Novel Way to Improve Satisfaction, Comprehension, and Anxiety in Caregivers: A Randomized Trial Exploring the Use of Comprehensive, Illustrated Children's Books for Pediatric Surgical Populations.

Background: Surgery generates anxiety and stress, which can negatively impact informed consent and postoperative outcomes. This study assessed whether educational, illustrated children's books improve comprehension, satisfaction, and anxiety of caregivers in pediatric surgical populations.

Methods: A prospective randomized trial was initiated at a tertiary care children's hospital.

The Effects of a Deliberate Practice Debriefing During a Response to Rescue Patient Simulation With Undergraduate Nursing Students.

The purpose of this multisite, randomized, pretest/posttest quasi-experimental study was to compare student nurse competency, learning retention, and perceived student support after exposure to a deliberate practice debriefing versus standardized debriefing. Fifty undergraduate students participated in the complex response to rescue simulation. The intervention group had significantly higher total mean and three subscale scores on the competency tool than the comparison group, although differences in learning retention and student support were not significant.

The Effect of Evaluator Training on Inter- and Intrarater Reliability in High-Stakes Assessment in Simulation.

Aim: The aim of this study was to evaluate the effectiveness of a training intervention in achieving inter- and intrarater reliability among faculty raters conducting high-stakes assessment of clinical performance in simulation.

Background: High-stakes assessment of simulation performance is being adopted in nursing education. However, limited research exists to guide best practices in training raters, which is essential to ensure fair and defensible assessment.

Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation.

There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students' perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events.

The integrated model for interprofessional education: a design for preparing health professions' students to work in interprofessional teams.

An important element in the process of helping students learn to work interprofessionally is figuring out how to design high-impact learning experiences that engage students in meaningful learning that is collaborative and experiential and can transform students understanding of their own and others' roles in the health care process. In this article, a model for interprofessional education, the Integrated Model for Interprofessional Education (IMIPE), is shared for introducing students in the health professions to the roles and responsibilities of some of the other healthcare professionals with whom they will work in practice. The IMIPE is a process model developed by an interprofessional faculty team used as the focal point of a pilot educational event for students from nursing, occupational therapy, physician assistant studies, and social work.

Constructing maternal-child learning experiences using clinical simulations.

Clinical simulations are gaining more attention in the field of maternal-child health and allow nursing programs and service organizations to assess competency of students and staff in key patient safety situations. Nursing and midwifery programs, orientations, and yearly reaccreditation modules commonly include simulation on postpartum hemorrhage, placenta abruption, shoulder distocia, and other high-risk, low-incidence emergency events. This article describes the use of simulations by educators and managers as teaching or professional development strategies.

Outcomes of clinical simulation for novice nursing students: communication, confidence, clinical judgment.

The use of clinical simulation in nursing education provides many opportunities for students to learn and apply theoretical principles of nursing care in a safe environment. The purpose of this study was to evaluate simulated clinical experiences as a teaching/learning method to increase the self-efficacy of nursing students during their initial clinical course in a prelicensure program. An integrated, quasi-experimental, repeated measures design was used.

Improved outcomes for laparoscopic appendectomy compared with open appendectomy in the pediatric population.

Introduction: The appendectomy is a common emergent surgical procedure in the pediatric population. The aim of this study was to examine our institution's experience and outcomes in the appendectomy in the pediatric population early in our transition from open surgery to a predominantly laparoscopic approach.

Methods: We retrospectively studied all pediatric patients (age 20 years) that underwent an appendectomy at a tertiary care center over 2 years.

Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass.

Objective: The goal of this study was to determine the effectiveness of mesenteric vein to left portal vein bypass operation (MLPVB) in correcting extrahepatic portal vein thrombosis (EHPVT) in children. The treatment of idiopathic EHPVT has been primarily palliative, whereas MLPVB restores hepatic portal flow in patients with EHPVT.

Methods: Thirty-four children with symptomatic EHPVT underwent surgery with intent to perform MLPVB and were followed for up to 7 years.

Simultaneous surgical and interventional radiological approach to treat complicated biliary strictures after pediatric liver transplantation.

Post-transplantation biliary strictures occur in 5-15% of the pediatric liver transplant patients and are conventionally managed by interventional radiological techniques. Failure of this treatment leads to reoperation and sometimes to retransplantation. Herein, we describe a surgical approach and interventional radiologic approach to manage biliary strictures that failed the conventional radiologic treatment, in order to avoid retransplantation.

A new technique for resecting 'unresectable' liver tumors.

Background/purpose: Liver tumors that surround the three major hepatic veins traditionally have been considered unresectable. This report describes an extended atypical left hepatectomy technique for tumors around the major hepatic veins.

Methods: Three children with tumors surrounding the 3 hepatic veins underwent intraoperative evaluation for extended atypical left hepatectomy.

Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension.

Background/purpose: Extrahepatic portal vein thrombosis (EPVT) in children can lead to severe bleeding from gastrointestinal varices, ascites, thrombocytopenia from hypersplenism, and other coagulation disorders. The authors have used the superior mesenteric vein to intrahepatic left portal vein (Rex) shunt in 5 children with symptomatic EPVT and report their results with this novel technique.

Methods: Children with symptomatic portal hypertension were screened for the underlying cause.

Cervical ECMO cannula placement in infants and children: recommendations for assessment of adequate positioning and function.

Background/purpose: Cervical extracorporeal membrane oxygenation (ECMO) cannula position is often difficult to confirm by chest x-ray alone. Malposition requires a second surgery to rectify the problem. Reoperation places the patient at risk for infection, bleeding, or death.

Contractile properties of intralobar pulmonary arteries and veins in the fetal lamb model of congenital diaphragmatic hernia.

Background/purpose: Pulmonary hypertension plays a significant role in the pathophysiology of congenital diaphragmatic hernia (CDH). Although there has been an intensive research effort directed at mediators that may cause pulmonary vasoconstriction, no single agent has been identified. The authors hypothesize that there may be an alteration in the cGMP-nitric oxide (NO) pathway of vasodilatation contributing to the pulmonary hypertension observed in CDH.

Effectiveness of cholecystokinin-stimulated cholescintigraphy in the diagnosis and treatment of acalculous gallbladder disease.

We retrospectively reviewed the medical records of 107 patients in two community hospitals who had undergone cholecystokinin-stimulated cholescintigraphy with ejection fraction to determine whether this test is reliable in identifying patients whose symptoms will improve following cholecystectomy. Patients with cholelithiasis or incomplete medical records and patients who could not be interviewed were excluded from the study. Forty-two of 58 study patients (72%) had an abnormal ejection fraction (defined as 35% or less); 27 of 42 patients (64%) underwent cholecystectomy.