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

Objectives: The aim of this study was to assess intraosseous (IO) access placement performance during a multidisciplinary simulation-based training (SBT) program according to the professional status, experience of caregivers, and the setting of the course.

Method: This prospective, multicentric study included emergency physicians, residents, certified registered nurse anesthetists, registered nurses, and students. It was carried out between April 6, 2020 and April 30, 2021 in emergency medical services, an emergency department, and a simulation center. Trainee performance was evaluated by 2 independent observers using a validated scale, before and after SBT. Self-assessment of satisfaction was carried out. Interobserver reproducibility was analyzed by intraclass correlation coefficient. The continuous variables were compared using a Student t test or a nonparametric Mann-Whitney U test. Comparative analysis between the different groups used analysis of variance. Correlation analysis was performed by a nonparametric Spearman test. A P value of 0.05 was considered significant.

Results: Ninety-eight participants were included. Intraclass correlation coefficient between the 2 observers was 0.96. Performance significantly increased after training, regardless of the site or device used (for the semiautomatic device, P = 0.004 in tibia and P = 0.001 in humeral; for the manual device, P < 0.001). Simulation-based training significantly reduced time for IO access ( P = 0.02). After SBT, no difference was found according to professional status and the setting of the course. Performance was not correlated with professional experience. All trainees were satisfied with the training.

Conclusions: Simulation-based training improved the IO access using a semiautomatic or a manual device, regardless of the experience or status of the trainees. Simulation-based training would work for many disciplines regardless of locations (simulation or clinical facilities).

Introduction: Simulation-based learning is an effective approach to teaching and assessing medical students. However, there is a lack of research regarding how playing the patient role during peer simulation impacts medical student learning. This study, therefore, examines the experiences of first-year medical students in the patient role during a high-fidelity, multiday peer simulation.

Methods: Using a phenomenological approach to qualitative data analysis, we analyzed 175 student reflection papers assigned to the students at the conclusion of the peer simulation. Our research team individually coded each paper and then came to a consensus on themes and patterns within the data.

Results: We discovered the following 4 themes within the data: (1) communication, (2) empathy, (3) stress, and (4) professional identity. Through observation and peer simulation students learned the importance of team, patient, and nonverbal communication, especially during transitions of care. Next, the students recognized the importance of quality patient care and prioritizing the humanity of their future patients. The students also connected stress and mistakes, teaching them the importance of stress management. Finally, inspired by their peers and looking to their future selves, the students expressed a commitment to continued professional development.

Conclusions: The patient role during peer simulation is an impactful learning experience for first-year medical students. Our study holds important implications for ways in which medical educators can maximize the benefits of simulation-based education for junior medical student learning.

Introduction: Current bone models used for pediatric intraosseous (IO) placement training are expensive or lack anatomic and/or functional fidelity. This technical report describes the development and validation of a 3-dimensional printed (3DP) tibia from a pediatric lower extremity computed tomography scan for IO procedural training.

Methods: Multiple 3DP tibia models were printed using a dual-extrusion fused-filament fabrication printer. Models underwent iterative optimization until 2 final models, one of polypropylene (3DP clear) and the other of polylactic acid/polypropylene (3DP white), were selected. Using an exploratory sequential mixed-methods design, a novel IO bone model assessment tool was generated. Physicians then used the assessment tool to evaluate and compare common IO bone models to the novel 3DP models during IO needle insertion.

Results: Thirty physicians evaluated the provided pediatric IO bone models. Compared with a chicken bone as a reference, the 3DP white bone had statistically significantly higher mean scores of anatomy, heft, sense of being anchored in the bone, quality of bone resistance, and "give" when interfaced with an IO needle. Twenty-two of the 30 participants ranked the 3DP white bone as either 1st or 2nd in terms of ranked preference of pediatric IO bone model. A 3DP white bone costs $1.10 to make.

Conclusions: The 3DP IO tibia models created from real-life computed tomography images have high degrees of anatomic and functional realism. These IO training models are easily replicable, highly appraised, and can be printed at a fraction of the cost of commercially available plastic models.

Summary statement: This manuscript focuses on interprofessional education (IPE) using simulation and its use between emergency department and emergency medical services personnel. It explores the theoretical frameworks behind IPE and applies them to simulation-based emergency medical services education. There is a notable lack of research on the use of IPE using simulation between these 2 professions. The need for IPE using simulation as well as barriers and recommendations to remove the barriers are discussed.

