Human Patient Simulator Research Articles

Concept and development of a telemedical supervision system for anesthesiology in operating rooms using the interoperable communication standard ISO/IEEE 11073 SDC.

Discussion of a telemedical supervision system for anesthesiology in the operating room using the interoperable communication protocol SDC. Validation of a first conceptual demonstrator and highlight of strengths and weaknesses. The system includes relevant medical devices, a central anesthesia workstation (AN-WS), and a remote supervision workstation (SV-WS) and the concept uses the interoperability standard ISO/IEEE 11073 SDC. The validation method involves a human patient simulator, and the system is tested in an intervention study with 16 resident anesthetists supervised by a senior anesthetist. This study presents a novel tele-supervision system that enables remote patient monitoring and communication between anesthesia providers and supervisors. It is composed of connected medical devices via SDC, a central AN-WS and a mobile remote SV-WS. The system is designed to handle multiple ORs and route the data to a single SV-WS. It enables audio/video connections and text chatting between the workstations and offers the supervisor to switch between cameras in the OR. Through a validation study the feasibility and usefulness of the system was assessed. Validation results highlighted, that such system might not replace physically present supervisors but is able to provide supervision for scenarios where supervision is currently not available or only under adverse circumstances.

Empathy and High-Fidelity Human Patient Simulators: A Critical Analysis of Undergraduate Nursing Education

Empathy and High-Fidelity Human Patient Simulators: A Critical Analysis of Undergraduate Nursing Education

Influence of High-Fidelity Manikin-Based Simulation on Nursing Students' Basic Cardiac Life Support Ability and Motivation

Introduction: One of the competencies that nursing students must have while dealing with cardiac arrest is the capacity to perform critical life support, namely basic cardiac life support (BCLS). Having the abilities and motivation to perform BCLS is a complex process and often goes beyond the planned laboratory session's timeframe. The study wanted to determine the intervention’s impact on nursing students' ability and motivation to conduct BCLS. Methods: This study employed a quasi-experimental design with a pre-post-test control group and was carried out in July 2023 at the Emergency Skills Lab with fourth-year undergraduate nursing students. In this study, the sample size for the control and intervention groups was 52 for each group, selected using a simple random sampling technique. The independent variable was high-fidelity manikin-based human patient simulation based on Kolb's experiential learning theory, while the dependent variables were BCLS abilities measured using a mega code checklist and student motivation measured using a valid and reliable motivation questionnaire. Data were examined using the independent sample t-test. Results: The independent t-test results for the motivation variable showed a significant difference (p = 0.004), indicating a significant difference in motivation among students before and after being exposed to high-fidelity manikin-based human patient simulation based on Kolb's experiential learning theory in performing BCLS. Conclusion: High-fidelity manikin-based Human Patient Simulation is an educational paradigm in healthcare that involves using manikins that closely resemble real patients in realistic scenarios. It can be used as an alternative teaching method to boost BCLS performance and motivation.

A prospective randomized comparative study of effectiveness of simulation-based training in improving the performance of non-technical skill among postgraduate students during anaesthesia crisis resource management

Background Non-technical skills are pivotal in ensuring patient safety during anaesthesia crisis resource management. Simulation-based training has emerged as a promising educational approach for enhancing these skills. This study protocol outlines a prospective randomised comparative study aimed at assessing the impact of simulation-based training on the performance of anaesthesia residents during anaesthesia crisis resource management, with a focus on task management, teamwork, situational awareness, and decision-making skills, using the Assessment of Non-Technical Skills (ANTS) scoring system. Methods Anesthesia residents in postgraduate years 1 and 2 from the Department of Anesthesia at Acharya Vinoba Bhave Rural Hospital will be included as study participants. Informed consent will be obtained, and no exclusion criteria will be applied. Participants will undergo an orientation session covering essential crisis management and simulation knowledge. The study will employ advanced simulation equipment, including a Human Patient Simulator (HPS) mannequin, an anaesthesia machine, and a simulated operating room. Faculty members have selected six distinct perioperative emergency scenarios for simulation sessions. Participants will be grouped in pairs and exposed to three scenarios during each session. Debriefing and feedback will follow each scenario, reinforcing non-technical skills. Experienced staff anesthesiologists, trained in the Assessment of Non-Technical Skills (ANTS) scoring system, will serve as assessors to evaluate participant performance. Expected outcomes Data collected will include ANTS scores, debriefing feedback, and post-test results. Statistical analysis will be employed to assess the effectiveness of simulation-based training in enhancing non-technical skills among anaesthesia residents during anaesthesia crisis resource management.

