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Bajwa M, Herx-Weaver A, Baily S, Ray J, Park YS, Palaganas J, Ahmed R. Human factors considerations in distance simulation: A nominal group technique application. CLINICAL TEACHER 2024; 21:e13724. [PMID: 38301733 DOI: 10.1111/tct.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 11/24/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION The pandemic-driven surge in global distance simulation (DS) adoption highlighted the need for effective educator training. A literature search identified the gap regarding human factors (HF) considerations for the professional development of DS practitioners. This study addresses this gap by applying HF principles to guide educators in developing and delivering evidence-based DS. METHODS This was a consensus-gathering, three-phase study using the nominal group technique (NGT) in the first phase, qualitative thematic analysis with member checking in the second phase and external expert opinion in the third. A dichotomised approach was used to divide the post-consensus discussion survey results into an agreement and non-agreement for quantitative analysis. RESULTS The results of the quantitative analysis identified the following needs: developing a conceptual framework for DS, tailoring the technical aspect to the educational objectives, investigating learner engagement, training faculty at an earlier stage and identifying at-risk students. Qualitative results identified primary themes of technology, people and outcome measurements. Key aspects of technology were identified as system- and programme-fit and resource considerations. Outcome measurement highlights the need for increased measurement and research at all levels of DS. DISCUSSION Specific HF focal points include human-technology interaction and learning outcome assessment within the DS context. Incorporating HF principles throughout the DS process, from inception to outcome evaluation, promises substantial benefits for both learners and educators. This approach empowers both learners and educators, fostering a dynamic and enriched educational environment and improved learning experiences.
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Affiliation(s)
- Maria Bajwa
- MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Anne Herx-Weaver
- MGH Institute of Health Professions, Boston, Massachusetts, USA
- Fitchburg State University, Fitchburg, Massachusetts, USA
- UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Shannon Baily
- Center for Advanced Medical Learning and Simulation, University of South Florida, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Jessica Ray
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Yoon Soo Park
- Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Rami Ahmed
- MGH Institute of Health Professions, Boston, Massachusetts, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
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Palaganas JC, Mosher CJ, Morton A, Foronda C, Cheng A, Anderson T. Engagement in Distance Healthcare Simulation Debriefing: A Concept Development and Framework. Simul Healthc 2024:01266021-990000000-00118. [PMID: 38587332 DOI: 10.1097/sih.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
SUMMARY STATEMENT Understanding distance health care simulation debriefing is crucial in light of the increased use of and emerging technology in remote education for reasons of accessibility, global collaboration, and continuous professional development. This article is a confluence of a number of previously published studies designed to serve as a foundation to develop the concept of "engagement in health care distance simulation debriefing" using the Schwartz-Barcott & Kim hybrid mixed methods model. The model uses 3 phases: theoretical (a realist systematic review of the literature), fieldwork (3 exploratory studies and 2 pilot experimental studies), and analytical (analysis of the theoretical and fieldwork findings through expert discussion). This study defines the concept of "engagement in health care simulation distance debriefing" through exploration of its uses and analysis in literature, interviews, and expert review. The hybrid approach to the analysis provided rigor to generate a new, reflective conceptual model. This conceptual model defines the complexity in engagement during distance debriefing and helps shape the development of simulationists and debriefers, leading to more effective distance simulations and debriefings.
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Affiliation(s)
- Janice C Palaganas
- From the MGH Institute of Health Professions (J.C.P., C.J.M., A.M.), Boston, MA; Alfaisal University (C.J.M.), Riyadh, Saudi Arabia; Oxford Medical (A.M.); SimConverse (A.M.); University of Miami (C.F.), Coral Gables, FL; University of Calgary (A.C.), Calgary, Canada; and Athabasca University (T.A.), Athabasca, Canada
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Bajwa M, Ahmed R, Lababidi H, Morris M, Morton A, Mosher C, Wawersik D, Herx-Weaver A, Gross IT, Palaganas JC. Development of Distance Simulation Educator Guidelines in Healthcare: A Delphi Method Application. Simul Healthc 2024; 19:1-10. [PMID: 36598821 DOI: 10.1097/sih.0000000000000707] [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: 01/05/2023]
Abstract
INTRODUCTION The abrupt disruption of in-person instruction in health care during the COVID-19 pandemic resulted in the rapid adoption of distance simulation as an immediate alternative to providing in-person simulation-based education. This massive instructional shift, combined with the lack of educator training in this domain, led to challenges for both learners and educators. This study aimed to disseminate the first set of competencies required of and unique to effective distance simulation educators. METHODS This was a multiphasic and iterative modified Delphi study validating the content of carefully and rigorously synthesized literature. Experts were invited from around the globe to participate in this study with mandatory attendance at an annual health care simulation conference to openly discuss the guidelines presented as competencies in this document. We divided each competency into "Basic" and "Advanced" levels, and agreement was sought for these levels individually. The experts provided their opinion by choosing the options of "Keep, Modify, or Delete." A free-marginal kappa of 0.60 was chosen a priori. RESULTS At the conclusion of the Delphi process, the number of competencies changed from 66 to 59, basic subcompetencies from 216 to 196, and advanced subcompetencies from 179 to 182. CONCLUSIONS This article provides the first set of consensus guidelines to distance simulation educators in health care, and paved the way for further research in distance simulation as a modality.
