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Nurse Education Today Aug 2024This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students.
DESIGN
Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results.
DATA SOURCES
Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies.
REVIEW METHODS
The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias.
RESULTS
Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported.
CONCLUSIONS
The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.
Topics: Humans; Students, Nursing; Education, Nursing, Baccalaureate; Clinical Competence; Systematic Reviews as Topic; High Fidelity Simulation Training
PubMed: 38701671
DOI: 10.1016/j.nedt.2024.106231 -
Breast (Edinburgh, Scotland) Apr 2024This systematic review aims to explore the impact of age on physical functioning post-treatment for early-stage, locally advanced, or locally recurrent breast cancer, as... (Review)
Review
PURPOSE
This systematic review aims to explore the impact of age on physical functioning post-treatment for early-stage, locally advanced, or locally recurrent breast cancer, as measured by patient-reported outcome measures (PROMs), identify PROMs used and variations in physical functioning terms/labels.
METHODS
MEDLINE, EmBase, PsycINFO, CINAHL and AMED were searched, along with relevant key journals and reference lists. Risk of bias (quality) assessment was conducted using a Critical Appraisal Skills Programme checklist. Data was synthesised through tables and narrative.
RESULTS
28,207 titles were extracted from electronic databases, resulting in 44 studies with age sub-groups, and 120 without age sub-groups. Of those with findings on the impact of age, there was variability in the way findings were reported and 21 % found that age did not have a significant impact. However, 66 % of the studies found that with older age, physical functioning declined post-treatment. Comorbidities were associated with physical functioning declines. However, findings from sub-groups (breast cancer stage, treatment type and time post-treatment) lacked concordance. Twenty-eight types of PROM were used: the EORTC QLQ-C30 was most common (50.6 %), followed by the SF-36 (32.3 %). There were 145 terms/labels for physical functioning: 'physical functioning/function' was used most often (82.3 %).
CONCLUSIONS
Findings point towards an older age and comorbidities being associated with more physical functioning declines. However, it was not possible to determine if stage, treatment type and time since treatment had any influence. More consistent use of the terminology 'physical functioning/function' would aid future comparisons of study results.
PubMed: 38691921
DOI: 10.1016/j.breast.2024.103734 -
Nurse Education Today Aug 2024This study examines the characteristics and effects of virtual reality (VR) intravenous injection training programs for nurses and nursing students, using Kirkpatrick's... (Review)
Review
OBJECTIVE
This study examines the characteristics and effects of virtual reality (VR) intravenous injection training programs for nurses and nursing students, using Kirkpatrick's four-level model of educational evaluation. Kirkpatrick's framework is based on the premise that learning from training programs can be classified into four levels: reaction, learning, behavior, and results.
DESIGN
A systematic review.
DATA SOURCES
Literature searches were conducted of eight electronic databases (PubMed, CINAHL, Cochrane, EMBASE, DBpia, KISS, RISS, KoreaMed) to identify original research articles from each database's inception to March 2023.
REVIEW METHODS
For the 13 selected articles, quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively.
RESULTS
Virtual intravenous simulators and desktop and immersive VR technologies were utilized in intravenous injection training. These VR technologies were applied either alone or in conjunction with simulators, focusing on junior nursing students without intravenous injection experience. We found a positive effect on nursing students' intravenous injection performance (Level 2: learning evaluation) in approximately half the studies. However, results were inconsistent due to measurement tools' diversity. In all studies, the degree of evaluation for Levels 1 (reaction evaluation), 3 (behavior evaluation), and 4 (results evaluation) of the Kirkpatrick Model was low.
CONCLUSIONS
Desktop or immersive VR with low-fidelity or high-fidelity simulators should be provided to senior nursing students and new nurses for intravenous injection training. Additionally, standardized tools should be developed to accurately measure training effects. Finally, the Kirkpatrick Model's four levels should be evaluated to demonstrate the training programs' value.
