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Power T, Sheehy L, Lucas C, Bosco A, Wang B, Gavegan FL, Quast C, Patton V. Avoiding controversy: Considerations for point-of-view nursing simulations. Nurse Education Today 2024; 137:106166. [PMID: 38508020 DOI: 10.1016/j.nedt.2024.106166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
Point-of-view simulations involve participants engaging in simulation to experience what it might be like to live with a health condition or disability. These types of simulations have been used frequently in nurse education as a valuable pedagogical tool, as research has shown that student engagement with point-of-view simulations increases student empathy. However, point-of-view simulations have also been problematised by disability community members and scholars researching in the disability space, as ableist and culturally unsafe. This manuscript explores recommendations for, and criticisms of, point-of-view simulations and offers considerations to address these concerns.
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Affiliation(s)
- Tamara Power
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia.
| | - Louise Sheehy
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia
| | - Cherie Lucas
- School of Population Health, Faculty of Medicine and Health, Level 3, Samuels Building (F25), University of NSW, Bedegal Country, Sydney, NSW 2052, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney (Adjunct Fellow), 15 Broadway, Gadigal Country, Ultimo, NSW 2007, Australia
| | - Anna Bosco
- Curtin School of Nursing, Curtin University, Building 405, Whadjuk Country, Bentley, WA 6102, Australia
| | - Bangyun Wang
- Faculty of Medicine and Health, Central Sydney (Patyegarang) Precinct Clinical Skills and Simulation Education, Level 1, D18, Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW 2006, Australia
| | - Fiona Lee Gavegan
- Westmead Hospital, G2 Outpatients and Dermatology, Darug Country, NSW 2145, Australia
| | - Carol Quast
- NSW Stoma Ltd, Unit 5, 7-29 Bridge Rd, Gadigal Country, Stanmore, NSW 2048, Australia
| | - Vicki Patton
- Curtin University & Royal Perth Bentley Group, Royal Perth Hospital, Wellington Street, Whadjuk Country, Perth, WA 6000, Australia
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Coisy F, Olivier G, Ageron FX, Guillermou H, Roussel M, Balen F, Grau-Mercier L, Bobbia X. Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients? Eur J Emerg Med 2024; 31:188-194. [PMID: 38100643 DOI: 10.1097/mej.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND AND IMPORTANCE There seems to be evidence of gender and ethnic bias in the early management of acute coronary syndrome. However, whether these differences are related to less severe severity assessment or to less intensive management despite the same severity assessment has not yet been established. OBJECTIVE To show whether viewing an image with characters of different gender appearance or ethnic background changes the prioritization decision in the emergency triage area. METHODS The responders were offered a standardized clinical case in an emergency triage area. The associated image was randomized among eight standardized images of people presenting with chest pain and differing in gender and ethnic appearance (White, Black, North African and southeast Asian appearance). OUTCOME MEASURES AND ANALYSIS Each person was asked to respond to a single clinical case, in which the priority level [from 1 (requiring immediate treatment) to 5 (able to wait up to 2 h)] was assessed visually. Priority classes 1 and 2 for vital emergencies and classes 3-5 for nonvital emergencies were grouped together for analysis. RESULTS Among the 1563 respondents [mean age, 36 ± 10 years; 867 (55%) women], 777 (50%) were emergency physicians, 180 (11%) emergency medicine residents and 606 (39%) nurses. The priority levels for all responses were 1-5 : 180 (11%), 686 (44%), 539 (34%), 131 (9%) and 27 (2%). There was a higher reported priority in male compared to female [62% vs. 49%, difference 13% (95% confidence interval; CI 8-18%)]. Compared to White people, there was a lower reported priority for Black simulated patients [47% vs. 58%, difference -11% (95% CI -18% to -4%)] but not people of southeast Asian [55% vs. 58%, difference -3% (95% CI -10-5%)] and North African [61% vs. 58%, difference 3% (95% CI -4-10%)] appearance. CONCLUSION In this study, the visualization of simulated patients with different characteristics modified the prioritization decision. Compared to White patients, Black patients were less likely to receive emergency treatment. The same was true for women compared with men.
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Affiliation(s)
- Fabien Coisy
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, CHU de Nimes, University of Montpellier, Nimes, France
| | - Guillaume Olivier
- Department of Emergency Medicine, Montpellier University Hospital, Montpellier, France
| | | | - Hugo Guillermou
- IDESP, University of Montpellier and INSERM, Montpellier, France
| | - Mélanie Roussel
- Emergency Department, Rouen University Hospital, Rouen, France
| | - Frédéric Balen
- Emergency Department, Toulouse University Hospital, Toulouse, France
| | - Laura Grau-Mercier
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, CHU de Nimes, University of Montpellier, Nimes, France
| | - Xavier Bobbia
- Montpellier University, UR UM 103 (IMAGINE), Department of Emergency Medicine, Montpellier University Hospital, Montpellier, France
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Malik TG, Mahboob U, Khan RA, Alam R. Virtual patients versus standardized patients for improving clinical reasoning skills in ophthalmology residents. A randomized controlled trial. BMC Med Educ 2024; 24:429. [PMID: 38649884 PMCID: PMC11034047 DOI: 10.1186/s12909-024-05241-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/28/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND History taking and clinical reasoning are important skills that require knowledge, cognition and meta-cognition. It is important that a trainee must experience multiple encounters with different patients to practice these skills. However, patient safety is also important, and trainees are not allowed to handle critically ill patients. To address this issue, a randomized controlled trial was conducted to determine the effectiveness of using Virtual Patients (VP) versus Standardized Patients (SP) in acquiring clinical reasoning skills in ophthalmology postgraduate residents. METHODS Postgraduate residents from two hospitals in Lahore, Pakistan, were randomized to either the VP group or the SP group and were exposed to clinical reasoning exercise via the VP or SP for 30 min after the pretest. This was followed by a posttest. One month after this activity, a follow-up posttest was conducted. The data were collected and analysed using IBM-SPSS version 25. Repeated measures ANOVA was used to track the effect of learning skills over time. RESULTS The mean age of the residents was 28.5 ± 3 years. The male to female ratio was 1:1.1. For the SP group, the mean scores were 12.6 ± 3.08, 16.39 ± 3.01 and 15.39 ± 2.95, and for the VP group, the mean scores were 12.7 ± 3.84, 16.30 ± 3.19 and 15.65 ± 3.18 for the pretest, posttest and follow-up posttest, respectively (p value < 0.00). However, the difference between the VP and SP groups was not statistically significant (p = 0.896). Moreover, there was no statistically significant difference between the VP and SP groups regarding the retention of clinical reasoning ability. In terms of learning gain, compared with the VP group, the SP group had a score of 51.46% immediately after clinical reasoning exercise as compared to VP group, in which it was 49.1%. After one month, it was 38.01 in SP and 40.12% in VP group. CONCLUSION VPs can be used for learning clinical reasoning skills in postgraduate ophthalmology residents in a safe environment. These devices can be used repeatedly without any risk to the real patient. Although similarly useful, SP is limited by its nonavailability for repeated exercises.
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Affiliation(s)
- Tayyaba Gul Malik
- Masters in Medical Education (Scholar), University of Lahore, Lahore, Pakistan.
| | - Usman Mahboob
- Institute of Health Professions Education & Research, Khyber Medical University, Peshawar, Pakistan
| | - Rehan Ahmed Khan
- Dean Riphah Institute of Assessment, Riphah International University, Islamabad, Pakistan
| | - Rabail Alam
- IMBB, University of Lahore, Lahore, Punjab, Pakistan
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Zwep LB, Guo T, Nagler T, Knibbe CAJ, Meulman JJ, van Hasselt JGC. Virtual Patient Simulation Using Copula Modeling. Clin Pharmacol Ther 2024; 115:795-804. [PMID: 37946529 DOI: 10.1002/cpt.3099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
Virtual patient simulation is increasingly performed to support model-based optimization of clinical trial designs or individualized dosing strategies. Quantitative pharmacological models typically incorporate individual-level patient characteristics, or covariates, which enable the generation of virtual patient cohorts. The individual-level patient characteristics, or covariates, used as input for such simulations should accurately reflect the values seen in real patient populations. Current methods often make unrealistic assumptions about the correlation between patient's covariates or require direct access to actual data sets with individual-level patient data, which may often be limited by data sharing limitations. We propose and evaluate the use of copulas to address current shortcomings in simulation of patient-associated covariates for virtual patient simulations for model-based dose and trial optimization in clinical pharmacology. Copulas are multivariate distribution functions that can capture joint distributions, including the correlation, of covariate sets. We compare the performance of copulas to alternative simulation strategies, and we demonstrate their utility in several case studies. Our work demonstrates that copulas can reproduce realistic patient characteristics, both in terms of individual covariates and the dependence structure between different covariates, outperforming alternative methods, in particular when aiming to reproduce high-dimensional covariate sets. In conclusion, copulas represent a versatile and generalizable approach for virtual patient simulation which preserve relationships between covariates, and offer an open science strategy to facilitate re-use of patient data sets.
