Juozapavičienė, Laima
Item type:Publication, book[2024][K2a1][M001][202]; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Kaunas : Krizių tyrimo centras, 2024-12-31Trauma ar ūminė būklė nėra kasdieninis mūsų gyvenimo reiškinys, tačiau pagalba tokiu atveju turi būti teikiama kvalifikuotai ir laiku. Nors ir kas atsitiktų (paprasčiausias įsidūrimas ar rimtas lūžis, saulės smūgis ar skendimas), žmogaus veiksmai turi būti pagrįsti racionalios pagalbos principais ir naujausiomis medicinos žiniomis. Šiame vadovėlyje išsamiai ir suprantamai pateikiami pagrindiniai pavojingos būklės diagnozavimo ir pirmosios medicinos pagalbos principai, padedantys išsaugoti gyvybę ir apsaugoti sveikatą. Pirmoji medicinos pagalba yra vienas iš daugelio pagalbos žmogui būdų, o kiekvienas būdas gali ne tik padėti, bet ir pakenkti, todėl susidūrus su realiomis situacijomis ar aplinkybėmis geriausia vadovautis sveiko proto principu, siekti įvertinti riziką, apsaugoti save, nepakenkti nukentėjusiam žmogui ir suteikti jam pagalbą. Dažnai labai norisi prisiimti atsakomybę už visus įvykius, todėl svarbu suprasti, jog mūsų pastangos ne visada būna vaisingos. Tam tikrais atvejais iš pat pradžių tampa aišku, kad pagalba bus nesėkminga, todėl tada reikia ne siekti absoliutaus rezultato, o daryti tai, kas įmanoma. Pareiga ir atsakomybė yra nematomos jėgos, lemiančios pirmosios medicinos pagalbos teikimo rezultatą. Šiuos veiksnius norime apibūdinti ne remdamiesi įstatymu (tai jau padaryta), bet pateikdami juos kaip galingą jėgą (žinias ir įgūdžius), kurie gali padėti išgelbėti žmogaus gyvybę. Pirmosios medicinos pagalbos teikėją įsivaizduojame kaip drąsų ir ryžtingą žmogų, norintį ir galintį panaudoti savo įgūdžius įvairiomis gyvenimo situacijomis. Vadovėlis skirtas aukštųjų mokyklų studentams ir visiems, kurie domisi pirmąja medicinos pagalba.
84 Item type:Publication, conference poster[2023][T1a][M001][1]; ; ; ; ; ; ; ; Resuscitation : Abstracts of RESUSCITATION 2023 : 02-04 November 2023, Barcelona, Spain : Abstract Book / European Resuscitation Council., 2023-10-31, vol. 192, no. suppl. 1, p. 156-156Purpose of the study: Simulation-based training enables the acquisition of clinical skills and apply them from a simulated environment to clinical practice (1, 2). In our study, we compared hybrid learning method, conventional learning, and mixed learning in teaching of airway management skills. Materials and Methods: 39 medical students were randomly divided into three groups, each of which was taught airway management skills. The first (conventional) group of subjects studied in a conventional way via lectures and classic simulationbased training sessions. The second (hybrid) group attempted the hybrid learning method, where e-learning was combined with small group peer to peer simulation sessions using interactive algorithms, under remote instructor supervision. After the teaching process, airway management procedures were performed on real patients under the supervision of an anesthesiologist in an operating theatre. Each step of the procedure was evaluated by standardized assessment form. Results: From 39 participants 10 participated in the conventional group, 14 in the hybrid, 15 in the group using the mixed learning method. [...]. Table. [...]. Conclusions: We conclude that algorithm driven hybrid learning method without the direct participation of the teacher improves acquisition of the practical skills and equally proficient as the mixed learning method.
30 Item type:Publication, conference poster[2023][T1a][M001][1]; ; ; ; ; ; ; ; Resuscitation : Abstracts of RESUSCITATION 2023 : 02-04 November 2023, Barcelona, Spain : Abstract Book / European Resuscitation Council., 2023-10-31, vol. 192, no. suppl. 1, p. 169-169Purpose of the study: The aim of the study is to compare the interobserver reliability of assessments of endotrachel intubation skills between students and teacher using the HybridLab® methodology. Methods: The study took place at the Lithuanian University of Health Science (LUHS) and Pennsylvania State University (PSU) in the US. A total of 92 students (60- LUHS and 32- PSU) were trained in endotracheal intubation using an algorithm-driven hybrid learning method. At the end of the training session, the participants had to complete the evaluation scenario, which was assessed by one of the students and evaluated remotely by a single teacher. The student assessment of the endotracheal intubation procedure was compared with the teacher’s assessment using correlation and estimation of the intraclass correlation coefficient. Results: Assessment of completion of the 16 steps of endotracheal intubation: comparison between student and teacher. Table. [...]. The intraclass correlation coefficient used for interobserver variations between the students’ and teachers’ assessments was 0.883 (95% confidence intervals 0.824 to 0.923). Conclusions: The algorithm-driven hybrid learning method allows students to reliably assess the endotracheal intubation skills when compared with the teacher’s evaluation.
