<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03761355</url>
  </required_header>
  <id_info>
    <org_study_id>N/ST/ZB/18/002/1206</org_study_id>
    <nct_id>NCT03761355</nct_id>
  </id_info>
  <brief_title>Mindfulness and Executive Functions for Prediction of Non-technical Skills of Students in Pediatric Medical Simulations</brief_title>
  <acronym>MindExSim</acronym>
  <official_title>Mindfulness and Executive Functions for Prediction of Non-technical Skills of Students in High-fidelity Medical Simulations in Pediatric Emergency Cases</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Medical University of Bialystok</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Medical University of Bialystok</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Medical simulation is a technique that creates a situation or environment to allow persons to&#xD;
      experience a representation of a real event for the purpose of practice, learning,&#xD;
      evaluation, testing or to gain understanding of systems or human actions Non-technical skills&#xD;
      in pediatric simulation are the skills of communication, leadership, teamwork, situational&#xD;
      awareness, decision-making, resource management, safe practice, adverse event minimization,&#xD;
      and professionalism, also known as teamwork skills. Mindfulness is the self-regulation of&#xD;
      attention with an attitude of curiosity, openness and acceptance. Executive functions include&#xD;
      a collection of interrelated functions that are responsible for purposeful, goal-directed,&#xD;
      problem-solving behavior. In this project, the investigators aim to check whether features of&#xD;
      mindfulness and executive functions can be used to predict teamwork skills of medical&#xD;
      students during repeated high-fidelity simulations in emergency pediatric care.&#xD;
&#xD;
      The project will include simulation center in Bialystok, Poland. The investigators will&#xD;
      conduct this project over a time of 2 years. Team project is made up of 5 persons, including&#xD;
      psychologist, simulation instructors and pediatricians. Participants will be students of&#xD;
      medical faculty in medical university. The investigators expect to include at least 340&#xD;
      students in the study which will result in 180 assessed as main or second leaders in repeated&#xD;
      simulations. Team project will assess the students during high-fidelity pediatric emergency&#xD;
      simulations.&#xD;
&#xD;
      Methods of assessment of medical students during pediatric emergency simulations: features of&#xD;
      mindfulness (Mindful Attention Awareness Scale), assessment of executive functions (The&#xD;
      Behavior Rating Inventory of Executive Functions - Adult), non-technical skills (Ottawa&#xD;
      Crisis Resource Management scale &amp; checklist), technical skills (checklists) and stress. The&#xD;
      researchers first will examine association between mindfulness or executive functions and&#xD;
      demographic variables. And finally team project will assess the possibility of prediction of&#xD;
      non-technical performance level during medical simulations with the use of mindfulness and&#xD;
      executive functions assessment.&#xD;
&#xD;
      In general the investigators anticipate that the results of the study will lead to the better&#xD;
      understanding of mechanisms that influence non-technical skills in medical students during&#xD;
      pediatric emergency cases.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Research Project Objectives / Research Hypothesis High-fidelity simulation is an effective&#xD;
      tool in creating psychological reality of pediatric emergency care. Non-technical skills play&#xD;
      a pivotal role in management of life-threatening cases in children. Mindfulness is the&#xD;
      self-regulation of attention with an attitude of curiosity, openness and acceptance. It is&#xD;
      possible that mindfulness could enhance medical students' capacity for focused attention and&#xD;
      concentration by increasing present moment awareness. On the other hand executive functions&#xD;
      include a collection of interrelated functions that are responsible for purposeful,&#xD;
      goal-directed, problem-solving behavior. It is likely that mindfulness and executive&#xD;
      functions and their relationship are important players in emergency cases. Repeated&#xD;
      simulations could be a crucial tool for stress management and improving skills in&#xD;
      high-fidelity scenarios. In this project, the investigators aim to define whether features of&#xD;
      mindfulness and executive functions can be used to predict non-technical skills of medical&#xD;
