***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: Purpose To compare medication administration error rates before and after the provision of educational sessions using either traditional didactic lecture or simulation-based training . Methods A single-center , parallel , controlled , prospect i ve study conducted in adult coronary critical care ( CCU ) and medical intensive care units ( MICU ) . Twenty-four nurses were observed administering medications . Documentation included drug name , dose , route , time and technique during observation and active medication orders in the patient ’s chart . A direct observation method was completed at baseline and repeated twice after the interventions . Data obtained during observation were analyzed for medication administration error rates . Interventions were two types of educational sessions with content developed from baseline medication administration error data : simulation-based training for CCU nurses and a didactic lecture for MICU nurses . Quizzes completed before and after the interventions were used to assess knowledge . Results A total of 880 doses ( 402 CCU , 478 MICU ) were observed . After the simulation-based educational intervention in the CCU , medication administration error rates decreased from 30.8 to 4.0 % ( p < 0.001 ) in the initial post-intervention observation and were sustained in the final post-intervention observation ( 30.8 to 6.2 % ; p < 0.001 ) . The error rate in the MICU after the didactic lecture intervention was not significantly different from the baseline and increased in the final post-intervention observation from 20.8 to 36.7 % ( p = 0.002 ) . Mean quiz scores were significantly improved after education sessions in both ICUs . Conclusions Simulation-based learning provides a significant advantage to patient care through the reduction of medication administration errors compared to lecture style education Introduction Peripheral intravenous catheter ( PIVC ) insertion is one of the most common invasive procedures performed in a hospital , but most nurses receive little formal training in this area . Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care . Methods The study was a r and omized , wait-list control group with crossover using nurses on three medical/surgical units . Baseline PIVC knowledge , confidence , and skills assessment s were completed for both groups . The intervention group then received a 2-hour PIVC online course , followed by an 8-hour live training course using a synergistic mix of three simulation tools . Both groups were then reassessed . After crossover , the wait-list group received the same intervention and both groups were reassessed . Results At baseline , both groups were similar for knowledge , confidence , and skills . Compared with the wait-list group , the intervention group had significantly higher scores for knowledge , confidence , and skills upon completing the training program . After crossover , the wait-list group had similarly higher scores for knowledge , confidence , and skills than the intervention group . Between the immediate preintervention and postintervention periods , the intervention group improved scores for knowledge by 31 % , skills by 24 % , and decreased confidence by 0.5 % , whereas the wait-list group improved scores for knowledge by 28 % , confidence by 16 % , and skills by 15 % . Conclusions Results demonstrate significant improvements in nurses '  knowledge , confidence , and skills with the use of a simulation-based blended learning program for PIVC insertion . Transferability of these findings from a simulated environment into clinical practice should be further explored Introduction Insufficient skills in drug dose calculations increase the risk for medication errors . Even experienced nurses may struggle with such calculations . Learning flexibility and cost considerations make e-learning interesting as an alternative to classroom teaching . This study compared the learning outcome and risk of error after a course in drug dose calculations for nurses with the two methods . Methods In a r and omised controlled open study , nurses from hospitals and primary healthcare were r and omised to either e-learning or classroom teaching . Before and after a 2-day course , the nurses underwent a multiple choice test in drug dose calculations : 14 tasks with four alternative answers ( score 0–14 ) , and a statement regarding the certainty of each answer ( score 0–3 ) . High risk of error was being certain that incorrect answer was correct . The results are given as the mean ( SD ) . Results 16 men and 167 women participated in the study , aged 42.0 ( 9.5 ) years with a working experience of 12.3 ( 9.5 ) years .  The number of correct answers after e-learning was 11.6 ( 2.0 ) and after classroom teaching 11.9 ( 2.0 ) ( p=0.18 , NS ) ; improvement were 0.5 ( 1.6 ) and 0.9 ( 2.2 ) , respectively ( p=0.07 , NS ) . Classroom learning was significantly superior to e-learning among participants with a pretest score below 9 . In support of e-learning  was evaluation of specific value for the working situation . There was no difference in risk of error between groups after the course ( p=0.77 ) . Conclusions The study showed no differences in learning outcome or risk of error between e-learning and classroom teaching in drug dose calculations . The overall learning outcome was small . Weak precourse knowledge was associated with better outcome after classroom teaching Background Web-based learning is becoming an increasingly important instructional tool in nursing education . Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice . Objective This study aims to describe the design , development , and evaluation of an interactive multimedia Web-based simulation for developing nurses ’ competencies in acute nursing care . Methods Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video , multimedia instructional material , virtual patients , and online quizzes . A r and omized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital . Following a baseline evaluation of all participants ’ clinical performance in a simulated clinical setting , the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program . All participants were re-tested for their clinical performances using a vali date d tool . Results The clinical performance posttest scores of the experimental group improved significantly ( P<.001 ) from the pretest scores after the Web-based simulation . In addition , compared to the control group , the experimental group had significantly higher clinical performance posttest scores ( P<.001 ) after controlling the pretest scores . The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation .  Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice , instructional strategies , and fostering problem solving . Conclusions Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses ’ competencies in acute care . Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency OBJECTIVES Nursing competence affects quality of care in intensive care units ( ICUs ) . Team competence is particularly important for preventing errors . This paper focuses on the feasibility of using an in situ simulation model to explore team competence in the ICU , and on using parts of the Anaesthetists ' Non-Technical Skills ( ANTS ) taxonomy for assessing Non-Technical Skills ( NTS ) in nursing teams . METHODOLOGY / DESIGN Seventy-two nurses were r and omised into two groups and introduced to a new guideline via either lecture-based or simulation-based teaching . A preprogrammed patient simulator and a video camera were installed inside the ICU , and a scenario was enacted to simulate the admission of a patient with septic shock . All available facilities in the ICU were used . Two blinded raters evaluated " Team Working " and " Situation Awareness " via video recordings using the ANTS taxonomy . RESULTS Due to high activity in the ICU , 54 nurses completed the in situ simulation . Assessment s of the video recordings revealed moderate agreement between the two raters . Observations revealed issues deviating from expected st and ards of competence . CONCLUSION In situ simulation may be feasible for assessing competence in ICUs . The ANTS appears to be a promising foundation for developing a team assessment tool for ICUs INTRODUCTION Simulation is an effective teaching strategy for educating health professionals . However , little is known about the effectiveness of simulations in midwifery education . The purpose of this project was to determine whether the use of high-fidelity simulations for the obstetric emergencies of shoulder dystocia and postpartum hemorrhage increases  student confidence in managing these complications . METHODS The participants were registered nurses enrolled in a graduate midwifery education program in the Southeastern United States . Student confidence in learning to manage shoulder dystocia and postpartum hemorrhage was studied in 2 groups of students . The control group ( n = 10 ) received st and ard teaching methods consisting of discussion , watching a video , and low-fidelity teaching methods . The intervention group ( n = 18 ) received a high-fidelity simulation learning experience .  Student confidence was measured before and after each learning experience using a vali date d , 8-item , Likert-type scale . RESULTS In the control group , student confidence did not significantly increase after a classroom discussion or low-fidelity simulation experience . Student confidence increased significantly ( P < .01 ) after the high-fidelity simulation learning experiences . When the differences between the pretest and posttest scores were compared for the control and intervention groups , there was a moderate effect size ( 0.54 ) for the intervention group for the shoulder dystocia simulations and a large effect size ( 1.68 ) for the postpartum hemorrhage simulations . CONCLUSION High-fidelity simulations for shoulder dystocia and postpartum hemorrhage significantly increased student confidence in managing these complications OBJECTIVES Military health care personnel need to have skills relative to caring for patients on the battlefield . No studies have compared the two teaching strategies of using the human patient simulator ( HPS ) and a CD-ROM in caring for combat injuries . The objective of this study was to determine if there were statistically significant differences in HPS and CD-ROM educational strategies relative to caring for patients who have trauma . METHODS A pretest/post-test prospect i ve experimental design was used . Anesthesia students were r and omly assigned to one of three groups : HPS , CD-ROM , or a control group . A valid and reliable instrument , Combat Performance , was used to evaluate the participant 's ability to give care to trauma patients . RESULTS A repeated analysis of variance and a least significant difference post hoc test were used to analyze the data . The HPS group performed better than the CD-ROM and control groups relative to performance ( p = 0.001 ) . There was no difference between the CD-ROM and control group ( p = 0.171 ) . DISCUSSION We speculate that the HPS group performed better than the CD-ROM group because of the realism . CONCLUSION In this study , the HPS method of instruction was a more effective method of teaching than the CD-ROM approach BACKGROUND Critical care nurses ' knowledge and skills in adhering to evidence -based guidelines for avoiding complications associated with intubation and mechanical ventilation are currently limited . We hypothesized that single simulation education session would lead to a long-lasting higher level of skills among critical care nurses . MATERIAL AND METHODS A r and omized controlled trial was conducted in a 22-bed adult mixed medical-surgical intensive care unit in Finl and during the period February 2012-March 2014 . Thirty out of 40 initially r and omized critical care nurses participated in a 24-month follow-up study . Behavior and cognitive development was evaluated through a vali date d Ventilator Bundle Observation Schedule and Question naire at the baseline measurement and repeated 3 times during simulation and real-life clinic setting s. RESULTS After simulation education , the average skills score increased from 46.8%-58.8 % of the total score in the final postintervention measurement ( Ptime < .001 , Ptime × group = .040 , and Pgroup = .11 ) . The average knowledge scores within groups did not change significantly . The average between-group difference in skills scores was significant only at the measurement taken at 6 months ( P = .006 ) . CONCLUSIONS Critical care nurses ' skills in adhering to evidence -based guidelines improved in both groups over time , but the improvements between the study groups was significantly different only at 6 months and was no longer evident after 2 years following a single simulation education Background Adult basic life support refresher training using voice feedback manikins has been shown to be feasible , but the superiority of this strategy over instructor-led ( IL ) refresher training for nurses in a hospital has not been studied in r and omized trials . Objectives To study if adult basic life support refresher training for nurses in a self-learning ( SL ) station using a voice feedback manikin is more effective than IL training . Methods A Resusci Anne Skills Station ( Laerdal , Norway ) was installed in a small room . A total of 235 nurses were r and omized to SL or IL training . After 1 month and after 7 months , the proportions of nurses achieving a mean compression depth of 38–51 mm , a mean compression rate of 80–120/min , incomplete release of at least 5 mm and a mean ventilation volume of 400–1000 ml were compared between the SL and IL groups . Results After 1 month , the proportion of nurses with any incomplete release of at least 5 mm was significantly lower in the SL group ( 23 of 54 nurses , 43 % ) compared with the IL group ( 33 of 47 nurses , 70 % ) ( P=0.005 ) . After 7 months , a lower proportion of nurses achieved a depth of 38–51 mm in the SL group ( 13 of 45 nurses , 29 % ) compared with the IL group ( 25 of 45 nurses , 56 % ) ( P=0.01 ) . For the other outcome parameters , no differences between SL and IL training could be demonstrated . Conclusions This 
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Other comparisons showed inconsistency in results .