Pub Date : 2025-12-04DOI: 10.1016/j.ecns.2025.101872
Jack Potter RN, MPH, Karen Theobald RN, PhD, Sandra Johnston RN, PhD
Background
A conversational generative AI platform (CG-AI) was introduced into a preregistration nursing program to enable nursing students to practice taking a patient history, give handover or engage in a challenging communication scenario. The aim of this study was to measure the impact of the platform on the development of communication skills and explore the acceptability and satisfaction of the program.
Methods
Preregistration nursing students (n = 339) used the platform during the teaching period. Automatically graded rubrics were generated by the platform and rubrics were compared at two time points. At the completion of each use, a feedback survey was automatically deployed.
Results
First year students achieved a 13.1% increase in scores between patient assessment scenarios, with a similar improvement between handover scenarios. Second year students completed interprofessional conflict resolution scenarios achieving 32.2% improvement between formative attempts and scoring 98.1% on a summative scenario. Some design features and functionality were suggested as improvements to the program.
Conclusion
A future larger, randomized controlled trial would provide a more rigorous methodology to evaluate effectiveness and is recommended before implementation of AI as a whole course approach.
{"title":"Acceptability and satisfaction of a conversational AI tool for communication skills training in preregistration nursing: A pilot study","authors":"Jack Potter RN, MPH, Karen Theobald RN, PhD, Sandra Johnston RN, PhD","doi":"10.1016/j.ecns.2025.101872","DOIUrl":"10.1016/j.ecns.2025.101872","url":null,"abstract":"<div><h3>Background</h3><div>A conversational generative AI platform (CG-AI) was introduced into a preregistration nursing program to enable nursing students to practice taking a patient history, give handover or engage in a challenging communication scenario. The aim of this study was to measure the impact of the platform on the development of communication skills and explore the acceptability and satisfaction of the program.</div></div><div><h3>Methods</h3><div>Preregistration nursing students (n = 339) used the platform during the teaching period. Automatically graded rubrics were generated by the platform and rubrics were compared at two time points. At the completion of each use, a feedback survey was automatically deployed.</div></div><div><h3>Results</h3><div>First year students achieved a 13.1% increase in scores between patient assessment scenarios, with a similar improvement between handover scenarios. Second year students completed interprofessional conflict resolution scenarios achieving 32.2% improvement between formative attempts and scoring 98.1% on a summative scenario. Some design features and functionality were suggested as improvements to the program.</div></div><div><h3>Conclusion</h3><div>A future larger, randomized controlled trial would provide a more rigorous methodology to evaluate effectiveness and is recommended before implementation of AI as a whole course approach.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101872"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pediatric surgical tracheotomy is a high-risk procedure demanding specialized training due to the unique anatomical and physiological characteristics of children. A key challenge in surgical education is the limited availability of high-fidelity simulators that provide a safe environment for skill development.
Methods
We developed an innovative pediatric task trainer for surgical tracheotomy using 3D printing and silicone casting. This simulator features a modular design with a replaceable cartridge replicating critical anatomical structures, including the trachea, thyroid gland, cervical fascia, vessels, and musculature. To enhance realism, it also simulates bleeding upon incision.
Results
Expert physicians evaluated the trainer’s anatomical accuracy, procedural realism, and overall training effectiveness. Feedback was highly positive, confirming that the device closely replicates pediatric tracheotomy conditions and offers a realistic training experience.
Conclusion
The positive expert feedback highlights the simulator's potential as a valuable tool for improving surgical proficiency and reducing the risk of complications in live procedures. This task trainer represents a significant advancement in pediatric airway management training and an essential asset for surgical simulation.
