Simulation-based Education Research Articles

Postgraduate Training in Prosthodontics: Residents' and Supervisors' Perspectives on Current Training: A Cross-Sectional Study.

To identify postgraduate (PG) prosthodontic trainees' and supervisors' introspective views regarding prosthodontic education and clinical training. Cross-sectional survey. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, from May to October 2021. Data regarding the trainee induction process, teaching and learning practices, research interests, frequency of assessment, and trainees' satisfaction levels with the adequacy of didactic and clinical training in their centres were collected from Prosthodontic PG trainees and supervisors in Pakistan using REDCap software and analysed using SPSS 23.0. Frequencies of the observed responses from both populations were reported, and associations among private and public training centres were studied with Chi-square (or Fisher's exact). Differences in satisfaction levels across theoretical and clinical training domains were assessed with Mann- Whitney U test. Out of 17 supervisors and 104 PG trainees, 30% reported having a supervisory board in their institute. Most participants had entry tests conducted in their centres. The interference of influential sources during trainee induction was reported by 88.2% of the supervisors, while 66.7% trainees expressed the need for such influence to acquire training. Simulation-based teaching was available to 43.2% of trainees, 83% expressed interest in publishing research and 85% in publishing cases. Trainees were overall satisfied with their didactic and clinical training, whereas their satisfaction level was found neutral with theory and clinical training in maxillofacial-prosthodontics and clinical training of occlusion and temporomandibular disorders. The results emphasise the need for regulation and monitoring of the trainee induction process, quality of training, and frequent assessments in the prosthodontics postgraduate training programmes across Pakistan. Prosthodontics, Programme evaluation, Graduate dental education, Postgraduate dental education, Postgraduate medical education.

501 Multidisciplinary Simulation-Based Resident Education for High Acuity Low Occurrence (HALO) Obstetric Emergencies

501 Multidisciplinary Simulation-Based Resident Education for High Acuity Low Occurrence (HALO) Obstetric Emergencies

Midwifery students’ satisfaction with simulation-based education and associated factors among governmental universities in Amhara region, Ethiopia 2022

BackgroundSimulation is a method of learning in which the learner experiences a simulated situation instead of being physically present in the clinical area. Exposing students to simulation-based education improves learners’ clinical competence and ability to make decisions, which are crucial for today’s health workforce. When given the proper circumstances, such as receiving feedback on their performance, having the chance for repeated practice, and having simulation as a core component of the curriculum, simulated instruction greatly aids in learning. Although previous studies have been conducted in this area, there are gaps in determining the factors related to their learning environment and design characteristics.MethodAn institution-based cross-sectional study was conducted on 413 midwifery students in Amhara region universities from August 1–30, 2022. Study participants were selected via a simple random sampling technique. Data were collected from third and fourth-year undergraduate midwifery students through a self-administered questionnaire. Epi Data version 4.6 and Statistical Package for Social Sciences version 26 were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression analyses were employed; a P-value of less than 0.05 was considered statistically significant in the study.ResultThis study revealed that 84.7% (95% CI: 81.1–88.3) of midwifery students in Amhara region universities were satisfied with simulation-based education. Year of study [AOR: 2.936; 95% CI (1.531–5.631)], adequate support [AOR: 2.903; 95% CI (1.217–6.922)], availability of instructors [AOR = 2.861, 95% CI (1.078–7.591)], and provision of checklists [AOR: 2.326; 95% CI (1.143–4.734)] were found to be statistically significant variables.ConclusionThis study revealed undergraduate midwifery students were more satisfied with simulation-based education compared with previous studies conducted in Ethiopia. Predictor variables such as year of study, support, instructor availability, and provision of checklists were significantly associated with student satisfaction. Hence, midwifery departments should strengthen the support given by staff, encourage their instructors to be available during simulations, improve the utilization and provision of checklists to students as much as possible.

Assessment of an Airway Curriculum in a Pulmonary and Critical Care Fellowship Program.