21 Item type:Publication, journal article[2023][S1][M001][9]; ; ; ; ; ; ; BMC Medical Education, 2023-04-18, vol. 23, no. 1, p. 1-9Background: Practical skill assessment is an important part of the learning process to confirm competencies in acquired medical knowledge. Objective: This study aimed to compare the assessments of endotracheal intubation skills using the HybridLab® methodology between students and teacher in terms of interobserver reliability. Methods: Reliability analysis was performed with observational data (data are reported according to STROBE guidelines). The study was conducted in two countries, the Lithuanian University of Health Science (LUHS) and Pennsylvania State University (PSU) in the US, between 1 January and 30 June 2020. A total of 92 students (60 from LUHS and 32 from PSU) were trained in endotracheal intubation using an algorithm-driven hybrid learning method. At the end of the training session, the participants had to complete the evaluation scenario, which was assessed by one of the students and evaluated remotely by a single teacher. The student assessment of the endotracheal intubation procedure was compared with the teacher's assessment using correlation and estimation of the intraclass correlation coefficient. Results: Overall, the medians of the student and teacher assessments were both 100% (0%). Spearman's correlation coefficient between the student and teacher assessments was 0.879 (p = 0.001). The intraclass correlation coefficient used for interobserver variations between the students and teacher was 0.883 (95% confidence interval from 0.824 to 0.923).Conclusions: The algorithm-driven hybrid learning method allows students to reliably assess endotracheal intubation skills to a level comparable with that of the teacher's evaluation. This learning method has the potential to be a cost-effective and efficient way to provide high-quality education while also saving human resources.
23WOS© Citations 2 Item type:Publication, conference paper[2023][T1d][M001][4]; IHS (International Health Sciences) Conference [7th] : abstract book : [March 30-31, 2023, Kaunas, Lithuania] / Students' Scientific Society of Lithuanian University of Health Sciences ; Edited by Joana Ažukaitė ; Abstracts’ reviewers: Martynas Špečkauskas, Brigita Glebauskienė, Reda Žemaitienė, Loreta Kuzmienė, Justina Kačerauskienė [et al.]. Kaunas : Students' Scientific Society of Lithuanian University of Health Sciences, 2023., 2023-03-30, p. 10-13.Introduction Preoperative anxiety (POA) is a common reaction that may be experienced by up to 80% of patients undergoing surgery [1-3]. While it is well known that POA can have negative effects on a patient's condition and may worsen the perioperative period, there is still a lack of information about the specific impact of anxiety on postoperative outcomes and how to address it in order to promote the patient's overall well-being and support a successful surgical outcome [4]. Aim To review and systematize the available evidence on the relationship between preoperative anxiety and perioperative outcomes in patients undergoing surgery. Methods A comprehensive search of scientific literature was conducted using the PubMed and ScienceDirect databases and following the PRISMA guidelines. The search included a combination of keywords such as "preoperative anxiety," "surgery," "perioperative outcomes”. Articles were selected based on inclusion and exclusion criteria developed using the PICO method. Inclusion criteria for the studies were: published in English, focused on adult patients undergoing surgery, assessed the impact of preoperative anxiety on perioperative outcomes, and published within the past 5 years. In total, 196 articles were screened for eligibility. Results Of the 196 articles screened, 12 studies met inclusion criteria. The studies included a total of16,670 patients. Findings were organized into seven areas: 1) POA was significantly associated with negative postoperative outcomes, including nausea, vomiting, reoperation on the same day, lower quality of recovery, and a longer hospitalization [4-7]. This relationship was observed across four studies, involving a total of 9,082 patients. 2) POA was strongly correlated with intraoperative propofol and postoperative opioid consumption, as well as greater postoperative pain [4, 5, 7-9]. This finding was supported by five studies, which included a total of 5,551 patients. 3) POA was linked to hemodynamic changes, including increases in mean arterial pressure, systolic blood pressure, and heart rate upon arrival to the operating room [10, 11]. Two studies, including a total of 308 patients, supported this finding. 4) POA was associated with a higher risk of postoperative delirium in elderly patients, although this relationship was not consistently observed in all studies [4, 12-14]. This finding was supported by four studies involving a total of 1,838 patients. 5) No significant correlation was found between preoperative anxiety and higher mortality risk [15]. This finding was supported by one study, which included a total of 241 patients. 6) Some studies found that younger patients were more likely to experience preoperative anxiety [9], while others found no significant difference between men and women in terms of the prevalence of POA [8]. 7) Various interventions, such as preoperative education, relaxation techniques, and pharmacological therapies, have been suggested to reduce anxiety and improve patient outcomes [1, 4].Conclusions Our systematic literature review showed that preoperative anxiety has strong negative impact on perioperative outcomes, such as nausea, vomiting, increased need for anesthetics and analgesics, as well as greater postoperative pain. Interventions such as preoperative education, relaxation techniques, and pharmacological therapies may be effective in reducing anxiety, though more research is needed to determine the optimal approach.
