414 results match your criteria BMJ simulation & technology enhanced learning[Journal]


User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study.

BMJ Qual Saf 2020 Jun 30. Epub 2020 Jun 30.

Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK.

Background: User-testing and subsequent modification of clinical guidelines increases health professionals' information retrieval and comprehension. No study has investigated whether this results in safer care.

Objective: To compare the frequency of medication errors when administering an intravenous medicine using the current National Health Service Injectable Medicines Guide (IMG) versus an IMG version revised with user-testing. Read More

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http://dx.doi.org/10.1136/bmjqs-2020-010884DOI Listing

Is virtual reality effective to teach prevention of surgical site infections in the operating room? study protocol for a randomised controlled multicentre trial entitled VIP Room study.

BMJ Open 2020 Jun 21;10(6):e037299. Epub 2020 Jun 21.

TIMC-IMAG, CNRS, Grenoble INP, University Grenoble Alpes, Grenoble, France

Introduction: Some surgical site infections (SSI) could be prevented by following adequate infection prevention and control (IPC) measures. Poor compliance with IPC measures often occurs due to knowledge gaps and insufficient education of healthcare professionals. The education and training of SSI preventive measures does not usually take place in the operating room (OR), due to safety, and organisational and logistic issues. Read More

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http://dx.doi.org/10.1136/bmjopen-2020-037299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311029PMC

Standardised patient encounters to improve quality of counselling for pre-exposure prophylaxis (PrEP) in adolescent girls and young women (AGYW) in Kenya: study protocol of a cluster randomised controlled trial.

BMJ Open 2020 Jun 21;10(6):e035689. Epub 2020 Jun 21.

Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA.

Introduction: Adolescent girls and young women (AGYW) in sub-Saharan Africa are at high risk of HIV acquisition. Pre-exposure prophylaxis (PrEP) demonstration projects observe that AGYW uptake and adherence to PrEP during risk periods is suboptimal. Judgemental interactions with healthcare workers (HCW) and inadequate counselling can be barriers to PrEP use among AGYW. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-035689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311012PMC

Predictors and triggers of incivility within healthcare teams: a systematic review of the literature.

BMJ Open 2020 Jun 7;10(6):e035471. Epub 2020 Jun 7.

Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA.

Objectives: To explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous.

Design: Systematic literature review of quantitative and qualitative empirical studies.

Data Sources: Database searches according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in Medline, CINHAL, PsychInfo, Web of Science and Embase up to January 2020. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-035471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282335PMC

'Turning the tide' on hyperglycemia in pregnancy: insights from multiscale dynamic simulation modeling.

BMJ Open Diabetes Res Care 2020 May;8(1)

Computational Epidemiology and Public Health Informatics Laboratory, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Introduction: Hyperglycemia in pregnancy (HIP, including gestational diabetes and pre-existing type 1 and type 2 diabetes) is increasing, with associated risks to the health of women and their babies. Strategies to manage and prevent this condition are contested. Dynamic simulation models (DSM) can test policy and program scenarios before implementation in the real world. Read More

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http://dx.doi.org/10.1136/bmjdrc-2019-000975DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265040PMC

Mapping tuberculosis prevalence in Ethiopia: protocol for a geospatial meta-analysis.

BMJ Open 2020 May 25;10(5):e034704. Epub 2020 May 25.

Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.

Introduction: Tuberculosis (TB), a major public health concern in Ethiopia, is distributed heterogeneously across the country. Mapping TB prevalence at national and subnational levels can provide information for designing and implementing control strategies. Data for spatial analysis can be obtained through systematic review of the literature, and spatial prediction can be done by meta-analysis of published data (geospatial meta-analysis). Read More

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http://dx.doi.org/10.1136/bmjopen-2019-034704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252965PMC
May 2020
2.063 Impact Factor

Improving newborn heart rate assessment using a simple visual timer.

BMJ Paediatr Open 2020 6;4(1):e000638. Epub 2020 May 6.

Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.

Objective: Newborn resuscitation relies on accurate heart rate (HR) assessment, which, during auscultation, is prone to error. We investigated if a 6 s visual timer (VT) could improve HR assessment accuracy during newborn simulation.

Design: Prospective observational study of newborn healthcare professionals. Read More

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http://dx.doi.org/10.1136/bmjpo-2020-000638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223635PMC

Beyond HOSPEX: what is the additional training value of military hospital exercises (HOSPEX)?

