These results suggest a significant role for CYP2B6, but not CYP3A, in stereoselective human methadone metabolism and disposition.

Background To reduce performance anxiety and increase engagement in medical-surgical simulations, virtual simulation (VS) was introduced prior to complex high-fidelity simulation to increase students' self-efficacy. Problem A presimulation preparation needed to be expanded for high-fidelity simulation involving emergent clinical situations. Approach Combined frameworks of Ericsson's theory of deliberate practice and Bandura's self-efficacy theory were applied. Students completed VS scenarios until a specific score of mastery was obtained, and then the same scenario was repeated in the high-fidelity simulation laboratory. A modified self-efficacy scale survey was administered presimulation and postsimulation. Data were collected on 3 cohorts of students (n = 151) over an academic year. Outcomes VS followed by high-fidelity simulation significantly increased student perception of self-efficacy in all 3 cohorts (P = .001, P = .037, P = .005). Conclusion Preparation for high-fidelity simulation using VS increases self-efficacy and allows students to engage in the simulation experience, thus achieving higher levels of mastery through deliberate practice.

Safe patient handling and mobility (SPHM) programs are needed in the home care environment. As patient-lifting technology and devices become more widely available for use in the home setting, caregivers need opportunities to learn how to properly use these devices. Nonmedical caregivers employed by personal support services agencies (PSSAs) and home caregivers have very limited access to opportunities for SPHM training in rural areas of Tennessee. Safe patient handling and mobility training utilizing simulation with an interprofessional approach was developed and provided to 17 nonmedical and family home caregivers. The training was evaluated utilizing Kirkpatrick’s Four-Level Training Evaluation Model. Participants completed anonymous surveys immediately following the training and 4 to 6 weeks after the training. Survey I (n = 17): Respondents indicated increased knowledge of safe patient handling (94%) and applied knowledge of safe patient handling in training (90%). Survey II (n = 6): Most respondents (67%) indicated that they had applied the knowledge and skills that they had learned in the training. Two respondents (33%) indicated that they had not yet had the opportunity to apply the knowledge and skills they learned. The survey also showed that all respondents believed that the knowledge and skills they had learned helped to decrease the risk of personal injury and injury to patients. Safe patient handling and mobility training utilizing simulation with an interprofessional approach was effective in promoting safety of nonmedical and family caregivers in the home setting. Based on the success of this program, more training opportunities should be implemented to improve patient and caregiver safety.