Facilitators and Barriers to Implementing Peer Observation of Teaching: A Qualitative Study

TPS9046 Background: In medical oncology, the "know-how-to-be" aspect of training is crucial but often underemphasized in resident education. Typically, residents develop their interpersonal skills through direct patient interactions. The challenge lies in delivering cancer diagnoses with empathy and effectively managing the patient experience through advanced communication strategies. High-fidelity simulation training has proven effective in educating professionals, including those in surgical fields. Our previous feasibility studies established a simulation framework for cancer consultation processes. This study aims to demonstrate that high-fidelity simulation training provides greater benefits for residents compared to traditional mentoring by reducing perceived stress levels. Methods: ACACIA2 ( n° HDH : F20221011092723) is a prospective, randomized, open-label, national, multicenter trial that aims to enroll 100 young doctors. After one high-fidelity simulation evaluation, they were randomly assigned (1:1) to have traditional mentoring (Arm A or control arm)+/- 2 sessions of high-fidelity simulation with theoretical training with a certified coach/actor (Arm B) during 6 months. This training adapted to the announcement has been validated in preliminary studies (ACACIA programme)(Figure 1). All the cases worked on in the sessions are taken from real life. Inclusion criteria include healthcare professionals aged 18 and older, actively participating in specialties where they frequently deliver cancer diagnoses, such as surgical and medical disciplines. The primary endpoint is to compare changes in stress levels between residents receiving simulation training and those undergoing conventional mentoring. Secondary objectives include assessing stress changes as measured by a coach/actor, evaluating self-assessed attitudes and skills during simulation sessions, comparing self-assessments before and after training, monitoring heart rate variability, exploring the relationship between skill development and heart rate changes, and assessing participant satisfaction. The first resident was enrolled in November 2022. Clinical trial information: F20221011092723 .

324 A Prospective Randomized Controlled Trial Comparing the Impact of High Fidelity Simulation versus Standard Lecture-based Training on Long Term Clinical Performance of Emergency Airway Management by Emergency Medicine Residents

Fellowship Training in Adult Cardiothoracic Anesthesiology: Navigating the New Educational Landscape as a Result of the Coronavirus Crisis

The experiences of last-year student midwives with High-Fidelity Perinatal Simulation training: A qualitative descriptive study.

High-fidelity simulation training with PPE may optimise resuscitation outcomes in the COVID-19 era

The use of interprofessional simulation training to enhance nursing students' performance of technical and non-technical clinical skills is becoming increasingly common. Simulation training can involve the use of role play, virtual reality or patient simulator manikins to replicate clinical scenarios and assess the nursing student's ability to, for example, undertake clinical observations or work as part of a team. Simulation training enables nursing students to practise clinical skills in a safe environment. Effective simulation training requires extensive preparation, and debriefing is necessary following a simulated training session to review any positive or negative aspects of the learning experience. This article discusses a high-fidelity simulated training session that was used to assess a group of third-year nursing students and foundation level 1 medical students. This involved the use of a patient simulator manikin in a scenario that required the collaborative management of a deteriorating patient.

The effectiveness of high-fidelity simulation training in emergency and critical care nursing education for undergraduate nursing students: A systematic review and meta-analysis.

Introduction Recent evidence support the use of High-fidelity simulation (HFS) among health care professional. Self-efficacy towards resuscitation competency is assumed to be influenced by HFS training that low fidelity simulation. Purpose This study aimed to examine the impact of the high-fidelity Resuscitation Simulation Training (RST) program on the nurse's self-efficacy. Methods A quasi-experiment, one-group pretest-posttest design was used. A total of 62 nurses enrolled the RST. Self-efficacy was assessed in both pretest and posttest phases using the Resuscitation Self-Efficacy Scale (RSES). Changes occurred in self-efficacy after conducting the study program and the potential influence of demographic characteristics were examined using descriptive and inferential statistics. Results Self-efficacy has significantly improved after the RST considering all self-efficacy dimensions; Recognition, Debriefing and recording, Responding and rescuing, and Reporting (P<0.05). This was also consistent with RSES assessment by the course instructors (t=−1.5, p=0.11). A moderate positive correlation was found between the RSES and the ACLS posttest written exam (r=0.303, p=0.017). While minimal influence of demographic characteristic was reported, nurses who had never been involved in resuscitation in the past had shown a significant improvement in their self-efficacy after the RSE. Conclusion The utilization of high-fidelity simulation training can improve nurse's self-efficacy regardless personal characteristics or experience. Funding Acknowledgement Type of funding source: None

The physician associate (PAs) profession is a relatively new profession to the NHS. As such, there is no official national or regionally agreed further training to support PAs transitioning from PA school into clinical practice once they have graduated. Simulation training has proved to be an effective tool for developing clinical and non-clinical skills in other groups of clinicians We aimed to describe the development and implementation of a novel PA-specific simulation training programme and present the evaluation of our initial work.We designed and implemented a bespoke simulation training programme based on existing training for junior doctors. This model has three separate simulation sessions, spaced over 2 years, each session has three different clinical scenarios. Seventeen PAs have undergone the first two sessions. The first session contained three scenarios that highlighted important local protocols such as the major haemorrhage protocol and the sepsis At this point in time, we have feedback from 16 candidates from session 1 and 11 from session 2. The results are overwhelmingly positive showing improved confidence, better team-working skills and a perceived perception of improved patient safety following the simulation training, as shown in graphs 1 and 2. The majority of candidates partaking in the session found the simulation training beneficial to their practise. The main negative feedback given was the lack of ‘senior support’ (i.e. from a senior doctor) in the scenarios that were unrealistic to actual practice.The introduction of a novel PA simulation training programme has demonstrated improvements in clinical and non-clinical skills. This supports our aim of improving post-graduate PA training. Work continues to further develop our PA simulation programme and further evaluate its effectiveness with the aim of making this as a regional simulation programme that PAs can undertake when joining the healthcare workforce.

