Introduction: Simulation has an increasing role in medical education. It offers the ability to learn and practice in a safe environment. Ultrasound is a key tool for many clinicians; however, it requires significant experience to gain expertise. The most common method to gain experience is by training courses with volunteers, where experts are present for one-on-one teaching. This is time and labour intensive. Commercial ultrasound simulators are increasingly available with software capable of generating automated metrics. We sought validity evidence to support the use of automated metrics as a tool for assessment of learners completing a Focused Assessment with Sonography in Trauma (FAST) exam. Methods: Three groups with differing expertise were recruited to participate: novices with no ultrasound training, intermediates who had completed a formal course within six months, and experts with at least five years of clinical experience. All participants were recorded while completing a FAST exam. Automated metrics of time, path length, angular movement, and percent area viewed were obtained. This video was then scored using the Quality of Ultrasound Imaging and Competence (QUICk) by two expert assessors. Participants were also asked to complete ten find fluid exercises, where automated metrics were generated. Automated metrics from the recorded FAST and QUICk were compared using Kruskall-Wallis to assess for differences in expertise. Correlations between QUICk score and the automated metrics were assessed using Pearson’s correlation coefficient. Find fluid exercises were also assessed using repeated measures one-way ANOVA models. Results: Time, angular movement, and percent area viewed left upper quadrant (LUQ) were significantly different with novices requiring more time and angular movement, and higher percent area viewed LUQ than experts. The QUICk scores were significantly higher for the experts and intermediates compared to the novices. The scores from the QUICk overall and checklist did not correlate with any automated metrics. Individual components of positioning and handling, probe handling, and image scrolling were negatively correlated with percent area viewed LUQ. Overall, the QUICk tool could differentiate novices from both intermediates and experts when using the VIMEDIX-AR simulator. Several automated metrics could differentiate expertise. Further work should develop a composite score of automated metrics to assess learners. / Thesis / Master of Science (MSc) / Simulation has become ubiquitous in medical education, offering a safe environment to learn and practice new skills. With the increasing availability of point of care ultrasound and the need for significant training to generate and interpret images, simulation is becoming ever more important. We sought to assess an expert assessment tool for use with an ultrasound simulator and to validate automated metrics associated with the VIMEDIX-AR simulator. The expert assessment tool could reliably differentiate different expertise levels. Three of our automated metrics could discern different levels of expertise. Further work is needed to assess if a composite score of automated metrics could better differentiate skill.

Purpose: Shared mental models (SMMs) represent commonly held understandings of task and team related knowledge within a team. Thought to facilitate implicit and adaptive coordination without the need for explicit communication, the construct has been thoroughly studied in non-health care settings. There has been increasing interest in the topic in the healthcare setting, but recent reviews have found that the construct is poorly defined and has significant heterogeneity in how it is measured (Floren et al., 2018). We conducted a scoping review examining the construct of SMMs in medical teams within the acute care setting. Method: Following the Arksey and O’Malley (2005) framework, five data bases were searched: Medline, CINAHL, PsychInfo, Web of Science, and Embase. Eligible studies examined SMMs in the context of medical teamwork in the acute care setting. Definitions, methods, and general study characteristics were examined. Results: Of the 1397 articles retrieved, 25 met eligibility criteria. The studies encompassed a variety of areas of clinical practice. There was no common definition for SMMs across the studies examined. The majority of studies (20/25) used quantitative methods with surveys, questionnaires, and observation being the most common. Conclusions: The construct of the SMM is poorly defined in the setting of acute care medical teams. Although many standard types of SMM measurement exist, few of the studies used these common methods. The lack of direct measurement of SMMs, especially in the case of observation, questions the validity of these studies. We propose a definition for SMMs in this context and a path forward for studying SMM in the acute care setting. / Thesis / Master of Science (MSc) / Health care is a team sport and as health care systems become more complex, teamwork becomes increasingly important. However, a team of experts does not make an expert team and highly effective teams possess a particular set of characteristics that allow them to perform high quality care. One characteristic that is receiving an increasing amount of attention is the Shared Mental Model. The purpose of this study was to examine what is already known about these shared mental models in the context of acute care medical teams. This study will act as a launching point for future research exploring how teams think and how it impacts the quality of care they can provide.

Admissions processes for health professions programs result in students entering these programs academically homogeneous. Yet some students have great difficulty with the programs. Research has shown a limited ability of traditional academic indicators to predict successful outcomes for health professions education. The purpose of this study was to examine the relationship between learning motivation and academic outcomes for students in health professions programs. The Modified Archer Health Professions Motivation Scale (MAHPMS) and a demographic survey were administered at orientation to 131 medical and 29 physician assistant students at the University of North Texas Health Science Center in the fall of 2005. At the end of the semester, the same version of the MAHPMS was administered, and final course grades and semester averages were collected. Descriptive statistics were analyzed for all the study variables. Analysis of variance was utilized to examine within subjects and between subjects differences for the learning motivation scores among programs and demographic categories. Linear regression analyses were used to determine the relationship between learning motivation scores and end-of-semester grades. And finally, logistic regression was performed to explore the ability of the motivation scores to predict academically high-risk students. Approximately three-fourths of the students indicated a preference for mastery learning and an internal locus of control. For the PA students, alienation to learning and performance goal scores statistically related to semester grades, and alienation to learning scores predicted high-risk academic performance almost 90% of the time. For the medical students, mastery goal scores statistically related to semester grades, but no motivation score predicted high-risk performance. External locus of control scores predicted high-risk performance 81% of the time for the total group of students at the end of the semester. Students in this study exhibited learning motivation preferences similar to those of other health professions students reported in the literature. The findings of this study agreed with the literature on achievement motivation theory and raised questions regarding the effect of health professions curricula on student learning goals. Similar studies, measuring larger samples longitudinally need to be conducted in order to further validate or elucidate the results of this study.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 4 uppsatser.