{"title":"Simulation of pediatric surgical tracheotomy: Development of a high-fidelity modular task trainer","authors":"Margherita Brogi MSc , Marta Mencarelli MSc , Paola Serio MD , Luca Puggelli PhD , Roberto Baggi MD , Stefano Avenali MD , Francesca Amoretti MD , Yary Volpe PhD","doi":"10.1016/j.ecns.2025.101867","DOIUrl":"10.1016/j.ecns.2025.101867","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric surgical tracheotomy is a high-risk procedure demanding specialized training due to the unique anatomical and physiological characteristics of children. A key challenge in surgical education is the limited availability of high-fidelity simulators that provide a safe environment for skill development.</div></div><div><h3>Methods</h3><div>We developed an innovative pediatric task trainer for surgical tracheotomy using 3D printing and silicone casting. This simulator features a modular design with a replaceable cartridge replicating critical anatomical structures, including the trachea, thyroid gland, cervical fascia, vessels, and musculature. To enhance realism, it also simulates bleeding upon incision.</div></div><div><h3>Results</h3><div>Expert physicians evaluated the trainer’s anatomical accuracy, procedural realism, and overall training effectiveness. Feedback was highly positive, confirming that the device closely replicates pediatric tracheotomy conditions and offers a realistic training experience.</div></div><div><h3>Conclusion</h3><div>The positive expert feedback highlights the simulator's potential as a valuable tool for improving surgical proficiency and reducing the risk of complications in live procedures. This task trainer represents a significant advancement in pediatric airway management training and an essential asset for surgical simulation.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101867"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Researchers are using CHAT AI more frequently. However CHAT AI experiences almost continuous model drift, meaning the knowledge base and behavior of the system are time-sensitive and change almost daily. Identical prompts can yield different logic, tone, or conclusions depending on the day. This temporal variability undermines reproducibility of results. Reporting the model number and version, access dates and settings, archiving full prompts and transcripts, and an acknowledgement of drift explicitly in the limitations section of the methods is required, to fully disclose the potential problems with research rigor.
{"title":"Epistemic instability and the mirage of consistency in generative AI research","authors":"Suzan Kardong-Edgren PhD, RN, ANEF, CHSE, FSSH, FAAN","doi":"10.1016/j.ecns.2025.101870","DOIUrl":"10.1016/j.ecns.2025.101870","url":null,"abstract":"<div><div>Researchers are using CHAT AI more frequently. However CHAT AI experiences almost continuous model drift, meaning the knowledge base and behavior of the system are time-sensitive and change almost daily. Identical prompts can yield different logic, tone, or conclusions depending on the day. This temporal variability undermines reproducibility of results. Reporting the model number and version, access dates and settings, archiving full prompts and transcripts, and an acknowledgement of drift explicitly in the limitations section of the methods is required, to fully disclose the potential problems with research rigor.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101870"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ecns.2025.101868
Michelle A. Wright DNP
Background
This study explored the effectiveness of virtual reality simulation on knowledge and confidence of nurses enrolled in a critical care, emergency nursing, and progressive care internship program, who participated in a virtual reality (VR) simulation, or a traditional manikin-based simulation related to the management of cardiopulmonary arrest.
Method
This randomized, controlled, pretest-posttest study was conducted with 34 nurses enrolled in a specialty internship program to evaluate the effectiveness of virtual reality simulation in acquiring knowledge and confidence. Data collection included standardized knowledge assessment, and the Simulation Effectiveness Tool-M (SET-M).
Results
Both groups had an increase in mean scores on the knowledge test. Participants in the experimental group had significantly greater knowledge gain (p < .05) on the knowledge test compared to the control group. The virtual group had a higher average score on the SET-M; however, this difference is not statistically significant. The majority of respondents in the experimental group (95%) indicated that they would like to continue using VR for training.
Conclusion
The findings of this study suggest that when comparing traditional manikin-based simulation to VR simulation, VR is an effective means of improving the knowledge and confidence in the management of cardiopulmonary arrest. Increasing the use of VR simulation in other educational offerings can have a positive impact on nursing practice.
