The scope of computerized simulation in competency-based maxillofacial training: a systematic review

Oral and maxillofacial surgery (OMS) teaching is set to undergo a paradigm shift towards competency-based training. With increasing focus on resident skill development and patient safety, computerized simulators are likely to play a more mainstream role in OMS training. A systematic review of the available literature was conducted, in accordance with the PRISMA guidelines, to highlight the scope of computerized simulation in OMS teaching. A PubMed search was performed by two independent reviewers, and 35 articles published in English between 2010 and 2021 that reported the use of computerized simulation for teaching maxillofacial procedures were included in the analysis. Eight articles on minor oral surgery, seven on orthognathic surgery, five on maxillofacial trauma, five on cleft lip and palate surgery, three articles each on nerve block techniques, endoscopic procedures, and reconstructive surgery, and one article on fibre-optic intubation reported the use of computerized simulation that can be applied to OMS training. Ten randomized controlled trials were identified in the search. However there was marked heterogeneity among the studies. Simulator training for skill acquisition mentored by an expert OMS educator could offer holistic resident training; however more studies that test common themes of resident training such as knowledge acquisition and skill development are necessary.     

Clinical Simulation Augments Traditional Interviewing of Advanced Practice Provider Candidates

An essential role of critical care advanced practice providers—advanced practice registered nurses and physician assistants—is to have knowledge and competency to make accurate and efficient decisions. The ability to manage clinical scenarios involving medically deteriorating patients requires higher-order cognitive thinking and leadership skills that are challenging to extrapolate in traditional interviews. In critical care, advanced practice providers must make rapid clinical assessments and implement appropriate medical interventions to deter progression of life-threatening illnesses. Adding clinical simulation to the traditional interview allows interviewers to evaluate applicants’ crisis resource management skills, leadership, and clinical competency.     

外柱细胞软化对Corti器感音影响的生物力学研究

Corti器的感音过程容易受到内部结构属性变化的影响。外柱细胞血管舒张刺激磷蛋白缺失会减缓肌动蛋白丝的形成,从而产生听力延迟。本研究运用COMSOL建立三维有限元模型研究肌动蛋白缺失导致外柱细胞软化时,Corti器感音过程中基底膜和外毛细胞与Deiters细胞结合点的力学行为变化。结果表明,外柱细胞软化会削弱外毛细胞主动力对基底膜位移增益的放大作用,但削弱作用并不会立即产生,Corti器存在维持正常功能的"缓冲"阶段。在100 dB和120 dB之间可能存在一个声压级临界值,在该临界值两侧外柱细胞软化对基底膜应力变化的影响是截然相反的。另外外柱细胞软化对不同外毛细胞与Deiters细胞结合点力学行为的影响也不同,位移增益优先级会因此产生改变。     

Modeling the Recovery of Elective Waiting Lists Following COVID-19: Scenario Projections for England

ObjectivesA significant indirect impact of COVID-19 has been the increasing elective waiting times observed in many countries. In England’s National Health Service, the waiting list has grown from 4.4 million in February 2020 to 5.7 million by August 2021. The objective of this study was to estimate the trajectory of future waiting list size and waiting times up to December 2025.MethodsA scenario analysis was performed using computer simulation and publicly available data as of November 2021. Future demand assumed a phased return of various proportions (0%, 25%, 50%, and 75%) of the estimated 7.1 million referrals “missed” during the pandemic. Future capacity assumed 90%, 100%, and 110% of that provided in the 12 months immediately before the pandemic.ResultsAs a worst-case scenario, the waiting list would reach 13.6 million (95% confidence interval 12.4-15.6 million) by Autumn 2022, if 75% of missed referrals returned and only 90% of prepandemic capacity could be achieved. The proportion of patients waiting under 18 weeks would reduce from 67.6% in August 2021 to 42.2% (37.4%-46.2%) with the number waiting over 52 weeks reaching 1.6 million (0.8-3.1 million) by Summer 2023. At this time, 29.0% (21.3%-36.8%) of patients would be leaving the waiting list before treatment. Waiting lists would remain pressured under even the most optimistic of scenarios considered, with 18-week performance struggling to maintain 60%.ConclusionsThis study reveals the long-term challenge for the National Health Service in recovering elective waiting lists and potential implications for patient outcomes and experience.     

Molecular modeling in cardiovascular pharmacology: Current state of the art and perspectives

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Assessment of the Benefits of Targeted Interventions for Pandemic Control in China Based on Machine Learning Method and Web Service for COVID-19 Policy Simulation

Taking the Chinese city of Xiamen as an example, simulation and quantitative analysis were performed on the transmissions of the Coronavirus Disease 2019(COVID-19) and the influence of intervention combinations to assist policymakers in the preparation of targeted response measures. A machine learning model was built to estimate the effectiveness of interventions and simulate transmission in different scenarios. The comparison was conducted between simulated and real cases in Xiamen. A web inter...     

情景模拟联合案例讨论在急诊护理临床带教中的应用体会

目的探究急诊护理临床带教中采用情景模拟、案例讨论联合教学法效果。方法在本院实习的若干名护生中,选取124名护生分按照教学方法分组,对照组62名实施传统急诊护理带教,观察组62名实施案例讨论、情景模拟联合教学法,对比临床带教效果。结果两组实践与理论成绩相比,观察组成绩更高(P<0.05)。思维、急救及应激能力自我评价相比,观察组的总提高率高于对照组(P<0.05)。实施案例分析结合情景模拟教学模式后,问卷调查中观察组无护生不赞同此模式,非常赞同此教学模式的护生占总人数的90%以上。结论实施案例讨论、情景模拟联合教学模式后,护生急诊护理实践与理论水平均提升,护生我评价较高。     

案例分析与情景模拟在急诊护理教学的效果

目的探讨分案例分析法结合情景模拟法在急诊护理学生教学中的应用价值。方法以2016年10月-2017年10月本院纳入的46例急诊科实习护士为例展开研究,以教学方式的不同将46例急诊科实习护士分成观察组(n=23,接受案例分析法结合情景模拟法教学)和对照组(n=23,接受传统法教学),教学结束后对比分析两组急诊科实习护士的学习情况以及评判性思维能力。结果教学结束后,经考核发现,观察组实操成绩以及理论成绩均高于对照组(P <0.05);观察组寻求真相、求知欲、系统化能力以及分析能力等评判性思维能力均高于对照组(P <0.05)。结论在急诊护理学生教学中应用案例分析法结合情景模拟法进行教学,有利于急诊科实习护士掌握理论知识以及实操知识,同时还可以提高其评判性思维能力,可实现有效教学。