Simulation Experience Research Articles

Curriculum Innovation: A Standardized Experiential Simulation Curriculum Equips Residents to Face the Challenges of Chief Year.

A chief resident's role incorporates administrative, academic, and interpersonal responsibilities essential to managing a successful residency program. However, rising chief residents receive little formal exposure to leadership training. To (1) define leadership styles; (2) understand the effect of cultural competence on leadership styles; (3) learn effective methods to advocate as the chief resident; (4) provide effective peer feedback; (5) provide effective supervisor feedback; (6) learn effective conflict management; (7) ensure psychological safety. We developed a 1-day curriculum combining didactics and simulation activities for our program's rising chief residents. Implementation of our curricular design included a morning session focusing on small groups and didactic-based lectures on specific topics pertinent to leadership, along with a debriefing of a psychometric evaluation tool administered before the curriculum day. The simulation activity consisted of 3 group objective structured clinical examination (G-OSCE) scenarios: (1) providing a struggling junior trainee with feedback; (2) debriefing an adverse clinical outcome as the team leader; (3) navigating a challenging situation with a supervising physician. Standardized participants were surveyed for specific objectives. Learners completed precurricular and postcurricular surveys on their familiarity and preparedness for their chief year. Comparison of preintervention (n = 16) and postintervention (n = 10) data shows improvements in familiarity with leadership models (p = 0.006), cultural competence in leadership (p = 0.027), and team organizational structure (p = 0.010) with notable improvement in report of advocating for the team to 100% of participants in the postcurricular survey. In addition, although not statistically significant, familiarity with specific strategies for feedback delivery improved (p = 0.053), as did learner comfort levels with feedback delivery (comparing 51% of learners were either very or somewhat comfortable precurriculum to 90% postcurriculum). This is further supported by standardized participant data after the G-OSCEs. Although familiarity with wellness resources did improve across learners (p = 0.421), learner-reported use of wellness resources was noted to be reduced after the curricular intervention and remains a result of further interest for exploration. A 1-day leadership development curriculum combining didactics and simulation is an effective means of preparing rising chief residents to succeed in their transition to this leadership role.

The Impact of Collective Pre-game Organization in the Perceived Experience of Digital Management Simulations in Higher Education

This study investigates the impact of pre-game preparation on the perceptions and outcomes of participants in a digital simulation game. Conducted on 542 students from 28 management schools, the research explores how team organization and strategic planning in the early stages influence game experience and performance in a business simulation context. The findings reveal that effective pre-game preparation significantly enhances both the participants’ perception of the game and their performance outcomes. These results underline the importance of structured team organization and the strategic definition of roles before the game begins. This study also contributes to the literature on simulation games by highlighting the crucial role of pre-game activities, especially in team-based settings. In addition, it offers practical insights for educators on optimizing the use of simulation games by focusing on preparation and organization strategies that mimic real-world business environments. This research not only fills a gap in our understanding of the preparatory phase of game-based learning but also enhances our knowledge of how simulation games can be effectively integrated into management education.

Simulation Experiences Focusing on Addressing Culturally Based Hidden Bias and RacisM (A-CHARM).

Racism experienced by nursing students contributes to a loss of confidence and anxiety. The Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) nursing project simulation experiences (SEs) provide opportunities to practice addressing racism/inappropriate comments experienced in the clinical setting. The aim is to describe the development of the A-CHARM nursing project SEs. The frameworks used in the development of the SEs include the (1) six-step approach, (2) ERASE framework, (3) SENSE debriefing model, and (4) Microaggressions Triangle model. Five SEs were created that depicted scenes where a nursing student encounters racism/inappropriate comments. Each SE aligned with one of the frameworks and users utilized the framework to navigate the SE. The A-CHARM nursing SEs may benefit nursing students by enhancing their knowledge and skills related to racism or inappropriate comments in clinical settings. Future research will evaluate the impact of the SEs on nursing students and clinical faculty. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Simulation as a method in a supervision course, experiences of midwives and specialist nurses: A qualitative study

