Safe Learning Environment Research Articles

Silicone as a smart solution for simulating soft tissue-an iterative approach to developing a high-fidelity sustainable training model for laparoscopic appendectomy.

Laparoscopic appendectomy (LA) is an effective treatment for the surgical care of appendicitis, with this minimally invasive approach allowing patients to typically spend less time in hospital and promptly return to normal life activities. Residents can acquire the competence and confidence needed in a safe learning environment prior to real patient encounters through simulation-based learning of these techniques. We propose a low cost, sustainable, high fidelity simulation-based training model for LA to compliment regular resident practice of these skills. A team dedicated to developing this surgical simulation training model was established, equipped with the clinical knowledge and model engineering expertise. We used concepts of design-based research (DBR) to iteratively develop this model at key intervals. Our LA training model underwent four stages of model development prior to unified stakeholder consensus that this model was deemed effective and suitable for integration into formative surgical simulation curricula. This model simulates most of the key anatomical structures associated with performing an LA. In order to provide high fidelity haptic feedback, attempts were made to mimic the tensile properties of real tissue using different concentrations of silicone. The model can be utilized with laparoscopic box trainers of various sizes due to its scalability. It cost €9.67 to create, and single use appendix components cost €1.22 to build thereafter. Surgical residents can benefit from the platform that simulation-based education offers to develop the psychomotor skills necessary to perform LA in a safe learning environment. We describe a model for LA, which allows learners to develop their skill proficiency in this area under expert supervision.

“They already trusted us a lot”: Allied health students’ experiences of an innovative hospital, service-focussed placement model

Background A service-focussed placement model involves an innovative partnership between service and education providers to a) address service delivery needs and b) facilitate students’ competency development. Services are collaboratively redesigned such that students are positioned as collaborators in service delivery with their learning supported through evidence-informed educational design. This model was implemented in the hospital setting and was found to promote positive patient outcomes. Our study explored whether this model supports student learning. Methods Students’ perception of learning was explored using a multiple-case study design with data collected from 22 semi-structured focus groups and interviews with 64 senior year allied health students (physiotherapy n = 55; occupational therapy n = 9) across six placement settings. Inductive thematic analysis identified aspects of this placement model that facilitated and challenged students’ learning. Results A service-focussed placement model provides a quality student learning experience. Students identified the need to be prepared for independent learning. This placement model promoted their professional development and sense of autonomy through engaging them in early, active learning within a safe learning environment. Conclusions Students perceived that a service-focussed placement model equipped them for the ever-changing complexities and challenges of hospital services.

Strategies to support mental health within a primary school setting

AbstractThis article explores an insight into different teaching strategies implemented within two educational settings in year 1 classrooms. Since the Coronavirus pandemic, evidence states that children's mental health is declining highlighting the need to teach children how to gain a positive mindset. This article shall reflect on my practice, which used different self‐regulation strategies to improve a child's emotional intelligence and transfer their knowledge into real‐life practice. It shall reflect on the three primary methods I implemented into my year 1 classroom to create a safe learning environment: Self‐regulation, brain breaks and calm corners. These methods were implemented in two different year 1 classrooms across two different academic years. These strategies were embedded and adapted throughout the whole year, yet this article shall reflect on the evidence of the Autumn term in each academic year. The same strategies were implemented in both academic years to compare these strategies in two different educational settings. The Autumn term was chosen as the reflection period due to the transition from EYFS to Year 1 being a key factor in most children's mental health at that age.

