Skills Simulation Training Research Articles

Emergency Medical Service Agency Practices and Cardiac Arrest Survival

Survival for out-of-hospital cardiac arrest (OHCA) varies widely across emergency medical service (EMS) agencies in the US. However, little is known about which EMS practices are associated with higher agency-level survival. To identify resuscitation practices associated with favorable neurological survival for OHCA at EMS agencies. This cohort study surveyed EMS agencies participating in the Cardiac Arrest Registry to Enhance Survival (CARES) with 10 or more OHCAs annually during January 2015 to December 2019; data analyses were performed from April to October 2023. Survey of resuscitation practices at EMS agencies. Risk-standardized rates of favorable neurological survival for OHCA at each EMS agency were estimated using hierarchical logistic regression. Multivariable linear regression then examined the association of EMS practices with rates of risk-standardized favorable neurological survival. Of 577 eligible EMS agencies, 470 agencies (81.5%) completed the survey. The mean (SD) rate of risk-standardized favorable neurological survival was 8.1% (1.8%). A total of 7 EMS practices across 3 domains (training, cardiopulmonary resuscitation [CPR], and transport) were associated with higher rates of risk-standardized favorable neurological survival. EMS agencies with higher favorable neurological survival rates were more likely to use simulation to assess CPR competency (β = 0.54; P = .05), perform frequent reassessment (at least once every 6 months) of CPR competency in new staff (β = 0.51; P = .04), use full multiperson scenario simulation for ongoing skills training (β = 0.48; P = .01), perform simulation training at least every 6 months (β = 0.63; P < .001), and conduct training in the use of mechanical CPR devices at least once annually (β = 0.43; P = .04). EMS agencies with higher risk-standardized favorable neurological survival were also more likely to use CPR feedback devices (β = 0.58; P = .007) and to transport patients to a designated cardiac arrest or ST-segment elevation myocardial infarction receiving center (β = 0.57; P = .003). Adoption of more than half (≥4) of the 7 practices was more common at EMS agencies in the highest quartile of favorable neurological survival rates (70 of 118 agencies [59.3%]) vs the lowest quartile (42 of 118 agencies [35.6%]) (P < .001). In a national registry for OHCA, 7 practices associated with higher rates of favorable neurological survival were identified at EMS agencies. Given wide variability in neurological survival across EMS agencies, these findings provide initial insights into EMS practices associated with top-performing EMS agencies in OHCA survival. Future studies are needed to validate these findings and identify best practices for EMS agencies.

A comparative study of venipuncture skills among intern students with and without simulator practice

Blood collection from small animals is difficult due to the increased risk of problems involved in getting a blood sample. The purpose of this paper was to analyze skill training using a simulator in the venipuncture method and investigate its impact. Twenty Intern Veterinary students were randomly chosen from Sylhet Agricultural University's 23-batch DVM program. They were separated into two groups. One group (n=10) was exposed to a simulator before practicing on a live animal, while another (n=10) was not exposed to the simulator. They worked with a live animal. Students in the experimental group demonstrated a 50% skill efficacy. The control group demonstrated inferior skill, with 25% efficacy. The difference between groups was statistically significant (p&lt;0.05). The experiment was carried out using a simple methodology and easily accessible resources to benefit other educational institutions and lessen the negative impact on live animals. Understanding the anatomy, physiology, and behavior of the species from whom the sample is being collected is critical for minimizing the risk of injury associated with venipuncture in these species. A physician must be aware of the benefits and drawbacks of venipuncture, the volume of blood that can be safely obtained, and the patient's preferred manner of getting the sample. Simulated skill training is a teaching strategy that aims to provide students with early education, enhance their confidence and skill development, and maximize process success while minimizing obstacles. Res. Agric. Livest. Fish. Vol. 11, No. 1, April 2024: 19-23

A novel low-cost device for tool targeting training and microsurgical hand tremor assessment.

