Resource Management Skills Research Articles

Beyond the Checklist: Pilot Education, Aviation Resources, and Health Management Skills

Beyond the Checklist: Pilot Education, Aviation Resources, and Health Management Skills

Can Culinary Medicine Training Provide Sustained Nutrition Knowledge and Food Resource Management Skills for Medical Education Students? Marshall Dietetics’ One-year Follow up Evaluation

Can Culinary Medicine Training Provide Sustained Nutrition Knowledge and Food Resource Management Skills for Medical Education Students? Marshall Dietetics’ One-year Follow up Evaluation

The influence of innovative organizational culture on innovativeness in Thai SMEs: The mediating effects of human resource management and innovative skills

The influence of innovative organizational culture on innovativeness in Thai SMEs: The mediating effects of human resource management and innovative skills

HUMAN RESOURCE MANAGEMENT SKILLS OF SCHOOL HEADS: BASIS FOR EMPLOYEE WELFARE PROGRAM IN THE SCHOOL CONTEXT

This study aimed to determine the level of the human resource management skills of the school heads, which would serve as the basis for designing an employee welfare program in the school context. The study employed a non-experimental descriptive survey research design to investigate the research problem. The respondents in this study were 145 teachers from the elementary schools in Santa Cruz South District. The findings of this research were beneficial to both teaching and non-teaching personnel, increasing awareness of the organization's initiatives regarding the employee welfare program that would be implemented in schools to address both personal and organizational needs. It was recommended that the Department of Education (DepEd) strengthen the implementation of the Employee Welfare Program in every school to ensure that the personal and professional needs of both teaching and non-teaching staff were met. This proactive approach not only enhanced the overall well-being of employees but also contributed to a more positive and collaborative school culture. In conclusion, the study underscored the importance of targeted employee welfare programs and provided a solid foundation for future initiatives aimed at improving human resource management in schools. KEYWORDS: Human Resource Management Skills in School Heads, non-experimental descriptive survey research design

РАЗВИТИЕ ПРЕДПРИНИМАТЕЛЬСКИХ НАВЫКОВ УЧАЩИХСЯ КАК ФАКТОР ЭКОНОМИЧЕСКОГО РАЗВИТИЯ: СТРАТЕГИИ И МЕТОДЫ ОБУЧЕНИЯ

In the modern world, the development of entrepreneurial skills among students is becoming an increasingly important factor for economic development. Entrepreneurship stimulates innovation, contributes to the creation of new jobs and increases the competitiveness of the market. This paper discusses learning strategies and methods aimed at developing students' entrepreneurial skills. Effective strategies include creating a stimulating educational environment where students can experiment, think creatively, and put their knowledge into practice. It is also important to introduce practical entrepreneurship courses that allow students to develop planning, resource management and risk-taking skills. Teaching methods should be interactive and adapted to the needs of students. This includes gaming technologies, case studies, mentoring, and project work. Such methods allow students not only to gain theoretical knowledge, but also to apply it in practice, developing their entrepreneurial abilities.

Transforming the delivery of care from “I” to “We” by developing the crisis resource management skills in pediatric interprofessional teams to handle common emergencies through simulation

BackgroundThe healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment.MethodsThis study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick’s Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training.ResultsThirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants’ pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing.ConclusionsThe study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.

Pendampingan dan Penyuluhan Siswa-Siswi SMA Katolik ST. Bonaventura Madiun dalam Menentukan Pilihan untuk Kuliah, Bekerja atau Bekerja Sambil Kuliah Setelah Lulus Sekolah

The purpose of this community service is helping provide direction to St. Bonaventura in choosing his goals after graduating from school, opening the paradigm for St. Bonaventura towards a bright future, and providing enthusiasm and motivation for St. Bonaventura in living life after graduating from school. The methods used in this community service are expository, namely conveying material verbally and inquiry, namely learning that emphasizes critical and analytical thinking processes related to human resource management skills and marketing management with in-depth understanding of the material on how to determine the future.The results of counseling and outreach carried out to grade 11 students of St. Catholic High School. Bonaventura's 42 students are 41 of them chose to continue their education/college and one person worked to continue his parents' business

