Introduction Of Simulation Research Articles

Playable Experiences Through Technologies: Opportunities and Challenges for Teaching Simulation Learning and Extended Reality Solution Creation

Aim/Purpose: This paper describes a technologies education model for introducing Simulation Learning and Extended Reality (XR) solution creation skills and knowledge to students at the tertiary education level, which is broadly applicable to higher education-based contexts of teaching and learning. Background: This work is made possible via the model’s focus on advancing knowledge and understanding of a range of digital resources, and the processes and production skills to teach and produce playable educational digital content, including classroom practice and applications. Methodology: Through practice-based learning and technology as an enabler, to inform the development of this model, we proposed a mixed-mode project-based approach of study within a transdisciplinary course for Higher Education students from the first year through to the post-graduate level. Contribution: An argument is also presented for the utility of this model for upskilling Pre-service Teachers’ (PSTs) pedagogical content knowledge in Technologies, which is especially relevant to the Australian curriculum context and will be broadly applicable to various educative and non-Australian settings. Findings: Supported by practice-based research, work samples and digital projects of Simulation Learning and XR developed by the authors are demonstrated to ground the discussion in examples; the discussion that is based around some of the challenges and the technical considerations, and the scope of teaching digital solutions creation is provided. Recommendations for Practitioners: We provide a flexible technologies teaching and learning model for determining content for inclusion in a course designed to provide introductory Simulation Learning and XR solution creation skills and knowledge. Recommendation for Researchers: The goal was to provide key criteria and an outline that can be adapted by academic researchers and learning designers in various higher education-based contexts of teaching and inclusive learning design focused on XR. Impact on Society: We explore how educators work with entities in various settings and contexts with different priorities, and how we recognise expertise beyond the institutional interests, beyond discipline, and explore ‘what is possible’ through digital technologies for social good and inclusivity. Future Research: The next step for this research is to investigate and explore how XR and Simulation Learning could be utilised to accelerate student learning in STEM and HASS disciplines, to promote knowledge retention and a higher level of technology-enhanced learning engagement.

Hands-on Simulation Workshop for Obstetric Ultrasound-Guided Invasive Procedures.

IntroductionDue to the introduction of cell-free DNA genetic testing options, the number of clinical ultrasound procedures has greatly diminished in recent years. With fewer real-life ultrasound-guided procedures being performed, it is difficult for OB/GYN and maternal-fetal medicine (MFM) trainees to achieve competency in doing them. Simulation can be utilized to address this issue and supplement a learner's real-life training.MethodsWe developed a simulation workshop incorporating previously described ultrasound guidance task trainers and simulators of amniocentesis and chorionic villus sampling. The workshop had three parts: needle guidance basics, targeting task performance, and procedure-specific simulation. A form of this workshop has been held at the annual meeting of the Society for Maternal-Fetal Medicine since 2015 and as a regional course for MFM fellows since 2017. During the 2019 and 2020 courses, participants completed Likert-scale surveys evaluating the course.ResultsSince the workshops began in 2015, approximately 300 people have participated. In 2019–2020, 41 MFM attending physicians, 136 MFM fellows, and three OB/GYN residents took our course and completed a postcourse survey. Participants rated the course highly and thought it was highly effective.DiscussionWe created an introductory simulation workshop for obstetric ultrasound-guided invasive procedures that participants rated highly and thought was very effective. Objective clinical assessment of skill improvement after completion of this course is needed to verify its true impact. Repeated exposure to this introductory simulation and creation of more challenging workshops are needed to achieve a sustained high level of procedural skill.

The Impact of Serious Games in Economic and Business Education: A Case of ERP Business Simulation

Digitalisation nowadays impacts business environments significantly. Therefore, if higher education wants to educate students properly for a successful career path, the business and economics curriculum must be enriched with innovative teaching approaches covering actual topics, such as, for example, the implementation of the ERPsim business simulation, a representative of serious games. The ERPsim business simulation is based on SAP ERP, and is aimed at teaching ERP concepts. It covers different business processes, and allows students to learn using a hands-on approach, simulating real-life scenarios. The presented research focuses on using an ERPsim business simulation as the introduction to the course. The simulation was implemented to ease the introduction of ERP and IT concepts to the business and economic oriented students. Considering the positive effects of serious games and gamification, our research was formed and focused on knowledge acquisition and future student engagement. We researched whether participation in the introductory simulation results in significant knowledge gain and impacts students’ future course engagement. The data were gathered using a self-assessment questionnaire before and after an introductory simulation. The results were highly positive, confirming many positive aspects of business simulation, among others, significant knowledge increase in the domains of business process and ERP transactions, and in the domain of technical knowledge for SAP ERP. The results confirmed that the introductory simulation is appropriate for introducing ERP concepts to newcomers, and, nevertheless, confirmed the positive impact on their intent on future course engagement.

