Motor capacities involved in the psychomotor skills of the cardiopulmonary resuscitation technique: recommendations for the teaching-learning process

It is a bibliographic study about the identification of the motor capacities involved in the psychomotor skills of the cardiopulmonary resuscitation (CPR) which aims to obtain subsidies to the planning of the teaching-learning process of this skill. It was found that: the motor capacities involved in the psychomotor skill of the CPR technique are predominantly cognitive and motor, involving 9 perceptive-motor capacities and 8 physical proficiency capacities. The CPR technique is a psychomotor skill classified as open, done in series and categorized as a thin and global skill and the teaching-learning process of the CPR technique has an elevated degree of complexity.     

The role of simulation for learning within pre-registration nursing education - a literature review

Simulated learning in a clinical skills centre has become more popular within undergraduate nursing education and is increasingly used to teach and assess clinical skill acquisition. Current literature suggests that there is some validity in teaching psychomotor skills in a designated simulated clinical skills centre, whilst other sources still question its value in terms of experience. Such contradictions demand further exploration and appraisal of the current literature.The findings show that simulated learning in a clinical skills laboratory is reported to increase student confidence and prepares students for real clinical setting, however, this acquisition of skill is often achieved at different rates by different students. A standardised approach to simulated learning in nursing education and the development of further holistic clinical scenarios which are linked to related theory and lectures, would offer measurable learning outcomes to meet professional and regulatory requirements. Therefore, further evaluation of the current learning methods within simulation may offer appraisal of the preparation of students for clinical practice, to ensure that students are offered quality-learning opportunities that are flexible and responsive to both their needs and the demands of the Health Care Services.     

A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review.

OBJECTIVE: Ultrasound is a versatile diagnostic modality used in a variety of medical fields. Wayne State University School of Medicine (WSUSOM) is one of the first medical schools in the United States to integrate an ultrasound curriculum through both basic science courses and clinical clerkships. METHODS: In 2006, 25 portable ultrasound units were donated to WSUSOM. First-year medical students were provided an ultrasound curriculum consisting of 6 organ-system sessions that addressed the basics of ultrasound techniques, anatomy, and procedural skills. After the last session, students were administered 2 anonymous and voluntary evaluations. The first assessed their overall experience with the ultrasound curriculum, and the second assessed their technical skills in applying ultrasound techniques. RESULTS: Eighty-three percent of students agreed or strongly agreed that their experience with ultrasound education was positive. On the summative evaluation, nearly 91% of students agreed or strongly agreed that they would benefit from continued ultrasound education throughout their 4 years of medical school. Student performance on the technical assessment was also very positive, with mean class performance of 87%. CONCLUSIONS: As residency programs adopt ultrasound training, medical school faculty should consider incorporating ultrasound education into their curriculum. Portable ultrasound has the potential to be used in many different settings, including rural practice sites and sporting events. The WSUSOM committee's pilot ultrasound curriculum will continue to use student feedback to enhance the ultrasound experience, helping students prepare for challenges that they will face in the future.     

Psychomotor skill development

Psychomotor skills represent those activities that are primarily movement-oriented. In teaching, emphasis is placed on this movement component, although ultimately in practice, performance requires an integration of related knowledges and values. This article examines the process of psychomotor skill development and provides guidelines for teaching motor skills.     

Nursing students' performance: administering injections in laboratory and clinical area

Little research has been done regarding the teaching of psychomotor nursing skills in order to achieve an appropriate level of proficiency. This study examined the skill of parenteral medication administration, comparing laboratory proficiency to clinical proficiency over time. Subjects included 35 associate degree nursing students. The Spielberger State-Trait Anxiety Inventory was used as well as an injection performance skill check list. There was no significant change in the number of errors between the laboratory "check-out" and the first clinical performance, nor was anxiety related to skill performance. Further study related to psychomotor skill acquisition is needed.     

Effect of Preclinical Simulation on Family Nurse Practitioner Student’s Readiness for Practice

This project aimed to enhance clinical education preparation in a family nurse practitioner graduate program in rural central Appalachian by providing a psychomotor skills-based simulation with the use of the defusing, discovering, and deepening (3D) debriefing method. The students were surveyed after graduation to determine effectiveness. Program outcomes to measure readiness to practice were graduation, employment, and certification rates. The postgraduation surveys indicated the simulation contributed to an increase in psychomotor skill performance, practicing safe patient care, and making independent decisions in practice. Common themes emerged of feeling “prepared for practice” and being “more marketable” with the procedural skills learned in the simulation.     

