***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: An interactive , self- study learning system for airway management instruction that utilizes a “ sensorized ” manikin head ( Actronics Inc. , Pittsburgh , PA ) was compared to didactic instruction from anesthesiologists during third-year medical student anesthesia rotations . Before students were allowed to participate in airway management on anesthetized patients , they were r and omly separated into two groups . One group received instruction from the learning system , and the other group was given a lecture with guided practice on a st and ard tracheal intubating manikin . Differences between groups were then assessed using 22 separate variables as all students performed actual airway management on patients undergoing general anesthesia . Anesthesia faculty , residents , and nurse anesthetists , blinded to group , served as assessors . There were 48 and 49 students in the didactic instruction and learning system groups , respectively . Beginning experience level of students with respect to airway management was similar between groups before the anesthesia rotations . There were 185 and 188 evaluation forms completed to assess the didactic instruction and learning system groups , respectively . Demographic data regarding patients were recorded . Patients in the learning system group on whom students performed airway management were older , had a larger average body mass index , and their airways more frequently received higher Mallampati classifications ( glottic structures more difficult to visualize ) . No difference in the quality of airway management efforts or in students ' appraisal of their own performances was seen between groups . Neither group demonstrated more rapid development of psychomotor skills . Students were equally satisfied with both methods of instruction . We conclude that the airway management self- study learning system is as efficacious as didactic instruction for pre clinical airway management instruction during third-year medical student anesthesia rotations Objective : To compare the usefulness for training of a porcine model ( larynx , trachea , and pig skin ) and a manikin model using a Portex cricothyrotomy kit ( PCK ) . Methods : In a prospect i ve r and omised crossover trial , participants in the airway workshop performed crico-thyrotomy using a PCK on the porcine and manikin models ( Tracheostomy Trainer and Case ) . The porcine model was made with larynxes and trachea from freshly  slaughtered pigs  and covered with a piece of thinned pigskin stapled to a wooden board . Participants were asked to assess the following : reality of skin turgor ; difficulty with skin penetration , l and mark recognition and procedure ; reality of the model ; and preference for each model using a visual analogue scale ( VAS ) of 0–10 cm . The VAS scores for each model were compared . Results : 49 participants were included in the study . Mean ( SD ) VAS scores for the reality of skin turgor , degree of difficulty with skin penetration and l and mark recognition were higher with the porcine model than with the manikin model ( 7.0 ( 2.1 ) vs 4.7 ( 2.0 ) , 6.4 ( 2.4 ) vs 3.6 ( 2.2 ) , 5.1 ( 2.2 ) vs 4.2 ( 2.5 ) , respectively ) . There was no difference between the models in the difficulty of the procedure ( 5.0 ( 2.4 ) vs 4.7 ( 3.2 ) ) . The porcine model had a higher VAS score for overall reality and preference of the model ( 7.1 ( 2.0 ) vs 4.8 ( 2.3 ) and 7.1 ( 2.0 ) vs 4.8 ( 2.2 ) , respectively ) . Conclusion : The porcine model is a more useful training tool than the manikin model for cricothyrotomy with PCK because of its reality and similarity to human anatomy 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 GOAL Isolate and evaluate the impact of mental imagery on the acquisition of an emergency surgical technique . METHOD We studied 44 first-year medical students performing a cricothyrotomy on a mannequin to determine the impact of teaching using mental imagery ( MI ) and /or kinesiology ( KG ) compared to the st and ard Adv and ec Trauma Life Support ( ATLS ) approach . Students were r and omly assigned to one of three groups : MI and KG , KG alone or control ( ATLS ) . Two weeks after the one-hour teaching session , they were evaluated with an OSCE testing the performance of the different steps of the technique , the time required and its fluidity . RESULTS Total results ( maximum : 25 marks ) are as follows : KG + MI = 20.3 + /- 1.5 ; KG = 19.3 + /- 2.9 ; ATLS = 18.2 + /- 2.5 . The only statistically significant difference for total results was in the use of MI and KG compared to the control group . Kinesiology alone or with mental imagery improved the fluidity of the performance . CONCLUSION Many factors influence the acquisition of a surgical technique . This study showed that acquisition and performance of an emergency procedure ( cricothyrotomy ) was improved when mental imagery and kinesiology were combined to teach it 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 OBJECTIVE To compare the ' 4-stage ' teaching technique ( demonstration , deconstruction , formulation , performance ) with the traditional ' 2-stage ' teaching technique ( deconstruction , performance ) in  laryngeal mask airway ( LMA ) insertion .  METHODS Using a prospect i ve r and omised study design , participants were taught LMA insertion on a manikin by either the ' 2-stage ' or ' 4-stage ' teaching method .  Subjects were eligible if they had never inserted a LMA .  Skill acquisition was assessed immediately following training , and skill retention assessed a number of weeks later . The primary outcome was  LMA insertion on a manikin , with successful ventilation within 30 s. Other outcomes included overall time to LMA insertion , and number of errors . Assessors were blinded to the teaching method used for each subject . RESULTS A total of 120 participants were r and omised between the two teaching groups ( 60 subjects in each group ) . Mean time to LMA insertion at acquisition was 39.7 s for 2-stage and 34.7 s for 4-stage ( p>0.05 ) , and proportion completing within 30 s was 41.67 % for 2-stage and 48.33 % for the 4-stage teaching group ( p>0.05 ) . With skill retention assessment , mean time to LMA insertion was 44.3 s for 2-stage and 42.5 s for the 4-stage teaching group ( p>0.05 ) . Proportion completing task within 30 s was 34.0 % for 2-stage and 41.67 % for 4-stage group ( p>0.05 ) . Overall , there was no significant difference found in skill acquisition or in skill retention between the 2 or 4-stage teaching method . CONCLUSION The 2-stage teaching technique is not statistically different to the 4-stage teaching method in efficacy of LMA insertion skill acquisition or retention 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 Introduction : Major resuscitation councils endorse the use of the laryngeal mask airway ( LMA ) by paramedics for lifesaving airway interventions . Learning and maintaining adequate skill level is important for patient safety . The aim of this project was to develop a training program that provides student paramedics with initial knowledge and experience in LMA insertion skills 
    Output:
    
Simulation-based airway management curriculum is superior to no intervention and nonsimulation intervention for important education outcomes .