Contributions of Clinical Simulation with Standardized Patients in the Subject of OT intervention in Mental Health

The paper discusses the contributions of clinical simulation with standardized patients in the teaching of occupational therapy at the Universidad Andrés Bello, highlighting its importance in the formation of practical skills, the improvement in the understanding of the empathic aspects of care, and its relevance of its use in mental health. The study was carried out using a quantitative methodology with a cross-sectional analytical design of local validation. The universe was made up of 60 students of the VIII semester of the Occupational Therapy career of the Andrés Bello University, Viña del Mar campus. Among the main results, it is inferred that clinical simulation offers a safe learning environment that allows students to practice skills before interacting with real users; facilitates the development of empathy and effective communication in a therapeutic context; contributes to a better understanding of emerging dynamics and challenges in mental health; It improves students' competencies to apply theories in practical situations. In conclusion, it promotes critical reflection on behavior and decisions in the context of the intervention, helping to evaluate performance in real attention situations, encouraging active and collaborative learning among students.

Promoting Nursing Diversity, Equity, and Inclusion Through Virtual Reality Learning.

Nurse leaders are foundational to the success of creating an inclusive culture and climate and responding to situations of discrimination, racism, microaggressions, and bias in healthcare settings. This article describes a leadership education initiative using virtual reality to provide diversity, equity, and inclusion training for nurse leaders. Immersion in a lived experience provides a safe and effective learning environment to promote, improve, and exemplify diversity, equity, and inclusion principles and should be explored for other educational applications.

Trauma-Informed Care in Undergraduate Nursing Education: An Integrative Review.

Trauma-informed care (TIC) requires health care providers and organizations to provide care in a way that assumes everyone has a trauma history (Hopper et al.). Although there has been a recent rise to investigate TIC within various nursing specialties, knowledge related to integrating TIC into nursing curricula remains unclear. An integrative review following Whittemore and Knafl procedures synthesized the literature related to TIC in undergraduate nursing education. Five themes surfaced: (1) isolated tic integration in undergraduate courses; (2) TIC for safe learning environments; (3) inconsistent TIC definitions in nursing education; (4) prerequisite nurse educator training; and (5) students recognizing an implementation gap and seeking solutions. This review highlights TIC integration challenges in nursing education, emphasizing the need for ongoing research, training, and collaboration. These efforts are vital to equip future nursing professionals with the skills to provide high-quality trauma-informed care, benefiting students, patients, and health care delivery. [J Nurs Educ. 2024;63(11):737-745.].

Embedding cultural safety in nursing education: A scoping review of strategies and approaches

IntroductionPost-secondary institutions can no longer ignore calls to action. Nursing programs are responsible for addressing racism and discrimination by integrating cultural safety into baccalaureate nursing curricula. This scoping review of peer-reviewed literature will reveal how cultural safety is integrated into nursing education across North American post-secondary institutions. Materials and methods57 records met the criteria for this scoping review. The database search was conducted from November 7, 2021, to November 9, 2021, and then updated on September 17, 2024, to include articles up to and including July 2024, yielding 3444 total search results (1448 from Medline; 1996 from CINAHL). Results were manually screened, and duplicates found were removed. ResultsThe articles were analyzed thematically to identify strategies for integrating cultural safety into undergraduate nursing education. Four main themes were identified: experiential, theoretical, analytical, and multimodal learning. ConclusionThis scoping review highlights nurse educators' role in fostering cultural safety and the importance of considering multiple strategies in curricular development. Strategies include practice experiences, simulations, storytelling, and case-based learning. To provide safe nursing care, education must be inclusive and responsive to people of all races, genders, abilities, and sexual orientations. By applying the concept of cultural safety to nursing education, students are required to acknowledge bias and address issues of power, colonialism, racism, and discrimination that exist in healthcare. These findings provide a foundation for future, more focused research. Further studies could expand on this work by evaluating the effectiveness of specific pedagogical strategies and exploring ways to better support nurse educators in promoting culturally safe learning environments.

