Simulation Education Research Articles

Introduction of Simulation-Based Learning Strategy to Bridge the Theory-Practice Gap in Advanced Concepts in Community Health Nursing Course: Lens from Students' Perspective.

Simulation has proven to be one of the most powerful forms of enactive experience in medical sciences, which enhances the efficacy of both direct and vicarious learning. At the undergraduate level, community health nurses are expected to be inclusively knowledgeable about population-based nursing practices with diverse communities; so, they prepare well to establish partnership skills with stakeholders and make collaborative decisions that promote awareness and understanding of the community's health needs. Problem prioritisation is an essential step of the planning cycle. It is one of the advanced concepts in community health nursing which needs in-depth knowledge and contemplation about the dynamics of the community. This paper highlights the students' perspectives regarding the impeccable effects of simulation pedagogy on students' learning in terms of improving their communication skills and alleviating the fear of dealing with community stakeholders before the actual problem-priority setting exercise for the clinical community project. Key Words: Community health nursing, Simulation-based learning, Problem prioritisation, Stakeholders.

A theoretical framework for understanding the importance of implementing simulation in social work education

ABSTRACT Social work engages in many complex and emotionally charged environments that challenge the educational requirements of students. The profession draws on various theories, including sociology, psychology, and political sciences to inform understandings of power, oppression, structural injustice, and complex lived experiences. However, contributions from psychological science are important in understanding how students develop the necessary cognitive function needed to handle complex situations, thereby providing a blueprint for ways of teaching and learning. Theories of learning and cognition can be utilized to understand how people develop the capacity to perceive, process, store, and act upon complex information. This paper investigates a theoretical model that social worker educators can use to understand how individuals draw upon learning to frame their understanding for future practice. Memory is a key feature in how students process, learn and adapt to new information within their environment, playing a pivotal role in learning and teaching. By harnessing cognitive load theory, simulation pedagogy can draw on memory as a defining ingredient in practice skill development and complex decision making. Thus, providing a theoretical framework for inclusion of simulation within social work education, protecting vulnerable service users, equipping students for placement and upholding the professional integrity of social work.

A Viewpoint on Simulation Debriefing to Optimize Student Learning

Purpose: The purpose of this article is to promote the viewpoint that simulation debriefing is a critical element of the simulation experience, which serves to facilitate students' ability to synthesize information and construct new mental models as they prepare for their future work as speech-language pathologists. The use of simulations in communication sciences and disorders (CSD) has grown significantly over the last decade. This article reviews key concepts in clinical simulation pedagogy and highlights the importance of debriefing as part of the simulation learning experience. Current guidelines and standards for simulations and debriefing in CSD are discussed, and debriefing models commonly used in nursing and medicine are described. Suggestions are provided to enhance current debriefing practices and guide future research in CSD. Conclusions: Clinical simulation, particularly the debriefing component, has the power to close the gaps in students' clinical knowledge and skills and to prepare students for robust and diverse careers. In a review of debriefing models originating from nursing and medicine, several crucial debriefing components are noted. Students need time to (a) react to and defuse emotions related to the simulation experience, (b) gather and describe key simulation details, (c) analyze simulation outcomes, and (d) summarize new knowledge and consider how it applies to future contexts. Additional research is needed to continue developing and refining simulation and debriefing best practices in CSD. Debriefing models from nursing and medicine ought to be explored and replicated in future CSD research.

Postgraduate Operating Room Nursing Students' Experiences with Blended Learning Combining Digital Learning Paths and Basic Skills Training as Preparation for Internship: A Qualitative Study.

