Didactic or Web-based Training

Transcription

1 Didactic or Web-based Training Massimo Lamperti MD Consultant in Neuroanesthesia and Pediatric Anaesthesia Cleveland Clinic Abu Dhabi, UAE

2 Objectives Current practice in training courses How a training course should be prepared The didactic part The supervised part Web-based courses

3 Current practice in training courses

4 Current practice in training courses Online registration Study (self-study, no online tutoring) Take the exam (passing score threshold 70%) Obtain your card

5 ACLS recertification Simple as ACLS exam Not expensive Web-based Objective

6 Current practice in training courses

7 ATLS aims A. Demonstrate concepts and principles of primary and secondary patient assessment B. Establish management priorities in a trauma situation C. Initiate primary and secondary management necessary within the "golden hour" for the emergency care of acute life-threatening emergencies D. Demonstrate, in a given simulated clinical and surgical skills practicum, the basic skills necessary for the initial assessment and management of patients with multiple injuries

8 ATLS structure Pre and post tests Core content lectures Interactive case presentations Discussions Development of life-saving skills (e.g. surgical airway) Practical laboratory experiences Final evaluation of proficiency in clinical procedures

9 Current practice of training courses

10 The Ultrasound Vascular Access Course Focused on US method for insertion of CICs Lack of teaching on CICs management No supervised training See one, do one philosophy (You-tuber)

11 Current practice in training courses

12 Vascular access for dialysis At the completion of the course, the participant will: - know current guidelines for vascular access provision - be proficient in theoretical and practical decision making regarding vascular access - be competent at basic upper limb arteriovenous ultrasound assessment prior to access formation - be proficient in the surgical techniques of vascular access creation - know options in post op surveillance options for vascular access - be competent in the management of access complications (e.g. failure to mature, thrombosis, venous hypertension, steal)

13 Current practice in training courses

14 A TRAINING COURSE SHOULD HAVE: Didactic part Hands on training on ultrasound devices Hands on training on models (inanimate, phantoms) Hands on training on patients Supervised training Manual/booklet Pre and post tests and final objective proficiency examination

15 The didactic part STANDARDIZED PROGRAM CONTAINING: Indications and contraindications to CICs A systematic method for CICs insertion (US guided vs landmark guided) Insertion complications (mechanical, infectious)

16 The didactic part A STANDARDIZED APPROACH improves: students knowledge behavioral changes in monitoring complications and improving quality of procedural notes patients comfort complications rate

17 The didactic part HANDS ON TRAINING Vascular access devices Ultrasound probes and machines CICs care (medications, fixation, tip s position, complications management)

18 The didactic part HANDS ON MODELS Cadavers Inanimate models Phantoms This part can be web-based lead (on-line demonstrations)

19 The didactic part HANDS ON PATIENTS (SUPERVISED TRAINING) It should be done ONLY when appropriate manual skills are obtained by the trainee There is no standard MINIMAL training suggested At this phase, a trainee s learning curve should be created (this should include time to success, complications and overall judgment on the process)

20 SUPERVISED TRAINING The training period should be performed as soon as possible after the theoretical part of the course and in a 5 days period in order to allow the trainee to perform as much procedures as possible on patients There should be some medico-legal problems related to performing such invasive procedures on patients. An insurance covering complications during academical teaching should be done by Local Institutions organizing the course

21 Manual/booklet A manual with course s contents should be mailed to the trainees at least one month before the beginning of the course with a pre-test course to be completed in order to assess trainees preparation The manual should have text and figures Videos should be provided by a web-based platform including a PDF manual

22 PRE and POST TEST + FINAL AUDIT Pre and post tests are a useful tool for assessing trainees preparation and trainers understanding A poor class post-test score means poor trainers ability Final audit should follow the GRS

23 SUPERVISION It can be done face-to-face or web-based FACE-TO-FACE supervision is more expensive but allows prompt revision of trainee s errors and improved outcome for the patient WEB-BASED supervision can be done as a face-to-face supervision if a webcamera is placed during this phase of the training

24 Web-Based Training The most used application of the www. course is in undergraduate education Students indicate that online courses material made lecture material more interesting and helped reinforce important concepts The effectiveness of online material depends on the quantity of other courses material and the ease with which students can access the materials

25 Web-Based Training Cost-effectiveness of online curricula: $3900 printed vs $1800 www The Web provides a way of managing educational material at a lower cost The use of printed material is disappearing with the coming of tablets

26 Web-based USVA training Didactic traditional course vs. Web Based course 22 trainees No differences on final examination scores, clinical examination scores Satisfaction scores similar (91% WB, 80% DT)

27 Take home points Current practice in training courses is heterogeneous Structured courses perform better Any course should provide a structured didactic and practical part Supervision should be always provided during the course till the final audit Web-based courses are cost-effective but need a good technological support

28 Questions at: