Simulation Experience Research Articles

Physical activity implementation in the curricula of healthcare professions: a systematic review

Background The objective was to investigate the impact of physical activity (PA) teaching and learning approaches in healthcare professionals (HCPs) education on PA-related knowledge, confidence, and behaviour. Methods Eligible experimental studies investigated the effect of interventions that incorporate PA in to the undergraduate and postgraduate education, and continuous professional development of any HCP (medical doctors, nurses, physiotherapists, etc.) on PA-related outcomes including knowledge, perceptions, and confidence to prescribe PA. Six databases (Cochrane Central Register of Controlled Trials, CINAHL, Embase, ERIC, Medline, and SPORTDiscus) were searched from inception to October 2022. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools. A narrative data synthesis was undertaken to assess the overall effectiveness of the reviewed educational interventions: knowledge, perceptions, confidence, attitudes, beliefs, and changes in behaviour/practice. Results A total of 32 studies comprising 3,256 participants fulfilled the eligibility criteria. The most frequently employed learning approach in eligible studies was training workshops (n=13), followed by experiential learning (n=4). Half of the studies included knowledge as an outcome (n=16) and 10 studies each included a measure of confidence and changes in behaviour/practice. Randomized controlled trials (RCTs) (n=7), showed no improvement in any measure of knowledge, confidence, or behaviour. Two RCTs reported beneficial effects of experiential learning on confidence and perceived behavioural control. In non-randomised studies, training workshops and didactic input with and without simulated e-learning led to statistical improvements in knowledge, confidence, perceived competence, and attitudes. Discussion Most of the eligible studies lacked an adequate sample size, and, in many cases, there was a high loss to follow up which represents a threat to the internal validity of the studies. We found that a blended approach to teaching and learning supported with experiential or simulated experiences to improve the knowledge, perceived competence, and confidence to prescribe PA.

Conceptualizing Student Experiences of Psychological Safety in Simulation: A Grounded Theory Study.

Simulation-based learning activities have become more prevalent in prelicensure nursing curricula. When following the Simulation Standards of Best Practice, optimal learning conditions can be achieved, including the creation of a psychologically safe learning environment. Yet, the process of how students come to feel psychologically safe during a simulation experience remains unknown. A grounded theory approach was used to conceptualize the basic social process by which nursing students feel psychologically safe during a simulation learning experience. Six categories emerged from the data: (1) being nervous; (2) having a good instructor; (3) learning; (4) coming together; (5) being in debriefing; and (6) leaving on a positive note. The core category of putting myself out there emerged as the basic social process. The social process of psychological safety in simulation develops within nursing students as the result of interplay among several dimensions of the learning experience. [J Nurs Educ. 2024;63(7):427-433.].

Reconceptualizing Simulations: Epistemic Objects and Epistemic Practices in Professional Education

This study explores how and why simulation training facilitates professional learning by investigating how simulators and simulations are used and conceptualized in two professional domains, nursing and maritime navigation, and offer a reconceptualization. Our aim is to move beyond past theorizing of simulators and simulations that has mainly centered on representational issues like validity, fidelity, and authenticity. Instead, we approach simulators as epistemic objects and simulations as epistemic practices. These concepts offer a lens to examine the situated and sociomaterial practices that make simulators into simulations and simulations into entry points to the epistemic culture of a profession. As a result, we pinpoint three central mechanisms for transforming the simulation experience into an event that facilitates the enrollment of students into their future profession. The first mechanism involves the instructional practice of “filling in” aspects of the work context that might be missing in the simulator. The second mechanism, sometimes labeled the “as-if” mode of simulations, manifests through the participants’ ongoing commitment to treat the simulation as-if it was a real professional encounter. The third relates to how simulation-based learning activities afford a crucial pedagogical orientation towards defining what constitutes exemplary professional practice in specific training situations.

Exploring Objective Simulation Competency Assessment Experience E-Learning Module Analytics: A Mixed-Methods Study to Improve Nursing Faculty Feedback.