32 Item type:Publication, journal article[2022][S1a][M001][9]; ; ; ; ; ; BMC anesthesiology. London : BioMed Central, 2022, vol. 21, no. 1., 2022-02-08, p. 1-9.BACKGROUND: Simulation-based training is a clinical skill learning method that can replicate real-life situations in an interactive manner. In our study, we compared a novel hybrid learning method with conventional simulation learning in the teaching of endotracheal intubation. METHODS: One hundred medical students and residents were randomly divided into two groups and were taught endotracheal intubation. The first group of subjects (control group) studied in the conventional way via lectures and classic simulation-based training sessions. The second group (experimental group) used the hybrid learning method where the teaching process consisted of distance learning and small group peer-to-peer simulation training sessions with remote supervision by the instructors. After the teaching process, endotracheal intubation (ETI) procedures were performed on real patients under the supervision of an anesthesiologist in an operating theater. Each step of the procedure was evaluated by a standardized assessment form (checklist) for both groups. RESULTS: Thirty-four subjects constituted the control group and 43 were in the experimental group. The hybrid group (88%) showed significantly better ETI performance in the operating theater compared with the control group (52%). Further, all hybrid group subjects (100%) followed the correct sequence of actions, while in the control group only 32% followed proper sequencing. CONCLUSIONS: We conclude that our novel algorithm-driven hybrid simulation learning method improves acquisition of endotracheal intubation with a high degree of acceptability and satisfaction by the learners' as compared with classic simulation-based training.
19WOS© Citations 7 Item type:Publication, book[2021][K2b][M001][79]; ; ; ; ; ; ; Kaunas : Lietuvos sveikatos mokslų universiteto Akademinė leidyba, 2021-12-31Šis leidinys skirtas susisteminti SPS atliekamos PSA principus bei rekomendacijas, apžvelgti įvairių amžiaus grupių pacientų PSA ypatumus, kas šių įgūdžių besimokantieji ir jau praktikuojantys specialistai kalbėtų viena - saugios procedūrinės sedacijos ir analgezijos - kalba. Leidinyje remiamasi jo rašymo metu buvusiais naujausiais mokslu grįstais įrodymais.
91 Item type:Publication, conference paper[2021][T1d][M001][3]; ; ; Health for All: 2021 - International conference: Health for all 2021 : abstract book : [7-8 April, 2021, Kaunas, Lithuania / virtual event] / [organised: Doctoral Student’s committee of Lithuanian University of Health Sciences ; Abstract reviewers: I. Ulozienė, R. Vosyliūtė, A. Giedraitienė]. Kaunas : Lithuanian University of Health Sciences, 2021., 2021-04-07, p. 23-25.Introduction The science of education is constantly looking for novel ways to improve the learning process. In medical studies, teaching students practical skills that can be readily and safely applied in clinical practice is one of the major goals. Simulation-based training is a clinical skills learning method that can replicate real-life situations in an interactive manner. In our study, we compared a novel hybrid learning method to a conventional learning in teaching of an endotracheal intubation. Aim To compare hybrid learning method with a classic simulation-based training for teaching endotracheal intubation skills. Methods One hundred medical students and residents were randomly divided into two groups and were taught the endotracheal intubation. The first group of subjects (control group) studied in a conventional way via lectures and classic simulation based training sessions. The second group (experimental group) attempted the hybrid learning method where the teaching process consisted of distance learning and small group peer-to-peer simulation training sessions with direct or remote supervision of the instructors. After the teaching process, endotracheal intubation (ETI) procedures were performed on real patients under the supervision of an anesthesiologist in the operating theatre. Each step of the procedure was evaluated by standardized assessment form (checklist) for both groups. Results From 77 participants 34 subjects participated in the control group and 43 were in the experimental group using the hybrid method. ETI performance in the operating theatre indicated significantly better performance for the hybrid group over the control group with overall average evaluation score for the hybrid group 88±11% (p<0.001) versus 52±18%,in the control group. Also, that all hybrid group subjects followed correct sequence of actions (100%)s, while in the control group only 11 participants (32%) followed sequencing. [...].