BMJ Mil Health 2020 May 14. Epub 2020 May 14.

256 (City of London) Field Hospital, London, UK.

Background: The use of simulation in clinical environments is a frequently used adjunct to training individuals and teams. The military uses clinical simulation to train large numbers of personnel, standardise patient pathways and sustain specific skills to ensure medical personnel are prepared to deploy in their clinical roles.

Methods: As part of a North Atlantic Treaty Organization (NATO) exercise, 256 Field Hospital (Reserves) deployed a team of clinicians to simulate a role 2 basic field hospital. Read More

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http://dx.doi.org/10.1136/bmjmilitary-2020-001438DOI Listing

Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population.

BMJ Open 2020 May 12;10(5):e032579. Epub 2020 May 12.

Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background And Objective: Simulation models can project effects of tobacco use and cessation and inform tobacco control policies. Most existing tobacco models do not explicitly include relapse, a key component of the natural history of tobacco use. Our objective was to develop, calibrate and validate a novel individual-level microsimulation model that would explicitly include smoking relapse and project cigarette smoking behaviours and associated mortality risks. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-032579DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228509PMC

Cohort study of neonatal resuscitation skill retention in frontline healthcare facilities in Bihar, India, after PRONTO simulation training.

BMJ Paediatr Open 2020 20;4(1):e000628. Epub 2020 Apr 20.

School of Medicine and Department of Obstetrics-Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.

Background: Use of simulation in neonatal resuscitation (NR) training programmes has increased throughout low-income and middle-income countries. Many of such programmes have demonstrated a positive impact on NR knowledge and skill acquisition along with reduction of early neonatal mortality and fresh stillbirth rates. However, NR skill retention after simulation programmes remains a challenge. Read More

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http://dx.doi.org/10.1136/bmjpo-2019-000628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204812PMC

Costs and consequences of using average demand to plan baseline nurse staffing levels: a computer simulation study.

BMJ Qual Saf 2020 Mar 26. Epub 2020 Mar 26.

School of Health Sciences, University of Southampton, Southampton, Hampshire, UK.

Background: Planning numbers of nursing staff allocated to each hospital ward (the 'staffing establishment') is challenging because both demand for and supply of staff vary. Having low numbers of registered nurses working on a shift is associated with worse quality of care and adverse patient outcomes, including higher risk of patient safety incidents. Most nurse staffing tools recommend setting staffing levels at the average needed but modelling studies suggest that this may not lead to optimal levels. Read More

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http://dx.doi.org/10.1136/bmjqs-2019-010569DOI Listing

Mixed-methods approach to understanding clinician macrocognition in the design of a clinical decision support tool: a study protocol.

BMJ Open 2020 Mar 25;10(3):e035313. Epub 2020 Mar 25.

Human Era, Department of Research and Innovation, North York General Hospital, Toronto, Ontario, Canada.

Introduction: The anatomic variants of congenital heart disease (CHD) are multiple. The increased survival of these patients and disposition into communities has led to an increase in their acute presentation to non-CHD experts in primary care clinics and emergency departments. Given the vulnerability and fragility of these patients in the face of acute illness, new clinical decision support systems (CDSS) are urgently needed to better translate the best practice recommendations for the care of these patients. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-035313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170622PMC

S-Vest: a novel hybrid method to allow standardised patients to put on the objective physical examination findings of a disease.

BMJ Innov 2019 Apr 28;5(2-3):78-81. Epub 2019 Aug 28.

Rector Clinical Skills and Simulation Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Background: Simulation hybrids combine single modality simulation such as simulated patients (SP) with low-fidelity simulation to create a potentially more powerful set of educational tools. To make a hybrid that is credible, standardised and inexpensive remains a challenge. We describe the development of the simulation vest (S-Vest), an inexpensive, standardised teaching tool that is 'worn' by an SP to form a hybrid. Read More

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http://dx.doi.org/10.1136/bmjinnov-2018-000312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045787PMC

Are low and middle-income countries prioritising high-value healthcare interventions?

BMJ Glob Health 2020 4;5(2):e001850. Epub 2020 Feb 4.

Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.

Introduction: Since resources are finite, investing in services that produce the highest health gain 'return on investment' is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.

Methods: We used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008-2017) of cost-saving health interventions in LMICs. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042606PMC
February 2020

The role of HIV viral load in mathematical models of HIV transmission and treatment: a review.