The spatial accuracy of microsurgical manipulations is one of the critical factors in successful surgical interventions. The purpose of this study was to create a low-cost, high-fidelity, and easy-to-use simulator for microsurgical skills training, which can be made by residents themselves at home. In response to the COVID-19 pandemic, we created a device for spatial accuracy microsurgical skills training and implemented it in our resident's training program. We propose a design for basic and advanced models. The simulator consisted of commonly available products. A low-cost, durable, and high-fidelity basic model has been developed at a total cost of <10 dollars per unit. The model allows trainees to practice the critical microsurgical skills of tool targeting in a home-based setting. The developed device can be assembled at an affordable price using commercially available materials. Such simulation models can provide valuable training opportunities for microsurgery residents.

Teaching and learning strategies in Home Enteral Nutritional Therapy: Knowledge gains perceived by caregivers.

to evaluate how different educational strategies contribute to knowledge gains perceived by caregivers of people using Enteral Nutritional Therapy. a quasi-experimental study conducted in two stages: the first one included an interactive lecture class (LC) and the second was carried out in two groups: in-situ simulated skills training (ST) and reading of an educational booklet (EB). The caregivers answered a self-administered questionnaire to assess knowledge before and after the interventions; for the analysis, a generalized linear model with Poisson distribution was proposed and the comparisons were carried out using orthogonal contrasts. the participants were 30 caregivers; evidence of a difference in knowledge between the t1and t0 moments is evidenced. The analysis of the final comparison about the knowledge gain between the EB and ST groups, according to Student's t, evidenced an estimated difference of -1,33, with 95% CI (-4.98; 2.31) and p-value=0.46. knowledge was further increased between the t1 and t0 moments, when compared to the t2 and t1 moments in both groups. When compared, we cannot conclude that one of the groups changed more than the other in relation to moment t0 and t2; thus, the study evidenced the knowledge gain after all the educational strategies in both groups.

State of the Art in Immersive Interactive Technologies for Surgery Simulation: A Review and Prospective.

Immersive technologies have thrived on a strong foundation of software and hardware, injecting vitality into medical training. This surge has witnessed numerous endeavors incorporating immersive technologies into surgery simulation for surgical skills training, with a growing number of researchers delving into this domain. Relevant experiences and patterns need to be summarized urgently to enable researchers to establish a comprehensive understanding of this field, thus promoting its continuous growth. This study provides a forward-looking perspective by reviewing the latest development of immersive interactive technologies for surgery simulation. The investigation commences from a technological standpoint, delving into the core aspects of virtual reality (VR), augmented reality (AR) and mixed reality (MR) technologies, namely, haptic rendering and tracking. Subsequently, we summarize recent work based on the categorization of minimally invasive surgery (MIS) and open surgery simulations. Finally, the study showcases the impressive performance and expansive potential of immersive technologies in surgical simulation while also discussing the current limitations. We find that the design of interaction and the choice of immersive technology in virtual surgery development should be closely related to the corresponding interactive operations in the real surgical speciality. This alignment facilitates targeted technological adaptations in the direction of greater applicability and fidelity of simulation.

A28Developing and delivering a telephone skills simulation training for non-registered NHS mental health call-handlers

Registered healthcare professionals undertake a wide range of mental health work, sometimes with little preparation and training [1]. Increasingly non-registered staff take on mental health call-handler roles, having conversations with vulnerable individuals over the phone; these staff often lack the training to effectively communicate with callers. The aim of this initiative was to design and deliver a telephone skills training program for non-registered NHS mental health call-handlers, with the hypothesis that such training would improve their communication skills and overall job performance. Studies have shown that receiving training in having supportive mental health conversations over the phone increases staff confidence and changes their attitudes [2] and has the potential to benefit staff retention. A mixed-methods approach was used in the design, incorporating both qualitative and quantitative data collection and based on the needs and feedback of the call-handlers themselves. Evidence shows that involving simulated patients (SPs) can be effective in telephone studies [3]; leading us to train experienced SPs in their roles as members of the community phoning the help line. All was face to face, although conducted over the phone with the SP hidden. Active participants, the SP and the observing participants all became involved in the debrief. The content covered active listening, empathy, signposting and options in handling the challenging situations. Developed over a month, the programme was delivered as part of an overall training for their roles. The evaluation of the session indicated significant self-rated confidence in having calls with members of the public. The scenarios increased in intensity, covering topics ranging from bullying, domestic violence, gambling addiction and intent to take life. Qualitative feedback from the call-handlers showed that they felt more confident and prepared in their roles, and were better equipped to handle challenging situations. The involvement of SPs was also found to be authentic and highly beneficial by the call-handlers. Participants requested frequent practice sessions, face to face or online. Investing in providing targeted training and support for non-registered NHS mental health call-handlers, can have a positive impact on their communication skills, overall job performance and likely staff retention. This can ultimately lead to improved quality of care and patient outcomes in the mental health sector. The involvement of SPs can provide a valuable learning experience, both in role and in the debrief, for call-handlers, and help to prepare them for real-life scenarios. 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.

