Simulation-based summative assessment in healthcare: an overview of key principles for practice

Assessment Tools for Evaluating Pharmacy Students' Knowledge on HIV Prophylaxis: A Scoping Review

OBJECTIVES

This study aimed to identify and evaluate instruments used to measure pharmacy students' knowledge of HIV prophylaxis, focusing on both preexposure prophylaxis (PrEP) and postexposure prophylaxis.

METHODS

A systematic literature search was conducted using PubMed, Virtual Health Library, Web of Science, Scopus, ScienceDirect, and Embase. Article screening was performed independently by 2 reviewers. Studies assessing pharmacy students' knowledge of HIV prophylaxis were included.

FINDINGS

Eight studies involving 1,797 students, mostly from the U.S., were identified. All had a cross-sectional design, with only one assessing knowledge retention. Six assessment tools focused on PrEP, one on PEP, and one on both. While confidence in PrEP was evident, significant gaps were found in PEP awareness, prophylaxis access, and prescribing guidelines.

SUMMARY

There is a notable shortage of assessment tools for PEP. Further research is needed to develop validated instruments for measuring knowledge and addressing educational gaps. Longitudinal studies with pre- and post-tests are crucial to evaluate educational interventions and enhance pharmacy students' preparedness for HIV prophylaxis.

Contribution of simulation in paediatric laparoscopic surgery: improving suturing skills before performing a laparoscopic procedure in children

INTRODUCTION

Mastering paediatric laparoscopic surgery competency (PLSC) is technically challenging. The present study aimed to determine whether the inter-academic PLSC degree (IAD_PLSC) practical training program enables trainees to improve their skills.

METHODS

This retrospective study included trainees enrolled in the IAD_PLSC program in 2021 and 2022 which included two separate 12 h-sessions. Trainees practiced to perform intracorporeal laparoscopic knots (ILK) using 5- and 3-mm instruments on a pelvi-trainer simulator; Peg Transfer (PT) was used as a dexterity test; final marks added the adapted Objective Structured Assessment of Technical Skills (OSATS) score (out of 40) and time to complete ILK. ILK was considered a success in case the OSATS score > 27/40.

RESULTS

A total of 43 trainees completed the IAD_PLSC program. N = 37 (86.0%) mastered the ILK (OSATS score > 27/40) using 5-mm instruments at the end of session 1 and N = 33 (76.7%) at the end of session 2 (p = 0.41). There was no significant improvement in the median [interquartile range, IQR] OSATS score (32 [30-36] vs. 32 [28-34], p = 0.19), but the median [IQR] knot completion time improved significantly (184 s [161-268] vs. 166 s [128-218], p = 0.002). There was a significant correlation between the knot completion time and PT time at the end of session 1 (ρ = 0.58, 95% confidence interval, CI [0.31;0.76], p < 0.0002) and session 2 (ρ = 0.78, 95%CI [0.62;0.87], p < 0.0001). When using 3-mm instruments, N = 34 (79.1%) of trainees mastered the ILK at the end of session 2. The median [IQR] OSATS score significantly improved between the end of the two sessions (22 [21-24] vs. 31 [28-33], p < 0.0001), but there was no significant correlation between OSATS score or knot completion time and PT time, at the end of both sessions.

CONCLUSION

A nation-wide training program in paediatric laparoscopic surgery provides valuable practical training of intracorporeal suturing for residents in pediatric surgery and urology.

Pharmacy student perceptions of academically dishonest behavior in skills activities

INTRODUCTION

Academic dishonesty is prevalent across pharmacy education. Understanding student perceptions and engagement in academically dishonest behaviors across skills activities is important, as skills curricula are essential components in assessing APPE readiness. The objectives of this study were to assess pharmacy student perceptions of academically dishonest behavior within a skills curriculum and to determine if correlations exist between students' perceived wrongness of a described behavior and their willingness to engage in the behavior or past engagement in that described behavior.

METHODS

Students within a Doctor of Pharmacy program were asked to respond to an anonymous, electronic survey. The survey described 18 specific academically dishonest student behaviors across 12 skills scenarios. For each behavior, students were asked to indicate their perception of the wrongness of the behavior, their willingness to engage in the behavior, and if they had engaged in the behavior in the past. Descriptive statistics were completed to assess responses. Fisher analysis was used to compare "yes" responses to "no/not sure" responses for each question.

RESULTS

Students indicated general agreement that most described behaviors were wrong. There was <50% agreement in the wrongness of behaviors that described failing to report another student's academically dishonest behavior. Generally, students who agreed that a particular behavior was wrong were less likely to report willingness to engage in the behavior or past engagement in the behavior.

DISCUSSION

Generally, students in our cohort agreed that the presented actions across multiple skills activities were wrong, with less agreement regarding turning classmates in for academic dishonesty. Relatively small percentages of students responded that they had engaged in these activities in the past.

CONCLUSIONS

Understanding these perceptions, as well as students' willingness to engage in academic dishonesty, can guide instructors in communicating expectations regarding academic integrity within the skills curriculum.

Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey

PURPOSE

Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs.

METHODS

We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology from October 2019 to January 2020. The survey consisted of questions pertaining to the characteristics of the simulation centres, their faculty, learners, curriculum, and assessment processes.

RESULTS

All 17 residency training programs participated in the survey and reported large variability in the number and formal training of simulation faculty and in content delivery. Five programs (29%) did not provide faculty recognition for curriculum design and running simulation sessions. Most programs offered one to four simulation sessions per academic year for each year of residency. All programs offered mannequin-based and part-task trainers for teaching technical and nontechnical skills. Fourteen programs (82%) offered interprofessional and interdisciplinary simulation sessions, and ten programs (59%) did not include in situ simulation training. Commonly reported barriers to faculty involvement were lack of protected time (12 programs, 71%), lack of financial compensation (ten programs, 59%), and lack of appreciation for SBME (seven programs, 41%).

