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Virtual reality versus webinar trans healthcare training for emergency medicine residents: a feasibility study 针对急诊医学住院医师的虚拟现实与网络研讨会跨医疗保健培训:可行性研究
Pub Date : 2024-08-08 DOI: 10.54531/qniz1640
M. Chisolm‐Straker, Adrian D. Daul, Shannon McNamara, Rhyan Goldman, Christina Hajicharalambous, Mariju F. Baluyot, Michael Cole, Cindy Clesca, George Loo, Maria-Pamela Janairo, Elizabeth A. Samuels, Lauren Westafer, Felipe Serrano, Zil Goldstein
Introduction Transgender and gender non-binary (TGNB) patient care is not routinely taught in medical training. As a result, clinicians frequently lack knowledge regarding gender-affirming practices, surgeries and medications. TGNB-specific health knowledge and care delivery are further negatively impacted by pervasive societal transphobia. Virtual reality (VR)-based instruction may provide learners with opportunities for perspective taking, empathy building and attitudinal shifting to improve care delivery to TGNB patients. Methods This was a feasibility trial that compared passive VR and webinar in changing learner attitudes, knowledge and medical decision-making (MDM). Residents were recruited from five US emergency medicine (EM) residencies and were randomized to either VR or webinar educational intervention arm. Pre- and post-intervention assessments were matched using a unique identifier. Participants provided feedback about platform usability. Results From August 2020 to October 2021, 206 resident participants were randomized into a case-based VR experience or webinar intervention on TGNB-specific EM medicine; 52 residents completed all three steps of the study. Webinar participants demonstrated more changes in attitudinal statements than VR participants. No improvements in knowledge or MDM were appreciated in either intervention arm. Participants in both arms shared positive and critical feedback about the intervention they accessed, with convenience and ease of use being valued for asynchronous webinar learning. Discussion The webinar arm demonstrated a higher increase in empathy or change in attitude compared to VR learners. As VR becomes more technologically agile, accessible and reliable, more work is needed to see if this novel format is an educational tool that closely approximates the standardized patient encounter.
导言 跨性别和性别非二元性(TGNB)患者护理并非医学培训的常规课程。因此,临床医生经常缺乏有关性别确认实践、手术和药物的知识。社会上普遍存在的对变性人的恐惧进一步影响了针对 TGNB 的健康知识和护理服务。基于虚拟现实(VR)的教学可为学习者提供透视、建立同理心和转变态度的机会,从而改善对 TGNB 患者的护理服务。方法 这是一项可行性试验,比较了被动 VR 和网络研讨会在改变学习者态度、知识和医疗决策(MDM)方面的作用。从美国五所急诊医学(EM)住院医师中招募住院医师,将他们随机分配到虚拟现实或网络研讨会教育干预组。干预前和干预后的评估使用唯一标识符进行匹配。参与者提供有关平台可用性的反馈意见。结果 从 2020 年 8 月到 2021 年 10 月,206 名住院医师被随机分配到基于案例的 VR 体验或关于 TGNB 特定急诊医学的网络研讨会干预中;52 名住院医师完成了研究的所有三个步骤。与虚拟现实体验参与者相比,网络研讨会参与者在态度陈述方面的变化更大。两个干预组在知识或MDM方面都没有明显改善。两组参与者都对他们所接受的干预措施给予了积极和批评性的反馈,异步网络研讨会学习的便利性和易用性受到了重视。讨论 与 VR 学习者相比,网络研讨会组在移情或态度改变方面有更大的提高。随着 VR 在技术上变得更加灵活、方便和可靠,我们需要做更多的工作,以确定这种新颖的形式是否是一种近似于标准化病人接触的教育工具。
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引用次数: 0
Mixed reality simulation training in the assessment and management of acutely unwell patients in undergraduate medical education: a pilot study 医学本科教育中评估和管理急性病患者的混合现实模拟训练:一项试点研究
Pub Date : 2024-08-08 DOI: 10.54531/tlan5397
Benjamin Rowlands, Natalie Cope, Dominic Proctor
Background: Development of the undergraduate simulation experience is needed to continue developing aspiring clinicians’ ability to assess and manage unwell patients. However, its heavy resource demand and ‘Generation Z’s’ desire for technologically enhanced learning means novel simulation modalities must now be considered. Mixed reality (MR) provides a platform to deliver such simulation; however, it is yet to be studied in this context. We conducted an observational cohort study with the aim to assess ift MR simulation improves students’ perceived ability to assess and manage unwell patients. Methods: We recruited 32 undergraduate medical students and asked them to rate their ability to assess and manage acutely unwell patients, out of 10. An MR simulation was then delivered using the Microsoft HoloLens and HoloScenario software produced by GigXR. Students then rated their assessment and management ability again, alongside their experience of the system and its usability. Data analysis used paired t-tests to assess for significant differences. Results: By attending the simulation, students showed a significant improvement in perceived ability to assess (p < 0.001) and manage (p < 0.001) acutely unwell patients. Mean assessment scores improved by 1.09/10 (95% confidence interval [CI 0.67, 1.52]) with 89% of students feeling more confident. Mean management scores improved by 1.63/10 (95% CI [1.15, 2.10]) with 84% of students reporting increased confidence levels. When considering usability, 69% of students did not find the MR system easy to use, with 75% of students having technical issues and 38% experiencing side effects. Overall, 88% of students believed the experience was beneficial to their learning. Conclusions: MR shows promise in its ability to deliver simulation training and improve students’ perceived ability to assess and manage unwell patients. Advances in software availability and content are required for integration into undergraduate medical curricula. Further research is required to assess if these results are replicated objectively.
