Introduction Managing difficult airways and adverse respiratory events is critical for anesthesia providers. Fiber-optic intubation (FOI) is a strategic management approach in difficult airway situations. Clinical exposure to FOI can be limited, posing challenges for skill development. Simulation-based medical education offers a safe alternative for training. This study aims to evaluate the effectiveness of a simulation-based FOI training program for student registered nurse anesthetists (SRNAs) in an educational context. Methods A repeated measure study was conducted during the Pediatric Anesthesia Simulation for Student Nurse Anesthetists course at the Peter M. Winter Institute for Simulation, Education, and Research. One hundred twenty-three SRNAs participated in the FOI simulation program. For the analysis, students were stratified into 2 groups based on their performance in the summative testing of nasal FOI time. Baseline characteristics and the students' performance during the simulation were analyzed. Results Among the participants, 58 were categorized as “above median time” (AMT) and 65 as “below median time” (BMT) for FOI testing. No significant differences were observed in baseline characteristics. The AMT group exhibited longer mean times for summative testing FOI (50 vs. 26 seconds), first FOI attempt (97 vs. 78 seconds), and subsequent sets (third: 374 vs. 325 seconds, fourth: 323 vs. 268 seconds). Both groups showed performance improvement across training sets with reduced variability. Conclusions The simulation-based FOI training program effectively enhanced SRNA skill, with performance improvement during the training period. This study underscores the importance of simulation in anesthesia education, offering a safe and structured environment for skill development in FOI.

Introduction Hands-on training of basic epistaxis management is often minimal during pregraduate medical training. The objective was to develop and gather structured content validity evidence for a 3D-printed model for simulation-based training and assessment of technical skills in basic epistaxis management. Methods A simulator for epistaxis management training was built based on publicly available 3D-print files with addition of tubing to mimic anterior bleeding. Ten otorhinolaryngologists evaluated the model after performing nasal cavity inspection and insertion and insufflation of a nasal tamponade device. Content validity evidence was collected following Messick's framework. Results Two content experts contributed to define features in the iterative building process. In the structured evaluation of the model, experienced clinicians found the appearance of the outer nose and the resistance when insufflating a nasal tamponade device into the nasal cavity satisfying (mean score of 3.9 and 4.7 out of 5, respectively), whereas the nasal cavity was found to be a bit too spacious compared with typical real-life conditions. Conclusions A 3D-printed simulator for simulation-based training of basic epistaxis management was successfully built. Content validity was gathered, and overall, content experts found the model to adequately represent the technical skills challenges for training novices such as medical students and junior doctors.

Introduction Health professions training programs must train future healthcare providers to meet the needs of equity-deserving patient populations. Standardized patient (SP) programs are one mechanism by which this training can occur. Our aim was to develop a set of recommendations for SP programs and educators around planning, organizing, and delivering SP-based education involving equity-deserving groups. Methods We undertook a qualitative analysis of interview transcripts of SPs, educators, and trainers involved in SP work with equity-deserving groups. Subsequently, we conducted a three-stage modified Delphi process to generate recommendations. Results We derived 10 tips to help stakeholders improve SP-based education involving equity-deserving groups. The underlying themes included collaborative involvement, including co-creation and co-delivery of content with members of equity-deserving groups, as well as consistent prioritization of the needs of SPs throughout the process. Conclusions Our findings suggest ways in which SP programs and educators can better train future healthcare providers to meet the needs of equity-deserving patient populations.