      students during repeated high-fidelity simulations in emergency pediatric care. The&#xD;
      researchers hypothesize that: 1) being mindful improves the performance during simulation 2)&#xD;
      better executive functions result in better non-technical skills of medical student 3)&#xD;
      repeated simulations will reduce stress and influence performance during scenarios 4) there&#xD;
      are some potential correlations between executive functions and mindfulness 5) it is possible&#xD;
      to predict non-technical performance with the assessment of mindfulness and executive&#xD;
      functions of students during pediatric emergency cases.&#xD;
&#xD;
      Research project methodology This is a multi-center, investigator-initiated prospective&#xD;
      study. The project will include simulation center in Poland (Medical University in&#xD;
      Białystok). The researchers will conduct this project over a time of 2 years. Team project is&#xD;
      made up of 5 persons, including psychologist, simulation instructors and pediatricians.&#xD;
      Participants will be students of medical faculty in medical university. Methods: First, to&#xD;
      increase the awareness of scientific community of the area of interest, the scientists will&#xD;
      prepare and publish the review of the current literature in the field of mindfulness,&#xD;
      executive functions and emergency medicine. Then, the researchers will adapt six&#xD;
      high-fidelity scenarios in the field of pediatric emergency for the requirements of the&#xD;
      project. The team project expect to include at least 340 students in the study which will&#xD;
      result in 180 assessed as main or second leaders in repeated simulations. For the&#xD;
      accomplishment of the aims of this study researchers will need: high-fidelity simulation&#xD;
      rooms = emergency rooms with full medical equipment, high-fidelity simulators, audio-video&#xD;
      systems for recording and playing scenarios, ECG Holters, debriefing rooms, computers and&#xD;
      software. All above mentioned equipment is available in simulation centers and the&#xD;
      investigators have the professional staff experienced in high-fidelity simulation and&#xD;
      assessment of non-technical skills in medical students. Demographic features will be assessed&#xD;
      in all participants: age, sex, year of medical faculty, medical school. The history of&#xD;
      previous high-fidelity simulations in participating students will be collected. Methods of&#xD;
      assessment of medical students during pediatric emergency simulations: features of&#xD;
      mindfulness (Mindful Attention Awareness Scale), assessment of executive functions (The&#xD;
      Behavior Rating Inventory of Executive Functions - Adult), non-technical skills (Ottawa&#xD;
      Crisis Resource Management scale &amp; checklist), technical skills (checklists) and stress&#xD;
      (heart rate, heart rate variability with Holter ECG, blood pressure, Stress-O-Meter and the&#xD;
      State-Trait-Anxiety Inventory). Data analysis strategy: The study team will first examine&#xD;
      association between mindfulness or executive functions and demographic variables (gender,&#xD;
      age, university). Then the researchers are going to construct the regression model to explain&#xD;
      the variability of features included in Ottawa scale. And finally the study team will assess&#xD;
      the possibility of prediction of non-technical performance level during medical simulations&#xD;
      with the use of mindfulness and executive functions assessment.&#xD;
&#xD;
      Expected impact of the research project on the development of science To date more than 150&#xD;
      students were enrolled for the preliminary research. The preliminary results showed that: in&#xD;
      the first simulation the students' non-technical performance is weak, one of the main&#xD;
      problems in non-technical skills is the fixation error and it is more frequent in simulations&#xD;
      with two cases at one time, in the repeated simulations non-technical skills are improving,&#xD;
      there is a growing interest in mindfulness training among medical students, technical skills&#xD;
      depend of theoretical introduction and students' preparation for the classes, concerning&#xD;
      stress the statistically significant increase in heart rate but not blood pressure in&#xD;
      students after each simulation was observed . These data clearly show that the proposed study&#xD;
      concept is a promising line of basic investigation with solid potential for defining a&#xD;
      predictive link between mindfulness, executive function and non-technical skills of medical&#xD;
