High-fidelity Simulation Teaching Research Articles

Feasibility and evaluation of high-fidelity simulation education for acute clinical toxicology.

To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.

Comparing the effect of assessment-simulation-animation-based against traditional education on nursing students’ anxiety and self-efficacy in maternity clinical practicum

BackgroundThe clinical practicum is the practical course that causes the most anxiety in nursing undergraduates. Although high-fidelity simulation education has been demonstrated to boost nursing students' self-efficacy and decrease anxiety in patient care, it is also associated with excessive psychological stress. Assessment-simulation-animation-based (ASA-based) education has been developed to solve the drawbacks of simulation-based education while preserving positive learning outcomes. ObjectivesTo compare the effects of ASA-based education and traditional education in reducing anxiety and improving self-efficacy of junior nursing students in their maternity clinical practicum. DesignThis study used a two-group pre-post quasi-experimental design. The comparison group was studied first followed by the experimental group. SettingsDepartment of Nursing and affiliated medical center at a medical university in southern Taiwan. ParticipantsWe enrolled 114 junior nursing students from two different class years. MethodsA convenience sample of junior nursing students was used in this study, with 55 in the experimental group and 59 in the comparison group. The intervention included online ASA-based education videos with pamphlets and was conducted three days a week for five weeks encompassing the maternity nursing clinical practicum. We developed and applied the Clinical Situation Anxiety Scale (CS-AS) and Clinical Situation Self-Efficacy Scale (CS-SES) before and after the intervention. Qualitative feedback was assessed after the intervention. Data were collected from both the comparison and experimental groups during the fall and spring terms of both the 2019–2020 and 2020–2021 academic years. ResultsCompared with the comparison group, the total CS-AS and CS-SES scores significantly improved from before to after the intervention in the experimental group. The students responded to the intervention by demonstrating clinical consistency, knowing what to do and how to do it and more confidently practicing health education. ConclusionOur results suggest that ASA-based education with videos and pamphlets contributed to reducing anxiety and increasing self-efficacy in nursing students during their maternity clinical practicum.

신생아 출생 간호에 대한 Head Mounted Displays기반 가상현실(Virtual Reality)시뮬레이션과 블렌디드 교육 프로그램 효과

Objectives This study confirms the effectiveness of a virtual reality simulation and blended education program based on Head Mounted Displays on newborn nursing for nursing college students.
 Methods The participants were 48 nursing students. The experimental group(n=24)received a blended simulation, combining a HMD based virtual reality simulation and a high-fidelity simulation, while the control group(n=24) received only a HMD based virtual reality simulation. Data were collected from January 9 to 12, 2023, and analyzed using SPSS version 25 for Windows.
 Results A blended education program was applied that includes an HMD-based VR and high-fidelity simulation education for neonatal nursing. There was a significant difference in problem-solving ability(t=3.47, p=.009)and clinical performance confidence(U=-3.68, p<.001)of the experimental group that received blended simulation training. Critical thinking disposition(t=2.86, p=.004),problem-solving ability(t=3.47, p<.001), and clinical performance confidence(U=-3.68, p=<.001) were significantly affected before and after training between the experimental and control groups. The difference in scores was statistically significant.
 Conclusions A blended simulation that integrates an HMD based virtual reality simulation program and high-fidelity simulation education for neonatal nursing was found to be effective in education. The goal is to provide basic data for children's nursing simulation education to operate more efficiently. Therefore, since the HMD based virtual reality simulation program can be integrated into the existing simulation program and used as an effective education method, it is believed that alternative practical education design research that applies various simulation education methods is necessary.

The influence of heart failure high-fidelity simulation education based on NLN Jeffries simulation framework in the prelicensure nursing program: A quasi-experimental study