Human resource management practices on Irish dairy farms: an exploratory study

Context Managing people outside the farm family unit is a new issue for many Irish dairy farmers. In the context of rapid growth, the demand for employees has increased, creating the need for Irish dairy farmers to have human resource management (HRM) skills. Aims This paper explores the extent and type of HRM practices adopted by Irish dairy farmers and the factors that influence their adoption. Methods A questionnaire was developed, piloted, and issued to farmers on the basis of herd size and location. Data from 203 dairy farmers who employ people were analysed to examine the adoption of different HRM practices and the influence of farm characteristics, farmer demographics and farmer attitudes on their adoption. HRM practices included compliance with employment legislation, health and safety, different approaches to recruitment, workforce management and retention. The questionnaire included one or more variables for each of these HRM practices. Where more than one variable was included, an aggregate variable was developed for that practice. Key results Whereas, overall, there was a low level of adoption of best HRM practices, farm characteristics such as herd size and number of employees had a significant influence on farmers’ adoption of compliance with employment legislation, health and safety, recruitment, workforce management and retention practices. Demographic factors such as age, level of education, and average hours worked influenced farmers compliance with employment law legislation, workforce management practices and retention practices. Conclusions The study highlighted an overall low compliance with employment legislation and low adoption of best practices in managing staff among dairy farmers in Ireland. Implications This study highlighted that improvement is needed in all areas of HRM on Irish dairy farms. The findings of this study would be useful to farm advisors who support dairy farmers in improving their management of their businesses. Overall, this study has contributed to a greater understanding of the challenges in managing people in agriculture and how certain factors influences the adoption of HRM practices on dairy farms.

Identifying the Predictors of School Improvement Plan Implementation by School Administrators

This study aimed to identify the level of managerial capabilities, human resource management, and quality assurance practices of school administrators on the implementation of School Improvement Plan (SIP). The respondents of the study were the 489 public school administrators of Northern Mindanao, Philippines. The data were gathered through survey questionnaires and was treated through descriptive statistics, Pearson product-moment correlation, and stepwise multiple regression analysis. School administrators exhibit remarkable managerial capabilities, earning high praise for their adept handling of operations, finances, and for fostering a conducive learning environment. Their strong human resource management skills are evident in nurturing collaborative communities, managing staff effectively, and conducting recruitment efficiently. Quality assurance practices are notably well-developed, indicating the school's ability to deliver top-notch education and support. Implementation of the SIP receives glowing reviews, showcasing the administrators' proficiency in enhancing learning environments, community engagement, resource allocation, curriculum, and staff management. Thus, the data highlights the school administrators outstanding performance and excellence across multiple crucial areas. The correlation analysis revealed significant relationships among managerial capabilities, human resource management, quality assurance practices, to the SIP implementation. Particularly, strong correlations were observed, indicating that schools excelling in one management area tend to perform well in others. Regression analysis highlighted five significant predictors of SIP implementation by administrators: school operation management, teacher and staff performance, leadership, processes, and partnerships/resources. These findings emphasize the significant role of effective management practices, especially in areas like staff performance, quality assurance, and resource allocation, in driving SIP implementation.

Pelatihan Peningkatan Kualitas Sumber Daya Manusia di Era Digital pada UMKM

This community service activity is carried out with the aim of increasing knowledge and skills in human resource management (HR) in MSME (Micro, Small and Medium Enterprises) companies. HR Management Training in the Digital Era is a training program designed to equip HR professionals with relevant and up-to-date skills in managing human resources in the digital era. This kind of training is designed to prepare HR professionals to face the challenges arising from the ongoing digital transformation. The method of implementing this activity is carried out using a material presentation model and followed by discussion activities. This training activity was attended by 16 MSME scale business actors from Badung district, Bali. From the results of the training, it was concluded that several weaknesses were found in MSME businesses, especially in DM management, such as lack of digital skills, uncertainty about change, lack of access to digital resources, inability to compete with large companies and data security and privacy.

