Learning Confidence Research Articles

Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review.

With the shift towards person-centered care (PCC) in oncology, there is a need for parallel evolution of oncology education programs to prepare the next generation of health professionals to deliver effective PCC. These programs should be designed utilizing perspectives from individuals who have lived experience with cancer to ensure that changes to education curricula translate to improved PCC in the clinic. Our goal was to identify existing literature describing such programs as well as identify gaps for further development. Keywords were agreed upon and searched across Ovid Medline, Ovid Embase, ERIC, Google Scholar, and MedEdPORTAL databases. Duplicates were removed, unique articles were screened for relevance by title and abstract, and a full text review of each article was completed for validation. Included articles describe methods for involving people with cancer in developing and/or delivering oncology-focused education programs. In total, 15 articles describing 12 unique oncology education programs from 7 different countries were identified, reviewed, and summarized. These programs involved learners undertaking undergraduate medical education, postgraduate medical education, continuing medical education, or training as nurses or radiation therapists. Current literature indicates that classroom-based sessions, experiential or simulated learning modalities, and/or asynchronous online modules can all feasibly be created with the integration of perspectives/narratives of people with cancer. Furthermore, involving people with cancer directly in the design and/or delivery of these education programs may contribute to improved patient experiences. Including the perspectives of people with cancer directly in oncology curriculum development and delivery can improve established pedagogical approaches and enhance learner confidence and competency in delivering PCC. We provide recommendations for stepwise implementation of patient perspectives into oncology education, with the hope that future programs will better prepare and motivate learners to provide PCC aimed at improving cancer care, quality of life, and disease outcomes.

일부 치위생학과 학생의 학습행동스타일에 따른 플립러닝 수업 효과에 관한 연구

Objectives: This study was conducted to confirm the difference in learning effect according to the learning behavior style of students in the flipped learning class. Methods: A Self-reported survey was conducted on 50 students of the dental hygiene department in the 3rd year of university located in Cheonan. Data analysis was performed using SAS 9.4 program. Results: The students belonging to the leader type classification showed higher self-direction than the assistant type(p=0.016), and the presenter type showed higher learner confidence and instrument performance confidence than the assistant type(Learning Confidence p=0.027; Periodontal instrumentation Confidence p=0.007). Conclusions: In order to provide effective education for all students during the flipped learning, it is necessary to grasp the learning behavior style in advance and active professor feedback.

Semi-supervised segmentation of coronary DSA using mixed networks and multi-strategies

The coronary arteries supply blood to the myocardium, which originate from the root of the aorta and mainly branch into the left and right. X-ray digital subtraction angiography (DSA) is a technique for evaluating coronary artery plaques and narrowing, that is widely used because of its time efficiency and cost-effectiveness. However, automated coronary vessel classification and segmentation remains challenging using a little data. Therefore, the purpose of this study is twofold: one is to propose a more robust method for vessel segmentation, the other is to provide a solution that is feasible with a small amount of labeled data. Currently, there are three main types of vessel segmentation methods, i.e., graphical- and statistical-based; clustering theory based, and deep learning-based methods for pixel-by-pixel probabilistic prediction, among which the last method is the mainstream with high accuracy and automation. Under this trend, an Inception-SwinUnet (ISUnet) network combining the convolutional neural network and Transformer basic module was proposed in this paper. Considering that data-driven fully supervised learning (FSL) segmentation methods require a large set of paired data with high-quality pixel-level annotation, which is expertise-demanding and time-consuming, we proposed a Semi-supervised Learning (SSL) method to achieve better performance with a small amount of labeled and unlabeled data. Different from the classical SSL method, i.e., Mean-Teacher, our method used two different networks for cross-teaching as the backbone. Meanwhile, inspired by deep supervision and confidence learning (CL), two effective strategies for SSL were adopted, which were denominated Pyramid-consistency Learning (PL) and Confidence Learning (CL), respectively. Both were designed to filter the noise and improve the credibility of pseudo labels generated by unlabeled data. Compared with existing methods, ours achieved superior segmentation performance over other FSL and SSL ones by using data with a small equal number of labels. Code is available in https://github.com/Allenem/SSL4DSA.