      students during pediatric emergency simulations. In general the investigators anticipate that&#xD;
      the results of the present study will lead to the better understanding of mechanisms that&#xD;
      influence non-technical skills in medical students during pediatric emergency cases. In the&#xD;
      future this research will be used for an overall improvement in team performance at emergency&#xD;
      events, which will ultimately translate into a subsequent reduction in the rate of errors and&#xD;
      adverse events in medicine. The team leaders also hope that an increased awareness of&#xD;
      non-technical skills in the emergency setting among medical students will have an indirect&#xD;
      beneficial effect on those skills in the day-to-day setting.&#xD;
&#xD;
      The scientific results of the project will include: review manuscript and at least two&#xD;
      original manuscripts, all published in Journals with Impact Factor ≥ 3, presentations on two&#xD;
      international meetings in Europe.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">October 1, 2018</start_date>
  <completion_date type="Actual">June 30, 2020</completion_date>
  <primary_completion_date type="Actual">June 30, 2020</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Non-technical skills - Ottawa scale</measure>
    <time_frame>12 months</time_frame>
    <description>We have chosen Ottawa Ottawa Crisis Resource Management Global Rating Scale to evaluate performance during our simulations. The following criteria will be evaluated: leadership skills (stays calm and in control during crisis, prompt and firm decision-making, maintains global perspective - &quot;big picture&quot;), situational awareness (avoids fixation error, reassesses and re-evaluates situation constantly, anticipates likely events), communication skills (communicates clearly and concisely, uses directed verbal /non-verbal communication, listens to team input), problem solving (organized and efficient problem solving approach, quick in implementation, considers alternatives during crisis), resource utilization (calls for help appropriately, utilizes resources at hand appropriately, prioritizes tasks appropriately). Each category is measured on a seven-point anchored ordinal scale with descriptive anchors. The higher values represent a better outcome.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Technical skills</measure>
    <time_frame>12 months</time_frame>
    <description>Technical skills of medical students during high-fidelity simulations. We designed and validated a scale for assessment technical skills in each scenarios. An example is presented below. The higher values represent a better outcome.&#xD;
An example of newly developed technical skills checklist for the use in this project - topic - &quot;Ketoacidosis&quot;&#xD;
Action:&#xD;
History - including polydypsia (1 point), polyuria (1 point), weight loss (1 point)&#xD;
Physical examination: breathing, pulse, blood pressure, saturation, heart and lung auscultation, abdomen, dehydration&#xD;
Treatment:&#xD;
Hydratation 0.9%NaCl i.v.1000ml / first hour (1 point)&#xD;
Insulin (rapid acting, 0.1Units/kg) iv (1 point)&#xD;
Potassium (15%KCl 10-20mmol) (1 point)&#xD;
No addition of Natrium carbonicum (1 point)</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Actual">600</enrollment>
  <condition>Mindfulness</condition>
  <arm_group>
    <arm_group_label>medical student of 6th Year</arm_group_label>
    <description>Students of medical faculty of 6th Year in Medical University of Bialystok, Poland.</description>
  </arm_group>
  <eligibility>
    <study_pop>
      <textblock>
        Students of medical faculty (6th year) at the Medical University of Bialystok&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  student of 6th Year of medical faculty&#xD;
&#xD;
          -  informed consent&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  pregnancy&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>23 Years</minimum_age>
    <maximum_age>25 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Wlodzimierz Luczynski, Prof</last_name>
    <role>Study Chair</role>
    <affiliation>Medical University of Bialystok</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Medical University of Bialystok</name>
      <address>
        <city>Białystok</city>
        <state>Podlaskie</state>
        <zip>15-029</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Poland</country>
  </location_countries>
  <reference>
    <citation>Eppich WJ, Brannen M, Hunt EA. Team training: implications for emergency and critical care pediatrics. Curr Opin Pediatr. 2008 Jun;20(3):255-60. doi: 10.1097/MOP.0b013e3282ffb3f3.</citation>
    <PMID>18475092</PMID>
