bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrological control and treatment of melasma in the COVID-19 pandemic: a concise systematic review
Authors: Bastos Patrícia Januzelli Cobianchi Parreiras
Published: January 2022

Introduction: In the skin disease scenario, hyperpigmentation (melasma) is present in about 14.5%-56% of pregnant women and 11.3%-46% of people taking oral contraceptives worldwide. The coronavirus disease 2019 (COVID-19) pandemic has brought great challenges to the treatment of melasma, as well as doubts about its worsening. Diet and nutrients for topical or oral use play an important role in the control of infectious diseases. Objective: It was to perform a concise systematic review on the occurrence, worsening, and nutrological treatment of melasma in the COVID-19 pandemic. Methods: The present study followed a systematic review model (PRISMA). After literary search criteria using MeSH Terms, a total of 98 clinical studies were compared and submitted to eligibility analysis and, after that, 70 studies were selected. The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile. Results and Conclusion: Melasma is an acquired hyperpigmentation disorder, and reactive oxygen species play an important role in the regulation of melanin synthesis. In nutrological terms, lycopene is one of the most effective oxygen neutralizers among tomato-derived carotenoids. Furthermore, hydroquinone is a compound that has been used for the treatment of hyperpigmentation by tyrosinase inhibition mechanism and can be found in wheat. Thus, an adequate knowledge of the role of nutritional supplements in dermatological diseases can be a useful tool. Based on this, there is growing interest in oral medications and dietary supplements to improve melasma. Oral medications and dietary supplements evaluated include tranexamic acid, Polypodium leucotomos extract, beta-carotenoid, melatonin, and procyanidin. Also, hydrolyzed collagen is a low molecular weight protein that has been widely used and can prevent melasma. Serum zinc levels can also predict the occurrence of melasma. Finally, there is still no report on skin darkening associated with COVID-19.
Định vị điểm chính xác cao có giải tham số đa trị và xử lý kết hợp đa hệ thống vệ tinh định vị
Authors: Nguyễn Ngọc Lâu , Nguyễn Thị Thanh Hương
Published: January 2022

Gần đây, định vị điểm chính xác (Precise Point Positioning - PPP) đã được những cải thiện đáng kể nhờ vào các sản phẩm PPP của một số dịch vụ khác nhau. Những dịch vụ này cung cấp các sản phẩm PPP khác nhau ở khả năng giải đa trị (Ambiguity Resolution - AR) và các hệ thống vệ tinh định vị. Chúng tôi muốn nghiên cứu xem các hệ thống ngoài GPS bổ sung và việc giải đa trị sẽ ảnh hưởng như thế nào đến độ chính xác của PPP. Bằng cách xử lý dữ liệu GNSS 24h tại 47 trạm thường trực IGS với các chọn lựa khác nhau về AR và sự kết hợp của các hệ thống vệ tinh, kết quả của chúng tôi cho thấy không có sự cải thiện về độ chính xác định vị đối với giải pháp tĩnh 24h (2.1, 2.1, 5.8mm ở các thành phần hướng Bắc, Đông và độ cao). Tuy nhiên, sự kết hợp của GPS + GLONASS + GALILEO với GPS AR mang lại độ chính xác tốt nhất ở định vị từng thời điểm (6.6, 6.2, 20.2mm). So với trường hợp chỉ dùng GPS với AR, tùy chọn này có thể cải thiện độ chính xác lên đến 26% trên thành phần độ cao.
41 Introduction of Emergency Department in situ Simulation
Authors: Holmes Catherine , Matson Andrew , Mulqueen Clare , Thompson Demi
Published: January 2022

simulation (ISS) is an effective way to deliver inter-professional education in the Emergency Department (ED)

The aim of this study was to describe the process to set up an ED ISS programme and share our challenges and successes.

We run a variety of cases including paediatric and adult on a broad topic range (anything that can be seen in the ED), e.g. medical, surgical, trauma, psychiatric and maternity emergencies. We prepare the case beforehand and ensure that we have the appropriate staff and equipment. A vital aspect to ISS is ensuring the ED is safe. Embedding the attitude that this is ‘just another patient’ has been key. We use a low-fidelity manikin and a simulated monitor app. All participants are briefed, everything is in real-time to closely simulate real life. After the simulation, a debrief takes place. Feedback is sought from all and a certificate is provided. From 14 October 2020 to 5 May 2021, we have run 39 ISS with 138 inter-professional ED participants.

demonstrates feedback given by these participants (largely positive).

Participant feedback

Although challenges exist, it is achievable and effective to run an ISS programme in a busy ED. While this was set up with the education of staff as the primary objective, it has become clear that ISS is also important in identifying system problems, testing new pathways and providing an educational response to incidents in the department.

Aspects of our programme that have worked for us include:

Picking a regular day weekly (early morning best for ED).

Having an inter-professional debriefing team helps to engage all professions.

Ensuring senior departmental support.

Build slowly to more complex simulations.