Teaching and learning to support climate-neutral transitions: Exploring opportunities and challenges for interdisciplinary design courses

Students’ individual and collective learning processes in interdisciplinary teaching and learning activities that integrate prototype-oriented courses present an opportunity for further exploration. This is particularly relevant given the broader need for capacity-building to support climate-neutral transitions. This contribution draws on an exploratory workshop-in-workshop (WiW) approach to understand and evaluate students learning experiences in an experimental and interdisciplinary design course setting. This experience was embedded in the ENHANCE Alliance, a European network cooperation to innovate research and education in science and technology. The inductive analysis and results from the WiW approach draw upon surveys, group discussions, mapping exercises, and reflections with students. These indicate strong appreciation for problem-based and prototype-oriented teaching along with learning experiences as a part of their individually differentiated but collectively shared learning trajectories. The final insights acknowledge the method as an effective way to enhance instructor-student relationship dynamics and interdisciplinary opportunities. Future improvements to the interdisciplinary design format are discussed and highlight students' desires for open and safe learning environments that are more transdisciplinary in nature.

Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills

BackgroundCommunication skills are an essential part of clinical competence that need to be acquired during health professions education. Simulations are extensively used for learning communication skills and have long been integral to medical degree programmes. In this research we use qualitative methodology to explore fourth-year medical students’ experiences in simulations aimed at improving versatile doctor-patient communication, focusing on their learning with trained actors.MethodsThe data comprises reflective writings from 208 fourth-year medical students, gathered after a communication skills course. These students provided informed consent for their writings to be included in the research. We performed an inductive qualitative content analysis on the textual data, with findings presented as themes, supported by categories, codes, and excerpts from raw data to enhance the trustworthiness of the analysis.ResultsWe identified eight key themes capturing students’ learning experiences through simulations: practising in a safe learning environment, valuing feedback, gaining new perspectives, finding simulations valuable and enjoyable, boosting confidence and self-knowledge, and viewing simulations as authentic and engaging learning opportunities. Some students offered critical perspectives on simulations. Throughout the course, students learned diverse aspects of patient care, emotional and behavioural communication dynamics, and lessons from medical errors. Some students offered critical perspectives on simulations, and a few indicated they did not learn anything new.ConclusionsA safe learning environment is vital for encouraging learners to explore, make errors, and absorb feedback to improve their communication with patients. Students predominantly valued the communication skills training with actors and the constructive feedback received and given in the debriefing discussions. However, some students expressed critical views toward simulations. Simulations are not static; they evolve and require continual improvements. Hence, we advocate for the ongoing exploration and enhancement of communication skills learning methods, including simulations, with careful consideration for students’ vulnerability and the importance of psychological safety. Additionally, it is critical to address students’ perceptions that certain clinical teachers prioritise biomedical knowledge over communication skills. Providing tailored training for teachers regarding the learning methods and the desired outcomes of communication courses is essential.

8.Q. Skills building seminar: “The Church of Fail”: Learning from Our Mistakes in Co-Creation

Abstract When delving into the co-creation research literature, it might seem that researchers consistently attain success in their projects without any exceptions. At the extremes, co-creation might even be portrayed as a quasi-moral scientific approach, where the results are inherently positive and beneficial to all participants. Rarely do researchers openly discuss failures or mistakes encountered during co-creation projects, despite the well-established understanding that co-creation presents significant challenges and demands for those involved. Therefore, we aim to use the well-established “Church of Fail” method to underscore the importance of learning from failures, particularly within the dynamic and demanding landscape of co-creation. Therefore, we invite participants to embrace the inevitability of failures, emphasizing that the key lies in deriving valuable lessons from these. Failures present the greatest potential for professional growth and innovation. Reasons for the workshop: Ensuring the professional growth of researchers and practitioners is vital to unlocking the full potential of co-creation and participatory methodologies. It may appear that success in co-creation is guaranteed by applying principles such as building ownership or fostering shared understanding. However, in reality, co-creation demands significant effort, resources, and dedication from everyone involved. One way to avoid mistakes or failures is to embrace them and learn from them, thereby fostering professional growth and innovation. Objectives This workshop will: 1) Increase awareness of co-creation as a methodology within public health, by generating an open and safe learning environment for professional growth; 2) Exchange experiences with failure, to learn and encourage professional growth. The presenters will engage the participants with cases that illustrate different known pitfalls within co-creation, such as power imbalance, participation fatigue, recruitment strategies, and aligning objectives; 3) Discuss important consideration on co-creation approaches, to achieve the best possibility for success in such research projects in public health in the future. Key messages • Failure is not a flaw, but an opportunity to learn and innovate. • Success in co-creation is not a given, even though it sometimes seems so when reading the literature.

School as a Safe Space through Gender-Responsive Basic Education Policy

Quality education promotes gender-responsive policies. Yet, this is not always the case in developing countries like the Philippines. There are gaps in policy implementation, and safety issues faced by LGBTQIA+ learners persist. Purpose. This study focuses on teachers’ and learners’ perception of Gender-Responsive Basic Education Policy (GRBEP) implementation and the safety of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and expanding identities (LGBTQIA+) learners in public and private schools. Hence, it determined the GRBEP implementation level and LGBTQIA+ learners' safety level. No significant correlation between policy implementation and learners’ safety, and no significant difference between public and private schools’ policy implementation and learners’ safety were assumed. The minimal studies and the urgent need to ensure a gender-responsive and safe learning environment underscore the significance of this research. Methodology. Validated questionnaires were distributed to 744 learners and teachers: 401 from private schools and 343 from public schools. The data collected were analyzed using mode, percentage, Pearson’s product-moment correlation, and independent samples test. Results. Learners and teachers perceived a “high level of implementation” of GRBEP in schools. LGBTQIA+ learners were generally “safe” in schools. The implementation level of Gender-Responsive Basic Education Policy correlates with the safety level of LGBTQIA+ learners in school, as it was statistically significant (p=.026 < α=0.05). There is no substantial evidence of a difference between public and private schools’ implementation level of GRBEP (p = 0.544 > α=0.05). There is not enough evidence of a significant difference between public and private schools’ safety levels of LGBTQIA+ learners (p = 0.188 > α=0.05). Conclusion. An efficient GRBEP implementation by schools ensures a working educational policy. LGBTQIA+ learners are safe in the learning environment. Public and private schools must strengthen awareness campaigns, address misconceptions and overlooked realities, conduct real-time monitoring, evaluation, and feedback mechanisms, as well as foster partnerships and linkages to uphold a safe space for every learner. With these actions, policymakers and school administrators can work towards creating a true quality and inclusive education that supports the well-being and success of all learners, regardless of their sexual orientation, gender identity, or gender expression.

Evaluation of a Child-Friendly School Program in Developing Peace Education at KB Joglo Pati

The purpose of this study was to evaluate the child-friendly school program in developing peace education at KB Joglo Pati. The evaluation model used is CIPP (Context, Input, Process, Product). Qualitative methods were used in the evaluation research. Data were collected through interviews, observations and documentation at KB Joglo Pati. The research results obtained are: (1) The implementation of the child-friendly school program is carried out in accordance with the current needs, namely to prevent violence and discrimination against children at school and in the community. (2) The child-friendly school program in KB Joglo already has good facilities and infrastructure, human resources and financial resources to support the implementation of a child-friendly school program by developing peaceful education. (3) The learning process is interactive, inspiring, and fun, inviting students to actively participate, and learning is tailored to the interests, talents, and psychological development of students by using the regenerative peace and justice curriculum. (4) The results of the implementation of the program are quite good and have shown the principles of child-friendly schools with peace education through habituation of students' attitudes or behavior. The findings of this study are important for children to learn non-aggressive education towards problems as an alternative experience to fighting, and to develop peaceful education while creating a safe and peaceful learning environment so that children are happy and fulfill their potential. Keywords: evaluation, CIPP, child-friendly school, Peace Education

Enhancing clinical reasoning skills for medical students: a qualitative comparison of LLM-powered social robotic versus computer-based virtual patients within rheumatology

