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Leslie K, Myles S, Alraja AA, Chiu P, Schiller CJ, Nelson S, Adams TL. Professional regulation in the digital era: A qualitative case study of three professions in Ontario, Canada. PLoS One 2024; 19:e0303192. [PMID: 38728239 PMCID: PMC11086820 DOI: 10.1371/journal.pone.0303192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
Technology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited. To examine the impact of technology and digitalization on regulation, we conducted an exploratory case study of the regulatory bodies for nursing, law, and social work in Ontario, Canada. Data were collected over two phases. First, we collected documents from the regulators' websites and regulatory consortiums. Second, we conducted key informant interviews with two representatives from each regulator. Data were thematically analyzed to explore the impact of technological change on regulatory activities and policies and to compare how regulatory structure and field shape this impact. Five themes were identified in our analysis: balancing efficiency potential with risks of certain technological advances; the potential for improving regulation through data analytics; considering how to regulate a technologically competent workforce; recalibrating pandemic emergency measures involving technology; and contemplating the future of technology on regulatory policy and practice. Regulators face ongoing challenges with providing equity-based approaches to regulating virtual practice, ensuring practitioners are technologically competent, and leveraging regulatory data to inform decision-making. Policymakers and regulators across Canada and internationally should prioritize risk-balanced policies, guidelines, and practice standards to support professional practice in the digital era.
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Affiliation(s)
- Kathleen Leslie
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Sophia Myles
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Abeer A. Alraja
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Patrick Chiu
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Catharine J. Schiller
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Sioban Nelson
- Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Tracey L. Adams
- Department of Sociology, Western University, London, Ontario, Canada
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Tunc EM, Caglar D, Ackley SH, Umoren R. Virtual Reality Simulation in Pediatric Resuscitation for Pre-hospital Providers. Cureus 2024; 16:e56090. [PMID: 38618441 PMCID: PMC11011234 DOI: 10.7759/cureus.56090] [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: 12/27/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024] Open
Abstract
This technical report explored the feasibility and utility of virtual reality (VR) pediatric resuscitation simulations for pre-hospital providers during their scheduled shifts. To our knowledge, neither the pediatric resuscitation VR simulation nor the feasibility of in situ, on-shift training with VR had been previously evaluated in pre-hospital providers. VR headset was available at an urban city fire station for 10 days where a total of 60 pre-hospital providers were scheduled to work. Providers were made aware of the VR module but no formal demonstration was done. There were no facilitators. Participants filled out an anonymous retrospective pre- and post-survey using a five-point Likert scale, rating their confidence from "not confident" to "very confident" in recognizing and managing pediatric emergencies. We found that VR simulation for pediatric resuscitation was a feasible training tool to use in situ as 63% of the providers were able to use it on shift. Furthermore, self-reported confidence increased after the training where responses of "very confident" increased from 20% to 30% for emergency medical technicians and 55% to 63% for paramedics.
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Affiliation(s)
- Emine M Tunc
- Department of Pediatrics, Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, USA
| | - Derya Caglar
- Department of Pediatrics, University of Washington School of Medicine/Seattle Children's Hospital, Seattle, USA
| | - S Heath Ackley
- Department of Pediatrics, University of Washington School of Medicine/Seattle Children's Hospital, Seattle, USA
| | - Rachel Umoren
- Department of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, USA
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Rutherford-Hemming T, Linder G. Exploring the Frameworks, Needs, and Barriers of Interprofessional Education and Simulation in Emergency Medicine. Simul Healthc 2024; 19:47-51. [PMID: 36727816 DOI: 10.1097/sih.0000000000000712] [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: 02/03/2023]
Abstract
SUMMARY STATEMENT This manuscript focuses on interprofessional education (IPE) using simulation and its use between emergency department and emergency medical services personnel. It explores the theoretical frameworks behind IPE and applies them to simulation-based emergency medical services education. There is a notable lack of research on the use of IPE using simulation between these 2 professions. The need for IPE using simulation as well as barriers and recommendations to remove the barriers are discussed.
