Publications by authors named "Isabel GroSS"

Objective: This study aimed to investigate whether distractions during simulated neonatal resuscitation impact mask leakage and visual gaze patterns during positive pressure ventilation (PPV) of a newborn manikin.

Study Design: In this observational, simulation-based study, medical students and paediatric residents managed a neonate requiring resuscitation alongside a standardised team and executed PPV on a leak-free manikin. The scenario incorporated distractions such as chest compressions, preparation and insertion of an umbilical vein catheter, administering fluids and interpreting venous blood gas.

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Plasticity-related gene (PRG) 5 is a vertebrate specific membrane protein, that belongs to the family of lipid-phosphate phosphatases (LPPs). It is prominently expressed in neurons and is involved in cellular processes such as growth-cone guidance and spine formation. At a functional level, PRG5 induces filopodia in non-neuronal cell lines, as well as the formation of plasma membrane protrusions in primary cortical and hippocampal neurons.

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Given the large accumulation of research focused on the effectiveness of in-person simulation-based education (SBE), this umbrella review-or systematic review of systematic reviews-was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to analyze collective findings and close identified literature gaps. This study presents a descriptive analysis of the most effective modalities, methods, and measurements of in-person SBE, as well as major themes that emerged during analysis as it relates to SBE outcomes.The major patterns or themes that emerged confirm for the first time a longstanding sentiment in the literature, specifically the following: a need to produce higher-quality research with greater rigor, larger sample sizes, more randomized controlled trials, mixed methods, and longitudinal studies.

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Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature.

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Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as "mixed- distance simulation.

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The use of distance simulation has rapidly expanded in recent years with the physical distance requirements of the COVID-19 pandemic. With this development, there has been a concurrent increase in research activities and publications on distance simulation. The authors conducted a systematic review of the peer-reviewed distance health care simulation literature.

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Background: Simulation has become a staple in the training of healthcare professionals with accumulating evidence on its effectiveness. However, guidelines for optimal methods of simulation training do not currently exist.

Methods: Systematic reviews of the literature on 16 identified key questions were conducted and expert panel consensus recommendations determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.

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Background: Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities.

Methods: This mixed-methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN.

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Background: Distance simulation is defined as simulation experiences in which participants and/or facilitators are separated from each other by geographic distance and/or time. The use of distance simulation as an education technique expanded rapidly with the recent COVID-19 pandemic, with a concomitant increase in scholarly work.

Methods: A scoping review was performed to review and characterize the distance simulation literature.

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Objectives: To describe the quality of pediatric resuscitative care in general emergency departments (GEDs) and to determine hospital-level factors associated with higher quality.

Methods: Prospective observational study of resuscitative care provided to 3 in situ simulated patients (infant seizure, infant sepsis, and child cardiac arrest) by interprofessional GED teams. A composite quality score (CQS) was measured and the association of this score with modifiable and nonmodifiable hospital-level factors was explored.

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Background: The COVID-19 pandemic forced rapid implementation and refinement of distance simulation methodologies in which participants and/or facilitators are not physically colocated. A review of the distance simulation literature showed that heterogeneity in many areas (including nomenclature, methodology, and outcomes) limited the ability to identify best practice. In April 2020, the Healthcare Distance Simulation Collaboration was formed with the goal of addressing these issues.

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Introduction: The abrupt disruption of in-person instruction in health care during the COVID-19 pandemic resulted in the rapid adoption of distance simulation as an immediate alternative to providing in-person simulation-based education. This massive instructional shift, combined with the lack of educator training in this domain, led to challenges for both learners and educators. This study aimed to disseminate the first set of competencies required of and unique to effective distance simulation educators.

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Background: Simulationists lack standard terms to describe new practices accommodating pandemic restrictions. A standard language around these new simulation practices allows ease of communication among simulationists in various settings.

Methods: We explored consensus terminology for simulation accommodating geographic separation of participants, facilitators or equipment.

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The functional importance of neuronal differentiation of the transmembrane proteins' plasticity-related genes 3 (PRG3) and 5 (PRG5) has been shown. Although their sequence is closely related, they promote different morphological changes in neurons. PRG3 was shown to promote neuritogenesis in primary neurons; PRG5 contributes to spine induction in immature neurons and the regulation of spine density and morphology in mature neurons.