AimTo explore supervisors’ experience of simulation in a student supervision course BackgroundThe relationship between student and supervisor is crucial for the students’ learning and quality of education. The supervisors have an important role in facilitating a good start and the best learning opportunities for students in clinical placement. Supervision can be demanding and there is a need to strengthen supervisors in their role. An interprofessional supervision course was designed, using simulation as a method. Simulation is frequently used for acute situations to improve patient safety but is less common in student supervision. In our supervision course, simulation was introduced in the digital component and practiced in the physical component. The 4–6 members of the interprofessional simulation groups were assigned roles as either participants or active observers. They were guided by a facilitator, who constructed student-supervisor scenarios, allocated roles and facilitated reflection. DesignA qualitative, explorative design involving focus groups and written reflections. MethodsTwo focus groups (n=9) were conducted following a pilot course in addition to written reflections (n= 80) after four courses. After revising the course and the interview guide, two additional focus groups (n =10) were held and a further 43 written reflections received. The empirical data were analyzed using thematic analysis by Braun and Clarke. ResultsThe three themes.1. Interprofessional simulation provides a wider perspective on the student- supervisor relationship.The participants experienced being active in different roles, followed by subsequent joint reflection. They expressed increased relational understanding as well as the importance of verbal and nonverbal communication in supervision through learning from other interprofessional supervisors.2. Simulation provides realism by entering into the situation. Simulation fostered activation of the senses that improved the supervisor’s ability to be attentive to the student’s needs.3.Challenging to simulate the role of supervisor. Most participants were willing to force themselves out of their comfort zone to learn. However, quite a few felt uncomfortable participating in simulation on communication and preferred observing others. ConclusionThe participants experienced simulation as valuable for strengthening their awareness of their ability to influence students’ learning and relational understanding. The results showed the value of reflective observation in addition to participating in simulation. Simulation might contribute to improved supervision, although different experiences that inhibit learning outcomes must be acknowledged.

Diversity and Inclusion Through Collaboration: Co-Producing a Simulation Curriculum to Address Discrimination Against Trainees.

Discrimination toward trainees is a pervasive problem, with surveys showing it is often perpetrated by patients. For several years, residents and faculty in an internal medicine residency have participated in a workshop offering a framework for responding to discriminatory behavior by patients. As part of a larger effort to reinforce this teaching and promote an inclusive environment, the authors pursued a multi-pronged simulation curriculum that could be incorporated into graduate medical education programs across their institution. First, the authors conducted trainee and faculty focus groups to better understand their experiences. Qualitative data was collected, including recommendations for responding to discrimination, characteristics of the most common experiences, and trainees' own ideas for worthwhile simulation scenarios. Trainees and faculty were then brought together in a collaborative process to co-develop simulation cases that were later implemented in curricula across multiple learner levels, specialties, and contexts. Participants in these simulations reported improved comfort in responding to discrimination in the moment and/or in the wake of such incidents. Through trainee-faculty collaboration, the project yielded authentic and impactful simulation experiences for learners, while also giving trainees an opportunity to turn previous trauma into constructive learning opportunities that promote an inclusive environment.

Reclaiming identities: exploring the influence of simulation on refugee doctors’ workforce integration

BackgroundHealthcare professionals are a precious resource, however, if they fail to integrate into the workforce, they are likely to relocate. Refugee doctors face workforce integration challenges including differences in language and culture, educational background, reduced confidence, and sense of identity. It has been proposed that simulation programmes may have the power to influence workforce integration. This study aimed to explore how an immersive simulation programme influenced workforce integration for refugee doctors joining a new healthcare system.MethodsDoctors were referred to a six-day immersive simulation programme by a refugee doctor charity. Following the simulation programme, they were invited to participate in the study. Semi-structured interviews, based on the ‘pillars’ conceptual model of workforce integration, were undertaken. Data were analysed using template analysis, with the workforce integration conceptual model forming the initial coding template. Themes and sub-themes were modified according to the data, and new codes were constructed. Data were presented as an elaborated pillars model, exploring the relationship between simulation and workforce integration.ResultsFourteen doctors participated. The ‘learning pillar’ comprised communication, culture, clinical skills and knowledge, healthcare systems and assessment, with a new sub-theme of role expectations. The ‘connecting pillar’ comprised bonds and bridges, which were strengthened by the simulation programme. The ‘being pillar’ encompassed the reclaiming of the doctor’s identity and the formation of a new social identity as an international medical graduate. Simulation opportunities sometimes provided ‘building blocks’ for the pillars, but at other times opportunities were missed. There was also an example of the simulation programme threatening one of the integration pillars.ConclusionsOpportunities provided within simulation programmes may help refugee doctors form social connections and aid learning in a variety of domains. Learning, social connections, and skills application in simulation may help doctors to reclaim their professional identities, and forge new identities as international medical graduates. Fundamentally, simulation experiences allow newcomers to understand what is expected of them. These processes are key to successful workforce integration. The simulation community should be curious about the potential of simulation experiences to influence integration, whilst also considering the possibility of unintentional ‘othering’ between faculty and participants.

