Simulated Learning Environment Research Articles

Capturing Debriefing and Enhancing Reflection within Simulated Clinical Learning Environments

This article presents findings from an evaluation of a new A3-size learner notes sheet designed for use by healthcare students engaging in clinical simulation and clinical skills sessions. The notes sheet consists of an adapted form of the SBAR (situation, background, assessment, response) tool, whilst capturing post-simulation oral debriefing provided by a facilitator. Additionally, the Driscoll (2007)model is used to provide students with an opportunity to reflect on their engagement in clinical simulation. Two cohorts of students, who engaged in separate simulation sessions, completed the A3 sheet. The study featured 33 midwifery and 21 operating department practitioner (ODP) students undertaking a simulation. Documentary analysis was undertaken to identify the depth of reflective writing of both groups of students. Midwifery student participants reflected on their experiences of simulation at a slightly deeper level than their ODP counterparts. All students adhered to the structure of the notes sheet when receiving their briefing from the facilitator and when asked to write their reflective accounts. This study has sought to explore an under-researched area of clinical simulation: the extent to which healthcare students can utilise reflection when engaging with a clinical scenario within a simulated learning environment.

Direct Measurement of Veterinary Student Learning Outcomes for the NAVMEC Professional Competencies in a Multi-User Virtual Learning Environment.

Education in veterinary medicine, as in other allied health care-health science professions and academia in general, has been subject to the public call for accountability for the quality of its student learning outcomes. A principal stakeholder in veterinary medicine is the American Veterinary Medical Association-Council on Education (AVMA-COE). AVMA-COE has adopted program accreditation standards requiring veterinary colleges to provide evidence that they are measuring and assessing the clinical competency of students before graduation and again shortly after graduation. Schools and colleges are required to develop relevant measures to validate scientific knowledge, skills, and values aligned with North American Veterinary Medical Education Consortium (NAVMEC) core competencies. Beginning in May 2012, the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University modified the professional veterinary medical curriculum by including a required clinical rotation centered on veterinary emergency preparedness and response. A distinguishing major component of the instructional design of the clinical rotation includes Second Life, a commercially obtained computer-generated multi-user virtual simulation learning environment. The virtual reality situations require high-volume, mass-casualty medical triage decision making. The interpersonal communications and interactivity among students, faculty, and third-party actors enable faculty and instructor observers and simulation facilitators to evaluate students actively engaged in critical thinking and complex problem solving while demonstrating skill in the NAVMEC professional competencies. The Second Life virtual simulation has been adopted as a primary tool for direct measurement of student learning objectives outcomes achieved in this clinical rotation and is being implemented in other clinical teaching platforms.

Establishing psychological safety in simulation: Faculty perceptions

BackgroundA psychologically safe learning environment is defined as one where individuals feel comfortable to take interpersonal risks without fear of negative consequences. Despite knowledge of best practice for simulation, there is a lack of knowledge regarding how nursing faculty perceive and establish psychological safety in a simulated learning environment. ObjectivesThe purpose of this study was to explore nursing faculty's perceptions of psychological safety as it exists within a simulation learning environment for pre-licensure nursing students. DesignMixed methods with online survey data collection. Settings/participantsPurposive sampling was used to recruit simulation nursing faculty who had previously participated in the National League for Nursing Leadership Development Program. Faculty were recruited from the United States and Canada. MethodsData were collected using a series of open-ended questions through the online survey tool, SurveyGizmo. Content analysis was utilized to discover how faculty established psychological safety during the pre-brief, scenario, and debriefing phases of simulation. Three researchers independently, then collaboratively, reviewed the data, identifying themes and patterns across each phase. ResultsThirty-seven nursing faculty participated in the study. Across the phases of pre-brief, scenario, and debriefing, five themes emerged: (1) Setting the Stage; (2) It's ok, It's Simulation; (3) Everyone is Here to Learn; (4) Planned Strategies; and (5) Facilitator as Observer. ConclusionsFaculty perceive that they play a role in establishing a psychologically safe learning environment during all three phases of a simulation experience. Scenarios are purposefully designed to emotionally protect students while they participate in unfamiliar encounters. Strategies are implemented throughout all three phases to facilitate student risk-taking as part of the learning process. Faculty watch for verbal and non-verbal cues by students signaling a potentially psychologically unsafe learning environment, and intervene to protect them if necessary.

