Increasing Student Confidence With Medically Complex Infants Through Simulation: A Mixed Methods Investigation.

Objective To evaluate the application effect of high-fidelity human patient simulation in cardiopulmonary resuscitation (CPR) training in emergency medicine course. Method All of the 84medical freshmen in the academic year of 2008, who studied emergency medicine course, were chosen as the study object. The students were randomly divided into high-fidelity simulator (SimMan) training group(EG) and ordinary training group (CG), when they finished the course. Two groups accepted training for the same time, and then examined the CPR performing by the system of advanced cardiovascular life support (ACLS) simulator, and make data-analysis with the software of SPSS 11.5. Result The students in EG group have higher total mean score than CG ( P ＜ 0.05). However, in the aspects of survival ratio,performing time and chest compression quality, EG has higher score than CG, but there is no significant statistical difference ( P ＞ 0.05 ). Conclusion This study demonstrates that high-fidelity human patient simulation can simulate many common symptoms of emergency patients, it has great effect on helping medical students to improve the quality of doing CPR, but the training results is not as good as the author expected compared with the ordinary training. So the training method in the application of high-fidelity human patient simulation should be improved. Key words: Simulate training; High-fidelity human patient simulation; Emergency medicine; Cardiopulmonary resuscitation(CPR); Medical student

Background: Effective teamwork and communication among healthcare professionals are essential to ensure quality patient care and safety. The use of high-fidelity human patient simulation scenarios enhances learning and has been used in various health professions education. The purpose of this study was to evaluate the efficacy and retention of teaching team-based competencies to interprofessional student teams using high-fidelity simulation. Methods: Quasi-experimental, pre/post-test design was used. The study was a teaching intervention using high-fidelity human patient simulation with crisis resource management techniques to teach team based competencies. A convenience sample of students from medicine, nurse anesthesia, undergraduate nursing, and physical therapy participated. There were pre/post data collected for fall and spring simulations from both participants and observers. Key variables were the various teamwork competencies. Participants and trained observers rated teamwork behaviors, each using two measures. Mean scores on participant and observer rated tools were compared using paired samples t -tests. Results: A total of 35 students underwent training in the fall of 2009 and 25 of the students returned in the spring of 2010 for repeat training. Participant paired samples t -tests showed a significant increase from simulation scenario one to two ( p < .05) in both the fall and spring. Observer data showed significant improvements in mean scores on one measure. Conclusions: High-fidelity simulation appears to improve both perceived and actual team-based competencies with retention over time. Findings support the benefit to students of repeat training in a six month period and provide some validation for faculty time and effort in repeated simulations.

Objective: The study aims to examine knowledge acquisition, improvement in nursing students exposed to high fidelity human patient simulation manikins. Methodology: This study, in which (80) fourth year nursing students participated, took place in a college of nursing. A quasi-experimental design was used to evaluate the effect of the level of manikin fidelity on knowledge acquisition and practice levels. Data were collected at three points in time: prior to the simulation, immediately after, and two weeks later. Results: Differences in mean scores between the control and experimental groups for exams 1, 2 and 3 werecalculated using independent t-tests and were statistically significant. Conclusion: While the effects of simulation remain elusive, this study lays the foundation for further research.The findings present us with the notion that clinical experience in combination with simulation training mayprovide better performance outcomes. Recommendation: Additional research with large cohorts of learners and the Knowledge gained of this studycan provide better evidence as to the benefits of simulation-based training.

Developing confidence in mental health students to recognise and manage physical health problems using a learning intervention

Immediately after 9/11, Burlington County College (BCC) realized that the focus of emergency preparedness must change. BCC responded by identifying community needs, developing customized simulation training using high-fidelity human patient simulators and laptop/desktop technology; developing partnerships, and securing outside funding. Over 8,500 individuals, at all levels, have received training.