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Affiliation(s)
- Tonya Rutherford-Hemming
- From the Emergency Department (T.R-H.), UNC Healthcare. Chapel Hill, NC; and Durham County EMS (G.L.), Durham, NC
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Simmons L, Kube E, Cortez E, Heron H, Gable B. Drive-thru continuing education to meet learners' needs. Surgery 2024; 175:311-316. [PMID: 37923672 DOI: 10.1016/j.surg.2023.09.013] [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: 03/16/2023] [Revised: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Continuing education is a requirement for emergency medical services practitioners in Ohio, and simulation-based learning has been effective for this purpose. Limitations to providing simulation for emergency medical services practitioners include a lack of simulation resources or equipment and a lack of trained simulationists to adequately use existing equipment, such as high-fidelity manikins. Here, we sought to provide simulation-based learning in the ambulance bays of our local hospitals to meet these needs. METHODS The OhioHealth simulation team, in conjunction with OhioHealth Emergency Medical Services, conducted simulation-based education sessions in ambulance bays scheduled in 2-h blocks for 3 consecutive days at 3 different hospitals in Columbus, Ohio. The outcomes of the education sessions were evaluated based on the ability to meet the educational objectives and the suitability of the environment for learning. In total, 171 learners completed educational sessions and evaluations. RESULTS Modified Likert scale surveys were completed by learners to assess their confidence in the learning objectives. For each session, the learners were able to meet the determined learning objectives after the education. Regarding the feasibility of using ambulance bays for education, 90% of learners (155/171) responded that they "Agree" or "Strongly Agree" that the environment was conducive to learning. CONCLUSION Using care site ambulance bays with simulation staff and content experts, we were able to effectively deliver simulation-based education. Based on learner perception and ability for education to meet its determined objectives, the ambulance bay provides a feasible way to address existing barriers (cost, access to equipment, and trained staff) to simulation-based education for emergency medical services practitioners.
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Affiliation(s)
| | - Erika Kube
- Mid-Ohio Emergency Services, Columbus, OH; Liberty Township Fire Department, Powell, OH; Concord Township Fire Department, Lake County, OH; Harlem Township Division of Fire, Galena, OH; Jerome Township Fire Department, Plain City, OH; Morrow County Emergency Services, Mount Gilead, OH
| | | | - Holly Heron
- OhioHealth Emergency Medical Services, Columbus, OH
| | - Brad Gable
- OhioHealth, Columbus, OH; Heritage College of Osteopathic Medicine, Ohio University, Athens, OH
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Andersson U, Boysen GN, Sterner A. Simulation-based education as a provider of fieldwork insights - experiences of ambulance nurse specialist students. BMC Nurs 2023; 22:485. [PMID: 38115025 PMCID: PMC10729564 DOI: 10.1186/s12912-023-01666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Medicine is facing a global shortage of nurses, including those with postgraduate education. One suggested educational method for undergraduate and postgraduate education, such as specialist ambulance nurse education, is simulation-based education (SBE). The implementation of SBE is motivated, in part, by the desire to attract and retain students, but also to contribute to student learning. Consequently, the use of SBE is increasing in specialist ambulance nurse education. The aim of this study was to explore how specialist ambulance nursing students experience SBE. METHODS This qualitative survey study involved the collection of study data using a purposefully designed, paper-based survey comprising five open-ended questions that required participant free-text answers. The answers were analysed using inductive content analysis and searching for descriptions of the participants' experiences. The survey was presented to 35 specialist ambulance nursing students. RESULTS The results are presented in two themes: SBE as learning and SBE as an educational method. Participating in SBE during the programme provides students with a realistic understanding of their future profession and its expected demands. The learning experience disregards prior work experience in ambulance services. CONCLUSIONS Based on the findings, conclusions are that SBE is an appreciated educational method among nursing students, regardless of their prior experience in the field of prehospital care. To some extent, this differs from previous research findings related to this subject. Furthermore, SBE contributes to the provision of field work insights, preparing the ambulance nurse specialist students.
