Torrey Laack - Academia.edu (original) (raw)

Papers by Torrey Laack

Additional file 1: Appendix

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Additional file 1.

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Search strategy. (DOCX 14Â kb)

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Telemedicine and e-Health, 2021

Background: Acute care telemedicine is a critical resource for rural and community Emergency Medi... more Background: Acute care telemedicine is a critical resource for rural and community Emergency Medicine (EM) providers. To address potential barriers and promote use of these services throughout our health system Emergency Departments (EDs), we embed telemedicine consultations within in situ simulations. Methods: Care teams in health system EDs participated in multidisciplinary in situ simulations that focused on Difficult Airway management or Obstetric Emergencies. Physicians in EM and Neonatology at the referral center were available for assistance via telemedicine consultation. Participants were then surveyed regarding their experience with the telemedicine consultation during the simulations. Results: Participants reported increased likelihood to use telemedicine as well as increased understanding of the technology, awareness of available consultation services, and comfort interacting with the consultant. Conclusions: Embedding telemedicine consultations into in situ EM simulations is an effective approach to address implementation barriers and may promote increased use of telemedicine services among rural and community EM providers.

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Education for Health, 2016

The West African Ebola epidemic that began in 2014 has exposed the vulnerability of medical facil... more The West African Ebola epidemic that began in 2014 has exposed the vulnerability of medical facilities when a patient presents with a life‐threatening and highly contagious infectious disease. The transmissibility and extremely high morbidity and mortality of Ebola Virus Disease (EVD) make it unique among infectious diseases. This epidemic has specifically been more challenging than prior threats due to the high infection risk of all those in contact, requiring multidisciplinary coordination to minimize risk to other patients, staff and the community. This is not the first time that an epidemic has created a time‐sensitive and complex task for hospitals across North America and the world. Previous epidemics, including novel influenza A/H1N1 in 2009 and Severe Acute Respiratory Syndrome (SARS) in 2003, have demonstrated that there are significant barriers to developing these strategies. Disaster planning and training remains a complex process, and implementation of hospital‐wide plans can be daunting, especially when information and responses need to change daily.

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BMC medical education, Jan 27, 2016

Evidence suggests that poor performance on standardized tests before and early in medical school ... more Evidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships. We evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000-2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available. We assessed the correlation between scores and assessments and determined USMLE 1 cutoffs predictive of poor performance (≤10th percentile) on the NBME examinations. We also compared the mean faculty assessment scores of MMS stud...

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A Tool for Bringing the Curriculum to Life, 2013

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Academic Emergency Medicine, 2008

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Academic Emergency Medicine, 2008

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Background The ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation for Learning) theor... more Background The ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation for Learning) theory of motor learning suggests that autonomy, external focus of attention, and perceived competence can improve learning of simple motor tasks. The authors hypothesized that enhanced (vs. routine) autonomy and external (vs. internal) focus of attention would improve first-try performance of two medical motor tasks.Methods The authors conducted a randomized two-by-two factorial design study with high school students as participants. Task instructions promoted either enhanced or routine autonomy, and either external or internal focus of attention. These conditions were replicated in a crossover design for two common medical tasks (chest compressions on a manikin and a Fundamentals of Laparoscopic Surgery peg transfer task). Primary outcomes were objective measures of task performance (chest compression deviation from target depth; peg transfer time with penalties for errors). Secondary outco...

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The Joint Commission Journal on Quality and Patient Safety

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Objective: Dyad learning has been shown to be an effective tool for teaching procedural skills, b... more Objective: Dyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner. In this pilot study, we investigate the relationship between dyad training on stress, anxiety, cognitive load, and performance in a simulated bradycardia scenario. Methods: Forty-one fourth-year medical school trainees were randomized as dyads (n=24) or individuals (n=17) for an education session on Day 1. Reassessment occurred on Day 4 and was completed as individuals for all trainees. Primary outcomes were cognitive load (Paas scale), stress (Cognitive Appraisal Ratio), and anxiety levels (abbreviated State-Trait Anxiety Inventory). Secondary outcomes were time-based performance metrics. Results: On Day 1 we observed significant differences for change in anxiety and stress measured before and after the training scenario between groups. I...