  </reference>
  <reference>
    <citation>Jirativanont T, Raksamani K, Aroonpruksakul N, Apidechakul P, Suraseranivongse S. Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management. Anaesth Intensive Care. 2017 Jul;45(4):469-475. doi: 10.1177/0310057X1704500410.</citation>
    <PMID>28673217</PMID>
  </reference>
  <reference>
    <citation>Botha E, Gwin T, Purpora C. The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI Database System Rev Implement Rep. 2015 Oct;13(10):21-9. doi: 10.11124/jbisrir-2015-2380.</citation>
    <PMID>26571279</PMID>
  </reference>
  <reference>
    <citation>Greeson JM, Toohey MJ, Pearce MJ. An adapted, four-week mind-body skills group for medical students: reducing stress, increasing mindfulness, and enhancing self-care. Explore (NY). 2015 May-Jun;11(3):186-92. doi: 10.1016/j.explore.2015.02.003. Epub 2015 Feb 16.</citation>
    <PMID>25792145</PMID>
  </reference>
  <reference>
    <citation>Kim J, Neilipovitz D, Cardinal P, Chiu M. A comparison of global rating scale and checklist scores in the validation of an evaluation tool to assess performance in the resuscitation of critically ill patients during simulated emergencies (abbreviated as &quot;CRM simulator study IB&quot;). Simul Healthc. 2009 Spring;4(1):6-16. doi: 10.1097/SIH.0b013e3181880472.</citation>
    <PMID>19212245</PMID>
  </reference>
  <verification_date>July 2020</verification_date>
  <study_first_submitted>November 19, 2018</study_first_submitted>
  <study_first_submitted_qc>November 29, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 3, 2018</study_first_posted>
  <last_update_submitted>July 16, 2020</last_update_submitted>
  <last_update_submitted_qc>July 16, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">July 17, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>mindfulness</keyword>
  <keyword>executive functions</keyword>
  <keyword>medical simulation</keyword>
  <keyword>medical students</keyword>
  <keyword>pediatrics</keyword>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03761355
org study id: N/ST/ZB/18/002/1206
nct id: NCT03761355
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Medical simulation is a technique that creates a situation or environment to allow persons to
      experience a representation of a real event for the purpose of practice, learning,
      evaluation, testing or to gain understanding of systems or human actions Non-technical skills
      in pediatric simulation are the skills of communication, leadership, teamwork, situational
      awareness, decision-making, resource management, safe practice, adverse event minimization,
      and professionalism, also known as teamwork skills. Mindfulness is the self-regulation of
      attention with an attitude of curiosity, openness and acceptance. Executive functions include
      a collection of interrelated functions that are responsible for purposeful, goal-directed,
      problem-solving behavior. In this project, the investigators aim to check whether features of
      mindfulness and executive functions can be used to predict teamwork skills of medical
      students during repeated high-fidelity simulations in emergency pediatric care.

      The project will include simulation center in Bialystok, Poland. The investigators will
      conduct this project over a time of 2 years. Team project is made up of 5 persons, including
      psychologist, simulation instructors and pediatricians. Participants will be students of
      medical faculty in medical university. The investigators expect to include at least 340
      students in the study which will result in 180 assessed as main or second leaders in repeated
      simulations. Team project will assess the students during high-fidelity pediatric emergency
      simulations.

      Methods of assessment of medical students during pediatric emergency simulations: features of
      mindfulness (Mindful Attention Awareness Scale), assessment of executive functions (The
      Behavior Rating Inventory of Executive Functions - Adult), non-technical skills (Ottawa
      Crisis Resource Management scale & checklist), technical skills (checklists) and stress. The
      researchers first will examine association between mindfulness or executive functions and
      demographic variables. And finally team project will assess the possibility of prediction of
      non-technical performance level during medical simulations with the use of mindfulness and
      executive functions assessment.

      In general the investigators anticipate that the results of the study will lead to the better
      understanding of mechanisms that influence non-technical skills in medical students during
      pediatric emergency cases.
