Simulation in Healthcare-Journal of the Society for Simulation in Healthcare最新文献

Summary statement: Simulated participants (SPs) are often employed to teach communication skills in medical education. Although there is a large number of qualitative and/or noncomparative studies in this field, there is no current evidence for the effectiveness of this teaching method based on quantitative comparative meta-data. The aim of this review was to evaluate the effectiveness of SP-based teaching on patient-centered communication skills in medical education compared with traditional teaching formats such as lecture or peer role play focusing on quantitative and comparative data. According to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we searched MEDLINE, Cochrane Library, PsycINFO, CINAHL, and ERIC databases for relevant studies published through February 2023. We also conducted hand searches and ancestry searches. Of the 8523 publications identified, 21 studies with 2500 participants and a Medical Education Research Study Quality Instrument score of 13.7 (SD = 1.3, N = 21) were included in the synthesis. Ten studies were eligible for meta-analysis. The pooled effect for communication skills outcomes suggests a medium effect preferring SP-based teaching to traditional teaching formats (standardized mean difference = 0.74, 95% confidence interval = 0.37 to 1.11, I2 = 95%, n = 2061). The heterogeneity is high among the analyzed studies. Further analysis reveals great differences among the studies' characteristics (population, objectives, interventions, control group settings, and outcome measurements).

Introduction: Interprofessional simulation (IP-Sim) training in crisis resource management (CRM) is widely used to improve team performance. Emerging social sensor-based technology and measurement provide an opportunity to enhance IP-Sim. Using these methods, signals generated by team members in action are collected, analyzed, and presented in a debriefing session as visual aids and statistics that summarize behavioral markers of teamwork and taskwork. We developed a novel social sensor-based measuring system and tested it in a pilot study to demonstrate its feasibility, acceptance, and relevance during IP-sim in CRM.

Methods: During 6 immersive scenario-based IP-Sim sessions, we gathered both quantitative (survey) and qualitative (videotaped debriefing) postsimulation exposure data. Six experimental teams, each containing 3 trainees (2 nurses and 1 physician), were involved in a scenario in which a life-threatening emergency in a hospital setting had to be identified and managed.

Results: By conducting successful deployment in a simulated environment, we demonstrated the viability of the proposed system and outlined the remaining obstacles (feasibility check). We documented users' successful and unsuccessful methods for incorporating the solution into existing training frameworks (acceptability check). In addition, we determined how users interpreted behavioral markers during debriefing such as space occupation, gaze dynamics, and verbal interaction to improve situational awareness and common understanding (relevance check).

Conclusions: We detailed the conditions under which a new sensor-based approach can be successfully integrated into immersive scenario-based simulation and identified areas for further development. The findings indicated that social sensor technology and measurement have the potential to enhance the overall experience of IP-Sim sessions in CRM.

Introduction: This systematic review aims to investigate the impact of team composition on learning outcomes following simulation-based training of teamwork competencies for healthcare professionals and healthcare students.

Methods: We searched Ovid Embase, CINAHL, and OVID Medline from 2011 to July 3, 2023, and included randomized trials and observational studies with a control group. Risk of bias was assessed using the revised Cochrane Risk-of-Bias tool and the Risk of Bias in Non-Randomized Studies tool. We did not conduct a meta-analysis because of heterogeneity. We evaluated certainty of evidence using GRADE methodology.

Results: We screened 14,309 abstracts and included 11 studies. We found 6 studies investigating uniprofessional (UP) versus multiprofessional (MP) teams, 3 studies investigating team size, 1 study investigating dynamic versus stable teams, and 1 study investigating the effect of gender composition. Studies overall found that team composition may affect team performance. Studies on UP versus MP teams investigated skill acquisition, knowledge acquisition, and self-efficacy, showing no difference between groups or a small benefit of MP team training. The certainty of evidence was very low.

Discussion: We identified very low certainty evidence, suggesting that team composition affects team performance and MP team training should be considered as opposed to UP team training when providers are expected to work together across professions in clinical practice. Further research is needed to identify the optimal team composition for training of teamwork competencies.

Summary statement: The evidence base supporting the adoption of simulation in health care has not kept pace with the rapid growth of the field. Although there is a growing body of research in health care simulation, many published studies describe small-scaled, underpowered projects with insufficient methodological rigor to inform our understanding of simulation. This problem is indicative of a larger challenge: the lack of focused, cohesive programs of research designed to advance the science of simulation. The METRICS framework is a model of scholarship that categorizes scholarship into 7 intersecting domains: Metascholarship, Evaluation, Translation, Research, Innovation, Conceptual, and Synthesis. In this article, we aim to explore how the METRICS framework can serve as a roadmap for researchers to develop cohesive simulation research programs. We also describe how the METRICS framework applies to existing institutional and network-based programs of health care simulation research and discuss future implications for the global health care simulation community.