Food Insecurity and Feeding Experiences Among Parents of Young Children in Australia: An Exploratory Qualitative Study

BackgroundResponsive feeding is a reciprocal process between caregiver and child that is primarily child-led. It is linked to the development of positive eating behaviors and food preferences. There is evidence that household chaos, family dynamics, the quality of mealtime routines, financial hardship, and food insecurity can impact the feeding relationship. ObjectiveThis study explored factors influencing feeding experiences among Australian parents with young children experiencing financial hardship, including household chaos and food insecurity. DesignThis qualitative semi-structured interview study was conducted as a component of a larger research program to design and evaluate a parent program to support responsive feeding practices in Australian families experiencing financial hardship and food insecurity. Participants/SettingParticipants were caregivers of a child aged 6 months to 3 years (n = 29), living in Australia, who self-identified as experiencing financial hardship. Interviews were conducted in person and via telephone between August 2021 and January 2022. AnalysisTranscripts were analyzed using the Framework Method of thematic analysis. ResultsFive key themes were generated: family tensions heightened through hardship, making tradeoffs and sacrifices, the unseen mental load, the inescapable impact of COVID-19, and resiliency and being creative. Despite facing multiple hardships and challenges with feeding the family, parents demonstrated resilience and capabilities through creative food resource management and organizational skills. Parents experienced a high mental load through the cognitive and emotional work of planning, adapting, anticipating, and caring for the family’s needs through meals and child feeding. ConclusionsPrograms to support child feeding need to consider the high mental load families with food insecurity experience and how this can impact parents’ capacity. Program content should be contextually sensitive to the experience of food insecurity and consider the constraints inherent in families and communities while building on capabilities and strengths.

Exploring nonstandard service frontline situations

THE AIMS OF THE PAPER Jaycustomer behavior often increases the unpredictability of the service to an unmanageable extent. A co-creation based development can be presumed in the attitude of the consumer and of the frontline staff. The primary goal of this research was to investigate the dynamics of interactions between customers and frontline staff, particularly in nonstandard situations. This study aimed to understand how 'jaycustomer' behavior, which includes unpredictable and challenging customer actions, impacts these interactions and the overall service process. METHODOLOGY To explore the above, the study employed a quasi-secondary data collection method (narratives, netnography). Frontline conflicts were simulated based on a mystery shopping scenario. Mystery shoppers were instructed to combine two theoretical jaycustomer types – the Belligerent and the Egocentric Edgar (the selfish) – in their approach. These shoppers were tasked with observing various aspects of frontline staff behavior, including reactions, communication, gestures, and problem-solving intentions. MOST IMPORTANT RESULTS The simulations led to the identification of distinct behavioral patterns on both sides of the customer-staff interaction. The study highlighted specific jaycustomer oriented patterns and the frontline staff's response strategies. Furthermore, essential human resource management skills in dealing with such jaycustomer scenarios were identified, providing insights into both customer and employee behavior in challenging service situations. RECOMMENDATIONS The findings of this research offer significant implications for service management and marketing theory, particularly in developing a consensual model for managing frontline processes. Additionally, the study suggests that reviewing and aligning staff training content with these research findings could be a fruitful direction for enhancing human resource management practices in customer service environments. An expert interview conducted post-experiment further affirmed special tasks for frontline management to handle such jaycustomer situations effectively.

Establishing the Economic Sustainability Criteria for Assessing Tenders in the Procurement of Building Works

As the global construction industry expands, it is imperative to prioritize economic sustainability due to the consequential effect on procurement practices. The procurement of building works, a pivotal phase in the realization of construction projects, requires a comprehensive framework to assess tenders that emphasise economic viability and align with sustainability principles. While traditional procurement processes primarily focus on cost considerations, the contemporary construction landscape necessitates a paradigm shift towards sustainable practices encompassing the economic dimension. Several studies have been conducted on public procurement and sustainability. Nevertheless, most of these studies focused on the environmental side of sustainability, leaving the social and economic dimensions unexplored. Hence, this study explores the sustainable economic criteria for assessing tenders in procuring building works. The study adopted the mixed research method; therefore, qualitative and quantitative data were employed in collecting the data for the study. The analysis deduced that the criteria for assessing the economic sustainability of tenders were categorized into management-related, technical, and commercial-related criteria, with the most significant variables being competitiveness, resource management skills, resource requirement assessment and profitability. The study’s findings can potentially influence the assessment tenders of construction firms for building works. Thus, it suggested that the management practices of the bidders must be thoroughly evaluated as it is a crucial factor in ensuring economic sustainability from the onset of the project processes. This study presents a novel to ascertain the criteria for assessing the sustainable economy of tenders in procuring building works in the Ghanaian Construction Industry. The results of this study can be a source of data to guide the evaluation of tenders in the construction industry in Ghana and other developing countries within the Sub-Saharan Region.