THE EFFECTIVENESS OF COLLABORATIVE WRITING TO IMPROVE THE STUDENTS' WRITING SKILL

This study aims to determine whether collaborative writing is effective to improve students' writing skills or not and to know students' perceptions of collaborative writing. This research was conducted at SMAN 3 Majene. The samples of the research were 40 students from grade X or tenth grade. The researchers employed mixed research methods. Researcher used tests to collect data about the ability to write descriptive texts and interviews as research instruments to collect data about the extent of the influence of collaborative writing on motivation and self-confidence in learning. The data analysis technique uses Statistical Product and Service Solution (SPSS) 20 to analyze quantitative data and qualitative descriptive analysis techniques to analyze qualitative data and the results of this study indicate that there is an effect of collaborative writing on learning motivation. Based on the results of the N-Gain score test which were analyzed using SPSS, it showed that the average N-Gain score for the experimental group (collaborative writing) was 52.5034. It is categorized less effective category with a minimum N-Gain value of 36, 17% and a maximum value of 66.67%, it indicates that the effect of collaborative writing on students' learning motivation is able to improve students' writing skills with category less effective. Thus, this collaborative writing is recommended to improve students’ writing skills.

Multidisciplinary Simulation of Trauma in Pregnancy with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Utilization.

Background Studies have demonstrated the use of resuscitative endovascular balloon occlusion catheters of the aorta (REBOA) in the setting of postpartum hemorrhage and traumatic hemorrhagic shock. However, REBOA is infrequently utilized leading to a lack of clinician comfort. This study's aim was to demonstrate the utility of REBOA in a hemorrhaging pregnant trauma patient and improve clinician comfort with the placement of REBOA while emphasizing collaboration between medical specialties. Methods A multidisciplinary in-situ simulation was developed for the management of a pregnant patient with an abdominal gunshot wound evaluated by obstetrics and surgery teams. A trauma survey, emergency c-section, massive transfusion protocol (MTP), and evaluation for and placement of REBOA were indicated during the simulation. A standardized Return on Learning questionnaire was utilized to determine participants' reactions and confidence gained during the simulation. Results A total of 32 of 41 participants completed the survey (78%). A statistically significant increase in confidence was reported in the ability toprioritize the care of a pregnant patient with hemorrhagic shock (p = 0.016), apply MTP to the appropriate clinical setting (p = 0.03), and analyze critical decisions made for abdominal trauma in pregnant patients (p = 0.006). Specifically for physicians, a significant increase in confidence in the ability to identify indications/contraindications for REBOA placement in hemorrhaging patients was observed (p = 0.021). Conclusions A multidisciplinary simulation for the management of a pregnant patient in hemorrhagic shock secondary to penetrating abdominal trauma improved learner confidence in MTP, care of pregnant patients in hemorrhagic shock, and abdominal trauma in pregnancy. Physician learners gained confidence in indications for REBOA placement in abdominal trauma. This simulation was highly relevant to all participants.

2188. A Quality Improvement Initiative for Influenza Diagnosis and Treatment within Health Systems Serving American Indian/Alaskan Native Patients