Topics: Humans; Students, Nursing; Virtual Reality; Injections, Intravenous; Clinical Competence; Simulation Training; Education, Nursing, Baccalaureate; Nurses
PubMed: 38691901
DOI: 10.1016/j.nedt.2024.106208 -
Virology Journal Apr 2024During the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold... (Meta-Analysis)
Meta-Analysis
BACKGROUND
During the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold the promise of outperforming their instrument-free, visually-read counterparts. Here, we provide a systematic review and meta-analysis of the SARS-CoV-2 iAg tests' clinical accuracy.
METHODS
We systematically searched MEDLINE (via PubMed), Web of Science, medRxiv, and bioRxiv for articles published before November 7th, 2022, evaluating the accuracy of iAg tests for SARS-CoV-2 detection. We performed a random effects meta-analysis to estimate sensitivity and specificity and used the QUADAS-2 tool to assess study quality and risk of bias. Sub-group analysis was conducted based on Ct value range, IFU-conformity, age, symptom presence and duration, and the variant of concern.
RESULTS
We screened the titles and abstracts of 20,431 articles and included 114 publications that fulfilled the inclusion criteria. Additionally, we incorporated three articles sourced from the FIND website, totaling 117 studies encompassing 95,181 individuals, which evaluated the clinical accuracy of 24 commercial COVID-19 iAg tests. The studies varied in risk of bias but showed high applicability. Of 24 iAg tests from 99 studies assessed in the meta-analysis, the pooled sensitivity and specificity compared to molecular testing of a paired NP swab sample were 76.7% (95% CI 73.5 to 79.7) and 98.4% (95% CI 98.0 to 98.7), respectively. Higher sensitivity was noted in individuals with high viral load (99.6% [95% CI 96.8 to 100] at Ct-level ≤ 20) and within the first week of symptom onset (84.6% [95% CI 78.2 to 89.3]), but did not differ between tests conducted as per manufacturer's instructions and those conducted differently, or between point-of-care and lab-based testing.
CONCLUSION
Overall, iAg tests have a high pooled specificity but a moderate pooled sensitivity, according to our analysis. The pooled sensitivity increases with lower Ct-values (a proxy for viral load), or within the first week of symptom onset, enabling reliable identification of most COVID-19 cases and highlighting the importance of context in test selection. The study underscores the need for careful evaluation considering performance variations and operational features of iAg tests.
Topics: Humans; COVID-19; Sensitivity and Specificity; SARS-CoV-2; COVID-19 Serological Testing; Antigens, Viral; COVID-19 Testing
PubMed: 38685117
DOI: 10.1186/s12985-024-02371-5 -
Resuscitation Plus Jun 2024To evaluate the effectiveness of augmented reality (AR) and virtual reality (VR), compared with other instructional methods, for basic and advanced life support training. (Review)
Review
OBJECTIVES
To evaluate the effectiveness of augmented reality (AR) and virtual reality (VR), compared with other instructional methods, for basic and advanced life support training.
METHODS
This systematic review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR) and reported based on the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and registered with PROSPERO (CRD42023376751). MEDLINE, EMBASE, and SCOPUS were searched from inception to January 16, 2024. We included all published studies comparing virtual or augmented reality to other methods of resuscitation training evaluating knowledge acquisition and retention, skills acquisition and retention, skill performance in real resuscitation, willingness to help, bystander CPR rate, and patients' survival.
RESULTS
Our initial literature search identified 1807 citations. After removing duplicates, reviewing the titles and abstracts of the remaining 1301 articles, full text review of 74 articles and searching references lists of relevant articles, 19 studies were identified for analysis. AR was used in 4 studies to provide real-time feedback during CPR, demonstrating improved CPR performance compared to groups trained with no feedback, but no difference when compared to other sources of CPR feedback. VR use in resuscitation training was explored in 15 studies, with the majority of studies that assessed CPR skills favoring other interventions over VR, or showing no difference between groups.
CONCLUSION
Augmented and virtual reality can be used to support resuscitation training of lay people and healthcare professionals, however current evidence does not clearly demonstrate a consistent benefit when compared to other methods of training.