Age and its impact on crisis management performance and learning after simulation-based education by acute care physicians: a multicentre prospective cohort study

BackgroundPhysiological changes associated with ageing could negatively impact the crisis resource management skills of acute care physicians. This study was designed to determine whether physician age impacts crisis resource management skills, and crisis resource management skills learning and retention using full-body manikin simulation training in acute care physicians. MethodsAcute care physicians at two Canadian universities participated in three 8-min simulated crisis (pulseless electrical activity) scenarios. An initial crisis scenario (pre-test) was followed by debriefing with a trained facilitator and a second crisis scenario (immediate post-test). Participants returned for a third crisis scenario 3–6 months later (retention post-test). ResultsFor the 48 participants included in the final analysis, age negatively correlated with baseline Global Rating Scale (GRS; r=–0.30, P<0.05) and technical checklist scores (r=–0.44, P<0.01). However, only years in practice and prior simulation experience, but not age, were significant in a subsequent stepwise regression analysis. Learning from simulation-based education was shown with a mean difference in scores from pre-test to immediate post-test of 2.28 for GRS score (P<0.001) and 1.69 for technical checklist correct score (P<0.001); learning was retained for 3–6 months. Only prior simulation experience was significantly correlated with a decreased change in learning (r=–0.30, P<0.05). ConclusionsA reduced amount of prior simulation training and increased years in practice, but not age on its own, were significant predictors of low baseline crisis resource management performance. Simulation-based education leads to crisis resource management learning that is well retained for 3–6 months, regardless of age or years in practice.

Playful Approaches to Leadership Development: Three Innovative Uses of Games in the Classroom

How can educators use games and playful interactions to enhance the practice of skills related to leadership and management? Effective leadership involves a number of skills, such as strategic thinking, perspective-taking, critical thinking, ethical thinking, resource management, and reflection on one’s biases. In this article, we will review how three different instructors use games and play in their higher education classrooms to teach critical leadership skills. We will share how we use three different types of games: (1) a commercially-available off-the-shelf digital game ( Democracy 4) to enhance resource management and ethical thinking skills; (2) a non-digital card game ( @Stake Game) to teach critical thinking and argumentation; and (3) an independent (indie) digital game ( SweetXHeart) to teach bias reduction and perspective-taking. We will share best practices and recommendations for using games in leadership and management education.

Comparing the Outcomes of Virtual Reality-Based Serious Gaming and Lecture-Based Training for Advanced Life Support Training: Randomized Controlled Trial.

Simulation-based Advanced Cardiac Life Support (ACLS) or Advanced Life Support (ALS) training for health care professionals is important worldwide for saving lives. Virtual reality (VR)-based serious gaming can be an alternative modality to be used as a part of simulation-based ALS training. The aim of this study is to investigate whether a VR-based ALS serious game module can replace classroom-based ALS lectures, the latter being part of existing conventional ALS training protocols in addition to skills training. Participants were students from Acibadem Mehmet Ali Aydinlar University's Vocational School for Anesthesiology (N=29) randomly divided into 2 groups with 15 (conventional training group) and 14 (VR-based training group) participants each. Participants in the conventional training group had to complete the pretest consisting of multiple-choice questions at the beginning of the study. Afterward, they took part in an interactive classroom-based ALS lecture. The next step involved skills training with task trainers to teach them compression skills. Following this, the conventional training group was divided into Code Blue teams, each consisting of 5 participants for the simulation session. Two independent instructors evaluated video recordings in terms of technical and nontechnical skills. The score acquired from the manikin-based simulation session was considered the main performance indicator in this study to measure the learning outcome. A similar workflow was used for the VR-based training group, but this group was trained with the VR-based ALS serious game module instead of the theoretical lecture. The final stage of the study involved completing the posttest consisting of multiple-choice questions. A preference survey was conducted among the study participants. Mann-Whitney U and Wilcoxon signed-rank tests were used to analyze the 2 groups' performances in this study. The improvement in posttest results compared with pretest results was significant in the conventional training group (P=.002). Hands-on technical scores of the conventional training group were higher than those of the VR-based training group during manikin-based simulation, but total scores, including those for technical and crisis resource management skills, acquired from the manikin-based simulation session did not reveal any significant difference between the 2 groups. The results of the VR preference survey revealed that the majority of the participants prefer VR-based serious game-based training instead of classroom lectures. Although hands-on technical scores of the conventional training group during the manikin-based simulation session were higher than those of the VR-based training group, both groups' total performance scores, including those for technical and crisis resource management skills, did not differ significantly. The preference survey reveals that the majority of the participants would prefer a VR-based ALS serious gaming module instead of lecture-based training. Further studies are required to reveal the learning outcome of VR-based ALS serious gaming. ClinicalTrials.gov NCT05798910; https://clinicaltrials.gov/study/NCT05798910.