Virtual patients (VPs) are increasingly used in medical education to train clinical reasoning (CR) skills. However, optimal VP design for enhancing interactivity and authenticity remains unclear. Novel interactive modalities, such as large language model (LLM)-enhanced social robotic VPs might increase interactivity and authenticity in CR skill practice. To evaluate medical students’ perceptions of CR training using an LLM-enhanced social robotic VP platform compared with a conventional computer-based VP platform. A qualitative study involved 23 third-year medical students from Karolinska Institutet, who completed VP cases on an LLM-enhanced social robotic platform and a computer-based semi-linear platform. In-depth interviews assessed students’ self-perceived acquirement of CR skills using the two platforms. Thematic analysis was employed to identify themes and sub-themes. Three main themes were identified: authenticity, VP application, and strengths and limitations. Students found the social robotic platform more authentic and engaging. It enabled highly interactive communication and expressed emotions, collectively offering a realistic experience. It facilitated active learning, hypothesis generation, and adaptive thinking. Limitations included lack of physical examination options and, occasionally, mechanical dialogue. The LLM-enhanced social robotic VP platform offers a more authentic and interactive learning experience compared to the conventional computer-based platform. Despite some limitations, it shows promise in training CR skills, communication, and adaptive thinking. Social robotic VPs may prove useful and safe learning environments for exposing medical students to diverse, highly interactive patient simulations.

Psychological safety in students’ clinical learning environment – thematic analysis of open-ended questions and DREEM questionnaire assessment

Introduction: The learning environment impacts students’ motivation, success and fulfilment, and central to this is the psychological safety of students. Psychologically safe environments lead to collaboration, positive learning experiences and effective practitioners. This study assessed the perception of clinical learning environments of medical and nursing students (NSs) using the Dundee Ready Education Measure (DREEM) and with two open-ended questions (OEQs): their memorable learning experience and the effect of being in medical school on their lives. Methods: This was a cross-sectional study using validated DREEM questionnaires and two OEQs: ‘tell us about a memorable learning experience in medical/nursing school’ (MLE) and ‘what impact has your time in medical/nursing school had on your life’ (IoL). Data were collected from fourth- to sixth-year clinical medical, and first- to third-year NSs. Questionnaire data were analysed using the Statistical Package for Social Sciences. For the OEQs, an inductive approach was used for coding and thematic analysis. Coding was both semantic and interpretive. Results: One hundred and ninety-three students completed the validated questionnaires. Fifty-seven (29%) and 59 (30%) answered the OEQs MLE and Impact IoL, respectively. Thirty-four per cent of medical and 7% of NSs had a negative response to one of the two OEQs. Six themes emerged from the memorable learning experience question, three of which centred around student-centred teachings and two around emotional responses and psychological safety. ‘I reviewed my materials over and over, ate well, put on my best clothes and went to present. It was beautiful’, a third-year medical student. ‘The tutor was a great teacher who, when he teaches, students learn’, an NS. There were four themes on the impact on life questions, and these centred around personal development, social awareness, aspirations and psychological safety. ‘It has made me see that broken people break others’, a third-year medical student. The mean total DREEM score was 111 ± 10.2, interpreted as more positive than negative. In only two of the five DREEM domains, perception of the atmosphere and social self-perception were more negative than positive findings. Whilst there was near unanimity about their teachers being knowledgeable, and most students felt teachers were well-prepared for their teaching sessions, complaints about behaviours that adversely affected learning because of their negative impact on psychological safety in the clinical learning environment were very common. Conclusion: Despite the overall positive picture of clinical learning environments, there are significant areas of students’ welfare that need addressing to ensure psychologically safe clinical learning environment. Students’ feedback feeding into annual appraisals, and pedagogic courses are means to achieving students-centred learning environments.