Summary statement: Biometric technology shows substantial promise to enhance patient safety and transform provider training. In patient care, biometric technology enables outpatient providers to optimize chronic disease by alerting providers to changes in patient conditions with real-time data. In provider training, biometric technology can inform training environments and curriculum. Certainly, there are hurdles to technology implementation including hardware fragility, cost, and software integration. Despite challenges, biometric technology has been effectively implemented in simulations and real patient settings.Looking forward, future developments focused on data security and privacy, standardizing data collection, and improving system compatibility will facilitate the wider adoption of biometric technology and improve health care quality, especially in resource-limited settings. Collaborative efforts among informatics experts, patient safety advocates, and health care providers are essential to overcome challenges and fully leverage biometric technology's potential in enhancing patient outcomes. The purpose of this commentary is to review current applications, identify key challenges, and offer recommendations to the simulation community for testing biometric technology, use in training programs, and facilitating systems integration to improve outcomes.

Background: Clinical residents play a crucial role in educating other healthcare professionals; however, formal training programs to develop teaching skills remain limited. This study evaluated the effectiveness of a "residents as teachers" course incorporating standardized learners (SLs) to enhance teaching competencies among clinical residents.

Methods: A single group pre-post intervention study was conducted with 38 second-year residents participating in the course between 2020 and 2023. Residents completed pre- and post-course assessments based on teaching entrustable professional activities (TEPAs). In addition, 26 residents completed a survey evaluating their perceptions of using SLs as a teaching and evaluation tool.

Results: Residents in the 2023 study group showed notable improvements in most teaching competencies after the course. Median scores increased significantly in TEPA 01, 02, 03, 05, 06, and 08 (P < 0.05), while no significant changes were observed in TEPA 07, and a decrease was noted in TEPA 04. Boxplot analysis indicated not only performance gains but also greater consistency among residents after training. In addition, 92% of participants rated SLs as highly useful for developing teaching skills, supporting their use across various educational contexts such as student engagement, classroom teaching, and feedback delivery.

Conclusions: Integrating SLs into resident training programs offers a highly accepted and effective strategy to strengthen teaching competencies and boost resident confidence in educational roles. Future studies should explore the long-term impact of SL-based training on residents' teaching practices and student learning outcomes.

Summary statement: This systematic review and meta-analysis evaluated the efficacy of simulation-based training for direct and indirect ophthalmoscopy. The primary outcome was successful fundus identification rate. Secondary outcomes included the simulation favorability rate, posttest results, and perceived benefits. Of the 955 studies identified, 11 studies were included, comprising a total sample of 772 participants. Simulation training improved fundus identification success, with 63.1% of participants correctly identifying fundus structures and demonstrated a high favorability rate, with 75.6% of participants preferring simulation over traditional training methods. Participants also demonstrated improvements in posttest knowledge and technical skills, with enhanced confidence, realism, and ease of learning, underscoring simulation's role in effectively advancing practical ophthalmic skills. Overall, simulation-based training seems effective in enhancing examination skills within simulated settings. These findings support its integration into ophthalmology curricula to enhance training outcomes. Interpretation of fundus identification outcomes should be cautious due to limited study numbers and assessment heterogeneity.

Summary statement: In response to the increased COVID-19 cases and staff limitations, the need to enhance critical care capacity was identified by the Aga Khan University Hospital (AKUH). We designed and delivered a series of in-person simulation-based workshops to rapidly upskill healthcare workers in Pakistan. The primary objective of our workshops was to train healthcare workers across various medical fields to serve as supplemental intensive care unit staff if needed. A total of 19 in-person workshops were organized, targeting physicians, nurses, and allied health workers from across Pakistan. Using high-fidelity medical simulation technology, these workshops provided hands-on exposure and addressed specific learning objectives such as diagnosis and management of COVID-19 patients, shock, arrythmias, respiratory failure, oxygen titration and noninvasive ventilation, mechanical ventilation, critical care pharmacy, interpretation of arterial blood gases, code simulation, prone positioning, central line placement, and video laryngoscopy.

Introduction: This study compares 2 commercially available infusion pumps in a simulated cardiac surgical perioperative setting to assess differences in usability, medication errors, and programming workload among experienced and trainee healthcare professionals. Perioperative medications are frequently administered to patients via infusion pumps. Major issues in the perioperative period include medication errors, usability challenges, and workflow inefficiencies.

Methods: Simulation of a cardiac perioperative setting was used to observe 24 trainee and experienced healthcare professionals. The primary outcome was time to correct completion of each drug infusion task. Participants completed usability and workload surveys after each simulation.

Results: Participants were comparable with regard to demographics, prior work, and simulation experience. Results showed no significant difference with regard to time to correct completion of each drug infusion task. There was a significant increase in aggregate Systems Usability Scores among anesthesia professionals favoring use of the pneumatic pump. There were no significant differences in either cohort in aggregates score of the NASA Task Load Index.

Conclusions: Aggregate System Usability Scoring among anesthesia professionals favored pneumatic pump use. However, there were no differences in time to complete infusion task or in medication errors in each pump group.