Simulation-based Training Research Articles

A Statewide Mobile Simulation Program For Improving Obstetric Skills in Rural Hospitals.

Closure of rural obstetric (OB) units has led to maternal care deserts, causing mothers to travel long distances for maternity care. Emergency departments (EDs) in hospitals where OB units have closed require regular training for personnel to maintain OB skills, as do rural Level-1 OB units with low volumes of maternity cases. We used a federal grant to develop an OB mobile simulation program to bring simulation-based training to rural providers. Our goal was to improve OB skills and standardize care through the framework of the Alliance for Innovation in Maternal Health (AIM) Patient Safety Bundles. We conducted needs assessments and built a mobile simulation unit. We defined 2 groups of learners: those in Level-1 OB units and those in EDs without OB units. For Level-1 OB units, we created a train-the-trainer curriculum, to create a statewide cohort of simulation experts to implement simulations in their facilities between our visits. We gifted each Level-1 unit an OB task trainer, implemented virtual train-the-trainer simulation and task trainer workshops, and conducted post-workshop assessments. We then traveled to each Level-1 unit and helped the cohort implement in situ simulations for their staff using facility-specific resources. We conducted assessments for the cohort and the hospital staff after the simulations. For EDs, we delivered virtual didactics to improve basic OB knowledge, then traveled to ED units, implemented in situ simulations, and conducted post-simulation assessments. We chose a postpartum hemorrhage (PPH) scenario for our first round of simulations. After train-the-trainer simulation workshops, 98% of participants surveyed agreed that workshop goals and objectives were achieved. After the task trainer workshop, 95% surveyed agreed that their knowledge of using the simulator had improved. After implementing in situ simulations in Level-1 OB units, 98.8% of the train-the-trainer cohort found that their ability to implement simulations had improved. The hospital staff participating in the simulations identified a 30% increase in ability to manage PPH. For the ED staff, postdidactic evaluations identified that 95.4% of participants reported moderate improvement in basic OB knowledge and after participation in the simulations >95% reported better skills as an ED team member when caring for pregnant patients. These results demonstrate improved skills of hospital staff in simulated PPH in Level-1 OB units and simulated OB emergencies in EDs that no longer have OB units. Further studies are warranted to assess improvement in maternal outcomes.

Acquisition of key clinical communication skills through simulation-based education: findings from a program for postgraduate psychiatry trainees (ComPsych)

ObjectiveFew studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice).MethodsForty trainee psychiatrists (15 males; age range 26–48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time.ResultsFor SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training.ConclusionsTraining improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

The ASPiH Standards – 2023: guiding simulation-based practice in health and care

The ASPiH Standards 2023 provide a common framework within educational and healthcare sectors, bolstering quality assurance for simulation providers, regulators, professional bodies and commissioners. They endeavour to meet the current needs of simulation practitioners and learners, reflect the evolution of simulation practice, and account for emerging technologies. Therefore, they are applicable to any modality of simulation-based education and training as well as to translational and transformative simulation interventions, including the use of simulation for quality improvement processes, whether carried out at education centres, simulation facilities or at the point of care. The standards encourage adherence to core values of safety, equity, diversity and inclusion, sustainability, and excellence. They provide guidance for all simulation practitioners, highlighting key principles for planning, facilitation and evaluation of simulation activities, as well as recommendations for optimum resource management. Implementation of these standards will require consideration of how they apply to each individual context, and what outcome measures are most meaningful to demonstrate alignment.