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Affiliation(s)
- Laura B Zwep
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Tingjie Guo
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Thomas Nagler
- Department of Statistics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Catherijne A J Knibbe
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jacqueline J Meulman
- LUXs Data Science, Leiden, The Netherlands
- Department of Statistics, Stanford University, Stanford, California, USA
| | - J G Coen van Hasselt
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
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Conway KA, Scoloveno RL. The Use of Standardized Patients as an Educational Strategy in Baccalaureate Psychiatric Nursing Simulation: A Mixed Method Pilot Study. J Am Psychiatr Nurses Assoc 2024; 30:414-417. [PMID: 35673847 DOI: 10.1177/10783903221101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Prior psychiatric simulation experiences required our nursing students to role-play in an unknown area of nursing. Students confidence, clinical satisfaction, and use of clinical skills were negatively impacted leading to unmet course objectives. The aim of this pilot study was to strengthen our baccalaureate senior nursing students' simulation experience in their psychiatric nursing course with the use of standardized patients (SPs) instead of student role-play and measure the impact of this strategy on students' learning, satisfaction, and confidence in an unfamiliar area of nursing. METHODS A mixed method explanatory sequential design was used. Participants consisted of a convenience sample of senior nursing students enrolled in their psychiatric nursing course. A quantitative simulation tool and a four-item questionnaire were analyzed after completion of the simulations (n = 47). RESULTS Findings of this study identified greater than 80% of students had increased level of learning, confidence, and satisfaction with the SP simulation experience. Nurse faculty were able to overcome simulation barriers, that is, a patient hearing voices, non-verbal signs of depression, and evaluate students meeting course learning outcomes. CONCLUSIONS Findings from this study highlight students' positive simulation experiences. Using SPs as an educational strategy can be effective for students to reach competency, achieve higher knowledge, and improve confidence. It is believed the use of SPs as a simulation strategy in psychiatric nursing will assist students with clinical judgment and better prepare them to meet the needs of vulnerable persons with psychiatric conditions.
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Affiliation(s)
- Kimberly A Conway
- Kimberly A Conway, PHD, RN-BC, CNE, Seton Hall University, Nutley, NJ, USA
| | - Robert L Scoloveno
- Robert L. Scoloveno, PhD, RN, CCRN, Seton Hall University, Nutley, NJ, USA
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Walshe N, Drennan J, Hegarty J, O'brien S, Crowley C, Ryng S, O'Connor P. A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study. Nurs Open 2024; 11:e2154. [PMID: 38606846 PMCID: PMC11010644 DOI: 10.1002/nop2.2154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/12/2023] [Accepted: 03/25/2024] [Indexed: 04/13/2024] Open
Abstract
AIM The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice. DESIGN A mixed methods cognitive task analysis with a convergent triangulation design. METHOD Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions. RESULTS The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic. REPORTING METHOD The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist. PATIENT OR PUBLIC CONTRIBUTION Patients and public were not involved in this research.
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Affiliation(s)
- Nuala Walshe
- Clinical Skills Simulation Resources Centre, School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Jonathan Drennan
- School of Nursing, Midwifery and Health SystemsUniversity College Dublin BelfieldDublin 4Ireland
| | | | - Sinéad O'brien
- Clinical Skills Simulation Resources Centre, School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Clare Crowley
- Clinical Skills Simulation Resources Centre, School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Stephanie Ryng
- Clinical Skills Simulation Resources Centre, School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Paul O'Connor
- Department of General PracticeNational University of IrelandNewcastle, Co GalwayIreland
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de Araújo Baptista VI, Braga LP, de Sousa Mata ÁN, Carreiro BO, Dos Santos Rosa LPG, de Morais HHA, de Azevedo GD, Appenzeller S. Validation of clinical simulation scenarios for the teaching of soft skills in child-centered care. BMC Med Educ 2024; 24:355. [PMID: 38553664 PMCID: PMC10981288 DOI: 10.1186/s12909-024-05284-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/11/2024] [Indexed: 04/01/2024]
Abstract
Consultations with children and their families are complex and require soft skills. However, there is a gap in the medical curriculum concerning these skills, especially as encounter training is often adult-centered. We developed, validated, and applied simulation scenarios that prioritize active participation of children to train soft skills in child-centered care for undergraduate medical students. This is a methodological study to develop three scenarios and a checklist of what is expected. The content was validated by 18 experts. A pre-test was carried out for adjustments. Then, the simulations were applied and evaluated by 18 medical undergraduate students. They included the participation of 6 pediatric simulated patients aged 9-12 years trained by a drama teacher. According to the results, the scenarios and checklist proved to be valid instruments in content terms (ICV-I > 0.8). The scripts were followed by the simulated pediatric patients, but they had difficulty mimicking a hypoactive state. Some were anxious, but everyone enjoyed participating in the feedback. The simulated parents had difficulty participating and giving space to the child's speech. Participants assessed that the simulations performed as they were proposed and, after experimenting them, felt more prepared. The simulations provided an opportunity for students to practice soft skills by interacting with children in a safe environment. Using children as simulated patients is feasible but presents some challenges. Our study has expanded the ways in which children's health content can be taught. We are investigating whether this training leads to better patient outcomes in real clinical settings.
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Affiliation(s)
- Vivianne Izabelle de Araújo Baptista
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil.
- Graduate Program in Child and Adolescent Health, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - Liliane Pereira Braga
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil
| | - Ádala Nayana de Sousa Mata
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil
| | - Bruno Oliveira Carreiro
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil
| | - Luiz Paulo Gomes Dos Santos Rosa
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil
| | | | - George Dantas de Azevedo
- Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Rio Grande Do Norte, Caicó, Brazil
| | - Simone Appenzeller
- Graduate Program in Child and Adolescent Health, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Department of Orthopedics, Rheumatology and Traumatology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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Rouse T, Gray B. Incorporating Bedside Shift Report in an Unfolding Simulation to Promote Clinical Judgment and Confidence in Nursing Students. Nurse Educ 2024; 49:79. [PMID: 37537700 DOI: 10.1097/nne.0000000000001487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Tresia Rouse
- By Tresia Rouse , MSN, RN, CNEn, and Brooke Gray , MSN, RN, C-EFM, University of Arkansas Fort Smith Carolyn McKelvey School of Nursing,
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Danieli PP, Hanson MD, VanRiper L, van Hoof MJ, Thomas I, Sibeoni J, Raats P, Prins C, Porter S, Piot MA, Nair B, Mian I, Leung K, Hibbard K, Billon G, Benoit L, Baker JD, Alleyne S, de Carvalho-Filho MA, Amsalem D, Martin A. Psychiatric Clinical Training Across Borders: Developing Virtual Communities of Practice Through International Co-constructive Patient Simulation. Acad Psychiatry 2024; 48:71-76. [PMID: 37789233 DOI: 10.1007/s40596-023-01880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Polina Perlman Danieli
- SickKids, The Hospital for Sick Children and Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mark D Hanson
- SickKids, The Hospital for Sick Children and Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Marie-José van Hoof
- iMindU GGZ, Leiden, The Netherlands
- University of Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Isaiah Thomas
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Jordan Sibeoni
- Service Universitaire de Psychiatrie de L'adolescent, Centre Hospitalier d'ArgenteuilUniversité Paris Cité, Paris, France
| | | | | | - Sara Porter
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Marie-Aude Piot
- Université de Paris-Cité, School of Medicine, Necker-Enfants Malades Academic Hospital - APHP, Paris, France
| | - Bina Nair
- University of Alberta, Edmonton, AB, Canada
| | - Irfan Mian
- SickKids, The Hospital for Sick Children and Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kitty Leung
- College of Medicine, University of Florida, Jacksonville, FL, USA
| | | | | | - Laelia Benoit
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - Doron Amsalem
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
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Cooper A, Iten R, Leslie GD, Barrett D, Lane M, Mould J, Hamsanathan P, Stokes S, Falconer P, Wood M, Cheesman S, Gill FJ. Using clinical simulation to assess a new paediatric ESCALATION system education package: Empirical research mixed methods. Nurs Open 2024; 11:e2100. [PMID: 38366769 PMCID: PMC10873682 DOI: 10.1002/nop2.2100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 02/18/2024] Open
Abstract
AIM The aim of the study was to assess the suitability of an online education package to prepare health professionals to use a new paediatric early warning system. DESIGN Quasi-experimental mixed methods using co-production. METHODS Participants completed the Package and participated in up to four clinical scenarios. Data were collected using self-report surveys, and during clinical scenarios; escalation of care, documentation, family involvement, communication handovers were assessed, and recorded debriefings were thematically analysed. Data were integrated using tabulated joint displays. RESULTS Eleven nurses and three doctors were recruited from three mixed adult and paediatric hospitals. Following completion of the Package and clinical scenarios 13/14 (93%) participants agreed preparedness and confidence to use the ESCALATION System had increased. For 53% handovers, the communication framework was followed, for 79% charts, documentation was complete. Participants engaged with the parent (actor) for 97% scenario interactions. The Package was effective and participation in clinical scenarios appeared to enhance learning. PATIENT OR PUBLIC CONTRIBUTION Consumers participated in the steering group overseeing the study and in the expert panel who reviewed the education package and clinical scenarios.
