Mankutė-Ūsė, Aida
Item type:Publication, [The Effectiveness of a Hybrid Simulation-Based Training Methodology in Developing Endotracheal Intubation Competencies and Implementing Critical Skills Training During a Pandemic]doctoral thesis[2026][M001][172]; ; ; ; ; Timler, DariuszEndotrachėjinė intubacija (ETI) – gyvybę gelbstinti procedūra, kurios saugiam atlikimui reikia daug pakartojimų. Pandemijos ir kitos ekstremalios situacijos šį poreikį dar labiau sustiprina. Hibridinė simuliacinė metodika jungia interaktyvius algoritmus, mokomuosius vaizdo įrašus ir standartizuotą vertinimą mažose grupėse su nuolatiniu grįžtamuoju ryšiu. Darbo tikslas – įvertinti šios metodikos efektyvumą ugdant ETI kompetencijas, lyginant su klasikine simuliacija, bei jos taikymą diegiant kritinių įgūdžių mokymus pandemijos metu. Atlikti trys tyrimai: atsitiktinių imčių tyrimas, lyginęs hibridinės ir klasikinės simuliacijos poveikį ETI atlikimui klinikinėje aplinkoje (n = 77); perspektyvusis kohortinis tyrimas dėl tarpusavio ir dėstytojo vertinimų patikimumo (n = 92); ir pandemijos metu įdiegtų nacionalinių kritinių įgūdžių mokymo modulių analizė. Išvados. Hibridinė metodika statistiškai reikšmingai pagerino ETI atlikimo kokybę klinikinėje aplinkoje (vidutiniškai 36 proc. daugiau teisingai atliktų procedūros žingsnių) ir padidino pasitenkinimą mokymais, tačiau pasitikėjimas savimi tarp grupių nesiskyrė. Studentų tarpusavio ETI įgūdžio vertinimai stipriai koreliavo su dėstytojų vertinimais ir buvo patikimi, todėl metodika tinkama tarpusavio formuojamajam vertinimui. Hibridinės metodikos pagrindu pandemijos metu sukurti moduliai buvo greitai parengti, plačiai taikyti ir vertinti kaip naudingi, todėl gali būti veiksminga priemone skubiam kompetencijų ugdymui.
7 18 - conference output[2026][T1e][M001][2]
; 10th International Health Sciences Conference IHSC : March 5th-6th, 2026 : Abstract book / Edited by Beatrice Ziulyte, Karina Zerr, Gabija Varkuleviciute & Ignas Jusis, 2026-03-05, p. 156-157Introduction High-concentration acetic acid ingestion causes serious corrosive injury of the upper airway and gastrointestinal tract due to coagulative necrosis. Reported complications include airway obstruction, esophageal necrosis, perforation and high mortality, up to 20-30% in severe adult cases (1,2). Airway involvement represents a major risk factor for death, as edema may make airway control impossible. The aim of this case report is to highlight the importance of early recognition and proactive airway management in patients with corrosive acetic acid ingestion. Case Presentation A 73-year-old male accidentally ingested 97% acetic acid and developed odynophagia, dysphonia, drooling and respiratory distress. ENT evaluation revealed severe oropharyngeal burns with supraglottic edema and a critically narrowed glottic opening. Due to imminent airway obstruction, early endotracheal intubation was performed. Endoscopy confirmed corrosive esophageal injury; perforation could not initially be excluded, therefore total parenteral nutrition and empirical antibiotics were started. After stabilization and improved endoscopic findings, the patient was extubated, enteral feeding established and he was discharged in stable condition. Discussion High-concentration acetic acid causes rapid coagulative necrosis with early supraglottic involvement and high risk of airway obstruction (1,2). Airway compromise is a stronger predictor of mortality than the extent of esophageal injury alone (2). Progressive edema may quickly render delayed intubation impossible, increasing the risk of fatal outcomes (3,5). In this case, early ENT evaluation revealed critical airway narrowing, enabling well-timed airway protection. Endoscopy guided further management and nutritional support, consistent with current recommendations (3). Conclusions This case demonstrates that early recognition of airway involvement and right airway management are critical determinants of outcome in concentrated acetic acid ingestion (1,3). Proactive intubation, guided by endoscopic airway assessment, can prevent catastrophic airway loss. Early endoscopy and staged nutritional support complement airway management and contribute to favorable recovery (4). Continuous monitoring is essential to detect late complications such as strictures (5).
10 5 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 paper[2024][T1e][M001][1]; ; ; ; ; Medicina : Abstracts of the International Scientific Conference on Medicine organized within the frame of the 82nd International Scientific Conference of the University of Latvia [: 5 April 2024, Riga, Latvia] / Editor-in-chief Edgaras Stankevičius, 2024-04-05, vol. 60, no. Suppl. 1, p. 213-213Background. Effective prehospital emergency care faces numerous challenges influenced by various factors. Decision-support tools are recognized for their valuable role in improving provider performance and patient outcomes during clinical emergencies. While cognitive aids have shown promise, the exploration of electronic field protocols in prehospital care settings has been limited. Additionally, the use of standardized field protocols is not a common practice in prehospital settings in Lithuania. Aim. This study aimed to assess the impact of newly developed electronic field protocols on the performance of prehospital care providers within a simulated environment. Methods. Conducted at the Lithuanian University of Health Sciences from October 17 to November 18, 2022, this randomized simulation-based study employed a specially designed simulation course. The course encompassed twelve distinct scenarios representing various acute conditions: adult resuscitation, paediatric resuscitation, delivery and postpartum care, seizures in pregnancy, stroke, anaphylaxis, acute chest pain, acute abdominal pain, respiratory distress in children, severe trauma, severe infection and sepsis, and initial neonatal evaluation and resuscitation. Standardized checklists were used for evaluation. Sixteen prehospital providers, each with a minimum of three years of clinical experience, were randomly assigned to either utilize the newly developed electronic field protocols or rely solely on their memory during simulated scenarios. Participant performance scores between the two modes of operation were then compared. Results. A total of 190 simulation sessions were carried out. The use of electronic field protocols resulted in a statistically significant improvement in participant performance scores across 10 out of the 12 simulated scenarios when compared to relying on memory alone. Compliance with standardized checklists increased from 60% to 85% (p < 0.001) when the electronic field protocols were employed. Post-course survey responses indicated that participants found the electronic field protocols user-friendly and directly applicable to prehospital clinical practice. Conclusion. The outcomes of this study suggest that newly developed electronic field protocols, functioning as cognitive aids, effectively enhance prehospital care providers’ performance in simulated scenarios. These findings highlight the potential of standardized electronic field protocols to elevate the quality of prehospital care in Lithuania, indicating a promising avenue for further development and implementation in healthcare settings.
7 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, 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. [...].
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