Simulation training on respectful emergency obstetric and neonatal care in north-western Madagascar: a mixed-methods evaluation of an innovative training program

BackgroundThe rates of maternal and neonatal deaths in Madagascar are among the highest in the world. In response to a request for additional training from obstetrical care providers at the Ambanja district hospital in north-eastern Madagascar, a partnership of institutions in Switzerland and Madagascar conducted innovative training on respectful emergency obstetric and newborn care using e-learning and simulation methodologies. The training focused on six topics: pre-eclampsia, physiological childbirth, obstetric maneuvers, postpartum hemorrhage, maternal sepsis, and newborn resuscitation. Cross-cutting themes were interprofessional communication and respectful patient care. Ten experienced trainers participated in an e-training-of-trainers course conducted by the Swiss partners. The newly-trained trainers and Swiss partners then jointly conducted the hybrid remote/in-person training for 11 obstetrical care providers in Ambanja.MethodsA mixed methods evaluation was conducted of the impact of the training on participants’ knowledge and practices. Trainees’ knowledge was tested before, immediately after, and 6 months after the training. Focus group discussions were conducted to elicit participants’ opinions about the training, including the content and pedagogical methods.ResultsTrainees’ knowledge of the six topics was higher at 6 months (with an average of 71% correct answers) compared to before the training (62%), although it was even higher (83%) immediately after the training. During the focus group discussions, participants highlighted their positive impressions of the training, including its impact on their sense of professional effectiveness. They reported that their interprofessional relationships and focus on respectful care had improved. Simulation, which was a new methodology for the participants native to Madagascar, was appreciated for its engaging and active format, and they enjoyed the hybrid delivery of the training. Participants (including the trainers) expressed a desire for follow-up engagement, including additional training, and improved access to more equipment.ConclusionThe evaluation showed improvements in trainees’ knowledge and capacity to provide respectful emergency care to pregnant women and newborns across all training topics. The hybrid simulation-based training method elicited strong enthusiasm. Significant opportunity exists to expand the use of hybrid onsite/remote simulation-based training to improve obstetrical care and health outcomes for women and newborns in Madagascar and elsewhere.

Pulmonary artery catheter and veno-arterial ECMO training for cardiology fellows: evaluation of a simulation-based program

Abstract Funding Acknowledgements None. Introduction Proficiency in pulmonary artery catheter (PAC) use and extracorporeal membrane oxygenation (ECMO) therapy is crucial for delivering high-quality critical care and improving patient outcomes in cardiac intensive care units (CICUs). Both procedures are conducive to immersive simulation training. Our study focuses on evaluating the efficacy of a simulation-based training program in these specific domains for cardiology fellows. Methods Cardiology fellows participated in two blended learning courses: one on PAC and one on veno-arterial ECMO. The PAC course consisted of a pre-course test of 12 multiple-choice questions assessing knowledge of indications, contraindications, and interpretation of PAC, a 45-minute didactic lecture, followed by a case-based, hands-on simulation training session for 60 minutes. The ECMO course consisted of a pre-course test of 15 multiple-choice questions assessing indications, contraindications, ECMO physiology, and circuit management, a 30-minute didactic lecture, followed by a case-based, hands-on simulation training session. Fellows completed a multiple-choice post-course test within 72 hours post-simulation training. All test questions were designed by experts in cardiac critical care. Results A total of 18 cardiology fellows completed the PAC simulation and 16 completed the ECMO simulation. For the PAC group the average score on the pre-exam was 60%, while on the post exam, the average score increased significantly to 86%, representing a 26% increase (p=0.04). For the ECMO training, the average score on the pre-exam was 67%, and on the post exam, the average score increased substantially to 90% in the ECMO exam, there was a 23% increase in the average post-exam score compared to the pre exam was recorded (p=0.05). Conclusion Simulation-based training in PAC and ECMO has a highly positive impact on the knowledge acquisition of cardiology fellows, with statistically significant increases in average post-exam scores in both areas. These findings not only validate the value of immersive simulation-based training programs but also underscore the need for further investigation into the implementation of educational initiatives aimed at enhancing care in cardiogenic shock.