Abstract Background This project aimed to identify practices, knowledge and confidence in diagnosing and treating influenza in health systems serving American Indian/Alaskan Native communities and to provide education to support alignment with IDSA guidelines. Methods Anonymous baseline surveys were completed electronically by healthcare professionals (HCPs) from Cherokee Nation Health Services (CNHS) and the Northwest Portland Area Indian Health Board’s teleECHO program. Responses informed a 2-part series of live virtual educational trainings featuring pre- and post-program surveys and team-based action planning. Results Baseline surveys were completed by 247 HCPs. 149 attended the 1st meeting, and 90 attended the 2nd. For outpatient influenza diagnosis, 72% of baseline survey respondents reported primarily using rapid antigen testing, and 11% reported using molecular testing. Similarly, 15% of learners in the live meetings correctly identified rapid molecular assay as the guideline-recommended test, which improved to 72% afterwards. All 9 CNHS outpatient health centers switched from rapid antigen to molecular testing for influenza diagnosis after the training. Influenza treatment decision-making was assessed using a case vignette. For a patient at high risk for complications with flu-like symptoms but stable for outpatient care, 23% of learners in the live meetings correctly chose to start antiviral treatment immediately, which improved to 54% after the program, and more learners felt confident applying diagnostic test results to treatment, from 31% before to 68% after the training. Learner confidence also improved from 19% feeling confident in selecting antiviral treatment and 33% feeling confident in identifying high risk patients before the program to 60% and 70% afterwards, respectively. Action plans prioritized by the HCPs included: patient engagement (61%), reviewing guidelines and data (57%), improving patient adherence to treatment (50%), and developing criteria for immediate antiviral treatment (50%). Conclusion Knowledge and confidence in influenza management improved after the training, as did system-wide alignment with IDSA-recommended diagnostic testing. Studies evaluating the clinical impact of this activity is warranted. Disclosures Jorge Mera, MD, FACP, Abbvie: Grant/Research Support|Gilead Sciences: Grant/Research Support|Gilead Sciences: Received one time honorarium for participating as a panelist in a COVID-19 Webinar|Merck: Grant/Research Support.

How to say "I don't know": development and evaluation of workshops for medical students and surgical residents on communicating uncertainty using the ADAPT framework.

Uncertainty, or the conscious awareness of having doubts, is pervasive in medicine, from differential diagnoses and the sensitivity of diagnostic tests, to the absence of a single known recovery path. While openness about uncertainty is necessary for shared decision-making and is a pillar of patient-centered care, it is a challenge to do so while preserving patient confidence. The authors' aim was to develop, pilot, and evaluate an uncertainty communication curriculum to prepare medical students and residents to confidently navigate such conversations. The authors developed ADAPT, a mnemonic framework to improve student comprehension and recall of the important steps in uncertainty disclosure: assess the patient's knowledge, disclose uncertainty directly, acknowledge patient emotions, plan next steps, and temper expectations. Using this framework, the authors developed, piloted, and evaluated an uncertainty communications course as part of an ongoing communication curriculum for second year medical students in 2020 and with surgical residents in 2021. Learner confidence in uncertainty communication skills significantly increased post-class. Resident confidence in disclosing uncertainty was significantly correlated with observer ratings of their related communication skills during simulation. Students expressed positive experiences of the class, noting particular appreciation for the outline of steps included in the ADAPT framework, and the ability to observe a demonstration prior to practice. The ADAPT communication curriculum was effective at increasing learner confidence and performance in communicating uncertainty. More rigorous evaluation of the ADAPT protocol will be important in confirming its generalizability. The online version contains supplementary material available at 10.1007/s44186-022-00075-4.

Curriculum Innovations: High-Fidelity Simulation of Acute Neurology Enhances Rising Resident Confidence

Introduction & Problem Statement The matriculation from internal medicine to neurology residency can be challenging. The most cogent approach to address this transition has yet to be identified. Studies show that simulation is highly effective at reinforcing knowledge and skills while improving learner confidence. We present the design and outcomes of an annual acute neurology simulation program. Objectives We hypothesized that incoming neurology residents would (1) report improved confidence with managing acute neurologic emergencies, (2) cite a high degree of educational value with the program, and (3) demonstrate improvement in their technical knowledge. Methods & Curriculum Description Our military, level 1 trauma institution's simulation laboratory and staff were used to develop and execute simulations for rising neurology residents based on the Accreditation Council for Graduate Medical Education neurology milestones. Three simulations were designed including a case of acute ischemic stroke (AIS), status epilepticus (SE) in an austere environment, and brain death evaluation with family counseling. Residents completed matched pre‐ and post assessments to gauge confidence, technical knowledge, and perceived educational value. Results & Assessment Data Over 3 years, 15 rising neurology residents from 2 training programs completed 3 high-fidelity acute neurology cases. Self-reported confidence with acute neurology skills improved after each simulation. Confidence ratings included assessing for and identifying contraindications to tissue plasminogen activator, identifying AIS, identifying clot retrieval candidates, identifying clinical and electrographic SE, diagnosing and treating SE, identifying contraindications to and confounders of brain death diagnosis, performing the examination, and delivering bad news to families (all p < 0.05). Technical knowledge also statistically improved in the stroke (p = 0.046) and brain death simulation (p = 0.039), but not the SE simulation (p = 0.296). Participants reported an average perceived personal value of 4.8, 4.3, and 4.7 (out of a maximum of 5) for AIS, SE, and brain death simulations, respectively. Discussion & Lessons Learned High-fidelity simulation of neurologic emergencies enhances confidence and knowledge of rising neurology residents. Satisfaction with the simulation cases was high. Academic hospitals can consider incorporating acute neurology simulations into their residency training.