Mathematical communication skills and students' self-confidence are still considered low, even though both are essential in learning mathematics. This study aims to determine the effect of the role-playing model on these two abilities. The method used is a quasi-experimental design with a randomized pretest-posttest control group. The population of the study includes all seventh-grade students at a private junior high school in Medan, consisting of five classes with a total of 185 students. The sample was selected using cluster random sampling, with classes VII-1 and VII-4, each consisting of 30 students, assigned as the experimental and control groups, respectively. The instruments used were a mathematical communication skills test and a student self-confidence questionnaire. Data were analyzed using an independent t-test. The results showed a significant difference between the experimental and control groups. The average improvement in mathematical communication skills in the experimental group was 74.48%, which was higher than that of the control group at 54.46%. Students' self-confidence also increased more in the experimental group (65.07%) compared to the control group (23.69%). It can be concluded that the role-playing model has a positive effect on improving students' mathematical communication skills and self-confidence. Therefore, teachers are encouraged to implement the role-playing model in mathematics learning, especially in contextual materials that require active student engagement.

BackgroundBone is a slowly regenerating tissue influenced by various physiological processes, including proliferation, differentiation, and angiogenesis, under the control of growth factors. Shortening this healing time is an important and popular clinical research focus in orthopedics. Negative pressure can stimulate angiogenesis, improve blood circulation, promote granulation tissue growth and accelerate tissue wound healing. We sought to determine whether negative pressure could reduce bone healing time in a rabbit cranial defect model.MethodsFour symmetrical holes (diameter, 3.5 mm) were drilled into the skulls of 42 New Zealand white rabbits, with two holes in each parietal bone. For each rabbit, the two sides were then randomly assigned into experimental and control groups. Using negative pressure suction tubes, experimental holes were treated with −50 kPa for 15 minutes, four times per day, whereas the control holes remained untreated. After 4 weeks, the negative pressure suction tubes were removed. At 2, 4, 6 and 8 weeks, three-dimensional (3D) reconstruction computed tomography (CT), X-ray radiopacity, and two-photon absorptiometry were used to evaluate new bone formation. Histological changes were determined by hematoxylin and eosin (H.E) staining. At weekly intervals until 6 weeks, the mRNA expression levels of vascular endothelial growth factor (VEGF) and bone morphogenetic protein (BMP)-2 were evaluated by RT-PCR. A paired student’s t-test was employed to compare X-ray radiopacity and bone density measurements between the experimental and control groups.Results3D-reconstruction CT showed that new bone regeneration in the experimental group was greater than that in the control group at 4 and 6 weeks. At these time points, the experimental group presented with higher X-ray radiopacity and increased bone density (P < 0.05) as compared with the control group. Cartilage islands and new bone were observed by H.E staining at 2 weeks in the experimental group. By 6 weeks, the new bone had matured into lamellar bone in the experimental group. RT-PCR results showed that VEGF and BMP-2 were highly expressed in the experimental group as compared with control.ConclusionsIntermittent negative pressure can promote the regeneration of bone possibly by enhancing the expression of VEGF and BMP-2.

The effects of walnut oil on wound healing and skin injury repair was observed in Sprague-Dawley (SD) rats, and mechanism of action was investigated. Normal SD rats were divided into an experimental group and a control group. Each group was observed at4 time points (day [D]3, D7, D14, and D21). In both groups, a skin wound was created on the back of the rats, with the spine as the central axis. In the experimental group, the wound was covered with walnut oil, and then bandaged and fixed with sterile gauze. In the control group, the wound was bandaged with vaseline gauze. At each corresponding time point, the wound area and wound healing time of each rat were examined. Epithelial cells of the wound tissues were observed using haematoxylin and eosin staining and immunohistochemical analysis,and the numbers of inflammatory cells and capillaries were counted. A western blot method was used to detect the expression of nuclear factor (NF)-κB and epidermal growth factor (EGF) in the wound tissues of both groups. Meanwhile, enzyme-linked immunosorbent analysis (ELISA) was used to detect the expression of transforming growth factor (TGF)-β1 and matrix metalloproteinase (MMP)-1 in rat sera. A total of 48 SD rats completed the experiment. Healing time of residual wounds in the experimental group was 10.0±3.5 days, which was significantly shorter than that in the control group (18.0±6.0 days) (p<0.05). The wound healing rates in the experimental group were 54.14 % (D3) and 91.2 3% (D7), whereas those in the control group were 22.12% (D3) and 54.84% (D7 (p<0.05).Histological examinations revealed no epithelial cells on D3, D7, D14, and D21 in both the experimental and control groups. However, the number of inflammatory cells decreased significantly and the number of capillaries increased significantly in the experimental group compared to control (p<0.05). NF-κB expression was significantly lower, EGF expression significantly higher in the in the experimental group. Conversely, ELISA showed a significant increase in the expression of TGF-β1 and MMP-1 in rat sera in the experimental group. So we conclude that walnut oil has significant effects in promoting the healing of skin defect wounds in SD rats.