The Impact of the Advances in Labour and Risk Management (ALARM) Course on Learners’ Perceptions of their Own and Others’ Professions

Background: Simulation-based training in emergencies is beneficial for all professionals who work in obstetrics. However, managing obstetric emergencies requires both technical and non-technical skills such as teamwork. Interprofessional education (IPE) offers an effective strategy for learning competencies in collaboration and teamwork. The Advances in Labour and Risk Management (ALARM) course offers a platform for simulated training in obstetric emergencies and has been offered for learners in maternity care at our university for the past five years. Objective: The aim of the project was to explore the impact of interprofessional learning during the ALARM course on the attitudes and perceptions of learners in maternity care. Methods: A two-part questionnaire was administered to midwifery students and to family medicine and obstetric residents before and after the ALARM course. The questionnaire incorporated the Interdisciplinary Educational Perception Scale (IEPS) and open-ended qualitative responses. Results: Despite openness to and awareness of the importance of collaboration for patient care demonstrated in the qualitative analysis, there was a statistically significant difference between learners’ pre- and post-ALARM IEPS scores, indicating more negative perceptions of IPE following the intervention. Conclusion: Learners in maternity care are aware of the need for collaboration in practice. More explicit attention to teamwork and collaboration as a component of the ALARM course would promote development of both technical skills and nontechnical collaborative competencies. This article has been peer reviewed.

EVALUATING THE IMPACT OF HYBRID SIMULATION IN ENHANCING THE LEARNING DOMAINS OF MEDICAL UNDERGRADUATES: A QUASI-EXPERIMENTAL STUDY

Objectivs: Medical education, crucial for understanding physiological processes and clinical application, faces limitations in traditional methods. Simulation-based training addresses this gap, providing a secure environment for hands-on skill practice. The objectives of the study are to (1) evaluate the impact of simulation on enhancing the learning domains of medical undergraduates and (2) gauge students’ perceptions of simulation based medical education (SBME) through a pre-validated, pre-designed questionnaire. Methods: A quasi-experimental study, involving 60 medical undergraduates, selected by convenient sampling. The study began after obtaining approval from the Institutional Human Ethics Committee and obtaining informed consent from students. A pre-test was conducted for all 60 students followed by a lecture on simulation and then a post-test. The students were then divided into two groups: Group A – SBME using part-task trainers and standardized patients and Group B – (non-SBME) with video lectures on simulation. After 1 month, an assessment of all domains, namely cognitive, affective, and psychomotor, was done by post-test and objective structured clinical examination, respectively. Perception was obtained using the pre-validated questionnaire. Results: The assessment scores of all domains of Group A (SBME) showed significant improvement p&lt;0.05 except cognitive domain. Conclusion: SBME is an effective teaching method for improving the learning domains of medical undergraduates.

A qualitative study of the value of simulation-based training for nursing students in primary care

BackgroundClinical placement is an essential component of nursing education, providing students with the opportunity to apply theoretical knowledge to practice. However, challenges such as lack of supervision and passive involvement in tasks can hinder the learning experience. Supplementing clinical placement with simulation-based training (SBT) has been explored as a potential solution, though this approach has been underexplored within primary care. This study aimed to explore the educational value of a supplemental SBT course for nursing students during primary care placement, as well as the adaption of this approach to a primary care setting.MethodsA qualitative descriptive study was conducted at a medical education and simulation academy in Denmark. Sixth-semester nursing students on placement in primary care were invited to participate. The intervention consisted of a three-day simulation course covering core nursing competencies and common clinical conditions encountered within primary care. Simulation adopted a standardised patient approach. Data was collected using focus group interviews, which was analysed using inductive thematic analysis.ResultsThirty-one nursing students participated in the study. Seven themes emerged from the analysis, including perceptions, educational value, simulation adjustments to primary care, educators’ competencies, learning needs within primary care, challenges of clinical placement and career guidance. Generally, participants perceived the intervention positively, appreciating its relevance to their clinical placement and its educational impact in this context. Participants also provided insights into the adaptation of SBT to a primary care setting, as well as nursing students’ learning needs within this context.ConclusionThe findings indicate that the intervention had a positive impact on participant competencies within this context and enhanced their clinical practice within primary care. Furthermore, the results inform educators on how to effectively employ primary care-related SBT. Overall, this study supports the need for an increased application of SBT within primary care.Trial registrationNot relevant.

