Amilee Huang

6 February 2019
Annotated Source List

Alexander, Ruth. ​The Hawthorne Effect​. Performance by Tim Harford, ​BBC​, BBC,
www.bbc.co.uk/sounds/play/p01j5xb1​.

Summary: Radio Program

This radio program is about the Hawthorne Effect. It starts with a story about a nine year
experiment of new fancy lightings on the worker’s production. The experiments came to
the conclusion that the more attention that was given to the workers, the workers worked
harder and became more productive. It emphasized the importance of the communication
between the coworkers. When you are observed, you change and work harder, trying to
look better in front of other people or the people judging you. This radio program, More
or Less, explores the original data about the lighting experiment in Chicago, showing that
it did and also did not support the Hawthorne effect that we know of today.

Application to Research: Radio Program

The radio program called “More or Less” cited public data and also reliable people who
have credit as scientific researchers. This will help me because I am not only focusing on
debriefing or the simulation side, but also how the recording affects the doctors and how
they act. Will they act better resulting in a better outcome because they are being
recorded. The hawthorne effect embodies that idea in a psychology philosophy which I
plan to research more.

AS, Laerdal Medical, director. ​How Does Deliberate Practice and Debriefing Work?
YouTube​, YouTube, 12 Sept. 2017,​ ​www.youtube.com/watch?v=KbCxd1oAec4​.

Summary: Video
This video was made by Laerdal, a medical simulation company that produces products
such as mannequins used for medical simulation. The video is a combination of many
high place people such as medical directors at Laerdal to discuss the practice and
importance of debriefing in the medical setting. Debriefing is used a reflection of what
have you done well or not. Many learners need it as a time of reflection. Debriefing is
an art form rather than a technique.

Application to Research: Video

This video shows high place people from a world renown medical simulation company
talking about an integral part of medicine and healthcare, debriefing. It shows that
debriefing is not just people talking, but has real significant value. There are many
people in the video that could be contacts such as Michael Seropian, Thomas Talbot and
Jeanette Zaichkin.
"American Hospital Association endorses Simulation-Based Training from Raytheon and MSC."
ENP Newswire​, 2 July 2013. ​Science In Context​,
http://link.galegroup.com/apps/doc/A335560758/SCIC?u=elli29753&sid=SCIC&xid=b4
406062. Accessed 29 Oct. 2018.

Summary: Newsletter
Raytheon Professional Services LLC and Medical Simulation Corporation has developed
a joint solution to improve patient care, safety and clinical outcomes, earning the
endorsement of the American Hospital Association. Hospitals now a days are struggling
with the efficiency and effectiveness of their care, but simulation based training can
improve these goals. It uses a variety of programs and technologies fitting many goals
and budgets of different hospitals under the American Hospital Association.

Application to Research: Newsletter

American Hospital Association is a nonprofit organization that centers their goal on
improving health in its communities. This organization collaborates with medical and
hospital leaders to progress the health of people, which in this case is Raytheon and
Medical Simulation Corporation. Since written in 2018, this article shows the growing
importance of medical simulation, even recognized by the American Hospital
Association, which has over 43,000 individuals in its health system.

Bash, Homa. “Case Western Student Studies Medical Records, Discovers Mom Was
Misdiagnosed 20 Years Ago.” ​newsnet5​, CBS, 6 Oct. 2017,
www.news5cleveland.com/news/local-news/cleveland-metro/case-western-student-studie
S-medic

Summary: Video
Debbie Montgomery twenty-two years ago was diagnosed with dermatomyositis, a rare
autoimmune disease, after her son, Turner Montgomery, was born. Dermatomyositis is
disease where the immune system attacks her muscles and skin, bounding many to a
wheelchair by forty. After Turner learned about her disease at 15 years old, he knew
what field he wanted to study in, biomedical engineering. As he was studying, he
realized that his mother had been misdiagnosed. She did not have dermatomyositis, she
actually had a type of muscular dystrophy. For two decades, she had been receiving
treatment for dermatomyositis. Turner has now created a device to aid his mother’s
treatment in addition to physical therapy, an EMG machine that measures electricity sent
from the brain to the muscle. Although there is no cute for the disease, she is now
recieving correct treatment for her correct diagnosis.

Application to Research: Video

The author, Homa Bash, is a journalist for News 5 Cleveland. The video focuses on
Turner Montgomery and his findings with his motivation to cure his mother. He also
mentioned that he could not believe he found something that the doctors had missed,
showing the superiority and non questionability that doctors innately have with the title.
Bernstein, Ethan. “How Being Filmed Changes Employee Behavior.” ​Harvard Business
Review,​ 10 Mar. 2015,
hbr.org/2014/09/how-being-filmed-changes-employee-behavior.