Abnormal uterine bleeding is a common clinical concern for adolescent women. This research study aims to improve the clinical reasoning skills of advanced practice nursing students instructed in blended Objective Simulation Competency Assessment clinical experiences by enhancing feedback loops given to students during simulated experiences. A sequential explanatory mixed-methods study design was conducted with two cohorts of first-year women's health nurse practitioner graduate nursing students enrolled in the Women's Health Program at a large Midwestern university. Data were collected across 2 years from two separate cohorts, and analyses included data from 15 participants. The Abnormal Uterine Bleeding module designed with decision pathways was a worthy effort, and faculty value using data analytics from the e-learning module to evaluate student learning. This study describes how nursing faculty created abnormal uterine bleeding content in an online module format that can aid the diagnostic reasoning process and enable feedback to students.

A Pilot Study Toward Development of the Digital Literacy, Usability, and Acceptability of Technology Instrument for Healthcare.

Electronic health record proficiency is critical for health professionals to deliver and document patient care. There is scarce research on this topic within undergraduate nursing student populations. The purpose of this study is to describe the psychometric evaluation of the Digital Literacy, Usability, and Acceptability of Technology Instrument for Healthcare. A cross-sectional pilot study for psychometric evaluation of the instrument was conducted using data collected through an emailed survey. Exploratory factor analysis, inter-item and adjusted item-total correlations, and Cronbach's α calculated subscale reliability. A total of 297 nursing students completed the survey. A seven-factor structure best fit the data: technology use-engagement, technology use-confidence, technology use-history, electronic health record-ease of use, electronic health record-comparability, and electronic health record-burden. Cronbach's α indicated good to very good internal consistency (α = .68 to .89). The instrument effectively measured digital literacy, acceptance, and usability of an electronic health record and may be implemented with good to very good reliability across varied healthcare simulation and training experiences.

Preparing healthcare professional students for rural, regional and remote practice: demonstrating the effectiveness of an interprofessional simulation learning experience

ABSTRACT Undertaking an authentic interprofessional simulation experience may be a useful and consistent strategy for healthcare professional students to build competencies required for a rural healthcare context. An observational comparative study design was adopted to evaluate a clinical simulation experience created to develop the interprofessional competencies of a sample of healthcare professional students at a regional university situated on multiple campuses in New South Wales (NSW), Australia. Over 200 students across three campuses of the university were involved in a simulation experience that included four interprofessional activities. Of these students, 189 (89%) agreed to participate in the study. The healthcare professional students who participated in the study were from second year occupational therapy, physiotherapy, and podiatry, and third year speech pathology programs. Retrospective pre and post self-assessed interprofessional collaborative competencies were compared for all students using the revised Interprofessional Collaborative Attainment Survey (ICCAS). Results demonstrated a statistically significant improvement in self-perceived scores using the validated revised ICCAS survey. The findings of this study suggest that carefully designed and authentic interprofessional simulation experiences can facilitate the development of competencies required for effective interprofessional practice, which are necessary for successful rural practice.

Development of the "Through the Eyes of …" Program for Improving Cultural Awareness.

Understanding the role implicit bias plays in health inequities can aid students in adopting a culturally humble approach to working with diverse communities. This article describes the development of the "Through the Eyes of …" training program, aimed at improving cultural humility, empathy, and implicit bias awareness of nursing students. A series of simulated experiences using 360-degree video capture was developed, allowing students to explore personal and societal responses to the experiences of the populations served within the community. The training materials were pilot tested with a group of prelicensure nursing students. Students (N = 25) reported strong agreement that the simulations provided adequate information, necessary support, problem-solving ability, time for feedback/reflection, and fidelity. The students enjoyed hearing other perspectives and the realistic nature of the simulated scenarios. The program allowed students the opportunities to explore with the goal of improving nursing practice and patient outcomes. [J Nurs Educ. 2024;63(X):XXX-XXX.].

FLIGHT SIMULATOR TRAINING: PSYCHOPHYSIOLOGICAL RESPONSE

Flight simulators have become indispensable in the aviation industry, providing accurate and detailed simulations of cockpit and environmental conditions. They serve a variety of purposes, including pilot training, aircraft design, and accident investigation. While simulators are able to replicate many aspects of real-world flying, there are still differences in stress levels and response intensities. As such, a comprehensive training program that includes both simulated and real-world experiences is necessary to ensure pilots are well-prepared for handling the diverse challenges of aviation operations.