本研究探讨了虚拟现实模拟对参加重症监护、急诊护理和渐进护理实习项目的护士的知识和信心的有效性，这些护士参加了虚拟现实（VR）模拟，或传统的基于人体模型的与心肺骤停管理相关的模拟。方法采用随机、对照、前测后测的研究方法，对34名专科实习护士进行虚拟现实模拟对其知识获取和信心培养的效果进行评估。数据收集包括标准化知识评估和模拟有效性工具- m （SET-M）。结果两组学生在知识测试中的平均得分均有提高。实验组在知识测试中获得的知识显著高于对照组（p < .05）。虚拟组在SET-M测试中的平均得分更高；然而，这种差异在统计上并不显著。实验组的大多数受访者（95%）表示他们愿意继续使用VR进行培训。结论本研究结果表明，将传统的基于人体模型的模拟与VR模拟进行比较，VR是提高心肺骤停管理知识和信心的有效手段。在其他教育产品中增加VR模拟的使用可以对护理实践产生积极影响。
{"title":"Exploring the role of virtual reality simulation in critical care nurses' training: A randomized controlled pilot study","authors":"Michelle A. Wright DNP","doi":"10.1016/j.ecns.2025.101868","DOIUrl":"10.1016/j.ecns.2025.101868","url":null,"abstract":"<div><h3>Background</h3><div>This study explored the effectiveness of virtual reality simulation on knowledge and confidence of nurses enrolled in a critical care, emergency nursing, and progressive care internship program, who participated in a virtual reality (VR) simulation, or a traditional manikin-based simulation related to the management of cardiopulmonary arrest.</div></div><div><h3>Method</h3><div>This randomized, controlled, pretest-posttest study was conducted with 34 nurses enrolled in a specialty internship program to evaluate the effectiveness of virtual reality simulation in acquiring knowledge and confidence. Data collection included standardized knowledge assessment, and the Simulation Effectiveness Tool-M (SET-M).</div></div><div><h3>Results</h3><div>Both groups had an increase in mean scores on the knowledge test. Participants in the experimental group had significantly greater knowledge gain (<em>p</em> < .05) on the knowledge test compared to the control group. The virtual group had a higher average score on the SET-M; however, this difference is not statistically significant. The majority of respondents in the experimental group (95%) indicated that they would like to continue using VR for training.</div></div><div><h3>Conclusion</h3><div>The findings of this study suggest that when comparing traditional manikin-based simulation to VR simulation, VR is an effective means of improving the knowledge and confidence in the management of cardiopulmonary arrest. Increasing the use of VR simulation in other educational offerings can have a positive impact on nursing practice.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101868"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ecns.2025.101871
Jack Potter RN, MPH, Karen Theobald RN, PhD, Sandra Johnston RN, PhD
Introduction
MatterportTM software was used to create panoramic views of nursing laboratories, integrating resources to support learning psychomotor skills. This study evaluated the usability, satisfaction and engagement among pre-registration nursing students using this virtual reality platform.
Methods
Pre-registration nursing students completed a usability and satisfaction survey and open-ended questions. The number of engagements with the interface were captured.
Results
Results indicated high usability, satisfaction and levels of engagement.
Conclusion
MatterportTM is a useful adjunct for psychomotor skill preparation but should not replace face to face learning activities. Future research should explore if application of psychomotor skills improves using Matterport.
{"title":"Virtual learning with Matterport: A novel approach to teaching psychomotor skills in nursing","authors":"Jack Potter RN, MPH, Karen Theobald RN, PhD, Sandra Johnston RN, PhD","doi":"10.1016/j.ecns.2025.101871","DOIUrl":"10.1016/j.ecns.2025.101871","url":null,"abstract":"<div><h3>Introduction</h3><div>Matterport<sup>TM</sup> software was used to create panoramic views of nursing laboratories, integrating resources to support learning psychomotor skills. This study evaluated the usability, satisfaction and engagement among pre-registration nursing students using this virtual reality platform.</div></div><div><h3>Methods</h3><div>Pre-registration nursing students completed a usability and satisfaction survey and open-ended questions. The number of engagements with the interface were captured.</div></div><div><h3>Results</h3><div>Results indicated high usability, satisfaction and levels of engagement.</div></div><div><h3>Conclusion</h3><div>Matterport<sup>TM</sup> is a useful adjunct for psychomotor skill preparation but should not replace face to face learning activities. Future research should explore if application of psychomotor skills improves using Matterport.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101871"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ecns.2025.101874
Tina X. Ung PhD, Claire L. O’Reilly PhD, Rebekah J. Moles PhD, Sarira El-Den PhD
Background
Simulated patient role-plays enable healthcare students to practice skills in a safe learning environment. However, simulated patient actors’ perspectives and experiences of being involved in this educational method are underrepresented.