Summary: Article
This article is about “How Being Filmed Changes Employee Behavior.” In this case, the
author uses the camera affect in the situation of police work, a modern controversy. It is
supposed to remove bias and record an objective perspective of what the officer is doing.
However in reality, the camera is changing how the officer is acting. When officers wore
cameras, every physical contact with another person was initiated by the other, compared
to officers who did not wear cameras, 24% of physical contact was initiated by the
officer. When a person is recorded, the person tries to achieve the goals set by another
because they are constantly being observed. Especially in a boss versus employee
relationship, the employee with try to meet the requirement of the boss even when not
around if being recorded.

Application to Research: Article

This article was written by Ethan Bernstein, an assistant professor of leadership and
organizational behavior in Harvard Business School. Harvard Business School is a
prestigious university, therefore an employee at this school would also be reliable or
credible. Although this article does not directly relate to my topic, it highlights how the
behavior changes when being recorded. Bernstein describes the actions affected in a
police situation, however it is similar to those in simulation or debriefs. I would like to
test this hypothesis by running experiments of the product of those who were recorded
versus the product of those who were not recorded.

Bernstein, Lenny. “20 Percent of Patients with Serious Conditions Are First Misdiagnosed,
Study Says.” ​The Washington Post​, WP Company, 4 Apr. 2017,
www.washingtonpost.com/national/health-science/20-percent-of-patients-with-serious-co
nditions-are-first-misdiagnosed-study-says/2017/04/03/e386982a-189f-11e7-9887-1a531
4b56a08_story.html?utm_term=.e32b236b1a24.

Summary: Article
Twenty percent of patients who received a second opinion at another medical facility had
been misdiagnosed by their primary doctors according to a new research. There are
thousands of diseases and over 200 symptoms. Finding a correct “diagnosis is extremely
hard” according to Mark L Graber, a fellow at research institute international. One
research study cited that out of 12 million people, 5 percent are misdiagnosed annually.
Misdiagnosis is under researched point of patient safety. A way to combat misdiagnosis
is to find a second opinion, however it is not guaranteeing a correct diagnosis. Many
patients with serious conditions are misdiagnosed which can lead to in worst case death.
Even though short term, it will cost more money: long term, there is no price on life. All
doctors make cognitive mistakes because they are all human, but receiving a second
opinion is beneficial to the patient. Lenny Bernstein, the author of this article, researches
 and writes news articles for the Washington Post, focusing on medical news (ebola,
planned parenthood, etc.).

Application to Research: Article

In the article, he mentions and quotes esteemed professionals. One of whom is Mark L.
Graber, a Stanford University School of Medicine. This article highlights statistics of
misdiagnosis and possible causes and temporary solutions.

Chantran, Kavita, and Tan Ee Lyn. "Lack of medical workers causes new health
crisis in developing countries." ​The New York TImes​, 1 Oct. 2008,
www.nytimes.com/2008/10/01/world/asia/01iht-medical.1.16607251.html.
Accessed 12 Oct. 2018.

Summary: Article
In many third world countries, there are not enough doctors or nurses in ratio to the
population. In India especially, there is a lack of doctors causing many in need of
medical attention to wait which could have detrimental effects. The author talks about a
certain instance of inadequate and inexperienced attention. Nivetha Biju watched her
baby turn blue as they rushed to the nearest hospital. The baby lost consciousness in the
emergency room while the uneducated nurses watched unsure of the course of action.
Luckily, help soon came and they were able to save the baby. Many hospitals lack
money and staff to help the people. Some wait in long lines for days to seek medical
attention. Many health care providers are underpaid, so many go overseas to work for
private companies with more benefits. The surplus of demand and lack of supply causes
less time for each patient which causes more error.

Application to Research: Article

Both authors have been journalists for ten plus years. There are also some credible
people mentioned such as Loone Gangte and Dr. Sunita Maheshwari. These people come
from the healthcare system in third world countries showing reliability due to the first
hand experience.

Cherry, Kendra, and Steven Gans. “How Does the Hawthorne Effect Influence
Productivity?” ​Verywell Mind,​ Dotdash, 11 Nov. 2018,
www.verywellmind.com/what-is-the-hawthorne-effect-2795234.

Summary: Article
The original goal of the 1950s experiment was to see how the lighting affects the
productivity of the workers in Western Electric’s Hawthorne electric company.
However,
the researchers realized that there was much fluctuation in the productivity, not
correlating to the lighting at all, instead that the productivity increased when the
supervisors were there. In the University of Chicago, the students researched the validity
of this research, realizing that the increase in productivity was caused by other factors
too, not just supervision, therefore decreasing the validity and reliability of the
 experiment. Although this term is overused and misunderstood, it is a compilation of
other psychological effects including socially desirable phenomenon and maximal versus
typical performance.