背景:要继续培养有抱负的临床医生评估和管理不适病人的能力,就必须发展本科生模拟体验。然而,对资源的大量需求以及 "Z 世代 "对技术强化学习的渴望意味着现在必须考虑新的模拟模式。混合现实(MR)提供了一个提供此类模拟的平台;然而,在这种情况下,它尚未得到研究。我们开展了一项观察性队列研究,旨在评估 MR 模拟是否能提高学生评估和管理不适患者的感知能力。研究方法我们招募了 32 名医学本科生,要求他们对自己评估和管理急性不适患者的能力进行评分(满分为 10 分)。然后使用微软 HoloLens 和 GigXR 开发的 HoloScenario 软件进行磁共振模拟。然后,学生们再次对自己的评估和管理能力以及对系统的体验和可用性进行评分。数据分析采用配对 t 检验来评估是否存在显著差异。结果通过参加模拟训练,学生们评估(p < 0.001)和管理(p < 0.001)急性病患者的能力有了显著提高。平均评估分数提高了 1.09/10(95% 置信区间 [CI 0.67, 1.52]),89% 的学生感到更有信心。平均管理得分提高了 1.63/10(95% 置信区间 [1.15,2.10]),84% 的学生表示信心水平有所提高。在考虑可用性时,69% 的学生认为 MR 系统不容易使用,75% 的学生遇到技术问题,38% 的学生遇到副作用。总体而言,88% 的学生认为这种体验有利于他们的学习。结论:磁共振系统在提供模拟训练、提高学生评估和管理不适病人的能力方面大有可为。要将其纳入医学本科课程,需要在软件可用性和内容方面取得进展。还需要进一步的研究来评估这些结果是否可以客观地复制。
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引用次数: 0
Using Forum Theatre techniques in teaching and learning about professionalism and communication in healthcare 利用论坛剧场技术教授和学习医疗保健领域的专业精神和沟通技巧
Pub Date : 2024-07-17 DOI: 10.54531/lfss8468
Camilla Thamdrup, Cathy Smith, Peter Dieckmann, A. Belsi, Debra Nestel
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引用次数: 0
Revising the ASPiH standards: reflections on the evolution of simulated practice 修订 ASPiH 标准:对模拟实践演变的思考
Pub Date : 2024-07-17 DOI: 10.54531/gwhw5303
Cristina Diaz-Navarro, Colette Laws-Chapman, Michael Moneypenny, Debra Nestel, M. Purva
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引用次数: 0
Stress and resilience among military medical students completing a high-fidelity military medical simulation 完成高仿真军事医学模拟的军医学生的压力和复原力
Pub Date : 2024-07-01 DOI: 10.54531/bhtx8590
Rebekah Cole, Michael V. Bronstein
Background High-fidelity medical simulations can help students successfully navigate the stressors of medical training and practice. Because sufficiently high stress levels can interfere with learning, the balance of stress and resilience factors during simulation training should be carefully curated. However, student experiences of stress and resilience during high-fidelity simulations are seldom well characterized, especially in military medical training. With this in mind, the authors investigated students’ lived experiences of stress and resilience during a well-established high-fidelity simulation at a military medical school. Methods Fourth-year active-duty military medical students (n = 23) from the United States Air Force, Army, and Navy who were attending Operation Bushmaster – a 5-day, high-fidelity military medical simulation – were interviewed during and after the simulation. Data were analyzed via a hermeneutic phenomenological qualitative approach. Another 21 students reported their stress levels and trait mindfulness. Experts rated their performance at Operation Bushmaster. Results Participant narratives pointed towards major internal stressors, including chronic uncertainty and fluctuating motivation, and external stressors, such as weather and equipment-related challenges. Narratives also identified multiple factors that mitigated stress, including the use of mindfulness skills (especially mindful/tactical breathing), giving/receiving social support, shifting perspectives to centre connections between Operation Bushmaster and students’ professional purpose, and positive self-talk that gave participants permission to make mistakes and learn from them. There was a moderate positive correlation between mindfulness and performance at Operation Bushmaster. Conclusions These stress and resilience factors are critical leverage points for educators seeking to optimize learning during Operation Bushmaster and other high-fidelity simulation trainings. Future research should continue to examine how the balance of these factors impacts medical students’ immediate learning (e.g. regarding medical decision-making, skill and leadership) and longer-term ability to successfully navigate the stressors of the medical profession.
