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postgraduate thesis: Simulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?

TitleSimulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?
Authors
Issue Date2013
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Sin, L. R. [冼樂文]. (2013). Simulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5098845
AbstractIntroduction Simulation training is widely adopted in clinical medicine. Simulated environment provides a safe condition for participants to practice without any harm inflicted on patients. Within the spectrum of clinical anaesthesia, simulation mannequin was first developed in 1960. The first journal article with description about the use of simulator to teach intubation to anaesthesia residents occurred in 1969. The first report about simulated anaesthesia training was in 1988. Since then, there has been a flourishing trend of adopting this simulation training in clinical anaesthesia, across various subspecialties including obstetric anaesthesia, cardiac anaesthesia. For individual perspective, simulation training expanded beyond skill development into non technical skill training. This article is to review the impact of simulation training for individual development for anaesthesia residents or trainees. The aim is to evaluate the evidence of simulation training on individual anaesthesia resident performance and improvement on patient outcome. As a result, more vigorous use of simulation is adopted in modular subspecialty anaesthesia and also non-technical skill training for residents. Methods A search of literatures through search engines of Pubmed, Google Scholars, EMBASE, Cochrane library for ‘Simulation for training of clinical anaesthesia’ was done. After limit the search for English language and past 10 years, there are 223 articles. With appropriate exclusion criteria, 25 articles are selected for detail evaluation. Results Simulation has good effects in various aspects. For various anaesthesia subspecialties, simulation-based training can improve trainees’ confidence and capability in handling rare but life-threatening peri-operative crises. For assessments, simulation is an essential part of Israeli Board Examination in Anesthesia with good discriminating power. For technical skill development, simulation-based training can reduce residents’ time requirement to perform cricothyroidotomy and improve successful rate of central line insertion. The specific skill developed can retain for long period of time such as 12 months. For non-technical skills, there are conflicting results in behavioural scores. For patient safety and outcome perspective, there lacks the result from individual simulation-based training study. Conclusions Simulation in anaesthesia residents training is a worldwide practice. These simulation training allow residents to have exposure in various anesthesia subspecialty including cardiac, obstetrics, liver transplant. There are specific technical and non-technical skill development. Individual performance particularly time to complete cricothyroidotomy and confidence, understanding of procedures and anatomy by residents are also enhanced. Thus, simulation should be allocated more proportion of anaesthesia resident training in Hong Kong. Although there remains no study showing better patient outcome after simulation-based individual training, future studies should be done to confirm such presence and degree of association with simulation training.
DegreeMaster of Public Health
SubjectAnesthesia - Study and teaching
Dept/ProgramCommunity Medicine
Persistent Identifierhttp://hdl.handle.net/10722/193781

 

DC FieldValueLanguage
dc.contributor.authorSin, Lok-man, Raymond-
dc.contributor.author冼樂文-
dc.date.accessioned2014-01-27T23:10:44Z-
dc.date.available2014-01-27T23:10:44Z-
dc.date.issued2013-
dc.identifier.citationSin, L. R. [冼樂文]. (2013). Simulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5098845-
dc.identifier.urihttp://hdl.handle.net/10722/193781-
dc.description.abstractIntroduction Simulation training is widely adopted in clinical medicine. Simulated environment provides a safe condition for participants to practice without any harm inflicted on patients. Within the spectrum of clinical anaesthesia, simulation mannequin was first developed in 1960. The first journal article with description about the use of simulator to teach intubation to anaesthesia residents occurred in 1969. The first report about simulated anaesthesia training was in 1988. Since then, there has been a flourishing trend of adopting this simulation training in clinical anaesthesia, across various subspecialties including obstetric anaesthesia, cardiac anaesthesia. For individual perspective, simulation training expanded beyond skill development into non technical skill training. This article is to review the impact of simulation training for individual development for anaesthesia residents or trainees. The aim is to evaluate the evidence of simulation training on individual anaesthesia resident performance and improvement on patient outcome. As a result, more vigorous use of simulation is adopted in modular subspecialty anaesthesia and also non-technical skill training for residents. Methods A search of literatures through search engines of Pubmed, Google Scholars, EMBASE, Cochrane library for ‘Simulation for training of clinical anaesthesia’ was done. After limit the search for English language and past 10 years, there are 223 articles. With appropriate exclusion criteria, 25 articles are selected for detail evaluation. Results Simulation has good effects in various aspects. For various anaesthesia subspecialties, simulation-based training can improve trainees’ confidence and capability in handling rare but life-threatening peri-operative crises. For assessments, simulation is an essential part of Israeli Board Examination in Anesthesia with good discriminating power. For technical skill development, simulation-based training can reduce residents’ time requirement to perform cricothyroidotomy and improve successful rate of central line insertion. The specific skill developed can retain for long period of time such as 12 months. For non-technical skills, there are conflicting results in behavioural scores. For patient safety and outcome perspective, there lacks the result from individual simulation-based training study. Conclusions Simulation in anaesthesia residents training is a worldwide practice. These simulation training allow residents to have exposure in various anesthesia subspecialty including cardiac, obstetrics, liver transplant. There are specific technical and non-technical skill development. Individual performance particularly time to complete cricothyroidotomy and confidence, understanding of procedures and anatomy by residents are also enhanced. Thus, simulation should be allocated more proportion of anaesthesia resident training in Hong Kong. Although there remains no study showing better patient outcome after simulation-based individual training, future studies should be done to confirm such presence and degree of association with simulation training.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.subject.lcshAnesthesia - Study and teaching-
dc.titleSimulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?-
dc.typePG_Thesis-
dc.identifier.hkulb5098845-
dc.description.thesisnameMaster of Public Health-
dc.description.thesislevelMaster-
dc.description.thesisdisciplineCommunity Medicine-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b5098845-
dc.date.hkucongregation2013-

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