Structured and evidence-based training of technical skills in respiratory medicine and thoracic surgery

Pietersen, Pia Iben; Laursen, Christian B.; Petersen, René Horsleben; Konge, Lars

doi:10.21037/jtd.2019.02.39

Cited by 11 publications

(11 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This could also work as an automatic assessment tool, which will be able to set an unbiased pass/fail criterion that is not susceptible to rater bias. Future studies should compare our automatic, objective scores with existing more subjective scoring systems from expert raters (40).…”

Section: Discussionmentioning

confidence: 99%

Using structured progress to measure competence in flexible bronchoscopy

Cold¹,

Svendsen²,

Bødtger³

et al. 2020

J Thorac Dis

Self Cite

View full text Add to dashboard Cite

Background: Flexible bronchoscopy is a core invasive procedure in pulmonary medicine and training in the procedure is mandatory. Diagnostic completeness and procedure time have been identified as useful measures of competence. No outcome measures have been developed regarding navigational path in bronchoscopy to assess whether the bronchial segments have been identified in an arbitrary or structured order. We investigated whether a new outcome measure for structured progression could be used to assess competency in flexible bronchoscopy. Methods:The study was designed as a prospective comparative study. Twelve novices, eleven intermediates, and ten expert bronchoscopy operators completed three full bronchoscopies in a simulated setting on a phantom. The following outcome measures were collected through a checklist evaluation by a trained rater: Diagnostic Completeness as amount of visualized bronchial segments, Structured Progress between the bronchial segments in ascending order, and average intersegmental time (AIT). Results: The ability to follow a structured ascending path through the bronchial tree correlated with a higher amount of identified bronchial segments (Pearson's correlation, r=0.62, P<0.001) and a lower AIT (Pearson's correlation, r=−0.52, P<0.001).Conclusions: Operators should advance through the bronchial tree in a structured ascending order to ensure systematic progress with the highest level of diagnostic yield and the lowest procedure time. Structured progression is a useful measure to evaluate competency in flexible bronchoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

Using structured progress to measure competence in flexible bronchoscopy

Cold¹,

Svendsen²,

Bødtger³

et al. 2020

J Thorac Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, diagnostic ultrasound examinations are operator-dependent, and to reach a sufficient and high diagnostic accuracy, correct technical execution of the ultrasound examination, as well as correct image interpretation are prerequisites [13]. Furthermore, the operator must possess the capability to integrate the ultrasound findings in context to the patient's history, symptoms, and other clinical parameters.…”

Section: Introductionmentioning

confidence: 99%

Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study

Pietersen

Mikkelsen

Lassen

et al. 2021

Scand J Trauma Resusc Emerg Med

Self Cite

View full text Add to dashboard Cite

Background In a prehospital setting, the severity of respiratory symptoms in patients calling for an ambulance differ. The initial evaluation, diagnosing, and thereby management can be challenging because respiratory symptoms can be caused by disease in many organs. Ultrasound examinations can contribute with important information and support the clinical decision-making. However, ultrasound is user-dependent and requires sufficient knowledge and training. The aim of this study was to explore the quality of thoracic ultrasound examinations performed on patients by emergency medical technicians and paramedics in a prehospital, clinical setting. Methods From November 2018 – April 2020, Danish emergency medical technicians and paramedics (n = 100) performed thoracic ultrasound examinations on patients with respiratory symptoms using a portable ultrasound device. The ultrasound examinations were stored and retrospectively assessed by a reviewer blinded to the patients’ symptoms and history, as well as the emergency medical technicians’ and paramedics’ findings. The image quality was scored from 1 to 5. The findings determined by the reviewer was then correlated with a questionnaire filled out by the emergency medical technicians and paramedics regarding ultrasonic findings and potential change in treatment or management of the patient. The agreement in percentage and as Cohen’s kappa was explored. Results A total of 590 ultrasound examinations were assessed, resulting in a median image quality score of 3 (IQ1 = 4, IQ3 = 3). The overall agreement in percentage between the emergency medical technicians and paramedics and reviewer was high (87.7% for a normal scan, 89.9% for interstitial syndrome, 97.3% for possible pneumothorax, and 96.3% for pleural effusion). Cohen’s kappa varied from 0.01 for possible pneumothorax to 0.69 for pleural effusion. Based on the questionnaires (n = 406), the ultrasound examination entailed a change in treatment or visitation in 48 cases (11.7%) which in this study population encompasses a number-needed-to-scan of 8.5. Conclusion Emergency medical technicians and paramedics perform focused thoracic ultrasound examinations with adequate image quality sufficient to determine if pathology is present or not. The emergency medical technicians’ and paramedics’ assessment correlates to some extent with an experienced reviewer and their findings are most reliable for the inclusion of a normal scan or inclusion of pleural effusion. Implementation could possibly impact the number of patients receiving correct prehospital treatment and optimal choice of receiving facility.

