***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / PURPOSE Conventional training in bronchoscopy may increase patient 's discomfort and procedure-related morbidity .  Computer-based bronchoscopy simulator ( CBBS ) permits the acquisition and evaluation of the necessary skills through a realistic bronchoscopic experience . This study was conducted to vali date the use of a CBBS system developed in Taiwan as a learning and assessment tool . METHODS Twenty novice bronchoscopists and 10 expert bronchoscopists were enrolled as subjects in this prospect i ve study . The 20 novice bronchoscopists were r and omized into two groups , which received conventional bronchoscopic training or CBBS training and then completed a satisfaction survey . Subsequently , the novices who received CBBS training underwent an observational performance trial and the results were compared with those of expert bronchoscopists . All 10 expert bronchoscopists completed a  realism survey  and observational trial after CBBS performance . RESULTS The satisfaction survey showed that the CBBS training program significantly increased participants ' satisfaction ( p = 0.002 ) and interest in learning ( p < 0.001 ) . The realism survey by the 10 expert bronchoscopists indicated that CBBS provides a favorable degree of realism with regard to the mechanical and visual parameters examined . Analysis of the performance results showed that the following parameters were capable of differentiating the participants by level of expertise : total procedure time ( p = 0.002 ) , percentage of bronchial segments entered ( p = 0.012 ) , percentage of bronchial segments identified ( p < 0.001 ) , percentage of repeated bronchial segments entered ( p = 0.004 ) , percentage of pathologies identified ( p < 0.001 ) , number of times that the bronchoscope tip collided with airway walls ( p = 0.013 ) , and number of times oral instruction was needed ( p = 0.01 ) . CONCLUSION CBBS is a valid training method that increases interest in learning and provides a favorable degree of virtual realism . It can also distinguish various levels of competence at actual bronchoscopy and may have a useful role in the bronchoscopic training curriculum INTRODUCTION The human patient simulator has proved to be an effective educational device for teaching physicians and paramedical personnel . METHODOLOGY To determine whether veterinary medicine students would benefit from similar educational sessions , 90 students each took a turn being the patient 's clinician as real-life scenarios were played out on the simulator . The students induced and maintained anesthesia on their patient and monitored vital signs . Several critical events were presented for the students to diagnose and treat as they occurred . All students su bmi tted a written evaluation of the course upon completion . The last 40 students were r and omly divided into two groups of 20 students each . The students in Group I experienced the simulator before their clerkship examination , and those in Group II took the examination before their simulator experience . RESULTS The students rapidly gained confidence in treating their simulated patient . This carried over to the clinical setting , where they appeared to be more confident when anesthetizing live patients . The simulator experience brought together much of the previous didactic material that they had been exposed to so they could appreciate its clinical relevance . The overwhelming response to the simulator experience was positive . The students in Group I had a significantly higher score on the clerkship examination dealing with concepts review ed by simulation than those in Group II , who engaged in self- study instead of the simulation exercise ( p < 0.001 ) . CONCLUSION We conclude that the human patient simulator was a valuable learning tool for students of veterinary medicine . It was exciting for the students to work with , made them deal with " real-life " scenarios , permitted them to learn without subjecting live patients to complications , enabled them to retrace their steps when their therapy did not correct the simulated patient 's problems , and facilitated correlation of their basic science knowledge with clinical data , thus accelerating their ability to h and le complex clinical problems in healthy and diseased patients Background With increasing pressure to use operating room time efficiently , opportunities for residents to learn fiberoptic orotracheal intubation in the operating room have declined . The purpose of this study was to determine whether fiberoptic orotracheal intubation skills learned outside the operating room on a simple model could be transferred into the clinical setting . Methods First-year anesthesiology residents and first- and second-year internal medicine residents were recruited . Subjects were r and omized to a didactic-teaching-only