Comparing student nurse knowledge and performance of basic life support algorithm actions: An observational post-retention test design study

This study aims to identify which basic life support skills of student nurses deteriorate in a period of four months. Secondly, it investigates the link between a specific cognitive skill and its corresponding motor skill in BLS. The population for this study consisted of 169 general nursing students within the first year cohort of a three-year undergraduate nursing education program. Following a BLS course, a multiple-choice questionnaire and a BLS performance test on a manikin was administered two weeks (post) and four months (retention) after the course. Seven BLS subcomponents were compared. In both the post and retention test, knowledge was better than the corresponding motor skill for five of the seven subcomponents. Two weeks after training, more than 50% of the students failed to perform ‘time to check respiration’, ‘ventilation volume’, ‘compression depth’ and ‘compression frequency’ correctly. Four months after training, significantly more students reached a correct ‘ventilation volume’ but performed it incorrectly. Nurse educators are recommended to spend more time on hands-on skills practice than on theory. Special attention should be given to the performance of a correct ventilation technique, a sufficiently deep chest compression and a correct compression frequency.     

Effect of PETTLEP imagery training on performance of nursing skills: pilot study

Title.  Effect of PETTLEP imagery training on performance of nursing skills: pilot study.
Aim.  This article is a report of a study to evaluate the effect of PETTLEP-based imagery training on nursing skill performance.
Background.  Imagery structuring has been demonstrated to facilitate the development of psychomotor skills in sporting performance. A form of imagery structuring known as PETTLEP was employed in this study. PETTLEP (an acronym for its procedures) involves preparation through focussing on physical characteristics, the environment, the task itself, timing, learning, emotion and perspective.
Methods.  A pilot study was conducted, using experimental design, and the data were collected in 2005. Participants in the experiment were 56 pre-registration students from one university in the United Kingdom. Half of the students received training for two basic nursing skills using PETTLEP procedures, and scores were compared for two objective structured clinical examinations.
Results.  Students who received PETTLEP training for blood pressure measurement performed statistically significantly better than those who did not ( F  = 4·62 P  = <0·05). The training did not have a statistically significant effect for aseptic techniques. We suggest that the psychomotor element in aseptic techniques was not as important as that involved in blood pressure measurement.
Conclusion.  PETTLEP imagery should be explored further as a method to help nursing students acquire skills that have a psychomotor component.     

Evaluation of a cardiopulmonary resuscitation course for secondary schools.

The objective of this study was to test the feasibility of teaching secondary school students to perform cardiopulmonary resuscitation (CPR) according to National Research Council (NRC)--American Heart Association (AHA) standards. Criterion levels specified by AHA call for cardiac compression at a rate of 60 times a minute with two ventilations interposed after 15 cardiac compressions. Translated into numerical performance per minute, this standard equates to 36 compressions and six ventilations per minute. Students were instructed by their usual teachers who received a special educational program in preparation. Both immediate learning and retention of the students after three months were evaluated using a practical and a written test. Teacher performance was evaluated by means of a practical test and a behavior rating. CPR is a motor task involving both continuous and discrete processes. Results of the study corresponded to analogous studies in the psychomotor literature: practice group students' retention of continuous skills (breaths and compressions) was good (little loss of skill), while retention of discrete motor skills (open the airway, check vital signs) was poor. Fifty-five per cent of the practice group in the initial test and 31 per cent in the retention study were able to perform the skills. Retention figures compare favorably with studies in the area of psychomotor learning. The study suggests that it is possible to train secondary school students to perform the ABC's of CPR if they have an opportunity to practice these skills. The study also suggests that the teacher training is an important factor.     

Teaching psychomotor skills in nursing: a randomized control trial

Historically, McMaster University School of Nursing in Hamilton, Ontario, Canada has utilized self-directed learning methods to teach psychomotor nursing skills to undergraduate nursing students. Second year students, in their post-clinical evaluations indicated a desire for a structured laboratory setting to assist them in acquiring these skills. In response, faculty designed a randomized control trial to compare the effectiveness of teaching psychomotor skills in a structured laboratory setting with self-directed self-taught modules. The results of this study substantiated the hypothesis of no difference between psychomotor skill performance of students who learn in a self-directed manner and those taught in a structured clinical laboratory.     