Gaming and anxiety in the nursing simulation lab: A pilot study of an escape room.

Anxiety accompanying educational simulations is a complex issue impacting nursing students and their learning. Research has provided evidence that some pre-simulation activities can increase student comfort with the simulation environment and may also reduce anxiety. Studies have also provided evidence of promising outcomes for gaming use in nursing education. This pilot study explored a medical-surgical escape room game as an introductory simulation experience for nursing students, particularly focused on determining student anxiety levels, and both faculty and student perception of the experience. A quasi-experimental one group pretest-posttest design was used with a convenience sample to explore student anxiety levels and perceived enjoyment of the game. Student anxiety levels significantly decreased (p=.013); however, anxiety levels remained high at posttest. Students reported high enjoyment of the game and provided positive comments. Escape rooms can provide an engaging, interactive way to teach nursing concepts in the simulation environment.

Anesthesiology Resident Induction Month: a pilot study showing an effective and safe way to train novice residents through simulation.

The transition of new residents from medical school to the post-graduate clinical environment remains challenging. We hypothesized that an introductory simulation course could improve new residents' performance in anesthesiology. The Anesthesiology Residents Induction Month (ARIM) program was designed as a non-clinical simulation training program aiming at providing the theoretical and practical skills to safely approach, as junior anesthesiologists, the operating rooms. For each participant, specific knowledge, procedural skills and non-technical performance were assessed with a pre and post-test approach, before and immediately after the participation in the study. Fifteen first-month residents participated in the study. As compared to pre-test, residents significantly improved in all three evaluated areas. Pre-test knowledge assessment mean improved from 56% to 73% in the post-test (P<0.001). In the procedural skills assessment, pre-test mean improved from 43% to 77% (P<0.001) and non-technical skills assessment improved from 3.17 to 4.61 (in a scale out of seven points) in the post-test (P<0.001). Data suggest that an intensive simulation-based program can be an effective way for first-year residents to rapidly acquire and develop basic skills specific to anesthesiology. There might be benefits to begin residency with a training program aiming at developing and standardizing technical and non-technical skills.

Testing Homogeneity of Variance

This paper compares empirical type I error and power of different tests that have been proposed to assess the homogeneity of within-group variances. The main questions answered in the paper are: (1) Which tests are most effective (powerful and robust) when testing the homogeneity of variances in various conditions of heterogeneity, and (2) When these conditions exist, do any of the tests of homogeneity of variance prove more effective in the detection of heterogeneity than others? An introductory simulation study established that Anova is extremely susceptible to heterogeneity of the variances. This occurs both in normally distributed and non-normal datasets. Even small deviances from homogeneity to that of heteroscedasticity results in inflated type I error. A subsequent simulation study was conducted. The purpose of this study was to determine which of the tests of homogeneity of variances preformed best in unfavourable conditions. These conditions included small sample sizes and a number of non-normal distributions. In these conditions, Bartlett's or Box's tests perform well. Conversely, Cochran's test and the Log Anova test exhibited low power with small to moderate sample sizes even with normally distributed datasets. A decision tree has been created for these results that can be used to determine the most effective test strategy.

Serious gaming for orthotopic liver transplant anesthesiology: A randomized control trial.

Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game," an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT. Forty-four residents on the liver transplant rotation were randomized to either the gaming group (GG) or the control group (CG) prior to their introductory simulation. Both groups were given access to the same educational materials and literature during their rotation, but the GG also had access to the OLT Trainer. Performance on the simulations were recorded on a standardized grading rubric. Both groups experienced an increase in score relative to baseline that was statistically significant at every stage. The improvements in scores were greater for the GG participants than the CG participants. Overall score improvement between the GG and CG (mean [standard deviation]) was statistically significant (GG, 7.95 [3.65]; CG, 4.8 [4.48]; P = 0.02), as were scores for preoperative assessment (GG, 2.67 [2.09]; CG, 1.17 [1.43]; P = 0.01) and anhepatic phase (GG, 1.62 [1.01]; CG, 0.75 [1.28]; P = 0.02). Of the residents with game access, 81% were "very satisfied" or "satisfied" with the game overall. In conclusion, adding a serious game to an existing educational curriculum for liver transplant anesthesia resulted in significant learning gains for rotating anesthesia residents. The intervention was straightforward to implement and cost-effective. Liver Transplantation 23 430-439 2017 AASLD.

