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Mitchell S, Blanchard E, Curran V, Hoadley T, Donoghue A, Lockey A. Effects of Simulation Fidelity on Health Care Providers on Team Training-A Systematic Review. Simul Healthc 2024; 19:S50-S56. [PMID: 38240618 DOI: 10.1097/sih.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT This systematic review, following PRISMA standards, aimed to assess the effectiveness of higher versus lower fidelity simulation on health care providers engaged in team training. A comprehensive search from January 1, 2011 to January 24, 2023 identified 1390 studies of which 14 randomized (n = 1530) and 5 case controlled (n = 257) studies met the inclusion criteria. The certainty of evidence was very low due to a high risk of bias and inconsistency. Heterogeneity prevented any metaanalysis. Limited evidence showed benefit for confidence, technical skills, and nontechnical skills. No significant difference was found in knowledge outcomes and teamwork abilities between lower and higher fidelity simulation. Participants reported higher satisfaction but also higher stress with higher fidelity materials. Both higher and lower fidelity simulation can be beneficial for team training, with higher fidelity simulation preferred by participants if resources allow. Standardizing definitions and outcomes, as well as conducting robust cost-comparative analyses, are important for future research.
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Affiliation(s)
- Sally Mitchell
- From the Department of Anesthesia (S.M.), Indiana University, Bloomington, IN; Department of Health Services Administration (E.B.), School of Health Professions, University of Alabama at Birmingham, Birmingham, AL; Faculty of Medicine (V.C.), Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada; Saint Francis Medical Center College of Nursing (T.H.), Peoria, IL; University of Pennsylvania Perelman School of Medicine (A.D.), Philadelphia, PA; Department of Emergency Medicine (A.L.), Calderdale & Huddersfield NHS Trust, Halifax, Huddersfield, UK; and School of Human and Health Sciences (A.L.), University of Huddersfield, Huddersfield, UK
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Stefanidis D, Cook D, Kalantar-Motamedi SM, Muret-Wagstaff S, Calhoun AW, Lauridsen KG, Paige JT, Lockey A, Donoghue A, Hall AK, Patocka C, Palaganas J, Gross IT, Kessler D, Vermylen J, Lin Y, Aebersold M, Chang TP, Duff J, Kolbe M, Rutherford-Hemming T, Decker S, Collings A, Toseef Ansari M. Society for Simulation in Healthcare Guidelines for Simulation Training. Simul Healthc 2024; 19:S4-S22. [PMID: 38240614 DOI: 10.1097/sih.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Simulation has become a staple in the training of healthcare professionals with accumulating evidence on its effectiveness. However, guidelines for optimal methods of simulation training do not currently exist. METHODS Systematic reviews of the literature on 16 identified key questions were conducted and expert panel consensus recommendations determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. OBJECTIVE These evidence-based guidelines from the Society for Simulation in Healthcare intend to support healthcare professionals in decisions on the most effective methods for simulation training in healthcare. RESULTS Twenty recommendations on 16 questions were determined using GRADE. Four expert recommendations were also provided. CONCLUSIONS The first evidence-based guidelines for simulation training are provided to guide instructors and learners on the most effective use of simulation in healthcare.