背景 高保真医学模拟可帮助学生成功应对医学培训和实践中的压力。由于足够高的压力水平会干扰学习,因此在模拟训练过程中,应仔细调节压力和恢复力因素之间的平衡。然而,学生在高仿真模拟训练中的压力和抗压能力很少得到很好的描述,尤其是在军事医学训练中。有鉴于此,作者调查了一所军事医学院校学生在成熟的高仿真模拟训练中的压力和恢复能力体验。方法 对来自美国空军、陆军和海军的四年级现役军医学生(n = 23)进行了访谈,他们参加了为期 5 天的高仿真军事医学模拟培训 "布什马斯特行动"(Operation Bushmaster)。通过诠释现象学定性方法对数据进行了分析。另外 21 名学生报告了他们的压力水平和心智特质。专家对他们在 "布什马斯特行动 "中的表现进行了评分。结果 参与者的叙述指出了主要的内部压力因素,包括长期的不确定性和波动的动机,以及外部压力因素,如天气和与设备相关的挑战。叙述还指出了缓解压力的多种因素,包括正念技能的使用(尤其是正念/战术呼吸)、给予/接受社会支持、转换视角,将 "布什马斯特行动 "与学生的职业目标联系起来,以及积极的自我对话,允许参与者犯错并从中吸取教训。正念与 "布什马斯特行动 "的表现之间存在中等程度的正相关。结论 这些压力和复原力因素是教育工作者在 "布什马斯特行动 "和其他高仿真模拟训练中寻求优化学习的关键杠杆点。未来的研究应继续探讨这些因素的平衡如何影响医学生的直接学习(如医学决策、技能和领导力)以及成功应对医学专业压力的长期能力。
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引用次数: 0
Translating Healthcare Simulationist Code of Ethics into Urdu: bridging gaps in Pakistani healthcare simulation 将《医疗模拟学家道德准则》翻译成乌尔都语:弥合巴基斯坦医疗模拟方面的差距
Pub Date : 2024-06-13 DOI: 10.54531/finn8478
Maria Bajwa, Maliha Zeba Khan
This paper detailed the translation process of the Healthcare Simulationist Code of Ethics from English to Urdu, Pakistan’s national language, addressing the need for healthcare simulation in the country’s native language. Pakistan, a lower–middle-income country, faces challenges accessing healthcare education in Urdu. The systematic translation by bilingual simulation and social sciences experts considered linguistic and cultural nuances by combining translation by committee and back-translation of selected text. Bilingual experts in linguistic research and healthcare practice verified this translation from healthcare, healthcare simulation and linguistics perspectives. This research contributes to the theoretical understanding of ethical values in healthcare simulation, positively influencing healthcare professionals and educators in Pakistan. The translation sought to enhance access to responsible healthcare training initiatives, specifically targeting remote regions and underserved rural communities. This includes health workers, who serve as the primary conduits for health-related initiatives in these areas.
