Effect of anesthesia simulation training on veterinary student clinical performance (original) (raw)
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Journal of Veterinary Medical Education
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access. The simulation outputs are determined by a script that outlines routine anesthesia scenarios and describes the consequences of students' hands-on actions and interventions during preestablished anesthetic tasks and critical incidents. Patients' monitored physiologic parameters may be changed according to predetermined learner events ...
Journal of Veterinary Medical Education
In veterinary medical education, reduction, replacement, and refinement (the three Rs) must be considered. Three clinical skills in anesthesia were identified as challenging to students: endotracheal intubation, intravenous catheterization, and drug dose calculations. The aims of this project were to evaluate students' perception of their level of confidence in performing these three clinical skills in veterinary anesthesia, to document the extent of students' previous experience in performing these three tasks, and to describe students' emotional states during this training. Veterinary students completed a series of four surveys over the period of their pre-clinical training to evaluate the usefulness of high-fidelity models for skill acquisition in endotracheal intubation and intravenous catheterization. In addition, practice and ongoing assessment in drug dose calculations were performed. The curriculum during this period of training progressed from lectures and non-a...
Journal of Veterinary Medical Education, 2018
A veterinary anesthesia simulated environment (VASE) with clinical scenarios has been integrated into the pre-clinical curriculum at Midwestern University College of Veterinary Medicine to simulate anesthesia of a live patient within a surgical suite. Although this modality was shown to significantly improve veterinary students' perceived preparedness to perform anesthesia on live patients, whether this would improve anesthesia competency in the actual clinical environment, described as operational performance, remained unclear. Our goal was to examine the relationship between anesthesia simulation training and student anesthesia operational performance. Anesthesia operational performance assessment of students was determined by quantifying critical event occurrences that negatively impacted patient safety during the anesthesia of 287 patients during students' initial surgical experience in 2015 and 2016. The relationship between total numbers of critical incidents to students having anesthesia simulation training was determined through evaluation of anesthesia records from 2015 and 2016, where students did not have anesthesia simulation training or they had pre-clinical training, respectively. Results showed a significant relationship between simulation training and critical incident occurrence, with a critical incident more likely to occur during patient anesthesia for students who did not experience pre-clinical anesthesia simulation training. Of the total critical incidents that occurred in the two-year study, 88% were in patients anesthetized by students who did not have simulation training. Our findings suggest that students who were given the opportunity to participate in anesthesia-focused simulations before a live-animal anesthesia encounter demonstrated significant improvements in anesthesia operational performance and improved patient safety.
Anesthesia & Analgesia, 2002
In this study, we compared two different training simulators (the computer screen-based simulator versus the fullscale simulator) with respect to training effectiveness in anesthesia residents. Participants were evaluated in the management of a simulated preprogrammed scenario of anaphylactic shock using two variables: treatment score and diagnosis time. Our results showed that simulators can contribute significantly to the improvement of performance but that learning in treating simulated crisis situations such as anaphylactic shock did not significantly vary between full-scale and computer screen-based simulators. Consequently, the initial decision on whether to use a full-scale or computer screen-based training simulator should be made on the basis of cost and learning objectives rather than on the basis of technical or fidelity criteria. Our results support the contention that screen-based simulators are good devices to acquire technical skills of crisis management. Mannequin-based simulators would probably provide better training for behavioral aspects of crisis management, such as communication, leadership, and interpersonal conflicts, but this was not tested in the current study. (Anesth Analg 2002;94:1560 -5) T he use of full-scale (FS) simulators for training in anesthesia is becoming a topic of great interest and a source of controversy in the anesthesia profession. One reason is their purchase and maintenance costs. Another is their effectiveness compared with other less-expensive training methods. Yet, Chopra et al.
International Journal of Advanced Research and Review www.ijarr.in ANAESTHESIA IN LABORATORY ANIMALS
Anaesthesia and analgesia are imperative components in laboratory animal science and these should be incorporated as essential components in all laboratory animal training programmes. It prevents unnecessary pain induced by various experimental procedures(Flecknell, 1993). The uncontrolled or unattended pain can create stress in an animal which creates release of uncontrolled substances. Finally it can lead to a series of unwanted changes in its body. Ultimately, this will influence the experimental outcome. Because of these reasons, the rational use of anaesthesia and analgesia is an ethical and a scientific requirement(Mcintyre, 1971). Anaesthesia is a state of unconsciousness and the component of anaesthesia is analgesia (pain relief), amnesia (loss of memory) and immobilization. The drug used to achieve anaesthesia usually has varying effects in each of these areas. Some drug may be used individually to achieve all three effects. Others have only analgesic or sedative properties(Whelan & Flecknell, 1992).