Objective: To observe the influence of exogenous insulin-like growth factor-Ⅰ(IGF-Ⅰ) on the expression of myocyte differentiation factor 5 (Myf5) and transforming growth factor β1(TGF-β1) in medial rectus muscle of cat model with strabismus. Methods: Experiment research. Twenty-seven kittens which were in sensitive period of visual development (4-6 weeks old), were randomly divided into experimental, control and blank control groups by random numbers table method. Each experimental group was further divided into 3 sub-groups (4 weeks, 8 weeks and 12 weeks) based on drug intervention time, hence 3 kittens in each sub-group. The control group and the blank control group were also divided into 3 sub-groups respectively. Exotropia treatment models were set up through surgical methods and injection of IGF-Ⅰ(0.05 ml,0.1 g/L). The internal rectus muscles of 4 weeks sub-group, 8 weeks sub-group and 12 weeks sub-group were taken respectively after the treatment model had been set up. The internal rectus muscles of the control group and the blank control group were also taken according to corresponding time. The expressions of Myf5 and TGF-β1 were tested with immunohistochemistry staining method, and optical density analysis method were employed to measure the average optical density value. The expression of Myf5 and TGF-β1 was analyzed by Kruskal-Wallis and Bonferroni test. The correlation between the expression of Myf5 and TGF-β1 and the time of drug intervention was analyzed by simple linear regression. Results: (1) In the experimental group, the expression of the Myf5 of the 4 weeks sub-group, 8 weeks sub-group and 12 weeks sub-group were 33.34±17.16, 39.24±15.25 and 47.70±19.39, which were higher than the control group (21.30±7.44, 19.43±4.75, 4.82±2.66) and the blank control group (18.95±6.59, 18.00±7.29, 5.86±2.61) at the same time point, and the differences were statistically significant in 8 weeks sub-group and 12 weeks sub-group (χ(2)=21.864, 31.814, both P<0.01). The expression of Myf5 in the experimental group increased with the extension of IGF-Ⅰ intervention time (R(2)=0.99, P<0.05). But there were negative correlation between expression of Myf5 and drug intervention times in the control group and the blank control group (R(2)=0.81, 0.80, both P<0.05). (2) In the experimental group, the expression of the TGF-β1 of the 4 weeks sub-group, 8 weeks sub-group and 12 sub-weeks group were 0.80±0.12, 0.53±0.09, 0.42±0.08, which were higher than the control group (1.91±0.23, 2.30±1.03, 1.82±0.72) and the blank control group (2.01±0.31, 2.62±1.11, 1.83±0.67) at the same time point, and the differences were statistically significant (χ(2)=30.801, 40.278, 35.177, all P<0.01). The expression of TGF-β1 in the experimental group decreased with the extension of IGF-Ⅰintervention time (R(2)=0.83, P<0.05). The average optical density value regression equation of TGF-β1 in the sterile water control group and the blank control group was 0.04 and 0.06, respectively, and the fitting degree was very poor. Therefore, there was no correlation trend with time. Conclusions: Exogenic IGF-Ⅰ could enhance the expression of Myf5 in medial rectus muscle of cat model with strabismus. Exogenic IGF-Ⅰ could inhibit the expression of TGF-β1 in medial rectus muscle of cat model with strabismus. Repeated injection of exogenous IGF-Ⅰ may continuously enhance the expression of Myf5 and inhibit the expression of TGF-β1. (Chin J Ophthalmol, 2018, 54: 375-382).