Endotracheal intubations (EIs) in the intensive care unit are high-risk procedures often performed by pulmonary and critical care medicine (PCCM) providers. The Accreditation Council for Graduate Medical Education mandates PCCM fellows' competency in this procedure; however, the learning experiences vary across programs. After conducting a needs assessment, we developed a curriculum unique to our institution to supplement our fellows' existing EI experiences in the operating room and the intensive care unit. To assess the curriculum's short-term objectives: knowledge acquisition, maintenance, and practical skills 1 year after participation. We administered a survey to the graduating PCCM fellows for two consecutive years. We designed the comprehensive airway curriculum to include didactic lectures and simulation-based education. The knowledge acquisition and maintenance were measured by administering a 26-question knowledge survey before and after curriculum participation and after 1 year. The fellows also received a practical examination 1 year after participation. To compare knowledge survey scores, we used paired t tests and permutation tests. In the needs assessment, 56% of graduating fellows believed they were proficient in performing EI, whereas 33% were undecided and 11% believed they were unprepared. Most believed they would need more than two courses after graduation to be confident in independently performing EIs. Most will only occasionally have backup for EI from anesthesiology or emergency medicine in their future jobs. One identified barrier to learning EI was the lack of a formal curriculum. In the knowledge assessment, nine first-year fellows participated in the curriculum. The cohort's mean presurvey score was 13.0 (standard deviation [SD], 4.5) versus 18.6 (SD, 3.6) mean postsurvey score. One year after participation, the mean survey score was 17 (SD, 1.2). The postsurvey and 1-year postparticipation survey scores were significantly higher than the presurvey scores (P < 0.05). One year after participation, the practical examination showed most fellows retained skills in EI using ramped position, video and direct laryngoscopy, bag-mask ventilation, and oropharyngeal airway placement. The airway curriculum enhances fellows' knowledge acquisition and maintenance 1 year after participation. The practical examination 1 year after participation highlighted the skills retained and those still needing improvement.

A comparison of approaches to teaching clinical skills

Background: The most appropriate timing and mode for teaching clinical skills as preparation for medical students’ clinical rotations or clerkships is not widely agreed upon. Increasing pressure on placement opportunities has led to a shift towards simulation-based teaching in the early years of medical training. Approach: A major curriculum renewal provided an opportunity for comparison of the effectiveness of a largely ward-based (early patient exposure) curriculum with a largely simulation-based one in preparing students for clinical rotations. Evaluation: We surveyed students from two different programs and invited them to take part in voluntary objective structured clinical examinations (OSCEs) to compare their skills and self-reported preparedness. Qualitative data was also collected from focus groups with a small number of students. Implications: The findings suggest that the more structured, simulation-based curriculum is at least equivalent to the ward-based approach in teaching clinical skills and preparing students for clinical rotations. Students’ clinical reasoning skills could be enhanced in a simulation-based curriculum through more explicit training to prepare them for being asked questions on clinical placement.

Advancing Specialist Geriatric Medicine Training: A Successful Introduction to Simulation-Based Training

Abstract Background Simulation-based education (SBE) has been adopted by various specialties and is used to complement other aspects of education. Geriatric medicine is a diverse specialty, requiring healthcare professionals (HCPs) to navigate complex social, medical, and ethical issues, necessitating a multifaceted and interdisciplinary approach making SBE the ideal vehicle to train geriatric medicine trainees. SBE is currently not a formal component of geriatric medicine training in Ireland and trainees experience varying levels of exposure to SBE. To address this, WICOPSIM in collaboration with the Royal College of Physicians (RCPI) facilitated a study day for geriatric medicine trainees demonstrating the design and implementation of gerontological SBE. Methods A faculty consisting of RCPI Irish Clinician Educator Track (ICET) training fellow, WICOP simulation fellow and two Consultant Geriatricians coordinated the event. All geriatric medicine trainees were invited to a one-day SBE event hosted by WICOPSIM. Lectures on simulation theory and application preceded a simulation scenario demonstration focusing on the interdisciplinary management of a patient whose capacity was in question; followed by a SBE participant workshop. Results Fifty-two trainees attended the event. Forty-five trainees completed the post-event survey. 98% (n=44) were satisfied with the variety of topics presented and felt more prepared to design and run a scenario. The simulation demonstration, debrief and design workshop met 100% trainees’ expectations. All trainees indicated that SBE should be a routine element of geriatric medicine training. 69% (n=31) intend to run SBE within their own department in the future. Conclusion This event successfully introduced geriatric medicine trainees to the design principles and practices of gerontological SBE. SBE offers trainees the opportunity to practice the technical and non-technical skills required to navigate complex, interdisciplinary and challenging scenarios, in a protected environment. The positive feedback generated suggests SBE is a useful tool to enhance the specialist geriatric medicine training experience and warrants further exploration.