European Journal of Anaesthesiology, 2009
Background and objective The aim of the study was to compare the effectiveness of teaching of general anaesthesia induction to medical students using either fullscale simulation or traditional supervised teaching with patients in the operating theatre. Methods Forty-six fourth year students attending their course in anaesthesiology were enrolled. The students were randomly assigned to two groups. The simulation group received training in the simulator. The traditional training group was supervised by a senior consultant anaesthetist. After the training sessions all students were tested in the simulator setting. The test was assessed using a 40-item evaluation list. Results Thirty-three per cent of students in the traditional group and 87% of the students in the simulation group passed the test. Statistically significant differences were: request of glycopyrrolate (P < 0.001), S p O 2 monitoring (P < 0.001), used gloves when placing an intravenous cannula (P U 0.012), intubation attempt within 30 s (P < 0.04), anaesthesia gas set at MAC at least 1 (P < 0.04), instructed anaesthetic nurse to keep S p O 2 at least 95% (P < 0.05), keep MAP at least 60 mmHg (P < 0.05), keep heart rate more than 50 beats per minute (P < 0.002), keep end-tidal p CO 2 4-5.5 kPa (P < 0.002). Conclusion The simulation group performed better in 25% of the tasks and similarly in the others compared with the traditional teaching group. With the same time and amount of teaching personnel we trained five or six students in the simulator compared with one student in the operating theatre. Further research will reveal whether these promising results with simulation may be applied more generally in anaesthesiology teaching to medical students.
Journal of Medical Education
Background: Simulation-based education has become more prominent in recent years. In our university, we have begun to use simulation at various levels in the curriculum. Objectives: We decided to utilize simulation to meet the challenges of teaching medical students in the operating theatre, which have slowly risen over the years at our place of practice. Methods: A total of 120 final year medical students posted to anesthesia were divided into two groups and exposed to two different operating theatre (OT) teaching environments: Group I: Actual OT and group 2: Simulated OT. The performance of the two groups on 25 MCQs was compared using the chi-square test and independent t-test. Results: The chi-square test showed no significant difference between the groups in the number of students who passed the test at the end of the posting [χ2 (2, N = 119) = 2.375, P > 0.05]. An independent t-test carried out on the test scores showed that the actual OT group (M = 10.15, SD = 2.284) perfor...
The Value of Simulation Training during Anesthesia Residency
Anesthesiology, 2006
To the Editor:-We read with great interest the article by Dr. Gijsenbergh et al. 1 about the reversal of rocuronium-induced neuromuscular block by Org 25969. The described reversal mechanism is highly promising both for the clinical application and in research endeavors. This being the first description of the pharmacokinetics of Org 25969, we hoped to reconstruct the time course of the plasma concentrations of Org 25969 using the provided data. Unfortunately, the combination of the pharmacokinetic parameters (tables 6 and 7) does not permit such a reconstruction, in part due to a nonstandard method of analysis. The authors do not mention whether an exponential equation or a compartmental model was fitted to the concentrations of Org 25969 in plasma. Was either approach even attempted? The terminal elimination half-life (t ½) could be appropriate for either a biexponential or a triexponential equation. The reported values for the areas under the plasma concentration curves are, in concept, dose dependent, and the reported values apparently reflect this. Presumably, the authors used areas under the plasma concentration curves to justify the claim of "doselinear pharmacokinetics," but this was not explicitly stated in the text. The reported "volume of distribution during the terminal phase" (V Z) is not routinely reported, and a comparison with the standard volumes, i.e., the initial volume of distribution for a multiexponential equation (V c), the volume of the central compartment in compartmental interpretation (V 1), or the volume of distribution at steady state (V SS), is difficult if not impossible. Furthermore, because V Z was evaluated from V Z ϭ CL/Ϫ, V Z is a function of t ½ and, hence, provides no additional information. Of the routinely reported parameters, the authors provide only the estimates for the systemic clearance (CL) and the mean residence time. These two parameters do not suffice to reconstruct the time course of the plasma concentrations. It would have been informative had the authors compared the doses of Org 25969 with the dose of rocuronium using molar units. The dose of rocuronium, 0.6 mg/kg, corresponds to approximately 1 • 10 Ϫ6 mol • kg Ϫ1. Given the molecular weight of Org 25969 of 2,000 Da, 2 the doses of Org 25969, 0.1 to 8.0 mg/kg, correspond to (0.05 to 4) • 10 Ϫ6 mol • kg Ϫ1. If one molecule of Org 25969 binds to one molecule of rocuronium and assuming that the whole dose of rocuronium is still present in the body 3 min after injection, then Org 25969 doses of less than 1 • 10 Ϫ6 mol • kg Ϫ1 , corresponding to less than 2 mg/kg, would, on theoretical basis, have little chance to reverse the neuromuscular block completely. As documented by the authors, only the molar doses of Org 25969 higher than the molar dose of rocuronium produced the desired reversal. Therefore, Org 25969 doses of 4.0 and 8.0 mg/kg efficiently reversed the block (table 9); on the molar basis, the two doses are two and four times higher than the dose of rocuronium. The Org 25969 dose of 2 mg/kg is equimolar to that of rocuronium and produced only a marginal reversal of neuromuscular block. Consideration of the doses in molar terms strengthens the authors' conclusion and explains why lower doses of Org 25969 could not have produced the reversal (table 9).
Simulation in teaching regional anesthesia: current perspectives
Local and Regional Anesthesia, 2015
The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.