Empowering Students’ Affective Factors in Teaching Speaking through Integrated Communicative Activities

This study investigates the students' affective factors in learning to speak through integrated communicative activities. Communicative activities aim to develop students' ability to use language to interact with people in real situations. Practising communicative activities can certainly help students to develop their language abilities. Integrated communicative activities are assumed to be the best way to empower the students' affective factors. Communicative activities are needed to help students to boost the students' anxiety, motivation and self-confidence in learning to speak. The participants were students in the fourth semester of the English Education Department of State Islamic Institute Parepare. The quantitative research was conducted by using a random sampling technique. In-depth analysis showed three results, 1) the students believed they desired to speak in front of the class. They were not afraid and shy when their friend laughed or the teacher correction at them; 2) the students were enthusiastic and spirit about learning as a good opportunity in the future; 3) the students also had confidence that they have intelligence and communication ability. The study's results suggested that integrated communicative activities should be implemented in the class to empower the students' affective factors.

Using virtual reality to support first-year online initial teacher education students

In Australia, online initial teacher education (ITE) has seen enrolments grow at six times the rate of other online degree programs, with 25% of all ITE students commencing studying fully online (Australian Institute for Teaching and School Leadership, 2020). Online learning provides increased accessibility and flexibility for students (He, 2014; Stone, 2012; Walker et al., 2020). The accessibility provided by online higher education has also been appreciated in the COVID-19 impacted environment; however, online study is different in character to on-campus study and this has raised issues in relation to student experience, engagement, and retention. Students studying online report feeling disconnected from their tutors, peers, learning purpose and higher education providers (Jaques & Salmon, 2010; Gillet-Swan, 2017). Low retention rates have been linked to students’ feelings of disconnection and exacerbated by poor study preparation for online learning (Elliot & Frost, 2018). This means that a critical factor in students’ online study success is orientation and study preparation tailored to their needs. Developing innovative approaches for transitioning online students into higher education is a challenge widely experienced across local, national, and global settings. The innovative use of Virtual Reality (VR) technologies is one approach that has had positive impacts on student engagement and motivation (Huang et al., 2021) and, as Yu (2021) identified in a meta-review of VR literature, promotes learner confidence and achievement. Whilst this emerging research indicates the benefits of using VR in learning and teaching, more exploration is needed to fully understand these and the barriers (Schott & Marshall, 2021). In the context of an online ITE program at an Australian university, research findings are presented from a single descriptive case study (Merriam, 1998) that investigated the impact of a created VR (2D and 3D versions) providing key study orientation information to Bachelor of Education Early Childhood, Primary and Secondary first-year students. The VR was incorporated into the online mandatory first-year technologies education unit and introduced to students in a supported way through recommended online learning and teaching activities. Quantitative and qualitative data that were collected through the online questionnaire Process of Learning with VR (Makransky & Petersen, 2019) examined participants’ experiences and barriers in using the VR (N = 20). Descriptive statistics and mean differences were calculated, and themes identified. Findings revealed participants felt confident using technology, preferred information to be communicated visually, and liked the option of 2D VR for home technology use. Further, the VR made learning more interesting, and the realism assisted in understanding the content. Although the overall results were positive, barriers and challenges were indicated. These include difficulties in accessing the VR using an Apple device, frustration with the movement controls, and feeling that the experience was not personalised enough. Insights gained about using VR to communicate information and support student experience are significant given the continuing rise of online higher education. The need for continued research and innovative use of technologies so that online education programs can be effectively humanised is particularly noted. The introduction of VR to online ITE students has additional ramifications for them as future teachers. This is a potential area of related study.