Comparison of Cardiac Auscultation Features on Four Different Simulation Mannequins Performed by Pediatric Residents.

Cardiac murmurs are a common problem in pediatric clinical practice. Studies demonstrated low accuracy in detecting and diagnosing various cardiac murmurs at all levels of medical training. So, supplementary training methods started to evolve, including simulation for auscultation skills training. Over the years, mannequins have evolved with different types of technology. Therefore, we decided to compare cardiac auscultation accuracy among high-fidelity mannequins as the primary objective and compare the performance of various postgraduate-level residents as a secondary objective. Pediatric residents at King Abdulaziz University Hospital were given a lecture on the basics of cardiac auscultation and then requested to auscultate four mannequins, namely SimJumior® (Laerdal Medical, Stavanger, Norway), SimBaby™ (Laerdal Medical), Pediatric HAL® (Gaumard Scientific, Miami, FL, USA), and Cardiac Patient Simulator K-Plus (Kyoto Kagaku Co. Ltd., Kyoto, Japan). The accuracies of murmur type, diagnosis, and auscultation time were compared. Results: A total of 56 pediatric residents were enrolled. Median murmur accuracy ranged from 50% to 53% (p-value 0.79), and median diagnosis accuracy ranged from 33% to 36% (p-value 0.77), with a nonsignificant difference between mannequins. Comparing resident levels in all mannequins, median murmur accuracy ranged from 49% to 56% (p-value 0.70), and median diagnosis accuracy ranged from 29% to 41% (p-value 0.09). While the median average auscultation time was between 41 and 50 seconds (p-value 0.34). Auscultation skills can be taught through simulation on any mannequin used in this comparison, not necessarily the cardiac one. For better accuracy, future comparisons might include more advanced cardiac mannequins based on cardiac auscultation expertise (i.e., consultant level). The introduction of an auscultation program from the undergraduate level throughout the training process and monitoring of these skills are mandated.

705 Assessment of a Novel Low-Cost Abdominal Box Simulator for Laparoscopic Skills Training

Abstract Aim To create a low-cost abdominal box simulator and assess its validity for Hassan’s entry technique and visiport. Method A low-cost abdominal box simulator was created using a metal box skeleton. This was covered in a layer of cling-film simulating the peritoneum. Red and blue tubing was placed over this creating the inferior epigastric vessels. A posterior rectus sheath was created on either side using a white cotton sheet whilst thick red woollen socks were used to simulate the rectus abdominus muscles. The entire surface was then wrapped in a thick canvas to simulate the anterior rectus sheath. Finally, a commercial skin with subcutaneous tissue was affixed and the umbilicus demarcated using a pen. This simulator was used by 30 surgical trainees (ST3 to ST7) attending a laparoscopic skills course who were asked to provide feedback on the simulator for both Hassan’s entry technique, visiport entry and the introduction of secondary ports. Results The simulator was rated 10/10 for validity as well as ease of use for Hassan’s open entry technique, visiport and secondary port insertion by all 30 of the trainees. Feedback highlighted that using the simulator trainees were able to see all layers of the abdomen and gain excellent haptic feedback. The model was described as realistic as trainees were able to identify each layer of the abdomen as they performed open or visiport entry. Conclusions A low-cost abdominal box simulator can easily be reproduced using our technique and used to train trainees effectively.

Design and Implementation of a Safe Equine Radiation-Free Radiographic Simulator for Veterinary Skills Training in the Pre-clinical Curriculum.