PubMed: 38681058
DOI: 10.1016/j.resplu.2024.100643 -
Children (Basel, Switzerland) Apr 2024In today's ever-changing world, fostering personal and social responsibility is essential for building strong and compassionate communities. This study aimed to provide... (Review)
Review
CONTEXT
In today's ever-changing world, fostering personal and social responsibility is essential for building strong and compassionate communities. This study aimed to provide a quantitative synthesis focusing on the emotional and social outcomes of Teaching Personal and Social Responsibility (TPSR) model-based Physical Education (PE) programs.
METHODS
A comprehensive literature review covering the period from November 2022 to September 2023 identified 637 articles published between 2005 and 2023. Of these, 20 met the inclusion criteria. Data from these articles were coded, and a comprehensive meta-analysis was conducted, incorporating 28 effect sizes. Methodological quality was assessed using the Medical Education Research Study Quality Instrument. Hedge's g served as the effect size measure and emotional and social outcomes subgroups were consolidated. Heterogeneity was evaluated with Cochran's Q and I. Meta-regression and ANOVA-like models addressed categorical moderators, whereas publication bias was assessed through funnel plot, failsafe number, and Egger's linear regression.
RESULTS
A significant and positive effect of the TPSR model on product outcomes (Hedge's g = 0.337, 95% CI = 0.199 to 0.476) was found. Despite considerable heterogeneity (I = 83.830), a random effects model was justified. Assessment of publication bias indicated a low likelihood. Moderator analyses revealed that publication countries significantly influenced the effect, with stronger effects in Turkey. Publication type (article vs. thesis) also played roles in moderation. The meta-regression analyses did not reveal significant effects for the grade level, duration of intervention, publication year or sample size on the TPSR model's impact on product outcomes. The TPSR model positively impacts emotional and social outcomes in PE, enhancing children' skills and behaviour. However, variations across cultures highlight the need for further research, considering limitations like language constraints and potential biases in study selection and data extraction.
PubMed: 38671676
DOI: 10.3390/children11040459 -
Behavioral Sciences (Basel, Switzerland) Apr 2024The aim of this paper was to analyze the acute and chronic effects of physical activity (PA) on cognition, behavior, and motor skill in youth with autism spectrum... (Review)
Review
The aim of this paper was to analyze the acute and chronic effects of physical activity (PA) on cognition, behavior, and motor skill in youth with autism spectrum disorder (ASD), taking into account potential confounders. In addition, it was intended to elaborate a guide of educational applications with strategies for PA use. Studies were identified in four databases from January 2010 to June 2023. A total of 19 interventional studies met the inclusion criteria. PA programs ranged from two weeks to one year in duration, with a frequency of one to five sessions per week. More than 58% of the studies showed positive effects of PA on cognition, and 45.5% on behavior and motor skill. Moderate-vigorous PA for 15-30 min has shown acute effects on cognition, general behavior, and stereotypic/repetitive behaviors in youth with ASD. A total of 9 out of 14 studies showed chronic effects on general behavior and stereotypic behaviors, and only 6 on motor skills.
PubMed: 38667126
DOI: 10.3390/bs14040330 -
PloS One 2024To assess whether different cervical spine immobilisation strategies (full immobilisation, movement minimisation or no immobilisation), impact neurological and/or other...
OBJECTIVES
To assess whether different cervical spine immobilisation strategies (full immobilisation, movement minimisation or no immobilisation), impact neurological and/or other outcomes for patients with suspected cervical spinal injury in the pre-hospital and emergency department setting.
DESIGN
Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES
MEDLINE, EMBASE, CINAHL, Cochrane Library and two research registers were searched until September 2023.
ELIGIBILITY CRITERIA
All comparative studies (prospective or retrospective) that examined the potential benefits and/or harms of immobilisation practices during pre-hospital and emergency care of patients with a potential cervical spine injury (pre-imaging) following blunt trauma.