Challenges we have found are:

Changing culture/attitudes – most support simulation once they have taken part/seen it happen regularly – persevere with it!

The ED is busy – we cannot change this but can be flexible.

Too many observers put the learners off and reduce learning. We have reduced observer numbers and have a sim ‘uniform’.

Some participants have difficulty engaging with the manikin/low-grade technology – a good briefing can help.
141 Simulation: a Tool to Optimize the Activation of Novel Hospital and Critical Care Pathway
Authors: Thompson Elizabeth , Hawkins Melanie
Published: January 2022

As part of the national COVID-19 response, an NHS Nightingale Hospital was established for our region. An initial cohort of patients was admitted with resource allocation, demanding that limitation of care be clearly defined, including avoidance of invasive ventilation. Within weeks, an increasing bed capacity need drove preparation to admit patients who might require escalation to mechanical ventilation. This shift in admission criteria demanded significant change to the hospital’s service provision, including the ability to stabilize and transfer critically ill patients from this satellite location to an acute partner trust

The aim of this study was to perform a rapid, prospective analysis of the critical care patient pathway and surrounding environment at a novel Nightingale Hospital using high-fidelity simulation.

Following a need assessment and discussion with stakeholders,

The internal environment and infrastructure were adequate to perform the task. A significant number of latent threats were identified and actioned during the simulation (

Latent threats found at the Exeter Nightingale hospital during simulated intubation of a critically unwell COVID-19 patient

simulation with a high-fidelity manikin proved to be a useful and reproducible tool in developing and testing the systems involved in managing critical care patients at a novel hospital. In accurately simulating a real-time clinical scenario, the care pathway is experienced and contextualized within the team. It offers an opportunity to expose deficits in the system without causing harm (Kaba and Barnes, 2019). Evidence gathered can be easily and rapidly reported to operational leaders allowing timely decision-making, change implementation and mitigation of preventable risk. This makes simulation a cost- and resource-effective quality improvement method. In addition to patient safety process testing,
167 Evaluating the Effectiveness of a Redesigned Simulation Programme for Final-Year Medical Students During their Assistantship Placement
Authors: Alam Azeem , Parker Hollie , Mathews Catherine , Simpson Thomas
Published: January 2022

The transition to a foundation doctor is often a daunting process for medical students and, to prepare for this, students attend an assistantship placement in the final months of medical school. The transition to foundation year 1 (TTF1) programme is an 8-week placement where students shadow a junior doctor, taking on a vocational role, and attend various teaching activities including high-fidelity simulation. Evidence suggests that medical students transitioning to clinical practice feel unprepared for working on-call, managing acutely unwell patients and task prioritization, and are often unprepared for scenarios requiring expert communication techniques

We aimed to evaluate the effectiveness of a redesigned simulation programme for TTF1 students, focussing on student satisfaction, confidence and attitudes across key domains.

Fifty-three TTF1 students attended a 1-day high-fidelity simulation training day, separated into cohorts of 10 students. Students completed a pre-course (

In terms of confidence, there was an improvement across all core domains, namely diagnosing and managing acute medical emergencies (2.8 vs. 3.8), performing cardiopulmonary resuscitation (3.0 vs. 3.6) and working effectively with colleagues in the interests of the patient (3.3 vs. 4.2). 96% of students found that simulation was a valuable learning experience, allowing them to integrate theory with practice. 94% of students felt that the simulation allowed them to analyse their behaviours and actions and 88% found that scenarios resembled real-world situations. Attitudes towards simulation were positive, with 92% of students agreeing that simulation is a good way of learning technical and non-technical skills. Qualitative themes focussed on the real-world applicability of the scenarios, increased confidence in task prioritization, closed-loop communication and early escalation.

We have demonstrated the benefit of integrating simulation training within the assistantship period and the value of creating novel scenarios directly related to future practice as a junior doctor.
117 Murder on the Laboratory Floor
Authors: Charlton Jan , Cordes Jill , Hayes Thomas , Walton Carrie
Published: January 2022

As leaders are now being encouraged to work across different organizations and in more complex ways, a Systems Leadership programme was developed. The programme required a final module to consolidate the learning which was simulation based. The candidates attending the ‘murder on the lab floor’ module were a mixture of clinical and non-clinical senior leaders from public and third sector organizations.

The aim of the study was to design a half-day course utilizing the simulation structure of pre-brief, scenarios and debrief which enable the candidates to reflect on their own learning in the areas of leadership, communication decision-making and collaborative skills.

We formed a working group to design the scenarios, which were a series of games, build prototypes, run pilots to assess suitability, identify modifications and ensure consistency. Games were linked to leadership traits to aid reflection through debriefing. Games were designed to be played face to face, or remotely, thus promoting inclusivity for shielding staff. A short pre-brief or introduction was filmed.