Numerous pedagogical practices ought to be contemplated for the acquisition of practical aptitudes imperative to postgraduate operating room nursing education. The employment of digital technologies has emerged as a strategic focus in higher education and learning paths exhibit potential as a digital approach in nursing education. This study aimed to investigate the experiences of postgraduate OR nursing students who underwent a blended learning approach, which combines digital learning paths with skills training, and to explore how this approach prepares students to attain specific learning outcomes during their internship period. This qualitative study employed a descriptive, exploratory design and utilized focus group interviews facilitated by an interview guide to gather qualitative data. A purposive sampling strategy was employed, and the collected data were analyzed using a systematic text condensation approach. The analysis of the data revealed two main categories and five subgroups. The first category, "Blended learning serves as adequate preparation for internship," includes subgroups that highlight the advantages of diverse learning activities that aid in the development of a strong foundation in practical skills. The positive influence of peer collaboration fosters improved learning through social interaction, while the organization of the curriculum has a significant impact on students' learning experiences. The second category, "The importance of skills training and behaving in an operating theater context," consists of subgroups that emphasize the necessity of progressing from basic technical skills training to simulation pedagogy to ensure appropriate behavior in the operating room. Small group sizes, close monitoring, and assessment by educators contribute to effective learning. The integration of digital learning paths with skills training fosters a problem-solving approach and encourages active and collaborative learning. Skills training in small groups, timely feedback, and coordination among subject managers to handle the students' workload can create an optimal learning environment.

An ethical framework for simulation-based pedagogy: a strengths-based, anti-oppressive, and intersectional approach

ABSTRACT Existing evidence supports simulation for improving competency in social work education. This evidence has focused almost exclusively on simulation outcomes with little attention given to best practices for the implementation of simulation. We maintain that best practices for implementing simulation require careful attention to a host of ethical challenges. Failing to attend to these challenges not only can compromise the learning experience in simulation but also educators’ and students’ ability to integrate crucial social justice principles related to anti-oppressive social work practice. In this conceptual paper, we describe and employ a strengths-based, anti-oppressive, intersectional framework to competently engage in best practices for simulation pedagogy. We demonstrate how educators can utilize this framework to mitigate ethical concerns from the beginning when case scenarios are developed to the end when students are debriefed on the simulation experience. We conclude with discussing ongoing work needed in social work education to ensure educators encourage ethical social work practice by first modeling it for students in simulation exercises.

Status of the implementation of simulation-based education in Germany: A cross-sectional study

Status of the implementation of simulation-based education in Germany: A cross-sectional study Abstract. Background: The importance of simulation-based learning in nursing education is growing. Its success depends on the qualification of facilitators and the use of standards. Up to now, there has been a lack of data on the state of implementation of simulation-based learning in nursing education in Germany. Research question: Which qualification level do simulation facilitators show in nursing education in Germany and which concepts and standards are used? Methods: A cross-sectional survey was conducted among simulation facilitators in three different educational areas. The questionnaire included socio-demographic and professional characteristics as well as qualification measures completed, and concepts and standards applied. Data were analysed descriptively by determining arithmetic means plus standard deviation (SD) or absolute and relative frequencies. Results: A total of 156 simulation facilitators (mean age 41.5 (SD 9.8) years, 74.2% female) participated. 95.4% of participants reported being (very) highly motivated for simulation-based learning. Specific simulation pedagogy training was completed by 16.8% of participants. The application of evidence-based concepts is not occurring across the board. Conclusions: Against the background of international standards, qualification needs for simulation facilitators in Germany become apparent. Increased specific, standardized continuing education and training as well as the establishment of evidence-based concepts are important for high quality in simulation facilitation.

Training Based on Simulation Pedagogy: Evaluation of Participants’ Satisfaction with the First National Forum on Simulation in Nursing in Morocco