Application to Research: Article

The articles cites a renowned psychologist, Rogelberg, as reference and reliability of
information. I think it is important to acknowledge the both side of the argument. In my
research and testing, I am relying on the Hawthorne effect to change their behavior and
increase the productivity and quality of debrief. Although this article disproves the
Hawthorne Effect, it acknowledges the effect of observer bias.

Couper, Keith. “Importance of Debriefing.” Received by Amilee Huang, 17 November,

2018.

Summary: Email
Keith Couper and I talked about hte GRADE policy which is a group in which he is a part
of. GRADE is a the grading​ of Recommendations Assessment, Development and
Evaluation. It is a collaboration of people to implement and address shortcomings of
the grading systems in healthcare. Many international organizations have already
implemented the GRADE approach. It is a way to rate the judgement and
recommendation of healthcare providers. It is a collaboration of people to implement and
address shortcomings of the grading systems in healthcare.

Application to Research: Email

I found Keith Couper through a systematic review article on debriefing to improve
outcomes from critical illnesses: a systematic review and meta-analysis. The debriefings
I use could be graded based on the GRADE system which is a universal way to grade
debriefings.

Davis, Shoshana. “Medical Misdiagnosis: How to Protect Yourself.” ​CBS News,​ CBS
Interactive, 11 May 2013,
www.cbsnews.com/news/medical-misdiagnosis-how-to-protect-yourself/​.

Summary: Video
Medical misdiagnosis is becoming more common, which can cause permanent damage or
even death. About 150,000 Americans are misdiagnosed per year (Journal of the
American Medical Association). Though there are many thoughts of the cause of
misdiagnosis, one main reason is the lack of a family doctor. Holly Phillips said “It used
to be that your doctor knew you, your mom, your sister, and if there was a change in your
symptoms, they picked it up right away.” If the doctor is more familiar with the patient,
he or she would realize the changes in their health leading to a more accurate diagnosis.
However, doctors are seeing an increasing amount of patients everyday, shortening the
appointments. They are also extremely busy, sometimes just quickly scanning a
diagnostic test without much thought, which has an increased chance of a misdiagnosis or
 missed symptom. One way to prevent this is by having a universal electronic medical file
of a patient smoothing out a kink in the health system. Each doctor would see the same
symptoms and file. Misdiagnosis are extremely common, more common than what most
think.

Application to Research: Video

The author, Shoshana Davis, works for CBS News. A medical contributor to CBS news
was also mentioned, Holly Phillips. She added a few quotes on the reasons of
misdiagnosis and the kinks of the healthcare system and some solutions. Davis also
refers to the Journal of the American Medical Association for statistics.

“Debriefing App.” ​SIMStation - Debriefing App​,

www.simstation.com/simDebriefingSW.html​.

Summary: Article
This article is an example of an app for facilitators that can be used for debriefing. It
consists of keywords and points that the facilitator and learner have to use. It says it
improves the efficiency and quality of video-supported debriefing. It can also be used to
go back to the video recording. It consists of keywords and points that the facilitator and
learner have to use. This could be revolutionary in the way that medical students and
facilitators debrief in a medical setting.

Application to Research: Article

This is extremely similar to recording videos which is what I proposed. I propose that
students record their debriefs and the recording will improve the efficiency of
debriefings. However, this is also another way of improving debriefs that is similar to
my method and that is using an app to help facilitate debriefings.

"Debriefing for Clinical Learning." ​Patient Safety Network​, Aug. 2018,

psnet.ahrq.gov/primers/primer/36/Debriefing-for-Clinical-Learning. Accessed
20 Oct. 2018.

Summary: Article
Debriefing is a conversation between two or more people to discuss mistakes, actions and
thought processes to encourage reflection for future patient care. It first developed in
medical simulation as a learning tool. The components of a debrief include reactions,
analysis and application. However in order to have an effective debrief, you need to
understand the reasoning behind the action and decisions, not just blame. A common
approach to a debrief include three questions. (I) What went well? (II) What did not go
well? (III) What can we do differently or what needs to change to improve care? There is
a leader who facilitates the group. Currently, debriefing is mostly part of medical
simulation, however it is a learning experience in multiple experiences. Real time
debriefing is effective but hard to implement due to the busy schedule of a doctor.

Application to Research: Article

 This article mentions many research projects and programs, including the American
Heart Association and the American Academy of Pediatrics. These are well known and
reliable organizations. This can help in future research on the definition of a debrief and
what questions a debrief entails. Also, the article gives an explanation of the usage of
debrief in current clinical settings.