Rapid cycle deliberate practice model: cardiac arrest simulation for ward-based staff

The Simulation Centre, in a largest district general hospital, provides a large portfolio of scenario-based courses, for all staffing groups, including the development of modified rapid cycle deliberate practice (RCDP) simulation. Modified RCDP is a model of simulation where learners repeat a scenario, with micro-debriefings, allowing for improvement upon each cycle, in a dynamic learning experience [1]. The centre developed a hybrid style of RCDP and simulation to create a model called Die, Debrief, and Develop, with a focus on the initial response during a cardiac arrest, based upon safety learning events and staff confidence during these emergency events. The aim of the sessions was to improve learner confidence, focusing on technical and non-technical skills in a safe learning environment. The simulation approach was delivered within the clinical environment, utilizing a manikin and equipment on the ward, including the cardiac arrest trolley. A clear pre-briefing was provided to ensure transparency around the expectations within the scenario, for example, the patient will be in cardiac arrest. Due to the repetitive nature of the simulation, there was also the freedom to fail [2]. Each cycle was 5 minutes and repeated 3 times, with a micro-debriefing between each cycle. The improvement between each cycle included patient assessment, ergonomics, human factors, critical thinking, communication, clinical skills and latent threats using elements of gamification. The micro-debriefing between each cycle allowed candidates to reflect on the experience to allow for improvement during each cycle. As well as learning personal safety in the pre-briefing, patients and relatives in the clinical area were informed that the session would be taking place. The feedback from learning following the simulation sessions included: ‘I enjoyed cardiac arrest practice it made much more sense and more relatable than talking through what you would do!’ ‘Was valuable learning and very relevant to our ward’ ‘Has helped me understand cardiac arrest’ ‘I feel empowered!’ ‘Now I know where things are on the crash trolley’ As a result of the RCDP model of training, this has been replicated in simulation sessions for Preceptorship and Internationally Educated Nurses. The outcome from this training has demonstrated the impact of RCDP in learner confidence and in technical and non-technical skills, that can be replicated in other forms of scenario-based training. 1. Peng CR, Schertzer, K. Rapid Cycle Deliberate Practice in Medical Simulation. Treasure Island, Florida: StatPearls Publishing; 2022. 2. Erickson A, Lundell J, Michela E, Pfleger PI. Gamification. In: Kimmons R, Caskurlu S (eds.) The Students’ Guide to Learning Design and Research. EdTech Books; 2020.

Online Courses Provide Robust Learning Gains and Improve Learner Confidence in the Foundational Biomedical Sciences.

The online version contains supplementary material available at 10.1007/s40670-022-01660-4.

Curriculum and Feedback Measures to Improve Writing Efficacy －Focusing on the Case of K University's Writing Subject

It must be tiresome and burdensome for college freshmen to write, the Z generation, most of whom get information and communicate through hypertext, digital media. In order to conduct writing education for learners with low confidence in writing, educators should start by trying to increase their student’s writing efficacy. In the preliminary survey of K University’s writing subject, it was found that the confidence of learners in writing was low.As part of the review, this paper presents a three-stage writing curriculum operation plan based on Fisher & Frey’s framework (2021:4) for effective education. In the first step, learning goals and achievement standards are set and presented clearly to learners. In the second stage, examples that meet achievement standards are presented to guide and educate, and feedback is provided to support learning. In the third step, learners must complete individual learning and instructors should present them with feedback.In the course of operating the three-stage curriculum, the feedback of the instructor is very important. Therefore, this paper examined that feedback, taking into consideration that the emotional aspects of learners is necessary to improve their writing efficacy. In addition, specific feedback procedures were presented for this approach, and cases of students enrolled in the writing curriculum of K University were also examined. As can be seen from the survey results of K University’s writing students, I think that the discussions in this paper will help improve writing skills by improving the efficacy of writing learners.

