Medical Simulation Center Research Articles

Script Concordance Test in Physiology: Preparation, Scoring, and Student Perceptions – A Mixed Method Study

Background: Although the curriculum has changed, assessment tools are not in alignment with the new types of teaching such as early clinical exposure (ECE) and self-directed learning. Both in summative and formative assessment most commonly used tools for assessment of cognitive domain are written formats including MCQ. However, these assessment tools such as MCQ and written essays cannot assess the higher order thinking skills and clinical reasoning skills. Materials and Methods: The present study was conducted in the department of physiology, in collaboration with medical simulation center, as a part of formative assessment for topics on pathophysiology of shock and obstructive and restrictive lung disorders taught during ECE using case scenarios. Two script concordance tests (SCTs) each on the topic of pathophysiological mechanism of different types of shock and obstructive and restrictive lung disorders each were prepared and administered to the students. Student perception to this assessment tools was obtained. Results: The Cronbach’s alpha of the 6-item SCT for respiratory and cardiovascular topic administered to the students (n = 107, 98) was 0.83 and 0.82, respectively. The inter-item correlation was respiratory and cardiovascular topic for 0.71, 0.69 suggesting that they are close and repetitive. Students were of the opinion that SCT are difficult to understand (75.8%), challenging to answer (47.2%), and it tested the clinical content better (71.4%). Conclusions: In our study, students felt though SCT tested the clinical content better when compared to conventionally used MCQ, they still find it challenging to understand and are not in favor of its use in summative and formative assessments.

Medical Simulation Center activity and knowledge transfer during the COVID-19 pandemic

Medical Simulation Center activity and knowledge transfer during the COVID-19 pandemic

How Argus Simplifies the Life of the Staff of Centers During Accreditation

The management system of a medical simulation and accreditation center Argus does not stand still and is developing together with the centers where it is installed today. The development team strives to make life easier for the staff of the centers during the evaluation procedures. Of course, first of all we are talking about federal accreditation. Many requirements for conducting evaluation procedures that require additional organizational efforts on the part of the center's staff are easily closed using Argus in automatic mode with minimal preliminary preparation.

Analysis of stress factors and the level of anxiety and depression among bachelor's degree nursing students – a pilot study

Background: Nursing students are affected by stressors related to academic activities and those related to clinical activities. Aim of the study: To analyze the stressors and the level of anxiety and depression among bachelor’s degree students of nursing.Material and methods: An observational study was conducted between July 2023 to February 2024 among 167 bachelor's degree nursing students. Hospital Anxiety and Depression Scale (HADS) and self-report survey were used.Results: Respondents considered stressors related to learning theoretical subjects (M=3.85, SD=1), stressors related to learning in the practical classes lab in the Medical Simulation Center (M=3.06, SD=1.08), and stressors related to patient care to be the strongest. (M=2.91, SD=0.91) A group of 79 (47.31%) participants had a severe anxiety disorder, 56 respondents (33.53%) had a borderline state of this disorder. A group of 56 (33.53%) had a borderline state of depressive disorders and 42 (25.15%) - severe depressive disorders. The mean score for the presence of anxiety was M=10.43 (SD=3.26) and for depression was M=8.2 (SD=3.42). Conclusions: The lecturers and the decision-makers should take these results into consideration and pay special attention to the stressors that students consider to be the worst. It is recommended that positive coping strategies for stress management be reinforced and that students be encouraged to participate in programs or workshops designed to teach them effective stress management techniques. It is similarly crucial to maintain communication with students, provide them with encouragement and assistance during challenging periods within the academic and clinical settings, and acknowledge and reinforce their strengths.

Experience of the medical accreditation and simulation center of the “National Medical Research Center for Hematology” from March 2021 to January 2024

The article presents the experience of the medical accreditation and simulation center of the "National Medical Research Center for Hematology" from March 2021 to January 2024.

The role of virtual reality in the development strategy of the Medical Simulation Centre: Polish experiences

The role of virtual reality in the development strategy of the Medical Simulation Centre: Polish experiences

Experience in Implementing an Additional Professional Advanced Training Program “Extracorporeal Membrane Oxygenation. Basic Course" at the Training and Accreditation Center — Medical Simulation Center of the Botkin Hospital

Training of anesthesiologists-resuscitators under the additional professional advanced training program “Extracorporeal membrane oxygenation. Basic course "(18 academic hours) at the Medical Center of the Botkin Hospital.