ObjectivesTo examine the influence of heart failure high-fidelity simulation education based on the National League for Nursing (NLN) Jeffries Simulation Framework in prelicensure nursing education. MethodsA heart failure high-fidelity simulation (HFHFS) education pilot project was carried out at Carrington College Sacramento. Twenty-three students participated in the study. This study used a quasi-experimental design. Students’ Self-Efficacy, Satisfaction, and Knowledge in Heart Failure Clinical Knowledge were measured pre- and post-HFHFS education. ResultsThe results of the high-fidelity simulation education for heart failure showed that students achieved a mean score of 45.39 (SD = 7.88) in self-efficacy, 18.70 (SD = 3.38) in satisfaction, and 64.09 (SD = 10.86) in knowledge after the intervention. The paired-sample t-test significantly improved between the pre- and post-intervention scores (P < 0.001). The students highly rated self-efficacy, student satisfaction, and knowledge because of the positive impact on the teaching effectiveness of simulation design (i.e., objectives, problem-solving, student support, fidelity, debriefing) activity that included the application of quality safety education for nurses (QSEN) three competencies safety, patient-centered care, and teamwork and collaboration during nursing care for patients with acute heart failure. The teaching effectiveness of the heart failure high-fidelity simulation education is closely correlated with student satisfaction, self-efficacy, and improvement of participant knowledge in clinical nursing skills performance and critical thinking. ConclusionA heart failure high-fidelity simulation education established upon the National League for Nursing (NLN) Jeffries framework enhanced student knowledge, satisfaction, self-efficacy, application of safety, patient-centered care, and teamwork and collaboration. Nurse educators should consider simulation planning to include the five simulation design characteristics, i.e., objectives, problem-solving, student support, fidelity, and debriefing, while integrating safety, patient-centered care, and teamwork and collaboration to bring about education effectiveness.

Leading Improvements in Rural Healthcare Through Mobile Simulation

Simulation in Motion – Iowa (SIM-IA) is a high-fidelity simulation education for health care providers throughout Iowa. SIM-IA is administered by the University of Iowa College of Nursing with mobile simulation trucks in Iowa City (east), Des Moines (central), and Sioux City (west). SIM-IA’s goal is to provide simulation continuing education to improve patient outcomes. In year 1, SIM-IA provided 110 sessions for over 2200 providers. Second-year goals include expanding from emergency medical service (EMS) providers to hospital and long-term care facility providers. Major implementation challenges include planning, budgeting, and supplies during COVID-19 pandemic, decentralized simulation staff, fiscal sustainability, and diverse local EMS protocols.

Advancing Maternal and Neonatal Safety Through High-Fidelity Simulation Education

&lt;p&gt;近年來，全球母嬰安全問題日益受到重視。根據世界衛生組織資料顯示，2020年，因孕產相關原因全球有近29萬女性喪命。其中，台灣的孕婦死亡率尤為引人關注，明顯超出周邊國家。鑒於此，衛生福利部已將&amp;ldquo;維護孕產兒安全&amp;rdquo;列入年度的病人安全重點工作。婦產科醫學培訓面臨眾多挑戰，不僅涉及複雜的臨床症狀辨識和高風險手術，還包括醫糾問題和醫患關係的管理。因此，以模擬為基礎的教育方法逐漸被認為是解決這些問題的關鍵策略。這種學習方式提供安全的模擬環境，使醫療從業者得以練習醫學技能、加強非技術性能力如團隊合作和溝通，並提升自信心，減輕臨床壓力。透過高階擬真模擬，我們不僅可以提供真實且低風險的學習環境，還能進一步優化醫學教育品質，為母嬰健康和安全提供有力的保障。此項文章旨在研析高階擬真教育在孕產兒安全中的卓越作用與提供實務經驗，期許為台灣和全球母嬰健康及安全帶來持續的進步。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Concern over maternal and neonatal safety has increased globally over the decades. According to data from the World Health Organization, approximately 290,000 women globally lost their lives due to pregnancy-associated complications in 2020. Of particular concern is Taiwan, where the maternal mortality rate significantly surpassed that of its neighboring countries. In response to these findings, Taiwan&amp;rsquo;s Ministry of Health and Welfare has prioritized enhancing pregnancy and childbirth safety as part of its annual patient safety initiatives.Students of obstetrics and gynecology must learn to grapple with a complex range of challenges, ranging from intricate clinical symptomatology and high-risk surgical procedures to the complexities of medicolegal disputes and doctor&amp;ndash;patient relationships. Simulation-based educational paradigms have emerged as pivotal solutions to address these challenges. Such pedagogical approaches provide a controlled simulated environment that enables medical professionals to cultivate nontechnical competencies such as interdisciplinary collaboration and patient communication, augment clinical self-efficacy, and mitigate real-world anxieties. High-fidelity simulation holds the potential to deliver an authentic, risk-mitigated learning experience, thereby refining the pedagogical standards of medical education. This approach lays the foundation for enhanced maternal and neonatal safety outcomes.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Measured task load in directed observers versus active participants undergoing high-fidelity simulation education in a critical care setting.

