Emergent Skills Research Articles

A virtual simulation-based clinical skills course.

Advancements in technology continue to transform the landscape of medical education. Virtual reality (VR) and remote simulation represent unique approaches to teaching students clinical skills through experiential learning. We developed, implemented and evaluated a virtual simulation-based course modelled on Kolb's Learning Cycle. A 5-day, 15-h virtual clerkship clinical skills curriculum designed to help students recognise a patient requiring urgent or emergent care was piloted in May 2020. VR and remote simulations facilitated concrete experiences, reflective observation, concept formation, and active experimentation. Curricular evaluation included analysis of usage, performance, self-assessment, and perceptions of educational value. One hundred and fifty-six students completed 436 VR sessions (median 3 per student). Students repeated virtual cases, on average, 75% of the time, demonstrating improvement in average performance scores from 59% (attempt 1) to 72% (attempt 2). Post-course evaluations, completed by 109 (69.9%) students, demonstrated significant improvements in mean scores in all domains of a self-assessment based on emergent care skills. We developed and implemented a virtual clinical skills course that allowed students to progress through all four stages of Kolb's Learning Cycle. VR and remote simulations represent an opportunity for educators to reimagine and expand opportunities for experiential learning. The number of students accommodated, total virtual simulations completed, and positive student feedback suggests that this may be a feasible, acceptable, and scalable method for increasing opportunities for progression through Kolb's Learning Cycle. Further investigation into impact on educational outcomes is needed.

Assessment and influencing factors of urban residents' flood emergency preparedness capacity: An example from Jiaozuo City, China

Public flood emergency preparedness capacity (EPC) is a key factor to reduce casualties and property losses in flood disasters. In this study, a flood EPC index of urban residents was constructed using four indicators (emergency knowledge, skills, awareness, and supplies) and used to assess the flood EPC of urban residents in Jiaozuo City, Henan province, China. Ten key factors influencing residents’ flood EPC were identified based on literature review and with the help of experts, and the impacts of influencing factors on EPC were analyzed using variance analysis (ANOVA) and post hoc multiple comparisons. The results showed that the flood EPC of urban residents in Jiaozuo City was at a medium level, and the numbers of respondents with low, medium and high levels were 21.03 %, 62.62 % and 16.35 %, respectively. The impact analysis of influencing factors to urban residents' flood EPC showed that (1) most influencing factors had significant impacts on residents' flood EPC except for gender and occupation. (2) The respondents with higher education, higher incomes, more family members, mobility-impaired family members, and more flooding experiences had higher flood EPC than others. (3) The age group between 26 and 50 had higher flood EPC than other age groups. (4) The respondents living on bungalow and near a river had higher flood EPC than others. The findings of this study can provide useful information for the local government to develop urban flood management policies and for urban residents to improve their flood EPC.

Comparison of Two Maintenance Training Arrangements with Instructive Feedback in Children with Autism

Instructive feedback (IF) can improve the efficiency of teaching in children with autism spectrum disorder (ASD) by establishing emergent skills. The purpose of this study was to compare the effects of two types of listener responding maintenance teaching with IF on acquisition of four untaught repertoires in three children with ASD. In one of the teaching cases, attending and tact responses of visual stimuli were required. The emergence was partial for all learners, with no great difference in the efficiency of the types of teaching. Two of the new repertoires were not demonstrated. Errorless performance of some relations was shown by all, but for only one child immediate emergence was verified. The results were discussed regarding the possibility of new investigations on alternative procedure to IF that could produce the emergence of new repertoires.

Cardiopulmonary resuscitation: knowledge among nurses in selected departments of a teaching hospital, Nepal