Review on Competency Assessment Instrumentation in Computer-based Simulation

AbstractComputer-based simulation is utilised across various educational fields, employing diverse technologies to facilitate practical understanding of content and the acquisition of skills that can help close the gap between theory and practice. The possibility of providing scenarios that resemble on-the-job tasks, enables instructors to both train and assess the trainee’s comprehension of the tasks at hand. The practices as well as the technologies for the assessment of simulation-based training vary across disciplines. Our motivation is to address quality procedures from a cross-discipline perspective. There seems to be a lack of scientific investigation that takes one step back from the specific application and investigates how assessment instruments can be developed to fit training outcomes regardless of the professional discipline. This scoping literature review on empirical studies aims to do so by exploring how competency is assessed with computer-based simulation. Objectives to achieve this are: (1) apply established training research theory to structure a decomposition of assessment instruments; to (2) review approaches to assessments factored over this structure; and (3) discuss quality procedures taken in the creation of the reported instruments and then propose an approach to assessment instrumentation that can be applied independent of discipline, with the range of current technology, and for any focal outcome competency. By reviewing a spectrum of fields, we capture reported assessment practices across a range of currently employed technologies. This literature review combines the methods of a scoping review with the qualities of a systematic literature review while keeping to conventional reporting guidelines. This allowed us to provide insight into current approaches and research designs that applied measurements in the range from automated assessment to observer rating of simulation-based training in professional work settings. This study found that all reviewed studies measured skill-based outcomes with some variation and that there is more theoretical and empirical work to be done to close the gap on quality instrumentation and its validity evidence. Our contribution to the field of training research is the operationalized component structure and the synthesised approach to instrumentation that could offer researchers and practitioners guidance and inspiration to develop and conduct quality assessments in competency development.

Abstract 3009: Progressive Structured Simulation-based Surgical Training Program (PROCESS) - Open Vascular Surgery: Study Protocol For A Cross-over, Randomized, Double-blinded Clinical Trial.

Objective: Vascular surgery has been directed towards endovascular approaches; however, not all patients qualify for these procedures. Open vascular surgery (OVS) remains an alternative, demanding a steep learning curve. Exposure to these procedures has declined resulting in a lack of standardization in acquiring OVS skills. Simulation is a solution to this challenge. However, in OVS, there is scarce evidence for structured programs. The measurement of surgical skills is based on objectively assessable subjective tools; yet, they have limitations as evaluators may introduce inherent individual biases. We aim to compare the effectiveness of technical surgical competencies acquisition between a structured progressive simulation-based training program and isolated experience-based training in OVS. Methods: We will conduct a randomized double-blind crossover clinical trial. A control sequence and an intervention sequence of three subgroups with different exposure levels to the simulation program are proposed using 3D printed models. Group 1: open abdominal aortic repair (AAOR), Group 2: vascular anastomosis (VA) and AAOR, and Group 3: specific micro-surgical skills, VA and AAOR. Surgical residents of general, vascular, or cardiovascular surgery programs will be included. Sample size calculation resulted in 45 participants, 15 in each group. Double blinding will involve participants and external evaluators. Randomization will occur in block randomization and permuted block randomization. Results: We anticipated that the structured and progressive simulation-based training program objectively enhances technical surgical competencies. We expect to determine a significant difference in the acquisition of technical surgical competencies based on the progression through different modules within the program and validate the reliability of an assessment tool based on objective metrics for technical surgical competencies in OVS. Conclusion: We hope this initiative will impact the formation of future vascular surgeons, complementing experience-based training with simulation-based programs in OVS. Ensuring that the trainee obtains all the necessary tools to perform OVS and standardize an objective assessment evaluation method.

Evaluation of Medical Students' Satisfaction With Using a Simulation-Based Learning Program as a Method for Clinical Teaching.

