Emergency Simulation Training Research Articles

Pertamina's Public Relations Communication Strategy in Dealing with the Plumpang Integrated Terminal Fire: Case Study of Corporate Crisis Communication in Dealing with Fire Victims

The fire incident at the Pertamina Plumpang Integrated Terminal that occurred in March 2023 was a disaster that resulted in casualties and losses for residents around Plumpang. The coverage of the Plumpang incident had a direct impact on the company's image and reputation. This is where public relations communication strategies play a role in restoring public trust as a form of post-disaster handling. The author uses descriptive qualitative analysis by applying issue life circle analysis to examine the findings regarding case handling. The research results show that the handling of the Plumpang Integrated Terminal fire tragedy crisis was carried out by adopting policies based on the results of discussions between Pertamina, affected residents and stakeholders, such as the program for creating an Integrated Information Post, the Sire Emergency Response program and the Emergency Training program. Handling efforts are divided into three stages, namely shor term strategy, with responsive handling through the Pertamina Peduli program, medium term, by building an Integrated Information Post, and long term, by conducting level 2 emergency simulation training. Pertamina's public relations communication strategy in handling The Plumpang Integrated Terminal fire tragedy was carried out through personal communication by holding discussions with community leaders related to the Integrated Information Post. Personal communication is also carried out by approaching residents, using empathy strategies to provide two-way communication while knowing the facts on the ground, conducting blusukan related to needs, complaints and desires in the event of the Plumpang Integrated Terminal fire tragedy.

Factors Influencing Virtual Reality Sickness in Emergency Simulation Training

Factors Influencing Virtual Reality Sickness in Emergency Simulation Training

The red hat — designating leadership using visual and verbal cues: a mixed-methods study

BackgroundDuring a critical event in the labor and delivery operating room, it is crucial for team members responding to the situation to be aware of the designated leaders. Visual and verbal cues have been utilized to designate leadership in various healthcare settings; however, previous research has indicated mixed results using visual cues for role designation.MethodsThe purpose of this study was to explore the use of the red surgical hat as a visual cue of leadership during obstetric emergency simulation training. We used a mixed-methods design to analyze simulation-based education video and debriefing transcripts.ResultsThere was a statistically significant difference in the proportion of participants who declared leadership vs. those who donned the red hat. Participants were more likely to visually declare leadership utilizing a red surgical bouffant hat than to verbally declare leadership. Most participants indicated that observing the red hat to detect leadership in the operating room was more effective than when leaders used a verbal declaration to inform others who was leading.ConclusionsOur findings suggest that utilizing a visual cue of leadership with the red surgical bouffant hat improves participant perceptions of communication of the surgical team during an obstetrical critical event in a simulation environment.

Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents

ProblemEmergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice. BackgroundSimulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched. AimTo investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations. MethodsA descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (N = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills. ResultsStudents rated their competence significantly better in the post-survey than in the pre-survey (p=<0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence. ConclusionThe results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.

Development of practical emergency simulation training in primary health care: Lessons learnt.

Emergency care in the primary health care setting is often sub-optimal leading to physician stress and adverse patient outcomes. Formal training opportunities in the management of emergency management are limited in public-sector facilities. Two family physicians conducted emergency simulation drills at primary health care facilities to address this need. The multi-disciplinary team at these facilities were involved, and each drill was followed by reflection and feedback. The drill evolved over an 18 month period, and the simulations as well as the feedback process were reviewed and improved. Reported benefits included improved skills and confidence, teamwork and sharing of information. Staff appreciated the support and the opportunity to review emergency equipment and drugs. Recommendations based on the experience gained and the outcomes of the simulation training include that the feedback is just as important as the simulations and that clinicians need to be trained in order to facilitate simulations successfully.

Interprofessional Paediatric High-Fidelity Simulation Training: A Mixed Methods Study of Experiences and Readiness among Nursing and Medical Students.