Psychometric evaluation of the Decision Support System (DSS) for municipal nurses encountering health deterioration among older adults

BackgroundA valid and reliable tool is crucial for municipal registered nurses (RNs) to make quick decisions in older adults who show rapid signs of health deterioration. The aim of this study was to investigate the psychometric properties of the Decision Support System (DSS) among older adults in the municipal healthcare system.MethodsFirstly, we utilized the Rasch dichotomous model to analyze the DSS assessments (n=281) that were collected from municipal RNs working with older adults in the municipal healthcare system. We examined the properties of the DSS in terms of its unidimensionality, item fit, and separation indices. Secondly, to investigate inter-rater agreement in using the DSS, four experienced municipal RNs used the DSS to assess 60 health deterioration scenarios presented by one human patient simulators. The 60 DSS assessments were then analyzed using the ICC (2,1), percentage agreement, and Cohen κ statistics.ResultsThe sample of older adults had a mean age of 82.8 (SD 11.7). The DSS met the criteria for unidimensionality, although two items did not meet the item fit statistics when all the DSS items were analyzed together. The person separation index was 0.47, indicating a limited level of separation among the sample. The item separation index was 11.43, suggesting that the DSS has good ability to discriminate between and separate the items. At the overall DSS level, inter-rater agreements were good according to the ICC. At the individual DSS item level, the percentage agreements were 75% or above, while the Cohen κ statistics ranged from 0.46 to 1.00.ConclusionsThe Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although further research with a larger sample size and more items is needed. The DSS has the potential to assist municipal RNs in making clinical decisions regarding health deterioration in older adults, thereby avoiding unnecessary emergency admission and helping to alleviate emergency department overcrowding.

Trauma surgical simulation: discussing the replacement of live animals used as human patient simulators

BackgroundDespite advances in simulator technology, live anaesthetised animals continue to be used as human patient simulators for medical professionals to practice techniques in the management of surgical trauma. This article describes the process of convening a working group of individuals with a professional interest in simulation to discuss the use of live animals and consider if and how they can be replaced in the future.Main bodyA working group was formed of voluntary attendees to a workshop held at the SESAM 2023 conference. Iterative discussions reflecting on the topic were used to produce statements summarising the working group’s opinions. The working group determined that live animals are used as human patient simulators due to the presence of accurate and responsive physiology in the presence of bleeding, realistic tissue tactility and an emotional response experienced by the learner due to interaction with the animal. They were unable to reach a consensus on replacement, determining that there is currently no single model which is able to provide all the learning aspects which a live animal model can provide. Several suggestions were made regarding development of technologies and pedagogical change.ConclusionReplacement of live animals in surgical simulation is not straightforward but should be an aspiration, if possible. For the ongoing development of trauma surgical simulation models, it is important to combine the knowledge, skills and perspectives of medical stakeholders and educators, academic researchers and industry experts in producing alternative options to the use of live animal simulators.

Self-Efficacy and Learner Satisfaction in the Management of Respiratory Emergency among Undergraduate Students: A Simulation-Based Study

Abstract Background Simulation is an educational method that utilizes scenarios and simulators that aide to replicate real clinical situations. This research was undertaken to evaluate the effectiveness of simulation and satisfaction following the use of high-fidelity simulation among nursing students studying at undergraduate level. Materials and Methods This is a quasi-experimental research study which was conducted in the simulation laboratory of Mangaluru, Karnataka. This study involves simulation-based learning to improve clinical competency among 100 B.Sc. nursing students. The presimulation self-efficacy was assessed by giving a questionnaire to the students. After the pretest, the researchers gave a brief introduction to the simulation scenario and explained the facilities available in the simulation laboratory. Learning objectives were explained and the samples were divided into small groups. The simulation was given using clinical scenarios and computer-assisted Human Patient Simulator for 45 minutes in the simulation laboratory. Postassessment of self-efficacy as well as student satisfaction assessment were performed using a questionnaire. Results The findings showed that the simulation is a productive learning strategy and builds confidence. After the simulation, 79% of students strongly agreed that their self-efficacy improved in the management of patients with respiratory emergencies. The results showed positive correlation between the variables which indicates higher level of self-efficacy improves satisfaction among learners. The present study results also revealed that 98% of students had good satisfaction and found debriefing very useful. Conclusion The high-fidelity simulation had a great influence on improving self-efficacy and satisfaction. Hence, simulation needs to be incorporated into the curriculum to enrich skills.

Mixed-methods education of mechanical ventilation for residents in the era of the COVID-19 pandemic: Preliminary interventional study.

In the current era of the severe acute respiratory syndrome-coronavirus-2 epidemic, the need for respiratory care, including mechanical ventilatory (MV) management, has increased. However, there are no well-developed educational strategies for training medical personnel dealing with respiratory care in MV management. A novel mixed-methods hands-on seminar for learning MV management was conducted for the residents at Chiba University Hospital in March 2022. The seminar lasted approximately 2 hours. The learning goal for the residents was to develop skills and knowledge in performing basic respiratory care, including MV, during an outbreak of a respiratory infection. The seminar with a flipped classroom consisted of e-learning, including modules on respiratory physiology and MV management, hands-on training with a low-fidelity simulator (a lung simulator), and hands-on training with a high-fidelity simulator (a human patient simulator). The effectiveness of the seminar was evaluated using closed questions (scored on a five-point Likert scale: 1 [minimum] to 5 [maximum]) and multiple-choice questions (maximum score: 6) at the pre- and post-seminar evaluations. Fourteen residents at Chiba University Hospital participated in the program. The questionnaire responses revealed that the participants' motivation for learning about MV was relatively high in the pre-seminar period (seven participants [50%] selected level 5 [very strong]), and it increased in the post-seminar period (all participants selected level 5) (p = 0.016). The responses to the multiple-choice questions revealed that the participants did not have enough knowledge to operate a mechanical ventilator, while the total score significantly improved from the pre- to post-seminar period (pre-seminar: 3.3 ± 1.1, post-seminar: 4.6 ± 1.0, p = 0.003). The seminar implemented in this study helped increase the residents' motivation to learn about respiratory care and improved knowledge of MV management in a short time. In particular, the flipped classroom may promote the efficiency of education on MV management.

The Effect of Expert Patient Simulation on Clinical Judgment: A Quasi-Experimental Study.

Worldwide, quality education is one of the important tools to improve healthcare quality. Healthcare practitioners must be competent in their clinical judgement to meet clients' need. However, poor clinical judgment skill accounts for almost one-third of all patient problems in health care. Expert patient simulation has been used as a training method for clinical judgement skill. However, according to empirical studies, using expert patients to develop clinical judgement skill is unclear. The method is effective in one situation but not in another. To examine the effect of expert patient simulation on the clinical judgment skill of health science students of Mizan-Tepi University. A pre-test/post-test quasi-experimental design was used on 92 randomly selected samples from the graduating cohort of midwifery students. The research subjects who took part in the experiment were picked at random. Tools included the Creighton Competency Evaluation Instrument (C-CEI®), the Learning Satisfaction and Self-Confidence Questionnaire, and the Kolb Learning Style Inventory (LSI). The Wilcoxon-signed rank test was utilized to compare the self-confidence scores among intervention and control group of students, and the paired sample test was used to compare clinical judgment scores. Cohen's d was used to assess the effect size, and Spearman correlation was used to explore the association. Clinical decision-making ability and self-confidence measures revealed statistical and practical differences between before and after simulation. There was a mean difference of 2.28 (95% CI, 1.78, 2.79), t (45)=9.13, p 0.001, and an effect size of 1.3, p 0.001. A pre-and post-simulation self-confidence measure showed statistically significant improvement after simulation (W = 1, Z = -3.57, P 0.001). A moderately significant positive connection (r = 0.419, p 0.004) was also discovered. The study found that human expert patient simulation is a tremendous clinical training technique for improving students' clinical decision-making skill competency and self-confidence.

Coronavirus-mimicking nanoparticles (CorNPs) in artificial saliva droplets and nanoaerosols: Influence of shape and environmental factors on particokinetics/particle aerodynamics

Severe acute respiratory syndrome coronavirus 2, abbreviated as SARS-CoV-2, has been associated with the transmission of infectious COVID-19 disease through breathing and speech droplets emitted by infected carriers including asymptomatic cases. As part of SARS-CoV-2 global pandemic preparedness, we studied the transmission of aerosolized air mimicking the infected person releasing speech aerosol with droplets containing CorNPs using a vibrating mesh nebulizer as human patient simulator. Generally speech produces nanoaerosols with droplets of <5 μm in diameter that can travel distances longer than 1 m after release. It is assumed that speech aerosol droplets are a main element of the current Corona virus pandemic, unlike droplets larger than 5 m, which settle down within a 1 m radius. There are no systemic studies, which take into account speech-generated aerosol/droplet experimental validation and their aerodynamics/particle kinetics analysis. In this study, we cover these topics and explore role of residual water in aerosol droplet stability by exploring drying dynamics. Furthermore, a candle experiment was designed to determine whether air pollution might influence respiratory virus like nanoparticle transmission and air stability.

Eye-Tracking-Based Analysis of Situational Awareness of Nurses.

Nurses are responsible for comprehensively identifying patient conditions and associated environments. We hypothesize that gaze trajectories of nurses differ based on their experiences, even under the same situation. An eye-tracking device monitored the gaze trajectories of nurses with various levels of experience, and nursing students during the intravenous injection task on a human patient simulator. The areas of interest (AOIs) were identified in the recorded movies, and the gaze durations of AOIs showed different patterns between experienced nurses and nursing students. A state transition diagram visualized the recognition errors of the students and the repeated confirmation of the vital signs of the patient simulator. Clustering analysis of gaze durations also indicated similarity among the participants with similar experiences. As expected, gaze trajectories differed among the participants. The developed gaze transition diagram visualized their differences and helped in interpreting their situational awareness based on visual perception. The demonstrated method can help in establishing an effective nursing education, particularly for learning the skills that are difficult to be verbalized.

Performance Based Evaluation of Cricothyroidotomy Simulators for Training

The U.S. military has become increasingly reliant on simulators to train combat medical personnel. Human patient simulators that exist for training medical procedures represent task elements with varying degrees of fidelity. The goal of this research was to evaluate the functional fidelity of two commonly used simulators to train surgical cricothyroidotomy to experienced participants. Following a task analysis informed by experts, we collected performance training and test data from 14 experienced trainees. Each participant performed surgical cricothyroidotomies on porcine tracheas before and after five training sessions using one of two simulators. Comparisons of procedure completion times and errors showed development of task mastery by members of both training groups. Analyses of transfer of training from the final training session to the porcine posttest suggested that experienced participants were sensitive to differences between the training simulators and conditions of the posttest. Implications are presented as they relate to the use of simulation technologies for training cricothyroidotomy and the application of a standard method for fidelity assessment.

Use of a human patient simulator for apnea studies: a preliminary in vitro trial.

BackgroundModern human patient simulators (HPSs) could be used for researching critical scenarios such as apnea oxygenation. We aimed to study the use of a high-fidelity HPS to assess prolonged apnea using various oxygenation strategies with a simple high-flow nasal cannula (15 L/min).MethodsAn experimental simulation study using an HPS (CAE Healthcare™) was conducted after obtaining approval from the Institutional Review Board. The HPS responded according to real-time physiologically modeled responses to external gases, such as oxygen (O2). Apnea experiments were performed with different physiological settings, such as shunt fraction (5%) and O2 consumption (250, 500, and 750 ml/min). The following four apnea experiments were conducted: no oxygenation (NO), apnea oxygenation alone (AO), preoxygenation alone (PO), and para-oxygenation (PAO). The time to 92%, 75%, and 50% saturation was recorded. Alveolar and arterial gas levels were recorded till 50% saturation.ResultsAt 250 ml/min, PO (1121 s) and PAO (1274.5 s) had a significantly longer time to 50% saturation (400% increase) compared to NO (222.5 s) and AO (239 s). A similar trend was observed for the time to 92% and 75% saturation. At higher O2 consumption rates, a shorter time to desaturation was observed.ConclusionsApnea trends in the HPS correlated with similar prior human experiments. AO without preoxygenation was found to provide no additional benefit. Preoxygenation with high-flow O2 via nasal cannula prolonged the time to desaturation in the PAO more than PO scenario. Therefore, HPSs can be used in future studies where patient safety is a concern.

Evaluation of a Novel Simulation Curriculum With the Segmented Model in Pediatric Cardiovascular Education.