Engaging students online: an analysis of students’ motivations for seeking individual learning development support

This presentation outlines the key findings of a small-scale research project aimed to explore the motivations for student engagement in self-selecting learning development (LD) online tutorials. The study used a mixed methods approach, including an online survey (n=43) and online interview (n=5). The recruitment invitation was emailed to all users booking a tutorial (n=390) within the project timeframe (October 2020-April 2021). Findings show that the main driver for engagement reported was participants’ limited confidence in their own academic writing abilities, which was consistently linked to attainment. Engagement was further motivated through a range of perceived impacts, including improved confidence and awareness of academic conventions. Participants reported a generally positive attitude towards online delivery, with key benefits including removing access barriers for students with complex commitments, travel and health issues. Conversely, the main downside of online tutorials was seen as diminished interpersonal contact. Qualitative data from both survey and interviews were further investigated using a Discourse analysis framework. One key finding was that the path to LD engagement is often mediated by academic authority figures, who may exert a significant impact on learner self-views. The presentation was designed to initiate discussion on the implications of these findings for learning developers. One area of reflection I planned to submit for the participants’ consideration is how lessons learned from the enforced pivoting to online delivery can underpin the developmental dimension of LD, with the ultimate goal of promoting learner confidence and growth.

Improving Trainees' Confidence and Participation in Serious Illness Communication: Testing the Serious Illness Care Program With Early Learners.

Purpose: Early conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. 1 The systems-based Serious Illness Care Program (SICP) 2 helps clinicians have more, better, and earlier conversations. 3–6 Central to this approach is a clinician conversation guide for patient encounters. 2 While the SICP works for practicing clinicians, it has not been tested with medical trainees. The goal of this training is to enable future physicians to conduct effective serious illness discussions and provide goal-concordant care for patients. Approach: We adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and 156 interns and obtained anonymous quantitative and qualitative feedback. Outcomes: Eighty-six percent of students and 91% of residents rated the session as “very good” or “excellent” and > 90% of all learners would either recommend this training or intended to apply this to their practice. Post-session learner confidence increased in all communication skills. Learners said the training provided a helpful framework and useful language for these conversations. Resident documentation of serious illness conversations in the medical record increased dramatically during the year following training commencement. Discussion: Grounded in principles of adult learning theory, this training was rated highly by trainees and resulted in demonstrable practice change, with significant increases in resident-documented serious illness conversations in the electronic health record. These early learners were more flexible and willing to try this approach than practicing clinicians who tend to resist or revert to old habits. Significance: A conversation guide represents a new paradigm for teaching communication skills and is valued by early learners. Our study is the largest report of SICP training for medical trainees and the only one to demonstrate behavioral change. The SICP training is a critical step to improving clinician confidence and perceptions of inadequate training in serious illness communication. Acknowledgments: The authors wish to thank the Massachusetts General Hospital Continuum Project for its support of this teaching effort.

A Multifaceted Educational Design Approach to Critical Care Rotation Improves Learner Confidence and Knowledge.