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Western Journal of Emergency Medicine

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Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, Jan 26, 2017

Value-based health care requires a balancing of medical outcomes with economic value. Administrat... more Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators. At the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes", our breakout session critically evaluated the cost benefit and return on investment of simulation. In this paper we provide an overview of some of the economic tools that a clinician may use to present the...

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International journal of emergency medicine, Jan 8, 2018

Clinical care review is the process of retrospectively examining potential errors or gaps in medi... more Clinical care review is the process of retrospectively examining potential errors or gaps in medical care, aiming for future practice improvement. The objective of our systematic review is to identify the current state of care review reported in peer-reviewed publications and to identify domains that contribute to successful systems of care review. A librarian designed and conducted a comprehensive literature search of eight electronic databases. We evaluated publications from January 1, 2000, through May 31, 2016, and identified common domains for care review. Sixteen domains were identified for further abstraction. We found that there were few publications that described a comprehensive care review system and more focus on individual pathways within the overall systems. There is inconsistent inclusion of the identified domains of care review. While guidelines for some aspects of care review exist and have gained traction, there is no comprehensive standardized process for care rev...

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Advances in Simulation

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Academic Emergency Medicine

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The Journal of emergency medicine, Jan 10, 2017

Quality-improvement efforts at our institution have identified chest tube dislodgement as a preve... more Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. Our aim was to develop and test a framework for teaching and assessing chest tube securement. A repeated-measures study design was used. At baseline, 19 emergency medicine residents (program years 1-3) placed and secured a chest tube in a cadaver. After a 45-min proficiency-based teaching session using a low-cost chest tube simulator (approximate cost, $5), each resident again placed and secured a chest tube in a cadaver, followed by 3-month retention testing. All securements were evaluated by two raters using a four-point checklist and a five-point global assessment scale (GAS). The checklist addressed suture selection, tying knots down to the tube, wound approximation, and tube displacement relative to ski...

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The American journal of emergency medicine, Jan 28, 2017

A wide variety of spinal needles are used in clinical practice. Little is currently known regardi... more A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening p...

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Additional file 1: Appendix

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Additional file 1.

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Search strategy. (DOCX 14Â kb)

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Telemedicine and e-Health, 2021

Background: Acute care telemedicine is a critical resource for rural and community Emergency Medi... more Background: Acute care telemedicine is a critical resource for rural and community Emergency Medicine (EM) providers. To address potential barriers and promote use of these services throughout our health system Emergency Departments (EDs), we embed telemedicine consultations within in situ simulations. Methods: Care teams in health system EDs participated in multidisciplinary in situ simulations that focused on Difficult Airway management or Obstetric Emergencies. Physicians in EM and Neonatology at the referral center were available for assistance via telemedicine consultation. Participants were then surveyed regarding their experience with the telemedicine consultation during the simulations. Results: Participants reported increased likelihood to use telemedicine as well as increased understanding of the technology, awareness of available consultation services, and comfort interacting with the consultant. Conclusions: Embedding telemedicine consultations into in situ EM simulations is an effective approach to address implementation barriers and may promote increased use of telemedicine services among rural and community EM providers.

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Education for Health, 2016

The West African Ebola epidemic that began in 2014 has exposed the vulnerability of medical facil... more The West African Ebola epidemic that began in 2014 has exposed the vulnerability of medical facilities when a patient presents with a life‐threatening and highly contagious infectious disease. The transmissibility and extremely high morbidity and mortality of Ebola Virus Disease (EVD) make it unique among infectious diseases. This epidemic has specifically been more challenging than prior threats due to the high infection risk of all those in contact, requiring multidisciplinary coordination to minimize risk to other patients, staff and the community. This is not the first time that an epidemic has created a time‐sensitive and complex task for hospitals across North America and the world. Previous epidemics, including novel influenza A/H1N1 in 2009 and Severe Acute Respiratory Syndrome (SARS) in 2003, have demonstrated that there are significant barriers to developing these strategies. Disaster planning and training remains a complex process, and implementation of hospital‐wide plans can be daunting, especially when information and responses need to change daily.

Bookmarks Related papers MentionsView impact

BMC medical education, Jan 27, 2016

Evidence suggests that poor performance on standardized tests before and early in medical school ... more Evidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships. We evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000-2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available. We assessed the correlation between scores and assessments and determined USMLE 1 cutoffs predictive of poor performance (≤10th percentile) on the NBME examinations. We also compared the mean faculty assessment scores of MMS stud...

