Edd 581 action research proposal rachel keller edd 581 february 17 2014 susan gertel
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EDD/581 Action Research Proposal Rachel Keller EDD 581 February 17, 2014 Susan Gertel PowerPoint PPT Presentation


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EDD/581 Action Research Proposal Rachel Keller EDD 581 February 17, 2014 Susan Gertel. Problem Statement. The problem is the sequence of education in medical simulation. Upon narrowing of the problem, an intervention will be implemented. Problem Description.

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EDD/581 Action Research Proposal Rachel Keller EDD 581 February 17, 2014 Susan Gertel

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Edd 581 action research proposal rachel keller edd 581 february 17 2014 susan gertel

EDD/581 Action Research ProposalRachel KellerEDD 581February 17, 2014Susan Gertel

Action Research Proposal


Problem statement

Problem Statement

  • The problem is the sequence of education in medical simulation. Upon narrowing of the problem, an intervention will be implemented.

Action Research Proposal


Problem description

Problem Description

  • The problem is inconsistent sequence of education.

  • Setting problems include

    • Acceptability to standardize

    • Student’s knowledge

Action Research Proposal


Writer s role

WRITER’S ROLE

  • Education Specialist

  • Train multi-discipline medical personal

  • With high fidelity simulation

Action Research Proposal


Purpose of the project

Purpose of the Project

  • The purpose of this project is to standardize the sequence of education in medical simulation.

Action Research Proposal

(Microsoft, 2010)


Problem documentation

Problem Documentation

  • Problem is inconsistent sequence of education

    • Pre Simulation versus Post Simulation

  • Influence learners

    • Perspective

    • Facilitator

    • Conformability

    • Experience

Action Research Proposal


Survey

Survey

Action Research Proposal


Survey1

Survey

Action Research Proposal


Literature review

Literature Review

  • Simulation in medical education

    • More effective

    • Structure is key component

  • Simulation before education

    • Better performance

    • Increase knowledge

Action Research Proposal

(Microsoft, 2010)


Literature review1

LITERATURE REVIEW

  • Education before simulation

    • Improves learning

  • Simulation before education

    • Negative attitude

Action Research Proposal

(Microsoft, 2010)


Literature review2

Literature Review

Action Research Proposal


Literature review3

Literature Review

Action Research Proposal


Literature review4

Literature Review

Action Research Proposal


Action goal

Action Goal

  • The goal of the intervention is to improve knowledge of participants in implementing a standardization in the sequence of education in medical simulation. A three-prong intervention will be implemented to meet the goal, which includes standardizing the sequence of education in medical simulation, instructor training, and weekly collaboration time supported by the administration.

Action Research Proposal

(Microsoft, 2010)


