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324 Self-Directed Learning Through Ultrasound Simulator: A Feasibility Study
Research Forum Abstracts equipment, successful REBOA utilization will be contingent on patient selection and common femoral artery access which may not be possible without operative exposure. These areas should become a focus of further training.
324
Self-Directed Learning Through Ultrasound Simulator: A Feasibility Study
Romo E, Field J, Ross S, Pidgeon H, Hutchins C, Christian E, Bailitz J/Cook County Emergency Medicine Residency, Chicago, IL; Rush University Medical Center, Chicago, IL
Study Objective: Clinical ultrasound (CUS) utilization continues to increase across medicine, from practicing physicians to medical student education. Evidence suggests that simulator training is comparable to human models when learning the Focused Assessment with Sonography in Trauma (FAST) US exam. The purpose of this pilot study was to measure the effectiveness of incorporating a novel US simulator into medical student ultrasound training in addition to assessing students’ attitudes concerning its use. Methods: This prospective observational study was performed January-February 2016 during a first-year medical student CUS elective. Students had no prior FAST training. A pre-survey assessed attitudes of online learning and exposure to simulation technology. A validated FAST Standardized Direct Observation Tool (SDOT) assessment was administered independently to students by emergency US faculty (EUSF) or fellow. A review of FAST image acquisition was then provided. Each participant was given a SonoSim US simulator and one week to complete the educational intervention. The intervention included a SonoSim online didactic and 5 cases requiring image acquisition and interpretation. After one week, students reviewed recorded case images with the EUSF and a post-educational intervention FAST SDOT was performed. Students completed a post-survey assessing attitudes towards future use. Results: The average age was 23.7 (58% female, 42% male). All students completed the pre-survey. Regarding interest in use of simulation technology, 9% were extremely interested, 61% were eager to learn more, and 30% were somewhat interested. All students completed a pre and post intervention SDOT. On the pre intervention SDOT, 4% of the students were rated by the EUS faculty or fellows as being able to perform a FAST exam independently, compared to 57% on the post intervention SDOT (p-value ¼ 0.0001 using two-tailed Z score with alpha of 0.05). Of the four FAST views, the average number of adequate views obtained by the students was one on the pre intervention SDOT, compared to three of four on the post intervention SDOT (p-value ¼ 0.0007 using two-tailed Z score with alpha of 0.05). 21 of 23 students completed the post-survey. 90% reported 1-3 hours of independent learning and 10% reported 3-5 hours required for completion of the didactic and five cases. Reported ease of use, 5% were neutral, 57% somewhat easy and 38% very easy. 52% liked and 48% loved utilizing the SonoSim. 100% replied that they would be interested in future use of the SonoSim. Conclusion: Survey results demonstrate that students enjoyed incorporating simulation in the CUS curriculum. Performance improved after the educational intervention. Future plans include testing students at one and three months to assess retention of skills, increase sample size, include students not in the US elective and blinding examiners to assess student performance.
Volume 68, no. 4s : October 2016
325
SimLIFE
Carter K, Joshi N, Pike L, Sivasankar S, Pike L/Stanford/Kaiser Emergency Medicine Residency, Stanford, CA; Stanford University, Stanford, CA
Study Objective: Simulation has become an integral part of medical education through experiential learning. Evidence supports the benefits of low and high fidelity simulation and debriefing discussions. Currently the reliance upon small groups and live debriefings has limited the application of simulation to curricula that mandates learner and educator to gather simultaneously for a set period of time. These stipulations limit the number of learners reached, and thus the impact. There is growing interest in combining social media and medical education, but a dearth of studies demonstrating that social media enhances medical simulation. The SimLIFE project goal is to reach an increased number of potential learners through social media resources. Our research question to study: Is there a significant difference in perceived learning outcomes achieved between emergency physicians when medical simulation debriefing is held in person, video conference, or online asynchronously? To address this, we created an online curriculum of medical simulation cases involving resuscitation of critically ill patients. The aim of this project is to show that through social media, money, time, and geography does not have to be a limiting factor for small group medical education with simulation. We are funded through VPOL seed grant awarded in 2015. Methods: The initial curriculum involves four staged videos filmed using simulated patients and task trainer manikins. These videos will be shown to graduate medical learners to compare live debriefing with debriefing conducted synchronously through online video conferencing and asynchronously on a blog post with debriefing conducted through the comments section. Each group will include 9 learners who will undergo the control (live debriefing) and intervention (synchronous online) study arms using different videos. The study will be performed twice in total with four groups of learners (36 learners). A pre- and post-test of knowledge gained and learner attitudes for each of the 4 video cases will be administered. The results will be analyzed using Wilcoxon Signed Rank test while learner attitudes will be assessed via a 5-point Likert scale. For both study arms, online synchronous and live, debriefing sessions will follow the same format. A separate, third arm of the study will assess learner experience for those who watch the video posted on a blog with debriefing conducted through the comments section asynchronously. Anticipated Challenges: We anticipate the challenge of obtaining 36 graduate learners but will use grant funding for nominal prize of amazon gift card. Next Steps: Our next step involves recruitment of emergency medicine graduate medical learners and creation of pre- and post-tests. In the future, we hope to develop a parallel curriculum in Spanish to repeat the same study with graduate medical learners in El Salvador and with English-speaking medical learners in India.
