Didactic or Web-based Training

(1)

Massimo Lamperti MD

Consultant in Neuroanesthesia and Pediatric Anaesthesia Cleveland Clinic Abu Dhabi, UAE

(2)

Objectives

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Current practice in training courses



How a training course should be prepared

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The didactic part

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The supervised part

(3)

(4)

Current practice in training courses

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Online registration

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Study (self-study, no online tutoring)

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Take the exam (passing score threshold 70%)

(5)

ACLS recertification

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Simple as ACLS exam

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Not expensive

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Web-based

(6)

(7)

ATLS aims

A. Demonstrate concepts and principles of primary and secondary patient assessment

B. Establish management priorities in a trauma situation

C. Initiate primary and secondary management necessary within the "golden hour" for the emergency care of acute life-threatening emergencies

D. Demonstrate, in a given simulated clinical and surgical skills practicum, the basic skills necessary for the initial assessment and management of patients with multiple injuries

(8)

ATLS structure

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Pre and post tests

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Core content lectures

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Interactive case presentations

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Discussions

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Development of life-saving skills (e.g. surgical airway)

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Practical laboratory experiences

(9)

(10)

The Ultrasound Vascular Access Course

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Focused on US method for insertion of CICs

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Lack of teaching on CICs management

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No supervised training

(11)

(12)

Vascular access for dialysis

At the completion of the course, the participant will:

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know current guidelines for vascular access provision

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be proficient in theoretical and practical decision making regarding vascular access

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be competent at basic upper limb arteriovenous ultrasound assessment prior to access formation

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be proficient in the surgical techniques of vascular access creation

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know options in post op surveillance options for vascular access

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be competent in the management of access complications (e.g. failure to mature, thrombosis, venous hypertension, steal)

(13)

(14)

A TRAINING COURSE SHOULD HAVE:

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Didactic part

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Hands on training on ultrasound devices

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Hands on training on models (inanimate, phantoms)

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Hands on training on patients

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Supervised training

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Manual/booklet

(15)

The didactic part

STANDARDIZED PROGRAM CONTAINING:

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Indications and contraindications to CICs

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A systematic method for CICs insertion (US guided vs landmark guided)

(16)

The didactic part

A STANDARDIZED APPROACH improves:

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students’ knowledge

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behavioral changes in monitoring complications and improving quality of procedural notes

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patients’ comfort

(17)

The didactic part

HANDS ON TRAINING

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Vascular access devices

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Ultrasound probes and machines

(18)

The didactic part

HANDS ON MODELS

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Cadavers

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Inanimate models

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Phantoms

(19)

The didactic part

HANDS ON PATIENTS (SUPERVISED TRAINING)

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It should be done ONLY when appropriate manual skills are obtained by the trainee

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There is no standard MINIMAL training suggested

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At this phase, a trainee’s learning curve should be created (this should include time to success, complications and overall judgment on the process)

(20)

SUPERVISED TRAINING

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The training period should be performed as soon as possible after the theoretical part of the course and in a 5 days period in order to allow the trainee to perform as much procedures as possible on patients

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There should be some medico-legal problems related to performing such invasive procedures on patients. An insurance covering complications during academical teaching should be done by Local Institutions organizing the course

(21)

Manual/booklet

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A manual with course’s contents should be mailed to the trainees at least one month before the beginning of the course with a pre-test course to be completed in order to assess trainees’ preparation

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The manual should have text and figures

(22)

PRE and POST TEST + FINAL AUDIT

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Pre and post tests are a useful tool for assessing trainees’ preparation and trainers’ understanding

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A poor class post-test score means poor trainers ability

(23)

SUPERVISION

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It can be done face-to-face or web-based

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FACE-TO-FACE supervision is more expensive but allows prompt revision of trainee’s errors and improved outcome for the patient

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WEB-BASED supervision can be done as a face-to-face supervision if a web-camera is placed during this phase of the training

(24)

Web-Based Training

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The most used application of the www. course is in undergraduate education

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Students indicate that online courses material made lecture material more interesting and helped reinforce important concepts

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The effectiveness of online material depends on the quantity of other

(25)

Web-Based Training

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Cost-effectiveness of online curricula: $3900 printed vs $1800 www

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The Web provides a way of managing educational material at a lower cost

(26)

Web-based USVA training

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Didactic traditional course vs. Web Based course

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22 trainees

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No differences on final examination scores, clinical examination scores

(27)

Take home points

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Current practice in training courses is heterogeneous

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Structured courses perform better

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Any course should provide a structured didactic and practical part

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Supervision should be always provided during the course till the final audit

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Web-based courses are cost-effective but need a good technological support

(28)

Questions at: