Simulation Center Research Articles

Peripheral Intravenous Catheter Insertion: Professionals' Performance and Implications for Patient Safety: A Cross-Sectional Study.

This study evaluated peripheral intravenous catheter insertion by licensed practical nurses in a simulated scenario. This cross-sectional and descriptive study was performed in a general hospital's simulation center located in Brazil, from January to October 2020. The authors developed a tool from the leading guidelines to measure peripheral intravenous catheter insertion performance in 60 licensed practical nurses. Data were analyzed using descriptive statistics, with proportions for categorical variables and analytical statistics to denote significance, using SPSS version 22.0. Ethical aspects were respected. Despite the sample comprising professionals who declared an average experience with peripheral intravenous catheter insertion of 6.4 years, at least 50% failed in some tool element. This low score on peripheral intravenous catheter insertion performance is because automation is possible without efforts to improve it. Adding years of practice does not generate better performance. The licensed practical nurses' performance was lower than expected, considering their reported experience, which poses a risk to patient safety. The training of these professionals needs to be discussed in countries where the practice is legal. Skills training should include simulation to approximate clinical practice; nurses must exercise their role in supervising the team.

Establishment of a simulation centre: Challenges and solutions.

The change in curriculum and increasing need for active healthcare professionals providing quality patient care has emphasised simulation-based regular training, reskilling and simulation centres to deliver these. However, there is limited literature on how to establish a simulation centre and overcome the challenges relating to developing faculty and maintaining the financial viability of these centres. Our review focuses on this gap in the current literature. The findings are presented as 1) identification of the methods of establishing a simulation centre, 2) setting up the resource in a simulation centre and 3) faculty development and curricular integration in a simulation centre. The space of a simulation centre depends on the organisation's or training body's needs. There is no single design which is recommended. Establishing a simulation centre should consider the needs of the organisation, educators and learners along with the available resources and ensure that curriculum integration and standards are met.

The importance of the development of extracorporeal life support simulation centres for improving skills and knowledge during the COVID-19 pandemic.

Despite increasing implementation of sophisticated and logistically challenging techniques to support patients in life-threatening conditions in the last years, there were no devoted education centres, especially in coronavirus pandemic. To assess the value of gaining evidence-based knowledge and improving the skills of physicians by means of simulation techniques in the safe use of extracorporeal technologies to support patients in the life-threatening conditions. In 2019, the National Education Centre for Artificial Life Support and Patient Safety and the frame program of the course of "Artificial Life Support with ECMO". was created. In years 2019-2023, we managed to organise 34 such courses for 405 physicians, which were additionally endorsed by ELSO (Extracorporeal Life Support Organisation). The physicians' cognitive, behavioural, and technical skills were evaluated before and after the courses. The participants' gender was well balanced (54% men and 46% women). Most of them (mainly at the age between 31-40 years) presented more than 5 years of clinical experience, predominantly in anaesthesiology and intensive care (63%). Of note, 54% of them had no experience with ECMO application. In all detailed aspects of cognitive, behavioural, and technical assessment and knowledge scores, significant improvement was observed after the course. The development of a simulation-based education centre was found to be an invaluable achievement that enabled not only successful standardised training and testing of novel or previously accepted procedures, but also the upgrading of technical skills, even in the challenging COVID-19 pandemic period.

Effect of Feedback Modality on Simulated Surgical Skills Learning Using Automated Educational Systems– A Four-Arm Randomized Control Trial

To explore optimal feedback methodologies to enhance trainee skill acquisition in simulated surgical bimanual skills learning during brain tumor resections. (1) Providing feedback results in better learning outcomes in teaching surgical technical skill when compared to practice alone with no tailored performance feedback. (2) Providing more visual and visuospatial feedback results in better learning outcomes when compared to providing numerical feedback. A prospective 4-parallel-arm randomized controlled trial. Neurosurgical Simulation and Artificial Intelligence Learning Centre, McGill University, Canada. Medical students (n = 120) from 4 Quebec medical schools. Participants completed a virtually simulated tumor resection task 5 times while receiving 1 of 4 feedback based on their group allocation: (1) practice-alone without feedback, (2) numerical feedback, (3) visual feedback, and (4) visuospatial feedback. Outcome measures were participants' scores on 14-performance metrics and the number of expert benchmarks achieved during each task. There were no significant differences in the first task which determined baseline performance. A statistically significant interaction between feedback allocation and task repetition was found on the number of benchmarks achieved, F (10.558, 408.257)=3.220, p < 0.001. Participants in all feedback groups significantly improved their performance compared to baseline. The visual feedback group achieved significantly higher number of benchmarks than the practice-alone group by the third repetition of the task, p = 0.005, 95%CI [0.42 3.25]. Visual feedback and visuospatial feedback improved performance significantly by the second repetition of the task, p = 0.016, 95%CI [0.19 2.71] and p = 0.003, 95%CI [0.4 2.57], respectively. Simulations with autonomous visual computer assistance may be effective pedagogical tools in teaching bimanual operative skills via visual and visuospatial feedback information delivery.