Aim
This study explored actors’ perspectives and feedback on the training process, and experiences role-playing psychosis-related scenarios with pharmacy students.
Methods
Ten actors enacted 86 role-plays with final-year pharmacy students. Role-plays were based on co-designed scenarios relating to psychosis, with students assessed on their ability to provide psychosis-related care. Postrole-plays, all actors were invited to participate in focus groups to explore their perspectives and provide feedback. Focus group interviews were audio-recorded, transcribed verbatim, then independently thematically analysed by two authors. Seven actors participated in two focus groups.
Findings
Five themes emerged: “motivations to participate”, “actor preparation and training”, “harnessing and respecting the role”, “value for students”, “suggested enhancements to the actor experience”. Actors felt supported by the academic team to portray a range of psychosis-related experiences.
Conclusion
While data saturation and generalizability were not aims of this preliminary study, actors’ recommendations, such as providing opportunities to rehearse with people with lived experience prior to enactment, for authentic and respectful portrayal, may be important to consider when engaging actors in academic activities.
{"title":"“Play it truthfully and authentically”: An exploratory study of actors’ perspectives on role-playing psychosis-related scenarios with pharmacy students","authors":"Tina X. Ung PhD, Claire L. O’Reilly PhD, Rebekah J. Moles PhD, Sarira El-Den PhD","doi":"10.1016/j.ecns.2025.101874","DOIUrl":"10.1016/j.ecns.2025.101874","url":null,"abstract":"<div><h3>Background</h3><div>Simulated patient role-plays enable healthcare students to practice skills in a safe learning environment. However, simulated patient actors’ perspectives and experiences of being involved in this educational method are underrepresented.</div></div><div><h3>Aim</h3><div>This study explored actors’ perspectives and feedback on the training process, and experiences role-playing psychosis-related scenarios with pharmacy students.</div></div><div><h3>Methods</h3><div>Ten actors enacted 86 role-plays with final-year pharmacy students. Role-plays were based on co-designed scenarios relating to psychosis, with students assessed on their ability to provide psychosis-related care. Postrole-plays, all actors were invited to participate in focus groups to explore their perspectives and provide feedback. Focus group interviews were audio-recorded, transcribed verbatim, then independently thematically analysed by two authors. Seven actors participated in two focus groups.</div></div><div><h3>Findings</h3><div>Five themes emerged: “motivations to participate”, “actor preparation and training”, “harnessing and respecting the role”, “value for students”, “suggested enhancements to the actor experience”. Actors felt supported by the academic team to portray a range of psychosis-related experiences.</div></div><div><h3>Conclusion</h3><div>While data saturation and generalizability were not aims of this preliminary study, actors’ recommendations, such as providing opportunities to rehearse with people with lived experience prior to enactment, for authentic and respectful portrayal, may be important to consider when engaging actors in academic activities.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101874"},"PeriodicalIF":2.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ecns.2025.101864
Or Bercovich MD , Kinneret Segal RN, CNM, MHA , Mali Zachi RN , Yuval Neeman MD , Noa A. Brzezinski Sinai MD , Or lee Rak MD , Emilie Klochendler Frishman MD , Eran Hadar MD , Ohad Houri MD, MSc
Background
Obstetric emergencies pose significant risks to maternal and fetal health. Enhancing maternity nurses’ abilities to manage such situations is critical for improving outcomes.
Methods
A prospective cohort study was conducted among maternity ward nurses at a high-volume tertiary center. A two-day, 12-hour obstetric emergency training program, combining lectures with realistic simulation scenarios, was implemented. Knowledge and competencies were assessed before and after the training using multiple-choice questions and Likert scale evaluations.
