Abdul Karim Qayumi

Background: Variety of tools have been used to teach history-taking skills to novice learners. Standardized Patient (SP) is the gold standard for medical education. We hypothesized that the use of online simulation platforms CyberPatient ™ (CP) is as effective as SP. Methods: In this prospective randomized controlled trial study, the educational effectiveness of CP was compared to SP in improving history taking skills. Twenty-two incoming students at University of British Columbia (UBC) were randomly divided into two (SP and CP) groups. SP Group (n = 11) practiced their history taking skills with standardized patients and CP Group (n = 11) with CyberPatients. The content for both groups included 3 cases of GI pathology and the study time was 60 minutes. Assessment method included Objective Structured Clinical Examination (OSCE) before and after interventions. Data were analyzed in a two-way between/within analysis of variance (ANOVA) and Wald test was used to deal with the violation of the ANOVA assumptions. Economic benefits were assessed as Cost-effectiveness (calculated as Cost/Effect Ratio) and Cost-Value Proposition (Cost-Vale Relationship). Results: Each group had significant (SP group p = 0.006 and CP group p = 0.0001) improvement in the knowledge domain of history taking. The history taking knowledge variable in both groups indicated that students did better after interventions with a significant main effect of time, p = 0.011. The groups performed at a similar level after intervention. Moreover, results show that the use of the CP is more cost-effective and has a better cost/value proposition for medical education. Conclusion: We conclude that CyberPatient™ is as effective as using standardized patients in delivery of practical knowledge for novice medical students, however, CyberPatient™ is more economically rewarding.

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Introduction: The difficulty of differential diagnoses between cellulitis and occult cutaneous abscess remains the main issue in clinical practice. Educational efforts, however, have been invested into building simulation models directed toward the treatment of cutaneous abscesses. The discrepancy between the problem in clinical practice and educational efforts in this area requires simulation models that can provide an opportunity for trainees to practice their diagnostic skills.Aims: The study focuses on creating a cutaneous abscess model that is detectable by ultrasound and evaluating the reliability and validity of detecting clinical and sonographic features of cutaneous abscess disease on the basis of the model.Materials and methods: Six identical models were made, each consisting of a water balloon filled with mock abscess and two glue threads inside a pork belly, and radiologist standardized ultrasound images of the model. Reliability and validity of detecting key diagnostic features on the basis of the model by 24 judges were explored.Results: Cronbach’s alpha across all models were 0.89 and 0.87 for clinical and sonographic features, respectively. The intraclass correlation coefficient was 0.71 for both clinical and sonographic features. The correlation between all clinical and sonographic features and corresponding construct were statistically significant (p
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Patient handover has been recognized as a highly complex and dynamic process that relies heavily on effective communication. The lack of effective communication, particularly in an interprofessional Emergency Department (ER) setting, can compromise the quality of patient care. The goal of this project is to improve patient handover process by utilizing SBAR (Situation, Background, Assessment and Recommendation) technique to standardize interprofessional communication in the ER. It is hypothesized that the modified SBAR protocol will be well perceived by healthcare providers and will improve completeness and accuracy of the information transferred during ER patient handover between members of different professional groups. Three specific objectives guided the work of this project: 1) to modify the SBAR technique and adapt it for an interprofessional ER setting; 2) to study how the modified SBAR protocol is perceived by the students (Usability Study); 3) to design an experimental study to evaluate the effectiveness of the modified SBAR protocol (Effectiveness Study). Following the modification of the SBAR technique, 47 third-year medical students were invited to participate in the Usability Study. The students were randomly assigned into eight teams. One student from each team was randomly selected to verbalize the handover using the modified SBAR protocol, while the other students observed. The usability of the protocol was assessed using the following criteria: ease of learning; ease of use; perceived usefulness and satisfaction. Students found the protocol easy to learn (91%); simple to implement (85%); and useful during the handover (87%). Students were satisfied with the protocol, as it helps structure the verbal report; promotes common language amongst team members and decreases confusion during the communication (83%). Nonequivalent groups post-test only design was developed to assess the effectiveness of the modified SBAR protocol on completeness and accuracy of the patient information transferred during ER patient handover between members of different professional groups. We anticipate that use of the modified SBAR protocol will significantly improve ER interprofessional communication by ensuring complete and accurate information transfer during the patient handover. Further studies are needed to support this claim.

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