Selected solutions

Selected Solutions

  • Standardizing the sequence of education

  • Instructor training

  • Weekly collaboration

Action Research Proposal


Calendar plan

Calendar Plan

  • Study Duration

    • March 3, 2014 – May 2, 2014

  • Instructors

    • Educators at the simulation center

  • Participants

    • Nurses <1 year

Action Research Proposal


Week 1 march 3 7 2014

Week 1: March 3-7, 2014

Action Research Proposal


Instructor training

Instructor Training

Action Research Proposal


Instructor training agenda

Instructor Training Agenda

Action Research Proposal


Student agenda

Student Agenda

Action Research Proposal


Student agenda1

Student Agenda

Action Research Proposal


Week 2 march 10 14 2014

Week 2: March 10-14, 2014

Action Research Proposal


Week 3 march 17 21 2014

Week 3: March 17-21, 2014

Action Research Proposal


Week 4 march 24 28 2014

Week 4: March 24-28, 2014

  • Study Group A

  • Weekly collaboration

    • Friday, March 28

Action Research Proposal


Week 5 march 31 april 4 2014

Week 5: March 31-April 4, 2014

  • Study Group B

  • Weekly collaboration

    • Friday, April 4

  • Evaluate Results

Action Research Proposal


Week 6 april 7 11 2014

Week 6: April 7-11, 2014

  • Study Group A

  • Weekly collaboration

    • Friday, April 11

Action Research Proposal


Week 7 april 14 18 2014

Week 7: April 14-18, 2014

  • Study Group B

  • Weekly collaboration

    • Friday, April 18

  • Evaluate Results

Action Research Proposal


Week 8 april 21 25 2014

Week 8: April 21-25, 2014

  • Study Group A

  • Weekly collaboration

    • Friday, April 25

Action Research Proposal


Week 9 april 28 may 2 2014

Week 9: April 28-May 2, 2014

  • Study Group B

  • Weekly collaboration

    • Friday, May 2

  • Evaluate Results

Action Research Proposal


Expected outcomes

Expected Outcomes

Standardization of course sequence is complete

  • The outcomes:

    • 100% of courses are sequenced

    • 90% of instructor’s trained in course sequence

    • 100% of staff have time established for weekly collaboration

Action Research Proposal


Measurement of outcomes

Measurement of Outcomes

The outcomes:

  • Knowledge Acquisition

    • Learners tests

  • Acceptability of Sequence

    • Learners surveys

    • Educators journal entries

Action Research Proposal

(Microsoft, 2010)


Analysis of results

Analysis of Results

  • Implemented plan has impacted the problem

    • Quantitative

      • Learner’s Test

    • Qualitative

      • Learner’s Survey

      • Educator’s Journal Entries

Action Research Proposal


Analysis of results1

Analysis of Results

  • Present findings to leadership

    • Written report

    • Presentation

Action Research Proposal


Questions

Questions

Action Research Proposal

(Microsoft, 2010)


References

References

  • Cendan, J. and Johnson, T. (2011). Enhancing Learning through Optimal Sequencing of Web-Based and Manikin Simulators to Teach Shock Physiology in the Medical Curriculum. Advances in Physiology Education, 35(4), 402-407.

  • Ciceroa, M., Auerbacha, M., Zigmonta, J., Rieraa, A., Chinga, K., and Baum, C. (2012). Simulation training with structured debriefing improves residents' pediatric disaster triage performance. Prehospital Disaster Medicine, 27(3), 239-244.

  • Lawrence D. (2007). The ethics of educational research. Journal Of Manipulative & Physiological Therapeutics, 30(4), 326-330.

  • Lee, J. (1999). Effectiveness of computer-based instructional simulation: A meta analysis. International Journal of Instructional Media, 26(1), 71-85.

  • Hendricks, C. (2009). Improving schools through action research: A comprehensive guide for educators (2nd ed.). Upper Saddle River, NJ: Pearson

Action Research Proposal


References continued

REFERENCES CONTINUED

  • Issenber, B., & McGaghie, E. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning. Medical Teacher, 27(1), 10-28.

  • McGaghie, W., Issenber, B., Cohen, E., Barsuk, J., Wayne, D. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A Meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706–711.

  • Microsoft, (2010). Image “All graphics”.

  • Stefaniak, J., & Turkelson, C. (2013). Does the sequence of instruction matter during simulation. Society for Simulation in Healthcare, 00(00), 1-6.

  • Zendejas, B., Cook, D., & Farley, D. (2010). Teaching first or teaching last: Does the timing matter in simulation-based surgical scenarios. Journal of Surgical Education, 67(6), 432-438.