Introduction: Cardiopulmonary Resuscitation (CPR) is considered a core emergency skill in which all health care professionals must be proficient. If early basic life support CPR is instantiated, the survival rate is improved. This study aims to assess the knowledge regarding CPR among nurses. Method: A descriptive cross-sectional study design was adopted among 150 nurses in critical care area of Patan Hospital Lalitpur Nepal, from January to April 2023. Researcher developed self-administered structured questionnaire was used for data collection. Statistical Package for Social Sciences (SPSS) version 20 was used for statistical analysis. Ethical approval was taken from the Institutional Review Committee of Patan Academy of Health Sciences. Result: Study revealed that majority 143(95.3%) of the respondents had knowledge regarding meaning of sudden cardiac death. Same as 137(91.3%) knew the indication of CPR and most of the respondents 140(93.3%) knew the carotid pulse should be checked before starting CPR. More than half 131(87.3%) had knowledge regarding ratio of chest compression. We found more than half respondents 83(55.3%) knew the best time to switch. Nearly half of the respondents 61(40%) knew the component of high-quality CPR whereas minority of the respondents; 20(13.3%) knew the algorithm of adult cardiac arrest. Conclusion: Majority of the respondents had knowledge regarding meaning, indication, site of pulse taking, and ratio of chest compression. Whereas more than fifty percent respondents had knowledge regarding, best time to switch, nearly half of respondents knew the components of CPR. Minority of respondents aware the algorithm of adult cardiac arrest.

Emergence of the cortical encoding of phonetic features in the first year of life

Even prior to producing their first words, infants are developing a sophisticated speech processing system, with robust word recognition present by 4–6 months of age. These emergent linguistic skills, observed with behavioural investigations, are likely to rely on increasingly sophisticated neural underpinnings. The infant brain is known to robustly track the speech envelope, however previous cortical tracking studies were unable to demonstrate the presence of phonetic feature encoding. Here we utilise temporal response functions computed from electrophysiological responses to nursery rhymes to investigate the cortical encoding of phonetic features in a longitudinal cohort of infants when aged 4, 7 and 11 months, as well as adults. The analyses reveal an increasingly detailed and acoustically invariant phonetic encoding emerging over the first year of life, providing neurophysiological evidence that the pre-verbal human cortex learns phonetic categories. By contrast, we found no credible evidence for age-related increases in cortical tracking of the acoustic spectrogram.

Research on the Effectiveness of Virtual Reality Technology for Locomotive Crew Driving and Emergency Skills Training

With the continuous expansion of road networks and the rise in railway transportation capacity, the scale of locomotive crew needs has increased sharply. However, the current training of locomotive crews is inefficient and costly and cannot meet the needs of the industry. This project adopted virtual reality technology to develop the driving and emergency skills of harmonious electric locomotive crews. The trainees can learn the composition and structure of the locomotive, master the working principles of the locomotive and receive training in relevant emergency skills in the virtual environment. After completion of the system development, we carried out a series of research studies and experiments; the results show that the use of this system to train personnel can lead to them quickly mastering the practical training content. This new training mode can effectively solve the outstanding problems with the current training system for locomotive crews.

Using simulation-based learning to increase outpatient staff confidence in emergency skills.

Using simulation-based learning to increase outpatient staff confidence in emergency skills.

Emergency Skills in Athletic Training: Perceived Knowledge and Continuing Education

Context Continuing education (CE) in health care, particularly in athletic training, often fails to meet the needs of its participants. Rapid increases in available information make it necessary for CE to be delivered as efficiently as possible. Objective To explore whether an interactive teaching strategy and various characteristics of athletic trainers affected the perceived knowledge of emergency skills among certified athletic trainers. Design Quasiexperimental study with a single-group pretest-posttest design. Patients or Other Participants Certified athletic trainers (N = 81) at the Great Lakes Athletic Trainers' Association Annual Meeting and Symposium. Intervention(s) Emergency skills practice session for anaphylaxis, opioid overdose, diabetes, and asthma. Main Outcome Measure(s) Participants completed a preintervention perceived knowledge questionnaire (PKQ) that included background information questions and completed a postintervention PKQ. Results A statistically significant difference (P < .001) in PKQ scores from pretest to posttest was found with pretest scores being lower than posttest scores (89.59 and 103.02, respectively). Age and years of experience had a weak correlation with PKQ pretest scores (rs = .32 and rs = .33, respectively). Participant characteristics including additional certification (P = .012), anaphylaxis experience (P = .036), opioid overdose experience (P < .001), diabetes experience (P = .025), and combined emergency experience (P = .029) had significantly different pretest PKQ scores. Conclusions The use of an interactive teaching strategy in CE and certain athletic trainer characteristics significantly affected athletic trainers' perceived knowledge of emergency skills.