The Use of Biometrics and Rubric Analysis to Assess How Students View, Cognitively Process, and Respond to 3D Physical Molecular Models in Undergraduate Biochemistry

Among the STEM disciplines biochemistry curricula present a particular challenge to students with abstract concepts that can lead to rampant and resistant misconceptions impeding learning and therefore impact retention. Moreover, research has shown two‐dimensional representations not only fail to effectively convey biochemical concepts, but also propagate misconceptions. In particular, research has shown students have significant difficulty understanding enzyme‐substrate relationships. One way instructors have suggested to support students while learning this content is through the use of 3D physical models of the enzyme and substrate. However, little research has been conducted on how the models impact the learning process and how to best design these models and corresponding activities. This presentation will describe an iterative design process based on biometric, observational and rubric data analysis. The biometric data is collected using electroencephalographic (EEG) and eye tracking tools and voice recordings from simulated learning environments where biochemistry students completed a serine protease activity with corresponding physical models. These results offer insights into how students view and cognitively process activities using physical models with respect to how the instructor intends students to learn with and use these tools. In addition, observational and rubric analyses of student responses to activities from the simulated learning environment and real classroom sessions provide further data for the iterative activity design process.Support or Funding InformationThis project is supported by the National Science Foundation under award number IUSE 1711402/1711425 to University of Minnesota, Rochester and Kennesaw State University.

Research on Application of Digital Art and Virtual Reality in Animal Medical Education

With the development of social science and technology, digital technology has been widely used in all walks of life. Especially in the field of medical education, the rational application of digital technology will create a simulated learning environment for students, which has a key impact on the improvement of medical education. This article is an analysis of the application of art and virtual reality in animal medical education. I hope that this analysis can play a certain role in improving the effect of today's animal medical education, and provide a certain reference value for the reasonable application of digital technology and virtual reality technology in today's animal medical education.

Stroke characterisation and description of identified risk factors in a Fabry disease large cohort

To prepare student nurses for clinical practice where patient electronic medical records (EMR) competence is required, nursing undergraduate curricula must provide simulation access to developing this skill set. At this stage, however, the integration of electronic documentation into the Australian undergraduate nursing curriculum has been piecemeal.AimThe aim of this integrated literature review was to identify benefits and challenges for faculty nursing staff and nursing students in relation to the integration, use and evaluation of EMR in an undergraduate nursing program.A systematic search of relevant peer-reviewed research and project report articles was conducted in the electronic databases. Generic qualitative thematic analysis was then undertaken with themes generated from the data itself.Fifty eight articles were identified, of these 23 were found to meet the inclusion criteria. Three major themes were identified: 1) Advantages of using EMR in academic settings, 2) Identified Challenges and Limitations of EMR programs; and 3) Developing an academic EMR program and implementing EMR education program in stages. All papers acknowledged that EMR will be standard in healthcare and should be viewed as an ‘essential tool’ for inclusion in undergraduate nursing programs.There is a significant increase of electronic technology in healthcare settings, especially relating to patient documentation. Therefore, teaching the use of EMR in the simulated clinical learning environment for new healthcare providers such as nursing students is essential. The papers reviewed identified an urgent need for higher education nursing programs to support undergraduate nursing students and faculty staff to ensure EMR can be implemented effectively into the undergraduate nursing curriculum.

"A privilege but also a challenge." Nurse educators' perceptions about teaching fundamental care in a simulated learning environment: A qualitative study.

To explore nurse educators' perceptions about teaching fundamental care to undergraduate nursing students in a simulated learning environment. Recent research has demonstrated that fundamental care is overlooked in nursing education, resulting in little empirical research on how to teach fundamental care within a simulated learning environment. The study has a qualitative, explorative design. The principles of consolidated criteria for reporting qualitative research (COREQ) were applied for reporting the methods and findings. Data were collected through participant observations and focus group interviews with nursing students, clinical nurses and nurse educators. The data were analysed using the qualitative content analysis method. The core category "A privilege but also a challenge" represents the overall perception of nurse educators' perceptions about teaching fundamental care in a simulated learning environment. The core category is supported by two subcategories: "Fundamental care is important to nursing education" and "To set a good example," which represent the attributes and the role nurse educators have in helping students achieve their fundamental care learning outcomes. Fundamental care can be taught to students by engaging them in an interplay between lectures and learning activities that are designed to enhance their skills during simulations in simulated learning environments. Nursing education should prepare students to develop the skills they will be applying when providing fundamental care in real life; thus, the students should learn how to deliver high-quality fundamental care.