In our first cohort, all candidates attended the 3-hour session in person. The pre-brief film was played to the candidates setting the scene of an industrial scientist collapsed on a laboratory floor. It outlined the aim to collect as many golden syringes as possible by completing seven 5-minute activities. The candidates were given 5 minutes to nominate which candidate would complete which of the seven games set out in the laboratory. The games were categorized as mental, physical, mystery and skill. The nominated candidate entered the laboratory fitted with a radio headset. Audio and video were fed to the debrief room and to remote candidates via Teams. Once the candidate entered the laboratory the timer was activated. Candidates in both rooms were expected to work together to solve the puzzle and demonstrate team dynamics, communication and strategic thinking. On completion of all games, the candidates participated in a structured debrief led by two of the faculty. This reflective process highlighted the intended learning points and also brought about a discussion examining the effects of COVID-19 on the individuals and their teams.

Qualitative feedback was collected. Candidates stated that

It was the best session of the programme

The method suited my style of learning

I would like my team to go through the process as I found it so valuable.

As this fitted social distancing guidelines it is a great alternative to an online programme

The activities joined the dots between leadership theory and how we work in practice
198 A Novel ‘Virtual Simulation’ for The Advanced Life Support Group, Making a Dream a Reality: A Beginner’s Guide
Authors: Van Heyningen Carl Leith , Denning Kate , Joseph Sibi
Published: January 2022

In the UK, it is a requirement for staff involved in paediatric critical care to remain up to date with advanced paediatric life support (APLS). To do so there is an expectation to participate in face-to-face courses on a four-yearly basis. The Advanced Life Support Group (ALSG), an organization dedicated to supporting professional education, sought to add to their resources in line with advances in online capabilities. With stakeholder input, the goal emerged to develop an engaging, interactive and entirely novel educational product. Here we present the pilot stages of our project.

The aim of this project was to produce an educationally effective and novel product that learners of APLS would engage with and enjoy.

Stage 1 involved determining clearly defined learning objectives mapped to the APLS curriculum. At a round table with stakeholders, educationalists, and a technologist an outline of the project was formed and the scenario of a sick baby with bronchiolitis chosen for a pilot. Informed by literature on serious game design, a branching narrative was created. Stage 2 involved collating resources. A photoshoot at Leicester Royal Infirmary A&E (Accident and Emergency) created a set of images. A video shoot at the Royal London Hospital A&E generated a series of videos. These were then edited and used to create a Microsoft PowerPoint slide set. Voiceovers to text, sound effects to add a hospital atmosphere and questions were then added. Stage 3 involved taking this draft and translating it into an interactive final product utilizing Articulate Software. This enabled its usage across smartphone, desktop, and laptop devices. Testing followed with anonymous online feedback informed by the 7Is framework

We launched the pilot version at the RCPCH (Royal College of Paediatrics and Child Health) Conference 2021. Feedback was collected from delegates and continues to be collected via online participants. It is hoped that ongoing quality improvement cycles will assist in assuring a finished fully functional online virtual advanced paediatric life support simulation for release in 2022. Further stakeholder review is pending. Thus far it has been met with universal approval, i.e. all learners questioned expressed that they would like to utilize this novel style of education again. The average duration to complete the virtual simulation was 15 minutes. All learners rated their knowledge and skills in APLS to be either unchanged/revised or improved. Finally, interactivity online was felt to need improvement by most participants. Interactivity is key if high levels of engagement are to be achieved. Future testing will determine whether any educational impact is maintained across time. The current pilot version can be accessed at the following webpage
99 A Fresh Model in the Vehicles for Learning: Redesigning an Established, Traditional Airway Course to be Delivered in a Multi-Site Hybrid Format in the COVID-19 Era
Authors: Singhal Manvi , Kee Mitchell , Eady Jonathan , Martin Claire , McBrien Michael
Published: January 2022

The Royal College of Anaesthetists (RCOA) stipulates that anaesthetists should be able to use advanced/novel airway management techniques. The RCOA-accredited annual Challenging Airway Course in Northern Ireland is a staple of the calendar, providing an opportunity for all those involved in airway management to gain, refresh and replenish skills. Having already been cancelled in 2020 due to the pandemic, there was a strong appetite, particularly within the trainee body, that it should be staged in some form this year.

The aim of the study was to deliver a high-quality course that outlined the theory behind airway management, without loss of the hands-on aspects of equipment/techniques, to a large candidate group in a COVID-19 safe environment.

Alteration of the face-to-face course to run in a hybrid multi-site format with both online components and practical workstations.