Experimental Design of Steel Surface Defect Detection Based on MSFE-YOLO—An Improved YOLOV5 Algorithm with Multi-Scale Feature Extraction

Integrating artificial intelligence (AI) technology into student training programs is strategically crucial for developing future professionals with both forward-thinking capabilities and practical skills. This paper uses steel surface defect detection as a case study to propose a simulation-based teaching method grounded in deep learning. The method encompasses the entire process from data preprocessing and model training to validation analysis and innovation optimization with the goal of deepening students’ understanding of AI technology and enhancing their ability to apply it to real-world scenarios. We have designed an experimental framework that incorporates the Efficient Multi-Scale Attention (EMA) mechanism into the Backbone network. This approach helps students understand the principles of feature extraction and the core functions of attention mechanisms. Additionally, we introduced a novel architecture—Convolution 3 Dilated Convolution X (C3DX)—into the Neck network. This architecture effectively expands the network’s receptive field, improves its ability to capture multi-scale information, and thus enhances defect detection accuracy. Furthermore, the implementation of the Efficient Intersection over Union (EIoU) loss function optimizes the bounding box predictions, further increasing the model’s accuracy and robustness. Overall, the teaching design not only ensures that the content remains at the cutting edge of technology but also emphasizes its practicality and operability. This approach enables students to effectively apply theoretical knowledge to real-world engineering projects.

A needs assessment for simulation-based training in emergency urological skills in Ethiopia.

Urologic emergencies are common and complications from their management are high. Simulation-based education (SBE) is a highly effective training method, allowing trainees to learn both technical and nontechnical skills in a safe environment. Training in the management of urological emergencies is limited in many healthcare settings, so we performed a needs assessment for a urological emergencies SBE course in Ethiopia. This study presents data from a descriptive cross-sectional, survey-based survey of consultants and residents in the Ethiopian surgical community. The survey was disseminated using online Google Forms, through social media (WhatsApp), and to colleagues in the College of Surgeons of East, Central and Southern Africa (COSECSA) via email and social media. One hundred-seven results were received; two were discarded due to incomplete data. Fifty three of the respondents were general surgeons and 38 of the respondents were urologists. Sixty nine respondents strongly agreed that simulation-based training was important for first-year surgical residents, whereas twenty-five respondents agreed and nine respondents strongly disagreed; one respondent disagreed and one was neutral. Eighty seven respondents suggested a 3-day training course, whereas 17 respondents suggested a two-day course. More than 80 of the respondents rated training in the management of acute urinary retention, acute scrotum, urethral, and suprapubic catheterization as extreme or very important and 79 respondents wanted education about urologic trauma and Fournier's gangrene. Surgical and urology residents in Ethiopia have expressed a need for, and a strong interest in, simulation-based urological emergency training.

A Simulation-Based Approach to Teach Interaction Effects in Postgraduate Biostatistics Courses

Simulation-based teaching can be a valuable method for learning statistical concepts. Its practical implementation for health-related subjects is seldomly evaluated. We propose a simulation-based approach to teach interaction effects in a postgraduate biostatistics course. We describe the steps involved in organizing and implementing a simulation-based activity and evaluate its execution. Mainly master and doctoral students in medical sciences (public health/epidemiology) participated to a 3-hr long online workshop on interaction effects. We presented one main learning activity, broken down into six progressive steps, from visualizing an interaction effect to investigating samples leading to erroneous inference. A total of 85 people attended of which 53 filled out an evaluation survey. Most (89%) of the respondents reported that the proposed activities helped them better understand interaction effects. A qualitative content analysis of free-text answers indicated that learning activities focusing on interaction effects in this way were useful for developing an understanding of both the meaning of statistical models and their interpretations. We conclude that a simulation-based approach can be a useful and interactive tool to create a valuable learning experience. The materials provided in this article can serve as a starting point for teachers who wish to implement such a method.