Effectiveness of Construction Safety Hazards Identification in Virtual Reality Learning Environment

Occupational Safety and Health Act (1994) and efforts taken to ensure the safety of workers in the construction industry. Despite these, accident rates are still alarming. One of the reasons is due to the weak pedagogy, lack of technology integration, and hazardous learning environment that lead towards low learning performance and practicing safety procedures. This study aims to discover the effectiveness of virtual reality simulation learning environment. Results show that there is a significant difference in trainee's achievements in a traditional construction site visit and virtual construction environment. To conclude, virtual reality learning environment offers effective learning platforms for millennials.Keywords: safety hazards; occupational safety and health; virtual reality;eISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA CE-Bs by E-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1802

Automatic control of cardiac ablation catheter with deep reinforcement learning method

To reduce the radiation exposure of personnel during an interventional procedure for arrhythmia, a robot has been developed and implemented herein for use in interventional procedures. Studies on the control of an electrophysiology catheter by robots are being conducted. However, controlling a catheter using a robot has limited precision owing to external forces subjected on the catheter due to blood flow and pulse inside a heart. This study implements a reinforcement learning method for automated control of a catheter by a robot. Using the reinforcement learning method, this study aims to show that such a robot can learn to manipulate a catheter to reach a target in a simulated environment and subsequently control a catheter in an actual environment. Randomization noise is used during the simulation to reduce the differences between the simulation and actual learning environments. Each environment is implemented with different movement values depending on insertion angles and steps of the catheter model. When the results from the simulated learning model are implemented in the actual environment, the success rate of catheter reaching the designated target is 73 %. In addition, the noise-implemented model shows that the success rate can be increased up to 87 %. Through these experiments, the study verifies that a simulated learning model can be implemented in a robot system to control an actual catheter as well as that the success rate of the model can be increased using randomization noise.

Application and Research of VR Technology in Art Design Teaching

In recent years, with the rapid development of science and technology, VR virtual reality technology is now applied in various fields, and this technology is gradually applied to art design teaching. VR virtual technology can construct a simulation learning environment, which enables students to have a comprehensive and systematic understanding of various courses of art design specialty, and cultivate students’ creativity and imagination. By analyzing the advantages of VR technology in teaching, this paper puts forward the teaching method of integrating VR virtual reality technology into classroom teaching, and explores the feasibility of applying SLOODLE platform to art design teaching, so that the platform can be widely used in art design teaching.

Student perceptions of two simulated learning environments in paediatric audiology

Objective: To determine audiology student perceptions of two simulated learning environments (SLE) in paediatric audiology.Design: A one-shot case study design.Study sample: Fifteen audiology students who completed questionnaires after participating in two SLEs, one simulating auditory brainstem response (ABR) assessments of neonates in a hospital ward and one simulating visually reinforced orientation audiometry (VROA) assessments of young children in an audiology clinic.Results: The students responded positively to 11/11 areas of audiometric testing and client interaction in both SLEs, to 7/7 aspects of their interactions with the mannequins in both SLEs, and to 8/8 aspects of their interactions with fellow students playing the role of parent in the ABR SLE and 7/8 of these aspects in the VROA SLE. The students reported low levels of anxiety towards both SLEs but rated the ABR SLE more highly than the VROA SLE in areas of preparedness, effectiveness, realism, pre-SLE training, reinforcement of lecture content, and overall usefulness.Conclusions: The participating students responded positively to almost all aspects of both SLEs. Further research is warranted using research designs capable of determining if these SLEs directly improve student abilities as they transition from academic settings to clinical placements in paediatric audiology.

The development of simulated learning environments involving coroner’s court attendance in mental health nursing education

Simulated learning environments (SLEs) provide students with the opportunity to experience complex practice elements with minimal professional risks. This article explores the development of an SLE in undergraduate mental health nursing education. The SLE focuses on events surrounding a client death and follows attendance at a coroner’s court. Student learning outcomes are focused on evaluating essential components of nursing care including communication, record-keeping, risk-taking and ethical decision-making. The SLE, which is now in its fourth iteration, allows educators to review and adapt the teaching practices to achieve the curriculum learning outcomes and encapsulate the Nursing and Midwifery Council’s Code. This article proposes future possibilities for the use of complex simulation dramas to enhance nursing student preparedness for registration.