The course was delivered simultaneously in real time across the multiple deanery teaching hospitals. There was a central hub from which the course lead could synchronize timings/broadcast recorded material. As part of contingency plans for any unanticipated technical difficulties, lectures were pre-recorded and played for candidates on the day. These were punctuated with four practical workstations that mandated two delegates per station. Additionally, some content was recorded for viewing online as pre-course material and new simulation videos of a failed intubation drill and the subsequent debrief were also created. For some unable to attend site locations, a fully virtual experience was also an option. These modifications allowed us to: maximize attendance without breaching social distancing guidelines; retain the hands-on aspect of using equipment/techniques and also maintain an excellent faculty to candidate ratio to allow ample time for practising/asking questions. The pre-course material also empowered the candidates to feel better prepared for the day. Post-course anonymous feedback was completed by the vast majority of delegates and was overwhelmingly positive. Pre-course material, facilities, content, lectures, simulations and workshops were rated highly. The use of airway exchange catheters was mentioned as the introduction of a new skill for many delegates. Apart from one candidate, no one had attended any RCOA-accredited airway events in the preceding year but 100% of the candidates would recommend this course to their peers. Amidst challenging times, we successfully restyled an established and respected course. The novel hybrid multi-site format allowed a larger number of candidates to network face-to-face and gain knowledge/practical skills within a COVID-safe environment. Until such times as ‘normality’ and perhaps beyond, this may be a new formula for learning.
13 Medical Emergency in situ Simulation Training for Dental Hygiene Therapists
Authors: Mahoney Jodie
Published: January 2022

simulation, in the clinical environment, can help detect any issues with the systems, policies and practices within an organization that may not work. Many system errors go unnoticed until there is a real incident. Conducting simulation

This simulation exercise is designed to develop the skillset of foundation dental therapists in respect of Medical Emergency recognition and management in their own working environment. The parameters for assessment included teamwork, knowledge, communication, effectiveness of actions and situational awareness.

Research methods for this project included a learning needs analysis, surveying and interviewing previous cohorts of hygiene therapists. The conclusions of which highlighted the need for further training in managing medical emergencies. The learning needs identified from stakeholders relating to this course have been used to develop the learning outcomes using Blooms’ taxonomy

Using GIBBs model of reflection, the 2021 delegates recognized personal learning needs including improvement in leadership and management skills, delivery of chest compressions and teamwork. Changes to practice were also recognized, for example, placing their emergency drugs in a more appropriate location. Using video, a ‘Hot Debrief’ method of evaluation was carried out whilst the experience was fresh. This proved to be powerful and enhanced personal reflection to support future learning and development. Later, an evaluation method in the form of a survey took place. Results of which showed that 50% of delegates had never partaken in simulation-based education before and 100% gave an excellent rating on the benefits to team and individual. One participant stated ‘this was such a good, real-life experience! I hope this can either be introduced into undergraduate training or as part of the practice annual BLS CPD!!’.

A successful session needed prior communications with the practice staff to free up a surgery for use, inform present patients of the activity and understand where the emergency equipment was during the session for patient safety. The benefits of conducting
190 Virtual Work Experience in Medicine: Widening Participation
Authors: Keshtkar Fatemeh , Ellerton Laura , Kelly Ryan , Parr Tim , Mercer Simon
Published: January 2022

The national lockdowns due to COVID-19 have caused significant disruption to schools and colleges. As well as interruption to their studies, pupils work-experience placements have been cancelled, particularly those based in healthcare. Despite this, the BMA continues to recommend all aspiring doctors undertake placements within healthcare to aid their application to medical school and give them an insight into being a doctor

Creating a ‘virtual work experience’ using simulated video demonstrations in order for students to gain an understanding of what working as a doctor encompasses. This course was offered free of charge to help encourage students, particularly from low-income households.

Invitation letters were sent to all public and private schools in Merseyside. Contact details and school information were obtained through the Office for Standards in Education, Children’s Services and Skills (OFSTED) Government website. Students were asked to fill out a pre- and post-course questionnaire.

Seventy-five schools and colleges were invited. A total of 326 students registered for the course and 220 participated in the virtual conference. All participants were from 18 schools and colleges. Students, where at least one parent had attended university, felt more confident in applying to medical school and securing a place, this was significantly higher when a parent was in the medical profession. Students from private or schools rated as above average by OFSTED felt that they were more likely to apply to medicine than those in schools who were rated average or below-average. Overall, students felt that they had an improved understanding of the different roles of doctors following the course and the simulated scenarios were most useful in encouraging them to apply to medicine.

Up to 20% of secondary schools provide 80% of all applicants to medicine, with half of the schools in the UK not providing any applicants to medicine at all. The selection alliance 2019 report on widening participation in UK medical schools suggested that there continues to be a discrepancy in underprivileged students applying to study medicine with barriers including limitations to securing work-experience placements
51 Preparing Ward Staff for Covid-19: Can Remote Simulation Replace Face-to-Face Learning?
Authors: Dunnell Liam , Sowole Luciana , Maule Sophie P. , Laws-Chapman Colette , El-Alami Wathik
Published: January 2022

Human factors are essential to patient and staff safety, particularly during the COVID-19 pandemic with redeployment of staff to different roles in unfamiliar environments

The aim of the study was to ascertain the efficacy of converting face-to-face simulation and debriefing into online asynchronous video-based scenarios and debriefing, to enhance understanding of human factors skills.