Increasing optimal coagulation factor dosing in the paediatric emergency department: Update to a quality improvement study.

Prompt, appropriate coagulation factor replacement according to injury and bleeding severity in persons with haemophilia is required to prevent acute and long-term complications. Increase proportion of persons with haemophilia A (HA) and B (HB) treated appropriately for an acute injury and bleeding episode at a tertiary children's emergency department (ED) from 65% to 85% and sustain for one year. Secondary aim: increase time interval between patient ED encounters with out-of-range factor dosing. Utilizing quality improvement methodology and plan-do-study-analyze cycles, ED encounters for individuals with HA/HB receiving coagulation factor replacement for injuries were audited for in-range coagulation factor dosing. Goal factor dose defined as 50% correction for minor bleeds and 100% correction for major bleeds. Optimal dosing range defined as 90%-120% of the calculated goal dose to account for vial size variability. Interventions targeted communication via the EMR problem list and optimization of physician education. Our previous publication demonstrated 33.3% of ED encounters with out-of-range factor replacement. Following several interventions, the cumulative rate of encounters with out-of-range dosing decreased to 18%. Overall, there was an increase in the mean percent of encounters receiving optimal factor dosing for both HA/HB compared to baseline (82.2% vs. 71.1%), though this was not a statistically significant difference. Despite implementation of multiple interventions, out-of-range factor dosing continues to occur. Our team plans to reinstate simulation center education for ED staff and continue education efforts of pharmacists and hematology trainees with the goal of further reducing out-of-range dosing in our ED.

The role of virtual reality in the development strategy of the Medical Simulation Centre: Polish experiences

The role of virtual reality in the development strategy of the Medical Simulation Centre: Polish experiences

Stanford University School of Medicine: Our Neurosurgical Heritage

The legacy of Stanford University's Department of Neurosurgery began in 1858, with the establishment of a new medical school on the West Coast. Stanford Neurosurgery instilled an atmosphere of dedication to neurosurgical care, scientific research, education, and innovation. We highlight key historical events leading to the formation of the medical school and neurosurgical department, the individuals who shaped the department's vision and expansion, as well as pioneering advances in research and clinical care. The residency program was started in 1961, establishing the basis of the current education model with a strong emphasis on training future leaders, and the Moyamoya Center, founded in 1991, became the largest Moyamoya referral center in the United States. The opening of Stanford Stroke Center (1992) and seminal clinical trials resulted in a significant impact on cerebrovascular disease by expanding the treatment window of IV thrombolysis and intra-arterial thrombectomy. The invention and implementation of CyberKnife® (1994) marks another important event that revolutionized the field of radiosurgery, and the development of Stanford's innovative Brain Computer Interface program is pushing the boundaries of this specialty. The more recent launch of the Neurosurgery Virtual Reality and Simulation Center (2017) exemplifies how Stanford is continuing to evolve in this ever-changing field. The department also became a model for diversity within the school as well as nationwide. The growth of Stanford Neurosurgery from one of the youngest neurosurgery departments in the country to a prominent comprehensive neurosurgery center mirrors the history of neurosurgery itself: young, innovative, and willing to overcome challenges.

Relevance of simulation centers in the development of future medicine

Simulation centers play a crucial role in the development of emoti onal and communication skills for various professions, including healthcare. The purpose of simulation centers in this context is to provide a safe and controlled environment where medical students can practice and improve their emotional and communication competencies through realistic scenarios.