Training in communication skills between nursing and medical students during interprofessional paediatric emergency simulation training represents a significant aspect of safe patient care. Evidence highlights that poor communication in paediatric emergency scenarios jeopardises patient safety. Through realistic simulations, students practice the communication strategies of crisis resource management (CRM), such as "closed-loop communication", "speaking up", and "team time-out". In this study, we aimed to evaluate the impact of interprofessional simulation on enhancing teamwork and communication skills. Additionally, we sought to assess the occurrence of contexts for the three CRM communication strategies during simulations. Employing a mixed methods research design, the analysed students completed pre- and post-simulation online questionnaires. To measure attitudes towards interprofessional collaboration, we used the German version of the University of West England Interprofessional Questionnaire (UWE-IP_german), and to measure interprofessional attitudes, we used the Greifswald Questionnaire for the Measurement of Interprofessional Attitudes (Greif Mie), also in German, for both pre- and post-simulation. For qualitative video analysis, we utilised Grounded Theory Methodology (GTM). Following simulation training, we observed a significant improvement (p > 0.001) in the subscale "attitude towards interprofessional learning" of the UWE-IP_german among nursing and medical students. Medical students consistently exhibited a significantly (p < 0.001) more positive attitude towards other professionals in both the pre- and post-simulation assessments. Overall, all the students expressed satisfaction with the interprofessional simulation training. In the qualitative selective coding process, the central phenomenon "participation" could be identified in the coding paradigm. This study presents substantial evidence of the learning impact of interprofessional paediatric simulation training on nursing and medical students.

Healthcare Students’ Anxiety, Cognitive Load, and Trait-mindfulness during Interprofessional obstetric Simulation Training

Background Simulation anxiety can hinder healthcare students' learning. Trait-mindfulness may help reduce learners' anxiety and improve their cognitive load during simulation training. However, the relationship between healthcare students' anxiety, trait mindfulness, and cognitive load has not been studied together during undergraduate interprofessional obstetric emergency simulation training. Methods This observational correlational research examined the relationship between healthcare students' anxiety, trait-mindfulness, and cognitive load. Furthermore, it examined whether healthcare students' trait-mindfulness can moderate the effect of anxiety on cognitive load during undergraduate interprofessional obstetric emergency simulation training. Forty-six undergraduate medical and nursing students were enrolled in this study. Each participant (in a team of 3 to 4) completed one postpartum hemorrhage scenario. The French versions of the State-Trait Anxiety Inventory (STAI-Y; Gauthier &amp; Bouchard, 1993), the Mindfulness Attention Awareness Scale (Germann et al., 2009), and Paas’s cognitive load scale (Paas, 1992) were used to measure anxiety, trait-mindfulness, and cognitive load, respectively. Results The study results show a positive correlation between healthcare students’ state-anxiety and cognitive load. Additionally, healthcare students’ mindfulness moderated the effect of state-anxiety on cognitive load during simulation training. Discussion As a personality trait, healthcare students’ mindfulness is associated with reduced simulation anxiety and improved cognitive load during obstetric emergency simulation training. Besides the learning tasks and simulation environment characteristics, simulation instructors should consider healthcare students’ anxiety and mindfulness to optimize their cognitive load during simulation training. Conclusion The study demonstrated that healthcare students’ trait mindfulness mitigates the magnitude of simulation anxiety on cognitive load during emergency simulation training. It suggests further examining healthcare students’ personality traits to detect potential interactions of their traits with the simulation learning process.

Impact of emergency simulation training in primary care: a rapid review

Impact of emergency simulation training in primary care: a rapid review

The impact of brief mindfulness meditation on anxiety, cognitive load, and teamwork in emergency simulation training: A randomized controlled trial

BackgroundEmergency simulation training may impose a heavy psychological burden on health professions students (HPS), evoking anxiety, and overwhelming their cognitive load. Mindfulness may have a positive impact on HPS’ anxiety, cognitive load, and teamwork during simulation training. The effects of integration of a brief pre-briefing mindfulness meditation (MM) practice into emergency simulation training, on anxiety, cognitive load, and teamwork remain understudied. MethodsFrom November 2021 to June 2022, 70 undergraduate HPS participated in this pilot randomized controlled study. Participants were randomly assigned to the experimental group (EG, n = 24) that completed a brief in-person mindfulness meditation training program (MMTP) (2 h/week during 4 weeks) or a control group (CG, n = 46). Each group was comprised of teams (2 medical students and 1–2 nursing students). Measures of anxiety, mindfulness, cognitive load, and teamwork were collected at 4-time points: baseline, after the completion of the brief MMTP (for the EG only), at the first simulation assessment within one month later, and the second (6-month follow-up) simulation assessment. Student's t and Wilcoxon Mann-Whiney tests were used to compare the groups' measures and changes over time. A one-way repeated measures ANOVA was conducted to assess anxiety and mindfulness scores' changes over time among EG participants. Results52 participants completed all time-point assessments. EG participants recorded better state-anxiety, cognitive load, and teamwork scores than the CG participants in both simulation assessments. However, no statistically significant differences were recorded between the EG and the CG in trait-anxiety and mindfulness at the 6-month follow-up assessment. ConclusionBrief pre-briefing MM practice mitigates HPS' state-anxiety, and promotes cognitive load, and teamwork during emergency simulation training. Simulation instructors should consider MM practice in the emergency healthcare simulation instructional design.