Results
Participants demonstrated significant improvement in self-assessed confidence (from 3.98 to 4.38, +10.05%), professional self-conception (4.29-4.58, +6.76%), and theoretical knowledge (4.13-4.31, +4.36%). The greatest improvements were seen in managing postpartum hemorrhage (4.27-4.73, +10.77%) and seizures (3.49-4.04, +15.76%). Correct identification of preeclampsia criteria rose by 73.27% (33.3%-57.7%), with 100% accuracy achieved in eclampsia prevention and severe preeclampsia management post-training.
Conclusion
Simulation-based training significantly enhances maternity nurses' emergency preparedness, suggesting its essential role in improving clinical competence and optimizing obstetric care during emergencies.
{"title":"Emergency scenarios simulations in the obstetrics maternity ward-“training together, treating together”","authors":"Or Bercovich MD , Kinneret Segal RN, CNM, MHA , Mali Zachi RN , Yuval Neeman MD , Noa A. Brzezinski Sinai MD , Or lee Rak MD , Emilie Klochendler Frishman MD , Eran Hadar MD , Ohad Houri MD, MSc","doi":"10.1016/j.ecns.2025.101864","DOIUrl":"10.1016/j.ecns.2025.101864","url":null,"abstract":"<div><h3>Background</h3><div>Obstetric emergencies pose significant risks to maternal and fetal health. Enhancing maternity nurses’ abilities to manage such situations is critical for improving outcomes.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted among maternity ward nurses at a high-volume tertiary center. A two-day, 12-hour obstetric emergency training program, combining lectures with realistic simulation scenarios, was implemented. Knowledge and competencies were assessed before and after the training using multiple-choice questions and Likert scale evaluations.</div></div><div><h3>Results</h3><div>Participants demonstrated significant improvement in self-assessed confidence (from 3.98 to 4.38, +10.05%), professional self-conception (4.29-4.58, +6.76%), and theoretical knowledge (4.13-4.31, +4.36%). The greatest improvements were seen in managing postpartum hemorrhage (4.27-4.73, +10.77%) and seizures (3.49-4.04, +15.76%). Correct identification of preeclampsia criteria rose by 73.27% (33.3%-57.7%), with 100% accuracy achieved in eclampsia prevention and severe preeclampsia management post-training.</div></div><div><h3>Conclusion</h3><div>Simulation-based training significantly enhances maternity nurses' emergency preparedness, suggesting its essential role in improving clinical competence and optimizing obstetric care during emergencies.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"110 ","pages":"Article 101864"},"PeriodicalIF":2.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ecns.2025.101858
Heather S. Cole Ph.D., RN, CHSE, CNEn , Marie Lindley PhD, RN, CNE , Amber Senetza MSN, RN, CHSE
Background
As artificial intelligence (AI) continues to influence healthcare education, simulation-based learning offers a valuable platform for integrating AI to improve learner outcomes and operational efficiency. The INACSL Healthcare Simulation Standards of Best Practice™ (HSSOBP) provide a framework for high-quality simulation, yet the alignment between current AI applications and these standards remains unclear.
Objective
This scoping review explored how AI is being integrated into simulation-based education and examined the extent of alignment with the INACSL HSSOBP.
Methods
Using Arksey and O’Malley’s scoping review framework and PRISMA-ScR guidelines, a comprehensive search was conducted across four databases. Studies were included if they described AI integration in simulation involving healthcare learners or educators and demonstrated relevance to one or more INACSL HSSOBP standards. Eighteen studies published between 2021 and 2025 met inclusion criteria.
Results
AI applications most frequently aligned with the standards for Simulation Design (n = 12), Evaluation of Learner Outcomes (n = 9), and Facilitation (n = 8). Tools included large language models, virtual patients, natural language processing, and AI-assisted debriefing. Gaps were noted in Professional Development, Sim-IPE, and Operations.
Conclusion
This review highlights the promise of AI in supporting simulation best practices and underscores the need for stronger alignment.