Developing Teachers’ Advocate Identities Through Exploratory Talk

ABSTRACT In educational contexts characterized by persisting inequalities, preparing teachers to advocate for historically marginalized students is a critical element in constructing more equitable educational experiences for all students and their families. However, little is known about how teachers develop and hone their sense of advocacy. Therefore, this study documents how English as a second language (ESL) endorsement candidates (ECs; n = 60) collaboratively develop a sense of “advocacy identity” when they engage in exploratory talk after a simulated advocacy experience. Drawing on group reflection videos, findings highlight how teachers’ lives and experiences inform their interpretations of advocacy. By sharing personal narratives and different types of knowledge, teachers articulate their thinking, solidify their stance as advocates, and co-construct new understandings of what it means to be an advocate for their multilingual learners (MLs). These findings have implications for promoting deeper engagement with advocacy in teacher education and professional development, ultimately toward building collaborative capacity for teachers to support and advocate for historically marginalized students.

A Coupling Physics Model for Real-Time 4D Simulation of Cardiac Electromechanics

Cardiac simulators can assist in the diagnosis of heart disease and enhance human understanding of this leading cause of mortality. The coupling of multiphysics, such as electrophysiology and active–passive mechanics, in the simulation of the heart poses challenges in utilizing existing methodologies for real-time applications. The low efficiency of physically-based simulation is mostly caused by the need for electrical-stress conduction to use tiny time steps in order to prevent numerical instability. Additionally, the mechanical simulation experiences sluggish convergence when dealing with significant deformation and stiffness, and there are also concerns regarding volume inversion. We provide a coupling physics model that transforms the active–passive dynamics into multiphysics solving constraints, aiming at boosting the real-time efficiency of the cardiac electromechanical simulation. The multiphysics processes are initially divided into two levels: cell-level electrical stimulation and organ-level electrical-stress diffusion/conduction. This separation is achieved by employing operator splitting in combination with the quasi-steady-state method, which simplifies the system equations. Next, utilizing spatial discretization, we employ the matrix-free conjugate gradient approach to solve the electromechanical model, therefore improving the efficiency of the simulation. The experimental results illustrate that our simulation model is capable of replicating intricate cardiac physiological phenomena, including 3D spiral waves and rhythmic contractions. Moreover, our model achieves a significant advancement in real-time computation while maintaining a comparable level of accuracy to current methods. This improvement is advantageous for interactive medical applications.

A simulated experience for using the Adverse Childhood Experiences assessment tool in case management: A feasibility study

A simulated experience for using the Adverse Childhood Experiences assessment tool in case management: A feasibility study

Introducing process simulation as an alternative to laboratory session in undergraduate chemical engineering thermodynamics course: A case study from Sunway University Malaysia

This study demonstrates the successful integration of process simulation using CHEMCAD into Sunway University's Chemical Engineering Thermodynamics curriculum, replacing the traditional lab sessions. This approach has two main benefits, i.e., it provides early exposure to process simulation software, bridging theory and practice, and it supports new chemical engineering programs where labs may not be fully operational. Aligned with Sunway University's commitment to innovative educational approaches, the impact of this integration on the students’ learning experiences is evident through feedback collected from a comprehensive survey conducted with a group of seven students enrolled in Chemical Engineering Thermodynamics in April 2023. The survey's three sections gathered the students’ perceptions, enjoyed aspects, challenges faced, and suggestions. Findings highlight the students’ positive views on the integration, enhancing comprehension of thermodynamics concepts and real-world applications. They also recognized the value of hands-on simulation experience for essential process simulation skills. The students appreciated the practical relevance in highlighting thermodynamics’ real-world importance. Challenges related to software access and technical issues were addressed, with planned improvements. The students expressed interest in deeper learning, including complex simulations, graphical representation use, and external resource access. While many found the integration effective, suggestions for more hands-on engagement and research resource access were noted.