BMJ Glob Health 2020 7;5(1):e001800. Epub 2020 Jan 7.

Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

Introduction: HIV viral load (VL) is accepted as a key biomarker in HIV transmission and pathogenesis. This paper presents a review of the role of VL testing in mathematical models for HIV prevention and treatment.

Methods: A search for simulation models of HIV was conducted in PubMed, yielding a total of 1210 studies. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042590PMC
January 2020

Using clinical simulation to study how to improve quality and safety in healthcare.

BMJ Simul Technol Enhanc Learn 2020 Mar 29;6(2):87-94. Epub 2018 Sep 29.

THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.

Simulation can offer researchers access to events that can otherwise not be directly observed, and in a safe and controlled environment. How to use simulation for the study of how to improve the quality and safety of healthcare remains underexplored, however. We offer an overview of simulation-based research (SBR) in this context. Read More

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http://dx.doi.org/10.1136/bmjstel-2018-000370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056349PMC

Timeliness of signal detection for adverse events following influenza vaccination in young children: a simulation case study.

BMJ Open 2020 03 1;10(2):e031851. Epub 2020 Mar 1.

Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.

Objectives: To determine how soon after commencement of the seasonal influenza vaccination programme, the AusVaxSafety active vaccine safety surveillance system, currently in use across Australia, would have detected a safety signal had it been operating in 2010 when there was an unprecedented number of febrile seizures in young children associated with one specific influenza vaccine brand, Fluvax (CSL Biotherapies).

Design: Simulation study.

Setting: Western Australian vaccine influenza coverage and adverse event surveillance data. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-031851DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050305PMC

Combined therapy of photobiomodulation and adipose-derived stem cells synergistically improve healing in an ischemic, infected and delayed healing wound model in rats with type 1 diabetes mellitus.

BMJ Open Diabetes Res Care 2020 02;8(1)

Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Objective: We assessed the therapeutic effects of photobiomodulation (PBM) and adipose-derived stem cell (ADS) treatments individually and together on the maturation step of repairing of a delayed healing wound model in rats with type 1 diabetes mellitus (DM1).

Research Design And Methods: We randomly assigned 24 rats with DM1 to four groups (n=6 per group). Group 1 was the control (placebo) group. Read More

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http://dx.doi.org/10.1136/bmjdrc-2019-001033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206914PMC
February 2020

Evaluation of the effect of multidisciplinary simulation-based team training on patients, staff and organisations: protocol for a stepped-wedge cluster-mixed methods study of a national, insurer-funded initiative for surgical teams in New Zealand public hospitals.

BMJ Open 2020 02 19;10(2):e032997. Epub 2020 Feb 19.

Department of Anaesthesiology, The University of Auckland, Auckland, New Zealand.

Introduction: NetworkZ is a national, insurer-funded multidisciplinary simulation-based team-training programme for all New Zealand surgical teams. NetworkZ is delivered in situ, using full-body commercial simulators integrated with bespoke surgical models. Rolled out nationally over 4 years, the programme builds local capacity through instructor training and provision of simulation resources. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-032997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045010PMC
February 2020

Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey.

BMJ Open 2020 02 10;10(2):e034029. Epub 2020 Feb 10.

Department of Biostatistics, University of Washington, Seattle, Washington, USA.

Objectives: The objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting.

Setting: Paediatric training workshops at a national paediatric conference in Nigeria.

Participants: All 200 healthcare workers who attended the workshop sessions were eligible to participate. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-034029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044915PMC
February 2020

Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care.

BMJ Open Qual 2020 Feb;9(1)

Emergency Department, Gold Coast University Hospital, Southport, Queensland, Australia.

Background: Trauma care represents a complex patient journey, requiring multidisciplinary coordinated care. Team members are human, and as such, how they feel about their colleagues and their work affects performance. The challenge for health service leaders is enabling culture that supports high levels of collaboration, co-operation and coordination across diverse groups. Read More

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http://dx.doi.org/10.1136/bmjoq-2019-000749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047507PMC
February 2020

Retrospective qualitative study evaluating the application of IG4 curriculum: an adaptable concept for holistic surgical education.

BMJ Open 2020 02 9;10(2):e033181. Epub 2020 Feb 9.

European University Cyprus, Nicosia, Nicosia, Cyprus.