In October 2020, a half-day simulation course commenced. Due to suspension of face-to-face teaching in December 2020 with COVID-19 cases rising, this was converted into a half-day online format through filming faculty participating in the existing scenarios. These films were shown to participants, followed by asynchronous online debriefing via Microsoft Teams. Both formats had e-learning as a pre-requisite. Data were collected using pre- and post-session questionnaires containing the Human Factors Skills for Healthcare Instrument (HuFSHI)

Post-training, staff demonstrated improvement in self-efficacy of human factors skills for healthcare. There was no statistical significance between mean improvements for both formats; the greatest improvement was split equally (Table 1). 100% found the face-to-face (N = 24) useful, versus 98% online (N = 54). Communication was the skill most learnt (face-to-face 58%, online 65%), with teamwork (face-to-face 50%, online 48%), escalation (face-to-face 42%, online 57%) and self-care (face-to-face 38%, online 19%) also frequently mentioned. Aspect’s learners’ thought were good included the discussion-based element (face-to-face 50%, online 37%), interactivity (face-to-face 13%, online 31%), multi-disciplinary team involvement (face-to-face 13%, online 20%) and videos for the online format (19%). 21% wanted the face-to-face longer, 15% wanted the online shorter. 9% would rather the online was face-to-face.

Online asynchronous debriefing produced similar outcomes to face-to-face for teaching human factors. We posit that this was because the videos were not ‘best practice’ – thus stimulating learning conversations, which accessed learners’ frames and past experiences. Challenges for faculty included: pace and volume of sessions, managing psychological safety, emotive discussions, screen fatigue, and technical aspects. A 6-month follow-up survey is planned and will be included in the presentation. Further work is required to understand why the results were similar.
59 Rapid Training During A Pandemic: An Evaluation of a Covid-19 Video E-Learning Package
Authors: Maule Sophie P. , Sowole Luciana , Dunnell Liam , Szulc Nick , Alami Wathik El
Published: January 2022

As COVID-19 hospital admissions rose in 2020, there was a requirement to prepare wards and staff to care for COVID-19 patients, especially given the rapidly emerging and frequently evolving guidance, and high levels of re-deployment (GMC, 2020). In one London Trust, this need for educational material geared towards ward staff resulted in a multi-disciplinary simulation education team being commissioned to produce an e-learning resource. We measured the effectiveness of the resource for ward staff as well as any improvement in learners’ COVID-19 knowledge.

The aim of the study was to quantify the effectiveness of an e-learning package in improving learners’ COVID-19 knowledge.

In November 2020, an e-learning package was created, comprising a video series documenting the journey of a patient with COVID-19 covering admission to discharge (filmed from the patient perspective). This was integrated with content highlighting key aspects of COVID-19 care, ending with a mandatory assessment with an 80% pass mark. The e-learning was disseminated to hospital staff (doctors, nurses and allied healthcare professionals) with data collection via SurveyMonkey® from November 2020 for 3 months. Pre- and post-surveys were included to investigate the average improvement of learners and the impact of the resource on learner self-efficacy through self-rating on six learning outcomes. Free-text options in the post-survey allowed qualitative feedback, aiding continual resource development.

In total, 108 learners, about half of whom were doctors, completed both surveys, with a significant difference (p < 0.01) between the pre- and post-learning results and an overall improvement in learners’ knowledge after completion of the e-learning (

Average pre- and post-learning scores of learners’ self-reported knowledge and percentage improvement

*Treatment escalation plans.

E-learning can rapidly disseminate learning, at a time when most feel the pandemic has had a mixed or negative impact on learning opportunities (Dean E, 2020; GMC, 2020). The e-learning is continually updated with new evidence, with plans to expand access across London. An iterative process was undertaken with updates in response to learner feedback due to the speed at which the resource needed to be developed, for example, turning resources into PDFs for home access. The e-learning remains live given rising COVID-19 cases. Further work is required to investigate the effectiveness of this resource across London and how beneficial it has been for clinical work.
10 Introducing a Virtual Ward Round in Times of COVID-19
Authors: Westerman Tanith , Ahmed Liban , Mills Helen
Published: January 2022

Many medical students feel unprepared for starting as FY1 doctors, and often report low confidence in taking responsibility for patients and working independently, and lack self-assurance in common FY1 skills, including assessing unwell patients and initiating management, task prioritization, referrals, documentation, ordering imaging and on-call shifts. These skills are developed during clinical placements; however, access to these opportunities during placements has diminished due to COVID-19 and concerns around patient safety. Simulation‐based teaching allows students to take responsibility and work within complex clinical environments without posing a risk to patients

The aim of the study was to evaluate whether simulated mock ward rounds increase final-year medical students’ overall confidence and feeling of preparedness for starting as FY1 doctors.

In total, 20 final-year medical students took part in the programme in two whole-day sessions. This was comprised of a simulated ward round of 10 patients. Students acted as FY1 doctors on the ward and carried out jobs, reviewed patients who deteriorated and had a number of tasks such as updating families, ordering radiology, initiating management and discharge summaries. Students’ confidence and preparedness was measured using pre- and post-course questionnaires. The questionnaires consisted of a 10‐point Likert scale for students to rate their confidence in key skills and overall preparedness for FY1 (1 = not at all confident, 10 = completely confident). These scores were matched and analysed using the Wilcoxon signed‐rank test. Additionally, there was blank spaces for feedback on the course which were analysed thematically.