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Affiliation(s)
- Ulf Andersson
- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden.
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, 501 90, Sweden.
| | - Gabriella Norberg Boysen
- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, 501 90, Sweden
| | - Anders Sterner
- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, 501 90, Sweden
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Pogson R, Henderson H, Holland M, Sumera A, Sumera K, Webster CA. Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review. MEDEDPUBLISH 2023; 13:207. [PMID: 38188096 PMCID: PMC10767249 DOI: 10.12688/mep.19758.1] [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] [Accepted: 09/08/2023] [Indexed: 01/09/2024] Open
Abstract
Background: With an increase in simulation being used in healthcare education, there is a need to ensure the quality of simulation-based education is high. This scoping review was conducted to answer the question: What are the current approaches to the evaluation of the quality of health-care simulation-based education provision? Methods: Databases PubMed, Cochrane, ERIC, CINAHL and Medline were searched in March 2023 to retrieve peer-reviewed healthcare research and review articles written in the English language within the last 20 years. All data were extracted from six studies, themed and presented in the main text and in tabular form. Results: Two scoping reviews, one systematic review and three research articles were included. Three main themes were found: adherence to existing design frameworks, lack of validation of these frameworks and lack of evaluation frameworks, and a proposed evaluation framework. Many of the excluded articles focussed on gaining participant feedback to evaluate simulation activities, rather than evaluating the quality of the design and implementation of the simulation. Conclusions: Benchmarking of current United Kingdom (UK) healthcare simulation against UK and international simulation standards is required to increase its quality, therefore, an agreed UK template framework to evaluate simulation packages is recommended.
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Affiliation(s)
- Rachel Pogson
- School of Medicine, Keele University, Keele, England, ST5 5BG, UK
| | - Helen Henderson
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Scotland, AB10 7QE, UK
| | - Matt Holland
- Library and Knowledge Service for NHS Ambulance Services in England, Bolton, BL1 5DD, UK
| | - Agnieszka Sumera
- Department of Acute Adult Care, University of Chester, Chester, England, CH1 4BJ, UK
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
| | - Kacper Sumera
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
- East Midlands Ambulance Service NHS Trust, Nottingham Trent University, Nottingham, England, NG11 8NS, UK
| | - Carl A. Webster
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
- Institute of Health and Allied Professions, Nottingham Trent University, Nottingham, England, NG11 8NS, UK
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Adamson HK, Chaka B, Hizzett K, Williment J, Hargan J. An exploration of communication skills development for student diagnostic radiographers using simulation-based training with a standardised patient: UK-based focus-group study. J Med Imaging Radiat Sci 2023; 54:465-472. [PMID: 37419724 DOI: 10.1016/j.jmir.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION Communication is an essential skill for all healthcare professionals but is particularly challenging for diagnostic radiographers since their role involves conveying extensive information within a relatively short amount of time. One method to develop communication skills in radiography is through simulation-based training using high fidelity simulation activities. The use of video recording for reflection and debriefing are also important elements that can be utilised to enhance learning. The aim of this project was to explore student radiographers' experiences of a simulation-based activity utilising a standardised patient designed to aid development of communication skills. METHODS Fifty-two undergraduate 3rd year diagnostic radiography students at a single Higher Education Institution undertook a simulation roleplay exercise with an expert by experience (EBE) who acted in an anxious manner in order to challenge the student's communication skills following the simulation, students received a debrief session where detailed feedback was provided from the EBE and an academic. Students were also able to watch their video of the simulation and reflect. Students were invited to participate in a focus group to discuss their experience and the learning they had developed and 12 students participated. Transcribed material from the focus groups was thematically analysed to deduce themes of learning developed and ways to improve for future simulations. FINDINGS Six main themes were identified from the thematic analysis of the transcripts from 12 diagnostic radiography students. These were patient care, radiographer's role and responsibilities, personal development, feelings, fidelity, and pedagogy. The themes represented the key learning points expressed by students and also aspects of the simulation which could be improved. Overall, the simulation provided a positive learning experience for the students. Having a video recording of the scenario was regarded as beneficial to enable a depth of reflection on non-verbal communication skills, which would be beneficial in future simulation scenarios. Students were aware that even though they used appropriate language their overall manner affected the interaction with the expert by experience more significantly. Students also considered methods to improve their communication if they encountered a similar patient interaction in their future practice. CONCLUSION There is great potential for simulation-based training in developing communication skills for diagnostic radiography students. EBEs are a vital addition to simulation and educational activities in Higher Education Institutions and should be involved with the design of simulation activities also, as they can bring unique patient insight.