Objectives This cross-sectional analytical study aims to evaluate medical students' awareness and satisfaction regarding the utilization of simulation-based learning (SBL) as a method for clinical teaching at King Saud University (KSU) over the past 12 months. It seeks to understand how such learning methods enhance students' self-satisfaction and clinical skills, facilitate the application of learned knowledge, and assess the role of instructors in providing ample practice opportunities in the skills laboratory. Furthermore, the study aims to assess the satisfaction levels of students in both preclinical and clinical years regarding the time allocated for skills laboratory sessions and the integration of high-fidelity technology in simulation-based training programs at KSU. Methods In this cross-sectional study, a total of 306 male and female medical students from the College of Medicine at KSU participated, comprising 196 preclinical students (first, second, and third years) and 110 clinical students (fourth and fifth years). Quantitative data was collected through a structured questionnaire on a 5-point Likert scale that showed degrees of satisfaction. The satisfaction was measured based on a 5-point Likert scale that shows the degree of satisfaction from (very dissatisfied, dissatisfied, neither dissatisfied nor satisfied, satisfied, and very satisfied), and we calculated the p-value based on an independent t-test, and the percentage represented the percentage of students who chose satisfied and very satisfied. Results The results showed overall satisfaction with SBL (mean: 3.98, 71.10%), and it was recognized as a useful and effective method of learning skills. It is reported that it helped the students implement what they learned. At the same time, lower satisfaction was identified in areas with less allocated time for skill labs. Moreover, lack of accessibility and lack of trained staff were reported, and they should be addressed by providing staff with proper training. Conclusion The results of the study will help to understand how students' learning needs should be addressed. Moreover, providing simulation-based training is a pathway compliant with the best educational standards that should be adapted according to each institution's singularities. Besides offering further results, the study presents suggestions for further research.

Clinical needs and preferences for AI-based explanations in clinical simulation training

ABSTRACT Medical training is a key element in maintaining and improving today's healthcare standards. Given the nature of medical work, students must master not only theory but also develop their hands-on abilities and skills in clinical practice. Medical simulators play an increasing role in supporting the active learning of these students due to their ability to present a large variety of tasks allowing students to train and experiment indefinitely without causing any patient harm. While the criticality of explainable AI systems has been extensively discussed in the literature, the medical training context presents unique user needs for explanations. In this paper, we explore the potential gap of current limitations within simulation-based training, and the role Artificial Intelligence (AI) holds in supporting the needs of medical students in training. Through contextual inquiries and interviews with clinicians in training (N = 9) and subsequent validation with medical experts (N = 4), we obtain an understanding of the shortcomings in current simulation-based training and offer recommendations for future AI-driven training. Our results stress the need for continuous and actionable feedback that resembles the interaction between clinical supervisor and resident in real-world training scenarios while adjusting training material to the residents' skills and prior performance.

Research on the Dual-Creation Talent Training Model of New Energy Automobile Based on Virtual Simulation

At present, as China vigorously develops new energy automobiles, the social demand for related talents has increased significantly, so the relevant institutions need to optimize and adjust the talent training mode to help the development of new energy automobiles. This paper summarizes the existing problems of China’s new energy automobile talent training mode, and analyzes the significance of the virtual simulation-based dual-creation talent training mode of new energy automobile and its specific implementation strategies, in order to provide references for the relevant personnel.

An evaluation of a simulation-based training programme to support final-year medical students in their preparation for foundation-year prescribing practice

