***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: Introduction : The percentage of patients having cesarean delivery ( CD ) under general anesthesia has decreased , which may have implication s for residency training in anesthesiology . We undertook this study to assess the effect of focused simulation-based training on resident performance during a simulated general anesthetic for emergency CD . Methods : Thirty-two second-year anesthesiology resident volunteers were r and omly assigned to one of the two groups : a group trained on the patient simulator performing general anesthesia for emergency CD ( CD group ) and a control group trained on the simulator using a different general anesthetic scenario unrelated to obstetric anesthesia ( SHAM group ) . Between 6 and 9 weeks , all the residents performed the emergency CD scenario on the simulator and were videotaped . Two blinded observers scored the videotaped performances using a valid and reliable scoring system separately and were blinded to each others score . The time interval from the start of the scenario until the simulated surgical incision was noted . Total scores and component scores in six subcategories were compared between resident groups , as was the start to incision time interval . Results : Residents in the CD group had higher total scores and higher scores in the preoperative assessment , equipment availability check , and intraoperative management before delivery subcategories than residents in the SHAM group . The start to incision time interval did not differ between the groups . Conclusions : Anesthesiology residents who underwent focused training on a simulator that included performance of a general anesthetic for emergency CD exhibited improved performance during a subsequent simulated anesthetic scenario compared with trainees who did not undergo such instruction BACKGROUND AND OBJECTIVES The use of ultrasound imaging in peripheral nerve block has been increasing . However , there are few reports in the literature on the learning curve of the ultrasound technique . The objective of this report was to evaluate the learning curve of  CET-SMA/HSL Anesthesiology residents of  ultrasound-guided peripheral block  using an experimental agar model . METHODS An experimental model was developed by filling a bowl with agar and olives .  Nine residents were r and omly divided in three groups ( G1 , G2 , and G3 ) , each one with a R1 , a R2 , and a R3 . All three groups received theoretical explanation . G1 also had two hours of practical training , G2 had one hour , and G3 had no training . Residents were then asked to place a needle at the middle of the olive wall , near the transducer and then reposition the needle between the olive and the bottom of the bowl , simulating the epidural injection of anesthetic . The speed and efficacy of the tasks , as well as technical flaws , were evaluated . RESULTS The mean length of time to perform the tasks was 37.63 seconds for G1 , without technical flaws ; 64.40 seconds for G2 , with two technical flaws ; and 93.83 seconds for G3 , with 12 technical flaws . CONCLUSIONS This study allows us to conclude that the longer training of ultrasound-guided peripheral nerve block in an experimental model improved the learning curve of the technique Background : Early acquisition of critical competencies by novice anesthesiology residents is essential for patient safety , but traditional training methods may be insufficient . The purpose of this study was to determine the effectiveness of high-fidelity simulation training of novice residents in the initial management of critical intraoperative events . Methods : Twenty-one novice residents participated in this 6-week study . Three hypoxemia and three hypotension scenarios were developed and corresponding checklists were vali date d. Residents were tested in all scenarios at baseline ( 0 weeks ) and divided into two groups , using a r and omized crossover study design . Group 1 received simulation-based training in hypoxemic events , whereas Group 2 was trained in hypotensive events . After intermediate ( 3 weeks ) testing in all scenarios , the groups switched to receive training in the other critical event . Final testing occurred at 6 weeks . Raters blinded to subject identity , group assignment , and test date scored videotaped performances by using checklists . The primary outcome measure was composite scores for hypoxemia and hypotension scenarios , which were compared within and between groups . Results : Baseline performance between groups was similar . At the intermediate evaluation , the mean hypoxemia score was higher in Group 1 compared with Group 2 ( 65.5 % vs. 52.4 % , 95 % CI of difference 6.3–19.9 , P < 0.003 ) . Conversely , Group 2 had a higher mean hypotension score ( 67.4 % vs. 45.5 % , 95 % CI of difference 14.6–29.2 , P < 0.003 ) . At Week 6 , the scores between groups did not differ . Conclusions : Event-specific , simulation-based training result ed in superior performance in scenarios compared with traditional training and simulation-based training in an alternate event 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 Problem : Advance cardiac life support ( ACLS ) training does not address coordination of team re sources to improve the ability of teams to deliver needed treatments reliably and rapidly . Our objective was to use a human simulation training educational environment to develop multidisciplinary team skills and improve medical emergency team ( MET ) performance . We report findings of a crisis team training course that is focused on organization . Setting : Large center for human simulation training at a university affiliated tertiary care hospital . Participants : Ten courses were delivered and 138 clinical ly experienced individuals were trained ( 69 critical care nurses , 48 physicians , and 21 respiratory therapists ) . All participants were ACLS trained and experienced in responding to cardiac arrest situations . Course design : Each course had four components : ( 1 ) a web based presentation and pretest before the course ; ( 2 ) a brief reinforcing didactic session on the day of the course ; ( 3 ) three of five different simulated scenarios ; each followed by ( 