The use of directed observers in high-fidelity simulation education is increasingly common. While evidence suggests similar educational outcomes for directed observers compared to active participants in technical skills, it remains uncertain if this benefit also exists for senior clinicians, especially in mental workload. We sought to compare the workload between active participants and directed observers using an objective measure. We performed a prospective, repeated-measures observational study during the New South Wales Ambulance Aeromedical Operations induction training from 2019 to 2020. Participants included senior critical care doctors, paramedics, and nurses undergoing high-fidelity simulation of prehospital and interhospital aeromedical missions. Task load was measured using the National Aeronautics and Space Administration task load index (NASA-TLX) administered following each simulation debrief. Prehospital and interhospital simulations were compared separately by building a multilevel model for complete case and all study data. Post hoc comparisons of NASA-TLX score for each group were performed using estimated marginal means (EMMs). We enrolled 70 participants, comprising 49 physicians (70%), 19 paramedics (27%), and two flight nurses (3%). From the complete case analysis, statistically significant differences were observed for total NASA-TLX scores between active participants and directed observers in both prehospital (participant EMM 78, observer EMM 65, estimated difference -13, 95% confidence interval [CI] -20 to -7) and interhospital simulations (participant EMM 69, observer EMM 59, estimated difference -10, 95% CI -16 to -3). When all available data were included, the pattern of results did not change. In our sample of senior clinicians, the task load experienced by both active participants and directed observers in high-fidelity simulation education was high for both prehospital and interhospital simulation exercises. The statistically significant differences we report are unlikely to be practically significant. Our results support the use of directed observers when resource limitations do not allow all course attendees to participate in every simulation.

통합시뮬레이션 교육이 간호대학생의 간호지식, 임상수행능력 및 임상추론역량에 미치는 효과

Objectives This study aimed to identify the effect of Integrated simulation(virtual reality simulation with high-fidelity simulation) education on nursing students’ knowledge, clinical performance, and clinical reasoning competency. A single group pre-post quasi-experimental design was used. Methods Data were collected from November 2021 to December 2021. Nursing knowledge, clinical performance ability, and clinical reasoning competency scores were analyzed from the learning evaluation data of 67 students before and after the integrated simulation class. Data were analyzed by Wilcoxon signed rank test using IBM SPSS 23.0 since the normality test was not satisfied. Results The results indicated that the group that participated in the integrated simulation education program had significantly higher nursing knowledge (z=6.201, p&lt;.001), clinical performance (z=4.999, p&lt;.001) and clinical reasoning competency (z=6.616, p&lt;.001) compared to the pre-test. Conclusions The results of this study can be used as basic data for developing educational programs that can enhance existing simulation classes and improve nursing knowledge, clinical performance, and clinical reasoning capabilities.

Clinical dyspnea scenario: Using high-fidelity situation simulation teaching program to evaluate learning effectiveness for clinical junior and pre-clinical nurses.

Confronting a patient's breathing difficulties, clinical junior nurses often do not know how to respond, and fail to give proper evaluation and treatment. Sudden changes in the condition make the clinical nursing novices feel pressured, and even, frustrated. This study aims at exploring the effectiveness of the high-realistic situational simulation of dyspnea teaching program for pre-clinical and clinical 1st year nurses after graduation. This study adopts a quasi-experimental repeated measure pre-post-test design study with nonequivalent control group pre- and post-test research design. A total of 135 subjects participated in the research: nurses, post graduate year (NPGY) (N = 69), have been employed in the adult ward of a medical center for less than 1 year; and pre-clinical nurses (N = 66), 3rd-year nursing students with nurse licenses from a university in the central part of Taiwan. Simulation-based education instructed and incorporated into the high-realistic situation simulation dyspnea teaching program. Questionnaires were used to measure the effectiveness of learning, data were analyzed with SPSS version 20.0, and the scores were repeatedly measured with the generalized estimating equation. For "cognition, skills, attitude, self-efficacy, teamwork," NPGY and pre-clinical nurses' post-tests are better than pre-tests, with statistically significant results. NPGY nurses' "skills," "attitude" and "teamwork" learning effectiveness are better than those of the pre-clinical nurses. The high-realistic situational simulation of dyspnea teaching program can significantly improve the learning effectiveness of NPGY nurses and pre-clinical nurses in the clinical evaluation and treatment of dyspnea.