8 Item type:Publication, conference paper[2020][T1a1][M001][1]; ; ; ; ; European journal of anaesthesiology - EJA : Euroanaesthesia 2020: The European Anaesthesiology Congress : abstracts : 28-30 November 2020, Barcelona, Catalonia, Spain / Editor-in-Chief Martin R. Tramèr [et al.] ; European Society of Anaesthesiology - ESA. Cambridge : Lippincott Williams & Wilkins, 2020, vol. 37, esuppl. 58, June., 2020-06-18, p. 402-402, no. 6229.Background and Goal of Study: Higher public and patient expectations have both encouraged the development and use of innovative educational methods. HybridLab is a distance learning and algorithm driven self-directed peer to peer medical simulation that allows learners to train 24/7 without direct presence of the instructor, while the training sessions are reviewed online by the experienced instructors. The first courses built on HybridLab platform is focused on the specific technical skills like advanced airways management. Conventional learning is a teaching and learning process that focuses on live lectures with faculty guided preclinical demonstration and practice. The goal of the study is to test the efficiency of a hybrid learning technique versus conventional learning technique in teaching endotracheal intubation among medical students. Materials and Methods: Medical students were randomly assigned into two study groups to be teached endotracheal intubation (EI) using conventional learning technique (Group C) and hybrid learning technique (Group H). During first week after teaching process both groups performed endotracheal intubation on real patients under supervision by trained instructors - doctors. 5 stages of EI (preparation, preoxygenation, laryngoscopy, endotracheal tube (ET) insertion, verification) were evaluated in both groups using statistical analysis. The stage was described as completed when student performed all actions correctly. Data was assessed for normality and found to have a non-parametric/parametric distribution. The level of significance was defined as p>0.05. Results and Discussion: 77 students were enrolled into study: 34 in Group C and 43 in Group H (p>0,05). There were no statistically significant differences between the patients in both groups with respect to demographic characteristics, ASA physical status and Mallampati score. Preparation was completed by 55,9% in Group [...].
11 Item type:Publication, book[2020][K2a2][M001,M005][227]; ; ; ; ; ; ; ; ; ; ; ; ; Kaunas :: Lietuvos sveikatos mokslų universiteto Leidybos namai,, 2020., 2020-05-13Išplėstinės slaugos anesteziologijoje ir intensyviojoje terapijoje dėstymas – neabejotinas laimėjimas rengiant mūsų šalies slaugos specialistus. Ši mokymo knyga skirta būsimiems specialistams – pirmoji kregždė tarp būsimų mokymo knygų ir vadovėlių. Rengiant šią knygą autoriai svarstė, kokias temas paliesti. Aišku, kad rengiant išplėstinės slaugos specialistus būtinos tiek bazinės, tiek ir specialiosios žinios. Šis pirmasis vadovėlis skirtas bazinių žinių išplėstinėje slaugoje mokymui. Neabejojama, kad slaugytojos turėtų įgyti tas pačias bazines žinias anesteziologijoje ir intensyviojoje terapijoje, kaip ir būsimi gydytojai. Gal todėl šio vadovėlio pagrindu tapo šiuolaikinės Anesteziologijos mokymo pradininkės Lietuvos sveikatos mokslų universitete – docentės Irenos Agnietės Marchertienės ir jos bendradarbių parengta mokymo knyga "Ūminis skausmas ir jo malšinimas", kuri vis dar išlieka bazinius poreikius tenkinančia mokymo knyga Medicinos fakulteto studentams. Greta šių pagrindinių žinių, kurias studijuoja ir medikai, bendraautoriai parengė kitas, slaugos procesui užtikrinti būtinąsias dalis skirtas komandiniam darbui, poanestezinei ir intensyviai priežiūrai, vaikų intensyviosios slaugos aktualijoms. Vadovėlyje aprašomi bendrinių ir vietinių anestetikų klinikinė farmakologija, ligonio parengimas operacijai ir anestezijai, bendrinės ir regioninės anestezijos metodai, ligonio stebėjimo metodai, ūminio pooperacinio ir lėtinio skausmo malšinimo principai. Skyrių pabaigoje pateikiami kontroliniai klausimai. Vadovėlis skirtas anestezijos ir intensyviosios terapijos slaugytojams, studijuojantiems išplėstinę anestezijos ir intensyviosios terapijos slaugos programą.
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