Designing Simulation Scenarios Research Articles

Designing of a High-Quality CPR Simulation Game Clinical Scenario for Nursing Students: A Qualitative Study

Cardiopulmonary resuscitation (CPR) is an important skill for nursing students. The process of learning high-quality CPR with a simulation-based learning method can be developed into a simulation game. In order to develop a CPR HQ simulation game, a clinical scenario that can be used as a guide in carrying out storyboards is needed. This research aims to formulate a simulation scenario that will serve as the basis for developing a high-quality CPR simulation game to increase nursing students' competency. This qualitative research uses a Participatory Action Research (PAR) approach by inviting 15 respondents from the prospective user population, namely Emergency Nursing Lecturers, Emergency Room Nurses, BLS Trainers, and nursing students, to carry out Focus Group Discussions. The study's results revealed clinical scenarios that were arranged based on 4 themes, including 1) suitability of the competency being tested, 2) minimum competency for 5 cycles of CPR, 3) settings in the pre-and intrahospital scope, and 4) choice of patient outcome. These components are crucial when designing simulation scenarios that support students’ cognitive processes to achieve High-Quality CPR in nursing students. Thus, the results of this research can then be used as a guide in developing the HQ-CPR game as a learning medium for nursing students.

Designing Simulation Scenarios to Enhance Nursing Students’ Clinical Judgment: A Qualitative Study

Clinical judgment is the cognitive process that emerges from critical thinking or clinical reasoning that affects patient safety. For example, not noticing clients’ deterioration signs while making a clinical judgment may cause inaction errors. Therefore, nursing students must have sound clinical judgment before entering professional nursing practice. Simulation-based learning has become a vital pedagogy used widely to develop students’ clinical judgment. However, to date, simulation-based learning in Thailand has focused on theoretical content and clinical practices rather than the development of cognitive ability. Nursing instructors are vital in developing the thinking process of nursing students. Therefore, a deep understanding of nursing instructors’ perspectives on the essential components of designing a simulation scenario for enhancing clinical judgment among nursing students remains important. This qualitative descriptive study aimed to explore the critical components in the design characteristics of nursing simulation scenarios for improving nursing students’ clinical judgment based on the perception of nursing instructors. Participants were 23 nursing instructors purposively selected from a nursing college in Thailand. Data were collected during March 2021 in focus group discussions with all participants, then five participants with simulation-based learning expertise undertook individual in-depth interviews. Data were analyzed using content analysis. From the findings, four themes emerged: 1) fostering instructor support, 2) recognizing students’ strengths, 3) enhancing specificity in scenarios, and 4) promoting cognitive development. Nursing instructors can apply the findings in creating simulation-based activities to develop their clinical judgment to support nursing students’ cognitive processes. Such actions will help to ensure patient safety and quality of care.

Quantification and evaluation of atmospheric pollutant emissions from open biomass burning with multiple methods: a case study for the Yangtze River Delta region, China

Abstract. Air pollutant emissions from open biomass burning (OBB) in the Yangtze River Delta (YRD) were estimated for 2005–2015 using three (traditional bottom-up, fire radiative power (FRP), and constraining) approaches, and the differences among those methods and their sources were analyzed. The species included PM10, PM2.5, organic carbon (OC), elemental carbon (EC), CH4, non-methane volatile organic compounds (NMVOCs), CO, CO2, NOx, SO2 and NH3. The interannual trends in emissions with FRP-based and constraining methods were similar to the fire counts in 2005–2012, while those with the traditional method were not. For most years, emissions of all species estimated with the constraining method were smaller than those with the traditional method except for NMVOCs, while they were larger than those with the FRP-based method except for EC, CH4 and NH3. Such discrepancies result mainly from different masses of crop residue burned in the field (CRBF) estimated in the three methods. Chemistry transport modeling (CTM) was applied using the three OBB inventories. The simulated PM10 concentrations with constrained emissions were closest to the available observations, implying that the constraining method provided the best emission estimates. CO emissions in the three methods were compared with other studies. Similar temporal variations were found for the constrained emissions, FRP-based emissions, GFASv1.0 and GFEDv4.1s, with the largest and the lowest emissions estimated for 2012 and 2006, respectively. The temporal variations in the emissions based on the traditional method, GFEDv3.0, and the method of Xia et al. (2016) were different. The constrained CO emissions in this study were commonly smaller than those based on the traditional bottom-up method and larger than those based on burned area or FRP in other studies. In particular, the constrained emissions were close to GFEDv4.1s that contained emissions from small fires. The contributions of OBB to two particulate pollution events in 2010 and 2012 were analyzed with the brute-force method. Attributed to varied OBB emissions and meteorology, the average contribution of OBB to PM10 concentrations in 8–14 June 2012 was estimated at 37.6 % (56.7 µg m−3), larger than that in 17–24 June 2010 at 21.8 % (24.0 µg m−3). Influences of diurnal curves of OBB emissions and meteorology on air pollution caused by OBB were evaluated by designing simulation scenarios, and the results suggested that air pollution caused by OBB would become heavier if the meteorological conditions were unfavorable and that more attention should be paid to the OBB control at night. Quantified with Monte Carlo simulation, the uncertainty of the traditional bottom-up inventory was smaller than that of the FRP-based one. The percentages of CRBF and emission factors were the main source of uncertainty for the two approaches. Further improvement on CTM for OBB events would help better constrain OBB emissions.