A Virtual Reality–Based Serious Game for Fire Safety Behavioral Skills Training

Fire disasters in tall buildings can cause considerable damage to property, injuries to people and death. An effective way to reduce injuries or death during a fire is to improve human evacuation behavior. Many studies have demonstrated that behavioral skills training can effectively help people of different ages to acquire safety skills for emergencies. Based on virtual reality (VR), serious games (SGs) and behavioral skills training (BST), this study proposes a theoretical model of “VR-SG-BST” as a fire safety training method. Older adults in care facilities were selected to evaluate the proposed model because their lack of knowledge on fire safety and the associated potential health problems increase the likelihood that they will become victims of a fire. It is expected that engagement and immersion in the SG can improve the elderly’s learning performance of fire evacuation skills and enhance their interest and sense of fun experienced during fire safety training. The SG could effectively improve the skills of evacuation in an emergency. Hence, this study involved two parallel investigations: 1) comparing fire safety behavior of the elderly between an experimental and a control group, and 2) determining the effects of BST for fire safety by comparing only the experimental group in pre- and post-BST phases. The study adopts in situ training (IST) to evaluate the acquisition of knowledge and skills during the experimental stage. It is concluded that the proposed VR-SG-BST model has potential to serve as an alternate approach to improve the elderly’s behavioral skills during a fire. Moreover, previous computer game experience enhances the elderly’s learning performance and fire safety behavior. The outcomes of the study provide suggestions and guidelines for VR-SG design in the practice of BST.

Does Nonlinguistic Segmentation Predict Literacy in Second Language Education? Statistical Learning in Ivorian Primary Schools.

Statistical learning (SL) is a learning mechanism that does not directly depend on knowledge of a language, but predicts language and literacy outcomes for children and adults. Research linking SL and literacy has not addressed children who first learn to read in their second language (L2), common in primary schools worldwide. Several studies have linked SL with childhood literacy in Australia, China, Europe, and the U.S., and we pre-registered an adaptation for Côte d'Ivoire, where students are educated in French and speak a local language at home. Recruiting 117 sixth-graders from primary schools in several villages, we tested for correlations >0.3 between SL and literacy with 80-90% power. We found no evidence for these correlations, but visual SL was correlated with L2 phonological awareness. Although this finding may suggest a role of SL in emergent L2 skills, it underscores the need to include L2 acquisition contexts in literacy research.

Exploring Factors and Challenges Influencing Nursing Interns’ Training Experiences in Emergency Departments in Saudi Arabia

This study aims to investigate nursing interns’ training experiences in emergency departments (EDs) in Saudi Arabia and explore the factors influencing their experiences. A descriptive research design was employed utilizing a survey distributed to nursing interns who completed their ED rotation within the last three months. The data were analyzed using SPSS version 27, and principal component analysis (PCA) was conducted to identify the challenges encountered by the interns. This study analyzed the responses of 126 nursing internship students in various regions of Saudi Arabia to assess their training experiences in emergency departments. The principal component analysis revealed two significant factors: (1) “Emergency Department Training and Skill Development”, which focused on challenges faced during training, and (2) “Integrated Emergency Department Training and Competence Development”, which provided a holistic view of nursing internship students’ experiences and preparedness for their careers. The results indicated moderately below-average challenges and a moderately positive overall training experience. The findings suggest a need to address these challenges to improve the training experience and better prepare nursing internship students for careers in emergency departments. This study recommends enhancing the nursing curricula alignment with practical training objectives, focusing on technical and interpersonal skills development. A supportive learning environment in emergency departments is crucial, including effective communication and collaboration. Diverse clinical experiences and reflection on training can guide students in exploring potential career paths in emergency departments or other specialized nursing areas.

The Role of Emergent Literacy Assessment in Brazilian Portuguese Literacy Acquisition during COVID-19.