Nurse-midwifery students’ experiences in high-fidelity simulation: a focus group study

Introduction: Active teaching methodologies, particularly those using high-fidelity simulation, stand out in nursing education for their ability to facilitate the development of students' technical-scientific and non-technical skills, as well as prepare them for clinical practice. High-fidelity simulation using realistic models is an effective tool for improving students' communication skills, leadership and critical thinking. This study aims to explore nurse-midwifery students’ learning experiences in high-fidelity simulation.Methods: Explorative qualitative study using two focus groups interviews with nurse-midwifery students at the Higher School of Nursing. Qualitative data were analyzed using content analysis. Results: Two main themes emerged from content analysis: (i) Simulation-based learning and (ii) Simulation-based teaching. The first theme includes three categories: development of technical-scientific skills, development of non-technical skills, and preparation for internship. The second theme also includes three categories: enhancing theoretical knowledge, facilitating teaching, and post-scenario discussion (debriefing). Conclusions: The use of high-fidelity simulation as a teaching strategy in the training of nurse-midwifery students contributed to the development of technical and non-technical skills essential to nursing practice

Improving Resident Comfort With Peripartum Cesarean Hysterectomy Through the Use of Low-Fidelity Simulation Models.

Introduction Cesarean hysterectomy is a relatively rarely performed, complex, life-saving procedure considered during post-partum hemorrhage and other obstetric complications. This multi-site study aimed at validating a low-cost, low-fidelity cesarean hysterectomy model to support resident proficiency and increase their confidence in performing this critical procedure. Materials and methods We developed a low-fidelity, anatomically representative model for cesarean hysterectomy simulation purposes. Obstetrics and Gynecology residents at two residency programs were offered a simulation experience using the model, with a performance assessment via two validated assessment tools. The clinical case involved a 38 y/o woman with a delivery complicated by postpartum hemorrhage who failed conservative therapy and required a peripartum hysterectomy. Participants included 26 residents, postgraduate year (PGY)1 through PGY4, at two midwestern university-based obstetrics and gynecology residency programs. Results The median resident scores on the Task Specific Checklist (TSC) and Global Rating Scale (GRS) correlated with increasing PGY levels. The combined TSC+GRS score was a median of 40 out of 49 total for the PGY4 class, while the PGY1 class had a median combined TSC+GRS score of 12 of 49. The PGY2 and -3 classes had TSC+GRS scores of 14 and 28, respectively. The simulation model was well-received with a median 4/5 rating for improving comfort level with cesarean hysterectomy and a median 4/5 rating for model realism. Conclusion This study validated a cost-effective, easily reproducible model that highlights the vital anatomy relevant to a cesarean hysterectomy. The model and simulation offer a way to introduce cesarean hysterectomies to residents while in training, particularly at sites that may not perform a substantial number of these procedures.