Objectives The aims of the study are to develop an insulin pump simulation curriculum using patients as simulators, to evaluate its effectiveness on knowledge, attitudes, and skills necessary for families to manage diabetic emergencies, and to identify ongoing gaps in care. Methods Our simulation curriculum developed using Kerns, consisted of 4 stations. A prospective simulation study was conducted at a pediatric tertiary care hospital with a convenience sample of children with type 1 diabetes on the insulin pump program and their families using patients as simulators and their parents as participants. The curriculum's success with developing competent skills was assessed using Kirkpatrick's 4-level evaluation model. Data from satisfaction questionnaires, performance gaps in emergency management, and postsimulation knowledge questionnaires were analyzed to identify ongoing gaps in care using a mixed methods approach. Results Among 70 families (169 participants), satisfaction was high (3.7–4.0/4.0) and confidence was increased (mean score 12 ± 0.03/12). Recurrent performance gaps across scenarios were found: misunderstandings about residual insulin during hypoglycemia (35%) and severe hypoglycemia with altered level of consciousness (22%), and failure to identify causes in 13% of simple and 11% of severe hypoglycemia scenarios and overtreating hypoglycemia with glucagon in a conscious patient in 14% of simple hypoglycemia scenarios. Postsimulation knowledge questionnaires revealed improvements in knowledge/management of simple hypoglycemia (mean score 87%), poor knowledge of pump parameters (mean score 56%), excellent knowledge of manipulating pump parameters to prevent emergencies (mean score 100%), and poor knowledge of basal rate concepts (mean score 19%). Conclusions Simulation using patient simulators improved management skills and confidence of families facing diabetic emergencies. Ongoing gaps in care were identified and used to enhance the current curriculum. Integrating simulation into insulin pump curricula can enhance patient self-care, safety, and be generalizable to other chronic-care patient-education programs. Future work should evaluate the impact of this curriculum on real-life events and patient outcomes.

Introduction The utility of using meat models for ultrasound-guided regional anesthesia simulation training has been well established. Feedback is considered the most important element of successful simulation-based education, and simulation offers an opportunity for evaluation. The objective of this study was to establish the discriminative ability of dye injected into a meat model to determine whether injectate is properly placed in the perineural (PN) space, thus providing an additional tool for learner feedback and evaluation. Methods Meat models containing a beef tendon (simulating a nerve) were injected with dye in one of 3 locations: PN, intraneural, and intramuscular. Blinded assessors then independently interpreted the dye staining on the models, marked the interpreted injection location, ease of interpretation, and whether staining was present on the beef tendon. Results Thirty meat models were injected with dye and independently assessed. Determining the location of injection was deemed to be easy or very easy in 72% of the models. Assessors correctly identified PN, intraneural, and intramuscular injections 100%, 95%, and 85% of the time, respectively. Assessor agreement was 87%. Conclusions The location of dye injected into a meat model, simulating a peripheral nerve blockade, can be accurately and reliably scored to provide feedback to learners. This technique offers a novel means of providing feedback to trainees and assessing block success in ultrasound-guided regional anesthesia simulation.

Assessment tools support simulation facilitation skill development by guiding practice, structuring feedback, and promoting reflective learning among educators. This scoping review followed a systematic process to identify facilitation assessment tools used in postlicensure healthcare simulation. Secondary objectives included mapping of the validity evidence to support their use and a critical appraisal of their suitability for simulation faculty development in low-resource settings. Database searching, gray literature searching, and stakeholder engagement identified 11,568 sources for screening, of which 72 met criteria for full text review. Thirty sources met inclusion; 16 unique tools were identified. Tools exclusively originated from simulation practice in high-resource settings and predominantly focused on debriefing. Many tools have limited validity evidence supporting their use. In particular, the validity evidence supporting the extrapolation and implications of assessment is lacking. No current tool has high context suitability for use in low-resource settings.

Peer teachers have been found to be effective instructors during simulation-based education. However, there is a lack of research regarding their professional identity development throughout the course of the teaching activity. The purpose of this qualitative study, therefore, was to develop a framework to illustrate how peer teachers develop as educators during a prehospital simulation. The participants in our study were 9 second-year medical students serving as peer teachers during a multiday prehospital simulation. We selected the grounded theory tradition of qualitative research to investigate the peer teachers' professional identity development. Our research team interviewed each participant twice during the simulation. We then used open and axial coding to analyze the interview data. We organized these codes into categories and determined connections between each category to construct our grounded theory framework. This framework described how the peer teachers progressed through 4 stages: 1) eager excitement, 2) grounded by challenges, 3) overcoming challenges, and 4) professional identity formation. Our results revealed that simulation-based education can serve as valuable learning environment not only for medical students, but also for peer teachers. Understanding their progressive development during the simulation will help medical educators focus on maximizing the peer teachers' growth and development during simulation.