Introduction
Rapid Cycle Deliberate Practice (RCDP) is a team-based simulation method, emphasizing repetitive practice over reflective debriefing, with progressively more challenging rounds, frequent starts and stops, and direct coaching. Although some studies have shown improved performance, no study has evaluated learners' perceptions. We aimed to explore learners' experiences during RCDP.
Methods
This was a qualitative study of participants' perceptions regarding RCDP during their pediatric emergency medicine rotation. Participants completed surveys about RCDP learning. A purposive sample of residents and nurses were interviewed. Two coders analyzed all interview transcripts to identify emerging themes. Constant comparison analysis was performed until thematic saturation was achieved.
Results
Forty-four participants completed surveys. Participants found RCDP interruptions beneficial and felt that they learned most during interruptions. Participants who were able to compare traditional and RCDP simulations felt that RCDP allowed more focused correction of mistakes, acquisition of new skills, and timely practice of team behaviors. Fourteen participants were interviewed. Three themes emerged. (1) The real-time corrections during RCDP allowed for learning and creation of new skills through repetition and practice. (2) The RCDP allowed learners to gain confidence, decrease anxiety, and learn in a safe environment. (3) By introducing new information in smaller chunks, participants maximized learning without cognitive overload.
Conclusions
Rapid Cycle Deliberate Practice is well received by learners. Because of frequent interruptions, learners noted early error correction, a safe learning environment, and skill improvement during RCDP. Learners recognized that the progressive advancement of RCDP helped prevent cognitive overload. Future studies should measure cognitive load and skills retention.
Background and Objectives
CDC guidelines recommend follow-up within 72 hours of diagnosis of pelvic inflammatory disease (PID) because patients with inadequate treatment are at increased risk of acute and chronic complications. Follow-up rates in adolescents after diagnosis range between 10 to 16%. The primary objective was to assess the effect of text message (TM) reminders to adolescent patients diagnosed with PID on obtaining follow-up care within 72 hours of emergency department (ED) discharge.
Methods
Single-blinded, randomized controlled trial of adolescents diagnosed with PID in the ED. Patients received standard discharge instructions or standard discharge instructions plus TM reminders. Patients in the TM group received daily, tailored TM for 4 days with a reminder to schedule and attend PCP follow-up. The primary outcome was follow-up within 72 hours of ED discharge.
Results
95 patients (48 standard; 47 TM) were randomized. 3 patients were excluded, leaving 92 patients (46 standard; 46 TM) for analysis. Baseline characteristics were similar between treatment groups. Follow-up was 15.2% in the standard group and 43.5% in the TM group. Patients receiving TM reminders were more likely to follow-up compared to the standard group (RR: 2.9; 95% CI 1.4–5.7). The absolute efficacy difference was 28.3% (95% CI 9.5–46.9) yielding NNT of 4 (95% CI 2.2–9.5).
Conclusion
Personalized TM reminders were efficacious in improving follow-up for adolescents after ED diagnosis of PID.
Based on debriefings from simulated scenarios, some prehospital providers identified the provision of emotional support and effective communication as important components to the delivery of PFCC. Other providers revealed several perceived barriers to providing PFCC, though potential solutions to overcome many of these barriers were also identified. These findings can be utilized to integrate effective communication and emotional support techniques into EMS protocols and provider training to overcome perceived barriers to PFCC in the prehospital setting.
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