Changes in the self-efficacy and communication of nursing, occupational therapy, and speech-language pathology students participating in a simulated patient simulation

BackgroundThis study aimed to examine changes in self-efficacy and communication of nursing, occupational therapy, and speech-language pathology students through participation in an interprofessional patient simulation. Methods: Twenty-two occupational therapy graduate students, 16 speech-language-pathology graduate students, and 25 undergraduate nursing students participated. Participants completed the Self-Efficacy for Interprofessional Experiential Learning (SE-12), the Interprofessional Collaboration Scale (ICS) pre and post simulation, and an open-ended post-simulation questionnaire on self-perceived stress levels. ResultsEach discipline group demonstrated significant changes in perceived self-efficacy (p < .001) and communication (p < .001). Analysis of the open-ended questions revealed a consistent pattern in reducing stress levels from before the simulation to the post-simulation assessment. ConclusionIncorporating interprofessional patient simulation experiences into pre-professional health programs significantly enhances interprofessional communication skills and self-efficacy and reduces self-reported stress, serving as a valuable tool for preparing students to collaborate effectively in interdisciplinary teams to provide high-quality patient care.

Introducing simulation-based education to Genitourinary Medicine specialty training in the North West of England: A quality improvement project exploring trainee perspectives and impact.

Simulation-based education (SBE) provides enactive experiences for learners. This project explores the utility of SBE in GUM training. Phase 1 was a qualitative survey of GUM trainees across the UK exploring their views on SBE. Phase 2 involved roll-out of SBE to new GUM trainees. Feedback was subsequently obtained. Twenty-three participants were surveyed in phase 1. When asked to rate the relevance of SBE to curriculum competencies on a scale of 1 to 5 (1 = not relevant, 5 = highly relevant), the highest ratings (score ≥4) were for proctoscopy (4.1), IUD insertion (4.1), SDI removal (4.1), SDI insertion (4.0), and punch biopsy (4.0). All curriculum items scored ≥3. Eighty-three percent (n = 19) felt SBE will improve clinician confidence and competence. Following introduction of SBE, participants fed back on the relevance of the session. All 5 respondents rated the session ≥4 for addressing their clinical and curriculum goals. All respondents rated the session ≥4 for improving clinician confidence and competence. The session received an overall rating of 5, and respondents similarly rated 5 for more sessions. Trainees recognise the value of simulated learning experiences and its role in improving procedural competence and addressing bespoke human factor skills relevant to GUM.

Creation and Implementation of a Blood Smear Simulation Model.

Being able to prepare a diagnostic blood smear for evaluation is an essential skill for veterinary practitioners. While this basic technique can be demonstrated via videos or illustrations, it can only be learned through practice and with feedback. With the necessity for virtual learning experiences during the COVID-19 pandemic, a model was developed and paired with an online module to facilitate at home instruction and practice of blood smear preparation. Materials for the simulated blood included water, corn starch, and gel-based food coloring. Students were supplied a kit that, in addition to the simulated blood, included slides, Kimwipes®, microhematocrit tubes, a disposable pipette, a cleaning cloth, and disposable gloves. The module includes an introduction to making blood smears, an explanation of simulation kit contents, a demonstration video, and a reflection component. The simulation experience was developed for a short course with 12 students, and the required clinical pathology course, which has 100 students. Overall, the model is cost-effective, and students felt that the activity was useful to practice making blood smears and provided a good introduction and useful explanation of the overall technique in a virtual/ distance learning environment.

Focus on proficiency levels is necessary when virtual reality simulator software is updated–a randomized trial

BackgroundVirtual reality simulators are an integral part of modern surgical training and allow novice surgeons to acquire basic laparoscopic skills that are transferable to the operation room without compromising patient safety. The gold standard training method is proficiency-based training, where all trainees practice until a pre-defined proficiency level is reached. Simulator software versions are regularly updated to increase the quality of the simulator experience, but the impact of software updates used in conjunction with existing proficiency levels is unknown. MethodsTwenty surgical novices were randomized to simulator training on the LapSim® virtual reality simulator using either a 2019-version (new software group) or a 2016-version (old software group) of the simulator software. All participants practiced until reaching the proficiency level established for the old software. After 3-5 weeks, all participants returned and practiced to proficiency again using the old software. ResultsThe mean time to proficiency for the new software group was 183 minutes (SD: 43) versus 285 minutes (SD: 26) for the old software group (p<0.001). During the follow-up test, participants from the new software group spent 189 minutes (SD: 61) versus 91 minutes (SD: 50) (p=0.001) for the old software group to reach proficiency again. ConclusionUpdating simulator software without updating the proficiency levels creates the risk of changing the amount of training necessary to reach proficiency. Updates of simulator software for virtual reality simulators must lead to a critical re-evaluation of the previously established proficiency levels to ensure optimal outcomes of simulation-based training.