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Affiliation(s)
- Dimitrios Stefanidis
- From the Department of Surgery (D.S., S.-M.K.-M.), Indiana University School of Medicine, Indianapolis, IN; Department of Internal Medicine (D.C.), Mayo Clinic, Rochester, MN; Department of Surgery (S.M.-W.), Emory University, Atlanta, GA; Department of Pediatrics (A.W.C.), University of Louisville School of Medicine and Norton Children's Medical Group, Louisville, KY; Department of Medicine (K.G.L.), Randers Regional Hospital, Randers, Denmark; Research Center for Emergency Medicine (K.G.L.), Aarhus University, Aarhus, Denmark; Department of Surgery (J.T.P.), LSU Health New Orleans School of Medicine, New Orleans, LA; Emergency Department (A.L.), Calderdale and Huddersfield NHS Trust, Halifax; School of Human and Health Sciences (A.L.), University of Huddersfield, Huddersfield, UK; Critical Care Medicine and Pediatrics (A.D.), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Department of Emergency Medicine (A.K.H.), University of Ottawa, Ottawa, Ontario, Canada; Department of Emergency Medicine (C.P.), Cumming School of Medicine University of Calgary, Calgary, AB, Canada; Department of Health Professions Education (J.P.), School of Healthcare Leadership, MGH Institute of Health Professions, Boston, MA; Department of Pediatrics (I.T.G.), Section of Emergency Medicine, Yale University, New Haven, CT; Department of Emergency Medicine (D.K.), Columbia University Vagelos College of Physicians and Surgeons, New York, NY,; Department of Medicine and Medical Education (J.V.), Feinberg School of Medicine, Northwestern University, Chicago, IL; KidSIM Simulation Research Program (Y.L.), Alberta Children's Hospital, Calgary, Canada; University of Michigan School of Nursing (M.A.), Ann Arbor, MI; Las Madrinas Simulation Center, Children's Hospital (T.C.), University South California, Los Angeles, CA; Department of Pediatrics (J.D.), University of Alberta, Edmonton, Alberta, Canada; Simulation Center (M.K.), University Hospital Zurich, ETH Zurich, Switzerland; Department of Nursing (T.R.-H.), University of North Carolina, Chapel Hill, NC; Department of Nursing (S.D.), Texas Tech University Health Sciences Center, Lubbock, TX; Department of Surgery (A.C.), University of Louisville, Louisville, KY; and Independent Methodologist (M.T.A.), Ottawa, Ontario, Canada
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Torres K, Evans P, Mamcarz I, Radczuk N, Torres A. A manikin or human simulator-development of a tool for measuring students' perception. PeerJ 2022; 10:e14214. [PMID: 36530415 PMCID: PMC9753758 DOI: 10.7717/peerj.14214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 09/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background Education with the use of medical simulation may involve the use of two modalities: manikins or standardized patients (SPs) to meet specific learning objectives. We have collected students' opinions about the two modalities which can be helpful in planning and evaluating the curriculum process. Although reviews or comparisons of student opinions appear in the literature, it is difficult to find a scale that would be based on a comparison of specific effects that can be obtained in the educational process. In order to fill this gap, an attempt was made to construct a questionnaire. Methods An experimental version of a questionnaire measuring the final-year students' (273) opinions about the effectiveness of both simulation techniques has been designed on the basis of semi-structured interviews. They were conducted with 14 final-year students excluded from the subsequently analyzed cohort. The scale has been completed, tested and validated. Results The authors developed a 33-statement questionnaire which contain two scales: teaching medicine with the manikins and with the SPs. Two factors were identified for each scale: Doctor-patient relationship and practical aspects. The scales can be used complementary or separately, as the article reports independent statistics for each scale. The Cronbach's alpha coefficient for the manikin scale is 0.721 and for the SP scale is 0.758. Conclusions The questionnaire may be applied to medical students to identify their opinions about using manikins and SPs in teaching. It may have an important impact for planning curriculum and implementing particular modalities in accordance with the intended learning objectives.
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Affiliation(s)
- Kamil Torres
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Lubelskie, Poland
| | - Phillip Evans
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Lubelskie, Poland
| | - Izabela Mamcarz
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Lubelskie, Poland
| | - Natalia Radczuk
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Lubelskie, Poland
| | - Anna Torres
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Lubelskie, Poland
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Nicholas C, Sanko JS. Human Simulation in Nursing Education. ANNUAL REVIEW OF NURSING RESEARCH 2020; 39:53-79. [PMID: 33431637 DOI: 10.1891/0739-6686.39.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although, human simulation methodology has its origins in medical education, nursing education has increased its use of simulated patient (SP) methodology to improve the education of nursing students across the curricula. This chapter will review the history of human simulation, introduce the human simulation continuum, and review different applications of SP methodology in undergraduate and graduate nursing education.