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Affiliation(s)
- Alannah Cooper
- School of Nursing, Faculty Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Rebecca Iten
- School of Nursing, Faculty Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | | | - David Barrett
- Postgraduate Medical EducationPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Marguerite Lane
- Nursing ResearchPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Jonathon Mould
- Postgraduate Medical EducationPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Prasanthy Hamsanathan
- Postgraduate Medical EducationPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Scott Stokes
- Kimberley Regional Paediatric ServiceBroome HospitalBroomeWestern AustraliaAustralia
| | - Pania Falconer
- School of Nursing, Faculty Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
- Nursing ResearchPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Margaret Wood
- Health consumer representativeChild and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Samantha Cheesman
- Health consumer representativeChild and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
| | - Fenella J. Gill
- Nursing ResearchPerth Children's Hospital, Child and Adolescent Health ServiceNedlandsWestern AustraliaAustralia
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Doyle AJ, Sullivan C, O'Toole M, Tjin A, Simiceva A, Collins N, Murphy P, Anderson MJ, Mulhall C, Condron C, Nestel D, MacAulay R, McNaughton N, Coffey F, Eppich W. Training simulated participants for role portrayal and feedback practices in communication skills training: A BEME scoping review: BEME Guide No. 86. Med Teach 2024; 46:162-178. [PMID: 37552799 DOI: 10.1080/0142159x.2023.2241621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND Providing feedback is a key aspect of simulated participants' (SPs) educational work. In teaching contexts, the ability to provide feedback to learners is central to their role. Suboptimal feedback practices may deny learners the valuable feedback they need to learn and improve. This scoping review systematically maps the evidence related to SPs' role as educators and identifies how SPs prepare for their role and feedback practices. METHODS The authors conducted a scoping review and included a group of international stakeholders with experience and expertise in SP methodology. Five online databases were systematically searched and ERIC, MedEdPortal and MedEdPublish were hand searched to identify relevant studies. Inclusion/exclusion criteria were developed. Data screening and subsequently data charting were performed in pairs. The results of data charting were thematically analysed including categories relating to the Association of SP Educators (ASPE) Standards of Best Practice (SOBP). RESULTS From 8179 articles identified for the title and abstract screening, 98 studies were included. Studies reported the benefit of SPs' authentic role portrayal and feedback interactions for learners and on the reported learning outcomes. Data was heterogeneous with a notable lack of consistency in the detail regarding the scenario formats for communication skills training interventions, SP characteristics, and approaches to training for feedback and role portrayal. CONCLUSIONS The published literature has considerable heterogeneity in reporting how SPs are prepared for role portrayal and feedback interactions. Additionally, our work has identified gaps in the implementation of the ASPE SOBP, which promotes effective SP-learner feedback interactions. Further research is required to identify effective applications of SP methodology to prepare SPs for their role as educators.
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Affiliation(s)
- Andrea J Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anna Tjin
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anastasija Simiceva
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Naoise Collins
- Department of Visual & Human Centred Computing, Dundalk Institute of Technology, Co. Louth
| | - Paul Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin Ireland
| | - Michael J Anderson
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Condron
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Debra Nestel
- School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia
- Department of Surgery, University of Melbourne, Australia
| | - Robert MacAulay
- School of Medicine, University of California San Diego, United States of America
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Frank Coffey
- DREEAM (Department of Research and Education in Emergency and Acute medicine, Nottingham University Hospitals' NHS Trust)
- School of Health Sciences, University of Nottingham, UK
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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12
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Daungsupawong H, Wiwanitkit V. Emotionally Responsive Virtual Patient Simulation. Simul Healthc 2024; 19:64. [PMID: 38153334 DOI: 10.1097/sih.0000000000000769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
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13
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Burt L, Clark L, Park C. Stronger together: learner reactions on a team-based, interprofessional first death simulation experience. J Interprof Care 2024; 38:95-103. [PMID: 37422861 DOI: 10.1080/13561820.2023.2232408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/08/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
Patient death is a common experience that may be traumatic for health care providers. Although current rates of burnout are high, evidence supports that interprofessional coping can improve clinician mental health. While health care simulation affords learners freedom of safety to participate in a variety of educational experiences, current application of simulation during patient death is limited to professional duties, without explicitly addressing learner emotional well-being. We designed a patient death simulation scenario within a supportive and reflective interprofessional environment to teach foundational coping and well-being strategies to preclinical nursing, medical, and pharmacy students. Sixty-one students participated in this team-based, First Death simulation experience. Debriefings were analyzed using qualitative inductive content analysis methodology. Students reacted to being part of an interprofessional team after having participated in simulation about the death of a patient as described by five categories: emotional awareness, communication insight, feeling stronger together, with role curiosity, and through reflections on support. Findings suggested that simulation is an effective teaching modality for mentoring interprofessional students on humanistic well-being strategies. Furthermore, the experience fostered reactions transcending interprofessional competencies, which are transferrable to future clinical practice.
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Affiliation(s)
- Leah Burt
- College of Nursing Department of Biobehavioral Nursing Science, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lou Clark
- M Simulation, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Park
- College of Medicine, Simulation and Integrative Learning (SAIL) Institute, University of Illinois, Chicago, Illinois, USA
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14
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Rutherford-Hemming T, Herrington A, Ngo TP. The Use of Standardized Patients to Teach Communication Skills-A Systematic Review. Simul Healthc 2024; 19:S122-S128. [PMID: 38240624 DOI: 10.1097/sih.0000000000000766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVES The aim of this systematic review was to synthesize research completed between 2011 and 2021 to report the current state of the science on the use of standardized patients (SPs) to teach communication skills. The research question that guided this study was, "Among health care professionals, does the use of SP methodology as a means of teaching communication skills result in improved learner knowledge, skills, attitudes, and/or patient outcomes when compared with other simulation methodologies?" DESIGN This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Data SourcesFour databases (CINAHL, Ovid Embase, Ovid Medline, and Scopus) were searched using a combination of medical subject headings, or Mesh terms, as well as keywords to retrieve nonindexed citations.Review MethodsThe inclusion criteria were broad to complete a comprehensive search of the literature. To be eligible for inclusion, a study had to be original research that compared simulation using an SP to another simulation methodology. The study had to evaluate communication knowledge, skill, attitude, and/or patient outcome with an academic or practicing health care professional. RESULTS The initial database search strategy yielded 8058 citations. These results were narrowed down to 18 studies through an in-depth analysis of each article using identified inclusion criteria. The SPs were superior to role play in 1 (33%, n = 3) study where knowledge was evaluated, 6 (75%, n = 8) studies where skills were evaluated, and 1 (20%, n = 5) study where attitude was evaluated. The SPs were compared with a manikin in 5 studies. The SPs were superior to a manikin in 3 (60%, n = 5) studies where knowledge was measured and in 1 (100%, n = 1) study where attitude was measured. No study measured the outcome knowledge of an SP to a manikin. Finally, SPs were compared with a virtual SP in 3 studies. When knowledge was evaluated, SPs were superior to a virtual SP in 1 study (100%, n = 1). When skills were evaluated, SPs were superior to a virtual SP in 1 study (50%, n = 2), and when attitude was evaluated, SPs were superior to a virtual SP in no study (0%, n = 2). No study evaluated patient outcomes in the comparison of an SP to another simulation methodology. CONCLUSIONS Studies show a weak indication that SP-based education is superior to other simulation methodologies in most contexts. However more rigorous studies with larger sample sizes, validated instruments, and effects on patient outcomes are needed to definitively determine the optimal method/modality for teaching communication to health care professionals.
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Affiliation(s)
- Tonya Rutherford-Hemming
- From the Emergency Department (T.R.-H.), UNC Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing (A.H.), Mississippi State University, Starkville, MS; and Philip R. Lee Institute for Health Policy Studies (T.P.N.), University of California, San Francisco, Mission Bay Campus Valley Tower, San Francisco, CA
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15
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Gardner AK, Rodgers DL, Steinert Y, Davis R, Condron C, Peterson DT, Rohra A, Viggers S, Eppich WJ, Reedy G. Mapping the Terrain of Faculty Development for Simulation: A Scoping Review. Simul Healthc 2024; 19:S75-S89. [PMID: 38240621 DOI: 10.1097/sih.0000000000000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.
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Affiliation(s)
- Aimee K Gardner
- From the Baylor College of Medicine (A.K.G., R.D., A.R.), Houston, TX; Indiana University School of Medicine (D.L.R.), Indianapolis, IN; McGill University, Faculty of Medicine and Health Sciences (Y.S.), Montréal, Canada; Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, RCSI SIM Center for Simulation Education and Research (C.C., W.J.E.), Dublin, Ireland; The University of Alabama at Birmingham (D.T.P.), Birmingham, AL; Copenhagen Academy for Medical Education and Simulation (S.V.), Copenhagen, Denmark; and King's College London (G.R.), London, United Kingdom
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16
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Tremblay ML. Embracing emotional disparities between simulation and real-life practice. Med Educ 2023; 57:1179-1181. [PMID: 37580915 DOI: 10.1111/medu.15188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 08/16/2023]
Abstract
This commentary addresses key aspects of the impact of emotions in simulation‐based training and disparities from real‐life. By exploring cognitive load and its influence on emotions, it sheds light on the intricacies of simulation and their implications.
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17
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Le Lous M, Dion L, Le Ray C. Simulation training for pelvic examination: A systematic review. J Gynecol Obstet Hum Reprod 2023; 52:102666. [PMID: 37739264 DOI: 10.1016/j.jogoh.2023.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Pelvic examination including vaginal digital examination and speculum inspection are crucial medical skills that are challenging to teach for both professors and students, because of its intimate nature. Consequently, education has shifted from a traditional approach to a simulation-enhanced education. This literature review summarizes the level of evidence for these not-so-new training modalities. METHODS For this systematic review, the Pudmed database have been consulted using the following keywords: (Pelvic examination OR Vaginal examination) AND simulation. Eligible studies had to be published in French or English within the past 20 years and investigate simulation training for pelvic examination in the field of gynecology and obstetrics. For each paper, the following outcomes were analyzed: Competence, confidence and communication, and were classified according to the Kirkpatrick hierarchy. RESULTS About competence, in initial training, one meta-analysis (9 studies of which 4 randomized studies) about pelvic examination teaching on procedural simulators have shown a significant benefit of simulation. One meta-analysis and one systematic review also demonstrated that Gynecological Teaching Associates (GTAs) teaching, who exist in Northern America and Scandinavian countries, was better that pelvic task trainers in terms of technical competence, and comfort. For the vaginal examination of women in labor, two randomized trials also showed a positive impact of pelvic task trainer on students' accuracy. CONCLUSION Simulation-enhanced education of pelvic examination brings a significant benefit in comparison to a classic education without simulation in terms of competence, confidence and communication. GTAs have the best impact on competence and communication, but they do not exist currently in France. Hybrid simulation (a patient actor combined with a pelvic task trainer) could be a solution to teach both technical skills and communication.