Objectives: Faced with a costly and demanding learning curve of surgical skills acquisition, the growing necessity for improved surgical curricula has now become irrefutable. We took this opportunity to formulate a teaching framework with the capacity to provide holistic surgical education at the undergraduate level.

Setting: Data collection was conducted in all the relevant healthcare centres the participants worked in. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-033181DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044980PMC
February 2020
2.063 Impact Factor

Optimising acute stroke care organisation: a simulation study to assess the potential to increase intravenous thrombolysis rates and patient gains.

BMJ Open 2020 01 20;10(1):e032780. Epub 2020 Jan 20.

Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Objectives: To assess potential increases in intravenous thrombolysis (IVT) rates given particular interventions in the stroke care pathway.

Design: Simulation modelling was used to compare the performance of the current pathway, best practices based on literature review and an optimised model.

Setting: Four hospitals located in the North of the Netherlands, as part of a centralised organisational model. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-032780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045180PMC
January 2020

Impact of loss-to-follow-up on cancer survival estimates for small populations: a simulation study using Hospital-Based Cancer Registries in Japan.

BMJ Open 2020 01 13;10(1):e033510. Epub 2020 Jan 13.

Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.

Objectives: The accuracy of the ascertainment of vital status impacts the validity of cancer survival. This study assesses the potential impact of loss-to-follow-up on survival in Japan, both nationally and in the samples seen at individual hospitals.

Design: Simulation study SETTING AND PARTICIPANTS: Data of patients diagnosed in 2007, provided by the Hospital-Based Cancer Registries of 177 hospitals throughout Japan. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-033510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045161PMC
January 2020

Use of 3D modelling and 3D printing for the diagnostic process, decision making and preoperative planning of periprosthetic acetabular fractures.

BMJ Case Rep 2020 Jan 9;13(1). Epub 2020 Jan 9.

Orthopedic and Trauma Clinic, University of Cagliari, Cagliari, Sardegna, Italy.

Periprosthetic acetabular fractures represent an uncommon but challenging complication of total hip arthroplasty (THA), mostly related to low-energy trauma and pathological conditions that reduce bone quality. Therefore, particularly in elderly patients, these fractures are associated with periprosthetic osteolysis and bone loss. CT scan is considered the gold standard to define the fracture pattern; however, the presence of the prosthetic implants in situ limits the full view of the articular surface and bone loss. Read More

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http://dx.doi.org/10.1136/bcr-2019-233117DOI Listing
January 2020

Adjusting Early Warning Score by clinical assessment: a study protocol for a Danish cluster-randomised, multicentre study of an Individual Early Warning Score (I-EWS).

BMJ Open 2020 01 7;10(1):e033676. Epub 2020 Jan 7.

Department of Emergency Medicine, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, Denmark.

Introduction: Track and trigger systems (TTSs) based on vital signs are implemented in hospitals worldwide to identify patients with clinical deterioration. TTSs may provide prognostic information but do not actively include clinical assessment, and their impact on severe adverse events remain uncertain. The demand for prospective, multicentre studies to demonstrate the effectiveness of TTSs has grown the last decade. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-033676DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955532PMC
January 2020

Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study.

BMJ Open 2020 01 7;10(1):e032754. Epub 2020 Jan 7.

Health Technology Assessment, Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Introduction: The introduction of intra-arterial thrombectomy (IAT) challenges acute stroke care organisations to provide fast access to acute stroke therapies. Parameters of pathway performance include distances to primary and comprehensive stroke centres (CSCs), time to treatment and availability of ambulance services. Further expansion of IAT centres may increase treatment rates yet could affect efficient use of resources and quality of care due to lower treatment volume. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-032754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955572PMC
January 2020

Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? A systematic review and narrative synthesis.

BMJ Qual Saf 2020 Jan 7. Epub 2020 Jan 7.

Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK.

Background: Teamwork and communication are recognised as key contributors to safe and high-quality patient care. Interventions targeting process and relational aspects of care may therefore provide patient safety solutions that reflect the complex nature of healthcare. Team reflexivity is one such approach with the potential to support improvements in communication and teamwork, where reflexivity is defined as the ability to pay critical attention to individual and team practices with reference to social and contextual information. Read More

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http://dx.doi.org/10.1136/bmjqs-2019-009921DOI Listing
January 2020

Effective coverage and budget implications of skill-mix change to improve neonatal nursing care: an explorative simulation study in Kenya.