The contributions of emergent literacy skills to reading and writing development have been evidenced in different linguistic contexts. The worsening of the Brazil literacy scenario during the pandemic denoted the importance of a better understanding of these contributions' specificities in Brazilian Portuguese to support evidence-based mitigation strategies. This study aimed to analyze the associations between emergent literacy components (emergent writing, alphabet knowledge, vocabulary, and phonological awareness) and word/pseudoword reading and spelling performance in first grade students during COVID-19. A total of 42 children (Mage = 6.29 years, SD = 0.45, 52.4% female) participated remotely in this study. Correlations and multilinear regression analyses were conducted. The results show significant associations between emergent literacy components and reading and spelling performance. Stronger associations were found with specific emergent skills such as letter writing, spontaneous writing, letter-sound production, and alliteration. Regression models indicated that children's performance in early literacy skills explained 49% of the variance in reading and 55% of the variance in spelling. This study highlighted the role of emergent writing and alphabet knowledge as reading and spelling predictors during literacy acquisition in Brazilian Portuguese. Implications for educational context and directions for remediating the negative impact of the pandemic on learning were discussed.

Seven Years Analysis of Postpartum Death in Selangor, Malaysia: A Lesson Learnt

Information on determinants of postpartum death enhances understanding of the fundamental causes of mortality. Studies on postpartum death in Malaysia are limited despite increasing trends of postpartum mortality. This study aimed to ascertain the determinants of postpartum death in Selangor, Malaysia. A case control was conducted using data from the Maternal Death Registry, Selangor State Health Department, Malaysia. A total of 144 postpartum death cases were included for analysis after the removal of fortuitous and unknown death. Controls were mothers who survived six weeks after childbirth and were selected via simple random sampling. The odds of postpartum death among multiparous was almost two times higher (aOR; 1.76 95% CI 1.10,2.82). The presence of pre-existing medical or surgical problems were associated with a three-folds increase in the odds of postpartum death (aOR 3.23; 95% CI 1.91,5.47). The odds of postpartum death were ten times higher for those who gave birth in non-health facilities (aOR 10.62; 95% CI 2.64,42.74). Women who underwent caesarean section had almost three times more odds (aOR 2.50; 95% CI 1.60,3.91) for death. Women who received antenatal care in government health facilities had low odds (aOR 0.34; 95% CI 0.19,0.60) for postpartum death. The determinants showed significant association with postpartum death in Selangor, Malaysia which included the presence of pre-existing medical or surgical illness, place of birth, mode of birth, place of antenatal care and Malaysian ethnicity-citizenship. In the future, health programmes should not only aim to reduce postpartum deaths by emphasising maternal education and empowerment, but should also enhance pre-pregnancy care, provide continual obstetric emergency skill training to healthcare providers, collaborate with several agencies and underwrite migrants’ maternal healthcare fees.

Beyond The Maritime Education Classrooms: Analysis Of Life Skills Gained From Maritime Trainings

Intensive maritime education and training cultivate the competence of students in their future career. As the industry evolves, it also requires professionals who can apply their skills in real-life scenarios. This investigation explored the life skills gained from maritime trainings by analyzing the experiences of maritime students (n=15). The participants in the one-on-one interview were purposively sampled based on several demographic characteristics i.e., a college student, have maritime units (>50), have been in curriculum-specified trainings. Findings of the study indicated that maritime students gained life-essential skills, including career-based, health-related, and emergency skills, through undergoing rigorous training programs. These acquired skills empower students to effectively address practical challenges and contribute positively to their career progression, personal growth, and well-being. As maritime students undergo specialized training and gain proficiency in technical and non-technical skills, their self-confidence and self-efficacy in addressing challenges and excel in their careers could be enhanced. The students' recognition of the practical use of their acquired skills in real-world scenarios highlights their self-efficacy, influencing their motivation, critical thinking, and problem-solving capabilities. It is the responsibility of maritime education industry to raise awareness and provide comprehensive education to aspiring seafarers.