Simulation and the diagnostic process: a pilot study of trauma and rapid response teams

Simulation is frequently used to recreate many of the crises encountered in patient care settings. Teams learn to manage these crises in an environment that maximizes their learning experiences and eliminates the potential for patient harm. By designing simulation scenarios that include conditions associated with diagnostic errors, teams can experience how their decisions can lead to errors. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error. We developed four scenarios that would require TrT and pediatric RRT to manage an error in diagnosis. The two trauma scenarios (spinal cord injury and tracheobronchial tear) were designed to not respond to the heuristic management approach frequently used in trauma settings. The two pediatric scenarios (foreign body aspiration and coarctation of the aorta) had an incorrect diagnosis on admission. Two raters independently scored the scenarios using a rating system based on how teams managed the diagnostic process (search, establish and confirm a new diagnosis and initiate therapy based on the new diagnosis). Twenty-one TrT and 17 pediatric rapid response managed 51 scenarios. All of the teams questioned the initial diagnosis. The teams were able to establish and confirm a new diagnosis in 49% of the scenarios (25 of 51). Only 23 (45%) teams changed their management of the patient based on the new diagnosis. Simulation can be used to recreate conditions that engage teams in the diagnostic process. In contrast to most instruction about diagnostic error, teams learn through realistic experiences and receive timely feedback about their decision-making skills. Based on the findings in this pilot study, the majority of teams would benefit from an education intervention designed to improve their diagnostic skills.

Integration of leadership competencies in a community health simulation

The purpose of this article is to address ways in which a nursing faculty can build nursing leadership competencies into a nursing programme. This article describes the use of simulation as a compelling learning strategy. Nurses need to be prepared to meet the demands of mass casualty events. With the growing need for major incident training, leadership competency development is a critical gap in the literature. A collaborative simulation was used to help students apply classroom knowledge. In this simulation, students participated in major incident triage and the application of leadership competencies to appropriately manage victims' care. Collaboration among faculty members when designing simulation scenarios is a powerful approach to nursing education. Students were able to engage in necessary skills for their future nursing practice.

Self-Learning Methodology in Simulated Environments (MAES©): Elements and Characteristics

The features and pedagogical foundations of self-learning methodology in simulated environments (MAES) are discussed in this article. MAES has six elements (team selection and creation of group identity, voluntary choice of subject of study, establishment of baseline and programming skills to be acquired through brainstorming, design of a clinical simulation scenario in which the students practice the skills to be acquired, execution of the simulated clinical experience, and finally debriefing and presentation of the acquired skills) that develop sequentially to achieve a high level of skills acquisition by students working in teams. The students direct their learning, design simulation scenarios, and discuss the outcomes and related scientific evidence under the guidance of a facilitator.

Integration of the Pedagogical Models “Simulation” and “Flipped Classroom” in Teacher Instruction

In a postgraduate course for teachers of English as a foreign language in secondary school, teacher trainees were introduced to simulations through the use of flipped learning and simulation design. The objective of the present fieldwork was to determine whether designing simulation scenarios based on literature which delves into human rights was effective in introducing teacher trainees to the use of simulations in secondary education. To achieve this, the flipped model was followed, and theoretical considerations of simulations were analyzed on the part of the teacher trainees outside of class whereas practice was done in class. This article presents the findings of the qualitative analysis of postgraduate students’ perceptions with results that show that designing simulation scenarios based on reading texts on human rights can be a powerful tool for their future students. By designing simulation scenarios, the teacher trainees could see simulations potential to use the foreign language purposefully at the time affective learning and empathy were sought through the literary pieces on human rights.

Designing Simulation Scenarios to Support Performance Assessment Validity

Designing Simulation Scenarios to Support Performance Assessment Validity

Designing Simulation Scenarios to Support Performance Assessment Validity

This article advances and demonstrates a validation process to guide the development of health care simulation scenarios for assessing performance competency. The development and evaluation of each scenario used in a simulation-based competency assessment must be based on multiple sources of evidence that support the validity of the assessment for its intended use. Procedures are proposed to optimize the validity of simulation-based assessments by linking the scenario directly to the instrument and using a systematic approach for gathering and processing input from experts in the field. This validation process is then applied to the development of an original scenario for use in an assessment of nursing competency that targets objectives through patient simulation scenarios scored by multiple raters.