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Affiliation(s)
- Maria Bajwa
- From the MGH Institute of Health Professions (M.B., R.A., H.L., M.M., A.M., A.H., J.C.P.), Boston, MA; Indiana University School of Medicine (R.A.), Indianapolis, IN; King Fahad Medical City (H.L.), Riyadh, Saudi Arabia; Nova Southeastern University (M.M.), Ft. Lauderdale, FL; Alfaisal University, College of Medicine (C.M.), Riyadh, Saudi Arabia; Henry Ford College (D.W.), Dearborn, MI; Fitchburg State University (A.H.), Fitchburg, MA; UMass Chan Medical School (A.H.), Worcester, MA; Yale University School of Medicine (I.T.G.), New Haven, CT; and Harvard Medical School (J.C.P.), Boston, MA
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Birido N, Brown KM, Olmo Ferrer D, Friedland R, Bailey SKT, Wawersik D, Charnetski M, Nair B, Kutzin JM, Gross IT, Palaganas JC. Health Care Simulation in Person and at a Distance: A Systematic Review. Simul Healthc 2024; 19:S65-S74. [PMID: 38240620 DOI: 10.1097/sih.0000000000000763] [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 Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as "mixed- distance simulation." A review of the distance simulation literature identified 10,929 articles. Screened by inclusion and exclusion criteria, 34 articles were ultimately included in this review. The findings of this review present positive and negative aspects of mixed-distance simulation formats, a description of the most frequent configurations related to delivery, terminology challenges, as well as future directions including the need for faculty development, methodological rigor, and reporting details.
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Affiliation(s)
- Nuha Birido
- From the Royal College of Surgeons in Ireland-Medical University of Bahrain (N.B., B.N.), Busaiteen, Bahrain; Johns Hopkins University School of Nursing (K.M.B.), Baltimore, MD; Norfolk and Norwich University (D.O.-F.), Norfolk, UK; University of South Florida (S.K.T.B.), Tampa, FL; Nova Southeastern University (D.W.), Fort Lauderdale, FL; Dartmouth Health (M.C.), Lebanon, NH; The Mount Sinai Hospital (J.M.K.). New York, NY; Yale University School of Medicine (I.T.G.), New Haven, CT; and MGH Institute of Health Professions (J.C.P.), Boston, MA
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Kolbe M, Goldhahn J, Useini M, Grande B. "Asking for help is a strength"-how to promote undergraduate medical students' teamwork through simulation training and interprofessional faculty. Front Psychol 2023; 14:1214091. [PMID: 37701867 PMCID: PMC10494543 DOI: 10.3389/fpsyg.2023.1214091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/01/2023] [Indexed: 09/14/2023] Open
Abstract
The ability to team up and safely work in any kind of healthcare team is a critical asset and should be taught early on in medical education. Medical students should be given the chance to "walk the talk" of teamwork by training and reflecting in teams. Our goal was to design, implement and evaluate the feasibility of a simulation-based teamwork training (TeamSIM) for undergraduate medical students that puts generic teamwork skills centerstage. We designed TeamSIM to include 12 learning objectives. For this pre-post, mixed-methods feasibility study, third-year medical students, organized in teams of 11-12 students, participated and observed each other in eight simulations of different clinical situation with varying degrees of complexity (e.g., deteriorating patient in ward; trauma; resuscitation). Guided by an interprofessional clinical faculty with simulation-based instructor training, student teams reflected on their shared experience in structured team debriefings. Using published instruments, we measured (a) students' reactions to TeamSIM and their perceptions of psychological safety via self-report, (b) their ongoing reflections via experience sampling, and (c) their teamwork skills via behavior observation. Ninety four students participated. They reported positive reactions to TeamSIM (M = 5.23, SD = 0.5). Their mean initial reported level of psychological safety was M = 3.8 (SD = 0.4) which rose to M = 4.3 (SD = 0.5) toward the end of the course [T(21) = -2.8, 95% CI -0.78 to-0.12, p = 0.011 (two-tailed)]. We obtained n = 314 headline reflections from the students and n = 95 from the faculty. For the students, the most frequent theme assigned to their headlines involved the concepts taught in the course such as "10 s for 10 min." For the faculty, the most frequent theme assigned to their headlines were reflections on how their simulation session worked for the students. The faculty rated students' teamwork skills higher after the last compared to the first debriefing. Undergraduate medical students can learn crucial teamwork skills in simulations supported by an experienced faculty and with a high degree of psychological safety. Both students and faculty appreciate the learning possibilities of simulation. At the same time, this learning can be challenging, intense and overwhelming. It takes a team to teach teamwork.
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Affiliation(s)
- Michaela Kolbe
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Jörg Goldhahn
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Mirdita Useini
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Bastian Grande
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
- Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland
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Morton A, J. Mosher C, C. Palaganas J. A Comparative Study of Debriefer Versus Debriefee Distance Simulation Engagement. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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