A grounded theory-based model of information communication in cultural heritage digital reading on the social media from the perspective of the embodied theory

New media technologies have opened up new possibilities for the communication of cultural heritage, and digital reading aligns with the participatory shift in museums, becoming an indispensable part of information communication. Currently, there exists a certain contradiction between the professional content of cultural heritage and the non-linear and immersive narrative style of new media. In order to find a balance between form and content, and explore the information communication pattern of cultural heritage in the era of mobile media, starting from practical issues, this article introduces the theory of embodied cognition, combines it with relevant theories in communication studies, and systematically explores the impact of embodied factors on audience reading behavior by using semi-structured interviews and grounded theory. The research reveals that embodied cognition, situational cognition, and interactive cognition have a significant impact on the digital reading information communication of cultural heritage on social media, which includes six factors: functional experience, sensory experience, interactive experience, scene simulation, emotional elevation and social experience. This study further constructed a theoretical model of the factors influencing the effectiveness of information communication in cultural heritage digital reading on the social media platform under the influence of embodied cognition theory, which confirms that these six factors play a significant role in the process of museum content generation, audience understanding, as well as the emergence of and the feedback loop of new meanings.

Identifying potential LGBTQIA+ competencies for genetic counseling student training.

The LGBTQIA+ community faces considerable health disparities. Developing and integrating LGBTQIA+ competencies into healthcare provider training programs is one way to promote inclusive high-quality care to potentially improve this community's health. Currently, there are no established LGBTQIA+-specific competencies for genetic counseling graduate programs (GCPs), so training across GCPs likely varies. This qualitative focus group-based study aimed to explore current topics related to genetic counseling (GC) for LGBTQIA+ patients covered in North American GCPs, their learning objectives, and LGBTQIA+-specific competencies that GC students (GCSs) should achieve by graduation. Eligible participants were program leaders at ACGC-accredited GCPs and/or faculty who taught LGBTQIA+-related content in at least one GCP over the last 5 years. A semistructured interview guide was used to conduct virtual focus groups that were recorded and transcribed. Transcripts were analyzed using reflexive thematic analysis and an inductive iterative approach that generated themes regarding what content is taught and what knowledge, attitudes, and skills GCSs should demonstrate as a result. Thirteen people participated, including nine LGBTQIA+ people. They represented 12 GCPs (22% of current GCPs) across the United States and Canada. Focus groups ran 73-90 min. Transcript analysis identified six themes, framed as learning objectives (LOs), and 24 subobjectives. These included recognizing the breadth of the LGBTQIA+ community and their lived experience with the healthcare system, demonstrating respect for and responding to patient identities to provide inclusive GC, employing strategies to mitigate social aspects that influence health care, and assessing personal biases and the impact of socialization. Participants used several teaching methods including didactic lectures, simulation, written activities, reflections, and fieldwork experiences. The six identified LOs may be a starting point for GCPs looking to develop or refine their LGBTQIA+ curricula. Competency-based education may enhance GCSs' abilities to provide inclusive GC to the LGBTQIA+ community.

A short simulated nature experience as an effective way to promote restoration from work-related stress.

Spending time in nature, and even watching images or videos of nature, has positive effects on one's mental state. However, cognitively stressful work is often performed indoors, in offices that lack easy access to nature during breaks. In this study, we investigated whether watching a 5-min audiovisual video that describes a first-person perspective walk on a forest path could help to restore one's mental state after cognitive stress. Participants were asked to perform cognitive stressor tasks, after which they were shown either a nature walk video or a control video. Subjective restoration was measured using self-reports before and after the videos, while electrodermal activity (EDA) and electroencephalography (EEG) were measured during the video-watching session. The results showed that experiencing the nature walk video enhanced subjective restoration more than watching the control video. Arousal of the autonomic nervous system, measured using EDA, decreased more during the nature walk video than during the control video. Additionally, activity in the EEG's upper theta band (6-8 Hz) and lower alpha band (8-10 Hz) increased during the nature walk video, suggesting that it induced a relaxed state of mind. Interestingly, the participants' connection with nature moderated the effects of the nature video. The subjective and physiological measures both suggest that watching a short, simulated nature walk may be beneficial in relaxing the mind and restoring one's mental state after cognitive stress.

Reserving the human touch in nursing education while integrating virtual reality and simulation

In the ever-evolving landscape of nursing education, the integration of virtual reality (VR) and simulation technologies presents both promise and challenges. Although these innovative tools offer unparalleled opportunities for skill acquisition and clinical reasoning, concerns have arisen regarding the potential erosion of compassionate care at the core of nursing practice. The article explores the balance between technical proficiency and compassionate care in nursing education. The importance of comprehensive educator training in utilizing VR and simulation to instill humanistic values, along with the need for curriculum development that seamlessly integrates compassionate care throughout nursing programs, is underscored. By emphasizing the integration of empathy, emotional intelligence, and reflection into VR and simulation experiences, nursing education can ensure that graduates possess the skill sets and values essential for patient-centered practice. The preservation of human touch remains a priority and a cornerstone in the preparation of nursing professionals equipped to deliver holistic and empathetic care in an increasingly technology-driven healthcare landscape.