Simulation in nursing is considered an innovative pedagogy for the development of clinical skills of nursing staff. A National Forum was held for the first time in Morocco concerning the pedagogy of simulation in nursing to raise awareness among educators and practitioners on the educational value of such an initiative in the field of nursing. The goals of this study were to describe the development of the first National Forum in Morocco on Nursing Simulation and to assess the satisfaction of participants with the different activities of this national event. A self-administered questionnaire was used in this study. Descriptive statistics and correlation tests were used to assess the level of participant satisfaction with the simulation. This event gathered more than 250 participants from different Higher Institute of Nursing Professions and Health Techniques (HINPHT) of Morocco during the 3rd, 4th, and 5th of June 2022 held at the HINPHT institute of Fez. 163 participants agreed to take part in our satisfaction survey in which 39.3% were nursing teachers and 6.7% were directors of nursing and technical health professions training institutes and 41.7% were nursing students. The participants evaluated the different pillars of the first National Forum on Nursing Simulation in Morocco and reported a general satisfaction of 80.8%. Directors showed higher satisfaction with the organization with a score of 88.89% ( p = 0.001 ), while teachers reported higher satisfaction with the Master Class workshop (65.27%; p = 0.003 ). Students’ satisfaction scores were positively correlated (86.36%; p = 0.004 ) with the usefulness and applicability of the knowledge acquired during the event. Nevertheless, dissatisfaction was recorded with the mediation of the Forum (8.6%), the duration of the Master Class (13.5%), and the quality of the technical and logistical material used (7.4%). These aspects should be improved in future editions. The findings of this scientific event could be of great interest to the organizers of future forums on nursing simulation in the Maghreb region and Africa more generally, and could serve as a model.

Facilitator competency rubric in nursing simulations: transcultural adaptation and validation of the German version

BackgroundSimulations are part of nursing education. To obtain good results, simulation facilitators need to be competent in simulation pedagogy. Part of this study was the transcultural adaptation and validation of the Facilitator Competency Rubric into German (FCRG) and the evaluation of the factors associated with higher competencies.MethodA written-standardized cross-sectional survey was conducted. N = 100 facilitators (mean age: 41.0 (9.8), female: 75.3%) participated. Test–re-test, confirmatory factor analysis (CFA), and ANOVAs were conducted to evaluate the reliability and validity of, and the factors associated with, FCRG. Intraclass correlation coefficient (ICC) values > .9 indicate excellent reliability.ResultsThe FCRG achieved good intra-rater reliability (all ICC > .934). A moderate correlation (Spearman-rho .335, p < .001) with motivation indicates convergent validity. The CFA showed sufficient to good model fits (CFI = .983 and SRMR = .016). Basic simulation pedagogy training is associated with higher competencies (p = .036, b = 17.766).ConclusionThe FCRG is a suitable self-assessment tool for evaluating a facilitator’s competence in nursing simulation.

Curricular Quality Improvement in Midwifery: Simulating Unexpected Perinatal Loss.

Caring for families experiencing perinatal loss is a fundamental component of midwifery practice, but little attention is paid to perinatal palliative care in midwifery curricula. Lack of educational preparation and self-care resources negatively impacts midwifery students and health care teams caring for families experiencing stillbirth. A private, urban university conducted a curricular quality improvement project to integrate perinatal palliative care into the midwifery curriculum using a high-fidelity, branching simulation pedagogy. Simulation objectives were developed from curricular gap analyses and the Core Competencies for Basic Midwifery Practice. Development of the Unexpected Perinatal Loss Simulation was guided by the International Nursing Association for Clinical Simulation and Learning Outcomes and Objectives and Design Standards. The Unexpected Perinatal Loss Simulation was revised based on qualitative data from student focus groups and expert content validation. Qualitative data yielded 4 key domains: presimulation, simulation skills, prior experience/personal reflections, and recommendations. Simulation procedures and scenario content were revised, after which 8 expert clinicians in the fields of midwifery, palliative care, and psychiatry validated the scenario content using the Lynn method. Two items did not meet the content validity index (CVI) threshold of 0.78, necessitating review by stakeholders; however, the overall scenario CVI threshold was met (0.82). Through this project, faculty integrated perinatal palliative care into the midwifery program using a novel approach of high-fidelity, branching simulation, structured debriefing, and an introductory self-care skills workshop. Potential clinical impact includes skillful perinatal palliative care with effective communication skills to mitigate how families experience and remember a traumatic loss and facilitate the grieving process. Students voiced insights into how they would process loss and seek support to mitigate their own grief as future midwives.