Pre- and post-course questionnaires demonstrated that students felt significantly more prepared for FY1 after the course (p < 0.001). There was also a significant improvement in nine other domains deemed important for FY1 that students had reported low confidence in (see Figure 1). Qualitative data revealed that students appreciated the programme. They stated its superiority to other educational methods such as shadowing or didactic teaching sessions.

Students mean confidence score in overall preparedness and key skills before and after the programme. P < 0.001 for all domains.

Simulated mock ward rounds can be used as an adjunct to clinical placements to increase medical students’ confidence about starting work, and to teach them valuable skills regularly utilized by FY1 doctors.
20 Special Delivery: Skills@Home
Authors: Spencer Beth , Henderson Helen , Gerrish Lorna , Ballard Ian , Rooney Jane
Published: January 2022

Due to the sudden shift in online learning at the start of the pandemic, an innovative idea was identified to encourage a student-centred approach for continuing the development of their essential skills whilst learning from home. Taking inspiration from other healthcare programmes, we developed, and risk assessed ‘Skills@Home’ packages to embed a mastery learning approach towards dexterous skills. These comprehensive packages included access to virtual resources and e-learning as well as practical and safety equipment. Implementation of these packages allowed students to maximize their exposure, experience and understanding of a range of skills that could be accessed at a time and pace to suit their needs. The pilot ‘Skills@Home’ package focussed upon the development of suturing, which is a traditional and essential midwifery skill.

A collaborative approach between the midwifery team and the clinical simulation and skills education team ensured a robust approach to the risk assessment, procurement and delivery of packages to students’ home addresses. A pre-requisite for receiving a pack was the completion and return of a detailed student agreement form which outlined safety considerations and their responsibilities. The package was piloted with a cohort of 29 third-year student midwives, as a priority group, to facilitate and increase confidence and application in the clinical area and to ensure enough opportunities for progression on the programme.

Students completed an online evaluation form after receiving their packs, which showed overwhelming support for this approach. Students identified that having the opportunity to learn in this manner at home not only enhanced their confidence and skills technique but also helped them to relate theory to practice. Additionally, students identified that they would like to see the ‘Skills@Home’ approach sustained and enhanced once on-campus learning has resumed.

This has inspired the clinical simulation and skills education team to identify other Skills@Home packages that can be used within healthcare learning. Ensuring that thorough risk assessments are completed along with the packages being created and delivered to the students in the most cost-effective way. Following the pilot study, ethics approval is currently being sought to explore, using focus groups, the midwifery students’ experiences and view of using the Skills@Home initiative.
109 Perceptions of Virtual Simulations by Inter-Professional Simulation Facilitators
Authors: Dickinson Karen , Ward Wendy L. , Neill Kathryn
Published: January 2022

The COVID-19 pandemic has necessitated pedagogical change with many events virtual or hybrid in nature. Simulation events are particularly affected due to their hands-on quality. In addition, requirement for virtual facilitators may be increased compared with in-person counterparts. Virtual simulation education must be as high quality as in-person efforts and facilitator training is key. Some principles of virtual facilitation differ from in-person, for example, in relation to debriefing

The aim of the study was to deliver virtual facilitator education addressing the format, objectives, expectations and strategies for virtual IP simulations.

The traditional in-person Facilitator Training and Inter-professional Education (IPE) Event Training Design course our university-affiliated program delivers was adapted based on a local needs assessment to the virtual Facilitating Virtual Simulations Crash Course. This was delivered as required as small-group Zoom-based teaching, outlining educational theory, practice and principles of virtual simulation facilitation.

Sixteen virtual inter-professional simulations have been delivered for students in 19 professions within our Office of IPE since September 2020 with 33 inter-professional facilitators from 4 institutions. To determine the efficacy of our novel virtual facilitation, training facilitators were surveyed. The majority had facilitated one to five simulations (in-person 58%, virtual 70%). In addition to the Office of IPE training, 30% of facilitators had received external education on in-person simulation facilitation compared with 6% for virtual facilitation. The majority of facilitators strongly agreed/agreed that they were as effective a facilitator in virtual simulations (80%), as confident facilitating virtually (70%), as psychologically safe in virtual debriefings (75%), and that virtual simulations will continue in their practice after the pandemic (100%). Most (95%) facilitators strongly agreed/agreed that students were as engaged with virtual simulations as with in-person and 80% felt virtual simulations were a good learning experience for students. The majority (88%) of facilitators strongly agreed/agreed that the virtual crash course provided the knowledge and practice to help them effectively facilitate virtually, and 75% strongly agreed/agreed that the crash course made them appreciate and foster IP relationships in their daily work. These results are comparable to evaluation of in-person training delivered before the pandemic.

