Pafitanis, Georgios;Serrar, Yasmine;Raveendran, Maria;Ghanem, Ali;Myers, Simon
Archives of Plastic Surgery
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v.44
no.4
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pp.293-300
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2017
Background Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here. Methods A step-by-step dissection guide on how to perform the chicken thigh adductor profundus free muscle flap is demonstrated. Forty trainees performed the novel simulation muscle flap on the last day of a 5-day microsurgery course. Pre- and post-course microvascular anastomosis assessment, along with micro dissection and end product (anastomosis lapse index) assessment, demonstrated skills acquisition. Results The average time to dissect the flap by novice trainees was $82{\pm}24$ minutes, by core trainees $90{\pm}24$ minutes, and by higher trainees $64{\pm}21$ minutes (P=0.013). There was a statistically significant difference in the time to complete the anastomosis between the three levels of training (P=0.001) and there was a significant decrease in the time taken to perform the anastomosis following course completion (P<0.001). Anastomosis lapse index scores improved for all cohorts with post-test average anastomosis lapse index score of $3{\pm}1.4$ (P<0.001). Conclusions The novel chicken thigh adductor profundus free muscle flap model demonstrates face and construct validity for the introduction of the principles of free tissue transfer. The low cost, constant, and reproducible anatomy makes this simulation model a recommended addition to any microsurgical training curriculum.
The Journal of Korean Academy of Sensory Integration
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v.16
no.1
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pp.25-34
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2018
Objective : This study aims to figure out the effect that sensory integration group therapy has on the fine motor, social interaction and playfulness of preschool children with intellectual disability. Methods : Participants were four children from three to five years old who were diagnosed with intellectual disabilities and they participated in twelve sessions of sensory integration group therapy, sixty minutes per session and once a week. Sensory integration group therapy was composed of parallel and peer play-centered gross motor activities, art activities and sensory plays that were related to each theme. Erhardt Developmental Prehension Assessment (EDPA), Penn Interactive Peer Play Scale (PIPPS) and Test of Playfulness (ToP) were used to evaluate participants' fine motor, social interaction and playfulness before and after the intervention. Results of fine motor, social interaction and playfulness before and after the intervention were compared using Wilcoxon matched-pair signed rank test. Results : After sensory integration group therapy intervention, the fine motor skills of participants did not show significant increases, but social interaction and playfulness showed significant increases (p< .05). Conclusion : Although sensory integration group therapy with preschool children with intellectual disability did not show positive improvement in fine motor skills, it showed positive effect on social interaction and playfulness. Group sensory integration therapy might be an intervention approach for all children with disabilities.
Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.
Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.
The Journal of Korean Academy of Sensory Integration
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v.15
no.2
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pp.93-106
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2017
Objective : The purpose of this study is to provide an evidence for clinical practice by systemic analysis on occupational therapy interventions for improvement of children's play. Methods : Articles used in this study were collected from database of Pubmed, ProQuest, EBSCOhost, Scopus, RISS, KISS, and National Library of Korea. The key words used in the search were "Play AND Occupational Therapy AND (Intervention OR Treatment)" and the publication period was limited from January 2007 to April 2017. 11 articles in total were selected for the systematic review analysis. Results : The results revealed that the majority of studies was one-group non-randomized study and the majority of intervention used was play-based intervention in case of that play itself was the intervention goal. The most frequently used environment for the intervention was parallel setting of home and treatment room. The majority of studies was for children with ADHD and the most commonly used assessment tool was Test of Playfulness (ToP). Dependent variables measured along with play were language skills, social interactive skills, communication and pragmatic skills, problem-solving skills, caregiver responsiveness, and parent-child interaction. Conclusion : This study help to understand the current state of occupational therapy intervention for improvement of children's play. Starting with the understanding, it is expected that various studies on play of children will be done in the future.
Background: The purpose of this study is to evaluate the effects of the Motivational Interviewing (MI) based communication training for third-year nursing students. Methods: This study use a quasi-experimental design with pre and post-test to evaluate a 4-hour MI based communication training. This training was offered to 35 third-year nursing students who were participating in elective psychiatric nursing clerkship course. Each student completed pre and post questionnaire which includes assessment of motivational interviewing skills as measured by Helpful Response Questionnaire (HRQ). Also confidence (5 items) in using MI based communication knowledge and core skills were included. Data were independently analyzed by two coders and blindly rated the pre and post HRQ self-reported responses. Data were analyzed using paired t-test, descriptive analysis. Results: Nursing students showed increasing use of reflection (4.10~5.67, p<.001), decreasing use of closed-ended question (2.00~0.73, p<.001), road blocks (2.94~0.64, p<.001), and improve in depth of reflection (12.79~20.86 p<.001). But they did not show significant changes in open-ended question (2.01~2.33, p=.257). Confidence in the interview has increased overall, except for reflecting. The overall satisfaction with the training was quite high, and the most helpful training method was group and individual feedback. Conclusions: This study provides evidences that 4 hour-training is effective in core skills such as reflection and depth of reflection, and also confidence in interviews. It is necessary to develop step-by-step training modules to enhance undergraduate communication skills. It is necessary to develop an effective training strategy focused on students' confidence in open-ended questions and reflection.
