Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19.
Identifieur interne : 000465 ( Main/Exploration ); précédent : 000464; suivant : 000466Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19.
Auteurs : Nicholas Pokrajac [États-Unis] ; Kimberly Schertzer [États-Unis] ; Cori M. Poffenberger [États-Unis] ; Al'Ai Alvarez [États-Unis] ; Paloma Marin-Nevarez [États-Unis] ; Christopher Winstead-Derlega [États-Unis] ; Michael A. Gisondi [États-Unis]Source :
- The western journal of emergency medicine [ 1936-9018 ] ; 2020.
Descripteurs français
- KwdFr :
- Betacoronavirus (MeSH), Californie (MeSH), Compétence clinique (statistiques et données numériques), Formation médicale continue comme sujet (méthodes), Formation par simulation (méthodes), Humains (MeSH), Infections à coronavirus (prévention et contrôle), Infections à coronavirus (transmission), Liste de contrôle (MeSH), Pandémies (prévention et contrôle), Pneumopathie virale (prévention et contrôle), Pneumopathie virale (transmission), Prévention des infections (instrumentation), Prévention des infections (méthodes), Service hospitalier d'urgences (MeSH), Transmission de maladie infectieuse du patient au professionnel de santé (prévention et contrôle), Équipement de protection individuelle (MeSH).
- MESH :
- méthodes : Formation médicale continue comme sujet, Formation par simulation, Prévention des infections.
- prévention et contrôle : Infections à coronavirus, Pandémies, Pneumopathie virale, Transmission de maladie infectieuse du patient au professionnel de santé.
- statistiques et données numériques : Compétence clinique.
- Betacoronavirus, Californie, Humains, Infections à coronavirus, Liste de contrôle, Pneumopathie virale, Prévention des infections, Service hospitalier d'urgences, Équipement de protection individuelle.
English descriptors
- KwdEn :
- Betacoronavirus (MeSH), COVID-19 (MeSH), California (MeSH), Checklist (MeSH), Clinical Competence (statistics & numerical data), Coronavirus Infections (prevention & control), Coronavirus Infections (transmission), Education, Medical, Continuing (methods), Emergency Service, Hospital (MeSH), Humans (MeSH), Infection Control (instrumentation), Infection Control (methods), Infectious Disease Transmission, Patient-to-Professional (prevention & control), Pandemics (prevention & control), Personal Protective Equipment (MeSH), Pneumonia, Viral (prevention & control), Pneumonia, Viral (transmission), SARS-CoV-2 (MeSH), Simulation Training (methods).
- MESH :
- geographic : California.
- instrumentation : Infection Control.
- methods : Education, Medical, Continuing, Infection Control, Simulation Training.
- prevention & control : Coronavirus Infections, Infectious Disease Transmission, Patient-to-Professional, Pandemics, Pneumonia, Viral.
- statistics & numerical data : Clinical Competence.
- transmission : Coronavirus Infections, Pneumonia, Viral.
- Betacoronavirus, COVID-19, Checklist, Emergency Service, Hospital, Humans, Personal Protective Equipment, SARS-CoV-2.
Abstract
INTRODUCTION
The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient.
METHODS
This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences.
RESULTS
All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%.
CONCLUSION
A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.
DOI: 10.5811/westjem.2020.6.48132
PubMed: 32970559
PubMed Central: PMC7514383
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Gisondi</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Department of Emergency Medicine, Palo Alto</wicri:cityArea></affiliation></author></analytic><series><title level="j">The western journal of emergency medicine</title><idno type="eISSN">1936-9018</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>California (MeSH)</term><term>Checklist (MeSH)</term><term>Clinical Competence (statistics & numerical data)</term><term>Coronavirus Infections (prevention & control)</term><term>Coronavirus Infections (transmission)</term><term>Education, Medical, Continuing (methods)</term><term>Emergency Service, Hospital (MeSH)</term><term>Humans (MeSH)</term><term>Infection Control (instrumentation)</term><term>Infection Control (methods)</term><term>Infectious Disease Transmission, Patient-to-Professional (prevention & control)</term><term>Pandemics (prevention & control)</term><term>Personal Protective Equipment (MeSH)</term><term>Pneumonia, Viral (prevention & control)</term><term>Pneumonia, Viral (transmission)</term><term>SARS-CoV-2 (MeSH)</term><term>Simulation Training (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Betacoronavirus (MeSH)</term><term>Californie (MeSH)</term><term>Compétence clinique (statistiques et données numériques)</term><term>Formation médicale continue comme sujet (méthodes)</term><term>Formation par simulation (méthodes)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (prévention et contrôle)</term><term>Infections à coronavirus (transmission)</term><term>Liste de contrôle (MeSH)</term><term>Pandémies (prévention et contrôle)</term><term>Pneumopathie virale (prévention et contrôle)</term><term>Pneumopathie virale (transmission)</term><term>Prévention des infections (instrumentation)</term><term>Prévention des infections (méthodes)</term><term>Service hospitalier d'urgences (MeSH)</term><term>Transmission de maladie infectieuse du patient au professionnel de santé (prévention et contrôle)</term><term>Équipement de protection individuelle (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>California</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Infection Control</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Education, Medical, Continuing</term><term>Infection Control</term><term>Simulation Training</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Formation médicale continue comme sujet</term><term>Formation par simulation</term><term>Prévention des infections</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Infectious Disease Transmission, Patient-to-Professional</term><term>Pandemics</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Infections à coronavirus</term><term>Pandémies</term><term>Pneumopathie virale</term><term>Transmission de maladie infectieuse du patient au professionnel de santé</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Clinical Competence</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Compétence clinique</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Checklist</term><term>Emergency Service, Hospital</term><term>Humans</term><term>Personal Protective Equipment</term><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Betacoronavirus</term><term>Californie</term><term>Humains</term><term>Infections à coronavirus</term><term>Liste de contrôle</term><term>Pneumopathie virale</term><term>Prévention des infections</term><term>Service hospitalier d'urgences</term><term>Équipement de protection individuelle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32970559</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>18</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1936-9018</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>5</Issue><PubDate><Year>2020</Year><Month>Jul</Month><Day>21</Day></PubDate></JournalIssue><Title>The western journal of emergency medicine</Title><ISOAbbreviation>West J Emerg Med</ISOAbbreviation></Journal><ArticleTitle>Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19.</ArticleTitle><Pagination><MedlinePgn>1089-1094</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.5811/westjem.2020.6.48132</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pokrajac</LastName><ForeName>Nicholas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schertzer</LastName><ForeName>Kimberly</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poffenberger</LastName><ForeName>Cori M</ForeName><Initials>CM</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alvarez</LastName><ForeName>Al'ai</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marin-Nevarez</LastName><ForeName>Paloma</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Winstead-Derlega</LastName><ForeName>Christopher</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gisondi</LastName><ForeName>Michael A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Stanford University, Department of Emergency Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>West J Emerg Med</MedlineTA><NlmUniqueID>101476450</NlmUniqueID><ISSNLinking>1936-900X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002140" MajorTopicYN="N" Type="Geographic">California</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057189" MajorTopicYN="N">Checklist</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002983" MajorTopicYN="N">Clinical Competence</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName><QualifierName UI="Q000635" MajorTopicYN="N">transmission</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004502" MajorTopicYN="N">Education, Medical, Continuing</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004636" MajorTopicYN="N">Emergency Service, Hospital</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017053" MajorTopicYN="N">Infection Control</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017758" MajorTopicYN="N">Infectious Disease Transmission, Patient-to-Professional</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000067393" MajorTopicYN="Y">Personal Protective Equipment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName><QualifierName UI="Q000635" MajorTopicYN="N">transmission</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000066908" MajorTopicYN="N">Simulation Training</DescriptorName><QualifierName UI="Q000379" 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IdType="pubmed">32293717</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Pokrajac, Nicholas" sort="Pokrajac, Nicholas" uniqKey="Pokrajac N" first="Nicholas" last="Pokrajac">Nicholas Pokrajac</name></region><name sortKey="Alvarez, Al Ai" sort="Alvarez, Al Ai" uniqKey="Alvarez A" first="Al'Ai" last="Alvarez">Al'Ai Alvarez</name><name sortKey="Gisondi, Michael A" sort="Gisondi, Michael A" uniqKey="Gisondi M" first="Michael A" last="Gisondi">Michael A. Gisondi</name><name sortKey="Marin Nevarez, Paloma" sort="Marin Nevarez, Paloma" uniqKey="Marin Nevarez P" first="Paloma" last="Marin-Nevarez">Paloma Marin-Nevarez</name><name sortKey="Poffenberger, Cori M" sort="Poffenberger, Cori M" uniqKey="Poffenberger C" first="Cori M" last="Poffenberger">Cori M. Poffenberger</name><name sortKey="Schertzer, Kimberly" sort="Schertzer, Kimberly" uniqKey="Schertzer K" first="Kimberly" last="Schertzer">Kimberly Schertzer</name><name sortKey="Winstead Derlega, Christopher" sort="Winstead Derlega, Christopher" uniqKey="Winstead Derlega C" first="Christopher" last="Winstead-Derlega">Christopher Winstead-Derlega</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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