Assessing the Financial Sustainability of High-Fidelity and Virtual Reality Simulation for Nursing Education: A Retrospective Case Analysis.

To stimulate classroom discussion and collaboration amid the COVID-19 pandemic, increasingly creative pedological methods for nursing education are necessary. Traditionally, high-fidelity simulation has been the standard for nursing education, but the use of virtual reality simulation is increasing. One of the major evaluative measures of simulation clinical training is the cost associated with each modality. In this retrospective case analysis, budget impact analysis methods were employed to compare high-fidelity simulation with virtual reality simulation. The components of each simulation pedagogy were compared in categorized cost buckets. Overall, virtual reality simulation education was determined to require 22% less time than high-fidelity simulation education. The cost associated with the virtual reality simulation was found to be 40% less expensive than the high-fidelity simulation. Our results demonstrate that virtual reality simulation is a financially advantageous, resource conscious pedagogical option for nursing education.

Evaluation of an immersive simulation programme for mental health clinicians to address aggression, violence, and clinical deterioration.

This study investigated the effectiveness of high-fidelity immersive simulation education to support inter-professional hospital clinical staff in recognizing and responding to aggression, violence, and clinical deterioration of patients admitted with mental health issues. Increased incidents of aggression and violence have been reported in many clinical hospital settings, especially in mental health wards. Patients experiencing severe psychological distress/agitation can result in the escalation of physiological symptoms such as chest pain, difficulty breathing, traumatic injury, etc. Mental health staff do receive aggression prevention training and medical emergency team training. However, there is added complexity when dealing with a mental health patient who is exhibiting aggressive, violent behaviour while also experiencing a medical or psychological emergency. Therefore, mental health staff needed a combined training programme that enhanced their delivery of recovery focussed care, de-escalation, and medical emergency crisis resource management skills. This study used a prospective quasi experimental research design with repeated measures. Hospital clinical staff were immersed in two mental health emergency response and clinical deterioration scenarios and debriefing sessions. Self-efficacy was evaluated using a 10-item validated tool which addressed non-technical skills of Leadership, Management, Communication, and Teamwork. The sample consisted of 122 clinical staff, with the majority from mental health wards (52%; n = 63) who were nurses (68%; n = 83). Mean self-efficacy scores increased significantly across the three time points (F = 11.555; df = 2; P = 0.000). Post hoc pairwise comparisons showed that self-efficacy scores increased between pretest (mean 62.9; n = 122) and posttest 1 (mean 83.2; n = 122) and follow up, 3 months later (posttest 2; mean 81.9; n = 24). Between pre- and posttest 1, significant improvements in self-efficacy were observed for both the Leadership/Management domain (t = 8.2; df 119; P < 0.000; 95% CI 13.3-21.7) and the Communication/Teamwork domain (t = 8.0; df 119; P < 0.000; 95% CI 11.1-18.4). Immersive simulation with high fidelity education was found to be effective in improving hospital nursing and medical staffs' confidence, when responding to incidents of aggression/violence and clinical deterioration of a mental health patient.

High fidelity ECMO simulation: a reality check with reality-use of simulation in ECMO teaching program.

Simulation based learning is becoming a crucial part in ECMO education. Simulation can provide a safe but also very realistic learning experience depending on simulation fidelity. In our institution we developed a simulation based ECMO training program that incorporates low- and high-fidelity simulation. Aim of this study was to evaluate effectiveness of low- and high-fidelity simulation teaching strategies in ECMO novices. We conducted four consecutive ECMO training courses that included fifty-one ECMO novices. We describe ECMO training execution and evaluate training effectiveness and perception by structured pre- and post-training questionnaires analysis. Results of our study show extremely high satisfaction rate with simulation training (4.9 ± 0.3, Lickert 5 point scale). High-fidelity simulation was perceived as very realistic and as such represents an important tool in learning immersion and experience. However, participants reported significant decline from their expectations with regard to structured approach to troubleshooting (4.7 ± 0.5 vs 4.3 ± 0.7, p = 0.02) and efficiency improvement (4.7 ± 0.5 vs 4.3 ± 0.6, p = 0.002) after high-fidelity simulation. There was also a significant decline from their expectation on self-confidence improvement (4.7 ± 0.5 vs 4.2 ± 0.7, p = 0.001). Our results therefore show, that complex high-fidelity simulation should probably be used with caution in novice participants, not to discourage them from further learning.