DATA EXTRACTION AND SYNTHESIS
Two authors independently selected and extracted data. Risk of bias was appraised using the Cochrane ROBINS-I tool for non-randomised studies. Data were synthesised without meta-analysis.
RESULTS
Six observational studies met the inclusion criteria. The methodological quality was variable, with most studies having serious or critical risk of bias. The effect of cervical spine immobilisation practices such as full immobilisation or movement minimisation during pre-hospital and emergency care did not show clear evidence of benefit for the prevention of neurological deterioration, spinal injuries and death compared with no immobilisation. However, increased pain, discomfort and anatomical complications were associated with collar application during immobilisation.
CONCLUSIONS
Despite the limited evidence, weak designs and limited generalisability, the available data suggest that pre-hospital cervical spine immobilisation (full immobilisation or movement minimisation) was of uncertain value due to the lack of demonstrable benefit and may lead to potential complications and adverse outcomes. High-quality randomised comparative studies are required to address this important question.
TRIAL REGISTRATION
PROSPERO REGISTRATION Fiona Lecky, Abdullah Pandor, Munira Essat, Anthea Sutton, Carl Marincowitz, Gordon Fuller, Stuart Reid, Jason Smith. A systematic review of cervical spine immobilisation following blunt trauma in pre-hospital and emergency care. PROSPERO 2022 CRD42022349600 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349600.
Topics: Humans; Cervical Vertebrae; Immobilization; Emergency Medical Services; Wounds, Nonpenetrating; Spinal Injuries; Emergency Service, Hospital
PubMed: 38662734
DOI: 10.1371/journal.pone.0302127 -
Frontiers in Medicine 2024Bioethics training is essential for healthcare professionals as it enables them to address ethical dilemmas in their clinical practice. However, there is still a lack of...
INTRODUCTION
Bioethics training is essential for healthcare professionals as it enables them to address ethical dilemmas in their clinical practice. However, there is still a lack of rigorous teaching programs, and assessing bioethical knowledge poses challenges.
METHODOLOGY
Systematic review using the PRISMA method.
RESULTS
Analysis of 27 studies reveals a lack of ethical knowledge and skills among healthcare professionals and students. Specific training in bioethics is effective in developing bioethical competencies. Different approaches have been employed, including integrated training in academic curricula and intensive or ongoing programs. The results demonstrate improvements in knowledge, attitudes, and ethical values, although regularly updating these courses is recommended.
CONCLUSION
Specific training, institutional support, and considering regional and disciplinary differences are necessary to enhance ethics in the practice of healthcare professionals.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437146, identifier CRD42023437146.
PubMed: 38660422
DOI: 10.3389/fmed.2024.1252386 -
Survey of Ophthalmology 2024We assessed risk factors for complications associated with resident-performed cataract surgery. Using the Preferred Reporting Items for Systematic reviews and... (Review)
Review
We assessed risk factors for complications associated with resident-performed cataract surgery. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched 4databases in September, 2023. We included peer-reviewed, full-text, English-language articles assessing risk factors for complications in resident performed cataract surgery. We excluded studies describing cataract surgeries performed by fellows, combined surgeries, and studies with insufficient information. Our initial search yielded 6244 articles; 15 articles were included after title/abstract and full-text review. Patient-related risk factors included older age, hypertension, prior vitrectomy, zonular pathology, pseudoexfoliation, poor preoperative visual acuity, small pupils, and selected types of cataracts. Surgeon-related risk factors included resident postgraduate year and surgeon right-handedness. Other risk factors included absence of supervision, long phacoemulsification time, and phacoemulsification with high power and torsion. The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation; most studies graded as moderate, primarily due to risk of bias. When assigning cases to residents, graduate medical educators should consider general and resident-specific risk factors to facilitate teaching and preserve patient safety.
Topics: Humans; Internship and Residency; Risk Factors; Ophthalmology; Clinical Competence; Postoperative Complications; Cataract Extraction; Education, Medical, Graduate; Intraoperative Complications
PubMed: 38648911
DOI: 10.1016/j.survophthal.2024.04.002