Surgical Skills Acquisition: Performance of Students Trained in a Rural Longitudinal Integrated Clerkship and Those From a Traditional Block Clerkship on a Standardized Examination Using Simulated Patients

ObjectivesRural longitudinal integrated clerkship (LIC) programs for third-year medical students provide strong educational curricula and can nurture interest in rural surgical practice. Students learn technical skills in an apprenticeship model. Variability in instruction and patient experiences across sites, coupled with a lack of simulation facilities, raise some concerns about technical skill development. To explore the adequacy of skills acquisition for students in the University of Minnesota Rural Physician Associate Program (RPAP), this study compared RPAP students’ performance on a scenario-based Objective Structured Assessment of Technical Skills (OSATS) with that of traditional surgery block clerkship students (Course 7500). Design, Setting, and ParticipantsThis is a nonexperimental post-only study. All enrolled students (n = 254) completed the OSATS examination. Students in the Course 7500 (n = 222) completed 15 hours of simulation skills training and supervised practice during their 6-week clerkship. RPAP students (n = 32) completed 3 hours of skills training before their 9-month rural assignment. Both groups had access to comprehensive online materials. Mean OSATS checklist, global rating, and total scores were compared at the end of training using t tests (p < 0.05). Self-reported OR and clinical experiences were explored. ResultsBoth groups did well on the OSATS. There were no statistical differences in completion time, checklist scores, mean global ratings, or total scores. RPAP students reported significantly more days in the OR, surgery cases, and first assists. Experience with OSATS tasks reported by RPAP students during clinical rotations correlated with their OSATS performance. ConclusionThis study supports the viability of the LIC model for fundamental skills acquisition when augmented with introductory simulation skills training and online resources. It also suggests that simulation fills a training gap for students in a traditional surgery block clerkship program. It opens a dialog about the potential partnership of surgery departments with rural LICs to address rural general surgery shortages. Further research in this aspect is needed.

A new national introductory simulation based course for ST3 level cardiothoracic surgical trainees

A new national introductory simulation based course for ST3 level cardiothoracic surgical trainees

Solar Thermal Plants Integration in Smart Grids

AbstractSolar energy penetration has been increasingly growing in recent years. Since solar energy is intermittent its integration in existing grids is difficult. This paper deals with the optimal integration of solar power plants in grids. The paper proposes a modification of energy hubs which allows to solve the optimization problem with a mixed integer programming algorithm in a distributed way. An introductory simulation study case is given.

University of South Florida College of Medicine

University of South Florida College of Medicine

High-fidelity simulation in anesthesiology training: a survey of Canadian anesthesiology residents’ simulator experience

The objective of this survey was to explore Canadian anesthesiology residents' educational experience with high-fidelity simulation and to improve understanding of the factors perceived to have either a positive or a negative effect on residents' learning. In 2008, all Canadian anesthesiology residents (n = 599) were invited to complete a ten-minute anonymous online survey. Survey questions were derived from two sources, a literature search of MEDLINE (1966 to present), EMBASE (1980 to present), and the Cochrane and Campbell collaboration libraries and the experience of 25 pilot residents and the lead author. The survey response rate was 27.9% (n = 167). Junior residents (PGY1-3) responded that it would be helpful to have an introductory simulation course dealing with common intraoperative emergencies. The introduction of multidisciplinary scenarios (where nurses and colleagues from different specialties were involved in scenarios) was strongly supported. With respect to gender, male anesthesia residents indicated their comfort in making mistakes and asking for help in the simulator more frequently than female residents. In accordance with the ten Best Evidence Medical Education (BEME) principles of successful simulator education, Canadian centres could improve residents' opportunities for repetitive practice (with feedback), individualization of scenarios, and defined learning outcomes for scenarios. Anesthesiology residents indicate that simulation-based education is an anxiety provoking experience, but value its role in promoting safe practice and enhancing one's ability to deal with emergency situations. Suggestions to improve simulation training include increasing residents' access, adopting a more student-centred approach to learning, and creating a safer learning environment.

An elevator problem

The elevator problem was composed by the Problem Corner editor for use in an introductory simulation course offered regularly at The University of Michigan. What appears here is an exact copy of the problem statement as handed out to the students. Hence, interested SIMULETTER readers who teach simulation might be able to use this problem statement, without modification, in their teaching. The problem was designed for GPSS implementation [it is appropriate for students who have finished the first five chapters in &lt;u&gt;Simulation Using GPSS&lt;/u&gt; (Wiley &amp; Sons, 1974)], but of course can also be modeled in GASP, or SIMSCRIPT, or SIMULA, etc.