The ninth standard of accreditation as outlined by the American Veterinary Medical Association (AVMA) Council on Education (COE) mandates that all accredited colleges of veterinary medicine must provide instruction in medicine and surgery, including principles of practice, hands-on experiences with diagnostic methods, and interpretation of clinical findings. In equine practice, diagnostic imaging is used as a first-line diagnostic approach and is an integral part of pre-purchase and lameness examinations. Accuracy and consistency of radiographic interpretation relies heavily upon procedural techniques to acquire diagnostic images and overcome both motion artifacts and obliquity. Because the sizes and temperaments of equine patients potentiate hazardous working conditions for the veterinary team, learners might benefit from simulations that allow them to practice holding the x-ray generator and the imaging plate for diagnostic image acquisition in the absence of live horses. This teaching tip describes the development of a novel equine radiographic simulator for skills training in the veterinary curriculum. The model allows learners to handle imaging equipment safely and without radiation exposure as they develop proficiency positioning radiographic plates and placing directional markers. Learners can also test their understanding of radiographic positioning in reverse: if given a radiograph, they can be asked to describe how the x-ray generator was positioned to obtain the diagnostic image. Future iterations will investigate the simulator's efficacy with respect to learning outcomes when the model is paired with an assessment rubric as part of an objective standardized clinical examination.

Hand Dominance Is Not of Significance in Performing Fundamental Arthroscopic Skills Simulation Training Tasks

To compare the performance of the dominant and nondominant hand during fundamental arthroscopic simulator training. Surgical trainees who participated in a 2-day simulator training course between 2021 and 2023 were classified, according to their arthroscopic experience in beginners and competents. Only right-handed individuals with complete data sets were included in the study. Ambidexterity was trained using a box trainer (Fundamentals of Arthroscopic Surgery Training, Virtamed AG, Schlieren, Switzerland).Two tasks, periscoping for learning camera guidance and triangulation for additional instrument handling, were performed 4 times with the camera in the dominant hand and then in the nondominant hand. For each task, exercise time, camera path length, and instrument path length were recorded and analyzed. Out of 94 participants 74 right-handed individuals (22 females, 52 males) were classified to novices (n= 43, less than 10 independently performed arthroscopies) and competents (n= 31, more than 10 independently performed arthroscopies). Competents performed significantly better than novices. No significant difference was found after changing the guiding hand for the camera from the dominant to the nondominant hand regarding the camera path length and the instrument path length. Notably, tasks were performed even faster when using the camera in the nondominant hand. Our data demonstrate that the learned manual skills during basic arthroscopic training are quickly transferred to the contralateral side. In consequence, additional fundamental skills training for camera guidance and instrument handling of the nondominant hand are not necessary. For skillful arthroscopy, camera guidance and instrument handing must be equally mastered with both hands. It is important to understand how hand dominance may affect learning during arthroscopic simulator training.

Qualitative and Quantitative Assessment of Invasive Surgery Skill Based on a Custom Training Simulator.

Qualitative and quantitative assessment of interventional performance is a vital component in the evaluation of endovascular surgery skill training. We established a custom simulator with qualitative and quantitative metrics for endovascular performance training. The simulator included an in vitro silicone phantom, mock circulation loop, visual module, force-sensing module, and custom software for image and force data postprocessing. Two tasks to deliver the guidewire to the target location of the carotid artery were conducted by the expert (n=4), novice (n=6), and test (n=4) groups. Seven features with significant differences extracted from the expert and novice groups were applied for qualitative assessment using the support vector machine (SVM) and quantitative assessment using the Mahalanobis distance (MD). Significant differences were observed in kinematic and force data between experts and novices during the intervention procedure. The median value of finished time for task 1 was 26.88 seconds for experts and 63.36 seconds for novices. The maximum speed for experts and novices was 32.79 and 7.43 cm/s, respectively. Moreover, the classified results depicted that the accuracy of qualitative assessment for task 1 and task 2 was 96.67% and 90%, respectively. As for the quantitative data, the residents had higher scores than individuals majored in biomedical engineering at 2 tasks (70.06±5.30 vs 41.81±6.58 for task 1, p=0.001). The proposed endovascular intervention skill training simulator provides qualitative and quantitative metrics on intervention performance skills and may be a useful tool in future interventional surgical training. This simulator comprised an in-vitro silicone phantom, mock circulation loop, visual module, force-sensing module, and custom software for image and force data post-processing. Seven interventional performance features were used for qualitative assessment using the support vector machine and quantitative assessment using the Mahalanobis Distance. From the observations, we conclude that this endovascular intervention skill training simulator provides qualitative and quantitative metrics on intervention performance and may be a useful tool in future surgical training.

