What Happened to Simulation-Based Education in Outpatient Setting in The 21st Century: A Scoping Review

Introduction

Simulation-based education (SBE) is an instructional approach that aims to accurately recreate real-life scenarios and engage learners in the practical application of lesson content. By replicating critical elements of clinical situations, SBE facilitates a deeper understanding and better preparation for managing such conditions in actual clinical practice. SBE offers promising prospects for improving medical education and patient care in various settings, such as outpatient clinics. Therefore, this scoping review aims to determine to what extent the most effective components and standards of the simulation have been considered in outpatient education.

Methods

The present scoping review adheres to the guidelines outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist" and the "Joanna Briggs Institute (JBI) Reviewers' Manual". This review focused on articles that specifically focused on the use of simulation in outpatient education. Google Scholar, PubMed, Scopus, Embase, and ERIC were searched for keywords related to simulation, ambulatory care, outpatient clinics, and medical education from January 1, 2001, to August 12, 2023.

Results

The search indicated 513 articles, which were narrowed down by title and abstract relatedness. Twenty-nine articles entered the study's second phase, and after reviewing their full text, nine articles that explicitly reported simulation use in outpatient education remained. Based on the findings of eligible articles, the ten most frequent components of SBE that should be considered and followed discussed. These features were training facilitators, pre-briefing sessions, the type of simulation techniques, the site of simulation participation, the simulation duration, unit of participation, extent of direct participation, Simulation fidelity, feedback, and debriefing and reflection.

Conclusion

SBE is a contemporary method of practical training for medical students that involves realistic modeling or simulation of clinical situations. It enhances learning effectiveness and provides a safe, educational atmosphere for teaching and learning. Designing simulations adhering to established standards and carefully considering essential components improves efficiency and effectiveness.

Developing measures of immersion and motivation for learning technologies in healthcare simulation: a pilot study

INTRODUCTION

Medical education has benefitted from the introduction of new technology within recent years. Immersive devices, such as, 360-degree films and virtual reality have become new ways of simulating clinical experiences. The aim of the study was to validate and test reliability of a new measure of engagement.

METHODS

A between-participants design of 2 groups viewing a clinical consultation on a 360-degree headset or 2D monitor was conducted following computer random allocation of 40 healthcare professionals recruited from scheduled teaching. Twenty-three were assigned to 360-degree and 17 to 2D Medias. Adapted Immersion Experience Questionnaire (AIEQ) and Abridged Intrinsic Motivation Inventory (AIMI) were modified to match factors relating to clinical encounters. AIEQ and AIMI were utilised as the data collection tool by each group following video viewing. Spearman's rank correlation was used to assess relationship between immersion and motivation. Comparisons between 360-degree and 2D media responses were made using Wilcoxon's signed ranks test. Internal reliability coefficients of adapted measures were calculated with Cronbach alpha scores.

RESULTS

Total immersion scores were statistically higher in those experiencing 360 (p<0.05), with a median difference of 14.50 (95% CI 6.50-22.00). A positive correlation existed between the total AIEQ and total score of the AIMI in both groups (r_s =0.88, n=17, p<0.001). Internal consistency and reliability was demonstrated with a high Cronbach alpha score for the AIEQ (α= 0.91). AIMI subscale alpha value was also high at (α= 0.95) which shows the measures to be of high internal reliability.

CONCLUSIONS

Adaptation and validation of existing measures for use in healthcare education can be used to quantify levels of immersion and motivation. Standardising measures for use in evaluating new Technology Enhanced Learning is a step to aid understanding on how we develop these tools in medical education and how we might learn from immersive technology.