Financial Resource Management Knowledge, Skills, and Attitudes for Entry-level Physical Therapist Practice: A Survey of Physical Therapists in Ohio.

The purpose of this study was to explore the perceptions of physical therapists (PTs) regarding the importance of financial resource management (FRM) knowledge, skills, and attitudes (KSAs) for entry-level practice and investigate the roles of PT education programs (PTEPs), clinical education experiences (CEEs), and employers in addressing these KSAs. FRM KSAs have been identified as components of professionalism and leadership and, as such, are a required element in student PTs (SPTs) educational preparation. A purposive sampling of convenience strategy was employed by requesting a free mailing list for Ohio-licensed PTs. An online survey was developed based on PT Clinical Performance Instrument Criterion #17, "Patient Management: Financial Resources," as this tool is frequently used to endorse entry-level status of SPTs. Potential participants were solicited through email. Mixed methodology was used to analyze survey results. The survey was completed by 266 PTs. FRM KSAs in legal and regulatory compliance were perceived as most important, followed by coding and billing. Forty-eight percent of participants indicated that FRM KSAs were "less important" (n = 111) or "considerably less important" (n = 17) than clinical care skills, whereas 39.8% (n = 106) believed that these skills are of the same level of importance. Ten themes were derived from qualitative responses regarding the FRM content that should be provided by PTEPs. Participants indicated that the role of PTEPs was to provide an introduction and foundation to FRM, whereas CEEs should facilitate intentional exposure and opportunities to apply FRM KSAs with supervision. Employers were expected to provide education regarding clinic-specific operations and reimbursement considerations, as well as mentorship that included reviewing complex billing for accuracy, offering guidance for improving time management skills, and discussing fiscal responsibilities to both the employer and patient. This information may guide PTEPs and clinical personnel in providing focused meaningful instruction regarding FRM aspects of PT practice to SPTs and entry-level clinicians.

Neonatal resuscitation workshop for trainees in standardized medical residency training-a pilot practice in Shenzhen, China.

Neonatal resuscitation is an important skillset for clinicians attending deliveries. Accredited neonatal resuscitation training is not obligatory in most training centers of standardized medical residency programs before 2022 in China. We investigated the feasibility and effectiveness of neonatal resuscitation simulation training (neo-RST) in residents in Shenzhen, China. Four two-day neo-RST workshops were conducted in the University of Hong Kong-Shenzhen Hospital and Shenzhen Health Capacity Building and Continuing Education Center in 2020-2021. The workshops had Neonatal Resuscitation Program (NRP)® update, skill stations and simulation practice with debriefing. Each participant had the integrated skill station assessment (ISSA) at the end of workshop. Participants of workshops included residents of different disciplines and health care providers (HCPs) of neonatal and obstetrical departments. We compared demographic characteristics, neonatal resuscitation knowledge before training, ISSA overall and categorical scores on skill sets between residents and HCPs. In 2020-2021, 4 neo-RST workshops were conducted with 48 residents and 48 HCPs. The residents group had less working experience, less prior experience in neo-RST and lower neonatal resuscitation knowledge scores than those of HCPs group. After the workshop, residents had higher overall ISSA score than that of HCPs group (90.2 ± 5.9 vs. 86.3 ± 6.6%, P = 0.003, respectively). There was no significant difference in the numbers of participants scored <80% in residents and HCPs group (3 [6.3%] vs. 7 [14.6%], respectively). Regarding the categorical scores, residents scored significantly higher in preparation, ventilation, crisis resource management and behavioral skills but lower in appropriate oxygen use, when compared with the HCPs. Neo-RST for residents is feasible with promising short-term educational outcomes. Neo-RST could be implemented in standardized medical residency programs in China.

