Standardized Patients Portraying Parents in Pediatric End-of-Life Simulation

Using Simulation Exercises to Deal With the Death of a Child as Part of Healthcare Studies

BACKGROUND

Almost all healthcare professionals find themselves in a situation where they witness death in their work. Meeting a family in crisis is challenging for healthcare professionals and students. Simulation is an effective tool to practice complex and emotionally challenging situations in healthcare education.

METHODS

The aims of the study were to find out what challenges healthcare students experience when facing a family in crisis and to assess the usability of simulation in teaching healthcare students how to manage this situation. Voluntary simulations for paramedic students and medical students (a total of 29 students) were held in the autumn of 2021. Before and after the simulations, the students evaluated their skills to meet a family in crisis (the loss of a child) with the help of a questionnaire that contained mostly open-ended questions. The study was completed using a qualitative method.

RESULTS

The challenges raised by our students were divided into three categories: child-, family-, and self/student-related. Child-related challenges included the developmental stage which impacted communication. Family-related challenges included family members' different reactions to a devastating situation. Student/self-related challenges were few previous child contacts, communication with the family, and a situation that requires paying attention to multiple things at the same time.

CONCLUSION

According to our study, the students find simulation as a useful method for preparing to communicate with a family in crisis. The students see that with the help of simulation, they can practice different modes of operation and communication when facing a family in crisis. They also have the possibility to think about the processing of their own emotions during a crisis.

Vicarious learning and communication self-efficacy: A pediatric end-of-life simulation for pre-licensure nursing students

BACKGROUND

End-of-life clinical experiences, particularly in pediatrics, are quite limited for pre-licensure nursing students. Though effective, end-of-life simulations can be costly, require facilitators trained in palliative and end-of-life care, and are restricted by limited space and time availability. Such barriers prompt the question as to whether there is an effective alternative to simulation by which students can gain improved self-efficacy in therapeutic communication during pediatric end-of-life situations.

PURPOSE

Bandura's Social Cognitive Theory and work exploring self-efficacy posits that vicarious learning provides learners opportunities to gain experience and knowledge through observation of peers in simulated settings. This study evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students' perceived self-efficacy in providing therapeutic communication during a pediatric end-of-life situation.

METHOD

Data were collected over three time points - pre-simulation, post-simulation, and post-debriefing - using a modified Self-Efficacy in Communication Scale.

RESULTS

Learners in both groups had significant improvement in self-efficacy across all time points. Only two items had significant differences between vicarious and active learner groups, but the effect was minor.

CONCLUSION

Vicarious learning presents as a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric end-of-life simulations during both the scenario and debriefing.

Investigating the Effectiveness of Using a Situated Simulation-Based Program to Improve Occupational Therapy Students' Interactions and Observation Skills with Children

Purpose

Interaction and observation are critical skills for occupational therapists who work with pediatric clients. The objective of this study was to investigate whether using standardized child patients within a situated simulation-based (SSB) program increases students' knowledge and clinical skills when working with children in occupational therapy.

Materials and Methods

This controlled trial with multiple measures recruited students from the pediatric occupational therapy curriculum enrolled in an SSB program in consecutive academic years (n = 62). Experimental group students participated in a simulation experience with video training sessions, followed by an SSB exam with standardized child patients; the control group performed the video training simultaneously. Quantitative outcomes included quizzes to measure clinical knowledge, video training scores, and a situated simulation exam to assess clinical skills.

Results

The experimental group had a significantly higher postwritten quiz scores than the control group; the video training scores were not significantly different between groups. Linear regression analysis showed a significant association between the SSB exam and postwritten quiz scores (β = 0.487, p = 0.017). The experimental group had a total pass rate of 65.6% for the SSB exam. The communication and interaction pass rate was 53.1%; the basic evaluation rate was 68.8%, implying that communication/interaction skills are hard to simulate from video training alone; therefore, the authentic fidelity of the SSB program needs to improve further to enhance learning.

Conclusions

The SSB program with standardized child patients improved students' clinical knowledge and skills more than lectures and practice alone. Using standardized child patients in programs or exams appears to positively influence students' performance. Situated simulation-based learning that allows the realistic practice of observation and communication skills may enhance students' clinical competency. Future research should develop standard training methods and evaluation processes in high-fidelity simulations for generalized use in other occupational therapy programs.

Engaging Children as Simulated Patients in Healthcare Education

STATEMENT

The value of "simulation" as a learning strategy is well established among healthcare professionals (Educ Prim Care 2015; 26(4):242-7). The use of "simulated patients (SPs)" to present real-world scenarios provides opportunities for students to develop "soft skills," including interpersonal communication, critical thinking, and problem solving. These skills are particularly relevant in pediatric care, where healthcare providers must consider the patient's cognitive development, emotional state, and familial context. This article focuses on middle childhood (6-12 years) a distinctive developmental stage between 2 major developmental transition stages: infancy and adolescence. Middle childhood is associated with compulsory school attendance, developing skills in self-discipline, conflict resolution, and decision-making. Child SPs can play an important role in healthcare education providing direct insight into this unique period of development. They can contribute to the design and delivery of simulations to increase fidelity and provide meaningful real-time feedback to learners on children's experience of the healthcare system. Despite children's expertise and particular care delivery needs, documented simulations using child SPs are limited. This article considers the role of child SPs to support a case for further research into the value of engaging middle years children in the development and delivery of "simulation-based learning experiences". It addresses the gap in child-focused education, the challenges inherent in working with children and outlines strategies and guidelines for effective practice.

Improving Patient- and Family-Centered Communication in Pediatrics: A Review of Simulation-Based Learning

Patient- and family-centered care focuses on relationships among patients, families, and health care providers that are mutually beneficial and improve health care outcomes and provider satisfaction. Building relationships is a key component of the provision of excellent health care and can be taught and enhanced through simulation-based communication skills training. This article reviews the available literature on simulation-based learning as used to improve patient- and family- centered communication in the discipline of pediatrics. In this narrative review, we examine the various methods, theories, and frameworks on which simulation-based learning for communication skills are built with the goal of assisting pediatric providers in using this powerful educational technique. [Pediatr Ann. 2021;50(1):e32-e38.].