Exploring how Undergraduate BSc (Hons) Nursing (Child) Students Learn About End of Life Care Through Simulation – A Descriptive Case Study.

Research suggests that nursing students have many anxieties about dealing with death and dying and feel unprepared to care for these patients as newly registered nurses. Effective education has been found to be an important factor in preparing nursing students for end of life care. Simulation is a pedagogical strategy widely used within nursing education and can provide an opportunity for students to develop their end of life care skills in the absence of opportunities in the practice setting. The purpose of this study was to explore how BSc (Hons) Nursing (Child) students learn about end of life care through simulation. A new simulation pedagogy was designed and delivered to second year child nursing students, and case study methodology was used to explore student learning. Data was collected through a focus group discussion and individual interviews. The findings revealed that during simulation, students learned about end of life care through a combination of hands-on practice and reflection, collaborating with their peers and facilitators, and by engaging in the experience through the provision of a safe and authentic environment. Learning theory was applied to the findings in order to explain the simulation learning process. In conclusion, learning through simulation is socially constructed, occurring through experiential learning which promotes perspective transformation. Student engagement in the simulation learning process is influenced by effective and supportive facilitation.

Equity, diversity and inclusion in clinical simulation healthcare education and training: An integrative review

Patient profiles have changed from shifting demographics, globalization and immigration. Such changes highlight the need to educate and train healthcare trainees and healthcare providers (HCPs) on the provision of person-centred care through an equity, diversity and inclusion (EDI) approach. Simulation pedagogy has the potential to be a useful and impactful teaching and learning approach for EDI. The purpose of this review was to explore and summarize the current literature on the level of integration and state of EDI in clinical simulation within healthcare education, curricula and training. An integrative literature review was conducted using Whittemore and Knafl’s (2005) method. Studies that met the selection criteria were assessed using the Johns Hopkins Nursing Evidence-Based Practice Model. A total of 64 studies were included in the review. Five themes emerged from EDI incorporation in clinical simulation education and training for HCPs and healthcare trainees: (1) increase in self-awareness; (2) enhanced communication; (3) enhanced insight and knowledge; (4) strengthened EDI-related self-efficacy; and (5) increase in EDI-related competence and skills. Clinical simulation provides opportunities for EDI integration in healthcare education. Several implications were identified: (1) employing a more systematic process for EDI integration in healthcare education and programs; (2) developing a digital repository of EDI-focused clinical scenarios; (3) co-creating EDI-focused clinical simulations with persons of diverse background; (4) the importance of maintaining a safe learning environment for all involved persons – learners, staff, faculty and standardized/simulated patients in the EDI simulations; and (5) the need for more robust and rigorous research to advance the science of clinical simulation.

Developing simulation games to advance public health nursing competence in baccalaureate education.

We describe the development of an innovative baccalaureate nursing education strategy for public health nursing. Virtual simulation pedagogy is known to be effective for acute care nursing practice while less known for public health nursing. Three Canadian nursing schools, the Canadian Association of Schools of Nursing (CASN), and the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) partnered to develop three public health nursing virtual simulation games. Learners work through unfolding population health scenarios, simulating public health nursing practice focused on entry level public health nursing competencies. Each game fosters clinical reasoning and collaborative, community decision-making to respond to population health issues during community assessment, evidence-informed health promotion planning, and evaluation processes. A companion guide was developed to support best practices in implementing virtual simulation and promote optimum student learning using the public health nursing games.

Model Arctic Council for sustainable development

ABSTRACT I argue that Model Arctic Council (MAC) has a role to play in Arctic sustainable development. Like the better-known Model United Nations (MUN), MAC is a form of simulation pedagogy, an experiential learning process in which secondary-school pupils or university students comprehend the nature and importance of complex issues such as sustainable development by imagining themselves as diplomats trying to negotiate a common approach to them. After demonstrating the educational value of diplomatic simulations in general, I introduce MUN as its most popular form, and I assess a case-study of a global MUN program designed to advance knowledge and action among youth in respect of the UN Sustainable Development Goals. This case-study, taken together with the structure, subject-matter and educational value of MAC itself, strongly suggests that MAC can be used to advance knowledge and action among both Arctic and non-Arctic youth in respect of Arctic sustainable development, including understanding how the notion of sustainable development is both contested in general and contextualized in the Arctic. Combining this analysis with professional experience, I offer practical recommendations to educators about the effective design and use of MAC and other simulation pedagogies.