The objectives of this study were (1) to determine the rank of purposes of Korean secondary school home economics education related to three systems of action: technical, communicative, and emancipatory action by home economics(HE) teachers and HE teacher educators, (2) to compare differences between HE teachers and HE teacher educators concerning the degree of importance and achievement of the purposes of current Korean secondary school HE education. Respondents in this study were 225 HE teachers and 35 HE teacher educators. The survey method was used in this descriptive study. To determine the rank, Borich's needs assessment model was used. The data were analyzed by using t-test to compare the differences between the two groups. To promote a good life and the full development of human beings, to develop creative and critical thinking, to make morally defensible judgments, and to develop self-esteem were needed purposes for Korean secondary school HE education. Overall, the most high ranked purpose needs for both groups related to emancipatory action. The two groups were significantly different on the degree of the importance of evaluating family and social conditions, acquiring the skills needed as a wage earner and a homemaker, developing creative and critical thinking, and demonstrating proficiency of homemaking work. The teachers and teacher educator groups were significantly different on the degree of the achievement of making morally defensible judgments, understanding Korean traditional culture, and taking care of each other.
Journal of the Korean Institute of Intelligent Systems
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v.21
no.1
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pp.62-67
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2011
This study has been undertaken to empirically test how the level of information Home Helpers have about their client and the hypothesis that home-helpers' expertise about their service provided to their clients is expected to positively affect their assessment of service provided to clients. Main results of this study are as follows : First, home-helpers' knowledge, skill, and information about clients is positively related to their assessment of service provided to clients. Home-helpers' information about clients plays a more important role than knowledge and skills in the process of assessing the services provided to clients. After maintaining that the hypothesis is empirically confirmed, the author discusses the implications of empirical findings.
PRIYONO, Djoko;Harlia PUTRI, Triyana;MAULANA, M. Ali;YANTI, Irma;PRABOWO, Thoriq Tri
Educational Technology International
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v.23
no.2
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pp.183-205
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2022
Mental status examination is an important stage in the assessment process because it serves as the foundation for establishing nursing diagnosis and intervention. Until now many students still feel difficult to understand the terms in the assessment of mental status. Interactive Mobile Learning in one of the media that is currently being developed. The use of this media will provide more in-depth learning opportunities, and students can practice their skills in carrying out practicals because of the mobility principle possessed by smartphones. The purpose of this study was to develop a smartphone-based app and evaluate the app's effectiveness by measuring nursing students' knowledge of mental status examination. Design: A randomized trial with a pre-and post-test design was conducted at a university in Indonesia. A total of seventy junior nursing students participated in this study. The intervention group received a smartphone-based app, and the control group received one-time lecture-based learning. We offered the experimental group the app and information about how to use it, and we encouraged them to use it. The control group received classroom instruction. Results: The intervention group scored significantly higher than the control group on knowledge score (t = 19.40, p = 0.000) and satisfaction with the learning method (t = 0.640, p = 0.021) Conclusion: These findings suggest that smartphonebased education could be an effective method in nursing education for teaching mental status examinations.
This study carried out a horticultural program for people with mental disabilities to determine suitability of the horticultural activity program and to actually apply to vocational rehabilitation. The program was carried out in 16 sessions from April 12 to June 7, 2018 with nine people with a strong will to participate in vocational rehabilitation at a health center for persons with mental disabilities. The tools used were the Horticultural Activity Performance Assessment (psychological behavior) and Purdue Pegboard Test that examines functions of hands and arms. The subjects sold the products they made during class time and obtained the profits. After the program, the scores increased with a significant difference (p = .000) in the psychological behavior area of the Horticultural Activity Performance Assessment. Hand and arm movement also showed continuous improvement along the program with a significant difference (p = .000), as well as finger dexterity also with a significant difference (p = .018). The net profit was 314,000 KRW (subtracting cost of goods 314,000 KRW from total sales 628,000 KRW). The profit was shared equally among the nine subjects, each receiving 34,900 KRW. Therefore this study proved horticultural activity class is suitable for vocational rehabilitation of people with mental disabilities proved by the positive effects. We also expect that the subjects will be able to make more profits if they learn more skills, since they are interested the process of making such profits.
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