Summary statement: Screen-based simulation is an effective educational strategy that can enhance health care students' engagement with content and critical thinking across various topics, including mental health. To create relevant and realistic simulations, best-practice guidelines recommend the involvement of experts in the development process. We collaborated with persons with lived experience and community partners to cocreate a mental health-focused screen-based simulation. Cocreating meant establishing a nonhierarchical partnership, with shared decision-making from start to finish.In this article, we present 8 principles developed to guide our cocreation with persons with lived experience: person-centeredness, trauma-informed approaches and ethical guidance, supportive environment, two-way partnership, mutual respect, choice and flexibility, open communication, and room to grow. These principles provide practical guidance for educators seeking to engage the expertise of persons who have been historically disadvantaged in society. By sharing these principles, we strive to contribute to a more equitable process in simulation development and promote meaningful, respectful, and safer collaborations.

Summary statement: This systematic review aimed to identify, appraise, and synthesize evidence for the effectiveness of simulation modalities in promoting nursing students' empathy. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was followed with 20 studies included. The Medical Education Research Study Quality Instrument (MERSQI) was used to evaluate the quality of the publications. The mean MERSQI score was 10.95 with an SD of 1.62, which was above the average in the literature.Five simulation modalities were identified: standardized patient, simulated suit, manikin, virtual simulation, and virtual reality simulation. Most of the studies (n = 15) reported significant differences in the measured outcomes after their simulation activities, including all 5 simulation modalities, but the most effective modality was the simulation suit. The simulation suit replicates the lived experiences of others, which enhances perspective taking by "turning the student into the patient" through the physical and sensory effects of simulated suits. However, outcome measures were limited to self-report instruments in the studies.

Introduction: Effective educational initiatives can elevate the quality of patient care globally. Simulation-based education is widely used in high-resource settings, but barriers exist to its widespread use in low-resource settings. Vital Anesthesia Simulation Training (VAST) overcomes these barriers by offering immersive, low-cost portable simulation along with simulation facilitator training. During the COVID-19 pandemic, in-person courses were stopped for more than 2 years. Postpandemic, a 3-day VAST SIMposium was hosted in Rwanda to unite 42 VAST facilitators from 12 widespread countries to introduce new and revised course materials and to rejuvenate dormant skills. The purpose of this study was to explore how the VAST SIMposium influenced perceived development of skills, confidence, and engagement in a community of practice for simulation educators working in low-resource settings.

Methods: This qualitative study involved in-depth interviews with a purposive sample of 16 VAST SIMposium attendees. Transcripts of audio recordings were analyzed using inductive thematic analysis.

Results: Six themes were identified during data analysis: 1) Diversity with shared passion for medical education; 2) Supportive in-person learning environment; 3) Simulation-based education relevant to low-resource settings; 4) Camaraderie; 5) Building knowledge, skills, and confidence; and 6) Being part of a community of practice.

Conclusion: The SIMposium rejuvenated passion, knowledge, skills, and, most importantly, strengthened global connections and partnerships. These collaborations will benefit areas that are underrepresented in simulation and will ultimately improve patient outcomes. A SIMposium of this format is an efficient and effective way to foster sustainable global dissemination of simulation-based global health education.

Summary statement: Simulation-based health professions educators can advance diversity, equity, and inclusion by cultivating structural competency, which is the trained ability to discern inequity not only at an individual level, but also at organizational, community, and societal levels. This commentary introduces Metzl and Hansen's Five-Step Model for structural competency and discusses its unique applicability to the metacognitive underpinnings of simulation-based health professions education. We offer a pragmatic guide for simulation-based health professions educators to collaboratively design learning objectives, simulation cases, character sketches, and debriefs in which structural competency is a simulation performance domain, alongside patient management, resource usage, leadership, situational awareness, teamwork, and/or communication. Our overall goal is to promote a paradigm shift in which educators are empowered to partner with patients, colleagues, and communities to recognize, learn about, and challenge the factors driving health inequities; a skill that may be applied to a broad range of health professions education within and outside of simulation.

Abstract: The Society for Simulation in Healthcare held its third research summit in January 2023 with the aim of establishing evidence-based guidelines for healthcare simulation training. A panel of researchers, clinicians, and subject-matter experts conducted reviews of the literature addressing 12 key topics and followed a formal process to generate 16 guidelines for simulation-based training in healthcare. Eleven peer-reviewed literature reviews accompany these guidelines. Over the last 12 years, the Society for Simulation in Healthcare research summits have evolved with a consistent aim to advance simulation research, culminating in the formal set of guidelines published in this special issue.