本文详细介绍了《医疗模拟师职业道德规范》从英语到巴基斯坦国语乌尔都语的翻译过程,以满足该国对母语医疗模拟的需求。巴基斯坦是一个中低收入国家,在获得乌尔都语医疗保健教育方面面临挑战。双语模拟和社会科学专家的系统翻译考虑到了语言和文化上的细微差别,将委员会翻译和选定文本的回译结合起来。语言学研究和医疗保健实践方面的双语专家从医疗保健、医疗保健模拟和语言学的角度验证了这一翻译。这项研究有助于从理论上理解模拟医疗保健中的伦理价值,对巴基斯坦的医疗保健专业人员和教育工作者产生积极影响。该翻译旨在提高负责任的医疗保健培训计划的可及性,特别是针对偏远地区和服务不足的农村社区。这其中包括卫生工作者,他们是这些地区卫生相关活动的主要渠道。
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引用次数: 0
Cultivating cultural humility through healthcare simulation-based education: a scoping review protocol 通过医疗保健模拟教育培养文化谦逊:范围界定审查协议
Pub Date : 2024-06-03 DOI: 10.54531/rafh4191
Francine Gonzales-Walters, Sharon M Weldon, Ryan Essex
Background Healthcare disparities within developed nations remain a critical concern, with ethnic minorities and marginalized groups experiencing pronounced inequalities. Cultural humility has emerged as a means to mitigate these disparities and enhance healthcare delivery. Simulation-based education is one of the most widely utilized pedagogical approaches in healthcare curricula across disciplines and specialities. It is recommended in the literature as an ideal strategy for teaching cultural humility to healthcare professionals. However, it is not clear what is known about integrating cultural humility into simulation-based education. This scoping review protocol provides the procedures we will take to explore the breadth of literature to explore how cultural humility is considered and incorporated in simulation-based and to identify current practices and knowledge gaps. Methods and analysis The review will synthesize data following the PRISMA-ScR guidelines for scoping reviews. A comprehensive database (MEDLINE, CINAHL Plus with Full Text, APA PsycINFO and Scopus), grey literature and reference screening will be conducted to identify eligible literature to answer the research question. The quality of the included literature and the risk of bias will be carried out using The Mixed Method Appraisal Tool (MMAT) for primary research papers and the ACCODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) checklist will be used to assess the quality of grey literature. The data will be analysed using descriptive statistics and basic qualitative content analysis.
背景 发达国家的医疗保健差距仍然是一个令人严重关切的问题,少数民族和边缘化群体经历着明显的不平等。文化谦逊已成为缓解这些差异和改善医疗服务的一种手段。在各学科和专业的医疗保健课程中,模拟教育是使用最广泛的教学方法之一。文献建议将其作为向医疗保健专业人员传授文化谦逊的理想策略。然而,目前还不清楚将文化谦逊融入模拟教学的情况。本范围审查协议提供了我们将采取的程序,以探索文献的广度,探讨如何考虑文化谦逊并将其融入模拟教学中,并确定当前的做法和知识差距。方法与分析 本次综述将按照范围界定综述的 PRISMA-ScR 指南对数据进行综合。将通过综合数据库(MEDLINE、CINAHL Plus with Full Text、APA PsycINFO 和 Scopus)、灰色文献和参考文献筛选来确定符合要求的文献,以回答研究问题。将使用 "混合方法评估工具"(The Mixed Method Appraisal Tool,MMAT)对原始研究论文进行质量评估,并使用 ACCODS(权威性、准确性、覆盖面、客观性、日期、重要性)清单评估灰色文献的质量。数据分析将使用描述性统计和基本的定性内容分析。
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引用次数: 0
Embracing discomfort and vulnerability: cultivating brave learning spaces within simulation-based nursing education 拥抱不适和脆弱:在模拟护理教育中培养勇敢的学习空间
Pub Date : 2024-05-20 DOI: 10.54531/fokp9401
Natalie J. Ford, L. M. Gomes, Erin. Lowe, Nicole Harder
Evolving evaluation methods and the changing pedagogical landscape of nursing education offer the opportunity to re-examine learning spaces in simulation. Psychological safety is an established standard within simulation-based experiences; however, limiting learning spaces exclusively within the construct of safety competes with shifting pedagogical practices in simulation within pre-licensure nursing programmes. Conflations of safety and comfort are pervasive in higher education. Shifting language from a place of safety towards one of courage and bravery holds the potential to better promote learning environments which foster agency and meaningful growth when discomfort is experienced. Brave learning spaces recognize discomfort and vulnerability as an essential component of learning and transformation, while also aligning with key principles of psychological safety to optimize learning experiences. Discourse exploring alternatives to safe learning spaces in simulation is notably absent in the current nursing simulation literature propelling the need for this discussion.