4 ) debriefing and analysis with the team . Three of five simulator scenarios were used ; scenario selection and order was r and om . Trainees did not repeat any scenario or role during the training . Participants were video recorded to assist debriefing . Debriefing focused on reinforcing organizational aspects of team performance : assuming design ated roles independently , completing goals ( tasks ) assigned to each role , and directed communication . Measures for improvement : Participants grade d their performance of specific organizational and treatment tasks within specified time intervals by consensus . Simulator “ survival ” depended on supporting oxygenation , ventilation , circulation within 60 seconds , and delivering the definitive treatment within 3 minutes . Effects of change : Simulated survival ( following predetermined criteria for death ) increased from 0 % to 89 % . The initial team task completion rate was 10–45 % and rose to 80–95 % during the third session . Lessons learnt : Training multidisciplinary teams to organize using simulation technology is feasible . This preliminary report warrants more detailed inquiry Examination scores from 109 students enrolled in the professional veterinary program at Washington State University were evaluated to determine the effectiveness and utility of the Virtual Ventilator computer simulation for teaching the principles of mechanical ventilation in an anesthesia course . Students were r and omly assigned to either a live-animal mechanical ventilation laboratory ( LIVE-1st ) or a computer laboratory using the mechanical ventilation simulation ( SIM-1st ) in week 1 . During week 2 , students in the LIVE-1st group participated in the ventilation simulation while students in the SIM-1st group participated in the live-animal laboratory .  Student knowledge was evaluated using two similar written quizzes administered following each laboratory . Student opinions concerning the value of the simulation were assessed using an online survey . Differences in quiz scores within and between groups were compared using t-tests while survey results were tabulated . A p value of less than 0.05 was considered significant . Within the LIVE-1st group , scores for the second quiz , which was taken after the students had completed the simulation exercise , were significantly higher than those obtained from the first quiz . Accordingly , the Virtual Ventilator simulation was at least equivalent to the live-animal laboratory in the ability to present information that was subsequently tested for on the quizzes . Students in the SIM-1st group reported that use of the simulation prior to a live-animal ventilation laboratory enhanced their underst and ing of and ability to provide mechanical ventilation to anesthetized patients . The Virtual Ventilator simulation appears to be a useful and well-received teaching tool 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 Background : Part task training ( PTT ) focuses on dividing complex tasks into components followed by intensive concentrated training on individual components . Variable priority training ( VPT ) focuses on optimal distribution of attention when performing multiple tasks simultaneously with the goal of flexible allocation of attention . This study explored how principles of PTT and VPT adapted to anesthesia training would improve first-year anesthesiology residents ' management of simulated adverse airway and respiratory events . The authors hypothesized that participants with PTT and VPT  would perform better than those with st and ard training . Methods : Twenty-two first-year anesthesia residents were r and omly divided into two groups and trained over 12 months . The control group received st and ard didactic and simulation-based training . The experimental group received similar training but with emphasis on PTT and VPT techniques . Participant ability to manage seven adverse airway and respiratory events were assessed before and after the training period . Performance was measured by the number of correct tasks , making a correct diagnosis , assessment of perceived workload , and an assessment of scenario comprehension . Results : Participants in both groups exhibited significant improvement in all metrics after a year of training . Participants in the experimental group were able to complete more tasks and answered more comprehension questions correctly . There was no difference in perceived workload or the number of correct diagnoses between groups . Conclusion : This study in part confirmed the study hypotheses . The results suggest that VPT and PTT are promising adjuncts to didactic and simulation-based training for management of adverse airway and respiratory events BACKGROUND Research into adverse events in hospitalized patients suggests that a significant number are preventable . The purpose of this r and omized , controlled study was to determine if simulation-based debriefing improved performance of practicing anaesthetists managing high-fidelity simulation scenarios . METHODS The anaesthetists were r and omly allocated to Group A : simulation debriefing ; Group B : home study ; and Group C : no intervention and secondary r and omization to one of two scenarios . Six to nine months later , subjects returned to manage the alternate scenario . Facilitators blinded to study group allocation completed the performance checklists ( dichotomously scored checklist , DSC ) and Global Rating Scale of Performance ( GRS ) . Two non-expert raters were trained , and assessed all videotaped performances . RESULTS Interim analysis indicated no difference between Groups B and C which were merged into one group . Seventy-four subjects were recruited , with 58 complete data sets available . There was no significant effect of group on pre-test scores . A significant improvement was seen between pre- and post-tests on the DSC in debriefed subjects ( pre-test 66.8 % , post-test 70.3 % ; F(1,57)=4.18 , P=0.046 ) . Both groups showed significant improvement in the GRS over time ( F(1,57)=5.94 , P 
    Output:
    
Simulation in anaesthesiology appears to be more effective than no intervention ( except for patient outcomes ) and non-inferior to non-simulation instruction .