326
Use of a Didactic Low Fidelity Simulated Model to Measure Objective Improvement in Corneal Foreign Body Removal
Truong K, Janssen A, Moore C, LaBond V/Genesys Regional Medical Center, Grand Blanc, MI
Study Objectives: Removal of ocular foreign bodies requires a unique skill set. We designed a low cost, low fidelity model that allows trainees to develop this skill set. The objective was to improve foreign body removal skills. Our goal was to quantify improvement with goal-oriented didactics compared to skill-only training. Methods: Twenty eight medical students and emergency medicine residents enrolled. Fifteen were assigned to experimental group and thirteen to control. Groups practiced foreign body removal on a simulated model with no instruction. Each subject was evaluated on a 15-point scoring system. The experimental group was provided a lecture on foreign body removal. The control group was provided a lecture on ocular emergencies (not including foreign body removal). Both groups repeated the exercise. Differences in scores between the groups were tested using a two-way Repeated Measures ANOVA. Change in score was calculated using a paired analysis and then each mean change score was compared for differences using the Independent T-test analysis. Results: There was a significant increase in score in the experimental group from attempt 1 (average score 5.40) to attempt 2 (average score 10.40) (p < 0.05). There
Annals of Emergency Medicine S125
324
Self-Directed Learning Through Ultrasound Simulator: A Feasibility Study
Romo E, Field J, Ross S, Pidgeon H, Hutchins C, Christian E, Bailitz J/Cook County Emergency Medicine Residency, Chicago, IL; Rush University Medical Center, Chicago, IL
Study Objective: Clinical ultrasound (CUS) utilization continues to increase across medicine, from practicing physicians to medical student education. Evidence suggests that simulator training is comparable to human models when learning the Focused Assessment with Sonography in Trauma (FAST) US exam. The purpose of this pilot study was to measure the effectiveness of incorporating a novel US simulator into medical student ultrasound training in addition to assessing students’ attitudes concerning its use. Methods: This prospective observational study was performed January-February 2016 during a first-year medical student CUS elective. Students had no prior FAST training. A pre-survey assessed attitudes of online learning and exposure to simulation technology. A validated FAST Standardized Direct Observation Tool (SDOT) assessment was administered independently to students by emergency US faculty (EUSF) or fellow. A review of FAST image acquisition was then provided. Each participant was given a SonoSim US simulator and one week to complete the educational intervention. The intervention included a SonoSim online didactic and 5 cases requiring image acquisition and interpretation. After one week, students reviewed recorded case images with the EUSF and a post-educational intervention FAST SDOT was performed. Students completed a post-survey assessing attitudes towards future use. Results: The average age was 23.7 (58% female, 42% male). All students completed the pre-survey. Regarding interest in use of simulation technology, 9% were extremely interested, 61% were eager to learn more, and 30% were somewhat interested. All students completed a pre and post intervention SDOT. On the pre intervention SDOT, 4% of the students were rated by the EUS faculty or fellows as being able to perform a FAST exam independently, compared to 57% on the post intervention SDOT (p-value ¼ 0.0001 using two-tailed Z score with alpha of 0.05). Of the four FAST views, the average number of adequate views obtained by the students was one on the pre intervention SDOT, compared to three of four on the post intervention SDOT (p-value ¼ 0.0007 using two-tailed Z score with alpha of 0.05). 21 of 23 students completed the post-survey. 90% reported 1-3 hours of independent learning and 10% reported 3-5 hours required for completion of the didactic and five cases. Reported ease of use, 5% were neutral, 57% somewhat easy and 38% very easy. 52% liked and 48% loved utilizing the SonoSim. 100% replied that they would be interested in future use of the SonoSim. Conclusion: Survey results demonstrate that students enjoyed incorporating simulation in the CUS curriculum. Performance improved after the educational intervention. Future plans include testing students at one and three months to assess retention of skills, increase sample size, include students not in the US elective and blinding examiners to assess student performance.