Successful emergency medical service training with virtual field trips using video during the COVID-19 pandemic: the Official Development Assistance Project in Uzbekistan

Purpose: The coronavirus disease 2019 pandemic saw many restrictions on the provision of emergency medical service (EMS) training through actual field trips (AFTs), requiring a search for alternatives. This study aimed to assess trainees’ reactions to virtual field trips (VFTs) and determine the characteristics of instructional design for successful VFTs using edited videos and expert interviews.Methods: This study evaluated Uzbekistan trainees’ reactions to the VFT of EMS training using questionnaires in three categories: satisfaction, relevance, and engagement. Factors of satisfaction and dissatisfaction were identified through open-ended questions.Results: A total of 286 trainees responded to the survey during 15 educational sessions conducted from 2020 to 2022. The trainees’ responses to the VFT were positive. Overall mean scores were 4.65±0.49, 4.63±0.50, and 4.63±0.50 out of 5 points for satisfaction, relevance, and engagement, respectively. The trainees reported that the most interesting and helpful videos concerned the introduction of an EMS training curriculum and the observation of training facilities, such as the simulation centers of educational institutes. The leading causes of satisfaction were (1) authenticity of the VFTs, (2) easy-to-understand content, and (3) relevance to the job. The trainees suggested that Uzbek or Russian voice-overs would be better than subtitles in the video clip for focusing on VFT.Conclusion: In situations where AFTs are not available, VFTs using edited videos and expert interviews are a good alternative to EMS education. Based on these results, it is possible that AFTs could be replaced by VFTs using qualified videos with designed instructions as a distance learning method under specific conditions.

A Low Budget Perineal Repair Model

BACKGROUND We designed a low-cost model to prepare junior surgeons for the limited accessibility and visibility of perineal lacerations. This model has advantages over the classical beef tongue model including lower cost, being easier to build, and lasting longer. METHODS To build the model, follow the instructions as described in appendix A. Users were surveyed to compare the model against established simulated formats. RESULTS Each of our models can made in about 5 minutes and costs $2.09 in materials per model. Our model was directly compared to the classical beef tongue model used by many programs to simulate perineal repairs. At our program, it took residents on average 15 minutes to create their beef tongue model and cost $16.50 per model which had to be used immediately and discarded afterwards due to the meat spoiling. Overall, our model was seen as a useful training tool to be used in addition to our current curriculum. It does not require significant preparation to build or use unlike the beef tongue model, and it is sufficiently cheap for medical students and residents to take home. DISCUSSION/CONCLUSION Many medical models are prohibitively expensive for the individual to purchase or are reserved for rare training sessions in a simulation center due to their scarcity. This is an efficient and practical model which accurately demonstrates the limited space and visibility of perineal repairs while also allowing residents to conveniently practice 3rd and 4th degree repairs, which are so infrequent in modern obstetrical practice.

Vehicle Attribute Engineering

Horiba Mira’s new Driving Simulator Centre is set to drive the virtual development of next-generation vehicle attribute engineering

Rapid Transformation from Face to Face to Virtual Simulation During the SARS-CoV-2 Pandemic: Impact on the Simulation Process during “The Little Room of Horrors”

Objective1. To explore the feasibility of a rapid transformation from face to face to virtual simulation and its impact on the simulation process 2. To explore the efficacy of a rapid transformation from face to face to virtual simulation and its impact on the simulation process. MethodsThe simulation process (preparation, pre-briefing, simulation, and debriefing) was investigated for feasibility and efficacy from the perspective of the educators and students. This study took place very early in the pandemic, thus highlighting the speed at which it needed to be conducted and acknowledging the limitations of technology at the time. The faculty (n = 3) involved in the virtual simulation experiment and year one medical students(n = 61) were invited to participate in the study voluntarily. The module chosen for this study was the Introduction to the Practice of Medicine, where the students were introduced to the concept of patient safety using simulation-based education. The “Little Room of Horrors” – is a simulation based educational session emphasising the importance of patient safety. Students were taken into a simulated medical ward that demonstrated common hospital-based errors. The learners were timed and asked to identify and document as many patient safety hazards as possible. The semi structured questionnaire was analysed using descriptive statistics and thematic analysis. ResultsThe Educator's perspective reflected that virtual simulation was technologically dependent and had limitations during debriefing but was also a sustainable and portable standardised process. The student's perspective revealed that the objectives were met, and the session helped them support the theory previously learned. The average rating was 4.09 on a 5-point scale. InnovationWhen resources of the simulation center like space, mannikins, and faculty cannot be accessed for reasons like social distancing during a pandemic, virtual simulation was developed and used as a feasible alternative for our students without impacting the learning objectives. ConclusionThis study demonstrates the use of virtual simulation as a valuable option for teaching when face to face simulation is challenging or not possible.