A Review of Simulation Pedagogy Past and Present; and The Experiences at One Center During the COVID-19 Pandemic

A Review of Simulation Pedagogy Past and Present; and The Experiences at One Center During the COVID-19 Pandemic

Virtual Faculty Development in Simulation in Sub-Saharan Africa: A Pilot Training for Pediatricians in Kisumu, Kenya.

IntroductionSimulation is an effective educational tool increasingly being utilized in medical education globally and across East Africa. Globally, pediatric patients often present with low frequency, high acuity disease and simulation-based training in pediatric emergencies can equip physicians with the skills to recognize and intervene. Northwestern University (NU) in Chicago, IL, USA, and Maseno University (MU), in Kisumu, Kenya launched a predominantly virtual partnership in 2020 to utilize the Jaramogi Oginga Odinga Teaching & Referral Hospital (JOOTRH) simulation center for MU faculty development in simulation based medical education (SBME) for medical students.Materials and methodsEducational goals, learning objectives, and educational content were collaboratively developed between MU and NU faculty. Virtual sessions were held for didactic education on simulation pedagogy, case development, and debriefing. Mixed educational methods were used including virtual mentored sessions for deliberate practice, piloted case facilitation with medical students, and mentored development of MU identified cases. Trained faculty had the summative experience of an intensive simulation facilitation with graduating MU students. MU faculty and students were surveyed on their experiences with SBME and MU faculty were scored on facilitation technique with a validated tool.ResultsThere were four didactic sessions during the training. Seven cases were developed to reflect targeted educational content for MU students. Six virtually mentored sessions were held to pilot SBME with MU students. In July 2021, fifty students participated in a week-long SBME course led by the MU trained faculty with virtual observation and mentorship from NU faculty. MU faculty reported positive experience with the SBME training and demonstrated improvement in debriefing skills after the training. The overwhelming majority of MU students reported positive experiences with SBME and endorsed desire for earlier and additional sessions.Discussion and conclusionsThis medical education partnership, developed through virtual sessions, culminated in the implementation of an independently run simulation course by three trained MU faculty. SBME is an important educational tool and faculty in a resource constrained setting were successfully, virtually trained in its implementation and through collaborative planning, became a unique tool to address gaps for medical students.

Assessing the Financial Sustainability of High-Fidelity and Virtual Reality Simulation for Nursing Education: A Retrospective Case Analysis.

To stimulate classroom discussion and collaboration amid the COVID-19 pandemic, increasingly creative pedological methods for nursing education are necessary. Traditionally, high-fidelity simulation has been the standard for nursing education, but the use of virtual reality simulation is increasing. One of the major evaluative measures of simulation clinical training is the cost associated with each modality. In this retrospective case analysis, budget impact analysis methods were employed to compare high-fidelity simulation with virtual reality simulation. The components of each simulation pedagogy were compared in categorized cost buckets. Overall, virtual reality simulation education was determined to require 22% less time than high-fidelity simulation education. The cost associated with the virtual reality simulation was found to be 40% less expensive than the high-fidelity simulation. Our results demonstrate that virtual reality simulation is a financially advantageous, resource conscious pedagogical option for nursing education.

Redefining Health-Care Simulation Facilitator Professional Development Through Online Learning.