Developing Clinical Judgment During Transition to Practice With Rapid-Cycle Deliberate Practice Simulation.

New-to-practice nurses (NPNs) make more errors than their experienced peers, affecting patient safety and contributing to sentinel events. Additionally, new nurses have a high attrition rate in their first year of practice. Simulation-based education may bridge the gap between education and practice by supporting the development of clinical judgment of NPNs. With quality improvement methods, an intradisciplinary team implemented a quality improvement project to improve NPNs' clinical judgment skills. A multipatient simulation that used rapid-cycle deliberate practice gave NPNs an opportunity to refine clinical decision-making and communication skills. In total, 24 NPNs participated in the pilot simulation. Pre- and postsurvey scores using the simulation effectiveness tool-modified showed self-reported improvement in clinical judgment and communication skills, among other competencies. Rapid-cycle deliberate practice simulation may support the development of essential nursing competencies, along with increased confidence and enhanced psychological safety among NPNs. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

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

Closing the Trauma Performance Improvement Loop With In-situ Simulation

IntroductionContinuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues. MethodsThis study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented. ResultsTwenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02). ConclusionsHigh-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.

Unravelling the differences between observation and active participation in simulation-based education

Background In simulation-based education, the effectiveness of observation or active participation on the retention of knowledge and skills is uncertain. The aim of the study was to investigate knowledge retention, technical and non-technical skills and self-efficacy among observers and active participants in a simulated palliative extubation. Method We included medical and nursing undergraduates and residents. On the first day, participants were divided into observers and active participants, each with one participant from medical and nursing backgrounds. We presented a recorded lecture, followed by knowledge and self-efficacy tests for all participants before and after the simulation. After fourteen days, both groups actively participated in the scenario, without observers. We assessed technical and non-technical skills during the simulation and repeated the knowledge and self-efficacy tests after the training. Results Forty-four individuals participated in this study, half from each training programme. Knowledge improved after the first training in both groups, with a significant drop only for active participants after 14 days. Self-efficacy increased in both groups, being higher for the active participants. After 14 days, active participants performed better in technical skills compared to observers, but it was similar in both groups for non-technical skills. Conclusions Active participation seems superior to observation in the development of self-efficacy and the retention of technical skills. Observation may be superior to active participation in knowledge retention. Retention of non-technical skills appears to be similar with both observation and active participation. The findings have important implications for current simulation-based education, but further research is recommended.

Development of Clinical Simulation Programs and Their Importance in the Accreditation of Simulation Centers

Introduction: The development of Clinical Simulation requires well-structured programs tailored to the demands of university-level education in the Health Sciences, as well as appropriate management and accreditation by international evaluation entities. Accredited simulation centers are essential for health sciences education, allowing students to learn safely through the repetition of activities until they are correctly executed, thereby safeguarding patient safety. Objective: Describe the guidelines and importance of a Clinical Simulation Program as support for the activities carried out by the Health Area Simulation Center of the San Gregorio de Portoviejo University (USGP), Manabí, Ecuador, under the demands of the organizations of international accreditation.Methodology: Exploratory qualitative research, based on a review of bibliographic sources from the last 10 years regarding Simulation Programs and their importance in the accreditation of Clinical Simulation Centers.Results: A solid bibliographic foundation for the development of the Clinical Simulation Program at USGP.Conclusions: USGP is engaged in sustained efforts to develop its Simulation Center and to apply Simulation-Based Education methodologies.

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.

Changes in the Professional Identity and Self-Efficacy of Nursing Students Engaged in the Objective Structured Clinical Examination Using Simulation Learning.