Medical simulation as a method of practical training in the opinion of nursing students

Abstract Introduction. Covid-19 pandemic has necessitated changes in practical training of nursing students. Classes previously conducted in a hospital environment were moved to a medical simulation center. Aim. The purpose of the study was to discover opinions of undergraduate nursing students on practical training using the medical simulation method. Material and methods. A total of 317 undergraduate nursing students participated in the survey. The research tool was authors’ own diagnostic survey. Participation in the study was anonymous and voluntary. It was conducted between April and May 2022. All correlations were assumed to be statistically significant when p≤0.05. Results. When it comes to 76.7% of respondents, they claimed that medical simulation classes developed their soft skills and 89.3% of respondents believe that participation in medical simulations facilitated their ability to perform patient care tasks during practical classes. Higher sense of self-efficacy is correlated with higher evaluation of the classes. Conclusions. Through the classes at the medical simulation center, a completely new environment was created to support the practical learning of nursing students. Results of the study highlight positive effects of learning that solidify students’ knowledge and improve their skills.

Recovering From Adversity: Do We Need to Protect Our Learners?

From the Department of Surgery, Medical Simulation Centre, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India. Correspondence to: Dinker Ramananda Pai, MS, FRCS (Edin), CHSE, FSSH, Medical Simulation Centre, MG MCRI, Sri Balaji Vidyapeeth, Puducherry, India (e-mail: [email protected]). The author declares no conflict of interest.

The COVID-19 drive-through point — screening and testing — first in Poland complex centre experience

Introduction: Rapid widespread of the SARS-CoV-2 virus in early 2020 caused global chaos. In the initial period, a lack of knowledge of epidemiology and viral contamination, as well as no availability of either causal treatment or preventive vaccination, resulted in mass testing of symptomatic individuals as the priority for protection. This study aimed to evaluate the effectiveness and safety of the first COVID-19 (coronavirus disease) drive-through testing model in the Greater Poland Region. Material and methods: The authors demonstrate step-by-step the creation and development of the Centre of Medical Simulation Poznan University of Medical Sciences (PUMS) COVID-19 drive-through testing point for 3.5 million inhabitants in the Greater Poland Region during the 1st through 4th coronavirus pandemic waves. For staff education, low and high-fidelity simulation techniques were used. Additionally, the number of tests performed at the swab point and the efficiency of the developed testing model were evaluated and assessed in all pandemic waves. Results: PUMS POST (point of screening and testing) activity lasted 24 months. Improvement of staff skills developed through simulation training increased the median number of 91 patients tested each day (with a median of 25 tests per hour) during the 1st wave to a maximum of 260 patients tested each day (135 tests per hour) during the 4th wave when the new drive-through POST system was employed (p < 0.001). Conclusion: The present study supported the previous preliminary reports that drive-through systems developed during the COVID-19 pandemic proved to be efficient and safe for mass population testing. Moreover, the Medical Simulation Centre confirmed the effectiveness of staff skills improvement.

Adapting an Objective Structured Clinical Examination (OSCE) on Conducting Difficult Conversations Between Nephrology Fellows and Patients to a Virtual Platform: A Research Letter