Numerical estimation of air gaps’ influence on the insulating performance of multilayer thermal insulation

This study aims to provide insights regarding the benefits of multilayer thermal insulations in building applications placed in combination with two air gaps. For this purpose, a numerical approach was developed to determine the influence of the air gap thickness on the overall thermal resistance of a composite wall. A validated combined radiation/conduction heat transfer numerical model was employed to predict the temperature distribution and heat transfer in typical multilayer insulation complexes comprised of insulating materials separated by multiple reflecting foils. The radiation scheme was based on the two-flux approximation, in order to model both optically thick and optically thin fibrous materials. The heat transfer equation was solved explicitly for a composite wall. A basic methodology for designing simulation scenarios was employed in order to reduce the number of simulated cases. Furthermore, strict entry requirements were provided in order to reduce extraneous variation due to the complexity of physical phenomena that should be investigated in such a case study. Finally, total nine different configurations were selected as initial state, where the theoretical thermal resistances were calculated and compared, leading towards an empirical polynomial equation that calculates the overall thermal resistance of such a composite wall complex departing from the two air gap thickness values.

Microscopic Traffic Simulation Approach to the Capacity Impact Analysis of Weaving Sections for the Exclusive Bus Lanes on an Urban Expressway

This paper presents a microscopic traffic simulation approach to the capacity impact analysis of weaving sections caused by the installation of exclusive bus lanes (XBLs) on urban expressways. Three typical configurations of XBL in Beijing are identified, including median bus lane with off-on-ramp, curbside bus lane with on-off-ramp, and curbside bus lane with off-on-ramp. Then, the weaving section length, headway, mainline volume, as well as off-ramp and on-ramp volumes for general traffic are considered as parameters in designing simulation scenarios. Finally, the microscopic simulation is executed, by which the capacity of general traffic for weaving sections is estimated and the impact of the weaving section length and headway on the capacity is evaluated. It is found that the weaving section length and headway have different impacts on the capacity of general traffic in different configurations. The results also provide that the weaving section length and headway are more sensitive in the on-off-ramp than in the off-on-ramp scenario with the curb bus lane.

Why simulation can be efficient: on the preconditions of efficient learning in complex technology based practices.

BackgroundIt is important to demonstrate learning outcomes of simulation in technology based practices, such as in advanced health care. Although many studies show skills improvement and self-reported change to practice, there are few studies demonstrating patient outcome and societal efficiency.The objective of the study is to investigate if and why simulation can be effective and efficient in a hi-tech health care setting. This is important in order to decide whether and how to design simulation scenarios and outcome studies.MethodsCore theoretical insights in Science and Technology Studies (STS) are applied to analyze the field of simulation in hi-tech health care education. In particular, a process-oriented framework where technology is characterized by its devices, methods and its organizational setting is applied.ResultsThe analysis shows how advanced simulation can address core characteristics of technology beyond the knowledge of technology's functions. Simulation's ability to address skilful device handling as well as purposive aspects of technology provides a potential for effective and efficient learning. However, as technology is also constituted by organizational aspects, such as technology status, disease status, and resource constraints, the success of simulation depends on whether these aspects can be integrated in the simulation setting as well. This represents a challenge for future development of simulation and for demonstrating its effectiveness and efficiency.ConclusionAssessing the outcome of simulation in education in hi-tech health care settings is worthwhile if core characteristics of medical technology are addressed. This challenges the traditional technical versus non-technical divide in simulation, as organizational aspects appear to be part of technology's core characteristics.

A Bayesian learning of probabilistic relations between perceptual attributes and technical characteristics of car dashboards to construct a perceptual evaluation model

Starting from a primary perceptual evaluation of a set of car dashboards, we propose to build a Bayesian network (BN) between perceptual attributes and design attributes. Two types of learning processes may be considered: supervised BN when the prediction on a targeted attribute must be optimised and unsupervised BN otherwise. These two types of BNs are considered along three design simulation scenarios: the direct scenario which consists of the prediction of a design change impact on customer perceptions, the inverse scenario for fixing design characteristics so as to result in an expected customer perception, and a more realistic combined scenario.

A Feasibility Study of Using GPS to Calibrate an Instrumentation Radar

This paper describes an investigation of the use of the Global Positioning System (GPS) to calibrate an instrumentation radar. An existing calibration program called STARCAL was used to perform computer simulations. The accuracy of STARCAL is used as a comparison as well as a guide to design simulation scenarios. It is shown that for a comparable calibration accuracy, the proposed procedure would require many hours to complete. Based on this and other findings, it is concluded that the proposed method is not practical. However, it is recommended that measurements be made to ascertain the true radar cross section (RCS) of the GPS satellites and the variation of it, so that a future analysis can be made to refine the current findings.