The Objective Structured Clinical Examination (OSCE) is widely adopted in nursing education to enhance clinical skills and professionalism. With OSCE, the learning process is important, and students who underwent OSCE felt more confident and better prepared for their next clinical training. This study aims to clarify how the self-efficacy and professional identity of nursing students change after learning through simulation education and OSCE. Clarification of these issues will allow an OSCE design utilizing simulation-based education as will be discussed. This study used a pre-post study design, and the participants were 74 nursing university students at one university in Japan who agreed to participate in the study. The total scores and subscale scores for professional identity and self-efficacy were compared before and after the OSCE using the Wilcoxon signed-rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy. There were significant increases in self-efficacy scores (p<0.05) after OSCE, but there were no significant changes in the total scores of professional identities before and after the OSCE. Professional identity scores, such as choosing nursing again and desire to improve nursing skills, increased. Simulation-based OSCE effectively enhances nursing students' self-efficacy and certain aspects of professional identity, indicating its potential for nursing education.

The status of interprofessional education for healthcare students in South Korea: a scoping review focusing on simulation-based education.

Simulation-based education is gaining attention worldwide as it is recognized as effective in fostering collaborative skills in healthcare students. We conducted a comprehensive review of simulation-based interprofessional education (IPE) to examine the current state of simulation-based IPE. This scoping review systematically analyzed studies on simulation-based IPE in South Korean healthcare education, following established guidelines. Relevant articles were comprehensively searched, and key data on simulation methods, implementations, and educational effectiveness were extracted for analysis. The present study included nine quantitative studies and one mixed-methods study. The majority of participants were undergraduate nursing and medical students. The duration of IPE interventions ranged from 2 hours to 2 weeks. Education methods included standardized patients, high-fidelity simulators, and role-playing. Educational outcomes focused on measuring IPE competencies and satisfaction levels, concentrating on Kirkpatrick levels 1 and 2. While most studies reported high satisfaction levels, there is a need for objective evaluation of educational effectiveness. As simulation-based IPE in Korean healthcare education evolves, there is a need for greater inclusivity of diverse roles, multidisciplinary respect, and scenario development allowing active participation across professions. Establishing institutional frameworks, community linkages, and a deep understanding of IPE's purpose and essence among practitioners is crucial for its academic maturation.

Effect of simulation based workshop on changing faculty perception for simulation-based education.

To compare the perceptions of participants before and after a one-day workshop on Simulation-based Education. The other objective was to determine the feedback of participants about the one day workshop on Simulation-based Education. In March 2023, a one-day workshop on Simulation-Based-Education (SBE) was conducted by the Department of Medical Education of Fazaia Ruth Pfau Medical Education in collaboration with the foreign guest faculty through zoom. This workshop was conducted with the participants (faculty members) of the Certificate program. The study adopted quasi experimental (pretest posttest) research design. For data collection we used a validated questionnaire which compromises of three parts. Data was analyzed using SPSS 23. This is a semi-structured questionnaire which consists of four parts. The first part entails the demographic data of the participants. The second structured part collects the perception of participants through 26 statements on 5 points Likert scale (strongly disagree = 1, disagree = 2, agree to some extent = 3, agree = 4, strongly agree = 5). The mean difference in participant perceptions was significant (P<0.05)on 13 statements: Improves communication skills (pretest 3.05±1.050, posttest 4.20±1.056; p=0.004), enhance teamwork (pretest 3.30±0.979, posttest 4.30±0.923; p=0.004), overcomes the challenge of uncooperative patients during real practice (pretest 3.80±0.696, posttest 4.30±0.470; p= 0.008), enact live patients (pretest 2.70±0.923, posttest 3.65±1.040; p=0.004), incopororation into medical education (pretest 3.20±0.894, posttest 4.40±0.503; p=0.000), provide safe, reliastic and conducive learning environment (pretest 2.85±0.875, postest4.00±0.795; p=0.000), provide easy learning (pretest 2.75±0.716, posttest 4.05±0.605 p=0.000), decrease ethical issues with more repeated practice (pretest 2.75±0.716, posttest 3.90±0.788; p=0.000), reduces the effort put in by a faculty in clinical teaching (pretest 2.80±0.696, posttest 3.45±0.999; p=0.039), supplement to clinical practice (pretest 2.75±0.444, posttest 4.55±0.510; p=0.000), evidence required for simulation activities (pretest 2.95±0.605, posttest 4.10±0.641; p=0.000), able to add simulation in clinical subject (pretest 3.15±1.089, posttest 3.80±0.834; p= 0.055), can instruct complex skills without simulation (pretest 2.55±0.887, posttest 3.40±0.883; p=0.018). The study signifiacnaty changed the faculty members' perceptions of simulation-based education.These encouraging findings may influence their future practice in simulation-based education, allowing them to provide safe, high-quality health care in the workplace and, eventually, enhance patient outcomes.