We previously described a nephrology-specific "Breaking Bad News" Objective Structured Clinical Examination (OSCE) assessing nephrology fellow communication and counseling skills in 3 scenarios: kidney replacement therapy (KRT) in kidney failure, urgent KRT in acute kidney injury (AKI), and kidney biopsy (KBx). The main objectives of this study is to adapt the OSCE to a virtual platform, simulating nephrology patient telemedicine encounters involving difficult conversations, and to assess fellow and faculty satisfaction with the virtual format. Description of a formative telemedicine simulation for nephrology fellows. Fully virtual simulation conducted by 2 academic medical simulation centers. Nephrology faculty and fellows at 3 urban/suburban training programs in the eastern United States. Description of the virtual OSCE process. Fellow and faculty satisfaction overall and for each scenario. Faculty and fellow estimates of frequency of virtual patient encounters in the past year. The OSCE consisted of 3 scenarios: KRT in kidney failure, urgent KRT in AKI, and KBx. Objective Structured Clinical Examinations were administered in May 2021. Each scenario lasted 20 minutes. The AKI scenario was audio only. Fellows telephoned a simulated patient surrogate for urgent KRT consent. Kidney failure and KBx scenarios were video encounters. Faculty observed while muted/video off. Immediately after the OSCE, fellows and faculty were anonymously surveyed regarding their satisfaction with each scenario, the OSCE overall, and their estimate of outpatient encounters and inpatient KRT counseling done virtually in the preceding year. Seventeen fellows completed the OSCE at 2 centers (3 programs). Sixteen (94%) completed the survey. Almost 94% rated the OSCE as a good/very good approximation of telemedicine encounters. Those satisfied/very satisfied with each scenario are as follow: 100% for AKI, 75% for kidney failure, and 75% for KBx. Two commented that they often did urgent KRT counseling by telephone. Fellows estimated a median 20% (interquartile range: 175, 50%) of counseling for acute inpatient KRT and a median 50% (IQR: 33.75, 70%) of outpatient encounters were virtual in the prior year. Two (regarding the kidney failure and KBx scenarios) indicated they would not have counseled similar outpatients virtually. The 15-minute interactions may be too short to allow the encounter to be completed comfortably. A small number of programs and fellows participated, and programs were located in urban/suburban areas on the east coast of the United States. Overall, fellows felt that the OSCE was a good approximation of virtual encounters. The OSCE is an opportunity for fellows to practice telemedicine communication skills.

Experience of Using a 3D Printer at the Medical Simulation Center of Botkin Hospital

The authors of this text present their views on the use of 3D printing technologies and consider various options for using a 3D printer in a simulation center in the training of medical workers.

Using the Experience of the Simulation Center of the Baku Branch of I.M. Sechenov First Moscow State Medical University in the Implementation of the Hybrid Learning Project

The situation that developed during the period of forced isolation created conditions that forced us to reconsider some aspects of the teaching methods in medical simulation centers. This material presents our experience in transforming simulation learning from a traditional format into a distance learning format while maintaining the structure and curriculum of classes. We propose to use the obtained results when introducing a hybrid teaching method, subject to careful evaluation, selection and modification of existing courses.

Federal Information System "Federal Register of Information on Documents on Education and (or) Qualifications, Documents on Education" as a Type of State Control

The aim of the study is to consider the current model for the construction and functioning of the Federal Information System "Federal Register of Information on Documents on Education and (or) Qualifications, Documents on Training", as a type of control and supervision in the field of education in the Russian Federation by analyzing the features systems.The system review was carried out on the basis of the Training and Accreditation Center - the Medical Simulation Center of the Botkin Hospital.

Case-method in the Training of Practical Healthcare Professionals in the Russian Federation

The Medical Simulation Center of the Botkin Hospital is actively developing towards creating unique educational content in medicine. Applying the Case method in the education of medical workers, we bring the academic training of practical health care specialists of the Russian Federation as close as possible to the field of their professional activity by discussing real clinical cases from medical practice (cases) aimed at a deep and multifaceted understanding of a specific situational problem in the context of real life, thereby improving the quality of medical care to the population.

Effects of relaxing breathing paired with cardiac biofeedback on performance and relaxation during critical simulated situations: a prospective randomized controlled trial

BackgroundActive participation in high-fidelity simulation remains stressful for residents. Increased stress levels elicited during such simulation impacts performance. We tested whether relaxing breathing, paired or not with cardiac biofeedback, could lead to enhanced performance of residents during simulation.MethodsThis randomized pilot study involved the fifth-year anesthesiology and critical care residents who participated in high-fidelity at Lyon medical simulation center in 2019. Residents were randomized into three parallel interventions: relaxing breathing, relaxing breathing paired with cardiac biofeedback, and control. Each intervention was applied for five minutes immediately after the scenario briefing. The primary endpoint was the overall performance during the simulation rated by two blinded independent investigators. The secondary endpoints included component scores of overall performance and changes in psychological states.ResultsThirty-four residents were included. Compared to the control group, residents in the relaxing breathing (+ 7%, 98.3% CI: 0.3 to 13.7, P = 0.013) and relaxing breathing paired with cardiac biofeedback (+ 8%, 98.3% CI: 0.82 to 14.81, P = 0.009) groups had a higher overall performance score. Following the interventions, compared to the control group, stress level was lower when participants had performed relaxing breathing alone (P = 0.029) or paired with biofeedback (P = 0.035). The internal relaxation level was higher in both the relaxing breathing alone (P = 0.016) and paired with biofeedback groups (P = 0.035).ConclusionsPerforming five minutes of relaxing breathing before the scenario resulted in better overall simulation performance. These preliminary findings suggest that short breathing interventions are effective in improving performance during simulation.Trial registrationThe study protocol was retrospectively registered on clinicaltrials.gov (NCT04141124, 28/10/2019).