Teaching and learning FNA biopsy: An update for the modern audience

Teaching and learning FNA biopsy: An update for the modern audience

Design Assessment in Virtual and Mixed Reality Environments: Comparison of Novices and Experts

The construction industry is facing a severe shortage of skilled workforce. Higher education is challenged to develop innovative strategies to help college students develop career-specific competency and accelerate the transition from novice to expert. Technology innovations such as virtual reality (VR) and mixed reality (MR) have been successfully integrated into learning and training programs to create authentic learning experiences within simulated virtual learning environments to facilitate tacit knowledge acquisition and workplace expertise development, which traditionally takes years of empirical experience and apprenticeship training. This study aims to explore potential VR and MR interventions in construction education and workforce development. It is directed at enhancing understanding of key differences between novices and experts and how VR and MR may facilitate tacit knowledge acquisition and expertise development to address the current skills gap in the construction industry. A simulation of accessibility design review and assessment for a tiny house was conducted via VR and MR mock-ups with the participation of both student novices and professional experts to collect behavioral and perceptual data using instruments that included a think-aloud protocol, a pair of pre- and postsurvey questionnaires, and audio/video recordings. Comparative analyses were conducted, and the results indicated that student novices, despite their lack of expertise, demonstrated comparable patterns of behaviors and achieved design review outcomes similar to those of professional experts with the VR and MR mock-ups. The findings of this study contribute to the body of knowledge by providing preliminary evidence of learning affordances of VR and MR in bridging experience-related gaps and suggesting opportunities for accelerating workplace expertise development among college students via technology intervention. These findings also have the potential to inform instructional design and pedagogical approaches that integrate VR and MR technology in undergraduate construction and engineering curricula.

Translation students’ conceptions of translation workflow in a simulated translation company environment

ABSTRACT Translation graduates need organisational skills to be able to cooperate in translation service production workflows. This paper explores the development of translation students’ workflow conceptions in a simulated translation company learning environment. Using the standard ISO 17100 as a frame of reference for a content analysis of student essays, two research questions are answered: 1) How does working in a simulated translation company learning environment affect translation students’ workflow conceptions? 2) What kind of workflow conception profiles emerge in a simulated translation company learning environment? A quantitative comparison of essays written before and after a one-year-long translation company simulation course showed a progression from rudimentary conceptions with few workflow task mentions towards more detailed conceptions that are closer to the translation industry model. Further quantitative analysis of the changes in individual task mention values revealed clusters of workflow tasks associated with the duties of two different task roles, the translation specialist and the project manager. The results showed a tendency for some students to stay with the conception associated with the translation specialist role and for some students to develop a workflow conception associated with the project manager role.

Self-Confidence of Nursing Students Related to their Simulation Learning Experience

Simulated learning environments are integral to the clinical training process in many nursing programmes. Active involvement through simulation may promote critical thinking skills and increase self-confidence levels. High-fidelity and low-fidelity simulation may impact students’ self-confidence differently due to the differences in their ability to project a real-life scenario. The purpose of this study was to compare the effect of high-fidelity and low-fidelity simulation on self-confidence among student nurses. The study was an analytic cross-sectional in design and took place in a public women’s university in the Kingdom of Saudi Arabia, Princess Nourah University. The College of Nursing has access to both low and high fidelity simulation Center. A total of 85 participants were included in the sample and used questionnaires to compare the effect of high-fidelity and low-fidelity simulation on self-confidence among student nurses. The data analysis methods used were frequency percentages, arithmetic mean, Standard Deviation and Pearson correlation. About 74.1% of the respondents were between 19-21 years of age, and 70.4% had a GP of 3.55-4. In addition, 95.1% had not practiced in a hospital before. Students were “hesitant” about their self-confidence after a low-fidelity simulation and “confident” after a high-fidelity simulation. The high-fidelity simulation technique had statistically significant effects on self-confidence compared to low-fidelity simulation. Nursing students who are put through the high fidelity simulation exhibit high degrees of self-confidence relative to their counterparts who are subjected to the low fidelity simulation training. Similar to the existing literature, the findings from the current research backed up this position. Keywords: High-fidelity simulation training, Low-fidelity simulation training, Nursing Students, Patient simulation, Self-confidence. DOI : 10.7176/JEP/10-15-20 Publication date :May 31 st 2019