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Affiliation(s)
- Maela Le Lous
- Department of Obstetrics and Gynecology, University Hospital of Rennes, France; LTSI - INSERM UMR 1099, University of Rennes 1, Rennes F35000, France; Academic Visitor at University College of London, Institute for Women's Health, London, UK.
| | - Ludivine Dion
- Department of Obstetrics and Gynecology, University Hospital of Rennes, France
| | - Camille Le Ray
- Maternité Port-Royal, Groupe Hospitalier Paris Centre, AP-HP, Université Paris Cité, FHU Préma, 75014 Paris, France
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18
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Preiksaitis CM, Lee MO, Schertzer K. Creating a Safe Space for Simulation: Is it Time to Stop Calling Them Confederates? Simul Healthc 2023; 18:392-394. [PMID: 36455290 DOI: 10.1097/sih.0000000000000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
SUMMARY STATEMENT Use of the term "confederate" is often used in research literature to describe an individual allied with the research team. Confederate is used in simulation research to describe participants allied with the simulation facilitator. Confederate can also refer to the Confederate States of America and has connotations of racial injustice and slavery. Use of this term in simulation may adversely affect psychological safety of learners. Use of the term within the literature is a potential driver of use during simulation sessions. We completed a rapid review of the health care simulation literature to determine the frequency of the term confederate. From 2000 to 2021, 2635 uses of confederate were identified in 765 articles. There seems to be an increased trend in use of this word. We argue that alternative terms exist and should be used to maximize psychological safety of learners.
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Affiliation(s)
- Carl M Preiksaitis
- From the Department of Emergency Medicine (C.M.P., M.O.L., K.S.), Stanford University School of Medicine, Palo Alto, CA
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19
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Jiang S, Chen H, Wang X, Chen L, Luo B, Konge L, Du J, Huang H. A smartphone-based online platform for clinical skills training and assessment with standardized patients: platform development and pilot study outcomes. Med Educ Online 2023; 28:2187954. [PMID: 36908080 PMCID: PMC10013262 DOI: 10.1080/10872981.2023.2187954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
There are limitations and difficulties in the management of traditional in-person standardized patient (SP) practice. The latest developments in online communication tools and the COVID-19 pandemic have promoted the needs for online clinical skills training objectively. However, existing commercial online platforms may not meet the requests for SP-based medical simulation. This paper described the methodology applied to develop a smartphone-based online platform for the management of clinical skills training and assessment with remote SPs, and aimed to determine whether this new platform is acceptable or useful through a pilot run in September 2020. The post-run survey including questionnaire inspired by technological acceptance model and determinants of the perceived ease of use was used to assess the acceptability and usefulness of the platform. Twenty four-year students of clinical medicine participated in the pilot study with twenty SPs and ten faculties. Data from the post-run survey showed that there was a general recognition that the platform is easy to use among all the users. Two questions regarding the usefulness of the platform showed significant differences between the SPs/faculties and the students. More SPs found the platform useful as a training method than the students did. The faculties showed more attempts than the students to use this platform for clinical skills training in the future. This smartphone-based online platform was widely accepted among the tested students, SPs and faculties, which meets the requests and challenges of the new era. It provides an effective approach for clinical skills training and assessment with remote SPs.
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Affiliation(s)
- Surong Jiang
- Department of Geriatric Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Huanhuan Chen
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaozhi Wang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Liling Chen
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Binlin Luo
- Department of Plastic and Burn Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark
| | - Junjie Du
- Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hua Huang
- Medical Simulation Center, Nanjing Medical University, Nanjing, China
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20
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Vasselin I, Cilia F, Malpart A, Jamault B, Ammirati C. [Health simulation, access to somatic care for people with ASD]. Soins Psychiatr 2023; 44:13-16. [PMID: 37926494 DOI: 10.1016/j.spsy.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The clinical characteristics of people with autism spectrum disorders can make it difficult for them to access care, including treatment and medical imaging examinations. Simulation-based learning can facilitate the performance of a CT scan, as in the case of Irène, who was able to adopt the expected body positions thanks to this intervention.
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Affiliation(s)
| | - Federica Cilia
- Centre de recherche en psychologie : cognition, psychisme et organisations, UR UPJV 7273 (CRP-CPO), Université de Picardie Jules-Verne (UPJV), chemin du Thil, CS 52 501, 80000 Amiens, France
| | - Aurore Malpart
- Centre de ressources autisme de Picardie, 4 rue Grenier-et-Bernard, 80000 Amiens, France
| | | | - Christine Ammirati
- CHU Amiens-Picardie, 80054 Amiens cedex 1, France; Centre de recherche en psychologie : cognition, psychisme et organisations, UR UPJV 7273 (CRP-CPO), Université de Picardie Jules-Verne (UPJV), chemin du Thil, CS 52 501, 80000 Amiens, France; Laboratoire Éducations et pratiques de santé, Université Sorbonne Paris Nord, Campus de Bobigny, 74 rue Marcel-Cachin, 93017 Bobigny cedex, France
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21
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Best MRM, Wehner L. Don't Let Lessons Learned Become Lessons Lost: An Example of Hybrid Simulation Using Human Avatars. Nurse Educ 2023; 48:345-346. [PMID: 37130211 DOI: 10.1097/nne.0000000000001445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Melody R M Best
- Assistant Professor of Nursing (Dr Best) and Associate Professor of Nursing (Dr Wehner), Hartwick College, Oneonta, New York
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22
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Melendez DR, Alexander AJ, Nardolillo J, Nebergall S, Lascano B, Riley T, Turner M, Braden-Suchy N. An Exploration of Diversity, Equity, Inclusion, and Antiracism in Standardized Patient Simulations. Am J Pharm Educ 2023; 87:100594. [PMID: 37783306 DOI: 10.1016/j.ajpe.2023.100594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
A trending topic in pharmacy education is the importance of educating and exposing student pharmacists to topics of diversity, equity, inclusion, and antiracism (DEIA). Incorporation of diverse patient populations is one emerging learning opportunity for students in the DEIA space. This commentary presents the findings of seven pharmacy programs reporting similarities and differences in standardized patient (SP) recruitment and training, and their use in DEIA simulation learning activities. Common barriers of DEIA-centric SP activities in pharmacy programs were also identified and included recruitment of diverse SPs, lack of faculty knowledge for implementation of DEIA-focused simulations, and emotional protection of SPs involved. While no best practices or standardized processes exist, the authors provide suggestions for addressing barriers, and make a call to action for further research to determine best practices related to recruitment, training, and utilization of diverse SPs in simulation activities in pharmacy education.
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Affiliation(s)
| | - Akash J Alexander
- LIU Pharmacy, Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY, USA
| | - Joseph Nardolillo
- University of Rhode Island College of Pharmacy and Rhode Island Primary Care Physicians Corporation/Integra Community Network, Kingston, RI, USA
| | - Sean Nebergall
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Bianca Lascano
- High Point University Fred Wilson School of Pharmacy, High Point, NC, USA
| | - Tanya Riley
- Wingate University School of Pharmacy, Hendersonville, NC, USA
| | - Malaika Turner
- Howard University College of Pharmacy, Washington, DC, USA
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23
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Quattrini V, Roesch A, Kretz D. Implementing a Transgender and Gender-Diverse Standardized Patient Simulation in Advanced Health Assessment: An Interprofessional Education Pilot. Nurse Educ 2023; 48:E196-E197. [PMID: 37043293 DOI: 10.1097/nne.0000000000001421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- Veronica Quattrini
- Senior Director for the Doctor of Nursing Practice Program, Office of Academic Deans (Dr Quattrini), Assistant Professor Family Community Health (Drs Quattrini and Roesch), and Family Nurse Practitioner (Drs Quattrini and Roesch), and DNP Student '23-PNP-PC Program (Ms Kretz) and Graduate Teaching Assistant (Ms Kretz), University of Maryland School of Nursing, Baltimore
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24
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Abstract
BACKGROUND The assignment to be an observer in simulation is common. Despite evidence that learning outcomes are similar for participants and observers, there is uncertainty among simulation facilitators about how to create a valuable learning experience for learners in observer roles. PROBLEM The prebriefing practices of establishing a fiction contract and orienting learners to their role are frequently centered on learners in participant roles. APPROACH Tailoring a fiction contract to the opportunities and challenges that observers experience as well as the use of feedforward to provide specific objectives to learners in observer roles is discussed. CONCLUSIONS Including specific strategies in the prebriefing for learners in observer roles sets observers up for success in simulation learning experiences.