Medical simulation as an educational tool in the opinion of nursing students

Abstract Introduction. Nursing education combined with medical simulation is currently a modern method of education, which, especially in the era of the SARS-COV-2 pandemic, is an essential form of preparing the student for professional tasks. Aim. The aim of the study was to find out the opinions of nursing students about the classes conducted in the Medical Simulation Center. Material and methods. A total of 186 undergraduate nursing students participated in the survey. It was conducted via the Internet. We used the method of diagnostic survey; surveying technique and the tool was the original questionnaire. The study was anonymous and voluntary and was conducted from February to May 2021. It is assumed that any relationship is statistically significant when p≤0.05. Results and conclusions. According to the respondents, medical simulation prepares to acquire practical skills, also consolidates theoretical knowledge, prepares to broaden social competence. For nursing students, its disadvantage is the lack of contact with the patient. Education realized with the use of medical simulation is an effective method of learning. Nursing students prefer to take classes in high fidelity rooms and with standardized patients because they are most similar to real life conditions.

Objective and Subjective Stress Parameters in Response to High and Low-Fidelity Simulation Activities.

Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve competences, simulation exercises can be beneficial to even reduce the stress that each individual may face during emergency management of patients. A total of 146 first-year nursing students participated in the study, including 124 women and 22 men aged between 19 and 50 years, with a mean age of 32 years. The objective method estimated psychophysiological parameters (serum cortisol). Objective and subjective methods were used. The subjective method assessed stress experienced by students based on the standardized Stress Appraisal Questionnaire Version B for dispositional assessment. The study was conducted in the Monoprofile Medical Simulation Centre at the University of Economics and Innovation in Lublin, Poland and was approved by the University Research Ethics Committee. Both participants under and over 25 years of age showed increased levels of stress after low and high-fidelity simulations, with statistically significantly higher stress levels found for the low fidelity method. Low-fidelity simulation methods generated a greater increase in cortisol levels, indicating a higher stress level than the high-fidelity methods. The analysis of the scores obtained in the Stress Appraisal Questionnaire (KOS-B) showed that higher cortisol levels after the low-fidelity simulation reduced the subjective perception of a threat, while higher cortisol levels before the high-fidelity simulation promoted higher intellectual activity among the students. Levels of stress in the education of nursing students using low and high-fidelity methods can limit the sense of threat and activate professional task performance. The use of low and high-fidelity simulation does not generate destructive stress levels.

Recommendations for Optimizing Virtual Simulation: A Trial and Error Process From the COVID-19 Pandemic.

Recommendations for Optimizing Virtual Simulation: A Trial and Error Process From the COVID-19 Pandemic.

How to resume safe access to a medical simulation center at the time of COVID-19 pandemic: The proposal of a protocol from a university institution in North-Eastern Italy.

Introduction: The Covid-19 global pandemic has suspended thousands of clinical education programs around the world. Also in Italy, as in the rest of the world, frontal teaching activities and internships in the medical field have been suspended. At the university hospital of Udine (North-Eastern Italy) it was decided to strengthen the use of simulation in all training stages to get over the block of training activities.Methods: A protocol has been drawn up with the aim of providing training in safety for every student of the degree courses in medicine and health area and for doctors in residency training. In this way it was possible to carry out training sessions with a maximum of 6 students engaged in the simulation activities offered by the Center (3D) virtual cadaver, laparoscopic pelvic trainer stations, ultrasound laboratory, microsurgery, etc.). The key points of the protocol were represented by i) internet booking of the training activity; ii) respect of safety measures (hand hygiene, safe distance, restricted total number of presences, constant use of the surgical mask) and iii) reorganization of the material and cleaning of the rooms.Results: Our educational strategy allowed to resume training activity maintaining adequate levels of safety for students and teachers. Applying our protocol, it was possible to guarantee safe access to our Medical Simulation Center (MSC) to a total of about 1400 students from different course of study during the period between June 2020 and February 2021.Conclusions: Our protocol could represent a practical tool in the management of resuming the activity at a MSC.