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Psychomotor Skills (psychomotor + skill)
Selected AbstractsSurgical skills training: simulation and multimedia combinedMEDICAL EDUCATION, Issue 9 2001Roger Kneebone Context Basic surgical skills are needed throughout the medical profession, but current training is haphazard and unpredictable. There is increasing pressure to provide transparency about training and performance standards. There is a clear need for inexperienced learners to build a framework of basic skills before carrying out surgical procedures on patients. Effective learning of a skill requires sustained deliberate practice within a cognitive framework, and simulation offers an opportunity for safe preparation. Objectives This paper presents a new approach to basic surgical skills training, where tuition using a specially designed computer program is combined with structured practice using simulated tissue models. This approach to teaching has evolved from practical experience with surgical skills training in workshops. Methods Pilot studies with 72 first-year medical students highlighted the need for separate programs for teaching and for self-directed learning. The authors developed a training approach in the light of this experience. Subsequent in-depth observational and interview studies examined (a) individual teaching sessions between surgical teachers and learners (five consultant surgeons and five senior house officers) and (b) group teaching sessions with general practitioners (14 participants in three group interviews). Further work has resulted in a self-directed learning program. Conclusions Qualitative analysis of observational and interview data provides strong preliminary support for the effectiveness of this approach. The response of teachers and learners was extremely positive. The combination of information (presented by computer) and practice of psychomotor skill (using simulated tissue models) could be extended to other surgical and practical skills. [source] The effect of nightshift on emergency registrars' clinical skillsEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2010Leonie Marcus Abstract Objective: The effect of nightshift on ED staff performance is of clinical and risk-management significance. Previous studies have demonstrated deterioration in psychomotor skills but the present study specifically assessed the impact of nightshift on clinical performance. Methods: The ED registrars in a tertiary hospital were enrolled in a prospective observational study and served as their own controls. During nightshift, subjects were presented simulated scenarios and tested with eight clinical questions developed to Fellowship examination standard. Matched scenarios and questions for the same subjects during dayshift served as controls. Two investigators, blinded to subject identity and the setting in which questions were attempted, independently collated answers. Results: Of 22 eligible subjects, all were recruited; four were excluded owing to incomplete data. A correlation of 0.99 was observed between the independent scoring investigators. Of a possible score of 17, the median result for nightshift was 9.5 (interquartile range: 8,11); corresponding value for dayshift was 12 (interquartile range: 10,13); P= 0.047. Conclusion: Nightshift effect on clinical performance is anecdotally well known. The present study quantifies such effects, specifically for the ED setting, and paves the way for focused research. The implications for clinical governance strategies are significant, as the fraternity embraces the mandate to maintain quality emergency care 24 h per day. [source] Modafinil reduces patient-reported tiredness after sedation/analgesia but does not improve patient psychomotor skillsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010E. GALVIN Background: Early recovery of patients following sedation/analgesia and anesthesia is important in ambulatory practice. The aim of this study was to assess whether modafinil, used for the treatment of narcolepsy, improves recovery following sedation/analgesia. Methods: Patients scheduled for extracorporeal shock wave lithotripsy were randomly assigned to one of four groups. Two groups received a combination of fentanyl/midazolam with either modafinil or placebo. The remaining groups received remifentanil/propofol with either modafinil or placebo. Modafinil 200 mg was administered to the treatment group patients 1 h before sedation/analgesia. Groups were compared using the digital symbol substitution test (DSST), trail making test (TMT), observer scale of sedation and analgesia (OAA/S) and Aldrete score. Verbal rating scale (VRS) scores for secondary outcome variables e.g. energy, tiredness and dizziness were also recorded before and after treatment. Results: Sixty-seven patients successfully completed the study. Groups received similar doses of sedation and analgesic drugs. No statistically significant difference was found for DSST between groups. No significant adverse effects occurred in relation to modafinil. No statistically significant difference between groups was identified for TMT, OAA/S and Aldrete scores. The mean VRS score for tiredness was lesser in the modafinil/fentanyl/midazolam group [1.3 (2.0)] compared with the placebo group [3.8 (2.5)], P=0.02. Such a difference was not found between the remifentanil/propofol groups [placebo 2.6 (2.2) vs. modafinil 3.1(2.7)], p>0.05. Dizziness was greater in the modafinil/remifentanil/propofol group 1.7 (2.0) vs. placebo 0.0 (0.5), p<0.05. Conclusion: Modafinil reduces patient-reported tiredness after sedation/analgesia but does not improve recovery in terms of objective measures of patient psychomotor skills. [source] Attention to Spoken Word Planning: Chronometric and Neuroimaging EvidenceLINGUISTICS & LANGUAGE COMPASS (ELECTRONIC), Issue 3 2008Ardi Roelofs This article reviews chronometric and neuroimaging evidence on attention to spoken word planning, using the WEAVER++ model as theoretical framework. First, chronometric studies on the time to initiate vocal responding and gaze shifting suggest that spoken word planning may require some attention, even though it is one of our most highly practiced psychomotor skills. Second, neuroimaging studies that localized brain activity during word planning suggest that attention enhances activity in perisylvian cortical areas. What word to enhance and for how long is determined by an executive control system located in anterior cingulate and lateral prefrontal cortex. Commonalities of anterior cingulate function across verbal vocalizations (speech) and nonverbal vocalizations (e.g. human crying, laughter, and monkey calls) are outlined. [source] Special Features: Education: Challenges and Opportunities Associated with Preceptored Community Health Clinical ExperiencesPUBLIC HEALTH NURSING, Issue 5 2010Gail H. Wade ABSTRACT Preceptored community experiences present challenges different from those of preceptored experiences in the acute care setting. Instead of focusing on psychomotor skills, faculty must address population-based skills and assess students' abilities to practice these skills. Faculty and preceptors' lack of knowledge to teach these skills further complicate the experiences, an issue indirectly related to faculty and nursing shortages. Although preceptors guide students, faculty are responsible for evaluating students in community preceptored experiences. The Association of Community Health Nursing Educators (ACHNE) Essentials of Baccalaureate Education (Essentials) offers opportunities for guiding and evaluating community health preceptored clinical experiences. Assignments and activities that reflect the ACHNE Essentials provide a firm foundation for the population focus of the course. This focus is validated through faculty visits to students in a variety of community settings. To plan successful community experiences and evaluate students, faculty must be knowledgeable about the population focus of community courses, apply this knowledge to students in a variety of settings, and ask challenging questions to assess student learning. [source] Validation of a novel fibreoptic intubation trainerANAESTHESIA, Issue 1 2010D. J. Williams Summary The aim of this study was to validate a novel inexpensive training device as a means of improving the psychomotor skills involved in the manipulation of a fibreoptic endoscope. Seventy-five subjects attempted to pass a fibreoptic endoscope through the device five times, with each attempt timed to the nearest second. Although prior clinical experience of fibreoptic intubation was associated with better performance, all groups showed improvement with each attempt. Qualitative feedback indicated that the device required subjects to use similar skills to those used in clinical practice. This study supports the use of such a device in training and assessment although further studies will be required to determine whether the skills learned on the device can be transferred to the clinical environment. [source] | ||||||||||