Purpose: We developed a pilot elective to enhance the critical care training experience for medical students through integration of didactic, simulation, and experiential learning with the goal to increase student confidence in caring for patients with critical illness and advance knowledge and competencies within core critical care topics. Approach: We created and piloted a 4-week critical care elective for fourth-year medical students pairing clinical experience with didactic and simulation-based training. Students completed two 2-week intensive care unit (ICU) rotations in both medical and surgical ICUs. Students received 6 half-days of didactics focusing on: respiratory failure, ventilator management, shock, acid/base, and discussions at the end of life. Didactic sessions were coupled with simulation-based training to reinforce content through application and provide opportunity to build procedural skills. Medical knowledge was assessed via multiple-choice questions delivered before and after course completion. Course grades were determined through clinical evaluations by faculty/residents, written examination, and simulation assessment. Pre- and postknowledge assessment performance was compared between students enrolled in the pilot and traditional curricula. The traditional curriculum involved clinical experience without formal didactics or simulation opportunities, and course grades were determined by evaluations only. Outcomes: No students received passing scores of 70% on the precourse medical assessment in either curriculum group. The mean score on the postcourse knowledge assessment for the novel-curriculum students (N = 13) was 21.8/30 (72.8%), compared with the 17/30 (56%) for the students in the traditional curriculum (N = 6). No students in the traditional curriculum received a passing score on the postcourse assessment. Before the course, few students felt “comfortable” or “very comfortable” managing common ICU conditions (acute respiratory distress syndrome, 0%; undifferentiated shock, acute hypercarbic respiratory failure, and identifying need for mechanical ventilation, 33%; acute hypoxemic respiratory failure and cardiogenic shock, 50%; septic and hypovolemic shock, 83%). At completion, there was an improvement in the reported level of comfort; 100% of students reported feeling “comfortable” or “very comfortable” with all topics, save for cardiogenic shock at 83%. Comfortability levels remained high on subsequent evaluation 12 months post-course (6 months into trainee’s intern year). Discussion: A limitation of traditional critical care curricula is that it lacks structure designed to ensure exposure to core critical care topics. It relies on the randomness of patient’s disease states present during a given rotation. Incorporating scheduled didactics ensures consistent exposure to these topics regardless of the patient cases on service. A limitation of this study is the small sample size of both the novel-curriculum group and the percentage of traditional curriculum students undergoing written assessment. Despite the small sample size (N = 13), this pilot demonstrates feasibility of consistent delivery of core content via didactics and simulation coupled with experiential learning. Our results may suggest benefit in this multimodal approach compared with experiential learning alone; however, further research is needed. Traditional assessment relies solely on clinical impression which is biased and often fails to capture an actionable level of detail. Lack of objective measures of assessment impedes identification of areas for improvement at the trainee level as well as within a curriculum. The use of multiple methods of assessment allows for mitigation of bias and overcomes some of the limitations of a single method alone. 1 Simulation assessment allows for greater practical assessment of procedural competency than written assessment. Significance: With this novel pilot curriculum incorporating multiple educational strategies, students improved their confidence and knowledge in core critical care topics. By harnessing didactic and simulation training to complement the clinical experience, consistent delivery of core content is assured. Furthermore, evaluation is strengthened through use of knowledge assessment questions and simulation-based assessment as compared with traditional evaluations which are largely subjective. More research is needed to understand the impact when scaled to a larger group.

Longitudinal videoconferencing and confidence development: The impact of perceived interlocutor cultural depth, richness, and self-involvement

Now more than ever before, language learners can autonomously engage with the target culture beyond the classroom through international television shows, online forums, video clips, and study abroad. Still, much of the literature has deemed the target-language dominant speaker (TLDS) as a key source of cultural knowledge, and, thus, the principal aim here is to ascertain how paid TLDSs and student peers are perceived in terms of their cultural expertise and whether these perceptions affect learners’ confidence development over time. This research is guided by the functional model of second language confidence (FML2C), which integrates the contact space dimensions of richness and self-involvement, and novel to this study is cultural depth. In terms of procedure, 32 second language learners of Spanish carried out eight 30-minute videoconferences over 12 weeks, four with a peer and four with a TLDS on Talk Abroad. In terms of the FML2C, the results revealed that the TLDSs were considered to afford significantly more richness and cultural depth than peers. In spite of this, longitudinal gains in learner confidence were indistinguishable by interlocutor type, suggesting that videoconferencing over time is beneficial, no matter the interlocutor with whom it is realized.

Relationship between Health Literacy and Simulation Learning in Korean Nursing Students

BackgroundNurses’ health literacy (HL) may be related to communication and patient safety. This study aimed to identify nursing students’ HL and determine its relationship with learning via simulation. MethodSelf-reported questionnaires, including the HL Survey in Europe, Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale (objectives and information support, problem-solving, feedback, guided reflection, and fidelity/realism), and Nursing Educational Practices Questionnaire (active learning, collaboration, diverse way of learning, and high expectation), were used to collect data from 123 nursing students from four colleges in Korea. ResultsThe average HL index was 37.36 (sufficient); however, 33.3% of the participants had limited HL. Nursing students’ HL was related to simulation design, educational practices, and learners’ confidence. ConclusionIn nursing education, higher HL among nursing students is associated with effective design and teaching methods of simulation.