냉동창고 건설공사 화재예방시스템 개선에 관한 연구

The domestic logistics environment must provide services in real time, regardless of time and place, due to increased delivery volume, increased logistics warehouse functions, increased delivery speed, increased low-temperature products, and the 4th Industrial Revolution. In order to survive in this logistics environment, logistics companies and others are pursuing profits on a large scale and short construction periods as business survival strategies, so the exposure of risks to logistics warehouse construction is very serious. Among them, more than 1,000 fire accidents with very serious disaster intensity have continued to occur over the past 10 years since 2010, and fire accidents have caused dozens of lives and property damage of tens of billions of won every year. The purpose of this study is to reveal the problems of the fire prevention system of the frozen warehouse construction work through case analysis and related laws and literature that occurred in the construction of the frozen warehouse among the logistics warehouses and to suggest ways to improve them.&#x0D; The research method was to investigate and analyze fire status, accident cases (centered on accidents at frozen warehouses in Icheon, Gyeonggi-do in 2008), theoretical consideration such as 4M techniques, and suggest ways to improve the fire prevention system.&#x0D; Fire prevention mechanisms of 4M refrigeration warehouse construction were investigated. Fire control by unqualified firemen, fire monitors, and lack of management by supervisors existed mechanically. The construction method of fire prevention was improved S.H.P(Safety Hold Point) operation, replacement of frozen warehouse insulation with semi-non-combustible urethane foam, introducing a mandatory fire prevention education system, strengthening emergency simulation training, and finally operating a one-out system for those who do not fulfill fire prevention guidelines.&#x0D; While conducting this study, it was an opportunity to examine the seriousness of fire accidents in frozen warehouse construction work, and I hope that the measures proposed through this study will help prevent fire in frozen warehouse construction work.

Design of Emergency Simulation Training Scene Construction System Based on Grid Model Interactive Correlation Technology

The construction of power grid emergency simulation training scenario can optimize the emergency treatment effect of staff on power grid equipment failure. Therefore, this paper designs an emergency simulation training scenario construction system based on the Interactive Association Technology of power grid model. When the user sends the data access request in the interface layer and transmits it to the data and interaction layer, the power grid information physical system based on Association characteristic matrix is used to build the emergency simulation training scenario The model method extracts the specific information of the electrical equipment structure needed for the emergency simulation training, and feedback it to the environment and simulation management layer. The three-level scene management module takes the form of data interaction in the model library module to get the specific information of the electrical network equipment structure for emergency simulation training, and realizes the construction of the emergency simulation training scene through 3D rendering technology, and uses it in the scene management program. The emergency simulation training scene management method based on slow elimination algorithm can deal with the problem of “sudden crossing” in the scene, so as to optimize the construction effect of emergency simulation training scene. After testing, the simulation training scene of the designed system is more realistic, which has a positive impact on the emergency treatment effect of power grid equipment failure.

65. Maxillofacial emergency simulation training for OMFS Dental Core Trainees – results from a new programme

Our aim was to initiate a training programme in OMFS emergencies for Dental Core Trainees (DCTs) using the resources in the Simulation Suite, in order to improve their competence and confidence in managing the emergencies they were likely to encounter during work as a maxillofacial SHO.

Medical emergency training for doctors and nurses in psychiatry: A quality improvement study.

We evaluated the impact of medical emergency simulation training on self-reported attitudes, confidence level and knowledge amongst psychiatric doctors and mental health nurses. Before and following Essential Life Support (ELS) simulation training for medical emergencies, pre and post-questionnaires were employed. Paired t-tests were used to analyse change in self-reported attitudes, confidence in self and the team, and theoretical knowledge. In 37 participants we found significant improvement in doctors and nurses attitudes (t = 2.168 p < .05 and 2.651 p < .05) and doctor's confidence t = 3.711 p < .001) following training. Knowledge increased for all participants and was significant for doctors (t = 2.112, p < .041). Comments supported training. Many doctors and nurses in mental health feel inadequately prepared and lack confidence in themselves and their colleagues to respond to medical emergencies. A structured simulation course was useful to change attitudes and increase confidence and knowledge which could benefit the team and patients.

Disaster Nursing Competency of Intensive Care Nurses in Jinan, China: A Multicenter Cross-Sectional Study.