Virtual simulation events require specific facilitation strategies, and virtual education is useful to improve the knowledge and confidence of facilitators. Facilitators value the virtual simulation experience for themselves and their students, and they believe that this will be an important pedagogy post-pandemic.
168 A Novel Approach to Interactive, Online History-Taking in Medical Education During the COVID-19 Pandemic
Authors: Adeboye Teniola , Ogunmwonyi Innocent , Alam Azeem , Parker Hollie , Mathews Catherine , Simpson Thomas
Published: January 2022

The COVID-19 pandemic resulted in an unprecedented shift from face-to-face to online teaching with a subsequent deleterious impact on the quality of teaching delivery within medical education

Our aim was to demonstrate the feasibility of utilizing a novel approach to interactive, online simulated history-taking.

The session was designed for students attending a virtual work-experience programme and is founded upon gamification principles. History-taking is a humanistic social process requiring effective communication skills and recognition of verbal and non-verbal cues. The session enabled students to directly instruct a passive clinician to take a history from a simulated patient actor, incorporating both verbal and non-verbal actions. This novel teaching method is analogous to Freire’s work, highlighting the importance of the learner being an active participant, thus enabling experiential learning

This interactive approach required a simulated patient actor, a passive clinician and a verbal instructor to be present. Students were presented with a case scenario and viewed the interaction between the simulated patient actor and passive clinician online via a video conferencing service (in this case, Zoom). Students provided instructions to the passive clinician using the typed chat function. These typed instructions were relayed by the verbal instructor to the passive clinician via an earpiece and the passive clinician would then embody these instructions. This allowed students to work as a group to directly elicit a history and witness their instructions being actioned. Examples of instructions included questions to verbalize, adjustments to body language and alteration of the tone of voice. Following good student instruction, the passive clinician gradually grew in competence and confidence throughout the scenario, thus allowing real-time, interactive feedback of their history-taking approach. The session concluded with a reflection of the communication traits that helped to gain an effective history from the patient using a debrief model.
77 Fast Track Simulation-Based Education for COVID-19 Deployment
Authors: Almomani Emad , Sullivan Jacqueline , Mathias Jesveena , Leighton Kimberly
Published: January 2022

COVID-19 created pressure on healthcare institutions to quickly prepare for maximum capacities. To meet the critical care capacity challenges, non-critical care nurses and overseas short-term temporary contracted nurses needed to be urgently deployed to the critical care units. That quick deployment and recruitment process raised concern about competence and patient safety; therefore, the deployed nurses were upskilled using fast track simulation-based education (SBE). SBE is an effective method to manage quick, focussed upskilling training, helping to improve patient care and safety

The aim of the study was to explore the effectiveness of the COVID-19 SBE upskilling program on perceived satisfaction, confidence and competence of deployed nurses.

Upskilling of 1200 non-critical care nurses was conducted using SBE between 14 March and 1 June 2021 during the country’s second wave of COVID-19. Training consisted of completing a mandatory 2-hour online critical care introductory module that included information on COVID-19 (the disease, pathophysiology), the critical care environment, critical care scope of service and infection control strategies. The online module was followed by 4 hours of in-person SBE using a demonstration and return demonstration approach. Considering the urgency of the situation and time constraints, skills were selected and prioritized according to patient safety and included care of the patient receiving mechanical ventilation, invasive line monitoring and care, recognition of deterioration, proning, and assessment of patient response to interventions. Post SBE, a survey was administered to collect data on the perceived satisfaction, confidence and competence of the nurses being deployed.

The majority of the nurses reported confidence in their new skills (97%), while 96% perceived themselves as competent after successful completion of SBEs. The nurses were highly satisfied with the training effectiveness (92%), and 99% believed that they were able to successfully achieve the learning objectives. Specifics about perceived competence and confidence per survey item will be reported in the presentation. The SBE upskilling programme was evaluated as an effective way to learn how to manage critically ill patients.

Nurses perceived themselves as confident and competent after participating in SBE. However, competence confirmation will be evaluated either in further SBE or through actual competency assessment in the clinical setting by trained competency validators. Nurses could perceive themselves as confident and competent but still perform incorrectly. Fast track SBEs should not be used to confirm full competence due to the inability to provide repetition of skills practice.
84 Using the Team Tool in High-Fidelity Immersive Simulation for Internal Medicine Trainees: Assessing Leadership of Cardiac Arrest Scenarios
Authors: Keay Rona , Kerins Joanne , Tallentire Vicky
Published: January 2022

Non-technical skills (NTS) play a crucial role in cardiac arrest resuscitation performance, both in simulated and clinical environments

This observational pilot study aimed to explore the leadership and team-working behaviours of IMT1 doctors in a simulated cardiac arrest scenario, to identify strengths and areas for improvement to focus future training.

The Scottish national IMT1 boot camp involves a variety of high-fidelity immersive simulation scenarios across the 3-day course. Trainees are in groups of six with one IMT taking a lead role in each scenario. This study assessed a scenario of shockable rhythm cardiac arrest. All group participants are involved as the cardiac arrest team, with the original ‘hot seat’ participant expected to take the role of team leader, unless otherwise agreed by the team. The scenario is followed by a facilitated debrief around leadership in cardiac arrest.