Simulation-Based Training for Ultrasound-Guided Central Venous Catheter Placement in Pediatric Patients.

IntroductionCentral venous catheter (CVC) placement in pediatric patients is lifesaving but associated with complications. To standardize training and decrease complications, we developed a simulation-based ultrasound-guided CVC placement training program for pediatric critical care providers.MethodsWe implemented our CVC placement training program with several groups of learners, including pediatric critical care medicine (PCCM) fellows, pediatric emergency medicine fellows, and PCCM advanced practice providers. Learners completed prework assignments and a knowledge test before participation. The session started with group activities including a learner-led CVC site-selection debate and a team-based competition to list the steps in CVC placement. Next, the learners rotated between four stations for deliberate practice on separate components of CVC placement. Finally, they performed CVC placement on a task trainer. Evaluation included assessment of learner confidence, a knowledge test, and measurement of procedure time before and after training.ResultsTwenty-seven learners participated in the training. Learner confidence in CVC placement increased significantly after participation (median confidence level: 1.5 vs. 4.0, p < .001). Learner CVC knowledge also increased significantly after participation (median test score: 68% vs. 88%, p < .001). CVC placement procedure time, a marker for skill in CVC placement, decreased significantly after participation (median procedure time: 264 seconds vs. 146 seconds, p < .001).DiscussionOur simulation-based training program effectively increased knowledge, skill, and confidence in CVC placement for a variety of learners. Future work should evaluate the optimal frequency and structure of maintenance training and the impact of training on clinical outcomes.

Virtual reality in midwifery education: A mixed methods study to assess learning and understanding

BackgroundVirtual reality learning environments (VRLEs) are a potentially valuable learning tool that have recently increased in popularity due to widespread availability and decreased cost. VRLEs can provide an immersive learning environment that increases the understanding of three-dimensional relationships between anatomical structures. However, there is a paucity of evidence in the literature supporting its use within Midwifery education. ObjectivesTo explore the effectiveness of a VRLE as an educational tool in midwifery education. SettingA large University in Ireland, with institutional ethical approval. ParticipantsUndergraduate and graduate degree midwifery students. DesignA descriptive qualitative and quantitative study was carried out. Data collection was carried out between September 2020 and March 2021. MethodsParticipants underwent a VRLE lesson based on the topic of fetal lie, position, and presentation in pregnancy. A multiple-choice questionnaire was used to quantitatively evaluate knowledge before and immediately after the intervention, and knowledge retention after one week. Qualitative data was collected using open-ended questions in the questionnaire. The primary outcome was a difference in pre- and post-intervention knowledge scores. Data was analysed using repeated measures one-way ANOVA. Qualitative data was analysed using thematic analysis and simple content analysis. All students participated in the quantitative and qualitative components of the study. Secondary outcomes included participant satisfaction and self-confidence in learning which were analysed using thematic analysis. The side effect profile of the virtual reality device was also explored using open-ended questions in the questionnaire. ResultsForty-one midwifery students participated in the study, with a 100 % participation and response rate. Repeated measures one-way ANOVA revealed no statistically significant differences in knowledge scores pre- and post-intervention. Participants rated high satisfaction and self-confidence scores with regard to the VRLE as a learning modality. Side effects most commonly experienced by participants included dizziness (49 %), disorientation (30 %) and symptoms similar to motion sickness (32 %). The following themes were identified: “Learning in 3D”, “The Power of Visual Learning”, “The value of Educational Technology”, “Learning can be fun and enjoyable”. ConclusionsThis study showed that the VRLE had no impact on knowledge gain, though high levels of satisfaction and self-confidence indicate a positive response to the VRLE. VRLEs are a potentially valuable learning tool to help enhance the student learning experience, promoting increased engagement, satisfaction, and self-confidence with the learning material.