BMJ Glob Health 2019 2;4(6):e001817. Epub 2019 Dec 2.

Health Services Unit, KEMRI - Wellcome Trust Research Programme, Nairobi, Kenya.

Introduction: Neonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.

Methods: Monte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001817DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936475PMC
December 2019

Cautionary study on the effects of pay for performance on quality of care: a pilot randomised controlled trial using standardised patients.

BMJ Qual Saf 2020 Jan 6. Epub 2020 Jan 6.

Department of Systems, Population and Leadership, University of Michigan, Ann Arbor, Michigan, USA.

Background: Due to the difficulty of studying incentives in practice, there is limited empirical evidence of the full-impact pay-for-performance (P4P) incentive systems.

Objective: To evaluate the impact of P4P in a controlled, simulated environment.

Design: We employed a simulation-based randomised controlled trial with three standardised patients to assess advanced practice providers' performance. Read More

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http://dx.doi.org/10.1136/bmjqs-2019-010260DOI Listing
January 2020

What are the chances for personalised treatment with antidepressants? Detection of patient-by-treatment interaction with a variance ratio meta-analysis.

BMJ Open 2019 12 23;9(12):e034816. Epub 2019 Dec 23.

Section for Clinical Psychology and Health Psychology, Zurich University of Applied Sciences/ZHAW, Zurich, Switzerland.

Objectives: To investigate if the treatment effect of antidepressants in patients with depression substantially varies in each patient (patient-by-treatment interaction or treatment heterogeneity), a necessary but largely unexplored prerequisite of personalised antidepressant treatment.

Design: Meta-analytic variance comparison of treatment outcome between drug arms and placebo arms of clinical trials, based on the assumption that patient-by-treatment interaction should lead to larger variances in drug arms than placebo arms. To put the results into context, we run simple simulations, assuming different definitions and rates of those who respond especially well to antidepressants. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-034816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008413PMC
December 2019

Effect of a simple intervention on hand hygiene related diseases in preschools in South Africa: research protocol for an intervention study.

BMJ Open 2019 12 19;9(12):e030656. Epub 2019 Dec 19.

Environmental Health, Faculty of Health Sciences, University of Johannesburg, Auckland Park, South Africa.

Introduction: Hand hygiene (HH) related illnesses such as diarrhoea and respiratory diseases, contribute to the burden of disease and are included in the top five causes of mortality in children under 5 years in South Africa. Children attending preschools are more susceptible to these infections due to the higher number of children in preschools. HH interventions have shown to reduce HH-related diseases by improving HH practices. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-030656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936989PMC
December 2019

Safer surgery through simulation: increasing compliance with the 5 Steps to Safer Surgery through an in-situ simulation based training programme at Guy's and St Thomas' NHS Foundation Trust.

BMJ Simul Technol Enhanc Learn 2019 Oct 12;5(4):196-197. Epub 2019 Feb 12.

Simulation and Interactive Learning (SaIL) Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.1136/bmjstel-2018-000430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892337PMC
October 2019

Optimising systemic insecticide use to improve malaria control.

BMJ Glob Health 2019 11;4(6):e001776. Epub 2019 Nov 11.

Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

Background: Long-lasting insecticidal nets and indoor residual sprays have significantly reduced the burden of malaria. However, several hurdles remain before elimination can be achieved: mosquito vectors have developed resistance to public health insecticides, including pyrethroids, and have altered their biting behaviour to avoid these indoor control tools. Systemic insecticides, drugs applied directly to blood hosts to kill mosquitoes that take a blood meal, offer a promising vector control option. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861066PMC
November 2019

Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

BMJ Qual Saf 2020 04 27;29(4):329-340. Epub 2019 Nov 27.

Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Objective: In this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive support to the pulmonary embolism (PE) diagnostic decision-making process in the emergency department. We hypothesised that the application of HF methods and principles will produce a more usable CDS that improves PE diagnostic decision-making, in particular decision about appropriate clinical pathway.

Materials And Methods: We conducted a scenario-based simulation study to compare a HF-based CDS (the so-called CDS for PE diagnosis (PE-Dx CDS)) with a web-based CDS (MDCalc); 32 emergency physicians performed various tasks using both CDS. Read More

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http://dx.doi.org/10.1136/bmjqs-2019-009857DOI Listing

Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms.

