55 Outside the comfort zone: Evaluation of a simulation-based curriculum in managing agitated patients for paediatric residents
Notice bibliographique
Résumé
Given the prevalence of mental health comorbidity in the paediatric population, it is important that paediatricians/paediatric trainees possess competence in the management of acute psychiatric emergencies, including agitation. Experiential learning through simulation is used for safety training when high-risk decisions must be made safely and rapidly. Simulation-based training in the management of acutely agitated patients has been studied in the context of psychiatric training programs; however, limited studies exist to inform effective methods of training paediatric residents in the management of agitation. This study assessed a simulation-based workshop on the knowledge, competence and confidence of paediatric trainees in the management of agitated patients compared to a didactic lecture or no formal educational intervention. This was a prospective comparative cohort study. Paediatric residents were divided among three study groups: Group 1 - a 1-hour didactic lecture on agitation management; Group 2 - a simulation-based workshop on managing the agitated patient; and Group 3 -no intervention. Confidence and knowledge were assessed in groups 1 and 2 using a pre- and post- intervention self-efficacy questionnaire and a clinical vignette. All three groups completed an agitated patient station in the 2018 in-training Objective Structured Clinical Examination (OSCE) assessment. Univariate analysis was completed on the pre- and post- intervention self-efficacy questionnaires, and clinical vignette scores were analyzed using a t-test. Analysis of variance was used to compare OSCE scores between groups. A subgroup analysis was performed to assess OSCE scores by postgraduate year (PGY). Simulation-based workshop participants performed better in the OSCE scenario as demonstrated by their OSCE score (mean 81.7%, CI: 75.1–88.3) compared to those from groups 1 (mean 74.6%, CI: 71.4–77.8) and 3 (mean 71.6%, CI: 69.2–74.0). The most significant difference was present between groups 2 and 3 (p=0.0055), whereas differences in the means between groups 1 and 2 were not as prominent (p=0.0577). No difference in mean OSCE scores was found between groups 1 and 3 (p= 0.1424). Subgroup analysis of OSCE scores by PGY of training did not demonstrate a statistically significant difference (p=0.0615). Scores for this scenario did not improve with increased level of training, demonstrating a persistent knowledge gap amongst trainees. Simulation-based learning may be an effective educational strategy for paediatric residents to acquire skills in managing acute agitation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».