Patients in disaster areas require the most urgent assistance. In recent large-scale natural disasters, intensive care nurses have served as an important reserve component of disaster response teams. In disaster nursing, ability and attitude directly affect the quality and effectiveness of disaster rescues. However, few studies have examined the disaster nursing competency of intensive care nurses in China. This study was designed to describe the current status of disaster nursing competency among intensive care nurses, analyze the related factors affecting the disaster response effectiveness, and evaluate the values of disaster nursing continuing education and training in cultivating professional personnel with disaster emergency rescue competence. This cross-sectional study was conducted at six tertiary general government hospitals in Jinan, Shandong Province, China. A convenience sampling method was adopted, and the Wenjuanxing website was used to compile the network questionnaire, which participants completed via a WeChat group. Descriptive, correlation, and regression analyses were performed using SPSS software. The participants in this study included 285 registered intensive care nurses employed at six hospitals in Jinan. Most were female (77.9%), and the mean age was 29.9 years. The mean total disaster nursing ability score was 122.98 (SD = 31.70), and the average scores for each item ranged from 2.78 to 3.70. The incident command system item earned the highest mean score (3.70, SD = 1.22), followed by triage (3.24, SD = 0.93). The biological preparedness item earned the lowest mean score (2.78, SD = 1.04). Being male, being < 30 years old, having an understanding of disaster nursing, having previously participated in disaster emergency simulation drills or training, and having a higher self-evaluation of rescue competence were all associated with higher disaster-nursing knowledge scores. Multiple linear regression analyses indicated that understanding of disaster nursing and experience participating in disaster emergency rescue drills or training had the most significant influence on the disaster nursing emergency knowledge score, followed by positive self-evaluation of disaster nursing ability and demand for training. The findings of this study indicate that the participants had a moderate disaster-nursing competency and that this competency may be improved through disaster-related continuing education and training. The cognitive attitude of disaster nursing was found to correlate positively with self-efficacy. Simulated emergency drills may effectively improve the disaster nursing competency of critical care nurses. The findings emphasize that experiences other than direct clinical practice such as specialized simulated emergency drills and training as well as willingness for such training are stronger factors for identifying and developing overall disaster nursing competency.

A model-based cost-utility analysis of multi-professional simulation training in obstetric emergencies.

ObjectiveTo determine the cost-utility of a multi-professional simulation training programme for obstetric emergencies–Practical Obstetric Multi-Professional Training (PROMPT)–with a particular focus on its impact on permanent obstetric brachial plexus injuries (OBPIs).DesignA model-based cost-utility analysis.SettingMaternity units in England.PopulationSimulated cohorts of individuals affected by permanent OBPIs.MethodsA decision tree model was developed to estimate the cost-utility of adopting annual, PROMPT training (scenario 1a) or standalone shoulder dystocia training (scenario 1b) in all maternity units in England compared to current practice, where only a proportion of English units use the training programme (scenario 2). The time horizon was 30 years and the analysis was conducted from an English National Health Service (NHS) and Personal Social Services perspective. A probabilistic sensitivity analysis was performed to account for uncertainties in the model parameters.Main outcome measuresOutcomes for the entire simulated period included the following: total costs for PROMPT or shoulder dystocia training (including costs of OBPIs), number of OBPIs averted, number of affected adult/parental/dyadic quality adjusted life years (QALYs) gained and the incremental cost per QALY gained.ResultsNationwide PROMPT or shoulder dystocia training conferred significant savings (in excess of £1 billion ($1.5 billion)) compared to current practice, resulting in cost-savings of at least £1 million ($1.5 million) per any type of QALY gained. The probabilistic sensitivity analysis demonstrated similar findings.ConclusionIn this model, national implementation of multi-professional simulation training for obstetric emergencies (or standalone shoulder dystocia training) in England appeared to both be cost-saving when evaluating their impact on permanent OBPIs.

Does Multidisciplinary Team Simulation-Based Training Improve Obstetric Emergencies Skills?

Clinical simulation in obstetrics has turned out to be a tool that can reduce the rate of perinatal morbidity and mortality. The objective of this study was to analyze the impact and evaluate the effects of training with high-fidelity simulation of obstetric emergencies on a multidisciplinary group. The quasi-experimental research study was structured in three phases: a first phase where the most important obstetric emergencies were determined, a second phase of design and development of the selected cases for simulation training, and a third and final phase where the abilities and satisfaction of the multidisciplinary team were analyzed. Three scenarios and their respective evaluation tools of obstetric emergencies were selected for simulation training: postpartum hemorrhage, shoulder dystocia, and breech delivery. The health professionals significantly improved their skills after training, and were highly satisfied with the simulation experience (p < 0.05). An inter-observer agreement between good and excellent reliability was obtained. Regarding conclusions, we can state that high-fidelity obstetric emergency simulation training improved the competencies of the health professionals.