show abstract

“…The development of the EMD program utilized a consecutive mixed approach starting with a competencybased with backward design method to ensure the achievement of targeted outcomes [8]. This was followed by the adoption of Kern's Six-step approach for structure content and integrated module development which has proven e cacy in many education settings [9,36,37,38,39,40]. The EMD Program targeted learning objectives were then developed by the education committee and Miller's pyramid of competencies was considered following its successful use in recent programs [41].…”

Section: Discussionmentioning

confidence: 99%

An Innovative Curriculum Development Experience: Emergency Medical Dispatch Role in the Healthcare Transformation Vision of Saudi Arabia

Alsofayan

Almakhalas

Alabdali

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundHealthcare medical dispatch systems play a fundamental role in the daily operations of prehospital services. This includes facilitating the interpretation of various dispatch-related systems, receiving incident calls, categorizing cases, guiding proper resources deployment, and providing proper instructions before the arrival of healthcare providers. Considering the Kingdom of Saudi Arabia’s (KSA’s) health sector transformation plan as part of Vision 2030, developing an Emergency Medical Dispatch (EMD) Program as part of essential prehospital services will allow rapid and competent healthcare delivery. In this study, our purpose is to describe the curriculum development of the EMD Program to improve the training of dispatchers and to share the experience in the interest of better prehospital dispatch systems.MethodsA selected group of education experts and academics in emergency medical services dispatch were assigned to develop an EMD curriculum over six months. This study aims to describe the approach followed in developing an innovative EMD Program to share the experience and ultimately standardize dispatch-related training programs. The data of this study was collected by reviewing approved documents of the EMD Program including program curriculum, syllabus, logbook, and exam blueprint after approval letters received from the Health Academy, Saudi Commission for Health Specialties.ResultsThe development of the EMD program utilized a consecutive mixed approach staring with a competency-based with backward design method to ensure the achievement of targeted outcomes followed by the Kern Six-step curriculum development model, namely: (1) problem identification and general need assessment; (2) targeted need assessment; (3) goals and objectives; (4) educational strategies; (5) implementation; and (6) evaluation and feedback. This resulted in four comprehensive modules and seventeen competencies throughout the fourteen-week EMD Program. Conclusion As part of the health sector transformation plan in KSA, EMD services play a fundamental role in the daily operations of prehospital healthcare services. Developing an EMD Program with a consecutive mixed approach including a competency-based with backward design method followed by the Kern Six-step curriculum development model led to a set of learning outcomes in the EMD Program including interpreting various dispatch systems, prioritizing incidents, deploying proper resources, and providing pre-arrival instructions to improve the current operations of EMD services, allow rapid access to healthcare facilities, and ultimately save more lives.

show abstract

Structured and evidence-based training of technical skills in respiratory medicine and thoracic surgery

Cited by 11 publications

References 47 publications

Using structured progress to measure competence in flexible bronchoscopy

Using structured progress to measure competence in flexible bronchoscopy

Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study

An Innovative Curriculum Development Experience: Emergency Medical Dispatch Role in the Healthcare Transformation Vision of Saudi Arabia

Contact Info

Product

Resources

About