Use of the Pope Engagement Index to Measure the Cognitive Load of Biochemistry Students while Completing a 3D Physical Serine Protease Modeling Activity

Research has shown students have significant difficulty understanding enzyme‐substrate relationships. One way instructors have suggested to support students while learning this content is through the use of 3D physical models of the enzyme and substrate. However, little research has been conducted on how the models impact the learning process and the cognitive load of the students. This study aims to measure the cognitive load of biochemistry students while completing a modeling activity focused on understanding the relationship between the substrates and active site of serine proteases. During a simulated learning environment, biochemistry students completed an activity related to how enzymes and substrates interact based on electronics, stereochemistry and geometric complementary using the serine protease physical models. During the activity electroencephalography was used to capture student cognitive processing in order to assign cognitive load of the tasks in the activity using the Pope Engagement Index. This presentation will specifically focus on how spatial ability of the student impacted the level of engagement and in what region of the brain was engaged when completing various tasks. Additional discussion will focus on how changes to the models impacted the cognitive load of the participants when completing the activity. Suggestions will be provided for faculty to think about when developing modeling activities to decrease extraneous cognitive load for students.Support or Funding InformationThis project is supported by the National Science Foundation under award number IUSE 1711402/1711425 to University of Minnesota, Rochester and Kennesaw State University.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Nursing students' perceptions towards being taught the fundamentals of care by clinical nurses within a simulated learning environment: A qualitative study.

Research in nursing education demonstrates that the fundamentals of care are paid less attention in this field resulting in negative consequences for students' learning outcomes. The aim of this qualitative study was to explore nursing students' perceptions towards being taught the fundamentals of care by clinical nurses within a simulated learning environment. The study has a qualitative explorative design. Data was collected through participant observation and focus group interviews and analysed using qualitative content analysis. The analysis revealed two main categories indicating how the students gained knowledge in the research setting: 'Getting the best of both worlds', and 'Having it in many ways'. The findings are discussed against Vygotsky's theory of cognitive development suggesting that the students were content with being taught the fundamentals of care by clinical nurses within an simulated learning environment.

Increasing the use of simulation in training

The focus of this paper is to explore the role and development of simulated learning within the apprenticeship assistant practitioner foundation degree programme. It will also discuss the challenge of influencing a change in practice within a competency-based learning programme. In order to shape and develop a supportive, effective and indeed inclusive teaching strategy, the use of the simulated learning environment will be incorporated across a number of mandatory non-clinical modules, such as communication, group dynamics and principles of care, among others. The key aims and philosophy behind simulated teaching and learning are to improve competence, communication and confidence and ultimately patient safety within all healthcare environments ( Forrest et al, 2013 ). The aim of this article is: To provide a wider understanding of the simulated learning environment To give an overview of how simulated learning can be incorporated into non-clinical teaching modules To demonstrate how the concept of simulation can widen participation and allow students to experience and flourish in a non-traditional environment.

South African university students’ attitudes towards chemistry learning in a virtually simulated learning environment

This mixed method study investigated changes in 3rd year Bachelor of Education students’ attitudes towards chemistry after learning interventions with virtual chemistry simulations. After participant students identified certain concepts from their 3rd year chemistry module as being abstract and not easily comprehensible, these concepts were facilitated during a 5 week learning intervention using PhET simulations as an alternative to traditional laboratory experimentation. In the first quantitative phase of the study, a 30-item pre-attitude test was administered to assess students’ attitudes towards chemistry, followed by PhET chemistry simulation learning interventions. Thereafter, students wrote a post-attitude test. Findings of this phase revealed a significantly higher mean post-attitude test score, with students showing a positive attitude towards chemistry learning, post-intervention. The quantitative phase was followed by a qualitative phase which examined students’ experiences on the use of simulations through semi-structured interviews. Findings from the qualitative phase revealed that students experienced autonomy and enjoyment during engagement with the simulations. They also perceived that their experiences in the virtually simulated environment improved their visualisation of chemistry concepts, thereby improving conceptual understanding. However, the students acknowledged that simulations cannot replicate the realism and authenticity associated with practical work in an actual laboratory. The implications of these findings are that virtual simulations provide a complementary learning tool capable of improving students’ attitudes towards chemistry, and perceived by students to support their visualisation of abstract chemistry concepts. The findings of this study are particularly significant for chemistry learning at schools and universities in economically challenged countries such as South Africa where there is a shortage of well-equipped laboratories.