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Shorten A, Ruppel H. Looking for zebras and finding horses: A qualitative narrative study of pre-RN licensure nursing Students' experience of a "normal" postnatal simulation. NURSE EDUCATION TODAY 2017; 48:185-189. [PMID: 27838493 DOI: 10.1016/j.nedt.2016.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 10/01/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Simulation-based learning may be particularly useful in specialty nursing clinical rotations, such as maternal-newborn care, where pre-RN licensure nursing students typically have fewer clinical hours or 'hands-on' opportunities. Although simulated obstetric emergencies are frequently reported in the literature, childbirth and the postnatal period involve normal physiologic processes, and therefore a focus on "normal" challenges in immersive perinatal simulations may provide students with vital uniform clinical learning experiences. OBJECTIVE To explore the value and meaning of an uncomplicated immersive postnatal simulation-based experience for pre-RN licensure nursing students. DESIGN Qualitative design using narrative analysis. SETTING Pre-RN licensure nursing program at a university in the northeastern United States. METHODS Narrative analysis was used to assess 229 written reflections from students following an uncomplicated, immersive postnatal simulation experience. RESULTS Themes identified through the analysis demonstrated that students experienced high anxiety in anticipation of the scenario, expecting a crisis to occur; students described looking for zebras as they searched for pathology but found "normality". Students derived confidence from performing assessments and making clinical decisions, moving from anxiety to relief as they concluded that the mother and infant were experiencing normal, rather than emergent, challenges of the postnatal period. CONCLUSION Most students found value in the experience, recognizing the importance of learning maternal-newborn nursing from a physiologic rather than pathologic perspective.
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Affiliation(s)
- Allison Shorten
- Yale School of Nursing, PO Box 27399, West Haven, CT 06516-7399, United States.
| | - Halley Ruppel
- Yale School of Nursing, PO Box 27399, West Haven, CT 06516-7399, United States.
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Tofil NM, Morris JL, Peterson DT, Watts P, Epps C, Harrington KF, Leon K, Pierce C, White ML. Interprofessional simulation training improves knowledge and teamwork in nursing and medical students during internal medicine clerkship. J Hosp Med 2014; 9:189-92. [PMID: 24420579 DOI: 10.1002/jhm.2126] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/04/2013] [Accepted: 11/07/2013] [Indexed: 01/03/2023]
Abstract
Simulation is effective at improving healthcare students' knowledge and communication. Despite increasingly interprofessional approaches to medicine, most studies demonstrate these effects in isolation. We enhanced an existing internal medicine curriculum with immersive interprofessional simulations. For ten months, third-year medical students and senior nursing students were recruited for four, 1-hour simulations. Scenarios included myocardial infarction, pancreatitis/hyperkalemia, upper gastrointestinal bleed, and chronic obstructive pulmonary disease exacerbation. After each scenario, experts in medicine, nursing, simulation, and adult learning facilitated a debriefing. Study measures included pre- and post-tests assessing self-efficacy, communication skills, and understanding of each profession's role. Seventy-two medical students and 30 nursing students participated. Self-efficacy communication scores improved for both (medicine, 18.9 ± 3.3 pretest vs 23.7 ± 3.7 post-test; nursing, 19.6 ± 2.7 pretest vs 24.5 ± 2.5 post-test). Both groups showed improvement in "confidence to correct another healthcare provider in a collaborative manner" (Δ = .97 medicine, Δ = 1.2 nursing). Medical students showed the most improvement in "confidence to close the loop in patient care" (Δ = .93). Nursing students showed the most improvement in "confidence to figure out roles" (Δ = 1.1). This study supports the hypothesis that interdisciplinary simulation improves each discipline's self-efficacy communication skills and understanding of each profession's role. Despite many barriers to interprofessional simulation, this model is being sustained.
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Affiliation(s)
- Nancy M Tofil
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Abstract
The 100-year anniversary of the Flexner report provides an opportunity to reflect on the future of medical education. We will consider the legacy of the original report, the centenary follow up to that report and consider how these, in concert with emerging learning theories, will influence medical education. We first provide a brief overview of the original Flexner report and review the recommendations of the 2010 centenary follow up to the report. We then discuss some of the major developments in learning theory and consider how they have influenced medical education. In general, there has been a gradual shift from passive to active methods, spurred in part by constructivist theories of learning. Many of the attitudes and skills required are particular strengths of the psychiatrist, making psychiatric educators particularly suitable to lead curricular change. Although much literature is devoted to determining the 'best' educational method, we take an ecumenical approach, suggesting that the various pedagogical approaches are all legitimate educational tools from which to choose. Each has its strength and limitations, and when designing a curriculum we should consider these when making pedagogical choices. We finish with some practical advice for those contemplating curricular change.
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Affiliation(s)
- Marcia L Verduin
- Department of Medical Education, College of Medicine, University of Central Florida, FL, USA
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