An investigation into emergency medicine resident cricothyrotomy competency: Is three the magic number?

Cricothyrotomy is a high-stakes emergency procedure. Because the procedure is rare, simulation is often used to train residents. The Accreditation Council for Graduate Medical Education (ACGME) requires performance of three cricothyrotomies during residency, but the optimal number of training repetitions is unknown. Additional repetitions beyond three could increase proficiency, though it is unknown whether there is a threshold beyond which there is no benefit to additional repetition. The objective of this study was to establish a minimum number of simulated cricothyrotomy attempts beyond which additional attempts did not increase proficiency. This was a prospective, observational study conducted over 3 years at the simulation center of an academic emergency medicine residency program. Participants were residents participating in a cricothyrotomy training as part of a longitudinal airway curriculum course. The primary outcome was time to successful completion of the procedure as first-year residents. Secondary outcomes included time to completion as second- and third-year residents. Procedure times were plotted as a function of attempt number. Data were analyzed using descriptive statistics, repeated-measures analysis of variance, and correlation analysis. Preprocedure surveys collected further data regarding procedure experience, confidence, and comfort. Sixty-nine first-year residents participated in the study. Steady improvement in time to completion was seen through the first six attempts (from a mean of 75 to 41 sec), after which no further significant improvement was found. Second- and third-year residents initially demonstrated slower performance than first-year residents but rapidly improved to surpass their first-year performance. Resident mean times at five attempts were faster with each year of residency (first-year 48 sec, second-year 30 sec, third-year 24 sec). There was no statistically significant correlation between confidence and time to complete the procedure. Additional repetition beyond the ACGME-endorsed three cricothyrotomy attempts may help increase proficiency. Periodic retraining may be important to maintain skills.

Abstract 19115: In-situ Resuscitation Training in Cardiology Procedural Suites

Background: Critical Care Advanced Resuscitation Training (CC-ART) prepares critical care teams for emergency situations through training that occurs in a simulated clinical space. Simulated environments do not always accurately mirror the actual clinical environments. Simulations conducted in the actual clinical environment, also known as in-situ simulation, may overcome some of these challenges. Goal: To explored the impact of in situ, ART simulation in a Cardiac Catheterization Lab (CCL) and an Electrophysiology Lab (EPL) on the staff’s experience, confidence, and communication skills. Method: Key leadership and educator team members collaborated on the in-situ simulation set up. Coordination with Simulation Center and Central Supply Department was completed to arrange for delivery of high-fidelity manikins and training crash cart to the site. A team of physicians and nurse educators created CCL and EPL scenarios for the simulations and wrote a simulation evaluation survey for CCL and EPL nurses and technologists who attended. Results: . Simulations were run by both critical care anesthesiologist and clinical nurse educator. Pre-simulation and post-simulation surveys were collected immediately prior to and after the in-situ simulation. 38 staff completed pre and post surveys. Pre-simulation, 50.00% of staff strongly agreed that they were confident in their ability to care for a decompensated patient based on the prior CC-ART training versus, post-simulation, 84.21% strongly agreed. Pre-simulation, 26.32% strongly agreed that the simulation center training was similar to their actual work experience versus post-simulation, 78.95% agreed the in-situ simulation matched their actual work experience. Pre-simulation, 52.63% strongly agreed that they were confident in their ability to communicate their needs during emergencies or code blue situations versus post-simulation 86.84% agreed. Conclusion: This quality improvement project highlights the effectiveness of in situ resuscitation simulation in improving healthcare professionals' confidence, training realism, and communication skills . Analysis of patient outcomes is needed to determine the effectiveness and duration of impact of in situ training for clinical practice.