Integration of a Low‐Cost Introductory Ultrasound Curriculum Into Existing Procedural Skills Education for Preclinical Medical Students

We evaluated integration of an introductory ultrasound curriculum into our existing mandatory procedural skills program for preclinical medical students. Phantoms consisting of olives, pimento olives, and grapes embedded in opaque gelatin were developed. Four classes encouraged progressive refinement of phantom‐scanning and object identification skills. Students improved their ability to identify hidden objects, although each object type achieved a statistically significant improvement in correct identification at different time points. The total phantom cost per student was $0.76. Our results suggest that short repeated experiences scanning simple, low‐cost ultrasound phantoms confer basic ultrasound skills.     

Integration of Point-of-Care Ultrasound Education Into the Internal Medicine Core Clerkship Experience

Point-of-care ultrasound (POCUS) is becoming an essential skill for internists. To date, there are no professional guidelines for how POCUS skills should be taught to medical students. A panel of POCUS experts from seven academic medical centers in the United States was convened to describe the components of independently developed IM clerkship POCUS training programs, identify areas of similarity and difference, and propose recommendations for alignment.     

Who Is the Preferred Tutor in Clinical Skills Training: Physicians,Nurses, or Peers?

Phenomenon: Clinical skills centers allow structured training of undergraduate medical students for the acquisition of clinical skills in a simulated environment. Physician, nurse, or peer tutors are employed for training in those centers. All tutors should have appropriate training about the methodology used in the clinical skills training. Many of the studies revealed the effectiveness of various types of tutors. The aim of our study was to evaluate medical students' satisfaction with clinical skills training, and their opinions about the differences in coaching skills among the physician, nurse, and peer tutors. Approach: This study was conducted with third-year students (467 students) in 2013-2014 academic year at Hacettepe University Faculty of Medicine. Participation rate was 85 % (397 students). The students attended the suturing skill training in groups of 40 students. First, a faculty member from the Department of Medical Education delivered a video demonstration and conducted discussion. After the demonstration, the students were divided into groups of 5-6 students. A physician, nurse, or a peer tutor facilitated each group. The students were asked to complete the Coaching Skills Evaluation Form after the practicum session. It contained 13 criteria for assessing the coaching skills. Additionally, the form included a question for rating the student's satisfaction with the tutor. The performance of the tutors at each step was rated on a three-point scale. Findings: Kruskal Wallis analysis was used to compare students' scores for their tutors. The students' satisfaction with tutors was high for all of the tutors. However, there was no difference between students' scores in suturing skill, and between physician, nurse, and peer tutors' coaching skills. Insights: In this study, we revealed that physician, nurse, and peer tutors were equally effective on the students' performances. They were also regarded as effective in their teaching role by students. But the most important point was that sufficient tutor training and preparation was crucial for the success of models.     

Enhancing effectiveness in assessing forensic nursing staff competency

Assessing the competency of forensic nurses is an evolving area of management practice. This article presents a performance-based model for the assessment process. Examples of competency assessment activities that can measure psychomotor skills, critical thinking, and interpersonal skills are discussed, along with a sample competency for a selected skill. Evaluation strategies and their effectiveness are also analyzed.     

Improvement in medical students’ communication and interpersonal skills as evaluated by patient satisfaction questionnaire after curriculum reform

Fifteen years of undergraduate medical education curriculum reform at Saga Medical School was evaluated by measuring medical students’ communication and interpersonal skills with a patient satisfaction questionnaire developed by the American Board of Internal Medicine. A multiphase cross-sectional study was conducted at the General Medicine Clinic of Saga Medical School Hospital in phase I (1998–1999), phase II (2001–2002), and phase III (2009–2010). A total of 1,963 patient ratings for 437 medical students’ performance was analyzed. The average scores of phases II and III were significantly higher than for phase I. The average score of female students showed a significant difference between phases I and II, but no difference between phases II and III. The average score of male students showed no difference between phases I and II, but significant difference between phases II and III. The phase II curriculum introduced basic clinical skills and examination and improved female students’ performance. The phase III curriculum was effective for male students because it emphasized the clinical skill program more and introduced problem-based learning. Curriculum reform at Saga Medical School is considered to have made good progress in improving students’ clinical competence and patient-centered attitudes.     