Following ethical approval from NHS Education for Scotland and written participant consent, videos of the cardiac arrest scenario were observed by the research team. Leadership and team behaviours were scored using the validated Team Emergency Assessment Measure (TEAM)

Seventeen videos involving 102 trainees were reviewed and scored using the TEAM tool. The average overall TEAM score was 6.19/10. Scores for each of the 11 NTS domains ranged from 2.13/4 to 3.25/4. IMT1s scored highly on adapting to changing situations and monitoring and reassessing, but poorly on team leader displaying direction and command and leader maintaining a global perspective. When leadership scores were high, overall team performance was also high. General observations from field notes found the team often did not allocate a leader until cardiac arrest occurred. The leader often struggled to remain hands-off with a lack of assertiveness and poor communication between the leader and team. One hundred and fourteen IMT1s completed a pre- and post-course questionnaire. Average pre-course confidence in cardiac arrest team leadership was 3.8/7, and among the lowest of all situations rated. This improved to 5.35/7 post-course, but compared with other situations, remained low.

This pilot study found leadership to be a key component in managing cardiac arrest for IMT1s, influencing overall team performance. Particular areas for improvement include hands-off leadership, leader assertiveness and whole team communication, which could be the focus of future educational interventions. Scenario participation and facilitated debrief improved overall confidence, but further focussed leadership and team training is required as IMT1s transition into the leadership role.
JINR WLCG TIER1 & TIER2/CICC ACCOUNTING SYSTEM
Authors: Kashunin I. , Mitsyn V. , Strizh T.
Published: January 2022

The problem of evaluating the efficiency of the JINR MLIT grid sites has always been topical. At thebeginning of 2021, a new accounting system was created, it managed to fully cover the functionalityof the previous system and further expand it. The article provides detailed information on theimplemented accounting system.
Kewenangan Kepala KUA sebagai Wali Hakim menurut Peraturan Menteri Agama No. 30 Tahun 2005
Authors: Ikhsan Harjanto  , Munifah
Published: January 2022

Penelitian ini bertujuan untuk mengetahui kewenangan Kepala KUA sebagai wali nikah. Jenis penelitian ini adalah penelitian yang bersifat deskriptif. Metode analisis yang dipergunakan oleh penulis dalam penelitian ini adalah metode kualitatif. Pengumpulan data dalam penelitian penulis mulai berusaha untuk menarik kesimpulan berdasarkan semua hal bersama-sama dalam reduksi data dan sajian datanya tersebut. Hasil penelitian menunjukkan, prosedur pelaksanaan perkawinan oleh kepala KUA sebagai wali hakim terhadap calon mempelai wanita yang walinya adhol menurut PMA No 30 tahun 2005 adalah calon pengantin wanita dan pria datang ke KUA kecamatan tempat tinggal pengantin wanita dengan membawa berkas persyaratan pernikahan untuk memberitahukan kehendak nikah, jika tidak terdapat keterangan wali nikah, Kepala KUA memanggil wali dengan surat diupayakan 3 (tiga) kali dengan berita acara pemanggilan
VOLUMNI UDIO DRVNIH TRAKOVA U STRUKTURI DEBLA I GRANA OBIČNE BUKVE (Fagus silvatica L.)
Authors: Gurda Safet
Published: January 2022

Istraživanja su rađena kako bi se utvrdilo a) varijacije radijalnih drvnih trakova unutar debla bukve i b) varijacije radijalnih dijelova drvnih trakova unutar bukovih grana normalnog i zategnutog drveta. Volumenski dio radijalnih drvnih trakova u deblu bukve varira između 5,44% i 29,26% (prosjek je 11,18% ± 0,130% i standardna devijacija 1,95 ± 0,0921%). Varijacija zapreminskog dijela radijalnih drvnih trakova u normalnom drvetu grana je od 6,21% do 33,11% (prosjek je 17,93 ± 0,113% i standardna devijacija 3,75 ± 0,0798%). Zapreminski udio radijalnih drvnih trakova u zategnutom drvetu grana varira od 5,91% do 32,18% (prosjek je 16,47 ± 0,115% i standardna devijacija 3,82% ± 0,0813%). Tako je zapreminski dio radijalnih drvnih trakova u normalnom drvetu bukovih grana veći za 6,75% nego u deblu i 1,46% u odnosu na tenzijsko drvo grana.
UNUTARPOPULACIJSKA I MEĐUPOPLACIJSKA VARIJABILNOST BROJA KOTILEDONA U POTOMSTVU PET POPULACIJA OBIČNE JELE (Abies alba Mill.) IZ SREDIŠNJE BOSNE
Authors: Ballian Dalibor
Published: January 2022

Proučavana je intra i interpopulacijska varijabilnost broja kotiledona jele (Abies alba Mill.) u srednjoj Bosni. Statistički značajna intrapopulacijska varijabilnost pronađena je u svim populacijama, ali ne i u međupopulacijskoj.