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Introduction: Procedural training is a universal concern amongst pediatric residents and their teachers. We developed and implemented formative assessments to generate direct and indirect procedural feedback. We analyzed changes in residents' perceived procedural knowledge, skills, confidence, and entrustment.

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Introduction: Emergent paediatric intubation is an infrequent but high-stakes procedure in the paediatric emergency department (PED). Successful intubations depend on efficient and accurate preparation. The aim of this study was to use airway drills (brief in-situ simulations) to identify gaps in our paediatric endotracheal intubation preparation process, to improve on our process and to demonstrate sustainability of these improvements over time in a new staff cohort.

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The physical requirements mandated by the COVID-19 pandemic have presented a challenge and an opportunity for simulation educators. Although there were already examples of simulation being delivered at a distance, the pandemic forced this technique into the mainstream. With any new discipline, it is important for the community to agree on vocabulary, methods and reporting guidelines.

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Article Synopsis
  • During adult neurogenesis, neuronal stem cells become mature neurons, with dendritic spines forming late in this process, crucial for brain communication.
  • Dendritic spines are linked to neurological disorders like Alzheimer’s disease and schizophrenia, but the mechanisms behind their formation and related issues are not well understood.
  • A study found that the Protein Plasticity-related Gene 5 (PRG5) is abundantly expressed in brain areas with high regenerative ability and plays a role in the late stages of neurogenesis, specifically in dendritic spine formation, suggesting it may help stabilize spine morphology.
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Background: As simulation matures, it is critical to develop pathways for researchers. A recent analysis, however, demonstrates a low conversion rate between abstract and peer-reviewed journal publication in our field. The International Network for Simulation-based Pediatric Innovation, Research, and Education has used the ALERT Presentation process for the past decade as a means of accelerating research.

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Background: Plasticity-related genes (Prgs/PRGs) or lipid phosphate phosphatase-related proteins (LPPRs) comprise five known members, which have been linked to neuronal differentiation processes, such as neurite outgrowth, axonal branching, or dendritic spine formation. PRGs are highly brain-specific and belong to the lipid phosphate phosphatases (LPPs) superfamily, which influence lipid metabolism by dephosphorylation of bioactive lipids. PRGs, however, do not possess enzymatic activity, but modify lipid metabolism in a way that is still under investigation.

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Background: The aim of this study was to investigate the effect of feedback devices on visual attention and the quality of pediatric resuscitation.

Methods: This was a randomized cross-over simulation study at the Medical University of Vienna. Participants were students and neonatal providers performing four resuscitation scenarios with the support of feedback devices randomized.

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Article Synopsis
  • The ECHO program fosters a two-way learning process between specialists at academic medical centers and community generalists, enabling them to address local challenges in pediatric emergency medicine (PEM) together.* -
  • The study aimed to create a PEM-focused ECHO community to enhance knowledge sharing and stimulate improvements in pediatric care in community emergency departments.* -
  • Participants in the PEM ECHO reported increased PEM knowledge, valued the collaborative learning format, and many implemented new pediatric improvement initiatives as a result.*
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We report the case of a 3-year-old boy who presented to the pediatric emergency department in undifferentiated shock with an acute abdomen. Point-of-care ultrasound revealed viscous perforation with a large amount of free fluid. Intraoperatively, a single magnet was discovered as the likely cause of bowel perforation and the resulting state of shock.

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Introduction: Diabetic ketoacidosis (DKA) is a life-threatening illness which classically presents with polyuria, polydipsia, and polyphagia that can rapidly progress to severe dehydration and altered mental status from cerebral edema. Younger patients may present with subtle or atypical symptoms that are critical to recognize and emergently act upon. Such patients are often cared for by teams in the emergency department (ED) requiring multidisciplinary collaboration.

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Background: The coronavirus disease pandemic caught many pediatric hospitals unprepared and has forced pediatric healthcare systems to scramble as they examine and plan for the optimal allocation of medical resources for the highest priority patients. There is limited data describing pediatric intensive care unit (PICU) preparedness and their health worker protections.

Aim: To describe the current coronavirus disease 2019 (COVID-19) preparedness efforts among a set of PICUs within a simulation-based network nationwide.

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