group ( n = 12 ) or a model-training group ( n = 12 ) . The didactic-teaching group received a detailed lecture from an expert bronchoscopist . The model-training group was guided , by experts , through tasks performed on a simple model design ed to refine fiberoptic manipulation skills . After the training session , subjects performed a fiberoptic orotracheal intubation on healthy , consenting , anesthetized , paralyzed female patients undergoing elective surgery with predicted “ easy ” laryngoscopic intubations . Two blinded anesthesiologists evaluated each subject . Results After the training session , the model group significantly outperformed the didactic group in the operating room when evaluated with a global rating scale ( P < 0.01 ) and checklist ( P < 0.05 ) . Model-trained subjects completed the fiberoptic orotracheal intubation  significantly faster than didactic-trained subjects ( P < 0.01 ) . Model-trained subjects were also more successful at achieving tracheal intubation than the didactic group ( P < 0.005 ) . Conclusion Fiberoptic orotracheal intubation skills training on a simple model is more effective than conventional didactic instruction for transfer to the clinical setting . Incorporating an extraoperative model into the training of fiberoptic orotracheal intubation may greatly reduce the time and pressures that accompany teaching this skill in the operating room Abstract Simulation-based teaching ( SBT ) is increasingly used in medical education . As an alternative to other teaching methods there is a lack of evidence concerning its efficacy . The aim of this study was to evaluate the potency of SBT in anesthesia in comparison to problem-based discussion ( PBD ) with students in a r and omized controlled setting . Thirty-three fourth-year medical students attending a curricular anesthesiology course were r and omly allocated to either a session of SBT or a session of PBD on an emergency induction method . Ten days later all students underwent examination in a simulator . The performance of each student was evaluated by weighted tasks , established according to a modified Delphi process . Confidence and a multiple-choice question naire were additionally performed pre- and post-intervention . A total of 32 students completed the study . Participants in the SBT group presented with significantly higher self- assessment scores after the intervention than students in the PBD group . However , students in the SBT group achieved only slightly and statistically insignificantly higher scores in the theoretical and simulator examination ( p > 0.05 ) with only a moderate effect size of d = 0.52 . The current study demonstrates that both PBD and SBT lead to comparable short-term outcomes in theoretical knowledge and clinical skills . However , undesirably , SBT students overrated their anticipated clinical abilities and knowledge improvement OBJECTIVES The primary purpose of this study was to determine whether the endotracheal intubation ( ETI ) success rate is different among paramedic students trained on a human patient simulator  versus on  human subjects in the operating room ( OR ) . METHODS Paramedic students ( n = 36 ) with no prior ETI training received identical didactic and mannequin teaching . After r and omization , students were trained for ten hours on a patient simulator ( SIM ) or with 15 intubations on human subjects in the OR . All students then underwent a formalized test of 15 intubations in the OR . The primary outcome was the rate of successful intubation . Secondary outcomes were the success rate at first attempt and the complication rate . The study was powered to detect a 10 % difference for the overall success rate ( alpha = 0.05 , beta = 0.20 ) . RESULTS The overall intubation success rate was 87.8 % in the SIM group and 84.8 % in the OR group ( difference of 3.0 % [ 95 % confidence interval { CI } = -4.2 % to 10.1 % ; p = 0.42 ] ) . The success rate on the first attempt was 84.4 % in the SIM group and 80.0 % in the OR group ( difference of 4.4 % [ 95 % CI = -3.4 % to 12.3 % ; p = 0.27 ] ) . The complication rate was 6.3 % in the SIM group and 4.4 % in the OR group ( difference of 1.9 % [ 95 % CI = -2.9 % to 6.6 % ; p = 0.44 ] ) . CONCLUSIONS When tested in the OR , paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects . The results support using simulators to teach ETI Background and objective The aim of the study was to compare the effectiveness of teaching of general anaesthesia induction to medical students using either full-scale simulation or traditional supervised teaching  with patients in the operating theatre . Methods Forty-six fourth year students attending their course in anaesthesiology were enrolled . The students were r and omly assigned to two groups . The simulation group received training in the simulator . The traditional training group was