Quick intentional practice in healthcare simulation – Nursing Education Network

This review of literature on the prudent practice of the fast cycle (RCDP) in medical education based on simulation (SBME).

: NG C, Primini N, Orchangian-Cheff a. (2021). Fast cycle targeted practice in healthcare simulation: space review. Med Scid Education. 2; 31 (6): 2105-2120.

This is the most important review to this point on the topic. He studies 23 published RCDP studies in healthcare simulation and summarizes them. RCDP is a type of “summary within events”. Students practice skills persistently and receive directed feedback to attain the championship. Only then do they go to the following goal of learning. It relies on the principles of deliberate practice and learning to master, from fields similar to music and sport.

• RCDP was introduced by Hunt et al. In 2014, it’s consistently defined in literature as a technique that “quickly the cycle (s) between deliberate practice and targeted feedback until the ability to master the skills.”
• It features a summary inside events through which the simulation is stopped on real -time coaching.
• The key RCDP rules include:
• Application through many possibilities of repetitive practice to attain “muscle memory”.
• Supply.
• Supporting the environment through which students feel comfortable, receiving feedback.

• The research included in design. Types of participants are primarily residents, especially pediatrics. Simulation types are most frequently pediatric resuscitation and adults. Research also has quite a lot of results.
• Although the essential definition of RCDP is consistent, there are differences in its application. These variations include the usage of needs assessment, pause time and rewinding or restarting. The progress and difficulty of escalation are also different, which makes it difficult to attract general conclusions about RCDP.
• Implementation strategies differed, including:
• Using the primary series of uninterrupted simulation as an assessment of needs (11 studies).
• In the script (9 studies) with previously established breaks (9 studies).
• Stopping to correct errors, praise or feedback (10 tests).
• Short cases have been repeated persistently (2 tests).
• Scroll to the start (9 tests) or to the break point (7 tests).
• Progress of cases through the script (15 research), often with growing difficulties (6 studies).

• RCDP is consistently related to positive results at Kirkpatricka (response) and K2 (learning) levels [more on Kirkpatrick Model of Evaluation]
• “The most common K1 results were the increased student trust (11 studies) and student satisfaction (11 studies)”.
• RCDP was related to higher knowledge and acquisition of skills, proven by:
• Significantly increased the outcomes of multiple alternative (MCQ) (4 research).
• Increased results of the checklist (8 tests).
• Reduced time for critical tasks (6 studies).
• Increased chest compression fraction (CCF) (2 tests).
• Studies have shown specific improvements. For example, there was a “significant decrease in the middle time from the occurrence of the” Illish V-Popodniech to defibrillation. ” The detention before Shock was shorter in comparison with the group before the intervention [5].

• While initially studied when it comes to technical resuscitation and procedures, RCDP simulation can teach non -university skills. It may successfully include notification of death and family communication.

• Adding RCDP to plain curricula seems “generally beneficial”, which ends up in an improvement in K2 results.
• However, comparisons between RCDP and traditional simulation gave mixed results.
• While some studies have shown immediate improvement within the case of RCDP (e.g. reduced time for critical tasks, higher checklist results), “three out of five studies in which RCDP with traditional simulation did not show significant differences in all measurements of K2 results.”
• Importantly, studies with observations (3-4 months) have shown that the outcomes of the checklist decreased each in RCDP and traditional simulation groups. RCDP groups have experienced a “greater decrease in results.” This happened despite initially showing higher results immediately after training.

• The results decreased more during remark in RCDP groups than in traditional simulation groups. This indicates that RCDP has a direct advantage within the knowledge application. However, no knowledge was demonstrated.
• This raises questions on creating a protracted -term “muscle memory” from RCDP.
• One study suggested that RCDP training should happen more often. Training every 3 months helps maintain skills. It also prevents the distribution observed after 6 months.

• Only two studies reported K3 results, which include the usage of learned skills in clinical practice. They include perceived improvement in leadership and communication [14]. In addition, nursing staff are in a position to higher manage cardiac arrest [21].
• “No results of K4 [systemic outcomes such as improved patient outcomes, cost-savings, etc.] were reported. “

• The need for standardization of RCDP implementation and simulation design to facilitate more consistent tests.
• Further research is required. They should examine how RCDP interventions “translate into clinical practice”. These studies should have a transparent impact outside the training environment (K3 and K4 results).
• Further research is mandatory to check RCDP with other SBME types, especially in relation to “long -term skill stopping”.
• You need more prime quality, properly powered, randomized controlled tests to finally assess the advantage of RCDP in comparison with traditional simulation.

• Excluding gray literature, conference summaries and poster presentations.
• Limitation for English research.
• Lack of critical assessment of the standard of the study as a result of the wide selection and heterogeneity of the research included.
• Most of the research was a small and single place, and there have been many comparisons, which makes it difficult to exclude interference.

RCDP is a rapidly developing technique in healthcare simulation. This is said to the immediate positive results of student satisfaction and confidence. It also increases the acquisition of data and skills when it comes to technical and non -technical skills. Adding RCDP to plain curricula seems helpful. However, its superiority over traditional simulation is currently unclear. This is as a result of mixed results of comparative research and lack of evidence of long -term skill retention. In addition, his translation into clinical practice is uncertain. Further normalized research is mandatory to clarify the long -term impact and comparative effectiveness of RCDP.

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