Research Project Objectives / Research Hypothesis High-fidelity simulation is an effective
      tool in creating psychological reality of pediatric emergency care. Non-technical skills play
      a pivotal role in management of life-threatening cases in children. Mindfulness is the
      self-regulation of attention with an attitude of curiosity, openness and acceptance. It is
      possible that mindfulness could enhance medical students' capacity for focused attention and
      concentration by increasing present moment awareness. On the other hand executive functions
      include a collection of interrelated functions that are responsible for purposeful,
      goal-directed, problem-solving behavior. It is likely that mindfulness and executive
      functions and their relationship are important players in emergency cases. Repeated
      simulations could be a crucial tool for stress management and improving skills in
      high-fidelity scenarios. In this project, the investigators aim to define whether features of
      mindfulness and executive functions can be used to predict non-technical skills of medical
      students during repeated high-fidelity simulations in emergency pediatric care. The
      researchers hypothesize that: 1) being mindful improves the performance during simulation 2)
      better executive functions result in better non-technical skills of medical student 3)
      repeated simulations will reduce stress and influence performance during scenarios 4) there
      are some potential correlations between executive functions and mindfulness 5) it is possible
      to predict non-technical performance with the assessment of mindfulness and executive
      functions of students during pediatric emergency cases.

      Research project methodology This is a multi-center, investigator-initiated prospective
      study. The project will include simulation center in Poland (Medical University in
      Białystok). The researchers will conduct this project over a time of 2 years. Team project is
      made up of 5 persons, including psychologist, simulation instructors and pediatricians.
      Participants will be students of medical faculty in medical university. Methods: First, to
      increase the awareness of scientific community of the area of interest, the scientists will
      prepare and publish the review of the current literature in the field of mindfulness,
      executive functions and emergency medicine. Then, the researchers will adapt six
      high-fidelity scenarios in the field of pediatric emergency for the requirements of the
      project. The team project expect to include at least 340 students in the study which will
      result in 180 assessed as main or second leaders in repeated simulations. For the
      accomplishment of the aims of this study researchers will need: high-fidelity simulation
      rooms = emergency rooms with full medical equipment, high-fidelity simulators, audio-video
      systems for recording and playing scenarios, ECG Holters, debriefing rooms, computers and
      software. All above mentioned equipment is available in simulation centers and the
      investigators have the professional staff experienced in high-fidelity simulation and
      assessment of non-technical skills in medical students. Demographic features will be assessed
      in all participants: age, sex, year of medical faculty, medical school. The history of
      previous high-fidelity simulations in participating students will be collected. Methods of
      assessment of medical students during pediatric emergency simulations: features of
      mindfulness (Mindful Attention Awareness Scale), assessment of executive functions (The
      Behavior Rating Inventory of Executive Functions - Adult), non-technical skills (Ottawa
      Crisis Resource Management scale & checklist), technical skills (checklists) and stress
      (heart rate, heart rate variability with Holter ECG, blood pressure, Stress-O-Meter and the
      State-Trait-Anxiety Inventory). Data analysis strategy: The study team will first examine
      association between mindfulness or executive functions and demographic variables (gender,
      age, university). Then the researchers are going to construct the regression model to explain
      the variability of features included in Ottawa scale. And finally the study team will assess
      the possibility of prediction of non-technical performance level during medical simulations
      with the use of mindfulness and executive functions assessment.

      Expected impact of the research project on the development of science To date more than 150
      students were enrolled for the preliminary research. The preliminary results showed that: in
      the first simulation the students' non-technical performance is weak, one of the main
      problems in non-technical skills is the fixation error and it is more frequent in simulations
      with two cases at one time, in the repeated simulations non-technical skills are improving,
      there is a growing interest in mindfulness training among medical students, technical skills
      depend of theoretical introduction and students' preparation for the classes, concerning
      stress the statistically significant increase in heart rate but not blood pressure in
      students after each simulation was observed . These data clearly show that the proposed study
      concept is a promising line of basic investigation with solid potential for defining a
      predictive link between mindfulness, executive function and non-technical skills of medical
      students during pediatric emergency simulations. In general the investigators anticipate that
      the results of the present study will lead to the better understanding of mechanisms that
      influence non-technical skills in medical students during pediatric emergency cases. In the
      future this research will be used for an overall improvement in team performance at emergency
      events, which will ultimately translate into a subsequent reduction in the rate of errors and
      adverse events in medicine. The team leaders also hope that an increased awareness of
      non-technical skills in the emergency setting among medical students will have an indirect
      beneficial effect on those skills in the day-to-day setting.