A mixed-reality stimulator for lumbar puncture training: a pilot study

BackgroundThe simulation is one of the basic methods of medical education, which is often used for procedural skills training. However, the existing simulator lacks internal anatomical landmarks. The study developed a mixed-reality stimulator and evaluated its usability and feasibility in lumbar puncture training.MethodsThe study recruited 40 subjects, including medical students, residents and faulty with varied levels of experience. Before training, participants completed the questionnaire about the basic information and watched a presentation about mixed reality. After practicing on mixed-reality stimulator, which provided internal anatomical structure, the examination was carried out and the results were documented. At the end of the training, trainees completed a survey of MR technology.ResultsIn this study, participants generally believed that the MR technology was very realistic (90%), and that the presentation of internal anatomy could help the operation (95%). Moreover, 72.5% and 75%, respectively, strongly agreed that the MR technology promoted learning and should be used in medical training. After this training, the success rate of puncture and the puncture time were significantly improved in experienced and non-experienced participants.ConclusionThe existing simulator was easy to be transformed into MR simulator. This study showed the usability and feasibility of MR simulator in lumbar puncture training. As a potentially good tool to simulated medical skills training, next, MR technology would be developed and evaluated in more clinical skills teaching scenarios.

Advancing immersive virtual reality-based simulation practices: developing an evidence-based and theory-driven pedagogical framework for VR-based simulations of non-technical skills among healthcare professionals

ABSTRACT Virtual reality (VR) based simulation is emerging as an innovative tool for the training and education of healthcare professionals. However, pedagogical frameworks specific to this type of simulation are yet missing. This paper explores participants’ experiences with VR-based simulation training in non-technical skills (VR-SIMI) and integrates them with established pedagogical theory. Non-technical skills refer to cognitive, social, and personal resource skills such as effective communication, relational competence, and stress management. An observational study was conducted involving 11 healthcare professionals in children and adolescents’ mental healthwho attended four VR-SIMI sessions over one year. Data were collected through field notes during participant observation and informal conversations with the participants. Directed content analysis was conducted, informed by the established practice of VR-SIMI (including INACL standards of best practice simulation), Jeffries simulation theory, Kolb’s experiential learning theory, and adult learning theory. The findings indicate that the participants positively evaluated the use of VR-SIMI. However, they also reported that the implementation and learning outcomes should be further refined. Based on these findings, an evidence-based and theory-driven pedagogical framework is proposed to guide and enhance the quality of VR-based simulations of non-technical skills for various of healthcare professionals, as well as inform future research.

THE EFFECT OF COMMUNICATION SKILLS TRAINING FOR NURSING STUDENTS BY AUGMENTED REALITY SIMULATION SYSTEM

Abstract Background Educational methods for improving communication with dementia patients are lacking. Our study aimed to evaluate the efficacy of simulated communication skills training for nursing students using augmented reality (AR). Methods A randomized controlled study. 25 nursing students enrolled and learned standardized multimodal communication skills using textbooks. Participants were randomly assigned to AR training or conventional mannequin training group and each had one-hour training of basic nursing care. The mannequin of AR group was superimposed a computer graphic of an elderly woman's face, which reacts to participants' communication. Further, participants’ gaze and voice were evaluated by artificial intelligence (AI) and the participants received real-time feedback to their head-mounted display. The conventional group had the self-training with nursing mannequins. Participants performed basic nursing care to simulated patients before and after training, which were video-recorded by eye-tracking cameras and fixed cameras, then the videos were analyzed by AI. The primary outcome was the proportion of eye contact, verbal, and multimodal communication time during the care to simulated patients. Additionally, participants' empathy was evaluated by the Jefferson Scale. Results The interactive communication in AR group significantly increased than conventional group (eye contact 13.6% versus 4.4%, verbal communication 27.7% versus 20.1%, multimodal communication 9.6% versus 3.8%, P&amp;lt; 0.05, respectively). The empathy score significantly increased in AR group, whereas it decreased in conventional group [Mean (SD): 9.1 (6.6) versus -1.3 (3.8), P&amp;lt; 0.01]. Conclusions The simulated communication skills training for nursing students using AR was associated with increased interactive communication skills and empathy to patients.