PurposeThis study aimed to evaluate the effects of a virtual reality (VR) program and simulation training on nursing students’ ability to measure vital signs in children.MethodsThis mixed-methods study, which included a randomized controlled trial and a qualitative study, was conducted from June 12 to November 15, 2023. Forty-four nursing students from a university in South Korea were randomly assigned to either the experimental or control group. The experimental group first participated in a VR program focused on measuring vital signs in children, followed by a high-fidelity simulation training. The control group received the training in the reverse order. The participants’ knowledge, confidence in practice, and satisfaction with the practice were analyzed using the repeated-measures analysis of variance. VR learning experiences were analyzed through qualitative content analysis.ResultsBoth the experimental and control groups showed significant increases in knowledge and confidence in practice after the interventions compared to baseline. However, there were no significant differences in changes in knowledge, confidence in practice, and satisfaction with practice between the two groups. Three themes were identified from the nursing students’ experiences with VR learning: ‘realistic learning training,’ ‘overcoming learning limitations,’ and ‘perceiving drawbacks.’ConclusionThe VR program was as effective as high-fidelity simulation training in improving nursing students’ ability to measure children’s vital signs. Moreover, VR program offered additional benefits in addressing limitations of simulation-based learning. These findings suggest that VR program can serve as a valuable educational tool to enhance pediatric nursing skills.

Simulation in anaesthesia training

The last few months have been busy for US medical educators and workforce experts—there are calls for substantial innovation in graduate medical education (GME)1,2 as well as echoes of a looming physician shortage.3 A report by the Institute of Medicine1 recommended significant changes in GME financing to address the health needs of the nation by, among other things, spurring innovation, and increasing administrative, team-based costs of care, health information technology, and quality improvement knowledge, skills, and activities. At the same time, the Association of American Medical Colleges (AAMC) reissued a statement3 regarding projected physician shortages. The AAMC projects a shortfall of 45 000 primary care physicians and 46 000 surgeons and medical specialists by 2020. These projections are hotly debated given the complexities of predicting supply and demand for the future health workforce.There also are reports of a gap between new physicians' knowledge and skills and the competencies required for future medical practice.1,4 Simply put as a question: Will the medical workforce of today be able to cope with future issues such as rising health expenditure; rising rates of chronic diseases, age-related illness, and antimicrobial resistance; and the health-related consequences of rapid urbanization, social inequality, and global warming? We suggest no. In the future, we believe nonclinical skills will be an increasingly important part of a physician's skills set, including leadership, research, education, administration, management, business, economics, government, politics, law, entrepreneurship, and innovation, as well as systems science and systems engineering.5There are some concerning questions about increasing nonclinical knowledge and skills. First, will increasing these knowledge, skills, and activities exacerbate the existing physician shortage because more nonclinical education and practice time may reduce time in direct patient care? The amount of nonclinical versus patient care time must be better understood. Data on nonclinical time are included in the AAMC's Physician Supply and Demand Model.6 However, projections may change if nonclinical knowledge, skills, and time are further promoted, and physician and nonphysician health providers' roles are modified. Thus, more detailed data describing the type of nonclinical engagement will be of interest. Second, will increased nonclinical skill development adversely affect the development and performance of physicians' clinical skills? At present, the nearest thing to data to answer this question relates to part-time, prolonged clinical training and its effects on performance. Thus, care must be taken when increasing nonclinical knowledge and skill development; further research and a measured approach will be required in efforts to enhance the nonclinical skills of US MDs.

Updating cross-cultural research of the past decade on the relationship between life aspirations and wellbeing, we compared Romanian (N=69) and US (N=64) undergraduates on the contribution of the importance and likelihood of attaining intrinsic and extrinsic aspirations to psychological maladjustment and life satisfaction, and on the qualitative meaning they assign to financial success. Similarly to prior studies, we found that extrinsic and intrinsic aspirations tended to be either negatively or positively correlated with life satisfaction, respectively; however, wealth predicted life satisfaction for Romanian students. Unlike previous research, we found generally negative relationships between intrinsic aspirations and psychological maladjustment. Although there were no differences between Romanian and US undergraduates on extrinsic and intrinsic orientation, on the overall importance of attaining aspirations, or on specific extrinsic and intrinsic aspirations, Romanian students expressed weaker expectations of fulfilling intrinsic aspirations than did US students. Finally, the groups produced similar rankings of aspirations and assigned similar meaning to financial success. The results favored a social cognitive rather than a self-determination model of psychological wellbeing in that expectations for attaining aspirations were more often predictive of life satisfaction than were their content. We interpret these findings and their convergence and departure from earlier research in terms of political economic, demographic, and cultural factors. We encourage future cross-cultural investigations of the social construction of aspirations, subsidiation of seemingly contradictory aspirations to each other, and cognitive and ecological mediation of the complex relationship of aspirations to psychological functioning.

This article extends earlier research regarding the relationships between senior travelers' participation in activities while on vacation, their overall satisfaction with their travel experiences, and their psychological well-being. A path model was developed to depict the direct and indirect relationships between these variables by using a sample of senior tourists traveling on North American escorted tour itineraries. Whereas the direct effect accounted for 98% of the relationships between the senior tourists'levels of participation in activities and their psychological well-being, the indirect effect was negligible. The study concluded that senior tourists'activity levels were significantly related to their psychological well-being, but their satisfaction with the tours was not.

Point: Should an Anesthesiologist Be the Specialist of Choice in Managing the Difficult Airway in the ICU? Yes