Edelson, Dana P., and Barbara Litzingers. "Improving In-Hospital Cardiac Arrest
Process and Outcomes With Performance Debriefing." ​JAMA Network,​ 26 May
2008, jamanetwork.com/journals/jamainternalmedicine/fullarticle/414230.
Accessed 28 Nov. 2018.

Summary: Journal
Dana P. Edelson, Barbara Litzinger, and Vineet Arora conducted an experiment on
improving reactions of in-hospital cardiac arrest process and differentiating outcomes
with performance debriefing. They wanted to use debriefing of correct process of
cardiopulmonary resuscitation to see if it would improve clinical outcomes. The
debriefing type they used was real time audiovisual feedback during resuscitation
attempts and feedback from the defibrillator. The participants attended weekly debriefing
sessions led by attending physicians from the fields of cardiology, anesthesiology and
emergency medicine. there was a huge difference in the outcomes, cutting down the time
to resuscitate a person by 5 minutes and outcomes of the patients improved.

Application to Research: Journal

This article is written by three authors who are associated with the American Medical
Association. I would like to contact one of the authors to understand how they came
across this problem and if it has been implemented in any hospitals since this article was
due in 2008.

Elias, Paul. "Robot Birth Simulator Gaining Popularity."​ Arizona Daily Star (Tucson, AZ)​, 16
Apr. 2006​. SIRS Discoverer​, ​http://discoverer.prod.sirs.com​.

Summary: Article
Noelle is a type of mannequin that simulates birth and has been taken to Afghanistan and
California and in medical school or maternity wards. There are many models of Noelle,
the basic model and a computerized version that simulated live birth. The article gives an
example of an event where Noell was giving birth and a nurse came in and saw her
umbilical cord, which is a bad sign, so the nurse called code 777. It went on for 30
minutes and a 20 minute operation, which after gave birth to twins.

Application to Research: Article

This article gives me some examples of how mannequins are used in simulation to
improve and train nurses and doctors, especially in the field of maternity. The article also
mentions some famous simulation companies like Gaumard.

Fariduddin, Muhamad Nur, et al. “Effectiveness of Debriefing towards Healthcare

 Professionals’ Nontechnical Skills: A Critical Review.” ​Malaysian Journal of Health
Sciences / Jurnal Sains Kesihatan Malaysia​, vol. 16, no. 1, Jan. 2018, pp. 17–28.
EBSCOhost,​ doi:10.17576/JSKM-2018-1601-03.

Summary: Article
This is a research paper based on an original study on medical debriefings. Medical
debriefings and simulations have increased in importance overtime from primal
minimalistic mannequins to automated simulations containing real life people. The
research consists of a control group and eight other techniques of debriefing
differentiating by time, quantity of people and lack or presence of facilitator especially
for teaching nontechnical skills. The authors of the research conclude that debriefing is
an effective tool in teaching non technical skills as part of a learning process of mistake
and how to avoid them next time.

Application to Research: Article

This is an article on an original study with four well educated people. It is from the
Malaysian Journal of Health Sciences which shows that simulations and medical
debriefings affect the whole world rather than just America or most prestigious hospitals.
It also gives a baseline of maybe my own research.

Fisher, James, director. ​Non-Judgmental Debriefing of a Medical Simulation Scenario​.

YouTube​, YouTube, 4 July 2013, ​www.youtube.com/watch?v=tOyk3t338b0​.

Summary: Video
This is a video based on a scenario of an undergraduate medical student in a medical
simulation and an example of if he does a poor performance, what should the facilitator
say and to improve and help the student, but also not discourage. Helping the student is
necessary in order for improvement as what the debriefing and simulation does. This is a
video based on a scenario of an undergraduate medical student in a medical
simulation and an example of if he does a poor performance, what should the facilitator
say and to improve and help the student, but also not discourage.

Application to Research: Video

There are four authors ranging from education of MD to PhD. The article also cites over
nineteen other sources which shows the reliability and background research they did for
their reliable observational study.

Goldhammer, Jordan E., et al. “Use of Provider Debriefing to Improve Fast-Track

Extubation Rates Following Cardiac Surgery at an Academic Medical Center.”
American Journal of Medical Quality​, no. 2, 2018, p. 172. ​EBSCOhost,​
proxy-bc.researchport.umd.edu​/

Summary: Journal
This article is an observational research study to see the effect of debriefing on fast-track
 extubation rates after cardiac surgery in a medical center. The organizers created three
randomized groups of patients varying in age, end-stage renal disease, diabetes, reduced
ejection fraction, or operative procedure. They measured the effectiveness based on the
post operation intensive critical care unit time. In conclusion, the debriefings instigated
the doctors to think and the invaluable feedback between the different groups providing
the care for the patients in the intensive care unit, such as what was the delay for the
blood gas analysis, the postoperative opioid administration, and residual neuromuscular
blockade?