Abstract Introduction Prescribing is a high-risk and error prone activity with doctors reporting a lack of preparedness for prescribing practice,[1] with potential for simulation-based training (SBT) to enhance prescribing skill development.[2] To support preparation for prescribing practice, a team-based SBT programme was developed for final-year medical students. Aim To determine the impact of the SBT on prescribing knowledge and student perceptions of SBT in supporting their prescribing practice. Methods An SBT event was designed to include three complex multi-morbid scenarios reflecting foundation practice. The scenarios were co-produced by a multidisciplinary team, with sessions facilitated by clinical pharmacists. Sessions focused on practical prescribing and authentic decision-making with a convenience sample of final-year medical students. Students worked in small groups to manage conditions including heart failure, atrial fibrillation, diabetic keto-acidosis and chronic obstructive pulmonary disease, all followed by a facilitated debrief. Effectiveness of the SBT on understanding of the treatment of the topics was measured anonymously using ten multiple choice questions (MCQs). A 28-item survey was self-administered to students pre and post session, including demographic questions and prescribing confidence agreement statements using a 5-point Likert-scale (strongly disagreed to strongly agreed), with further open-ended questions used to evaluate views of the SBT, and the perceived impact on prescribing confidence. Data were entered into a database and analysed using SPSS v29. Mann-Whitney U-tests were used to determine differences in unpaired agreement scores with independent t-tests used to explore change in unpaired MCQ test-scores. Results Thirty-seven students attended the SBT with 34 students completing post session surveys. Pre session, mean test scores were 4.5±2.0, and post session, mean test scores were 7.7±1.5, an improvement of 3.2 (CI 2.4 to 4.1) t(69)= 7.5, p&amp;lt;0.0001 (d=1.8 large effect). Self-rated prescribing confidence scores significantly increased post-teaching for ability to identify drug interactions (pre-median: 3 [neutral], post-median: 4 [agreed], p=0.019), monitoring of medications (pre-median: 3, post-median: 4, p&amp;lt;0.001) and ordering of appropriate investigations (pre-median: 3, post-median: 4, p&amp;lt;0.001), with significant differences in mean rank reported for all other self-rated confidence scores, except for completion of drug histories, and accessing of information resources. The majority of participants strongly agreed/agreed that the training was valuable (99.1%), interactive (94.1%), practical and relevant (97.1%), contextualised prescribing (94.1 %), and helped preparation for practice (94.1%). Students also strongly agreed/agreed that they were more confident with their prescribing (82.3%), and that pharmacists were appropriate subject teachers (97.1%). Open-ended responses suggested that students found the session challenging and tiring, but realistic, focusing on common prescribing scenarios they would likely encounter. The debrief and personalised feedback was valued, whilst students reported that more SBT was needed throughout their training for other topics including fluids and insulin prescribing. Conclusion Deficits were identified for self-rated prescribing confidence and knowledge-based competence on final-year medical students. A contextualised prescribing SBT programme is acceptable and valued by final-year medical students to prepare them for practice. Whilst it can improve medical student prescribing knowledge and confidence, impact on prescribing competence is unknown and further work is required to explore this educational modality on prescribing quality.

Tackling discrimination in medicine head on: The impact of bystander intervention training

Purpose A mixed-methods study to evaluate Bystander Intervention Training (BiT), a simulation-based small-group training programme designed to teach skills to tackle discrimination. Materials and methods Norwich Medical School delivered the intervention online between January 2020 and June 2023 to medical students, physician associate trainees, and qualified doctors. A sample of 569 participants was used in the main analysis. Participants completed pre- and post-training and follow-up evaluations. Results Paired post-training scores were significantly different (all p < 0.001) from the pre-training scores for all 12 questions, in favour of the post-training scores. Of the 159 participants who completed follow-up questionnaires, 27 (17.9%) reported having the opportunity to be an active bystander; of those, 23 (85%) intervened. Scores in the follow-up questionnaire were significantly higher than those in the pre-training survey and significantly lower than those in the post-training questionnaire (p < 0.001). Participants had an increased sense of responsibility to be an active bystander and were empowered to challenge discrimination. Participants from marginalised groups expressed positive views about the training. Conclusions Interventions that allow open discussion and carefully supported personal disclosure in safe spaces, where difficult and uncomfortable discussions can occur, with an opportunity to change behaviour, must be developed to tackle discrimination.

