2015-II period (traditional method). Results: 204 students were included in the blended learning group and 90 students in the control group (traditional method). The median final exam score among the blended learning group was 16.5 (IQR: 15.5-17.8), and 15.0 (RIQ: 13.5-16.5) (p=0.001) in the control group. On average, gained knowledge among the blended learning group was 5.8 (SD:2.4) points. The association between gained knowledge and number of visits to online modules was statistically significant (p<0.05). The proportion of good performance was close to 100% on the satisfaction survey. Conclusions: The blended learning method increases the grades obtained in the tests performed and also shows higher satisfaction rates compared to the traditional method among medical students.

Resumen Introducción. La inclusión de ambientes virtuales de aprendizaje a la educación presencial se denomina aprendizaje mixto (Blended Learning). Objetivos. Diseñar, implementar y evaluar una metodología de aprendizaje mixto para la enseñanza de radiología a estudiantes de medicina. Materiales y métodos. Se diseñaron cinco módulos virtuales como parte del curso Introducción a las Imágenes Diagnósticas. La metodología de aprendizaje mixto se implementó durante los periodos 2016-II y 2017-I; se obtuvieron desenlaces de desempeño académico con pruebas estandarizadas y se evaluó el efecto de la intervención mediante la comparación con un grupo control del período 2015-II. Resultados. 204 estudiantes fueron incluidos en el grupo de aprendizaje mixto y 90 en el grupo control. La mediana de la nota final en el grupo de educación mixta fue de 16.5 (RIQ: 15.5-17.8) y en el grupo control de 15.0 (RIQ: 13.5-16.5) (p=0.001). La ganancia de conocimiento promedio en el grupo de aprendizaje mixto fue de 5.8 puntos (desviación estándar: 2.4) y se asoció con el número de visitas a los módulos virtuales (p<0.05). El porcentaje de estudiantes satisfechos fue cercano al 100%. Conclusión. La metodología de aprendizaje mixto aumenta el puntaje de calificación obtenido por los estudiantes y presenta altos índices de satisfacción en comparación con la metodología convencional.

[Effects of a Virtual Reality Simulation and a Blended Simulation of Care for Pediatric Patient with Asthma]. / 천식 아동 간호에 대한 가상현실 ì‹œë®¬ë ˆì´ì ˜ê³¼ ë¸”ë Œë””ë“œ ì‹œë®¬ë ˆì´ì ˜ 교육 효과.

PURPOSE: The purpose of this study was to examine the effects of a virtual reality simulation and a blended simulation on nursing care for children with asthma through an evaluation of critical thinking, problem-solving processes, and clinical performance in both education groups before and after the educational intervention. METHODS: The participants were 48 nursing students. The experimental group (n=22) received a blended simulation, combining a virtual reality simulation and a high-fidelity simulation, while the control group (n=26) received only a virtual reality simulation. Data were collected from February 25 to 28, 2019 and analyzed using SPSS version 25 for Windows. RESULTS: The pretest and posttest results of each group showed statistically significant improvements in critical thinking, problem-solving processes, and clinical performance. In a comparison of the results of the two education groups, the only statistically significant difference was found for critical thinking. CONCLUSION: Simulation-based education in child nursing has continued to involve high-fidelity simulations that are currently run in many programs. However, incorporating a new type of blended simulation, combining a virtual reality simulation and a high-fidelity simulation, into the nursing curriculum may contribute to the further development of nursing education.

Effects of a Virtual Reality Simulation and a Blended Simulation of Care for Pediatric Patient with Asthma

PURPOSE: The purpose of this study was to examine the effects of a virtual reality simulation and a blended simulation on nursing care for children with asthma through an evaluation of critical thinking, problem-solving processes, and clinical performance in both education groups before and after the educational intervention.METHODS: The participants were 48 nursing students. The experimental group (n=22) received a blended simulation, combining a virtual reality simulation and a high-fidelity simulation, while the control group (n=26) received only a virtual reality simulation. Data were collected from February 25 to 28, 2019 and analyzed using SPSS version 25 for Windows.RESULTS: The pretest and posttest results of each group showed statistically significant improvements in critical thinking, problem-solving processes, and clinical performance. In a comparison of the results of the two education groups, the only statistically significant difference was found for critical thinking.CONCLUSION: Simulation-based education in child nursing has continued to involve high-fidelity simulations that are currently run in many programs. However, incorporating a new type of blended simulation, combining a virtual reality simulation and a high-fidelity simulation, into the nursing curriculum may contribute to the further development of nursing education.

Educación continuada en Radiología: Perspectivas hacia un modelo basado en competencias / Continuing Education Radiology: Perspectives towards a Model Based On Competences

La educación médica continuada hace referencia a la planeación, organización, desarrollo y ejecución de diversas actividades académicas, con el fin de actualizar los conocimientos y desarrollar competencias a lo largo de la vida profesional de los posgraduados. En la especialidad de radiología e imágenes diagnósticas, la renovación del conocimiento va de la mano de los adelantos tecnológicos y la mejor evidencia científica, lo que implica un alto dinamismo en la validez de los mismos. En el presente artículo se revisa cuál es el propósito y justificación de un programa de recertificación en radiología con miras al mejoramiento de la calidad y el desempeño profesional, se discuten diferentes modelos internacionales de formación continuada, así como las metodologías más eficientes para la adquisición de competencias, ajustado a las necesidades y perspectivas de aprendizaje del radiólogo en nuestro país

The continuing medical education (CME) refers to the planning, organization, development and implementation of various academic activities, in order to update knowledge and develop skills throughout the professional life of postgraduates. In the specialty of Radiology and Diagnostic Imaging, renewal of knowledge goes hand in hand with technological advances and the best scientific evidence, which implies a high dynamism in the validity thereof. In this article we review what the purpose and justification of a recertification program in radiology with a view to improving the quality and professional performance, different international models of continuing education are discussed as well as the most efficient methodologies for the acquisition of competencies, tailored to the learning needs and perspectives of the radiologist in our country

Development of the ubiquitous spaced retrieval-based memory advancement and rehabilitation training program.

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0±1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0±4.1; post-USMART, 17.9±4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.

Development of the Ubiquitous Spaced Retrieval-Based Memory Advancement and Rehabilitation Training Program

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0+/-1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0+/-4.1; post-USMART, 17.9+/-4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.