Human Patient Simulation Versus Written Case Studies for New Graduate Nurses in Nursing Orientation: A Pilot Study

Background and Study Aim. Physical fitness and psychological well-being of student-athletes had decreased significantly and became the main problem in this study. This study aims to investigate the effect of virtual reality-based Tabata training to increase the level of physical fitness and psychological well-being through a mixed method. Material and Methods. This study used a mixed method. The participants involved in this study were student-athletes (n=40) at Singaperbangsa Karawang University (Indonesia). Quantitative instruments used to measure physical fitness include 20 m shuttle run, 30 m sprint run, horizontal jump and leg dynamometer. While the qualitative instrument used to measure student-athlete perceptions through in-depth interviews for 30 minutes. Quantitative statistical analysis through IBM SPSS was used to find the mean and standard deviation. Independent samples t-test was used to test the difference in values between the experimental and control groups before and after the experiment. Meanwhile, the Paired samples t-test was used to investigate the effect of this training, both in the experimental and control groups. Qualitative statistical analysis was carried out qualitatively thematically, namely the results of in-depth interviews were coded and categorized into three themes. Results. There were several finding in quantitative research. First, there was no difference in physical fitness or psychological well-being between the experimental and control groups before the experiment (p&gt;0.05). Second, there were differences in the values of physical fitness and psychological well-being between the experimental and control groups after the experimental program (p&lt;0.05). Third, there was a significant effect in the experimental group on the level of physical fitness and psychological well-being (p&lt;0.05) and the control group also showed an effect on changes in physical fitness and psychological well-being but smaller than the experimental group (p&lt;0.05). In Qualitative research, student-athletes provided positive perceptions about virtual reality-based Tabata training which was easy, efficient and effective, fun and encouraged them to be more active. Negative perceptions were not all student-athletes and universities were equipped with virtual reality facilities. It must carried out in a location or place that was completely safe or far from vehicles. Conclusions. Our mixed study confirms that virtual reality-based Tabata training had positive effect to change the level of physical fitness and psychological well-being among student-athletes.

Background To investigate the effect of combined oral contraceptives (COC) on orthodontic tooth movement (OTM) and periodontal remodelling in a female rat model. Methods A total of 80 three-month-old female, Sprague-Dawley rats were randomly divided into experimental and control groups. The maxillary first molars were moved mesially using nickel-titanium coil springs (50 g force). The experimental group (N = 40) ingested 1.5 ml COC (Marvelon, 0.12 mg/d, N.V. Organon, Oss, The Netherlands) daily. The control group (N = 40) ingested 1.5 ml saline (0.9% sodium chloride) daily. After 7, 14, 21 and 28 days of force application, 10 rats in each group were euthanased and a vernier calliper was used to measure the orthodontic movement of the first molar. Root resorption at pressure areas was assessed by H and E staining. Micro-CT was used to detect alveolar bone mineral density. Results and conclusion The amount of OTM in the experimental group (0.46 ± 0.16 mm) was significantly less than in the control group (0.85 ± 0.25 mm; p = 0.003) during the 28 days of observation. There were significantly smaller (p = 0.002) root resorption lacunae in the experimental group (111710 ± 4037 pixels) compared with the control group (204962 ± 21318 pixels) after 28 days. There was no statistically significant difference in the bone mineral density between the experimental and control groups throughout the study period (p &gt; 0.05 at each time point). The short-term administration of COC may retard tooth movement and reduce the level of root resorption during OTM in female rats.

This study aimed to explore low and non-low achievers’ motivation towards science learning among 8th graders in two public schools in central Taiwan under inquiry-based instruction. Mixed design research methods were adopted, and students were divided into experimental (n = 56) and control groups (n = 45). Six non-consecutive inquiry units (90–180 minutes each) were taught to the experimental group during one semester, while same topic units were instructed traditionally in the control group. A questionnaire measuring students’ motivation towards science learning [MILS] was implemented as pre- and post-tests in both the experimental and control groups. Moreover, the teachers and 12 non-low achievers, and six low achievers from each group were interviewed four times in this semester. ANCOVA were used to analyze quantitative data in the questionnaire, and the interview data were coded. The results showed that statistically non-low achievers’ achievement goals and perception of their learning environment in the experimental group significantly improved more than those in the control group. Practically, non-low achievers’ expectancy and learning strategies and low achievers’ confidence, value of science learning, achievement goals, learning strategies, and perception of learning environment in the experimental group were better than those in the control group. Low achievers still needed to use more learning strategies. Additionally, in the experimental group, hands-on activities and conceptual understanding motivated both achievers, various learning strategies motivated non-low achievers, and teachers and peers’ assistance motivated low achievers. However, both achievers under intervention had more exam anxiety than those under traditional teaching due to their weak ability to calculate.