Interprofessional education and high-fidelity simulation teaching in medical and nursing students in Peking Union Medical College

Interprofessional education and high-fidelity simulation teaching in medical and nursing students in Peking Union Medical College

“It’s real life, isn’t it?” Integrated simulation teaching in undergraduate psychiatry education – a qualitative study

PurposeHigh-fidelity simulation has well-established educational value. However, its use in psychiatry remains underexplored. This study explores medical students’ experiences of high-fidelity simulation teaching during their psychiatry placements. A session was delivered on “psychiatric emergencies”, set in a simulated emergency department, with equal emphasis on the management of physical and psychiatric aspects of patient care. This paper aims to report on student attitudes to high-fidelity simulation teaching in psychiatry, as well as student attitudes to “integrated” teaching (i.e. covering both physical and psychiatric knowledge).Design/methodology/approachSemi-structured focus groups were conducted with medical students at a UK university. This exploratory approach generated rich qualitative data. Thematic analysis was used.FindingsHigh-fidelity simulation teaching in psychiatry is well regarded by medical students, and helps students recognise that psychiatric problems can present in any clinical setting. This study has demonstrated that students value this type of “integrated” teaching, and there is potential for this approach to be more widely adopted in undergraduate health-care professional education. High-fidelity simulation could also be considered for incorporation in undergraduate examinations.Originality/valueTo the best of their knowledge, the authors are the first to conduct an in-depth exploration of attitudes to simulation teaching specifically in psychiatry. The authors are also the first to directly explore student attitudes to “integrated” teaching of psychiatry and physical health topics. The results will support the effective planning and delivery of simulation teaching in psychiatry, the planning of undergraduate summative assessments and will likely be of interest to health-care professionals, educational leads, simulation practitioners and students.

Effects of high-fidelity simulation education on medical students' anxiety and confidence.

IntroductionPsychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students.Materials and methodsThis study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students’ level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience.ResultsStudents had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience.ConclusionsWe confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

Impact of Obstetric Emergency High-Fidelity Simulation on Maternity Nurses' Self-Efficacy in the Rural Hospital Setting.

The purpose of this study was to explore the impact of an obstetric emergency high-fidelity simulation on maternity nurses' perceived self-efficacy levels at three different time points. We used a quasi-experimental, repeated measures design. A convenience sample of maternity nurses recruited from three institutions within a single rural health care system participated in simulation exercises at an academic high-fidelity simulation center. They completed the Obstetric Nursing Self Efficacy survey before, immediately after, and 2 months following the simulation. Twenty-nine nurses were included in the analysis. All were women and Caucasian. Most (72.4%) had a baccalaureate nursing degree, with an average nursing experience of 11 years (range 1 to 44 years), and <5 years of OB experience (55.1%). Self-efficacy scores were 55.62 (SD = 9.8), 58.93 (SD = 8.9), and 61.86 (SD = 9.5) for pre-, post-, and 2 months postsimulation, respectively. There were significant changes from self-efficacy scores before the simulation when compared with scores 2 months after the simulation (p < 0.001), with a medium effect size of .45. High-fidelity simulation can improve maternity nurses' perceived self-efficacy in managing emergency obstetric clinical situations. Health care institutions should consider investing in high-fidelity simulation education or partnering with academic institutions that have simulation centers to promote maternity nurses' self-efficacy that can potentially translate into improved clinical skills and improved patient outcomes.

The Learning Effectiveness of High-Fidelity Simulation Teaching Among Chinese Nursing Students: A Mixed-Methods Study.