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A Tool for Bringing the Curriculum to Life, 2013

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Bookmarks Related papers MentionsView impact

Academic Emergency Medicine, 2008

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Academic Emergency Medicine, 2008

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Background The ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation for Learning) theor... more Background The ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation for Learning) theory of motor learning suggests that autonomy, external focus of attention, and perceived competence can improve learning of simple motor tasks. The authors hypothesized that enhanced (vs. routine) autonomy and external (vs. internal) focus of attention would improve first-try performance of two medical motor tasks.Methods The authors conducted a randomized two-by-two factorial design study with high school students as participants. Task instructions promoted either enhanced or routine autonomy, and either external or internal focus of attention. These conditions were replicated in a crossover design for two common medical tasks (chest compressions on a manikin and a Fundamentals of Laparoscopic Surgery peg transfer task). Primary outcomes were objective measures of task performance (chest compression deviation from target depth; peg transfer time with penalties for errors). Secondary outco...

Bookmarks Related papers MentionsView impact

The Joint Commission Journal on Quality and Patient Safety

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Objective: Dyad learning has been shown to be an effective tool for teaching procedural skills, b... more Objective: Dyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner. In this pilot study, we investigate the relationship between dyad training on stress, anxiety, cognitive load, and performance in a simulated bradycardia scenario. Methods: Forty-one fourth-year medical school trainees were randomized as dyads (n=24) or individuals (n=17) for an education session on Day 1. Reassessment occurred on Day 4 and was completed as individuals for all trainees. Primary outcomes were cognitive load (Paas scale), stress (Cognitive Appraisal Ratio), and anxiety levels (abbreviated State-Trait Anxiety Inventory). Secondary outcomes were time-based performance metrics. Results: On Day 1 we observed significant differences for change in anxiety and stress measured before and after the training scenario between groups. I...

Bookmarks Related papers MentionsView impact

Western Journal of Emergency Medicine

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Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, Jan 26, 2017

Value-based health care requires a balancing of medical outcomes with economic value. Administrat... more Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators. At the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes", our breakout session critically evaluated the cost benefit and return on investment of simulation. In this paper we provide an overview of some of the economic tools that a clinician may use to present the...

Bookmarks Related papers MentionsView impact

International journal of emergency medicine, Jan 8, 2018

Clinical care review is the process of retrospectively examining potential errors or gaps in medi... more Clinical care review is the process of retrospectively examining potential errors or gaps in medical care, aiming for future practice improvement. The objective of our systematic review is to identify the current state of care review reported in peer-reviewed publications and to identify domains that contribute to successful systems of care review. A librarian designed and conducted a comprehensive literature search of eight electronic databases. We evaluated publications from January 1, 2000, through May 31, 2016, and identified common domains for care review. Sixteen domains were identified for further abstraction. We found that there were few publications that described a comprehensive care review system and more focus on individual pathways within the overall systems. There is inconsistent inclusion of the identified domains of care review. While guidelines for some aspects of care review exist and have gained traction, there is no comprehensive standardized process for care rev...

Bookmarks Related papers MentionsView impact

Advances in Simulation

Bookmarks Related papers MentionsView impact

Academic Emergency Medicine

Bookmarks Related papers MentionsView impact

The Journal of emergency medicine, Jan 10, 2017

Quality-improvement efforts at our institution have identified chest tube dislodgement as a preve... more Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. Our aim was to develop and test a framework for teaching and assessing chest tube securement. A repeated-measures study design was used. At baseline, 19 emergency medicine residents (program years 1-3) placed and secured a chest tube in a cadaver. After a 45-min proficiency-based teaching session using a low-cost chest tube simulator (approximate cost, $5), each resident again placed and secured a chest tube in a cadaver, followed by 3-month retention testing. All securements were evaluated by two raters using a four-point checklist and a five-point global assessment scale (GAS). The checklist addressed suture selection, tying knots down to the tube, wound approximation, and tube displacement relative to ski...

Bookmarks Related papers MentionsView impact

The American journal of emergency medicine, Jan 28, 2017

A wide variety of spinal needles are used in clinical practice. Little is currently known regardi... more A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening p...

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