BMJ Open 2019 11 24;9(11):e030430. Epub 2019 Nov 24.

Department of Anaesthesiology, Johannes Gutenberg Universitat Mainz, Mainz, Germany.

Objectives: During a 'cannot intubate, cannot oxygenate' situation, asphyxia can lead to cardiac arrest. In this stressful situation, two complex algorithms facilitate decision-making to save a patient's life: difficult airway management and cardiopulmonary resuscitation. However, the extent to which competition between the two algorithms causes conflicts in the execution of pivotal treatment remains unknown. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-030430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887030PMC
November 2019
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Protocol for a mixed-methods feasibility study for the surviving opioid overdose with naloxone education and resuscitation (SOONER) randomised control trial.

BMJ Open 2019 11 12;9(11):e029436. Epub 2019 Nov 12.

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.

Introduction: The surviving opioid overdose with naloxone education and resuscitation (SOONER) project uses co-design and trial methods to develop and evaluate a point-of-care overdose education and naloxone distribution (OEND) tool. We plan to conduct a randomised controlled trial to assess the effectiveness of our OEND tool in comparison with best available standard of care by observing participants' performance as a responder to a simulated overdose. Recruiting and retaining people at risk of or likely to witness opioid overdose raises scientific, logistical and bioethical challenges. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-029436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858090PMC
November 2019

Towards a safer culture: implementing multidisciplinary simulation-based team training in New Zealand operating theatres - a framework analysis.

BMJ Open 2019 10 31;9(10):e027122. Epub 2019 Oct 31.

Centre for Medical and Health Sciences Education, The University of Auckland, Auckland, New Zealand

Aim: NetworkZ is a simulation-based multidisciplinary team-training programme designed to enhance patient safety by improving communication and teamwork in operating theatres (OTs). In partnership with the Accident Compensation Corporation, its implementation across New Zealand (NZ) began in 2017. Our aim was to explore the experiences of staff - including the challenges they faced - in implementing NetworkZ in NZ hospitals, so that we could improve the processes necessary for subsequent implementation. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830648PMC
October 2019

Association between measured teamwork and medical errors: an observational study of prehospital care in the USA.

BMJ Open 2019 10 31;9(10):e025314. Epub 2019 Oct 31.

Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon, USA

Objectives: The goal of this study was to examine the relationship between measured teamwork and adverse safety events in the prehospital emergency care of children using high-fidelity simulation. We posit that non-technical skills such as leadership, teamwork, situation awareness and decision-making are associated with the clinical success of teams.

Design: Observational study. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830602PMC
October 2019

Interventions for improving teamwork in intrapartem care: a systematic review of randomised controlled trials.

BMJ Qual Saf 2020 01 10;29(1):77-85. Epub 2019 Oct 10.

Department of Anesthesiology and Pain Medicine, Ottawa Hospital, Ottawa, Ontario, Canada

Background: The labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics. Read More

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http://dx.doi.org/10.1136/bmjqs-2019-009689DOI Listing
January 2020

Methods for scaling simulation-based teamwork training.

BMJ Qual Saf 2020 02 9;29(2):98-102. Epub 2019 Oct 9.

Ariadne Labs, Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1136/bmjqs-2019-009515DOI Listing
February 2020

How to pass the emergency OSCE station.

BMJ 2019 Oct 1;367:l2414. Epub 2019 Oct 1.

Cardiff and Vale University Health Board, UK.

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http://dx.doi.org/10.1136/sbmj.l2414DOI Listing
October 2019

How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.

BMJ Glob Health 2019 5;4(5):e001609. Epub 2019 Sep 5.

HERMES Logistics Team, Pittsburgh, Pennsylvania and Baltimore, Maryland, USA.

Introduction: Coping occurs when health system personnel must make additional, often undocumented efforts to compensate for existing system and management deficiencies. While such efforts may be done with good intentions, few studies evaluate the broader impact of coping.

Methods: We developed a computational simulation model of Bihar, India's routine immunisation supply chain where coping (ie, making additional vaccine shipments above stated policy) occurs. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747917PMC
September 2019

Companion robots for older people: importance of user-centred design demonstrated through observations and focus groups comparing preferences of older people and roboticists in South West England.

BMJ Open 2019 09 26;9(9):e032468. Epub 2019 Sep 26.

Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK.