Application to Research: Journal

There are four authors ranging from education of MD to PhD. The article also cites over
nineteen other sources which shows the reliability and background research they did for
their reliable observational study. This article is form the American Journal of Medical
Quality. This article could help me develop my own original research project or
observational study.

Hanna, Debra R., and Maria Romana. "Debriefing after a Crisis." ​Nursing
Management,​ vol. 38, Aug. 2007, pp. 38-47.

Summary: Article
This article stresses the fact that debriefing is necessary after a traumatic event. After a
traumatic event, there is usually quietness, less conversation, and less responsiveness. A
critical event include workplace violence, terrorism, industrial accidents or other serious
events. A group session can last from 30 minutes to 3 hours. A debrief includes eight
stages: Introduction, fact gathering, reaction phase, symptom phase, stress response,
suggestions, incident phase, and referral phase. Debriefing helps the climate of the
healthcare environment and individual healthcare professionals and even the organization
of the team for improvement next time.

Application to Research: Article

Both of the authors are qualified, having an education level of PhD. I want to contact one
of the authors to gain more insight on the implementation into hospitals or medical
settings. In the article they mostly talked about theoretical events, however I also want to
see if the authors are able to implement it into the hospitals or other healthcare settings.

Heukelom, Jon N. Van, et al. “Comparison of Postsimulation Debriefing Versus

In-Simulation Debriefing in Medical Simulation.” ​Simulation in Healthcare: The
Journal of the Society for Simulation in Healthcare,​ vol. 5, no. 2, 2010, pp. 91–97.,
doi:10.1097/sih.0b013e3181be0d17.

Summary: Article
This article is from a peer edited journal in which it compares two different styles of
debriefing, already acknowledging that simulation is an integral part of a medical setting
 in order for improvement. It compares post-simulation debriefing and in-simulation
debriefing to see which method is more effective for the learner. The students thought
that the post-simulation debriefing was more effective than the interruptions during the
simulation, however both methods showed improvement from initial stance of the
learners. Both showed high scores with minimal difference between them, but the
learners thought otherwise.

Application to Research: Article

This made me acknowledge that there are multiple types of debriefing and therefore it
can be difficult to create a grading system based on the broad category of debriefing.
However, I am only listening to post-event debriefing therefore it is one type of category
and one grading system.

"High-Tech Mannequin Teaches Medics."​SIRS Discoverer,​ 30 Oct. 2000,

http://discoverer.prod.sirs.com​.

Summary: Website
This website describes a high tech mannequin called Stan which is a part of the Air Force
of the United States of America. He is able to simulate gunshot victim, a bomb victim
and even change the type of victim to vary the reaction of the nurses or doctors. They
can change his age and gender. This force’s doctors and nurses are thrown into the field
where there could be conditions that are not ideal. Stan could be used as part of a
medical situation where he was a bomb victim and the nurse or doctors have to go into
the field and figure out how to treat him with primitive tools or to move him.

Application to Research: Website

This website gives me a feel of how it can be used in not just the sterile medical field, but
also in the armed forces. This article plus my background of interning at Val G
Hemming Simulation Center, a medical simulation for armed forces.

Huang, Lucas. Personal interview. October 28, 2018.

Summary: Interview
In the interview, Lucas Huang talked about the effects of debriefing and the ideal debrief
does not include the word “Why?” because it puts many people on the defensive, where
as the effect of a debrief should be to work together and overcome mistakes as a group.
He reached out to a hospital in Adelaide, Australia to see if they would want to record
their debriefs. They got back to him a few months later and found that just the act of
recording debriefs improved their patient outcomes.

Application to Research: Interview

Lucas Huang is the cofounder of B-line Medical, a medical simulation software
company. He was an extremely thorough interview and maybe I could interview him
another time on more effects of debrief and the ideal debrief.
"Imperial College London: Imperial showcases work to improve patients' experience of NHS
services." ​ENP Newswire​, 12 July 2018. ​Science In Context​,
http://link.galegroup.com/apps/doc/A546274292/SCIC?u=elli29753&sid=SCIC&xid=b6
58293c​. Accessed 29 Oct. 2018.

Summary: Article from Journal

The Hub used medical simulation tools to improve patient care at St. Mary’s Hospital.
The Hub is directed by Professor Roger Kneebone and Dr Fernando Bello. This even
focused on robotics in the medical field. They used a specific robotic system called the
Mira system which uses technology to enable physiotherapy and rehabilitation services.
The Hub is an example of innovative technology that is slowly improving in our digital
age. It shows the revolutionary technology in order to improve healthcare, surgery and
the less invasive and effective surgeries.