Impact of the COVID-19 Pandemic on Surgical Residency Training: Time to Digitalization

Background: The COVID-19 pandemic has had a profound impact on medical education, particularly in surgical specialties. Surgical training, traditionally reliant on hands-on experience, has faced unprecedented challenges due to reduced clinical activities and elective surgeries. Aim: The primary aim of this study was to evaluate the effects of the COVID-19 pandemic on the clinical and surgical training of Tunisian surgical residents, along with their psychological well-being. Additionally, the study aimed to propose feasible and cost-effective measures for enhancing surgical training in low-income countries, like Tunisia, during and after the pandemic. Methods: A cross-sectional survey was conducted at a teaching hospital in Tunisia between December 1st and 30th, 2020. The survey, distributed to 36 surgical residents, included questions on demographic characteristics, training activities, and psychological impact using the GAD-7 and PHQ-9 questionnaires. Data on respondents' suggestions for training improvements were also collected. Results: Of the invited residents, 72% (26 participants) responded. The respondents reported a significant reduction in clinical and surgical training opportunities, with 85% believing the pandemic negatively impacted their training. Psychological assessment revealed increased stress and anxiety among all participants, with 77% showing signs of depression. The residents suggested increasing the frequency of teleconference-based college courses and clinical case discussion sessions. Additionally, the adoption of low-cost simulation-based training, free access to online surgical video libraries, and use of the Touch Surgery application were highlighted as valuable tools. Conclusion: The COVID-19 pandemic has significantly disrupted surgical residency training in Tunisia, impacting both the training quality and psychological well-being of residents. The findings emphasize the need for innovative training methodologies in low-resource settings. Proposed measures, including simulation-based training using low-cost models and enhanced digital resources, offer practical solutions to sustain surgical education during such global crises. The study underscores the importance of adapting and expanding surgical training methodologies to ensure continued learning and skill development in challenging times.

Development and evaluation of a "simulator-based" ultrasound training program for university teaching in obstetrics and gynecology-the prospective GynSim study.

This study addresses the challenges of ultrasound education in obstetrics and gynecology, focusing on the potential benefits of simulation techniques in medical training. Aiming to evaluate the impact of a structured simulator-based training program, this prospective, randomized, interventional study examines its effects on educational outcomes for 5th year medical students. A total of 153 medical students were randomized into two groups: one receiving both theoretical instruction and hands-on ultrasound simulator training (study group), and the other receiving only theoretical instruction (control group). The study assessed theoretical knowledge and practical skills at two time points: upon enrollment and at the end of the course. The practical skills were specifically evaluated using a dedicated test on the ultrasound simulator. Out of 153 students, 113 completed the study (study group n=59, control group n=54). The students in the study group demonstrated a greater improvement in theoretical test scores. They also achieved better results at the practical test, with regard to image quality, accuracy, and efficiency. Both groups showed an increase in self-confidence and competency in performing ultrasound examinations independently. Students expressed high satisfaction with the course and a positive attitude toward simulator-based training. Simulator-based training presents a valuable supplement to traditional clinical education methods in obstetrics and gynecology. This approach is particularly effective in overcoming the challenges posed by the sensitive nature of gynecological examinations in medical student training. The study highlights the benefits of integrating simulator-based methods into medical curricula, improving both theoretical and practical ultrasound skills among students.

Effectiveness of Simulation-Based Training of Undergraduate Medical Students Regarding the Management of Eclampsia: A Randomized Controlled Educational Trial.