Maximizing Learning in Caring for Older Patients Through a Multi-Specialty Simulation Approach

Background: Simulation-based learning has been utilized in medical education and studied to enhance its educational impact since the 1960s (Hallinger, &amp; Wang, 2020). However, there is a lack of multispecialty simulations in the literature (Fisher, &amp; Walker, 2014; Age UK. 2023; NHS England, 2021; Romero-Ortuno, Stuck, &amp; Masud, 2022; Keijsers, et al., 2016). We developed and delivered simulations on Orthopaedics and Geriatric topics. Simulation mannequins, role players, imaging, and simulated clinical documentation were incorporated into scenarios. We evaluated the effectiveness of this approach on students’ knowledge and confidence when caring for older patients. Methods: Fourth-year medical students at the University of Nottingham received simulation-based teaching during their Geriatrics placement at Queens Medical Centre. Their knowledge and confidence levels were assessed before and after the simulations. We utilized six knowledge-based and six confidence-level questions mapped to their learning outcomes for hip fractures, pressure ulcers, and discharge planning stations. In addition, we asked students to provide scenario-specific feedback and their thoughts on whether the simulation workshop was pitched at the right level. Results: Students’ knowledge and confidence levels improved significantly following the simulation workshop. About 75% of the students displayed enhanced results in the knowledge-based category. In terms of their confidence level, there was improvement seen across all simulation stations, with most learners feeling four times more confident when comparing proportions pre and post-simulation. Furthermore, 99% of the students thought the simulations had positively impacted their learning. Conclusion: Our findings demonstrate the effectiveness of the multispecialty simulation approach in undergraduate geriatrics teaching. Given significant improvements in students’ knowledge, confidence levels, and positive feedback, we aim to continue delivering this multispecialty simulation-based teaching to our students. To measure the long-term efficacy of this approach, we can perhaps re-evaluate students learning after a month to assess the efficacy of this simulation workshop.

Simulation Training to Increase Holding of Fragile Infants in Cardiac Intensive Care Units.

Promoting bonding and neurodevelopmental care is an important element in the cardiovascular intensive care unit (CICU); however, holding of infants by family members is inconsistently practiced. This quality improvement study aimed to safely increase the holding of medically complex infants in the CICU by developing a holding guideline and offering simulation-based staff education. Using consensus methodology and high-fidelity simulation, an expert work group created a holding guideline and training to increase staff confidence and competence in holding critically ill infants in the CICU. The effectiveness of the intervention was tested via a postintervention survey used to assess participants' confidence in and comfort with holding critically ill infants and elicit suggestions for further support. Participants who engaged with the mannequin were surveyed to assess the validity of the simulation trainer. After the intervention, participants (N = 130) reported increased confidence with infant holding (76%) and greater confidence in preparing families to hold their infants. Participants (95%) strongly agreed that the simulation enabled realistic, safe practice in holding a medically complex infant with catheters and tubes. More years of experience and engagement with the simulation trainer were associated with increased posttraining confidence. Participants cited increased resources, practice, and adherence monitoring as key supports for infant holding. Expert group consensus with high-fidelity simulation training is a feasible, safe, and reliable method for teaching higher risk skills and guiding protocol development.