Application to Research: Article from Journal

Dr Fernando Bello, a leader of the Hub, is renowned doctor that leads the organization to
improve the safety and efficiency of patient care. He also wants to in future endeavors of
the organization into adolescent mental health and vaginal examinations of pregnant
women.

"Imperial College London: Imperial showcases work to improve patients' experience of NHS
services." ​ENP Newswire​, 12 July 2018. ​Opposing Viewpoints in Context,​
http://link.galegroup.com/apps/doc/A546274292/OVIC?u=elli29753&sid=OVIC&xid=5
723f​855. Accessed 29 Oct. 2018.

Summary: Article from Journal

Virtual exercise games for rehabilitation and prostate cancer detection simulation is used
at St. Mary’s Hospital in order to improve the patient care. A huge contributor is The
Hub, an organization to lead the medical field by redesigning patient care and improve
the training of clinical staff. The game for patient care involves incentives to do correct
exercises for rehabilitation. There is also a simulation for doctors and nurses to perform
rectal examinations. They feel around for the sphincters and prostate to improve their
examination techniques.

Application to Research: Article from Journal

Dr Fernando Bello, a leader of the Hub, is renowned doctor that leads the organization to
improve the safety and efficiency of patient care. He also wants to in future endeavors of
the organization into adolescent mental health and paediatric physiotherapy.

Laushkina, Zhanna. “The Analysis of Factors Associated with Misdiagnosis Pneumonia

in TB Hospital.” ​European Respiratory Journal​, European Respiratory Society, 1
Sept. 2015, erj.ersjournals.com/content/46/suppl_59/PA1524.

Summary: Journal
 This article is part of the European Respiratory journal. The European Respiratory
Society created a research project based on factors with misdiagnosis pneumonia in TB
hospital. Essentially, tuberculosis(TB) and pneumonia are extremely similar and many
doctors misdiagnose pneumonia as pulmonary TB. When one comes into the hospital
with symptoms of TB or or pneumonia, the doctors take certain tests. Some tests include
a sputum test (symptom of tuberculosis), radiological tests (cavity pattern on chest x-ray),
auscultative lun changes, laboratory inflammatory hematological disturbances. All of
these tests can be used to differentiate TB and pneumonia. But because the lab tests of
the patients were similar to TB and pneumonia, there was a misinterpretation of the
information as TB instead of pneumonia because there is a high incidence of tuberculosis
in the United States of America. Cognitively, a doctor will reason that because there is
an increased chance of tuberculosis rather than pneumonia, they will conclude the disease
as TB.

Application to Research: Journal

Zhanna Laushkina, the author of this article, works in a TB Research Institute dealing
with the therapy and diagnosis of TB. She includes statistics of different factors that
could cause this misdiagnosis out of the 105 patients clinical records. This article is
helpful for the errors of precious doctors to differentiate between the diagnosis of
tuberculosis and pneumonia.

Levett-Jones, Tracy. “Importance of Debriefing.” Received by Amilee Huang, 18

November, 2018.

Summary: Email
Tracy Levett-Jones sent me an email about the importance of debriefing. Debriefing is
an integral component of simulation that has to be undertaken by skilled and trained
facilitators. The systematic review in which I found her as an author was designed to
provide an evidence based grading system. The facilitators would be judged on
effectiveness of simulation. However, the critical idea that was highlighted in her email
was that most types of debriefs are effective.

Application to Research: Email

I found Tracy Levett-Jones from an article called “The ​effectiveness of debriefing in
simulation-based learning for health professionals: A systematic review” from the JBI
Library of systematic reviews. This will be implemented in my paper as a part of my
own grading system of effectiveness of debriefing.

Paull, Douglas E., et al. “Briefing Guide Study: Preoperative Briefing and Postoperative
Debriefing Checklists in the Veterans Health Administration Medical Team
Training Program.” ​The American Journal of Surgery,​ vol. 200, no. 5, 2010, pp.
620–623., doi:10.1016/j.amjsurg.2010.07.011.

Summary: Article
 This article was based on a study by the authors in which they tested the outcomes of
checklist-driven preoperative briefings and postoperative debriefings in the Veterans
Health Administration. The outcomes included antibiotic and deep venous thrombosis
prophylaxis compliance rates before and after use of the checklist. The results include
checklist driven preoperative briefings and postoperative briefings are associated with
improvements in patient safety for surgical events.

Application to Research: Article

This is a research project based on many cited sources and statistics. There are over ten
cited sources, showing reliability and broad range of information. The author focuses on
natural science, applied biology and global development.

“Patient Safety And Health Care Management.” ​Advances in Health Care Management
Patient Safety and Health Care Management​, p. iii.,
doi:10.1016/s1474-8231(08)07017-1.