ObjectiveThe need to develop the full range of knowledge, skills, and professionalism poses new challenges for pediatric cardiovascular education. This study aimed to investigate the effectiveness of a novel simulation curriculum with the segmented model for pediatric cardiovascular residents.Materials and MethodsFirst, the simulation course was designed according to a prior survey and based on a human patient simulator setting. Then, another 55 residents were randomly selected and assigned to participate in a simulation course (about acute fulminant myocarditis in children), either in the experimental group or the control group. Taking full advantage of the simulation education, the simulation case in the experimental group was divided into three segments and included a micro-debriefing at the end of each segment. The three segments were independent but together formed the whole case. It was designed through three cycles of running and debriefing, and more challenging tasks were gradually proposed to residents. The case in the control group was not split and included only one case running and debriefing. The assessments of the residents' knowledge, skills, professionalism performance, and satisfaction feedback from residents were analyzed to evaluate the effectiveness of the course.ResultsIn total, 44 residents completed the whole experimental period, including 23 participants in the experimental group and 21 participants in the control group. The pre-course knowledge assessment scores of the two groups were comparable, while the mean post-course score in the experimental group was 82.61 ± 17.38, which was significantly higher than that in the control group (50.48 ± 18.57, p < 0.01). The mean skills assessment score of residents in the experimental group was 84.17 ± 6.01, which was significantly higher than the control group (54.50 ± 5.72, p < 0.01). In terms of the professionalism assessment, the residents in the experimental group achieved better performance than those in the control group in all aspects (respect, privacy, communication, responsibility, and cooperation) (p < 0.05). Satisfaction feedback from residents showed that self-confidence regarding knowledge mastery in the experimental group was significantly higher than that in the control group (p < 0.05), while there were no significant differences in the evaluations of the teacher's performance (p > 0.05).ConclusionsThe novel simulation curriculum with the segmented model helps residents achieve better performance in terms of knowledge, skills, and professionalism while improving self-confidence. It has some value in pediatric cardiovascular education and is worthy of further promotion.

Using High‐fidelity Human Patient Simulation to Teach Functional Aerodigestive Tract Anatomy And Bridge Clinical Skills: Student Perceptions of Clinical Preparedness

Introduction &amp; ObjectiveHigh‐fidelity human patient simulation (HPS) improves emerging clinical competencies in medical training programs. HPS simulates complex learning environments while minimizing risks. Limited evidence is available regarding HPS use in aerodigestive tract (AT) disorders. Our objective was to explore clinical graduate students’ perceptions regarding their knowledge, skills, and confidence in functional AT anatomy across three different learning environments: didactic, standardized patient (i.e., role play), and HPS.Materials &amp; MethodsUsing a cross‐over design, and following completion of didactic head and neck anatomy lectures, graduate students in a speech‐language pathology clinical program were randomly assigned to one of two case‐based scenarios: standardized patient (STP) or HPS. Following the completion of their assigned scenario, students then completed the alternate. A self‐administered survey using a 10‐pt Likert scale (1 = none/no, 10 = extreme/strongly agree) rated student perceptions across domains of knowledge (K), skills (S) and confidence (C) at four time points (baseline, after didactic, STP, and HPS). Between and within subject comparisons were conducted using the repeated measures. For each domain (K, S, and C), separate and aggregate group mean differences were calculated comparing the domains using t‐test with Welch modification (assuming unequal variance). Within subject changes following each learning environment were calculated using Pearson product moment. Statistical significance was p&lt; .05.ResultsA total of 66 (N) students participated with 227 surveys completed (50% response rate). Across participants, mean (SD) baseline knowledge (4.6 [2.3]), skills (3.6 [2.3]) and confidence (3.2 [2.0]) significantly improved to 7.7 (1.2), 7.1 (1.5) and 6.7 (1.7) respectively following all learning environments. Significant overall increase across K, S and C (aggregate) was 1.5 and strongly correlated to didactic lecture r(35) = .76 (p&lt;.001) and the completion of one scenario r(27) = .84 (p&lt;.001). When comparing STP and HPS, significant improvements were reported in the areas of knowledge (+0.4, p&lt;.05) and confidence (+0.3, p&lt;.05) only with strong correlation to HPS (K=r(23) = .80, p&lt;.001; C = r(23) = .90, p&lt;.001). The majority strongly agreed that both STP and HPS are extremely useful (9.3 [1.2]). Overall, mean (SD) perceived clinical reasoning increased from 3.7 (2.2) to 6.7 (1.1) with significant improvements following didactic (p&lt;.01) at least one case scenario (p&lt;.001), however no significant differences were observed when comparing STP to HPS. Students rated the value of both STP and HPS highly (9.4 [1.2] vs. 9.3 [1.1]).Conclusion &amp; SignificanceStudents perceived that multiple learning environments enhance their knowledge, skills and confidence in AT disorders. While they determined that STP and HPS are equally valuable, their knowledge and confidence improved significantly following HPS. Clinical skills did not change between STP and HPS. This study was the first to develop HPS modules while incorporating functional AT anatomy with clinical skills training across didactic and STP environments. Student learning and confidence is maximized through these environments and using HPS is feasible and effective in our clinical training program.