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Affiliation(s)
- H K Adamson
- Diagnostic Radiography, University of Bradford, Mid Yorkshire NHS Trust, United Kingdom.
| | - B Chaka
- Diagnostic Radiography, University of Bradford, United Kingdom
| | - K Hizzett
- Diagnostic Radiography, University of Bradford, United Kingdom
| | - J Williment
- University of Bradford, Bradford, United Kingdom
| | - J Hargan
- University of Bradford, United Kingdom
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Laari L, Duma SE. Barriers to nurses health advocacy role. Nurs Ethics 2023; 30:844-856. [PMID: 36999769 DOI: 10.1177/09697330221146241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role. RESEARCH QUESTION What would cause nurses to take no action when they witness situations that require them to act as health advocates for their clients or communities? RESEARCH DESIGN An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis. PARTICIPANTS AND RESEARCH CONTEXT Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions. ETHICAL CONSIDERATIONS The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study. FINDINGS Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role. CONCLUSIONS Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates.
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Affiliation(s)
- Luke Laari
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sinegugu E Duma
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Davidson TJ, Waxenegger H, Mohamed I, McConnell DS, Sanderson PM. SPECTRa: An Online Tool for Simulating Prehospital Patient Care. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:375-394. [PMID: 35437057 DOI: 10.1177/19375867221090984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To (1) develop a simulation software environment to conduct prehospital research during the COVID-19 pandemic on paramedics' teamwork and use of mobile computing devices, and (2) establish its feasibility for use as a research and training tool. BACKGROUND Simulation-based research and training for prehospital environments has typically used live simulation, with highly realistic equipment and technology-enhanced manikins. However, such simulations are expensive, difficult to replicate, and require facilitators and participants to be at the same location. Although virtual simulation tools exist for prehospital care, it is unclear how best to use them for research and training. METHODS We present SPECTRa-Simulated Prehospital Emergency Care for Team Research-an online simulated prehospital environment that lets participants care concurrently for single or multiple patients remotely. Patient scenarios are designed using Laerdal's SimDesigner. SPECTRa records data about scenario states and participants' virtual interaction with the simulated patients. SPECTRa's supporting environment records participants' verbal communication and their visual and physical interactions with their interface and devices using Zoom conferencing and audiovisual recording. We discuss a pilot research implementation to assess SPECTRa's feasibility. RESULTS SPECTRa allows researchers to systematically test small-team interaction in single- or multipatient care scenarios and assess the impact of mobile devices on participants' assessment and care of patients. SPECTRa also supports pedagogical features that could allow prehospital educators to provide individual trainees or teams with online simulation training and evaluation. CONCLUSIONS SPECTRa, an online tool for simulating prehospital patient care, shows potential for remote healthcare research and training.
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Affiliation(s)
- Thomas J Davidson
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Harald Waxenegger
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Ismail Mohamed
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Duncan S McConnell
- School of Medicine, Griffith University, Nathan, Queensland, Australia.,St John Ambulance, Casuarina, Northern Territory, Australia
| | - Penelope M Sanderson
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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