Technology enablement of the skills ecosystem

PurposeAs the skills economy becomes the norm, learning focused on skills, learners who understand those skills and can iterate the learners to potential employers, and hiring personnel who prioritize skills when making personnel decisions create a visible currency that can be leveraged by all the stakeholders. This paper seeks to analyze those emergent skills, show the skills' impact on the self-organizing skills ecosystem and illustrate how the skills provide a conduit to wholesale global change by creating a talent pipeline designed to generate economic vitality.Design/methodology/approachThrough a system thinking lens and by exploring related skills ecosystem literature, this paper explores the concept of the self-organizing learn-earn skills ecosystem and the role technology plays in the development, implementation and continuation of the process. Tools such as customer, actor, transformation, worldview, owner and environment (CATWOE) and levers have been implemented to probe the maturity, challenges and opportunities the emerging ecosystem provides.FindingsAs the ecosystem evolves, there is much to be done to align stakeholders to reach the ecosystem's full potential. However, by applying a systems lens to the work in progress, greater clarity and definition can be achieved, thereby generating more forward momentum to propel the skills movement toward the intended outcomes.Originality/valueWhile there are many recent publications that define the elements, parameters and attributes of the referenced skills ecosystem, this article aggregates information, through a system thinking lens, to provide a deeper, more cohesive analysis.

Effect of Health Education in Performing Detection and First Aid in Puerperal Emergency Toward Knowldge and Skill Among Cadre

Aims: Increasing the utilization of The Maternal and Child Handbook can be done in various ways, including by increasing the participation of cadres, because cadres can become facilitators for mothers and families in obtaining The Maternal and Child Handbook. However, what happens in the field is the low knowledge and skills of posyandu cadres in carrying out detection and first aid during postpartum emergencies. Objectives: To determine the effect of health education about the kia book on the knowledge and skills of posyandu cadres in carrying out detection and first aid for Methods: The study was quasi-experimental in nature, using a single group design. The Nagasari Health Center area provided 30 cadres for this study. This study's sample included 30 cadres from the Nagasari Health Center area. The Wilcoxon test is used in bivariate analysis. Results: The knowledge of posyandu cadres in detecting and providing first aid in postpartum emergencies prior to receiving health education is 1.77 (Insufficient) and the SD value is 0.430, whereas their skills in detecting and providing first aid in postpartum emergencies prior to receiving health education are 1.73 (unskilled) and the SD value is 0.450. The knowledge of posyandu cadres in performing detection and first aid in postpartum emergencies after receiving health education is 1.30 (Good) and the standard deviation is 0.466, while their skills are 1.23 (skilled) and the standard deviation is 0.430. Conclusion: health education regarding the kia book has an influence on the knowledge and skills of posyandu cadres regarding emergency detection and first aid during the postpartum period.

Strengthening midwives' competencies for addressing maternal and newborn mortality in Tanzania: Lessons from Midwifery Emergency Skills Training (MEST) project

IntroductionIn Low- and Middle-Income Countries (LMICs), maternal and infant mortality remains a significant problem. Inadequate healthcare provider competencies, including those of midwives, are cited as one of the major contributors to the high maternal and newborn mortality rates. Thus, enhancing the skills of midwives is a prerequisite for enhancing positive maternal and newborn health outcomes. This study describes the lessons learned from a Midwifery Emergencies Skills Training (MEST) project implemented in Tanzania between 2013 and 2018. MethodsAn exploratory qualitative study was used to purposefully recruit and interview twelve health facility in-charges and eighteen midwives from twelve selected health facilities in six districts of Tanzania mainland to discover their perceptions about the midwifery practice after MEST training. The data were transcribed verbatim and analysed with qualitative content analysis. ResultsFour categories were generated from the analysis (i) enhanced knowledge and skills in the provision of midwifery care and management of obstetric emergencies, (ii) improved midwives’ communication skills, (iii) increased trust and support between midwives and community and (iv) transformed attitudes of midwives toward continued professional development (CPD). ConclusionMEST enhanced the knowledge and skills of midwives in the management of obstetric emergencies and referral protocol practice. However, notable gaps remain in the capacity of midwives to provide human rights-based respectful maternity care. Continued professional development for nurses and midwives through training, mentorship and supervision programs is recommended for improving maternal and newborn health.