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Affiliation(s)
- Brandon Kyle Johnson
- Associate Professor & Associate Dean for Simulation (Dr Johnson), Texas Tech University Health Sciences Center School of Nursing, Lubbock; and Principal Faculty (Dr Fey), Center for Medical Simulation, Boston, Massachusetts
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25
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Bee RE, Watkins J, Barnes R. The Effects of Low-Fidelity Simulation on Students' Perceived Abilities to Build Therapeutic Relationships. J Nurs Educ 2023; 62:575-579. [PMID: 37812823 DOI: 10.3928/01484834-20230815-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
BACKGROUND The combination of nursing student anxiety toward patients with mental health conditions, along with their unpreparedness for exercising active listening, empathy, and self-awareness in clinical situations, creates a barrier to achieving therapeutic nurse- patient relationships. METHOD A quantitative quasiexperimental study with a one-group pretest-posttest design was used to determine whether a low-fidelity communication simulation laboratory would decrease nursing students' perceived anxiety levels toward mental health patients and increase students' perceived empathy, self-awareness, and active listening levels. RESULTS After completing the communication simulation laboratory, students' anxiety decreased significantly (p < .001) and active listening increased significantly (p < .001); empathy and self-awareness levels were relatively unchanged. CONCLUSION Using a communication simulation laboratory effectively decreased nursing students' perceived anxiety levels toward patients and improved their perceived active listening skills. The findings of the study support the use of low-fidelity simulations to prepare students for psychiatric nursing clinical practice. [J Nurs Educ. 2023;62(10):575-579.].
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26
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Lapierre A, Lavoie P. To die or not to die: manikin death in resuscitation simulation does not impact nursing students' self-efficacy. Evid Based Nurs 2023; 26:154. [PMID: 37197911 DOI: 10.1136/ebnurs-2022-103671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Affiliation(s)
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
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27
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Smith SE, Kerins J, McColgan-Smith S, Stewart F, Power A, Mardon J, Tallentire VR. The development of a marker system for Pharmacists' Behavioural Skills. Int J Pharm Pract 2023; 31:520-527. [PMID: 37452687 DOI: 10.1093/ijpp/riad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Pharmacists increasingly require complex behavioural skills to fulfil enhanced roles within healthcare teams. Behavioural marker systems are used to assess behavioural (or non-technical) skills during immersive simulation. This study aimed to develop a marker system for pharmacists' behavioural skills in patient-focussed care scenarios, and to investigate its content validity. METHODS Literature describing existing marker systems and the requisite behavioural skills of pharmacists were presented to two expert panels, alongside video examples of pharmacists in patient-focussed care simulations. The expert panels used this information to develop a new behavioural marker system. A third expert panel assessed the content validity, and the item- and scale-content validity indices were calculated. KEY FINDINGS The resulting tool contains four categories, each with three or four skill elements: situation awareness (gathering information; recognising and understanding information; anticipating, preparing and planning), decision-making and prioritisation (identifying options; prioritising; dealing with uncertainty; implementing or reviewing decisions), collaborative working (involving the patient; information sharing; leadership or followership), self-awareness (role awareness; speaking up; escalating care; coping with stress). The scale-content validity index was 0.95 (ideal) and the only item below the acceptable cut-off was 'leadership or followership' (0.7). CONCLUSIONS This tool is the first marker system designed to assess the behavioural skills of pharmacists in patient-focussed care scenarios. There is evidence of good content validity. It is hoped that once validated, the Pharmacists' Behavioural Skills marker system will enable pharmacy educators to provide individualised and meaningful feedback on simulation participants' behavioural skills.
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Affiliation(s)
- Samantha Eve Smith
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Lothian, Edinburgh, UK
| | - Joanne Kerins
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | | | - Julie Mardon
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
| | - Victoria Ruth Tallentire
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
- NHS Lothian, Edinburgh, UK
- NHS Education for Scotland, Edinburgh, UK
- University of Edinburgh, Edinburgh, UK
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28
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Sindal MD, Ratra A, Ratra D. Enhancing surgical training - Role of simulators and mentors. Indian J Ophthalmol 2023; 71:3260-3261. [PMID: 37602619 PMCID: PMC10565920 DOI: 10.4103/ijo.ijo_1798_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Affiliation(s)
- Manavi D Sindal
- Vitreoretina Services, Aravind Eye Hospital, Pondicherry, India
| | - Aashna Ratra
- Department of Ophthalmology, Stanley Medical College, Chennai, Tamil Nadu, India
| | - Dhanashree Ratra
- Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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29
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Sullivan C, Doyle AJ, O'Toole M, Mulhall C, McNaughton N, Eppich W. 'How can we help the students learn?' A grounded theory study of simulated participants as educators. Med Teach 2023; 45:1047-1053. [PMID: 36726233 DOI: 10.1080/0142159x.2023.2171857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Despite the demonstrated value of simulated participant (SP) feedback, we are only beginning to understand how to optimize SPs' feedback practices for communication skills and strengthen their role as educators. SPs portray roles and engage in feedback practices to support simulated-based learning for communication skills training. SPs come to their role with diverse experiences, knowledge, and training, such as (a) professional actors, (b) lay people, and (c) health professions educators. This study explored what factors influenced SPs' role as educators, including their preparation, training, and approach to role portrayal and feedback practices and how these aspects were influenced by SPs' backgrounds. METHODS Using grounded theory methodology, we collected and analysed data iteratively from 16 semi-structured in-depth interviews. We identified key concepts, using constant comparison and by exploring how concepts were related , to develop a conceptual model of SPs as educators. RESULTS The SP role as educator was shaped by several interrelated dualities which spanned both the SP and learner roles and contributed to the identity formation of both SP and learner: (a) building competence (SP competence as educator and learner competence as healthcare professional), (b) engaging in reflective practice (SPs prompting learner reflection and SPs reflecting on their own role), and (c) establishing a safe space (SP needing to feel safe in their role to create safety to support learner engagement). SPs' backgrounds influenced how they learned to portray roles and how they engaged in feedback practices, both in-action, through in-role prompts and cues, and on-action, through post-scenario feedback discussions. CONCLUSION Our conceptual model about SPs as educators informs SP selection and training. Further, this model enables practical suggestions for SP educators and faculty who involve SPs in teaching. Enhanced feedback practices have the potential to improve learning from simulated encounters.
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Affiliation(s)
- Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrea Jane Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Skinner JY, Banner H, Cristancho S, Siu S, Blissett S. The role of multidisciplinary simulations in cardio-obstetrics education: perspectives from simulated hemodynamically unstable patients. Am J Obstet Gynecol MFM 2023; 5:101052. [PMID: 37321540 DOI: 10.1016/j.ajogmf.2023.101052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/09/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Jamila Y Skinner
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Harrison Banner
- Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sayra Cristancho
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Samuel Siu
- Division of Cardiology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sarah Blissett
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, B6-117A, 339 Windermere Rd, London, Ontario N6A 5A5, Canada; Division of Cardiology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
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Ebeling M, Bloom A, Boggiano MM, Peterson DT, Peterson T. Employing High-Fidelity Simulation for the High-Risk, Low-Frequency Diagnosis and Management of Acute Radiation Syndrome (ARS). MedEdPORTAL 2023; 19:11331. [PMID: 37538304 PMCID: PMC10394119 DOI: 10.15766/mep_2374-8265.11331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/21/2023] [Indexed: 08/05/2023]
Abstract
Introduction Acute radiation syndrome (ARS) is a high-risk, low-frequency diagnosis that can be fatal and is difficult to diagnose without an obvious history of ionizing radiation exposure. Methods Twenty-two emergency medicine residents and one pharmacy resident participated in an hour-long simulation session. To accommodate all learners, the simulation was conducted eight times over a block of scheduled time (two to four learners/session). Sessions included a prebriefing, pre/post questionnaires, the ARS case, and a debriefing. Learners evaluated and managed a 47-year-old male (manikin) with the hematopoietic and cutaneous subsyndromes of ARS who presented with hand pain/erythema/edema and underlying signs of infection 2 weeks after an unrecognized radiation exposure. Learners had to perform a history and physical, recognize/manage abnormal vitals, order/interpret labs, consult appropriate disciplines, and initiate supportive care. Results There was a mean reported increase in ability to recognize signs and symptoms of ARS (p < .001) and appropriately manage a patient with this condition (p = .03) even after controlling for baseline confidence in ability to make and manage uncommon diagnoses, respectively. Learners rated this simulation as a valuable learning experience, effective in teaching them how to diagnose and treat ARS, and one they would recommend to other health care professionals. Discussion This simulation aimed to teach the diagnosis and initial management of the hematopoietic and cutaneous subsyndromes of ARS. It should be used to increase awareness of the potential for ionizing radiation exposure under less obvious conditions and raise the index of suspicion for ARS in the undifferentiated patient.
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Affiliation(s)
- Mel Ebeling
- Third-Year Medical Student, University of Alabama at Birmingham Heersink School of Medicine
| | - Andrew Bloom
- Assistant Professor, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine
| | - Mary M. Boggiano
- Associate Professor, Department of Psychology, University of Alabama at Birmingham
| | - Dawn Taylor Peterson
- Associate Professor, Department of Medical Education, University of Alabama at Birmingham Heersink School of Medicine
| | - Todd Peterson
- Associate Professor, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine
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Dodson TM. Effects of Expert Modeling Videos on the Development of Nursing Students' Clinical Competence. J Nurs Educ 2023; 62:454-460. [PMID: 37561901 DOI: 10.3928/01484834-20230612-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
BACKGROUND Nurse educators are called to develop innovative teaching strategies to build clinical competency. Expert modeling videos (EMVs) promote clinical competency by demonstrating exemplar nursing care. METHODS A quasiexperimental research study was conducted using a prebriefing intervention of a nursing process video for demonstration (experimental) and discussion (control) groups of nursing students. Simulation competency was measured using the Creighton Competency Evaluation Instrument (CCEI). RESULTS Students in the experimental group demonstrated a statistically significant improvement in simulation competency (p = .001) and performed significantly better in the CCEI domains of communication (p = .009) and patient safety (p = .002). CONCLUSION The use of EMVs in simulation prebriefing is an innovative teaching strategy to prepare undergraduate nursing students with the knowledge and skills required to enter the simulated environment. Through watching an exemplar demonstration of desired behaviors, students significantly improved their simulation performance and demonstrated clinically competent care of an acutely ill simulated patient. [J Nurs Educ. 2023;62(8):454-460.].