A change of mind: Error motivation is shaped by error perceptions in different learning environments

Background The medical profession has traditionally had a culture of “blame and shame,” despite the importance errors have for learning, motivation, and improvement of clinical skills. This study aimed to explore how medical students and newly graduated doctors perceive errors across different learning contexts and levels of expertise, and how error perceptions influence motivation and engagement in learning activities. Methods Semi-structured interviews were conducted, and thematic analysis was used to identify themes. Survey questions were developed based on the themes. The final survey included 27 questions divided into three sections. The survey was distributed via RedCap to medical students in year 1, year 4, and year 6 together with newly graduated doctors in Denmark. Results Of the 541 respondents, a majority anticipated making errors in both non-clinical (77.4%) and clinical (61.5%) learning situations, finding them motivating for participation (91.9% and 96.2%, respectively). A psychologically safe learning environment was seen to enhance the perception of errors as learning opportunities (96.9%) and increase risk willingness (96.3% non-clinical, 97.7% clinical). Respondents focused on the specific errors they made (86.0%), and their supervisors were perceived to focus more on correct handling of errors (70.7%). Respondents expected to conduct fewer errors in non-clinical learning situations in PGY-1 compared to medical students in year 1 (F(3529) = 3.0, adjusted p = 0.03). They showed an increase in risk willingness in clinical learning situations from year 6 to PGY-1 (F(3520) = 2.7, adjusted p-value 0.006) as long as the learning situations were considered psychologically safe. Conclusion The study suggests that a psychologically safe learning environment mitigates the “shame and blame culture” associated with errors. Respondents generally embraced errors as valuable learning experiences but noted a lack of specific error-related feedback. These findings underscore the nuanced relationship between errors, explicit learning activities, and supervisor support in medical education.

Diverse Perspectives: An Inclusive Serious Game for (International) Students

Universities have increasingly diverse student populations. While a greater variety of students' backgrounds, skills and abilities exist, this does not necessarily mean they have more inclusive interactions. A lack of inclusive interactions can cause negative biases against people who are different from oneself. One strategy to mitigate bias is exposure to situations where students encounter social dilemmas with others and are stimulated to reflect on their interactions. These experiences could be simulated within a serious game as a safe learning environment. Moreover, serious games allow the player to broaden their mental perspective by showing the world through the eyes of others. This paper presents the design and evaluation of the serious game called Diverse Perspectives. This visual novel with multiple endings captures social dilemmas and allows the player to view them from a different angle through perspective switches. We evaluate Diverse Perspectives with quantitative ( N = 32) and qualitative measures on attitude towards diversity and gaming experience measured with the Shortened Version of the Miville-Guzman Universality-Diversity Scale and the Game Experience Questionnaire. Participants indicate they find the perspective switch helpful as it creates an understanding of the other person's view.

“A safe, non-judgmental space where I can really challenge myself:” learner experiences in a virtual, case-based diagnostic reasoning conference for students

ABSTRACT Case-based diagnostic reasoning conferences, like morning reports, allow undergraduate medical trainees to practice diagnostic reasoning alongside senior clinicians. However, trainees have reported discomfort doing so. Peer-assisted learning offers an alternative approach. We describe the design, implementation, and evaluation of a virtual, student-only diagnostic reasoning conference that leverages peer-assisted learning. Student virtual morning report’s (VMR) design was informed by social and cognitive congruence and experience-based learning. We evaluated participant experiences using a survey focused on participant perceptions of Student VMR’s value, their methods for participation, and their preferences for Student VMR compared with VMR with more senior clinicians. 110 participants (28.9%) completed the survey. 90 participants (81.2%) reported that Student VMR was educational. Compared to VMR, participants reported being more likely to participate in Student VMR by turning on their video (50.0%), presenting a case (43.6%), verbally participating (44.5%), or participating in the chat (70.0%). Strengths included a safe learning environment to practice DR and the opportunity to engage with an international learning community. When asked whether they preferred Student VMR or non-Student VMR, most respondents (64.5%, 71/110) identified that they did not have a preference between the two. A student-focused DR conference may offer a valuable complement to, but not a replacement of, apprenticeship-based DR case conferences.