Freehand 3-D Ultrasound Imaging: A Systematic Review

Two-dimensional ultrasound (US) imaging has been successfully used in clinical applications as a low-cost, portable and non-invasive image modality for more than three decades. Recent advances in computer science and technology illustrate the promise of the 3-D US modality as a medical imaging technique that is comparable to other prevalent modalities and that overcomes certain drawbacks of 2-D US. This systematic review covers freehand 3-D US imaging between 1970 and 2017, highlighting the current trends in research fields, the research methods, the main limitations, the leading researchers, standard assessment criteria and clinical applications. Freehand 3-D US systems are more prevalent in the academic environment, whereas in clinical applications and industrial research, most studies have focused on 3-D US transducers and improvement of hardware performance. This topic is still an interesting active area for researchers, and there remain many unsolved problems to be addressed.     

Integrating technology in skills lab: Using smartphones for urinary catheter validation

Nurse educators are challenged to promote student success in all learning environments. Historically, students had increased anxiety associated with poor outcomes for indwelling urinary catheter skill validation. Faculty were looking for alternative ways to reduce stress, improve learning, and achieve successful student skill validations.The purpose of this process change project was to implement and evaluate an innovative teaching strategy of a psychomotor skill. Specifically, the integration of smartphone technology, self-evaluation, and peer feedback on indwelling urinary catheter skill validation was implemented and student perceptions of this strategy were evaluated. Throughout two, four-hour skills lab sessions, 81 students in the second semester of a baccalaureate program in nursing participated in peer pairs where they used smartphones to video and refine their indwelling urinary catheter skills through self-reflection and peer feedback.Students reported the utilization of technology and peer feedback positively enhanced learning and “decreased anxiety”. However, students agreed integrating technology into a psychomotor skill validation was not without challenges. However, the benefits outweighed the challenges providing implications for nursing education to use smartphones to evaluate a psychomotor skill as a strategy to integrate technology, self-reflection, and peer feedback into a clinical skills lab environment.     

Ultrasound Exposure During Gross Anatomy

Background

As medical schools seek to standardize ultrasound training and incorporate clinical correlations into the basic science years, we proposed that ultrasonography should have a greater role in the anatomy curriculum.

Objectives

To describe the introduction of ultrasound into the curriculum of a first-year medical student anatomy course and evaluate the utility of this introduction.

Methods

First-year medical students attended two ultrasound lectures and three small-group hands-on sessions that focused on selected aspects of musculoskeletal, thoracic, abdominal, and neck anatomy. Pre and post surveys were administered to assess student perception of their ability to obtain and interpret ultrasound images and the utility of ultrasound in the anatomy course. Understanding of basic ultrasound techniques and imaging was tested in the practical examinations.

Results

Of the 269 first-year medical students who completed the course, 144 students completed both surveys entirely, with a response rate of 53%. Students' interest and self-perceived experience, comfort, and confidence in ultrasound skills significantly increased (p < 0.001) as a result of this early introduction to ultrasonography. Objective evidence, provided by practical examination scores on ultrasound images, is consistent with this self-perceived confidence reported by students.

Conclusions

Ultrasound can be effectively incorporated into an anatomy course for first-year medical students by utilizing didactics and hands-on exposure. Medical students found the addition of ultrasound training to be valuable, not only in enhancing their understanding of anatomy, but also in increasing their interest and experience in ultrasound imaging.     

Assessing Southeastern Advanced Practice Registered Nurses’ Business and Operational Skill Sets

As advanced practice registered nurses (APRNs) open private practices in medically underserved areas, clinical, practice management, and business skills are needed conjunctively to remain operational. Further information is needed to understand APRN business and entrepreneurial skill needs. A convenience sample assessed perceptions of confidence in business and operational skill sets needed for entrepreneurial roles in 102 APRNs, representing diversity of subspecialties and practice locations in 4 southeastern states with provider shortages: Alabama, Florida, Mississippi, and Tennessee. Sustaining practices in underserved areas requires providing innovative educational offerings to address APRN business skills needs.