Nurses’ experiences in a rural interprofessional simulation course

Introduction: The Rural Inter-Professional Simulation Course (RiSC) in New Zealand is a 3-day immersive course that brings rural doctors and nurses together to practise emergency and trauma skills using workshops and a simulation-enhanced interprofessional experience (SEIPE). The course aims to increase practitioners’ psychomotor skills, communication, teamwork and leadership skills through simulation-based learning and translate this into the management of trauma in rural settings. Methods: This study employed an exploratory, descriptive design to explore transfer of learning from RiSC into clinical practice 8 months post course participation. Six registered nurses who participated in RiSC took part in semi-structured interviews. The transcribed interviews were analysed using a general inductive approach. Results: The nurses valued the learning experience in RiSC and used the skills they learnt in clinical practice, however factors such as their perception of the authenticity of the scenario and performance anxiety impacted the SEIPE. The nurses also observed interprofessional dynamics playing out during the SEIPE. Conclusions: RiSC is effective for rural trauma team training, however some aspects of the use of simulation in interprofessional education could be further enhanced.

Helping medical undergraduate students to understand healthcare costs.

Developing clinical leadership competencies in medical students ideally would be an experiential process. One crucial leadership competency in the UK Faculty of Medical Leadership and Management leadership framework, is ‘managing services’; a key aspect of this is being aware of healthcare costs. This is challenging within the crowded MBBS curriculum, with students naturally focused on their emergent diagnostic and clinical management skills. A pre-existing epidemiology assessment at St George's University of London (SGUL), the case analysis project (CAP), requires first year clinical students to investigate the sensitivity and specificity of screening and diagnostic tests and the treatment evidence base for a patient condition they have encountered clinically. To give students an appreciation of the cost of healthcare, this innovative extension of the project required that students additionally estimate the costs of both their chosen diagnostic tests and treatment. The students are provided with a tailored form of the English National Cost Collection for the NHS,1 an annually published spreadsheet of average costs for every test and treatment, ranging from phlebotomy to heart transplantation. The resource was downloaded, irrelevant content removed, and a simple costing methodology created, ignoring the database's subtle categorisations such as 'case complexity'. Students were directed to the British National Formulary for drug costs. A pre-recorded lecture and worked examples were prepared on the SGUL online learning platform, demonstrating the use of the tailored spreadsheet, and other resources, in estimating costs. Students are supported with their project by clinical and epidemiological tutors in two separate small group tutorials. A training session and access to student resources were provided to tutors, as this was unfamiliar content for them. During implementation, student queries which tutors could not answer were escalated to the CAP clinical academic lead. The tutor training session generated improvements in presentation of material and offered an opportunity to pilot the intervention with educators. Keeping the task simple, and our focus on developing clear training resources for students and tutors, were successful approaches as there were few student queries requiring escalation. Delivering the tutorials required no additional tutor time. Nearly all students costed investigations and treatments correctly. Tutors reported lively and engaged discussions around healthcare costs and encouraged students to use this resource in their future discussions and learning around health economics. The innovation was successful in achieving an appreciation of health service costs for medical students and giving them the opportunity to practise scholarship relating to a crucial leadership competency. Two challenges encountered by students were the different terminology used for tests in the database compared with clinical terms and locating the test or treatment, both issues were resolved within the tutorials. Finally, an important limitation is that the costings in the NHS database do not take account of ‘care’ provision, admission duration, costs for co-morbidities or indirect costs such as building maintenance/utilities. However, these limitations could be a focus for further expansion of this educational intervention, thus continuing the development of our future clinical managers and leaders.

Spatial visualization and measurement of area: A case study in spatialized mathematics instruction

The purpose of this study was to explore the influence of spatial visualization skills when students solve area tasks. Spatial visualization is closely related to mathematics achievement, but little is known about how these skills link to task success. We examined middle school students’ representations and solutions to area problems (both non-metric and metric) through qualitative and quantitative task analysis. Task solutions were analyzed as a function of spatial visualization skills and links were made between student solutions on tasks with different goals (i.e., non-metric and metric). Findings suggest that strong spatial visualizers solved the tasks with relative ease, with evidence for conceptual and procedural understanding. By contrast, Low and Average Spatial students more frequently produced errors due to failure to correctly determine linear measurements or apply appropriate formula, despite adequate procedural knowledge. A novel finding was the facilitating role of spatial skills in the link between metric task representation and success in determining a solution. From a teaching and learning perspective, these results highlight the need to connect emergent spatial skills with mathematical content and support students to develop conceptual understanding in parallel with procedural competence.