Effects of adaptive scaffolding on performance, cognitive load and engagement in game-based learning: a randomized controlled trial

BackgroundWhile game-based learning has demonstrated positive outcomes for some learners, its efficacy remains variable. Adaptive scaffolding may improve performance and self-regulation during training by optimizing cognitive load. Informed by cognitive load theory, this study investigates whether adaptive scaffolding based on interaction trace data influences learning performance, self-regulation, cognitive load, test performance, and engagement in a medical emergency game.MethodsSixty-two medical students from three Dutch universities played six game scenarios. They received either adaptive or nonadaptive scaffolding in a randomized double-blinded matched pairs yoked control design. During gameplay, we measured learning performance (accuracy, speed, systematicity), self-regulation (self-monitoring, help-seeking), and cognitive load. Test performance was assessed in a live scenario assessment at 2- and 6–12-week intervals. Engagement was measured after completing all game scenarios.ResultsSurprisingly, the results unveiled no discernible differences between the groups experiencing adaptive and nonadaptive scaffolding. This finding is attributed to the unexpected alignment between the nonadaptive scaffolding and the needs of the participants in 64.9% of the scenarios, resulting in coincidentally tailored scaffolding. Exploratory analyses suggest that, compared to nontailored scaffolding, tailored scaffolding improved speed, reduced self-regulation, and lowered cognitive load. No differences in test performance or engagement were found.DiscussionOur results suggest adaptive scaffolding may enhance learning by optimizing cognitive load. These findings underscore the potential of adaptive scaffolding within GBL environments, cultivating a more tailored and effective learning experience. To leverage this potential effectively, researchers, educators, and developers are recommended to collaborate from the outset of designing adaptive GBL or computer-based simulation experiences. This collaborative approach facilitates the establishment of reliable performance indicators and enables the design of suitable, preferably real-time, scaffolding interventions. Future research should confirm the effects of adaptive scaffolding on self-regulation and learning, taking care to avoid unintended tailored scaffolding in the research design.Trial registrationThis study was preregistered with the Center for Open Science prior to data collection. The registry may be found at https://osf.io/7ztws/.

Integrating Simulation in Pediatric Health Care: Collaboration of Primary and Acute Care Pediatric Nurse Practitioners Across Settings

Pediatric nurse practitioner (PNP) education continues to evolve. Clinical placement availability significantly impacts student’s exposure to complex pediatric patients. The intricacy of pediatric health care demands innovative educational approaches, especially in managing high-risk, low-frequency emergencies. Simulation-based education is a vital tool to bridge learning gaps and enhance core competencies, particularly in diagnosing and managing pediatric patients across diverse health care settings. Here we explore a collaborative formative simulation experience for primary care PNPs and acute care PNPs, focusing on a single patient transitioning through primary care, emergency, and acute care settings. Results demonstrate enhanced student satisfaction and self-confidence, underscoring the efficacy of such simulations in preparing future pediatric health care providers. Opportunities for improvement and future directions are discussed, highlighting the significance of interprofessional collaboration and continuous innovation in PNP education.