Action Research Proposal


Appendix a education scenarios

Appendix A: Education Scenarios

STATUS ASTHMATICUS

Action Research Proposal


Status asthmaticus algorithm

STATUS ASTHMATICUS ALGORITHM

Action Research Proposal


Fbao arrest

FBAO ARREST

Action Research Proposal


Fbao algorithm

FBAO ALGORITHM

Action Research Proposal


Supraventricular tachycardia

SUPRAVENTRICULAR TACHYCARDIA

Action Research Proposal


Supraventricular tachycardia algorithm

SUPRAVENTRICULAR TACHYCARDIA ALGORITHM

Action Research Proposal


Heat illness

HEAT ILLNESS

Action Research Proposal


Heat illness algorithm

HEAT ILLNESS ALGORITHM

Action Research Proposal


Appendix b participant tests and answers

Appendix B: Participant Tests and Answers

Action Research ProposalTest Weeks 2 and 3

Action Research Proposal


Continued action research proposal test weeks 2 3

Continued Action Research ProposalTest Weeks 2 & 3

Action Research Proposal


Action research proposal answers weeks 2 3

Action Research ProposalAnswers Weeks 2 & 3

ANSWERS

1.B

2.D

3.B

4.D

5.B

6.A

7.C

8.C

9.B

10.C

Action Research Proposal


Action research proposal test weeks 4 and 5

Action Research ProposalTest Weeks 4 and 5

Action Research Proposal


Continued action research proposal test weeks 4 5

Continued Action Research ProposalTest Weeks 4 & 5

Action Research Proposal


Action research proposal answers weeks 4 5

Action Research ProposalAnswers Weeks 4 & 5

ANSWERS

1. C 2.A 3.C 4.B 5.C 6.D 7.C 8.B 9.B 10.C

Action Research Proposal


Action research proposal test weeks 6 7

Action Research ProposalTest Weeks 6 & 7

  • Simple measures to restore upper airway patency in a child may include any of the following EXCEPT:

    • Using head tilt - chin lift to open the airway

    • Cricothyrotomy

    • Perform foreign body airway obstruction relief techniques

    • Use airway adjuncts (e.g., nasopharyngeal or oropharyngeal airway)

      2. Stridor is a sign of what?

    • Pneumonia

    • Aspiration

    • Upper airway obstruction

    • Bronchoconstriction

      3. The Glasgow Coma Scale (GCS) is scored based on response to all of the following EXCEPT:

    • Eye opening

    • Verbal response

    • Motor response

    • Cardiac Output

      4.Medications used in the treatment of Croup may include:

    •  Dexamethasone

    •  Nebulized epinephrine

    •  Heliox

    •  All of the above

      5. Common causes of upper airway obstruction include all of the following EXCEPT:

    • Aspirated foreign body

    •  Asthma

    •  Swelling of the airway

    •  Retropharyngeal abscess

Action Research Proposal


Continued action research proposal test weeks 6 7

Continued Action Research ProposalTest Weeks 6 & 7

6. The initial impression consists of assessing all of the following EXCEPT:

  • Consciousness

  •  Deformity

  •  Breathing

  •  Color

    7. Types of shock include all of the following EXCEPT:

  • Hypovolemic shock

  •  Hypoglycemic shock

  •  Distributive shock

  •  Cardiogenic shock

    8. Common causes of acute community-acquired pneumonia include which of the following?

  • Streptococcus pneumonia

  •  Mycoplasma pneumonia

  •  Chlamydia pneumonia

  •  All of the above 

    9. A room air SpO2 reading less than _____ in a child indicates hypoxemia.

  •  99%

  •  97%

  •  95%

  •  94% 

    10. Signs of increased respiratory effort include all of the following EXCEPT:

  • Abdominal bloating

  •  Nasal flaring

  •  Chest retractions

  •  Head bobbing or seesaw respirations

Action Research Proposal


Action research proposal answers weeks 6 7

Action Research ProposalAnswers Weeks 6 & 7

ANSWERS

1. B

2. C

3. D

4. D

5.  B

6. B

7. B

8. D

9. D

10. A

Action Research Proposal


Action research proposal test weeks 8 9

Action Research ProposalTest Weeks 8 & 9

1. You are caring for a 5-year-old patient with supraventricular tachycardia (hear rate = 220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to provide without delay?

  • Place cold packs on the distal upper and lower extremities

  • Ask the child to blow through a small straw

  • Exert light pressure on the eyes bilaterally

  • Provide synchronized cardioversion at 0.5 to 1 joules/ kilogram

    2. You are initiating treatment for a child with septic shock and hypotension. While administering high-flow oxygen you determine that the child’s respirations are adequate and SpO2 is 100%. You have just established vascular access and obtained blood samples. Which of the following is the next most appropriate therapy to support systemic perfusion?