Abstract 13914: Development of a High School Mentorship and Scholarship Program to Promote Interest in Healthcare Among Students Underrepresented in Medicine

Introduction: Despite the rising demand, positive career outlooks, and promising salary in healthcare professions, youth from underrepresented backgrounds continue to be poorly represented in these careers. Mentorship has emerged as a strategy to enhance the involvement of underrepresented youth in healthcare careers, serving as one of the few effective approaches to address this disparity. Aims: The aim of this study was to develop practical recommendations for founding, growing, and sustaining a mentorship and scholarship program between a physician group and a racially, ethnically, and socioeconomically diverse local high school. Methods: Each year, six events were hosted for high school students interested in healthcare. Events included hands-on activities, networking events, career panel discussions, and field trips to our simulation center. Following 2 years of successful program execution, a modified mini-Delphi approach was used to develop formal recommendations for founding, growing, and sustaining such a program. Results: On an observational basis, the mentorship program appeared effective at growing high school student interest in healthcare careers. Utilizing a modified mini-Delphi method, we created recommendations for the development of a healthcare mentorship and scholarship program. These recommendations are shown in Figure 1. Conclusions: These recommendations may serve as a guide for other programs that wish to establish similar programs. All our self-developed curricula, grant proposals, and marketing materials will be freely shared with any group wishing to develop a similar program.

A77Translational simulation in practice: an enhanced orthopaedic induction for new trainees

The gap between imagined and realized healthcare practice is indisputable. For trainees who rotate between departments, the challenges of navigating complex healthcare systems are unmet by standard induction programmes [1,2]. Our simulation centre and orthopaedic department collaborated to create an enhanced departmental induction using immersive simulation. Following a thorough needs assessment for new trainees rotating to trauma and orthopaedics. We looked at previous trainee feedback, adverse event data from our safeguarding reporting system, and expert opinion from orthopaedic staff. It became clear that at times of transition, the process of accessing timely and appropriate support was challenging. Furthermore, there were a myriad of clinical duties and patient cohorts covered by the trauma team. Working within this dynamic and complex structure was difficult for new trainees. We used team-informed process mapping to define the escalation systems in place, and the distinct roles within the team. We identified key learning objectives for a simulation induction session. We used a case vignette of an unwell trauma patient and aligned the scenario design to the required learning objectives on clear escalation pathways and whole team working within a complex environment. Following a successful pilot run, this enhanced induction is routinely delivered four monthly for junior doctors rotating to the orthopaedic department. Current trainees, orthopaedic consultants, and senior managers also attend this trainee induction as an open forum for dialogue on service improvements. All participants have rated these sessions as good or excellent; they value the whole team approach and repeatedly ask for further simulation sessions. Feedback from other members of the trauma team following these sessions commented on increased connection within the team, which included junior trainees attending departmental meetings. The orthopaedic team also felt that, following the induction programme, new trainees had demonstrated improved handover skills when escalating unwell patients. This whole team simulation-enhanced approach to orthopaedic induction is novel, and in contrast to the majority of standardized induction programmes [3]. This work provides a template that can be applied to different healthcare systems. By delivering constructively aligned simulation sessions, we can improve team training and enable new trainees to flourish during periods of transition. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

192 Enhancing Learning Outcomes in Emergency Courses: Evaluating the Impact of Simulation Training at the Berlin Simulation and Training Center

192 Enhancing Learning Outcomes in Emergency Courses: Evaluating the Impact of Simulation Training at the Berlin Simulation and Training Center

A50The SEIPS game: An interprofessional teaching aid to promote understanding of human factors in healthcare

As a human-factors focused simulation centre, we begin all our simulation courses with a human factors workshop introducing participants to the SEIPS model of human factors [1]. This enables them to explore systems-based impacts on clinical practice during post-scenario debriefs. However, we have noticed that some participants struggle to identify and discuss human factor themes which impact on them in their workplace. We aimed to develop an innovative teaching aid which would promote participant understanding and engagement. Previous experience has provided evidence that participants enjoy simulation games. Therefore, we chose to develop a table-top game to play with participants based on the SEIPS work system. We worked with interprofessional colleagues to identify factors that help and hinder processes in the work system and categorized them under SEIPS headings. We made a series of cards based on these factors which participants collect. The winner was the person who collected a helpful card for each SEIPS heading first. We have piloted our SEIPS game with interprofessional faculty, including those with specialist expertise in human factors in healthcare. We surveyed participants to obtain feedback. Survey results so far include data contained in ‘Play’ is a kinaesthetic way of learning and helps embed ideas and thinking. It also can create opportunities for discussion on different headings for human factors and systems thinking. The examples are fun but are also realistic so helps you see how HF is relevant. With the examples of human factors in the game it could be useful for staff with little clinical experience. Liked the competitive element and the examples helped expand on what SEIPS was and how it could be relevant to lots of areas. SEIPS game participant survey results We have developed a SEIPS game to facilitate discussion of human factors in healthcare. This novel approach has received positive initial feedback following our pilot. We are confident we can now move forward to integrate our SEIPS game into our Foundation Doctor’s simulation programme from August 2023. Following this, we intend to continue the process of data collection and analysis, with the intention of incorporating our SEIPS game more widely across simulation courses within various clinical specialties in future. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A91Integrating Simulation Based Education to Trauma &amp;amp; Orthopaedic Training: A Regional Experience