Simulated communication skills training program effects using augmented reality with real‐time feedback: A randomized control study

AbstractBackgroundWhile communication with dementia patients is challenging, known educational methods to improve communication skill for medical professionals are lacking. Our study aimed to assess the efficacy of simulated communication skills training for nursing students using augmented reality (AR) with real‐time feedback.MethodsThis is a randomized control study. Twenty‐five nursing students enrolled and learned standardized multimodal comprehensive care communication skills through a self‐learning material, which includes pathophysiology and clinical manifestations of dementia. Subsequently, participants were randomly assigned to one of the two learning systems—AR training or conventional nursing mannequin training. Each group had the training intervention to change the clothes of mannequins for one hour. The mannequin of the AR group was a superimposed computer graphic of an elderly woman’s face which reacted to participants' communication. Further, the communication skills of gaze and voice were evaluated by artificial intelligence (AI) and feedbacked to the participants’ head‐mounted display in real‐time. The conventional training group had the self‐training with nursing mannequins. All participants performed basic nursing care, including changing clothes and bed bath, to simulated patients before and after the training intervention, which were video‐recorded by an eye‐tracking camera and a fixed camera, then the videos were analyzed the communication skills by AI. Additionally, participants' empathy to patients was evaluated by the Jefferson Scale of Empathy‐Health Professions Students Version (JSPE‐HSP). The primary outcome was the proportion of time spent in eye contact during the care to simulated patients. The secondary outcome was the empathy score of JSPE‐HSP.ResultsAfter the training intervention, the proportion of time spent in eye contact in the AR training group significantly increased than the conventional training group (eye contact 13.6% versus 4.4%, P&lt;0.05). Moreover, the JSPE‐HSP score increased from pre‐training to post‐training in the AR training group, whereas it decreased in the conventional training group [Mean (SD): 9.1 (6.6) versus ‐1.3 (3.8), P&lt;0.01].ConclusionsThe simulated communication skills training for nursing students using augmented reality with real‐time feedback was associated with increased interactive communication skills to simulated patients and the empathy to patients.

Virtual Laboratory ChemСollective: Features, Benefits and Prospects of Using in Chemistry Practical Classes in Higher Education Establishments

The article examines the application of the virtual laboratory ChemCollective in the educational process of pharmacy student studying. The ChemCollective Virtual Lab is an online chemistry lab simulation that allows students to conduct experimental research according instruction and procedures, but also to design, invent and carry out their own home experiments. The Virtual Lab helps students to link chemical computations with authentic laboratory chemistry. The autograded labs create unknowns and provide feedback on students answers. The lab allows students to select from hundreds of standard reagents (aqueous) and manipulate them in a manner resembling a real lab. &#x0D; It is established that such virtual experimental works are interesting and useful for students. It is shown that the use of electronic instructions and procedures in Google Form for virtual laboratory work allows to get grades automatically, to set the time. These are too important during online studying. In addition, instructions in Google Form have the ability to attach photos, videos for illustration of processes, as well as providing of English vocabulary with Ukrainian translation to avoid language barrier. It is established that the effectiveness of the learning process increases because virtual laboratory is a simulator for skills training and independent preparation for laboratory research. It is shown that only a combination of virtual work with investigations in a real laboratory can develop skills for work with real equipments and cause rapid development of research competencies. The direction of further research is to study the resources of Royal Society of Chemistry, in particular the application of a multi-stage virtual screen experiment in chemistry practical classes for foreign students of higher education establishments.

Orientation of Healthcare Educators Towards Using an Effective Medical Simulation-Based Learning: A Q-Methodology Study.