Objective: Companion robots, such as Paro, may reduce agitation and depression for older people with dementia. However, contradictory research outcomes suggest robot design is not always optimal. While many researchers suggest user-centred design is important, there is little evidence on the difference this might make. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-032468DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773331PMC
September 2019
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Evaluating the population impact of hepatitis C direct acting antiviral treatment as prevention for people who inject drugs (EPIToPe) - a natural experiment (protocol).

BMJ Open 2019 09 24;9(9):e029538. Epub 2019 Sep 24.

Glasgow Caledonian University, Glasgow, UK.

Introduction: Hepatitis C virus (HCV) is the second largest contributor to liver disease in the UK, with injecting drug use as the main risk factor among the estimated 200 000 people currently infected. Despite effective prevention interventions, chronic HCV prevalence remains around 40% among people who inject drugs (PWID). New direct-acting antiviral (DAA) HCV therapies combine high cure rates (>90%) and short treatment duration (8 to 12 weeks). Read More

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http://dx.doi.org/10.1136/bmjopen-2019-029538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773339PMC
September 2019
3 Reads

Designing and evaluating a novel mobile application for Helping Babies Breathe skills retention in Uganda: comparative study protocol.

BMJ Paediatr Open 2019 3;3(1):e000561. Epub 2019 Sep 3.

Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.

Introduction: Over 600 000 newborns die each year of intrapartum-related events, many of which are preventable in the presence of skilled birth attendants. Helping Babies Breathe (HBB) is a neonatal resuscitation training programme designed for low-resource settings that can reduce both early neonatal mortality and stillbirths. However, as in other similar educational programmes, knowledge and skill retention deteriorate over time. Read More

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http://dx.doi.org/10.1136/bmjpo-2019-000561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733314PMC
September 2019
6 Reads

Can clinical audits be enhanced by pathway simulation and machine learning? An example from the acute stroke pathway.

BMJ Open 2019 09 17;9(9):e028296. Epub 2019 Sep 17.

Medical School, University of Exeter, Exeter, UK.

Objective: To evaluate the application of clinical pathway simulation in machine learning, using clinical audit data, in order to identify key drivers for improving use and speed of thrombolysis at individual hospitals.

Design: Computer simulation modelling and machine learning.

Setting: Seven acute stroke units. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-028296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756466PMC
September 2019
1 Read

Ophthalmic simulated surgical competency assessment rubric (Sim-OSSCAR) for trabeculectomy.

BMJ Open Ophthalmol 2019 18;4(1):e000313. Epub 2019 Aug 18.

International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.

Background/aims: To develop, test and determine whether a surgical-competency assessment tool for simulated glaucoma surgery is valid.

Methods: The trabeculectomy ophthalmic simulated surgical competency assessment rubric (Sim-OSSCAR) was assessed for face and content validity with a large international group of expert eye surgeons. Cohorts of novice and competent surgeons were invited to perform anonymised simulation trabeculectomy surgery, which was marked using the Sim-OSSCAR in a masked fashion by a panel of four expert surgeons. Read More

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http://dx.doi.org/10.1136/bmjophth-2019-000313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711460PMC
August 2019
1 Read

Reliability of instruments that measure situation awareness, team performance and task performance in a simulation setting with medical students.

BMJ Open 2019 09 12;9(9):e029412. Epub 2019 Sep 12.

Department of Nursing, Umeå University, Umeå, Sweden.

Objectives: The assessment of situation awareness (SA), team performance and task performance in a simulation training session requires reliable and feasible measurement techniques. The objectives of this study were to test the Airways-Breathing-Circulation-Disability-Exposure (ABCDE) checklist and the Team Emergency Assessment Measure (TEAM) for inter-rater reliability, as well as the application of Situation Awareness Global Assessment Technique (SAGAT) for feasibility and internal consistency.

Design: Methodological approach. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-029412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747650PMC
September 2019
1 Read

Evaluating the implications of Brexit for research collaboration and policy: a network analysis and simulation study.

BMJ Open 2019 09 10;9(9):e025025. Epub 2019 Sep 10.

Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London, UK.

Objective: To evaluate the role of the European Union (EU) as a research collaborator in the UK's success as a global leader in healthcare research and innovation and quantify the impact that Brexit may have.

Design: Network and regression analysis of scientific collaboration, followed by simulation models based on alternative scenarios.

Setting: International real-world collaboration network among all countries involved in robotic surgical research and innovation. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747879PMC
September 2019