In recent years we have seen an exponential increase in the use of simulation-based education (SBE) within surgical training. Early evidence supported initial integration of simulation to Trauma &amp; Orthopaedic (T&amp;O) training [1] with more contemporary evidence focused on refining training methods and technology usage [2,3]. We aim to assess the integration of established as well as novel SBE components within our T&amp;O training programme in Northern Ireland. Simulation sessions were introduced to the Northern Ireland (NI) T&amp;O Core Curriculum in academic year 2022/23: Trauma Simulation Scenario Training: Pelvic trauma scenarios were delivered to all T&amp;O specialist trainees as part of Core Curriculum teaching in a regional simulation centre. Multi-professional input was sought and delivered by Blood Transfusion Service (Major Haemorrhage Protocol training) and Urological micro-teaching session (traumatic urological injuries in setting of pelvic trauma). Arthroscopy Simulation Course: A knee arthroscopy course was developed in conjunction with industry for all T&amp;O trainees in NI utilizing passive haptic feedback arthroscopy simulators. Pre + post simulation surveys were completed assessing educational value, engagement with SBE as method of teaching, desire for further SBE content and suggestions for topics of same. Focus groups of lead educators were set up to plan development of further SBE training within T&amp;O curriculum. Trainees reported increased confidence in management of pelvic trauma. Overwhelmingly positive response to integration of SBE sessions to core curriculum with 89% in favour of further multi-specialty simulation training sessions. There was a preference seen within feedback for a variety of SBE iterations with in-situ and operative/ procedural simulation being slightly preferred to scenario-based training. With majority of trainees requesting procedural SBE training as topic for future sessions, Knee Arthroscopy Simulation Course was subsequently developed (to be delivered as part of Core Curriculum in May 2023). From lead educator focus groups further simulation-based training sessions are planned for development in 2023/24 including shoulder arthroscopy simulation course, rare approaches simulation and advanced supracondylar simulation sessions. Feedback will be sought throughout to ensure training is tailored to needs of trainees as well as curriculum requirements. Recognition of benefits and scope of SBE training within T&amp;O has prompted development of formal simulation trainee role as result of initial regional experience. Our experience of integrating SBE training methods to T&amp;O core curriculum has been hugely positive with demand amongst trainees high for a wide range of further sessions and courses. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A95UCLH Simulation Centre - Let us show you around: A digital hybrid approach to simulation environment familiarization

It is well established that familiarization with the simulation environment is integral to the pre-brief [1]. This fosters psychological safety and creates optimal learning conditions for participants and faculty. We sought to enrich our visitors’ psychological safety by providing a digital preview of our simulated environment, prior to the face-to-face familiarization they receive when attending a course. Combining 360 and 2D video production techniques we have produced an online experience hosted on the CenarioVR platform. This gives visitors an opportunity to explore the simulated environment, patient and equipment, in their own time, while introducing aspects of the fiction contract. We believe accessibility is key to the utilization of this resource. So we have ensured it can be used on a range of devices including: Virtual Reality Headsets (HTC/Meta) Desktops/ Laptops Mobiles/ Tablets (enhanced with accelerometer controls) The content is cloud-based and accessed via an internet browser across all platforms, requiring no additional app. One limitation is that the experience requires a stable internet connection. A link to the tour was embedded in our pre-simulation communication to participants and faculty, and its usage and impact was evaluated over a period of 2 months using additional questions in our post-course questionnaire. 50 feedback responses to CenarioVR were received. 24 delegates viewed it 26 did not. Of the 24 that viewed 58.3% agreed virtual tour strengthened their experience, 12.5% strongly agreed, 20.8% neutral, 4.2% disagreed and 4.2% strongly disagreed. From our data we concluded that over 70% of delegates that viewed the virtual familiarization found it to be beneficial to their simulation experience. With simulation being used more in education it is imperative that those with less experience in this setting are provided with resources they need to feel psychologically safe. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.