supervised by a senior consultant anaesthetist . After the training sessions all students were tested in the simulator setting . The test was assessed using a 40-item evaluation list . Results Thirty-three per cent of students in the traditional group and 87 % of the students in the  simulation  group passed the test . Statistically significant differences were : request of glycopyrrolate ( P < 0.001 ) , SpO2 monitoring ( P < 0.001 ) , used gloves when placing an intravenous cannula ( P = 0.012 ) , intubation attempt within 30 s ( P < 0.04 ) , anaesthesia gas set at MAC at least 1 ( P < 0.04 ) , instructed anaesthetic nurse to keep SpO2 at least 95 % ( P < 0.05 ) , keep MAP at least 60 mmHg ( P < 0.05 ) , keep heart rate more than 50 beats per minute ( P < 0.002 ) , keep end-tidal pCO2 4–5.5 kPa ( P < 0.002 ) . Conclusion The simulation group performed better in 25 % of the tasks and similarly in the others compared with the traditional teaching group . With the same time and amount of teaching personnel we trained five or six students in the simulator compared with one student in the operating theatre . Further research will reveal whether these promising results with simulation may be applied more generally in anaesthesiology teaching to medical students The study objective was to vali date a flexible bronchoscopy simulator by determining if it could differentiate between expert and novice bronchoscopists . A subsequent evaluation phase was then done to determine whether use of the simulator would improve the rate of bronchoscopy skill acquisition for new pulmonary fellows . A multicenter prospect i ve cohort study was performed using a bronchoscopy simulator . Three cohorts were evaluated based on the number of bronchoscopies previously performed : " experts " ( > 500 , n = 9 ) , " intermediates " ( 25 to 500 , n = 8) , and " novices " ( none , n = 11 ) . Each participant performed two simulated cases with performance measures being recorded by the simulator . Performance measures that distinguished between groups were then used to evaluate the learning curve for new fellows training on the simulator . A r and omized-controlled trial was then conducted comparing the quality of bronchoscopy performance for new pulmonary fellows who were trained either with conventional methods or with the simulator .  Expert bronchoscopists performed better on the simulator than intermediates who performed better than novices in terms of procedure time , percentage of segments visualized , time in red-out , and wall collisions . Training of new fellows demonstrated that after performing 20 bronchoscopic simulations , the skill level acquired with the simulator significantly improved in terms of speed , percentage of segments visualized , time in red-out , and collisions . Fellows trained on the simulator performed better than fellows trained using conventional methods during their first actual bronchoscopies as assessed by procedure time ( 815 versus 1,168 s , p = 0.001 ) , a bronchoscopy nurse 's subjective quality assessment score ( 7.7 + /- 0.3 versus 3.7 + /- 2.5 , p = 0.05 ) , and by a quantitative bronchoscopy quality score ( percentage of segments correctly identified/procedure time , 0.119 + /- 0.015 versus 0.046 + /- 034 , p = 0.03 ) . In conclusion , the bronchoscopy simulator was able to accurately assess bronchoscopy experience level . Training new fellows on the bronchoscopy simulator leads to more rapid acquisition of bronchoscopy expertise compared with conventional training methods . This technology has the potential to facilitate bronchoscopy training and to improve objective evaluations of bronchoscopy skills BACKGROUND : Pediatric housestaff are required to learn basic procedural skills and demonstrate competence during training . To our knowledge , an evidence d-based procedural skills curriculum does not exist . OBJECTIVE : To create , implement , and evaluate a modular procedural skills curriculum for pediatric residents . METHODS : A r and omized , controlled trial was performed . Thirty-eight interns in the Boston Combined Residency Program who began their training in 2005 were enrolled and r and omly assigned .  Modules were created to teach residents  bag-mask ventilation , venipuncture , peripheral intravenous catheter ( PIV ) insertion , and lumbar puncture skills . The curriculum was administered to participants in the intervention group during intern orientation . Interns in the control group learned procedural skills by usual methods . Subjects were evaluated by using a structured objective assessment on simulators immediately after the intervention and 7 months later . Success in performing live-patient procedures was self-reported by subjects . The primary outcome was successful performance of the procedure on the 
    Output:
    
ConclusionS BT may be not superior to NSBT on airway management training