CONCLUSION

Large variability exists in the delivery of SBME in Canadian anesthesiology residency simulation programs, in part because of differences in financial/human resources and educational content. Future studies should explore whether training and patient outcomes differ between SBME programs and, if so, whether additional standardization is warranted.

Accessibility and satisfaction's analysis of simulation-based training in surgery for residents and surgical fellows in France

BACKGROUND

In surgery, simulated-based training improves the knowledge and interpersonal skills needed for surgeons to improve their performance and meet the "never the first time on a patient" imperative. The objective is to evaluate the effects of a 2017 reform on surgeon's accessibility to simulation-based training, five years after the implementation of the program, and to gauge surgeon satisfaction.

METHODS

A 27-item national online survey was sent to all surgical residents and fellows in the 13 surgical specialties.

RESULTS

Among 523 responses, 405 (77.4%) were residents and 118 (22.6%) were surgical fellows. Two hundred forty-seven (47.2%) of surgical residents and fellows stated they did not have a simulation structure or simulation program in the town of their university hospital center. Two hundred thirty-five (44.9%) reported having simulation training programs and 41 (7.8%) reported having easy and free access to their simulation structure. Regarding simulation-based training, 44.6% of surgical residents and fellows had never received training in technical skills on simulators, 82.2% had never received training in teamwork or interprofessional skills and 76.1% had never received training in behavioral or relational skills. There was a significant difference between the degree of satisfaction of residents at the beginning and at the end of the study (P=0.02).

CONCLUSION

Simulation is a well-established educational tool, but there are still strong inequalities between universities. Despite the national deployment of simulation-based teaching programs and institutional efforts, surgical simulation is insufficiently developed in France, and learner satisfaction is poor.

Simulation's Use Across the Clinical Landscape

Across the healthcare continuum simulation is routinely integrated into the curriculum for nurses and other professionals. The amount of simulation experienced at different points in the clinical setting highly depends on the specialty and organizational investment. The use of simulation in nursing can be divided into five specific use cases. Required and specialty certification courses include the following: Nurse Onboarding, Nurse Continuing Education, Regulatory & Joint Commission, and Interprofessional Education. Although common elements exist for each of the abovementioned use cases, there are distinct advantages, disadvantages, and implementation challenges with each that need to be considered.

Developing a competency framework for training with simulations in healthcare: a qualitative study

BACKGROUND

Simulation is a technique used to create an experience without going through the real event. Competency-based medical education focuses on outcomes and ensures professionals have the necessary knowledge, skills, and attitudes. The purpose of this study was to develop a set of competencies for the instructors providing basic and advanced levels of simulation-based training in healthcare.

METHODS

We conducted a qualitative study in three steps, with each next step building on and influenced by the previous one. First, we conducted a literature review, then a consensus development panel, and finally a three-step Delphi process. The participants were experts in the fields of healthcare, education, and simulations.

RESULTS

The six main competencies identified for the instructor providing simulation-based training at the basic level in healthcare include knowledge of simulation training, education/training development, education/training performance, human factors, ethics in simulation, and assessment. An instructor providing simulation-based training at an advanced level in healthcare should also possess the following five competencies: policies and procedures, organisation and coordination, research, quality improvement, and crisis management.

CONCLUSION

The identified competencies can serve as a valuable resource for simulation educators and organisations involved in simulation education, to plan curriculum and implement a continuous train-the-trainers programme.

Simulation in contemporary medical education: Current practices and the way forward

Integration of theoretical knowledge and practical skills is critical for effective medical education. Simulation is crucial in bridging the gap to prepare medical professionals for high-quality patient care in a safe environment. Simulation-based teaching has become the standard practice in medical education, especially in postgraduate courses like Anaesthesia. However, undergraduate medical education and other doctoral courses are still nascent. In line with the current National Medical Commission guidelines, it is imperative to complement the existing curriculum with a simulation-based approach as early as the first year of medical school. This review focuses on the current practices related to simulation-based medical education during undergraduate and postgraduate courses, particularly on anaesthesiology. We aim to discuss different types of simulation, the advantages of integration, students' perspectives, and the role of simulation in assessment and feedback. Finally, recommendations for future advancements of simulation in medical education and the way forward will be laid.

Crisis-ready educational skills of life support in newborns and adults' scenarios: the impact of simulation-based training on student proficiency

OBJECTIVE

Aim: To assess the impact of multidisciplinary simulation training on the educational outcomes of medical students in the emergency care of adults and newborns and implement changes in the curriculum to master simulation scenarios more.

PATIENTS AND METHODS

Materials and Methods: To assess the differences in learning outcomes between medical students who study the same curriculum without simulation interventions and those who undergo multidisciplinary emergency care simulation training. A quasi-experimental approach was used to assign students to the Intervention Group or the Control Group.

RESULTS

Results: According to individual criteria, the lowest scores in both groups were obtained for the stages that required the greatest accuracy and correct technique. After the appropriate cycle of initiation, the results in both groups improved significantly, but the results of students from the first group were significantly higher than those of students from the second group. Despite the absence of a significant difference in the average overall score for the skills, students in the first group significantly improved the accuracy and correctness of the criteria that assess the technical aspects of performance, while students in the second group mainly improved the quality of the descriptive and communicative parts of the practical skill.

CONCLUSION

Conclusions: We believe that reallocating curricular time to additional hours dedicated to simulation scenarios will better prepare aspiring healthcare professionals for the demanding and dynamic nature of their career, as we continue to increase our understanding of the potential of simulation-based education.