The body is undoubtedly the first language of communication in human history. Body language, which dates back to the first human, was the first language with which humans communicated with each other. Human being is a social being; just as it needs nutrition, shelter, security, knowledge, respect and love, it also needs communication. Therefore, speaking skill has become one of the language skills that individuals use most in daily life throughout their lives. Drama method is a method that can be used to help people get to know themselves and their environment, improve their relationships, gain different perspectives, and increase social harmony. The aim of this research is to determine the effect of body language-centered drama activities on the development of students' speaking skills in secondary school Turkish teaching. The participants of the study consist of 55 7th grade students studying in a secondary school in Battalgazi district of Malatya province. In this research, mixed research method sequential explanatory design was used. A semi-experimental design was used in the quantitative part of the research, and the quantitative data of the research was collected using the Speaking Skills Attitude Scale (2017), and the phenomenology design was used in the qualitative part, and the data were collected with student diaries, semi-structured interview form and observation form. In the quantitative part of the research, a control and an experimental group were created. Experimental and control groups were determined according to the students' pre-test results from the attitude scale. According to the results of the Mann Whitney U test, the groups were found to be equivalent. In the experimental group, body language-centered drama prepared in the context of Turkish language teaching program achievements was taught, and in the control group, lessons were taught taking into account the current Turkish course curriculum. At the end of the research, a semi-structured interview was conducted with 9 experimental group students, a diary was collected after each drama application, and observations were made by taking pre- and post-videos of the students' body language-centered speaking skills. A reliability and validity study was conducted on the applied quantitative and qualitative data collection tools. Analysis of the post-tests in the experimental and control groups was made with the Mann Whitney U test. Qualitative data were analyzed with codes and categories created by content analysis and descriptive analysis. When the results of the research were examined, it was concluded that the Turkish lesson taught with body language-centered drama activities was more effective than the normal Turkish lesson in terms of giving speaking skill gains. Similarly, it was observed that the interest and love of the students participating in the study regarding speaking skills increased after the body language-centered drama activities, and their anxiety decreased. In addition, it was observed that students began to use body language easily both in the classroom and in daily life. Looking at the results of the qualitative data of the research, it was seen that the students started to use body language in and outside the classroom, their speaking skills improved and even their existing speech disorders improved. The study results were examined in the literature and compared from both similar and different perspectives. Looking at the results, researchers can make variations in their studies in order to obtain rich data; for drama practices, they should conduct pilot exercises before implementing the created drama workshops and pay attention to the physical characteristics of the place where the drama will be implemented; recommendations were made for institutions to give teacher candidates the opportunity to practice in drama classes in faculties of education and to provide drama training to teachers in in-service courses opened within the Ministry of National Education.

Introduction: Hypothyroidism is a leading public health concern, affecting one in ten Indians. Along with conventional treatment with supplemental Thyroid Hormones (TH), problems associated with hypothyroidism can be managed with complimentary nursing interventions. Aim: To assess the effect of a nurse-led multi-interventional program on Quality of Life (QoL), Subjective Well-Being (SWB), and level of TH among patients with hypothyroidism. Materials and Methods: A quasi-experimental double arm study was conducted from August 2021 to October 2021, at selected endocrinology clinics on patients with hypothyroidism were divided into interventional (n=39) and control group (n=38) non randomly. Information related to socio-demography, QoL, SWB, and TH levels were collected and followed by the implementation of a nurse-led multi-intervention program for the intervention group. The intervention was done individually, which consisted of a demonstration of yoga asana, yoga mudra, and neck exercises. Two-way repeated measures Analysis of Variance (ANOVA) was performed, to check if there is any significant difference in the average QoL/SWB/level of TH across different time points as well as between the experimental and control group. Results: A total of 77 participants 64 (83.1%) males and 13 (16.9%) females were included in the study with maximum participants belonged to the age group of 18-28 years. It was observed that after the implementation of multi-intervention program QoL was significantly improved among the experimental group (F=31.53, &lt;0.001), and SWB also significantly improved (F=36.615, &lt;0.001). Thyroid Stimulating Hormones (TSH) were significantly reduced among the experimental group (F=3.39, p=0.022) and Thyroxine (T4) levels were statistically significant among the experimental group (F=3.151, p=0.030). Conclusion: Patients with hypothyroidism require holistic care. Patients with hypothyroidism could be intervened with programs like yoga, neck exercise, pranayama, and yoga mudras.