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Awan OA. Simulation in Medical Education: Why We Need It. Acad Radiol 2023; 30:1764-1765. [PMID: 37544712 DOI: 10.1016/j.acra.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 08/08/2023]
Affiliation(s)
- Omer A Awan
- University of Maryland School of Medicine (O.A.W.), 655 W Baltimore Street, Baltimore, MD, 21201.
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Abstract
SUMMARY STATEMENT Standardized patients (SPs) play a pivotal role in medical education. They are proxies for real patients, preparing students to meet the challenges of excellent patient care. Human simulation, with SPs, is used for teaching and assessing communication and clinical skills in medical education around the world. Standardized patients work individually with other faculty, students, or in conjunction with medical faculty to facilitate learning with feedback. In most simulation centers, SPs receive extensive training in communication and clinical skills, yet they inhabit territory often unrecognized as professional in medical education. The manner in which SPs are seen and treated by faculty and students may be a reflection of how real patients are seen and treated-not always heard, not always respected-and this tension detracts from both simulated and real patient encounters. Exploring how SPs, as proxies for real patients, are treated in medical education is a key to what we might learn and how we might close gaps in cultural respect and, ultimately, in patient care.
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Affiliation(s)
- Temple D West
- From the Eastern Virginia Medical School, Norfolk, VA
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Stone M, Bazaldua O, Piernik-Yoder B, Sculley R, Kosub K. A Novel Simulation Program for Interprofessional Health Literacy Training. Health Lit Res Pract 2023; 7:e139-e143. [PMID: 37552489 PMCID: PMC10406578 DOI: 10.3928/24748307-20230713-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 11/30/2022] [Indexed: 08/09/2023] Open
Abstract
Effective communication with patients and between members of the health care team are important strategies to enhance health care outcomes. Despite the prevalence of low health literacy and associated risks in the population, health professionals are often not trained adequately in health literacy communication practices. The purpose of this pilot program is to determine if offering learners an opportunity to practice health literacy communication techniques in a simulated patient care team can increase skills, attitudes, and confidence in this important area of patient care. We implemented a novel, team-based interprofessional Objective Structured Clinical Examination (iOSCE) focused on health literacy. Evaluation took place on three levels: student self-assessment of health literacy communication skills and beliefs about interprofessional teamwork, standardized patient assessment of skills during the clinical encounter, and observer assessment of interprofessional teamwork. Statistically significant gains were seen in students' health literacy communication confidence, as well as beliefs, attitudes and understanding of interprofessional teamwork. The aim of this article is to describe our pilot health literacy iOSCE findings. This pilot shows that an OSCE is an effective assessment tool for a mix of health professional learners at different levels to demonstrate health literacy practices in an interprofessional teamwork environment. [HLRP: Health Literacy Research and Practice. 2023;7(3):e139-e143.].
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Affiliation(s)
- Melanie Stone
- Address correspondence to Melanie Stone, DrPH, MEd, Community Service Learning, Center for Medical Humanities & Ethics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7730, San Antonio, TX 78229;
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Zou L, Su J, Li J, Wang J, Kang J, Yin A, Ren H, Jiang X, Ding Y, An P. Application of bilingual simulated patients in the medical history collection for international medical students in China. BMC Med Educ 2023; 23:525. [PMID: 37479971 PMCID: PMC10362765 DOI: 10.1186/s12909-023-04480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND In all international medical student (IMS) programs in China, language barriers between IMSs and Chinese patients greatly reduced the learning in clinical practice and brought great challenges to IMSs in their transition from preclinical to clinical practice. This study aimed to investigate the role of bilingual simulated patients (B-SPs) in IMSs learning of medical history collection in China. METHODS 48 IMSs of grade 4 between October 2020 to Jan 2021 were enrolled in this study. During the training of medical history collection, students were randomly arranged into two groups trained with either B-SPs (B-SP group) or English-speaking SP (E-SP group). All SPs in Objective Structured Clinical Exam station (OSCE) were trained in the Affiliated Hospital of Wuhan University. Clinical skills in medical history collection were assessed by instructors during pre-clinical, post-clinical OSCE and clinical rotations. RESULTS The scores of IMSs in each group were analyzed in terms of medical history collection including the ability to effectively consult for information and key communication skills related to patient care. Our results indicated that IMS in B-SP group obtained similar scores in preclinical training for history collection (67.3 ± 8.46 vs 67.69 ± 8.86, P < 0.05) compared to E-SP group, while obtaining significantly higher score improvements between pre- and post-OSCE (17.22 (95% CI 12.74 to 21.70) vs 10.84 (95% CI 3.53 to 18.15), P = 0.0007). CONCLUSION B-SPs are more conducive to doctor-patient communication and actually improve IMSs learning in medical history collection in China.
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Affiliation(s)
- Liping Zou
- The Clinical Skill Center, Teaching Office of the First School of Clinical Medicine, Renmin Hospital of Wuhan University, 9 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
| | - Juan Su
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiao Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian Kang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Anning Yin
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Haixia Ren
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaoda Jiang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yijuan Ding
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ping An
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China.
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China.
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De Belen E, Ganesan D, Paculdo D, Gill R, Peabody JW. Clinical Variation in the Treatment Practices for Patients With Type 2 Diabetes: A Cross-Sectional Patient Simulation Study Among Primary Care Physicians and Cardiologists. J Am Heart Assoc 2023; 12:e028634. [PMID: 37382120 PMCID: PMC10356086 DOI: 10.1161/jaha.122.028634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/07/2023] [Indexed: 06/30/2023]
Abstract
Background Cardiovascular disease risk stratification is necessary and critically important in patients with type 2 diabetes. Despite its known benefits to guide treatment and prevention, we hypothesized that providers do not routinely incorporate this into their diagnostic and treatment decisions. Methods and Results The QuiCER DM (QURE CVD Evaluation of Risk in Diabetes Mellitus) study enrolled 161 primary care physicians and 80 cardiologists. Between March 2022 and June 2022, we measured the care variation in risk determination among these providers caring for simulated patients with type 2 diabetes. We found a wide variation in the overall assessment of cardiovascular disease in patients with type 2 diabetes. Participants performed half of the necessary care items with quality-of-care scores, ranging between 13% and 84%, averaging 49.4±12.6%. Participants did not assess cardiovascular risk in 18.3% of cases and incorrectly stratified risk in 42.8% of cases. Only 38.9% of participants arrived at the correct cardiovascular risk stratification. Those who correctly identified a cardiovascular risk score were significantly more likely to order nonpharmacologic treatments, advising on their patients' nutrition (38.8% versus 29.9%, P=0.013) and the correct glycated hemoglobin target (37.7% versus 15.6%, P<0.001). Pharmacologic treatments, however, did not vary between those who correctly specified risk and those who did not. Conclusions Physician participants struggled to determine the correct cardiovascular disease risk and specify the appropriate pharmacologic interventions in simulated patients with type 2 diabetes. Additionally, there was a wide variation in the quality of care regardless of risk level, indicating opportunities to improve risk stratification.
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Affiliation(s)
| | | | | | | | - John W. Peabody
- QURE HealthcareSan FranciscoCAUSA
- University of CaliforniaSan FranciscoCAUSA
- University of CaliforniaLos AngelesCAUSA
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Sibbald M, Last N, Keuhl A, Azim A, Sheth U, Khalid F, Banji F, Geekie-Sousa A, Yilmaz DU, Monteiro S. Challenges facing standardised patients representing equity-deserving groups: Insights from health care educators. Med Educ 2023; 57:516-522. [PMID: 36987681 DOI: 10.1111/medu.15085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Health professions training programmes increasingly rely on standardised patient (SP) programmes to integrate equity-deserving groups into learning and assessment opportunities. However, little is known about the optimal approach, and many SP programmes struggle to meet these growing needs. This study explored insights from health care educators working with SP programmes to deliver curricular content around equity-deserving groups. METHODS We interviewed 14 key informants in 2021 who were involved in creating or managing SP-based education. Verbatim transcripts were analysed in an iterative coding process, anchored by qualitative content analysis methodology and informed by two theoretical frameworks: sociologic translation and simulation design. Repeated cycles of data collection and analyses continued until themes could be constructed, aligned with existing theories and grounded in empirical data, with sufficient relevance and robustness to inform educators and curricular leads. RESULTS Three themes were constructed: (i) creating safety for SPs paid to be vulnerable, (ii) fidelity as an issue broader than who plays the role and (iii) engaging equity-deserving groups. SP work involving traditionally marginalised groups risk re-traumatization, highlighting the importance of (i) informed consent in recruiting SPs, (ii) separating role portrayal from lived experiences, (iii) adequately preparing learners and facilitators, (iv) creating time-outs and escapes for SPs and (v) building opportunity for de-roling with community support. CONCLUSIONS SP programmes are well positioned to be allies and advocates to equity-deserving groups and to collaborate and share governance of the educational development process from its outset. SP programmes can support the delivery of curricular content around equity-deserving groups by advocating with curricular leadership, building relationships with community partners, facilitating co-creation and co-delivery of educational content and building safety into simulation.