Development of Extemporaneous Compounding as an Initiating Factor in the Transformation of Pharmaceutical Education: International Experience and Current Trends

INTRODUCTION. Currently, stakeholders across the Russian medical and pharmaceutical community are focusing on the restoration of national pharmaceutical compounding. The Russian pharmaceutical compounding market, with its great potential for growth, requires highly qualified professionals able to ensure the operation of compounding pharmacies and the proper quality of extemporaneous medicinal products. The effectiveness of training for such specialists can be improved by analysing the experience of educational institutions in countries with developed pharmaceutical compounding systems.AIM. This study aimed to analyse the distinguishing features of training for pharmaceutical compounding specialists, as well as determine the main trends in pharmaceutical compounding education in leading international academic institutions.MATERIALS AND METHODS. The study used methods of logical, comparative, structural, and content analysis. The analysis covered 106 pharmacy and pharmacology curricula of the top-25 higher education providers from the QS World University Rankings by Quacquarelli Symonds. The curricula were analysed using open data published online, particularly, on the official websites of the selected universities.RESULTS. The article presents the distinguishing features of pharmaceutical compounding education at different academic qualification levels; these features include the requirements for applicants, time to degree, competence standards, structure of exams, and specifics of students’ professional engagement, with consideration of the national context. The key trends in the education of specialists in pharmaceutical compounding include a decrease in training time for mid-level specialists; a tendency towards concentrating on clinical disciplines due to the expansion of the roles of pharmacy professionals; a growing focus on specialisation in the areas of paediatric, dental, sterile, veterinary, radiopharmaceutical, and orphan drug compounding; increasing use of simulated practice experiences and online learning technologies; and the development of continuing professional education systems.CONCLUSIONS. Pharmaceutical education programmes of leading international educational organisations include disciplines related to extemporaneous compounding. Current international trends—pharmaceutical education with further specialisation in extemporaneous compounding, integration of simulation technologies and online learning into the educational process, and development of continuing professional education—coincide with the development directions of pharmaceutical education in the Russian Federation. Whereas international pharmacy specialists complete additional professional education programmes to gain an additional specialisation in the extemporaneous preparation of paediatric medicinal products, sterile dosage forms, chemotherapy products, radiopharmaceuticals, veterinary products, and dental products, Russian specialists can acquire these additional competencies through further education programmes at the levels of advanced training and residency.

Simulation-based education in the Pacific Islands: educational experience, access, and perspectives of healthcare workers.

The World Health Organization (WHO) recommends simulation-based education (SBE) to acquire skills and accelerate learning. Literature focusing on SBE in the Pacific Islands is limited. The aim of this study was to determine Pacific Island healthcare workers' experiences, perspectives, and access to SBE. This was a cross-sectional survey of Pacific Island healthcare workers. We designed an online questionnaire based on existing literature and expert consultation. The questionnaire included Likert scales, multiple-choice, multi-select and open-ended questions. Participants were healthcare workers recruited from professional networks across the region. Descriptive statistics and relative frequencies summarized data, and comparative testing included unpaired t-tests, Mann-Whitney U, Chi-squared and Fisher's exact tests. Free-text responses were presented to illustrate findings. Responses from 56 clinicians working in 11 Pacific Island countries were included. Fifty were medical doctors (89%), including 31 (55%) surgeons. Participants reported experience with scenario-based simulation (73%), mannequins (71%), and simulated patients (61%). Discrepancies were identified between previous simulation experience and current access for simulated patients (P = 0.002) and animal-based part-task trainers (P = 0.002). SBE was seen as beneficial for procedural skills, communication, decision-making and teamwork. Interest in further SBE was reported by most participants (96%). Barriers included equipment access (59%), clinical workload (45%) and COVID-19 restrictions (45%). Some Pacific Island healthcare workers have experience with SBE, but their ongoing access is predominantly limited to low-technology modalities. Despite challenges, there is interest in SBE initiatives. These findings may inform planning for SBE in the Pacific Islands and may be considered prior to programme implementation.

Analysis of the development model for the microteaching laboratory to effectively train qualified teachers

This study aims to develop an effective microteaching laboratory model in preparing superior prospective teachers. This study was conducted through a series of stages, including needs analysis, model design, implementation, evaluation, and refinement. Needs analysis was conducted to understand the needs and expectations of microteaching course lecturers and prospective teachers regarding the microteaching practice experience. The design of the microteaching laboratory model involved the development of infrastructure, curriculum, guidelines, and supporting implementation procedures. The implementation of the model was carried out by involving course lecturers and prospective teachers in a structured microteaching practice implementation session. Evaluation was conducted to evaluate the effectiveness of the model based on predetermined criteria. Refinement was carried out to improve and enhance the model based on evaluation findings and to prepare prospective teachers well through structured simulation, reflection, and feedback experiences. The implication of this study is the importance of developing a learning model that is in accordance with the needs of prospective teachers to produce superior graduates in the education profession. The results of the study indicate that the development of a microteaching laboratory can improve the teaching skills of prospective teachers through simulation, reflection, and feedback provided in an environment that supports learning. The implication of this study is the importance of developing learning facilities and infrastructure that are in accordance with the needs of prospective teachers in developing their teaching skills.