Introduction Obstetric emergencies, like eclampsia, need a quick and accurate response from the treating physician coming into first contact with the patient. Therefore, all doctors, even primary care physicians, interns, and resident doctors, need training to handle such cases proficiently, leaving minimal chances of error. Providing training for the management of these critical conditions on actual patients is not practically feasible. Clinical simulation in obstetrics can be used for the improvement of these skills for undergraduate and postgraduate students. We conducted a non-blinded randomized controlled trial with the primary aim of developing and implementing a module for training undergraduate medical students on the assessment and management of eclampsia and to evaluate and compare it with traditional didactic lectures or case-based learning. Methods The present randomized controlled educational trial was conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India. The undergraduate medical students (Phase 3, Part 1) posted in the department during their clinical postings or tutorials were randomized into two groups. A total of 62 students were randomly divided into two groups, Group A and Group B, each consisting of 31 students. However, only 24/31 (77.42%) in Group A and 19/31 (61.3%) in Group B finally agreed to participate in the study. One group (Group A, with 24 participants) was taught the diagnosis and management of antepartum eclampsia through simulation-based training, and the other group (Group B, with 19 participants) was taught the same topic through conventional teaching, which consisted of didactic lectures through PowerPoint presentations and case-based discussion. Learning objectives were kept identical for both groups. Pre- and post-test scores were compared for both groups. Results The mean pre-test score of the simulation group was 6.13 ± 1.39, and that of the conventional teaching group was 6.05 ± 1.54. The post-test score of the simulation group was 9.17 ± 1.34, and that of the conventional teaching group was 7.37 ± 1.70. The simulation group showed an extremely significant (two-tailed p < 0.0001) improvement in their post-test scores when compared to their scores before the module was taught. The difference in the scores of simulated teaching (Group A) and conventional teaching (Group B) was also statistically significant (p = 0.005). Simulation-based learning was found to be more interactive, helpful in providing real-life-like experiences, led to better retention and understanding, and motivated the students for self-directed learning. Conclusion Although both conventional and simulation-based teaching were useful, simulation-based training was more effective in teaching undergraduate medical students regarding the diagnosis and management of eclampsia. Simulation-based learning is more interactive, provides real-life-like experiences, leads to better retention and understanding, and motivates the students for self-directed learning.

A multi-feedback system integrated simulation-based teacher training to scaffold pre-service teachers’ teaching skills: A phenomenological approach

AbstractBefore taking full responsibility for a real classroom, pre-service teachers (PTs) can safely experience a rich learning atmosphere in a simulated virtual classroom environment and receive feedback on their lesson planning and teaching performance. This research aims to support and examine the process of structuring PTs’ teaching skills with a multi-source feedback system integrated with simulation-based teacher training (SimInTeach-FBS). A phenomenological approach was employed in order to understand the nature of PT’s experiences from a feedback system focusing on teaching skills. Seventy PTs, twelve mentor teachers (MTs), and six teacher educators (TEs) participated in the study. Various data collection tools were used to gain a deeper understanding of the participants' experiences: reflective journals, open-ended feedback forms, and observation notes. The results of the content analysis showed that teaching experience with SimInTeach-FBS raises self-awareness and improves PTs’ teaching skills. It was revealed that teaching skills were mutually structured, feedback given to the PTs multiplied the effect of the development process, and teaching experience facilitated the transfer of acquired teaching skills to real life.

A prospective randomized comparative study of effectiveness of simulation-based training in improving the performance of non-technical skill among postgraduate students during anaesthesia crisis resource management

Background Non-technical skills are pivotal in ensuring patient safety during anaesthesia crisis resource management. Simulation-based training has emerged as a promising educational approach for enhancing these skills. This study protocol outlines a prospective randomised comparative study aimed at assessing the impact of simulation-based training on the performance of anaesthesia residents during anaesthesia crisis resource management, with a focus on task management, teamwork, situational awareness, and decision-making skills, using the Assessment of Non-Technical Skills (ANTS) scoring system. Methods Anesthesia residents in postgraduate years 1 and 2 from the Department of Anesthesia at Acharya Vinoba Bhave Rural Hospital will be included as study participants. Informed consent will be obtained, and no exclusion criteria will be applied. Participants will undergo an orientation session covering essential crisis management and simulation knowledge. The study will employ advanced simulation equipment, including a Human Patient Simulator (HPS) mannequin, an anaesthesia machine, and a simulated operating room. Faculty members have selected six distinct perioperative emergency scenarios for simulation sessions. Participants will be grouped in pairs and exposed to three scenarios during each session. Debriefing and feedback will follow each scenario, reinforcing non-technical skills. Experienced staff anesthesiologists, trained in the Assessment of Non-Technical Skills (ANTS) scoring system, will serve as assessors to evaluate participant performance. Expected outcomes Data collected will include ANTS scores, debriefing feedback, and post-test results. Statistical analysis will be employed to assess the effectiveness of simulation-based training in enhancing non-technical skills among anaesthesia residents during anaesthesia crisis resource management.