Project Management Skills, People Management Skills, and Operational Excellence of Construction Project Managers in Private Construction Management Services

This study was conducted to determine the level of project management skills, people management skills and operational excellence of construction project managers in private construction services. The respondents were the project management team composed of 215 engineers, architects, technical staff and document controllers fairly distributed to the three business units. The study utilized the descriptive correlational research method. Analysis of data revealed the following findings: The construction project managers had a high level of project management skills in terms of scope management skills, schedule management skills, resources management skills, risks management skills, and quality management skills (=3.62). The construction project manager had a very high level of people management skills in terms of integrity, influence and persuasion, leadership, and planning (= 3.64). In terms of operational excellence, the construction project managers obtained a very high level on customer focus, flexibility, and systematic problem solving (= 3.62). A significant relationship was noted between construction project manager’s project management skills and people management skills; a significant relationship was perceived between project manager’s project management skills and operational excellence; and a significant relationship was noted on people management skills and operational excellence. Based on the summary of findings, the following conclusions were drawn, (1) The construction project managers had a very high level of project management skills in terms of scope management skills, schedule management skills, cost management skills, resources management skills, risks management skills, and quality management skills. (2) The construction project managers had a very high level of people management skills in terms of integrity, influence and persuasion, leadership, and planning. (3) The construction project managers had a very high level of operational excellence in terms of customer focus, flexibility, and systematic problem-solving. (4) The higher the level of construction project manager’s project management skills, the higher the level of their people management skills. (5) The higher the level of construction project manager’s project management skills, the higher the level of their operational excellence. (6) The higher the level of construction project manager’s people management skills, the higher the level of their operational excellence. (7) All the constructs of project management skills, only risks management skills and management skills are the significant predictors of the respondents’ level of operational excellence, implying that the higher the level of project management skills in terms of risks management and scope management skills, the higher the level of operational excellence of the respondents. To deliver the project successfully, the construction project managers should consistently demonstrate and balance the application of project management and people management since the area of focus of CPM in the project revolves in day to day managing of resources (material, manpower and equipment), solving problems, overcoming project challenges, dealing with changes in project requirements, communicating with stakeholders and satisfying the customer’s expectations. With these, the decision and approach of CPM would be solid and cohesive through collaboration with the project management team.

Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial.

Introduction The simulation of patient death remains controversial in simulation-based education. We investigated the effect of simulated patient death on learners' skill retention, stress levels, and emotions. Methods After ethics approval, we recruited residents at two Canadian universities. Participants were randomized to manage a simulated cardiac arrest ending with either the unexpected death (intervention group) or survival (control group) of the simulated patient (i.e., manikin). Three months later, all participants performed the same scenario but with the opposite outcome. Blinded video raters assessed participants' non-technical and technical crisis resource management (CRM) skills at both time points. Stress levels (represented by anxiety level, salivary cortisol concentration, and cognitive appraisal) and emotional valence were measured. Outcomes were analyzed using analysis of covariance (ANCOVA) or generalized estimating equations as appropriate. Results The analysis included 46 participants (intervention: n=24; control: n=22). Simulated death neither affected retention of non-technical CRM skills (mean retention Ottawa Global Rating Scale score in the death group [29.4, 95% CI: 27.0, 31.8] versus control group [29.4, 95% CI: 26.8, 32.0; p=0.87])nor technical CRM skills (mean retention task-specific checklist score in the manikin death group [11.8, 95% CI: 10.5, 13.0]versus the control group [12.5, 95% CI: 11.3, 13.7; p=0.69]). The simulated death had negative effects on participants' anxiety levels, cognitive appraisal, and emotions. Conclusion Simulated patient death did not affect the retention of non-technical or technical CRM skillsbut led to greater levels of short-term anxiety, stress, and negative emotions among learners.