Stepping Up Psychosis: The Use of Virtual Reality in Pre-registration Mental Health Nursing Education

BackgroundThere has been growing interest in the development of mental health-related simulation packages for pre-registration mental health nursing education. The authors will present the creation of a simulation package created for pre-registration mental health nurses during their final year. MethodThe simulated experience consisted of a five-minute Virtual Reality (VR) recording which shares the experience of living with symptoms of psychoses. The package, not only looked at the hearing of voices, but in addition enhances the user's experience by simulating visual perception and placing the student within a secluded environment. This was delivered to students in their final six months of the program. ResultsStudents noted the increase in empathy for patients experiencing these symptoms and how it would enhance the care they gave. ConclusionThe results of this innovation demonstrate how virtual reality (VR) could be used to standardize student nurses' education in the field of mental health.

A Comparison of Telesimulation Using the Virtual Resus Room and In Situ Simulation in Pediatric Emergency Medicine.

During the COVID-19 pandemic, there was a marked shift toward telesimulation in medical education. Limited studies exist comparing the effectiveness of online and offline simulation education. The goals of this study are to evaluate active learners' perceived effectiveness of telesimulation versus in situ simulation and to identify potential shortcomings of existing online teaching platforms. Through participant evaluations after a simulation, we compared telesimulation using the Virtual Resus Room (VRR) to in situ simulation in the domains of (1) self-efficacy, (2) fidelity, (3) educational value, and (4) teaching quality. Study subjects included medical and pharmacy residents and medical students completing their pediatric emergency medicine rotation at two children's hospitals as well as nurses, nurse practitioners, and physician assistants who were recently hired and orienting to their new roles in the emergency department. Learners used a modified Michigan Standard Simulation Experience Scale to evaluate either a telesimulation or in situ simulation case. Survey responses were compared using Wilcoxon rank sum tests with Bonferroni correction for multiple comparisons. In overall assessment, in situ simulation was rated higher than telesimulation. There were significant differences noted related to perceived realism, utility in training device-related skills, and utility in training team-building skills. All P values were less than 0.0036. There were no significant differences between simulation types in perception of physical examination fidelity, instructor adequacy, or self-efficacy. Telesimulation using the VRR is comparable to in situ simulation in learners' perception of improvement in self-efficacy and of teaching quality for pediatric emergency medicine topics. However, participants felt less able to practice tactile and communication skills virtually. Further innovation is needed to improve learners' experience with fidelity and educational value.

Innovative Insights: Teaching Best Debriefing Practices Through Debriefing the Debrief.

Debriefing is essential in nursing education, aiding self-reflection and knowledge comprehension. Following the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice for Debriefing is key in promoting self-awareness and achieving learning objectives. Nurse educator students must practice designing, prebriefing, facilitating, and debriefing simulations to identify areas for improvement. A simulation experience was developed for graduate nurse educator students who participated in a postoperative scenario as nurses. Debriefing followed using the Promoting Excellence and Reflective Learning in Simulation (PEARLS) method. Students debriefed the debrief gaining insight from an educator's perspective. The experience was valuable, gaining insights into the application of simulation. Debriefing the debrief allowed for reflection and dialogue from the educators' perspective. Debriefing the debrief allows nurse educator students to effectively analyze simulation-based education. Utilizing the PEARLS method allows for active engagement and reflection, improving the simulation's debrief. Deliberate practice and reflective debriefing prepare nurse educator students for their roles, by enhancing simulation outcomes and nursing education. [J Nurs Educ. 2024;63(X):XXX-XXX.].