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Jeffrey B Cooper

Publications and source records attributed to Jeffrey B Cooper.

9 recordsLinked to original sources

A randomized controlled trial of simulation-based teaching versus traditional instruction in medicine: a pilot study among clinical medical students.

OBJECTIVE: To compare simulator-based teaching with traditional instruction among clinical medical students. METHODS: Randomized controlled trial with written pre-post testing. Third-year medical students (n = 38) received either a myocardial infarction (MI) simulation followed by a reactive airways disease (RAD) lecture, or a RAD simulation followed by an MI lecture. RESULTS: Mean pre-post test score improvement was seen across teaching modalities (overall change score [simulation] = 8.8 [95% CI = 2.3-15.3], pretest [62.7]; change score [lecture] = 11.3 [95% CI = 5.7-16.9], pretest [59.7]). However, no significant differences were observed between simulator-based teaching and lecture, in either subject domain. CONCLUSIONS: After a single instructional session for clinical medical students, differences between simulator-based teaching and lecture could not be established by the written test protocols used in this pilot. Future studies should consider the effects of iterative exposure assessed by clinical performance measures across multiple centers.

Clinical Clerkship↗

A method for measuring the effectiveness of simulation-based team training for improving communication skills.

Team behavior and coordination, particularly communication or team information-sharing, are critical for optimizing team performance; research in medicine generally provides no accepted method for measurement of team information-sharing. In a controlled simulator setting, we developed a technique for placing clinical information (probes) with members of a team of trainees participating in a 1-day Anesthesia Crisis Resource Management course and later tested the teams for knowledge of the probes as an indicator of overall team information-sharing. Despite the low level of team information-sharing, we demonstrated construct validity of the probe methodology by the correlation of measured change in team information-sharing from beginning to end of training with self-rated change. There was no statistical difference in "group sharing" from beginning to end of training, despite trainees' survey responses that the course would be useful for their education and practice.

Communication↗

Crisis resource management training for an anaesthesia faculty: a new approach to continuing education.

BACKGROUND: Human error and system failures continue to play a substantial role in adverse outcomes in health care. Anaesthesia crisis resource management addresses many patient safety issues by teaching behavioural skills for critical events but it has not been systematically utilized to teach experienced faculty. METHODS: An anaesthesia crisis resource management course was created for the faculty of our medical school's anaesthesia teaching programmes. The course objectives were to understand and improve participants' proficiency in crisis resource management (CRM) skills and to learn skills for debriefing residents after critical events. Through surveys, measurement objectives assessed acceptance, utility and need for recurrent training immediately post-course. These were measured again approximately 1 year later along with self-perceived changes in the management of difficult or critical events. RESULTS: The highly rated course was well received in terms of overall course quality, realism, debriefings and didactic presentation. Course usefulness, CRM principles, debriefing skills and communication were highly rated immediately post-course and 1 year later. Approximately half of the faculty staff reported a difficult or critical event following the course; of nine self-reported CRM performance criteria surveyed all claimed improvement in their CRM non-technical skills. CONCLUSIONS: A unique and highly rated anaesthesia faculty course was created; participation made the faculty staff eligible for malpractice premium reductions. Self-reported CRM behaviours in participants' most significant difficult or critical events indicated an improvement in performance. These data provide indirect evidence supporting the contention that this type of training should be more widely promoted, although more definitive measures of improved outcomes are needed.

Adult↗

Bringing good teaching cases "to life": a simulator-based medical education service.

Realistic medical simulation has expanded worldwide over the last decade. Such technology is playing an increasing role in medical education not merely because simulator sessions are enjoyable, but because they can provide an enhanced environment for experiential learning and reflective thought. High-fidelity patient simulators allow students of all levels to "practice" medicine without risk, providing a natural framework for the integration of basic and clinical science in a safe environment. Often described as "flight simulation for doctors," the rationale, utility, and range of medical simulations have been described elsewhere, yet the challenges of integrating this technology into the medical school curriculum have received little attention. The authors report how Harvard Medical School established an on-campus simulator program for students in 2001, building on the work of the Center for Medical Simulation in Boston. As an overarching structure for the process, faculty and residents developed a simulator-based "medical education service"-like any other medical teaching service, but designed exclusively to help students learn on the simulator alongside a clinician-mentor, on demand. Initial evaluations among both preclinical and clinical students suggest that simulation is highly accepted and increasingly demanded. For some learners, simulation may allow complex information to be understood and retained more efficiently than can occur with traditional methods. Moreover, the process outlined here suggests that simulation can be integrated into existing curricula of almost any medical school or teaching hospital in an efficient and cost-effective manner.

Clinical Clerkship↗

Cellular phone interference with the operation of mechanical ventilators.

OBJECTIVE: To determine whether a cellular phone would interfere with the operation of mechanical ventilators. DESIGN: Laboratory study. SETTING: University medical center. SUBJECTS: Fourteen mechanical ventilators. INTERVENTIONS: We evaluated change in operation and malfunction of the mechanical ventilators. MEASUREMENTS AND MAIN RESULTS: The cellular phone (Nokia 6120i) was computer controlled, operating at 828.750 MHz analog modulation. It was operated at 16, 40, 100, 250, and 600 mW, 30 cm from the floor and 30, 15, and <3 cm from all sides of each ventilator. Six of the 14 ventilators tested malfunctioned when a cellular phone at maximum power output was placed < or =15 cm from the device. None of these responses were considered immediately life threatening except for the response of the Puritan Bennett 840, which stopped ventilating when the cellular phone at maximum power output was placed < or =30 cm from the ventilator. One ventilator doubled the ventilatory rate and another increased the displayed tidal volume from 350 to 1033 mL. In one of the infant ventilators, displayed tidal volume increased from 21 to 100 mL. In another ventilator, the high respiratory rate alarm sounded but the rate had not changed. CONCLUSIONS: In a controlled laboratory setting, cellular phones placed in close proximity to some commercially available intensive care ventilators can cause malfunctions, including irrecoverable cessation of ventilation. This is most likely to occur if the cellular phone is <30 cm from the device and ringing. Based on our data and the available literature, we believe it is reasonably safe to permit the use of cellular phones in the intensive care unit, as long as they are kept > or =3 feet from all medical devices. The current electromagnetic compatibility standards for mechanical ventilators are inadequate to prevent malfunction. Manufacturers should ensure that their products are not affected by wireless technology even when placed immediately next to the device.

Boston↗