不断发展的评估方法和护理教育教学格局的变化为重新审视模拟学习空间提供了机会。心理安全是模拟体验的既定标准;然而,将学习空间完全限制在安全范围内,与执照前护理课程中不断变化的模拟教学实践相冲突。安全与舒适的矛盾在高等教育中普遍存在。将语言从 "安全 "转向 "勇气 "和 "勇敢",有可能更好地促进学习环境,在经历不适的时候,促进能动性和有意义的成长。勇敢的学习空间承认不适和脆弱性是学习和转变的重要组成部分,同时也符合心理安全的关键原则,以优化学习体验。在当前的护理模拟文献中,探索模拟安全学习空间替代方案的论述明显缺乏,这也推动了这一讨论的必要性。
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引用次数: 0
The ASPiH Standards – 2023: guiding simulation-based practice in health and care ASPiH 标准--2023:指导卫生和护理领域的模拟实践
Pub Date : 2024-05-14 DOI: 10.54531/nyvm5886
C. Diaz-Navarro, Colette Laws-Chapman, Michael Moneypenny, M. Purva
The ASPiH Standards 2023 provide a common framework within educational and healthcare sectors, bolstering quality assurance for simulation providers, regulators, professional bodies and commissioners. They endeavour to meet the current needs of simulation practitioners and learners, reflect the evolution of simulation practice, and account for emerging technologies. Therefore, they are applicable to any modality of simulation-based education and training as well as to translational and transformative simulation interventions, including the use of simulation for quality improvement processes, whether carried out at education centres, simulation facilities or at the point of care. The standards encourage adherence to core values of safety, equity, diversity and inclusion, sustainability, and excellence. They provide guidance for all simulation practitioners, highlighting key principles for planning, facilitation and evaluation of simulation activities, as well as recommendations for optimum resource management. Implementation of these standards will require consideration of how they apply to each individual context, and what outcome measures are most meaningful to demonstrate alignment.
ASPiH 标准 2023 为教育和医疗保健领域提供了一个通用框架,加强了模拟提供商、监管机构、专业团体和委托方的质量保证。这些标准努力满足模拟从业人员和学习者的当前需求,反映模拟实践的发展,并考虑到新兴技术。因此,这些标准适用于任何形式的模拟教育和培训,也适用于转化和变革性模拟干预,包括使用模拟进行质量改进过程,无论是在教育中心、模拟设施还是在医疗点进行。该标准鼓励遵守安全、公平、多样性和包容性、可持续性和卓越性等核心价值观。这些标准为所有模拟从业人员提供指导,强调了规划、促进和评估模拟活动的关键原则,以及优化资源管理的建议。在实施这些标准时,需要考虑这些标准如何适用于每种具体情况,以及哪些成果措施对证明一致性最有意义。
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引用次数: 0
Attitude and perception of medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education at an institute in India 印度某学院医护专业本科生和教师对模拟强化跨专业教育的态度和看法
Pub Date : 2024-05-07 DOI: 10.54531/pxfl2917
Lulu Sherif Mahmood, Ciraj Ali Mohammed, John H.V. Gilbert
Background The need for interprofessional education (IPE) has been recognized on the basis of compromised patient care due to ineffective communication and teamwork among healthcare providers. Using Simulation to enhance IPE has been advocated to achieve the competencies required for effective interprofessional collaborative practice. However, the implementation of this powerful tool and its integration into Indian medical education are a relatively recent development, gradually gaining momentum in recent years. Purpose This study was undertaken to assess the attitudes and perceptions of a group of Indian medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education (Sim-IPE) before introducing this module at the institute. Methods A descriptive correlational design was conducted using the KidSIMTM ATTITUDES scale on a convenient sample of 82 students and faculty of medical and nursing colleges. Results The total scores for the 30-item questionnaire revealed an overall positive attitude towards IPE and Simulation as a learning modality. Analysis of variance tests revealed lesser scores for students when compared to faculty. Conclusions A positive attitude towards Sim-IPE by students and faculty is promising, and it is the first step towards integrating Sim-IPE into the undergraduate curriculum in India.
背景 由于医疗服务提供者之间缺乏有效的沟通和团队合作,导致病人护理受到影响,跨专业教育(IPE)的必要性已得到认可。人们提倡利用模拟来加强跨专业教育,以实现有效的跨专业合作实践所需的能力。然而,这一强大工具的实施及其在印度医学教育中的整合是一个相对较新的发展,近年来逐渐获得势头。目的 本研究旨在评估印度医护专业本科生和教师在学院引入模拟增强跨专业教育(Sim-IPE)之前对该模块的态度和看法。方法 使用 KidSIMTM ATTITUDES 量表对医学院和护理学院的 82 名师生进行了描述性相关设计。结果 30 个项目的问卷总分显示,学生对 IPE 和模拟作为一种学习方式总体持积极态度。方差分析检验表明,学生的得分低于教师。结论 学生和教师对模拟 IPE 的积极态度令人鼓舞,这是印度将模拟 IPE 纳入本科课程的第一步。
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引用次数: 0
期刊
International Journal of Healthcare Simulation
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