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Affiliation(s)
- Matt Sibbald
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Last
- Centre for Simulation-Based Learning, McMaster University, Hamilton, Ontario, Canada
| | - Amy Keuhl
- McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, Ontario, Canada
| | - Arden Azim
- Centre for Simulation-Based Learning, McMaster University, Hamilton, Ontario, Canada
| | - Urmi Sheth
- McMaster University, Hamilton, Ontario, Canada
| | - Faran Khalid
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Farhan Banji
- Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, Quebec, Canada
| | - Aaron Geekie-Sousa
- School of Medicine, Waterloo Regional Campus, McMaster University, Hamilton, Ontario, Canada
| | - Derya Uzelli Yilmaz
- Centre for Simulation-Based Learning, McMaster University, Hamilton, Ontario, Canada
- Department of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Sandra Monteiro
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, Ontario, Canada
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Sahin Karaduman G, Basak T. Is Virtual Patient Simulation Superior to Human Patient Simulation: A Randomized Controlled Study. Comput Inform Nurs 2023; 41:467-476. [PMID: 36633879 DOI: 10.1097/cin.0000000000000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Virtual and human patient simulation methods offer an effective way to increase patient safety, reduce the incidence of errors, and improve clinical decision-making skills. The study was conducted to compare the effects of virtual and human patient simulation methods on performance, simulation-based learning, anxiety, and self-confidence with clinical decision-making scores of nursing students. A quasi-experimental, stratified, randomized controlled study was conducted with third-year nursing students. The students (n = 166) were divided into experimental and control groups. The difference between the pretest-posttest scores of intragroup nursing anxiety and self-confidence with clinical decision-making and total and sub-scale scores of in-group simulation-based learning were statistically significant ( P < .05). Performance scores were found to be statistically significantly high in the virtual patient simulation group ( P < .001). It was determined that virtual patient simulation was superior to other methods in terms of nursing anxiety and self-confidence with clinical decision-making, simulation-based learning, and performance scores.
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Affiliation(s)
- Gul Sahin Karaduman
- Author Affiliations: University of Health Sciences Turkey, Gulhane Training and Research Hospital (Dr Sahin Karaduman); and University of Health Sciences Turkey, Gulhane Faculty of Nursing (Dr Basak), Ankara
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Bond WF, Mischler MJ, Lynch TJ, Ebert-Allen RA, Mou KM, Aiyer M, Park YS. The Use of Virtual Standardized Patients for Practice in High Value Care. Simul Healthc 2023; 18:147-154. [PMID: 35322798 DOI: 10.1097/sih.0000000000000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study examined the influence of high value care (HVC)-focused virtual standardized patients (VSPs) on learner attitudes toward cost-conscious care (CCC), performance on subsequent standardized patient (SP) encounters, and the correlation of VSP performance with educational outcomes. METHOD After didactic sessions on HVC, third-year medical students participated in a randomized crossover design of simulation modalities consisting of 4 VSPs and 3 SPs. Surveys of attitudes toward CCC were administered before didactics and after the first simulation method. Performance markers included automated VSP grading and, for SP cases, faculty-graded observational checklists and patient notes. Performance was compared between modalities using t tests and analysis of variance and then correlated with US Medical Licensing Examination performance. RESULTS Sixty-six students participated (VSP first: n = 37; SP-first: n = 29). Attitudes toward CCC significantly improved after training (Cohen d = 0.35, P = 0.043), regardless of modality. Simulation order did not impact learner performance for SP encounters. Learners randomized to VSP first performed significantly better within VSP cases for interview (Cohen d = 0.55, P = 0.001) and treatment (Cohen d = 0.50, P = 0.043). The HVC component of learner performance on the SP simulations significantly correlated with US Medical Licensing Examination step 1 ( r = 0.26, P = 0.038) and step 2 clinical knowledge ( r = 0.33, P = 0.031). CONCLUSIONS High value care didactics combined with either VSPs or SPs positively influenced attitudes toward CCC. The ability to detect an impact of VSPs on learner SP performance was limited by content specificity and sample size.
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Affiliation(s)
- William F Bond
- From Jump Simulation (W.F.B., M.J.M., T.J.L., R.E.A., K.M.M., and M.A.), a collaboration of OSF Healthcare and the University of Illinois College of Medicine at Peoria; the Department of Internal Medicine (T.J.L., M.J.M., M.A.), Department of Pediatrics (T.J.L., M.J.M), and Department of Emergency Medicine (W.F.B) University of Illinois College of Medicine at Peoria; and Department of Medical Education (Y.S.P.), University of Illinois College of Medicine at Chicago, Chicago, IL
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Peterson JLH, Ranganna R, Gottstein R. Simulation to Investigate Effective Airway Positioning in the Neonatal Patient. Clin Pediatr (Phila) 2023; 62:533-536. [PMID: 36411597 DOI: 10.1177/00099228221137157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jennifer L H Peterson
- Neonatal Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ranganath Ranganna
- Neonatal Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ruth Gottstein
- Neonatal Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, UK
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Abstract
SUMMARY STATEMENT Psychological safety in high-fidelity simulation-based experiences ensures that learners feel safe with new experiences in the service of learning. This article is a faculty reflection on breaches in the psychological safety among nursing students in 2 independent, high-fidelity simulation-based experience studies that were conducted in 2019. Demonstrated breaches in psychological safety included fear and anxiety in the sole provider role in multiple-patient simulations and incivility directed toward nursing students in a primary nurse role in interprofessional simulations. This article adds to the growing literature on psychological safety by sharing important lessons learned regarding role clarity and interprofessional colleagues, proposing recommendations, and providing suggestions for future research on psychological safety.
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Affiliation(s)
- Laura Klenke-Borgmann
- From the University of Kansas (L.K.-B.), School of Nursing, Kansas City, KS; University of Delaware Health Sciences (H.D.), School of Nursing, Newark, DE; and Villanova University (M.A.C.), M. Louise Fitzpatrick College of Nursing, Villanova, PA
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Anton NE, Zhou G, Hornbeck T, Nagle AM, Norman S, Shroff AD, Yu D. Detailing experienced nurse decision making during acute patient care simulations. Appl Ergon 2023; 109:103988. [PMID: 36801523 DOI: 10.1016/j.apergo.2023.103988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Nurse decision making (DM) is critical for patient safety. Eye-tracking methods can effectively assess nurse DM. The purpose of this pilot study was to use eye-tracking methods to assess nurse DM during a clinical simulation. MATERIALS AND METHODS Experienced nurses managed a simulated patient manikin who suffered from a stroke mid-simulation. We assessed nurses' gaze patterns prior to and after the stroke. DM in general was assessed by nursing faculty using a clinical judgement rubric, and dichotomously based on recognition of the stroke or not. RESULTS Data from eight experienced nurses was examined. For the nurses who recognized the stroke, visual attention was focused on the vital sign monitor and patient's head, which suggest those locations were consistently examined for correct decision-makers. CONCLUSIONS Dwell time on general AOIs was associated with poorer DM, which may reflect poorer pattern recognition. Eye-tracking metrics may be effective to objectively assess nurse DM.
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Affiliation(s)
- Nicholas E Anton
- School of Industrial Engineering, Purdue University, West Lafayette, IN, 47906, USA.
| | - Guoyang Zhou
- School of Industrial Engineering, Purdue University, West Lafayette, IN, 47906, USA
| | - Tera Hornbeck
- School of Nursing, Purdue University, West Lafayette, IN, 47907, USA
| | - Amy M Nagle
- School of Nursing, Purdue University, West Lafayette, IN, 47907, USA
| | - Susan Norman
- School of Nursing, Purdue University, West Lafayette, IN, 47907, USA
| | - Anand D Shroff
- School of Industrial Engineering, Purdue University, West Lafayette, IN, 47906, USA
| | - Denny Yu
- School of Industrial Engineering, Purdue University, West Lafayette, IN, 47906, USA.
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Ross JG, Meakim CH, Latz E, Arcamone A, Furman G, Prieto P, Reynolds K, Franklin AE. Effect of Multiple- Patient Simulation on Baccalaureate Nursing Students' Anxiety and Self-confidence: A Pilot Study. Nurse Educ 2023; 48:162-167. [PMID: 36730039 DOI: 10.1097/nne.0000000000001336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Multiple-patient simulation (MPS) allows nursing students to develop leadership skills. Limited research examining student outcomes following MPS exists. PURPOSE This pilot study investigated the impact of MPS on (1) anxiety with transition to practice, (2) anxiety with clinical decision-making, (3) self-confidence with clinical decision-making, and (4) perceptions about MPS as a learning strategy. METHODS Twenty-two senior baccalaureate nursing students participated in this 2-group mixed-methods study. Data were collected before and after a leadership course using the State-Trait Anxiety Inventory, Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, and a researcher-developed perceptions survey. RESULTS Self-confidence with clinical decision-making significantly increased for all participants regardless of group assignment. Anxiety and anxiety with clinical decision-making decreased without significant changes. No significant differences were found between groups. Qualitative findings yielded 3 themes: preparation for clinical practice, overcoming anxiety, and confidence. CONCLUSION Research investigating additional student outcomes after MPS with larger, more diverse samples is needed.