  • Administer repeated fluid boluses of isotonic colloid

  • Administer repeated fluid boluses of isotonic crystalloid

  • Begin immediate dopamine infusion

  • Begin immediate dobutamine infusion

    3. You arrive on the scene of a 12-year-old who suddenly collapsed on the playground. The child is unresponsive, apneic, and pulseless and CPR is in progress. A lay rescuer just brought the school AED, turned it on, and attached it. The AED recommends a shock. Which of the following should be done next?

  • Obtain intravenous access

  • Attempt defibrillation

  • Change compressions: ventilations from 30:2 to 15:2

  • Attempt endotracheal intubation

Action Research Proposal


Continued action research proposal test weeks 8 9

Continued Action Research ProposalTest Weeks 8 & 9

4. You attempted synchronized cardioversion for an infant with supraventricular tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg shock. Which of the following should you attempt now? 

  • Synchronized cardioversion at a dose of 2 J/kg

  • Synchronized cardioversion at a dose of 4 J/kg

  • Unsynchronized cardioversion at a dose of 2 J/kg

  • Unsynchronized cardioversion at a dose of 4 J/kg

    5. You are treating a 5-month old with a 2-day history of vomiting and diarrhea. The patient is listless. The respiratory rate is 52 breaths/ minute and unlabored. The heart rate is 170/ minute and pulses are present but weak. Capillary refill is delayed. You are administering high-flow oxygen, and intravenous access is in place. At this point, the most important therapy is to:

  • Administer an epinephrine bolus

  • Begin bag-mask ventilation

  • Provide a rapid 20ml/kg isotonic crystalloid fluid bolus

  • Administer a bolus of 0.5 g/kg of dextrose

    6. Which of the following groups of clinical findings would be most consistent with categorizing a patient with compensated shock?

  • Normal systolic blood pressure, decreased level of consciousness, cool extremities with delayed capillary refill, and faint or nonpalpable distal pulses

  • Decreased level of consciousness, extensor posturing in response to pain, hypertension, and apnea

  • Normal blood pressure, normal level of consciousness, bounding distal pulses, hypercarbia, hypoxemia, and normal urine output

  • Unresponsiveness, normal breathing, and good distal pulses.

Action Research Proposal


Continued action research proposal test weeks 8 91

Continued Action Research ProposalTest Weeks 8 & 9

7. You are caring for an 8-month-old with bradycardia and very poor perfusion that has persisted despite effective ventilations with high-flow oxygen. You should begin chest compressions if the heart rate is: 

  • More than 200/min

  • More than 150/min

  • Less than 100/min

  • Less than 60/min 

    8. You are called to treat a 5-year-old with a 3-day history of worsening respiratory distress. The child responds only to pain. The heart rate is initially 45/ min and regular with poor capillary refill. You provide bag-mask ventilations (BVM) with high-flow oxygen that produces good chest rise with full and clear bilateral breath sounds. The heart rate rises in response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min). Which of the following interventions would be most appropriate for you to do first? 

  • Perform transcutaneous pacing

  • Administer epinephrine IV

  • Administer atropine IV

  • Resume bag-mask ventilations

Action Research Proposal


Continued action research proposal test weeks 8 92

Continued Action Research ProposalTest Weeks 8 & 9

9. You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor shows a sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and central pulses are weak. Intravenous access has been established. The core temperature is 37.3 Celsius. Based on the PALS bradycardia algorithm, which of the following should be provided first?

  • Epinephrine IV

  • Transcutaneous pacing

  • Atropine IV

  • Dobutamine IV infusions

    10. When monitoring the quality of chest compressions during resuscitation, you should ensure that providers are

  • Pushing hard – ensure that the chest is compressed ¾ of the anterior-posterior diameter

  • Pushing fast – compress at a rate of 150/ min

  • Allowing complete recoil – let the chest return to its original position between compressions

  • Minimizing interruptions – do not permit interruptions for more than 1 minute

Action Research Proposal


Action research proposal answers weeks 8 9

Action Research ProposalAnswers Weeks 8 & 9

ANSWERS

  • D

  • B

  • B

  • A

  • C

  • B

  • D

  • D

  • A

  • C

Action Research Proposal


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