High-fidelity simulation (HFS) is an interactive and complex experiential learning pedagogy. Given the limited and inconclusive evidence on the effectiveness of HFS in terms of improving student learning outcomes, a more thorough understanding of students' learning experiences and effects of HFS may inform the improvement of nursing training. The aim of this study was to examine the learning effectiveness score of HFS, its influencing factors, and the learning experience of nursing students. A convergent parallel mixed-methods research design was adopted. Five hundred thirty-three third-year undergraduate nursing students completed the Simulation Learning Effectiveness Inventory. Semistructured interviews were used to elicit the opinions of 22 participants regarding their participation in the HFS experience. The quantitative findings showed a moderately high learning effectiveness of HFS among Chinese undergraduate nursing students (121.81 ± 14.93). The learning effectiveness for equipment resources (15.02 ± 2.38), course arrangement (11.18 ± 1.73), and confidence (18.56 ± 3.67) was relatively low. Extroversion and mixed personality (β = 0.14 and 0.10) and "dislike" or "general like" of the course (β = -0.45 and -0.33) were found to influence learning effectiveness (F = 54.79, p < .001, adjusted R2 = .29). In addition, the qualitative findings indicated that the participants felt positively regarding the "debriefing," "clinical abilities," and "problem solving" dimensions of the training. The focus of the education process and curriculum design of HFS activities should be on improving course arrangement, equipment resources, and students' confidence while paying attention to nursing students' personality traits and course preferences.

Nursing and medical students' perceptions of an interprofessional simulation-based education: a qualitative descriptive study.

PurposeThe purposes of this study were to describe the development and implementation of an interprofessional simulation-based education (IPSE) for undergraduate nursing and medical students, their perceptions of the impact of IPSE, and identify their changes in attitudes toward each other’s health professions after participating in IPSE in South Korea.MethodsThis study used a qualitative descriptive design. A purposive sample of 43 third-year medical students and a convenient sample of 44 fourth-year nursing students participated in a 2-day IPSE program that consisted of ice-breaking and patient safety activities, and 4-hour three interprofessional team-based high-fidelity simulation education sessions. Data were collected through reflective journal after the IPSE program and keywords before and after the IPSE program, and were analyzed using the content analysis and word cloud analysis.ResultsThree themes emerged: “positive experience” with understanding roles and responsibilities and learning by doing in simulation environments being reported. In the second theme, “positive learning outcomes” participants reported enhancing collaboration and confidence in communication skills. The final theme “benefits to patients of interprofessional collaborative practice” included high quality of care and patient safety. Before the IPSE experience, most medical students perceived the nurse as nightingale and syringe, and nursing students perceived the doctor as order, expert, and knowledge. After their IPSE experience, both nursing and medical students viewed each other as colleagues.ConclusionThese results suggest that the use of high-fidelity team-based simulation in IPE is effective in practicing and developing undergraduate nursing and medical students’ interprofessional collaboration through hands-on experience.

Simulated Video Consultations as a Learning Tool in Undergraduate Nursing: Students' Perceptions.

Simulated video consultations, a teaching tool based on high-fidelity simulations, were implemented in response to the necessary adaptation of high-fidelity clinical simulation sessions to the online or virtual modality during the university closure due to the COVID-19 confinement. The purpose of our study was to explore the undergraduate nursing students’ satisfaction and perceptions about simulated video consultations using the high-fidelity simulation methodology. A mixed-method was utilized with 93 undergraduate nursing students using a validated satisfaction questionnaire (quantitative data), which included an observations section (qualitative data). Of the total sample, 97.8% of the students expressed a high overall satisfaction with simulated video consultations, highlighting their practical utility and positive learning outcomes. From the students’ comments, two main themes and their related categories emerged: advantages (satisfaction and enjoyment, learning, and calmness during simulated scenarios), and disadvantages (technical issues and technical skills development). Simulated video consultations may be considered as one more high-fidelity simulation teaching option. Nursing students should be trained in this modality of healthcare to face the challenge brought on by its increased use in healthcare services, beyond the specific adaptation of clinical simulation sessions due to the closure of universities during this pandemic.

Teaching Crisis Resource Management Skills to Nurses Using Simulation

Education programs teaching crisis resource management (CRM) skills (problem solving, situational awareness, resource utilization, communication, and leadership) have been shown to positively affect learner competence in handling crisis events. As part of an education program, a high-fidelity simulation program was used as a learning intervention to teach these skills to practicing nurses. In this repeated-measures observational study, 11 RNs were evaluated at four time points, measuring the effect of an education program on observed performance of CRM skills. Performance was measured using the Ottawa Global Rating Scale and a checklist tool. Statistically significant changes in mean scores occurred between times one and two, and nonstatistically significant improvement occurred in means overall. This study adds evidence of the effectiveness of high-fidelity simulation education and highlights the need for further research. [J Contin Educ Nurs. 2020;51(6):257-266.].