Competition for nursing clinical sites has intensified as universities have increased enrollment to meet the growing demand for nurses. Hospital mandates have reduced opportunities for nursing students to practice clinical skills, leading nursing programs to use simulation to help learners gain the knowledge, skills, and attitudes needed for transition to clinical practice. Simulation offers a safe learning environment and a guarantee that every student will have experience with critical clinical encounters. To be effective, health-care simulation must be facilitated by trained educators knowledgeable in simulation pedagogy, including theory-based simulation frameworks and debriefing models. Training simulation facilitators is often challenged by financial and time constraints. The need for an easily accessible, asynchronous, cost-effective method of providing foundational simulation training led a group of experienced simulationists to develop a series of seven online educational modules grounded in simulation best practices.

(De)Colonizing Pedagogy: Possibilities and Tensions in Undergraduate Transformative Learning Through Simulation

This article employs transformative learning and decolonial theories to investigate the efficacy of simulation pedagogy for undergraduate student learning about refugees and the internally displaced. The simulation of refugee experience was adapted from the Doctors Without Borders’ Forced From Home exhibit and facilitated by an experienced affiliate for eighty-nine education and economics undergraduate students. Data include surveys, debriefing discussions, and written reflections. We ask: Does simulation pedagogy support transformative learning toward the decolonial goals of recognizing and deconstructing current power relations? How or how not? Overall, we find that simulation pedagogy successfully supports initial stages of transformative learning through engaging a combination of kinesthetic (body), affective (heart), and cognitive (mind) realms to shift students’ perspectives and knowledge. Through a decolonial lens, we chronicle the strengths and limitations of transformative learning processes and find that the simulation pedagogy achieved a combination of colonial and decolonial purposes.

Effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development, in low- and middle-income countries: A systematic review

Objective: The development of a body of knowledge in simulation pedagogy is a source of enrichment of teaching methods, beneficial for the professional training of nurses and midwives. This review synthesized the effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development in low- and middle-income countries (LMICs).Methods: The search for primary research papers was conducted in PubMed, CINAHL, ERIC, and EMBASE. For additional papers, hand-searching was performed in key journals. All studies published in the English language between 2011 and 2020 were included. Titles and abstracts were screened after removing duplicates and then full texts of the remaining studies. Thirteen research studies were initially selected for a full review, with fifteen studies that fulfilled inclusion criteria included in the final analysis. The quality of studies was appraised using the Mixed Methods Appraisal Tool. A narrative approach was used for synthesizing data. Results: Of the fifteen primary studies included in the review, there are three qualitative studies, ten quantitative studies, and two mixed methods studies. Among these studies, five were conducted in Turkey, three in South Africa, two in Ethiopia, one in Jordan, one in Kenya, one in Zambia, one in Brazil, and one in China. Student-level outcomes measured included knowledge, attitudes, skill performance, and satisfaction. Most of the outcomes at the reaction level demonstrated students’ satisfaction. At the learning level, outcomes involve knowledge (knowing), attitudes (feeling), and skills (doing).Conclusions: Educators and researchers in undergraduate education programs need evidence to inform best practice strategies for students’ skill development. This research presents preliminary evidence of the effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development on satisfaction, knowledge, attitudes, and skills. In addition, it could enlighten policymakers, managers and educators in LMICs countries on the need to use simulation pedagogy in nursing and midwifery professional training institutes.

Person-first Language in Healthcare: The Missing Link in Healthcare Simulation Training

Simulation pedagogy and training strive to adequately educate practitioners who will care for a diverse patient population. In the pursuit of protecting patients, simulation education has included a curriculum of cultural humility , diversity, equity, and inclusion that provides patient-centered best-practice. However, the missing link is person-first language essential for optimum patient/client communication. Failing to use person-first language can negatively affect patient-provider relationships. The result can adversely lead to poor patient outcomes due to mistrust, errors, decreased satisfaction, poor adherence to treatment, wasted resources, and increased healthcare costs. The use of words and how others perceive the utilization of those words matter. It is essential to acknowledge that words matter as a symbol of respect and identity in the quest towards inclusive practices. Healthcare providers carry the burden of providing quality and safe patient care. They should incorporate training strategies such as using person-first language and evidence-based resources to support an inclusive culture of diversity, equity, and inclusion.