The Use of Simulation Based Learning: With Bachelor of Science Pharmaceutical Science and PharmD Students

Background and purpose Interprofessional education between bachelor of science pharmaceutical science (BSPS) students and Doctor of Pharmacy (PharmD) students is rare. According to the Association of American Medical Colleges, more than 80% of medical schools incorporate simulation based teaching within all four years of the curriculum. Educational activity and setting: The University of Rhode Island College of Pharmacy healthcare simulation lab has developed integrated educational opportunities for both groups of students by offering independent study opportunities that allow BSPS students to collaborate with PharmD students. A recent example of this model includes BSPS student development of patient cases which are integrated into high-fidelity human patient simulators with faculty assistance. A senior BSPS student researched and designed four clinical patient cases which were presented to P3 pharmacy students. Findings: In all four cases, there was an increase in knowledge and attitudes following the simulation. Qualitative comments from students noted the importance of patient education and an enhanced ability to manage disease and side effects. Summary: The nature of the simulation lab at the University of Rhode Island is a platform that can be modeled by other institutions with both PharmD and BSPS programs.

Increasing Student Confidence With Medically Complex Infants Through Simulation: A Mixed Methods Investigation.

The purpose of this study was to compare student knowledge and confidence, related to the assessment and management of oral feeding readiness in medically complex infants, following a written case study versus a high-fidelity human patient simulation (HPS). A sequential, two-phase, embedded mixed methods design was conducted. Participants were two sequential cohorts of second-year speech-language pathology graduate students enrolled in a didactic Pediatric Dysphagia course. At the end of the course, students completed the same case scenario presented as a written case study (control group; N = 28) or as an HPS (experimental group; N = 24). Pre- and post-knowledge assessment results and self-assessments of confidence conducted at three time points were compared. All students made gains in knowledge, regardless of intervention (written case study or HPS). Despite different baselines, the percent change in knowledge was significant with the control group improving 33% and the experimental group improving 76% from baseline. Students in the experimental group demonstrated significantly greater gains in confidence with skills enhanced by the hands-on, immersive experience of HPS. Qualitative analysis further identified factors contributing to increased confidence with all students reporting that experience significantly contributes to their confidence in their ability to treat patients. While knowledge outcomes were similar between the groups, the confidence that the experimental group gained through the hands-on experiences of HPS fosters student development as confident professionals in assessing feeding readiness and managing medically complex infants. Results support integration of simulation into the graduate curriculum to support student learning. https://doi.org/10.23641/asha.19233504.

Nursing Students' Satisfaction and Self-Confidence Levels After Their Simulation Experience.

Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience. To obtain an understanding of the human patient simulation experience and nursing students' perceptions of satisfaction and self-confidence. Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students' satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables. The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students' satisfaction and self-confidence. Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students' current levels of satisfaction and self-confidence that can lead to developing future policies.

Learning activities in bachelor nursing education to learn pre- and postoperative nursing care—A scoping review

The aim of this scoping review was to systematically map and summarise the existing literature on learning activities in pre- and postoperative nursing care for undergraduate nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Extension for Scoping Reviews (PRISMA-ScR) and the Johanna Briggs Institute guidelines were applied. Eleven articles were included in the scoping review. The learning activities involved simulation-based learning (including human patient simulation and virtual simulation), web-based learning and case studies. A range of pre- and postoperative content was applied in the learning activities. Students’ knowledge, skills, clinical decision making, clinical reasoning, experiences and stress and anxiety were measured. The review highlights findings for nursing educators planning teaching methods for pre- and postoperative nursing care.

Factors facilitating independent training using human patient simulators for nursing students

Factors facilitating independent training using human patient simulators for nursing students