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Affiliation(s)
- Jennifer Gunberg Ross
- Associate Professor (Dr Ross), Assistant Professor of the Practice (Ms Meakim), Director, Second Degree BSN Track (Ms Meakim), Former Student Nurse (Ms Latz), Clinical Assistant Professor (Dr Arcamone and Ms Reynolds), Executive Director, Simulation Center (Dr Furman), Clinical Professor (Dr Furman), and Assistant Director, Simulation and Learning Resource Center (Ms Prieto), M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania; and Polly & Tex Rankin Endowed Professor of Nursing (Dr Franklin), Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth
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Le Boudec J, Félix S, Gachoud D, Monti M, Barazzoni MS, Clair C. The influence of patient gender on medical students' care: Evaluation during an objective structured clinical examination. Patient Educ Couns 2023; 110:107655. [PMID: 36805929 DOI: 10.1016/j.pec.2023.107655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/15/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To assess whether men and women are evaluated and treated differently by medical students. METHODS We evaluated patient care provided by 110 fifth-year medical students during an objective structured clinical examination (OSCE), using two clinical cases with standardized patients (SPs): generalized anxiety disorder (GAD) and ascending aortic dissection (AAD). Half of the students encountered male and half female SPs. Except for gender, the cases were identical. We compared diagnosis and treatment of male vs female SPs. RESULTS Students diagnosed GAD more often in female SPs than in male SPs (diagnosis completed, partially completed, and not completed in 47%, 16% and 36% respectively vs. 22%, 20%, and 58% for male SPs, p = 0.02). The nature of symptoms was better described for male SPs. For AAD, the emergency was more frequently identified and the examination of femoral pulses better performed in female SPs. CONCLUSION Medical students have a gender bias when evaluating patients with GAD and AAD. PRACTICE IMPLICATION The observed gender bias in the evaluation of patients, likely leads to differences in treatment between male and female patients (i.e. under-recognition of anxiety in men). Medical schools should implement gender-sensitive medical education initiatives to improve inclusive patient care.
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Affiliation(s)
- Joana Le Boudec
- Centre for Primary Care and Public Health, Department of Training, Research and Innovation, Lausanne, Switzerland.
| | - Sylvie Félix
- Faculty of Biology and Medicine, University of Lausanne, Clinical Skills Unit, Medical School, Lausanne, Switzerland.
| | - David Gachoud
- Faculty of Biology and Medicine, University of Lausanne, Medical Education Unit, Lausanne, Switzerland; Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
| | - Matteo Monti
- Faculty of Biology and Medicine, University of Lausanne, Medical Education Unit, Lausanne, Switzerland; Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
| | | | - Carole Clair
- Centre for Primary Care and Public Health, Department of Training, Research and Innovation, Lausanne, Switzerland.
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Altmiller G, Wilson C, Jimenez FA, Perron T. Impact of a Virtual Patient Simulation on Nursing Students' Attitudes of Transgender Care. Nurse Educ 2023; 48:131-136. [PMID: 36383074 DOI: 10.1097/nne.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Transgender individuals experience considerable prejudice and bias, creating barriers to health care. PURPOSE The purpose of this study was to determine the effect of a virtual patient simulation scenario of caring for a transgender adult on nursing students' attitudes and beliefs about transgender people. METHODS A validated 29-item instrument developed to assess an individual's view of transgender identity was administered in a pre-/posttest nonequivalent-groups design to junior- and senior-level nursing students. RESULTS Statistically significant differences were found between the control and treatment groups for the subscale human value. CONCLUSIONS Findings support experiential learning in nursing as an effective tool in teaching cultural competence and sensitivity when caring for transgender patients. Attitudes and beliefs of senior nursing students and junior nursing students toward transgender individuals differed, with senior students being more receptive.
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Affiliation(s)
- Gerry Altmiller
- Professor (Drs Altmiller and Perron), The College of New Jersey, Ewing; and Director Education, Research and Design (Dr Wilson) and Psychometrician (Dr Jimenez), Elsevier, Shadow Health, Gainesville, Florida
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Zerilli T, Fidler BD, Tendhar C. Assessing the Impact of Standardized Patient Encounters on Students' Medical History-taking Skills in Practice. Am J Pharm Educ 2023; 87:ajpe8989. [PMID: 36375843 PMCID: PMC10159019 DOI: 10.5688/ajpe8989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 07/29/2022] [Indexed: 05/03/2023]
Abstract
Objective. To investigate whether exposing students to professional standardized patients (SPs) in a didactic course would impact the transferability of students' medical history-taking skills to practice.Methods. In 2018, peer role-play and virtual simulation activities were used to teach medical history-taking in a first-year physical assessment and medication administration course. An unannounced SP evaluated students' medical history-taking skills during a subsequent community introductory pharmacy practice experience (IPPE) using a 17-item medical history checklist. In 2019, 3 SP encounters were added to the course to supplement existing learning activities. This student cohort was then assessed by the same unannounced SP during their IPPE in summer 2019. Medical history-taking performance was compared with the 2018 control group to assess the impact of the changes to the course.Results. Thirty-nine students in both the summer 2018 and 2019 cohorts had usable data. There was a statistically significant increase in the 2019 mean composite score on the medical history checklist (24.3 vs 18.1). The 2019 cohort performed significantly better than the 2018 cohort in 7 of the 17 items on the checklist. The correlation between students' performance on the summative medical history-taking assessment during the course and their performance in practice was r=.15 in 2018 and r=.08 in 2019.Conclusion. Incorporating SPs into a physical assessment and medication administration course contributed to an improvement in students' ability to take a medical history in practice as compared with solely using a virtual patient simulation program.
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Affiliation(s)
- Tina Zerilli
- Long Island University, Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York
| | - Brooke D Fidler
- Long Island University, Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York
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Muehlbauer M, Bradley C, Marquard J, Monsen KA. Clinical Judgment and Informatics: Encoding Simulations Using the Omaha System. J Nurs Educ 2023; 62:237-239. [PMID: 37021941 DOI: 10.3928/01484834-20230208-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND Clinical judgment is a critical nursing competency. Unfolding case study is a pedagogy used to develop clinical judgment. The Omaha System is an accepted taxonomy for standardizing nursing documentation. METHOD An unfolding case study was developed from a simulation scenario by encoding 33 nursing interventions with the Omaha System, then developed multiple true-false response items which were sent electronically in survey format to prelicensure baccalaureate nursing students. Differences between identified essential and distractor interventions were evaluated. RESULTS Participants (n = 101) identified correct interventions (M = 74.6%, standard deviation [SD] = 12%). A paired t-test indicated the percentage of correctly identified essential interventions (M = 78%, SD = 18.7%) was significantly higher than distractor interventions (M = 67%, SD = 18%). DISCUSSION Nursing students can identify appropriate interventions using the Omaha System, demonstrating potential to extend highly effective and low-cost learning experiences using unfolding case study and multiple true-false response items. [J Nurs Educ. 2023;62(4):237-239.].
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Sanz Cortes M, Tidwell E, Doughty C, Ketaroo P, Sundgren N, Belfort M. Simulation-based clinical rehearsal in preparation for delivery of conjoined twins. Ultrasound Obstet Gynecol 2023; 61:533-534. [PMID: 36350051 DOI: 10.1002/uog.26115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Affiliation(s)
- M Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - E Tidwell
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
- Creighton University, Omaha, NE, USA
| | - C Doughty
- Texas Children's Hospital Simulation Center, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - P Ketaroo
- Department of Radiology, Texas Children's Hospital, Houston, TX, USA
| | - N Sundgren
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - M Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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Siemerkus J, Petrescu AS, Köchli L, Stephan KE, Schmidt H. Using standardized patients for undergraduate clinical skills training in an introductory course to psychiatry. BMC Med Educ 2023; 23:159. [PMID: 36922802 PMCID: PMC10016160 DOI: 10.1186/s12909-023-04107-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The goal of this study was to assess the value and acceptance of Standardized or Simulated Patients (SPs) for training clinically inexperienced undergraduate medical students in psychiatric history taking, psychopathological assessment, and communication with psychiatric patients. METHODS As part of a newly developed introductory course to psychiatry, pairs of 3rd year medical students conducted psychiatric assessments of SPs, including history and psychopathological state, under the supervision of a clinical lecturer. Prior to the assessment, students attended introductory lectures to communication in psychiatry and psychopathology but were clinically inexperienced. After the interview, the students' summary of their findings was discussed with other students and the lecturer. Students, lecturers, and actors were invited to a survey after the course. Questions for the students included self-reports about perceived learning success and authenticity of the interviews. RESULTS 41 students, 6 actors and 8 lecturers completed the survey (response rates of 48%, 50%, and 100%, respectively). The survey results indicated that, despite their lack of clinical experience, students learned how to conduct a psychiatric interview, communicate in a non-judgmental and empathetic manner, take a psychiatric history and perform a psychopathological examination. SPs were perceived as authentic. The survey results suggested that this setting allowed for an enjoyable, non-distressful and motivating learning experience within a restricted time frame of just two afternoons. CONCLUSION The results indicated that the SP approach presented is useful for teaching clinical skills in psychiatry to students with limited previous clinical experience and knowledge of psychiatry. We argue that SPs can be used to teach practical psychiatric skills already during an early phase of the curriculum. Limitations of our study include a limited sample size, a temporal gap between the course and the survey, reliance on self-reports, and lack of comparison to alternative interventions.
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Affiliation(s)
- Jakob Siemerkus
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.
| | - Ana-Stela Petrescu
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Laura Köchli
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Klaas Enno Stephan
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
- Max Planck Institute for Metabolism Research, Cologne, Germany
| | - Helen Schmidt
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
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