PurposeThis study explores the healthcare educators’ orientations about medical simulation in clinical skills training —its benefits, needs, challenges, and implications for proper implementation and integration into curricula.MethodsThe study used a Q-sort technique, allowing quantitative and qualitative representation of the participants’ orientations and was conducted at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A total of 22 healthcare educators from different roles were included. Participants pre-sorted into three categories and then ranked statements related to medical simulation, by level of agreement, and they answered open-ended and demographic questions. Data was uploaded to Ken-Q Analysis application to conduct Q-factor analysis.ResultsA total of 22 healthcare educators participated in the study. Q-factor analysis was performed with principal component analysis and varimax rotation, identifying three factors. Most educators shared a similar orientation regarding the benefits of using simulation-based learning. Most participants considered medical simulation a simple, effortless, and beneficial method of learning. However, challenges in scheduling sessions and obtaining the necessary resources, such as human resources and funds, and lack of training had a negative impact on some participants’ motivation to use medical simulation.ConclusionHealthcare educators shed light on the influence of multiple factors on using medical simulation. The possibility for students to learn practical and clinical skills was a leading factor. Financial resources, funds, and faculty training were identified as challenges and needs. It is important for institutions and leaders to be aware of the variations in faculty perceptions and to provide resources and training to improve the current use of medical simulation.

A multi-screen collaboration-based low-cost portable dry-lab simulator for basic laparoscopic skills training: A technical note

Laparoscopic skills training has always been crucial for novice surgeons. Readily accessible equipment, as well as structured training curriculum should be provided to guarantee adequate practice hours and skill proficiency. Dry-lab training is typically adopted before animal model surgery, usually comprising of purpose-built bulky simulators that is neither accessible nor portable. In this technical note, we designed a home-made simulator, using two 4 L water jugs as operating space that are communicated inside, plus an observation hole taped in between to mimic the triangular working space of laparoscopic surgery. Imaging was achieved via smartphone camera, which was wirelessly connected to a laptop and a projector for real-time display on multiple screens, using built-in multi-screen collaboration software. A self-regulated and proficiency-based training curriculum was adopted. This dry-lab simulator is low-cost, highly portable and easily replicable for basic laparoscopic skills training for the beginners to intermediate surgeons, which may serve as a good way for the standardized residency and specialist training program.

Online simulation for information technology skills training in higher education.

The purpose of this study was to explore student’s experiences when practicing information technology skills with an online simulation environment. After using the online simulation environment over a five-week period, 215 undergraduate students were surveyed regarding their usage-related experiences, satisfaction with the environment, and perceived learning. Both quantitative and qualitative data collection methods were employed. The quantitative results suggested that perceived ease of use had a direct effect on student’s satisfaction with the online simulation environment, and that the satisfaction with the online simulation environment led to higher perceived learning. The qualitative findings revealed that technical problems, not being able to accomplish the objective of a step due to the precision required by the task, and the inflexibility of certain features of the online simulation environment were the commonly referenced issues, which might have impacted student’s satisfaction and their perceived learning.

Surgical training during the COVID-19 pandemic - a single institution's trainee survey

Few studies have assessed the impact of COVID-19 on surgical training in low- and middle-income countries. The aim of this study was to survey the effect of the COVID-19 pandemic on postgraduate surgical training, research and registrar wellbeing in South Africa.A cross-sectional study was conducted as an online survey from 5 October 2020 to 1 December 2020. The study population was registrars from all surgical disciplines at the Faculty of Medicine and Health Sciences of Stellenbosch University. The survey consisted of 26 multiple-choice and five open-ended qualitative questions on the impact of COVID-19 on physical and mental wellbeing, skills acquisition and postgraduate research.Of 98 surgical registrars, 35 (36%) responded. Twenty-three (65.7%) reported missed planned surgical rotations, 30 (85.7%) decreased surgical training time, and 22 (62.9%) reported a perceived decrease in training quality. Simulated skills training was only available to eight (22.9%) participants. Twenty-four (68.6%) experienced burnout and/or depression symptoms during the pandemic. Twenty-seven (77.1%) reported that postgraduate research was unaffected by the pandemic.During the COVID-19 pandemic, surgical trainees at this institution reported a decrease in the quality of surgical training and skills acquisition and a negative impact on their mental wellbeing.