{"title":"Artificial intelligence meets best practice: A scoping review of AI integration in simulation-based education","authors":"Heather S. Cole Ph.D., RN, CHSE, CNEn , Marie Lindley PhD, RN, CNE , Amber Senetza MSN, RN, CHSE","doi":"10.1016/j.ecns.2025.101858","DOIUrl":"10.1016/j.ecns.2025.101858","url":null,"abstract":"<div><h3>Background</h3><div>As artificial intelligence (AI) continues to influence healthcare education, simulation-based learning offers a valuable platform for integrating AI to improve learner outcomes and operational efficiency. The INACSL Healthcare Simulation Standards of Best Practice™ (HSSOBP) provide a framework for high-quality simulation, yet the alignment between current AI applications and these standards remains unclear.</div></div><div><h3>Objective</h3><div>This scoping review explored how AI is being integrated into simulation-based education and examined the extent of alignment with the INACSL HSSOBP.</div></div><div><h3>Methods</h3><div>Using Arksey and O’Malley’s scoping review framework and PRISMA-ScR guidelines, a comprehensive search was conducted across four databases. Studies were included if they described AI integration in simulation involving healthcare learners or educators and demonstrated relevance to one or more INACSL HSSOBP standards. Eighteen studies published between 2021 and 2025 met inclusion criteria.</div></div><div><h3>Results</h3><div>AI applications most frequently aligned with the standards for Simulation Design (<em>n</em> = 12), Evaluation of Learner Outcomes (<em>n</em> = 9), and Facilitation (<em>n</em> = 8). Tools included large language models, virtual patients, natural language processing, and AI-assisted debriefing. Gaps were noted in Professional Development, Sim-IPE, and Operations.</div></div><div><h3>Conclusion</h3><div>This review highlights the promise of AI in supporting simulation best practices and underscores the need for stronger alignment.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"109 ","pages":"Article 101858"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ethical dilemmas are frequent in clinical practice, yet many health professionals report inadequate preparation. Simulation-based education (SBE) may support ethical reasoning through experiential and reflective learning.
Aim
This study aimed to identify the ethical topics addressed and simulation modalities used to teach bioethics in undergraduate health education.
Methods
A scoping review was conducted using the PRISMA-ScR framework. Articles published in English, Spanish, or Portuguese from four major databases were screened. Inclusion criteria required curricular simulation activities targeting undergraduate health students and bioethics.
Results
Of the 30 included studies, 73.3% used quantitative methods. Nursing and Medicine were most represented. Standardized patients and hybrid simulations were the predominant modalities. Key themes included informed consent, patient autonomy, and confidentiality. However, only half of the studies assessed outcomes, and few reported structured debriefing or facilitator training.
Conclusions
Simulation supports ethical learning, but its implementation in bioethics education lacks methodological depth. Future work should enhance design, evaluation, and interprofessional integration to strengthen its educational impact.
{"title":"Global implementation of undergraduate health bioethics teaching using simulations: A Scoping review","authors":"Jenny Forero MSN , Soledad Armijo-Rivera MD, M.Ed., CHSE-A , Scarlett Vicencio-Clarke MD, M.Ed. , Weimar Tovar MD , Rossana Navarro RN , Alix Soublette MD, PhD , José Calleja MD, PhD , Paulina Húmeres PhD , Natalia Palma M.Ed. , Eugenia Ruiz M.Ed. , Rossemarie Krebs M.Sc. , Katerina Castillo MHA","doi":"10.1016/j.ecns.2025.101863","DOIUrl":"10.1016/j.ecns.2025.101863","url":null,"abstract":"<div><h3>Background</h3><div>Ethical dilemmas are frequent in clinical practice, yet many health professionals report inadequate preparation. Simulation-based education (SBE) may support ethical reasoning through experiential and reflective learning.</div></div><div><h3>Aim</h3><div>This study aimed to identify the ethical topics addressed and simulation modalities used to teach bioethics in undergraduate health education.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using the PRISMA-ScR framework. Articles published in English, Spanish, or Portuguese from four major databases were screened. Inclusion criteria required curricular simulation activities targeting undergraduate health students and bioethics.</div></div><div><h3>Results</h3><div>Of the 30 included studies, 73.3% used quantitative methods. Nursing and Medicine were most represented. Standardized patients and hybrid simulations were the predominant modalities. Key themes included informed consent, patient autonomy, and confidentiality. However, only half of the studies assessed outcomes, and few reported structured debriefing or facilitator training.</div></div><div><h3>Conclusions</h3><div>Simulation supports ethical learning, but its implementation in bioethics education lacks methodological depth. Future work should enhance design, evaluation, and interprofessional integration to strengthen its educational impact.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"109 ","pages":"Article 101863"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ecns.2025.101865
Federica Dellafiore PhD , Pierpaolo Servi MSC , Angela Durante PhD , Marco Di Nitto PhD
Background
In nursing education, simulation contributes to improve knowledge, competence, and critical thinking. Some criticalities are recognized, too. An overall view on facilitators and barriers to learning through simulation in undergraduate nursing education is still lacking. This study explored facilitators and barriers to learning through a low, medium, or high-fidelity simulation in undergraduate nursing education.