Introducing Emergency Simulation Training in Paediatrics

Poster presented at BAPIO National Conference, London Nov 2019&#x0D; Peer reviewed by Subarna Chakravorty &amp; Sunil Daga

An Immersive Multi-User Virtual Reality for Emergency Simulation Training: Usability Study.

BackgroundVirtual reality (VR) is increasingly used as simulation technology in emergency medicine education and training, in particular for training nontechnical skills. Experimental studies comparing teaching and learning in VR with traditional training media often demonstrate the equivalence or even superiority regarding particular variables of learning or training effectiveness.ObjectiveIn the EPICSAVE (Enhanced Paramedic Vocational Training with Serious Games and Virtual Environments) project, a highly immersive room-scaled multi-user 3-dimensional VR simulation environment was developed. In this feasibility study, we wanted to gain initial insights into the training effectiveness and media use factors influencing learning and training in VR.MethodsThe virtual emergency scenario was anaphylaxis grade III with shock, swelling of the upper and lower respiratory tract, as well as skin symptoms in a 5-year-old girl (virtual patient) visiting an indoor family amusement park with her grandfather (virtual agent). A cross-sectional, one-group pretest and posttest design was used to evaluate the training effectiveness and quality of the training execution. The sample included 18 active emergency physicians.ResultsThe 18 participants rated the VR simulation training positive in terms of training effectiveness and quality of the training execution. A strong, significant correlation (r=.53, P=.01) between experiencing presence and assessing training effectiveness was observed. Perceived limitations in usability and a relatively high extraneous cognitive load reduced this positive effect.ConclusionsThe training within the virtual simulation environment was rated as an effective educational approach. Specific media use factors appear to modulate training effectiveness (ie, improvement through “experience of presence” or reduction through perceived limitations in usability). These factors should be specific targets in the further development of this VR simulation training.

Lessons learnt from an obstetric and neonatal emergency simulation program in India

BackgroundCombined obstetric and neonatal emergency simulation based training is gaining popularity in healthcare settings. Methods: In this qualitative study, through semi-structured one to one interviews, we evaluated participant attitudes, perceptions of retention of learning, and application to clinical practice one year after a simulation workshop. Audio recordings of interviews were transcribed, collated and subjected to thematic analysis. Results: Five major themes were identified through the thematic analysis: comparing simulation to clinical practice; learning and working in teams; thinking retention and sustainability; relating relevance of simulation based education to roles; and managing leadership. Conclusions: Participants’ acknowledgement of training being relevant to their routine practice, and keenness to learn management of complicated births highlighted the sustained impact of obstetric and neonatal emergency simulation training.

The impact of a bundled intrahospital transfer protocol on the safety of critically ill patients in a South African Metropolitan Hospital System

Background: Intrahospital transfer (IHT) of critically ill patients is associated with a high incidence of adverse events (AEs). This study aimed to determine whether the introduction of an intervention bundle could decrease AEs during, and immediately after IHT to the intensive care unit (ICU), as compared to event rates prior to the bundle’s introduction. Methods: This was a prospective, pre- and post-intervention trial, conducted in both a regional and tertiary hospital in Pietermaritzburg, South Africa. The intervention bundle consisted of an IHT protocol, a transport backpack, emergency drug container and simulation training. Primary outcomes were: 1) composite outcome of serious AEs, and 2) composite outcome of AEs contributing directly to morbidity or mortality. Secondary outcomes were miscellaneous complications, equipment-related AEs, total number of AEs, total number of IHTs complicated by AEs and the subjective measure of IHTs needing intervention within the first 30 minutes after arrival in ICU. Results: There were 381 pre-intervention IHTs and 264 post-intervention IHTs with one documented serious AE. Adverse events directly contributing to morbidity or mortality showed a reduction from 58.3% (CI 0.53–0.63) pre-intervention, to 56.1% (CI 0.50–0.62) post-intervention (p = 0.6). Miscellaneous complications yielded a reduction of 12.9% (CI 10.3–14.7%) pre-intervention to 9.5% (CI 8.3–11.1%) post-intervention (p = 0.2). Equipment-related AE reduced from 5.2% (CI 3.4–8%) to 1.9% (CI 0.8–4.5%) (p = 0.03). The total number of AEs reduced from 5% (CI 3.6–7.4%) to 4.1% (CI 2.4–6.8%) (p = 0.03), while the total number of transfers complicated by AEs reduced from 63.3% (CI 61.9–65.1%) to 60.6% (CI 58.8–63.1%) (p = 0.5). There was a reduction in IHTs requiring intervention within the first 30 minutes of arrival in ICU (34.6% to 22.7%; p = 0.001). Conclusion: These results support the use of an intervention bundle to decrease the incidence of AEs during IHT.