Volume 68, no. 4s : October 2016
325
SimLIFE
Carter K, Joshi N, Pike L, Sivasankar S, Pike L/Stanford/Kaiser Emergency Medicine Residency, Stanford, CA; Stanford University, Stanford, CA
Study Objective: Simulation has become an integral part of medical education through experiential learning. Evidence supports the benefits of low and high fidelity simulation and debriefing discussions. Currently the reliance upon small groups and live debriefings has limited the application of simulation to curricula that mandates learner and educator to gather simultaneously for a set period of time. These stipulations limit the number of learners reached, and thus the impact. There is growing interest in combining social media and medical education, but a dearth of studies demonstrating that social media enhances medical simulation. The SimLIFE project goal is to reach an increased number of potential learners through social media resources. Our research question to study: Is there a significant difference in perceived learning outcomes achieved between emergency physicians when medical simulation debriefing is held in person, video conference, or online asynchronously? To address this, we created an online curriculum of medical simulation cases involving resuscitation of critically ill patients. The aim of this project is to show that through social media, money, time, and geography does not have to be a limiting factor for small group medical education with simulation. We are funded through VPOL seed grant awarded in 2015. Methods: The initial curriculum involves four staged videos filmed using simulated patients and task trainer manikins. These videos will be shown to graduate medical learners to compare live debriefing with debriefing conducted synchronously through online video conferencing and asynchronously on a blog post with debriefing conducted through the comments section. Each group will include 9 learners who will undergo the control (live debriefing) and intervention (synchronous online) study arms using different videos. The study will be performed twice in total with four groups of learners (36 learners). A pre- and post-test of knowledge gained and learner attitudes for each of the 4 video cases will be administered. The results will be analyzed using Wilcoxon Signed Rank test while learner attitudes will be assessed via a 5-point Likert scale. For both study arms, online synchronous and live, debriefing sessions will follow the same format. A separate, third arm of the study will assess learner experience for those who watch the video posted on a blog with debriefing conducted through the comments section asynchronously. Anticipated Challenges: We anticipate the challenge of obtaining 36 graduate learners but will use grant funding for nominal prize of amazon gift card. Next Steps: Our next step involves recruitment of emergency medicine graduate medical learners and creation of pre- and post-tests. In the future, we hope to develop a parallel curriculum in Spanish to repeat the same study with graduate medical learners in El Salvador and with English-speaking medical learners in India.
326
Use of a Didactic Low Fidelity Simulated Model to Measure Objective Improvement in Corneal Foreign Body Removal
Truong K, Janssen A, Moore C, LaBond V/Genesys Regional Medical Center, Grand Blanc, MI
Study Objectives: Removal of ocular foreign bodies requires a unique skill set. We designed a low cost, low fidelity model that allows trainees to develop this skill set. The objective was to improve foreign body removal skills. Our goal was to quantify improvement with goal-oriented didactics compared to skill-only training. Methods: Twenty eight medical students and emergency medicine residents enrolled. Fifteen were assigned to experimental group and thirteen to control. Groups practiced foreign body removal on a simulated model with no instruction. Each subject was evaluated on a 15-point scoring system. The experimental group was provided a lecture on foreign body removal. The control group was provided a lecture on ocular emergencies (not including foreign body removal). Both groups repeated the exercise. Differences in scores between the groups were tested using a two-way Repeated Measures ANOVA. Change in score was calculated using a paired analysis and then each mean change score was compared for differences using the Independent T-test analysis. Results: There was a significant increase in score in the experimental group from attempt 1 (average score 5.40) to attempt 2 (average score 10.40) (p < 0.05). There
Annals of Emergency Medicine S125