Methods
According to the Whittemore and Knafl framework, an integrative review was conducted, performing a systematic search on five databases (Pubmed, CINAHL, PsycINFO, Web of Science, Scopus), from 2012 to September 2024. The Mixed Methods Appraisal Tool (MMAT) assessed the quality appraisal.
Results
32 included studies revealed 29 key factors, grouped into four themes: Realism and environment; Team working; Nursing education; Nursing learning and students' abilities. Nineteen of these were identified as facilitators and 10 as barriers.
Conclusion
The review results could provide useful hints to guide the development of effective and efficient simulation training programs, especially after the Covid-19 period that had accelerated the use of technologies in educational setting.
在护理教育中，模拟有助于提高知识、能力和批判性思维。一些批评也得到了认可。对本科护理教育中通过模拟学习的促进因素和障碍的整体看法仍然缺乏。本研究通过低、中、高保真度模拟，探讨本科护理教育中学习的促进因素和障碍。方法根据Whittemore and Knafl框架，从2012年至2024年9月对Pubmed、CINAHL、PsycINFO、Web of Science、Scopus等5个数据库进行系统检索，进行综合评价。采用混合方法评价工具（MMAT）对质量评价进行评价。结果32项研究揭示了29个关键因素，分为四个主题：现实主义和环境；团队工作;护理教育;护理学习与学生能力。其中19个被确定为促进者，10个被确定为障碍。结论综述结果可为指导制定有效和高效的模拟培训方案提供有用的提示，特别是在新冠肺炎疫情后，技术在教育环境中的应用加快了。
{"title":"Facilitators and barriers to learning through simulation in undergraduate nursing education: An integrative review","authors":"Federica Dellafiore PhD , Pierpaolo Servi MSC , Angela Durante PhD , Marco Di Nitto PhD","doi":"10.1016/j.ecns.2025.101865","DOIUrl":"10.1016/j.ecns.2025.101865","url":null,"abstract":"<div><h3>Background</h3><div>In nursing education, simulation contributes to improve knowledge, competence, and critical thinking. Some criticalities are recognized, too. An overall view on facilitators and barriers to learning through simulation in undergraduate nursing education is still lacking. This study explored facilitators and barriers to learning through a low, medium, or high-fidelity simulation in undergraduate nursing education.</div></div><div><h3>Methods</h3><div>According to the Whittemore and Knafl framework, an integrative review was conducted, performing a systematic search on five databases (Pubmed, CINAHL, PsycINFO, Web of Science, Scopus), from 2012 to September 2024. The Mixed Methods Appraisal Tool (MMAT) assessed the quality appraisal.</div></div><div><h3>Results</h3><div>32 included studies revealed 29 key factors, grouped into four themes: Realism and environment; Team working; Nursing education; Nursing learning and students' abilities. Nineteen of these were identified as facilitators and 10 as barriers.</div></div><div><h3>Conclusion</h3><div>The review results could provide useful hints to guide the development of effective and efficient simulation training programs, especially after the Covid-19 period that had accelerated the use of technologies in educational setting.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"109 ","pages":"Article 101865"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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