Hybrid data clustering algorithm and interactive experience in E-learning electronic course simulation of legal education

With the development of multimedia technology, interactive entertainment experience is an important feature of online teaching mode. Students can engage in interactive learning through various mobile apps and online tools. E-learning provides an innovative way of learning that enables distance learning through electronic course simulation. The objective of this research is to design and develop an improved E-learning course simulation for law teaching by applying hybrid data clustering algorithms and enhancing interactive experiences to improve student engagement and learning outcomes. This article analyzes the simulation of legal education E-learning electronic courses based on mixed data clustering algorithms and interactive experiences. On the basis of the mixed data clustering model of the k-means algorithm, we propose a probability based mixed clustering model that can effectively handle the clustering problem of mixed data. Based on this algorithm, we have established a legal teaching network system platform based on artificial intelligence. The hybrid data clustering algorithm solves the instability problem of the k-means algorithm in the construction of the legal teaching network course platform, providing a reliable solution for the development of artificial intelligence network courses. Based on teaching concepts and combined with various technological characteristics such as network technology and multimedia technology in the information age, users who pass through this teaching system can fully utilize the teaching resources and various functions in the system. The hybrid data clustering algorithm proposed in this article has good clustering performance.

Enhancing Adult Hearing Screening Skills for Speech-Language Pathology Students Through Simulation

Purpose: This study evaluated student performance and perception of a simulated hearing screening utilizing an adult standardized patient (SP). It explored the relationship between student performance and student perception of the simulation. Method: Sixty-nine first-year speech pathology graduate students completed a high-fidelity simulation to demonstrate competency in hearing screening administration with an adult SP. Student performance was assessed by supervising educators through standardized rubrics in the following domains: (a) explaining the task, (b) following the university screening protocol, (c) demonstrating clinical and critical thinking, and (d) using the audiometer efficiently. Students also completed surveys to provide feedback regarding their simulation experience. Results: The median rating for student performance across the four domains evaluated was determined using nonparametric tests, while a one-sample t test was used to determine average ratings. Additionally, central tendency and dispersion measures were computed using rubric ratings of students' performance in each domain evaluated. Overall, students performed well in this simulation, with nearly all students demonstrating competency in explaining the task and demonstrating clinical/critical thinking. Following the screening protocol and using the audiometer efficiently showed the most room for improvement. Student survey responses generally indicated that this was a positive and beneficial learning experience and provided constructive feedback for future iterations of this simulation. Conclusions: Hearing screening simulations effectively train graduate speech-language pathology students in the necessary skills. Student perceptions of this simulation were resoundingly positive.

Mitigating Value Hallucination in Dyna-Style Planning via Multistep Predecessor Models

Dyna-style reinforcement learning (RL) agents improve sample efficiency over model-free RL agents by updating the value function with simulated experience generated by an environment model. However, it is often difficult to learn accurate models of environment dynamics, and even small errors may result in failure of Dyna agents. In this paper, we highlight that one potential cause of that failure is bootstrapping off of the values of simulated states, and introduce a new Dyna algorithm to avoid this failure. We discuss a design space of Dyna algorithms, based on using successor or predecessor models---simulating forwards or backwards---and using one-step or multi-step updates. Three of the variants have been explored, but surprisingly the fourth variant has not: using predecessor models with multi-step updates. We present the \emph{Hallucinated Value Hypothesis} (HVH): updating the values of real states towards values of simulated states can result in misleading action values which adversely affect the control policy. We discuss and evaluate all four variants of Dyna amongst which three update real states toward simulated states --- so potentially toward hallucinated values --- and our proposed approach, which does not. The experimental results provide evidence for the HVH, and suggest that using predecessor models with multi-step updates is a fruitful direction toward developing Dyna algorithms that are more robust to model error.

Investigating User Experience of an Immersive Virtual Reality Simulation Based on a Gesture-Based User Interface

Investigating User Experience of an Immersive Virtual Reality Simulation Based on a Gesture-Based User Interface