Summary: Video
Medical misdiagnosis is becoming more common, which can cause permanent damage or
even death. About 150,000 Americans are misdiagnosed per year (Journal of the
American Medical Association). Though there are many thoughts of the cause of
misdiagnosis, one main reason is the lack of a family doctor. Holly Phillips said “It used
to be that your doctor knew you, your mom, your sister, and if there was a change in your
symptoms, they picked it up right away.” If the doctor is more familiar with the patient,
he or she would realize the changes in their health leading to a more accurate diagnosis.
However, doctors are seeing an increasing amount of patients everyday, shortening the
appointments. They are also extremely busy, sometimes just quickly scanning a
diagnostic test without much thought, which has an increased chance of a misdiagnosis or
missed symptom. One way to prevent this is by having a universal electronic medical file
of a patient smoothing out a kink in the health system. Each doctor would see the same
symptoms and file. Misdiagnosis are extremely common, more common than what most
think.

Application to Research: Video

The author, Shoshana Davis, works for CBS News. A medical contributor to CBS news
was also mentioned, Holly Phillips. She added a few quotes on the reasons of
misdiagnosis and the kinks of the healthcare system and some solutions. Davis also
refers to the Journal of the American Medical Association for statistics.

Rota, Chris. "The Wrong Diagnosis: Why Infectious Disease Continues to Undermine
Africa‘s Development." ​The People, Ideas, and Things Journal,​ 2011,
pitjournal.unc.edu/article/wrong-diagnosis-why-infectious-disease-continues-undermine-
africa%E2%80%99s-development. Accessed 12 Oct. 2018.

Summary: Journal
 Infectious disease are no big deal in countries where there is an adequate healthcare
system, however in countries where there is a lack of fund, diseases are everyday. Africa
has improved since a century ago due to foreign financial help, however it is still an
everyday crisis. There are inadequate nutrition, lack of clean water, and communicable
diseases. Many times, patients are misdiagnosed with a deadly disease and given
antibiotics, however they do not even need it when there are others who need it more.
Doctors were also scared to keep giving people antibiotics, leading to death, when it is a
preventable death. Many of these diseases can be prevented, but with the contaminated
environment, lack of staff, and inadequate medicine.

Application to Research: Journal

This is a research project based on many cited sources and statistics. There are over ten
cited sources, showing reliability and broad range of information. The author focuses on
natural science, applied biology and global development. However, there is some bias
due to the article focusing on improvement which includes speculation. This article adds
to information on subject of medicine in developing countries.

Rudolph, Jenny W., et al. “Debriefing as Formative Assessment: Closing Performance

Gaps in Medical Education.” ​Academic Emergency Medicine​, vol. 15, no. 11, 3 Nov.
2008, pp. 1010–1016., doi:10.1111/j.1553-2712.2008.00248.x.

Summary: Journal
The article discusses and tests a four step debriefing process of ​1) note salient
performance gaps related to predetermined objectives, 2) provide feedback describing the
gap, 3) investigate the basis for the gap by exploring the frames and emotions
contributing to the current performance level, and 4) help close the performance gap
through discussion or targeted instruction about principles and skills relevant to
performance. The authors also propose that this four-step process can be used for
emergency department and other clinical departments as a way to assess debriefings.

Application to Research: Journal

I could use their assessment of debriefings in combination with the GRADE system in
order to create my own grading system in which I judge the effectiveness of debriefings
that I listen to.

Sjöberg, David, and Staffan Karp. “Video–Based Debriefing Enhances Reflection,

Motivation and Performance for Police Students in Realistic Scenario Training.”
Procedia - Social and Behavioral Sciences,​ vol. 46, 2012, pp. 2816–2824.,
doi:10.1016/j.sbspro.2012.05.570.

Summary: Journal
The article discusses and tests a debriefing process when recorded and not and how it
affected the learners actions and behaviors. The research shows that not only did the
debriefing improve, but also the motivation to do better and to train more. It also
increased the students reflection to have more possibilities of new methods and trainings
 to try. It is a good example of why we should record debriefs and why it is necessary to
not only improve motivation, but also the outcome of patients.

Application to Research: Journal

This is the same method and ideology of my idea and that video will change and enhance
the efficiency or in this case the reflection of the learner in the debrief. This will be very
helpful to me in the future because it is essentially the same project as I am doing except
in real life medical setting, not simulation.

Specter, Michael. “A Deadly Misdiagnosis.” ​The New Yorker​, The New Yorker, 19 June 2017,
www.newyorker.com/magazine/2010/11/15/a-deadly-misdiagnosis​.