Development and validation of teacher artificial intelligence (AI) competence self-efficacy (TAICS) scale

AbstractEvaluating teacher AI competence levels and building effective, safe, and healthy learning environment are crucial steps in transitioning to AI-based education. Current established digital competence frameworks may indirectly address AI competence but often overlook the impact of AI on society, ethics, and assessment. Research on teacher AI competence is at its first stage, primarily focusing on theoretical and professional discussions, along with qualitative investigations. This study aims to propose and confirm the reliability and validity of a scale measuring teacher AI competence self-efficacy (TAICS) in K-12 education. The scale was developed using a Delphi method, and includes six dimensions: AI knowledge, AI pedagogy, AI assessments, AI ethics, human-centered education, and professional engagement. Each dimension contains four items. The scale was evaluated on a sample of 434 K-12 teachers through confirmatory factor analysis and model comparisons. The analyses showed that the scale is consistent across male and female teachers, as well as scientific and non-science teachers. The completed TAICS scale consists of 24 items and encompasses six dimensions of AI competence. It can be used to examine interventions and correlational research, as well as to inform the creation of new strategies and policies for AI in relation to teacher AI competence development.

Optimizing modern surgical simulation through instructor feedback - insights from a retrospective observational study in a tertiary hospital.

Laparoscopic surgery is associated with a prolonged learning curve for emerging surgeons, and simulation-based training (SBT) has become increasingly prominent in this context due to stringent working time regulations and heightened concerns regarding patient safety. While SBT offers a safe and ethical learning environment, the accuracy of simulators in the context of evaluating surgical skills remains uncertain. This study aims to assess the precision of a laparoscopic simulator with regard to evaluating surgical performance and to identify the instructor's role in SBT. This retrospective study focused on surgical residents in their 1st through 5th years at the Department of Surgery of Linkou Chang Gung Memorial Hospital. The residents participated in a specially designed SBT program using the LapSim laparoscopic simulator. Following the training session, each resident was required to perform a laparoscopic procedure and received individualized feedback from an instructor. Both simulator and instructor evaluated trainees' performance on the LapSim, focusing on identifying correlations between the simulator's metrics and traditional assessments. Senior residents (n = 15), who employed more complex laparoscopic procedures, exhibited more significant improvements after receiving instructor feedback than did junior residents (n = 17). Notably, a stronger correlation between the simulator and instructor assessments was observed in the junior group (junior Global Operative Assessment of Laparoscopic Skills (GOALS) adjusted R2 = 0.285, p = 0.016), while no such correlations were observed among the senior group. A well-designed, step-by-step SBT can be a valuable tool in laparoscopic surgical training. LapSim simulator has demonstrated its potential in assessing surgical performances during the early stages of surgical training. However, instructors must provide intuitive feedback to ensure appropriate learning in later stages.

Operating room team's perception of procedure shift to cemented hemiarthroplasty.

A procedural change in the treatment of patients with femoral neck fracture from uncemented to cemented hemiarthroplasty was to be implemented to follow new national guidelines. In accordance with implementation science, it is important to understand the team's thoughts and educational needs. The study aimed to explore surgeons', scrub nurses', anaesthesiologists' and anaesthesia nurses' perceptions of barriers and facilitators to foster a safe educational introduction. We conducted four semi-structured group interviews with 15 team members. The interviews were recorded, transcribed, and analysed using systematic text condensation to define important factors. We found barriers, e.g., potential fear related to handling the cement and "thoughts" concerning limited time. Patient, individual and organisational factors were also identified. A "cement-time-out" was suggested to prepare and complete cementation safely. The interviewees emphasised continuous training to ensure the procedure's success and maintain skills and confidence after the initial training. The importance of a safe learning culture, team collaboration and the provision of feedback was discussed. The study provides novel insights into the specific educational needs that may arise during the transition to cemented hemiarthroplasty. A training package including simulation was proposed to maintain a safe learning environment and ensure patient safety. The team highlighted the importance of maintaining their competence. Results are relevant for departments introducing procedural change. None. Not relevant.