      The scientific results of the project will include: review manuscript and at least two
      original manuscripts, all published in Journals with Impact Factor ≥ 3, presentations on two
      international meetings in Europe.
observational model: Cohort
time perspective: Prospective
measure: Non-technical skills - Ottawa scale
time frame: 12 months
description: We have chosen Ottawa Ottawa Crisis Resource Management Global Rating Scale to evaluate performance during our simulations. The following criteria will be evaluated: leadership skills (stays calm and in control during crisis, prompt and firm decision-making, maintains global perspective - "big picture"), situational awareness (avoids fixation error, reassesses and re-evaluates situation constantly, anticipates likely events), communication skills (communicates clearly and concisely, uses directed verbal /non-verbal communication, listens to team input), problem solving (organized and efficient problem solving approach, quick in implementation, considers alternatives during crisis), resource utilization (calls for help appropriately, utilizes resources at hand appropriately, prioritizes tasks appropriately). Each category is measured on a seven-point anchored ordinal scale with descriptive anchors. The higher values represent a better outcome.
measure: Technical skills
time frame: 12 months
description: Technical skills of medical students during high-fidelity simulations. We designed and validated a scale for assessment technical skills in each scenarios. An example is presented below. The higher values represent a better outcome.
An example of newly developed technical skills checklist for the use in this project - topic - "Ketoacidosis"
Action:
History - including polydypsia (1 point), polyuria (1 point), weight loss (1 point)
Physical examination: breathing, pulse, blood pressure, saturation, heart and lung auscultation, abdomen, dehydration
Treatment:
Hydratation 0.9%NaCl i.v.1000ml / first hour (1 point)
Insulin (rapid acting, 0.1Units/kg) iv (1 point)
Potassium (15%KCl 10-20mmol) (1 point)
No addition of Natrium carbonicum (1 point)
arm group label: medical student of 6th Year
description: Students of medical faculty of 6th Year in Medical University of Bialystok, Poland.
study pop: 
sampling method: Probability Sample
criteria: 
gender: All
minimum age: 23 Years
maximum age: 25 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Wlodzimierz Luczynski, Prof
role: Study Chair
affiliation: Medical University of Bialystok
facility: 
country: Poland
citation: Eppich WJ, Brannen M, Hunt EA. Team training: implications for emergency and critical care pediatrics. Curr Opin Pediatr. 2008 Jun;20(3):255-60. doi: 10.1097/MOP.0b013e3282ffb3f3.
PMID: 18475092
citation: Jirativanont T, Raksamani K, Aroonpruksakul N, Apidechakul P, Suraseranivongse S. Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management. Anaesth Intensive Care. 2017 Jul;45(4):469-475. doi: 10.1177/0310057X1704500410.
PMID: 28673217
citation: Botha E, Gwin T, Purpora C. The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI Database System Rev Implement Rep. 2015 Oct;13(10):21-9. doi: 10.11124/jbisrir-2015-2380.
PMID: 26571279
citation: Greeson JM, Toohey MJ, Pearce MJ. An adapted, four-week mind-body skills group for medical students: reducing stress, increasing mindfulness, and enhancing self-care. Explore (NY). 2015 May-Jun;11(3):186-92. doi: 10.1016/j.explore.2015.02.003. Epub 2015 Feb 16.
PMID: 25792145
citation: Kim J, Neilipovitz D, Cardinal P, Chiu M. A comparison of global rating scale and checklist scores in the validation of an evaluation tool to assess performance in the resuscitation of critically ill patients during simulated emergencies (abbreviated as "CRM simulator study IB"). Simul Healthc. 2009 Spring;4(1):6-16. doi: 10.1097/SIH.0b013e3181880472.
PMID: 19212245
responsible party type: Sponsor
sharing ipd: Undecided