Summary: Article
In the article “A Deadly Misdiagnosis,” Specter starts off with a story about Runi, a
mother who had a persistent cough and was diagnosed with tuberculosis. He then
continues the idea of misdiagnosis, especially in India. Tuberculosis is an extremely
often case in such a densely populated area, India. Around two million cases per year,
tuberculosis could have been a real possibility of Runi’s condition. However, a doctor
just drew blood and looked in a microscope, a non accurate type of test for tuberculosis.
This ended in a six month regimen where she actually ended up in worst shape,
developing tuberculosis. Spencer then goes into the progressions (actually more static)
evolution of tuberculosis testing. The most common test for tuberculosis is a sputum test,
which is still fairly inaccurate and takes a long time. There are resources that can
determine a positive or negative test within a few minutes, but there is unwillingness to
change even though people's lives are at stake.

Application to Research: Article

Giving insight on the effects of misdiagnosis, this article shows that they can be
detrimental to people’s health. It also cites many credible sources and organizations that
are active in the area.

“Summative Debriefing Video Review Process.” ​Center for Medical Simulation,​

harvardmedsim.org/resources/summative-debriefing-video-review-process/.

Summary: Article
In the article “Summative Debriefing Video Review Process,” the Center for Medical
SImulation (CMS) discusses the importance of debriefing and different necessary
products and things. ​In the center, there is an operating room, an intensive
care/emergency room and a surgical suite. The university joins a growing number of
institutions offering simulation as a foundation for their student’s medical education.
There are resources that can determine a positive or negative test within a few minutes,
but there is unwillingness to change even though people's lives are at stake.

Application to Research: Article

 Giving insight on the effects of debriefings and simulation, this article shows that many
things are necessary for debriefings. It also cites many credible sources and
organizations that are active in the area.

"Video games or surgery? Howard University launches new simulation center

(Video)." ​Washington Business Journal,​ uploaded by Tina Reed, 24 Jan. 2014,
www.bizjournals.com/washington/blog/2014/01/
howard-launches-medical-simulation.html. Accessed 15 Nov. 2018.

Summary: Video
Howard University launches a new simulation center spearheaded by Debra Ford, the
medical director of Howard University’s Simulation Center. The 6000 square feet center
consists of an environment simulating the hospital as a learning space for doctors and
medical students while eliminating the risk of harming real patients. Howard University
invested 5 million dollars in the simulation center hoping for a return in improvement of
its medical education. In the center, there is an operating room, an intensive
care/emergency room and a surgical suite. The university joins a growing number of
institutions offering simulation as a foundation for their student’s medical education.

Application to Research: Video

This is a video by Tina Reed, a staff reporter from washington business journal. The
video shows the simulation center’s director, Debra Ford. Debra Ford is a doctor
specializing in colon and rectal surgery. I want to contact her for an interview to see how
the simulation center has improved as it was launched in 2014.

Walsh, Kieran. ​Oxford Textbook of Medical Education​. Oxford: Oxford University Press, 2013.

Summary: Book
This book is about a broad curriculum of medical education, going through multiple
processes. It ranged from delivery of education, supervision, stages, selection,
assessment, quality, and what the author foresees in the future. In areas where the author
mentions simulation, the author talks about communication and learning procedures that
is applicable to my topic. There is also some simulation curriculum that the author
mentions that are examples of effective curriculums of teaching. The author also
mentions learning procedures using simulated patients or SPs.

Application to Research: Book

I think chapter 16 and 17 are the most important to me because they emphasize the idea
of simulated education and simulated patients or SPs. This will be helpful to me because
it is an official medical book of a prestigious university.

Zhang, Xiao Chi, et al. "A Novel Approach to Debriefing Medical Simulations: The
Six Thinking Hats." ​Cureus,​ vol. 10, no. 4, 27 Apr. 2018,
www.ncbi.nlm.nih.gov/pmc/articles/PMC6021188/. Accessed 15 Nov. 2018.
Summary: Journal
This article investigates a specific debriefing technique developed by Edward De Bono
called “The Six Thinking Hats.” Each of the six colored hats represent six unique
approaches to critical thinking. The white hat represents the facts; the red hat, emotions;
the black, judgement and weaknesses; the yellow hat, optimism; the green hat, creativity;
and the blue hat, facilitation. This technique was tested using two randomly chosen video
simulations and two junior faculty to facilitate the debrief who had learned the six
thinking hats technique. ​ Both the facilitators and participants felt that the strategy
helped the facilitators keep the conversation and flow of conversation organized and
easily followed by the participants.

Application to Research: Journal

There are five authors, education ranging from MD to PhD and all from the department
of emergency medicine of Thomas Jefferson University. The article explained the
background, testing and conclusion of the experiment they conducted. I want to contact
one of the authors for more information on this experiment and other types of strategies
for effective debriefs.