"To Err Is Human" but Disclosure Must be Taught: A Simulation-Based Assessment Study.

Introduction: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario.

Methods: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event.

A comprehensive, simulation-based approach to teaching clinical skills: the medical students' perspective.

The purpose of this study was to determine if third-year medical students participating in a mandatory 12-week simulation course perceived improvement in decision-making, communication, and teamwork skills. Students participated in or observed 24 acute emergency scenarios. At 4-week intervals, students completed 0-10 point Likert scale questionnaires evaluating the curriculum and role of team leader.

Meta-analysis of protocolized goal-directed hemodynamic optimization for the management of severe sepsis and septic shock in the Emergency Department.

Introduction: To perform a meta-analysis identifying studies instituting protocolized hemodynamic optimization in the emergency department (ED) for patients with severe sepsis and septic shock.

Methods: We modeled the structure of this analysis after the QUORUM and MOOSE published recommendations for scientific reviews. A computer search to identify articles was performed from 1980 to present.

Use of ultrasound guidance improves central venous catheter insertion success rates among junior residents.

Objectives: The purpose of this study was to determine whether junior residents had higher rates of first cannulation and overall success at central venous catheter insertions with the use of ultrasound (US) guidance compared to the landmark technique.

Methods: We conducted a secondary analysis of data from a prospective randomized controlled study of junior residents from January 2007 through September 2008, which assessed the impact of simulation training on central venous catheter insertion success rates. Blinded independent raters observed in-hospital central venous catheter insertions using a procedural checklist.

Simulation and patient safety: evaluative checklists for central venous catheter insertion.

In the advent of concerns for patient safety, simulation training is emerging as a method to train healthcare providers to perform invasive procedures such as central venous catheter (CVC) insertion while minimising harmful complications to the patient. New technologies in medical simulation have begun to shift research attention to the performance component of clinical competency. Accurate assessment of healthcare provider competence is a major priority in medical education necessitating the development of valid and reliable assessment tools.

Simulation training in central venous catheter insertion: improved performance in clinical practice.

Purpose: To determine whether simulation training of ultrasound (US)-guided central venous catheter (CVC) insertion skills on a partial task trainer improves cannulation and insertion success rates in clinical practice.

Method: This prospective, randomized, controlled, single-blind study of first- and second-year residents occurred at a tertiary care teaching hospital from January 2007 to September 2008. The intervention group (n = 90) received a didactic and hands-on, competency-based simulation training course in US-guided CVC insertion, whereas the control group (n = 95) received training through a traditional, bedside apprenticeship model.

Teaching and assessing procedural skills using simulation: metrics and methodology.

Simulation allows educators to develop learner-focused training and outcomes-based assessments. However, the effectiveness and validity of simulation-based training in emergency medicine (EM) requires further investigation. Teaching and testing technical skills require methods and assessment instruments that are somewhat different than those used for cognitive or team skills.