Simulation Workshop Research Articles

“Removing the home court advantage”: A qualitative evaluation of LEGO® as an interprofessional simulation icebreaker for midwifery and medical students

AimThe study aimed to evaluate the use of LEGO® as an educational tool for midwifery and medical students. BackgroundThe concept of LEGO® SERIOUSPLAY® ® was conceived in 1996 when Swiss Professors Roos and Victor explored using LEGO® as a strategic planning tool. We adapted this concept as an icebreaker activity for interprofessional education workshops at an Australian university. MethodUsing a qualitative evaluation, we used cross-sectional pre- and post-surveys to gain midwifery and medical students’ perspectives and insights. Students were divided into mixed discipline groups at the commencement of a one-day birthing and birthing complexities workshop and asked to design and build a birthing room using LEGO®. A pre-and post-workshop survey asked students about their experiences using LEGO® as a learning tool for team communication and collaboration. ResultsPre-workshop responses demonstrated intrigue as to how LEGO® could be used for learning. Post-workshop feedback was overwhelmingly positive and students described how it helped them develop communication and collaboration skills and understand the other disciplines' priorities and values. ConclusionUsing LEGO® as an icebreaker activity enabled open discussion and connection, promoting easy-going conversation and aiding a collaborative team-building process before students worked together in an interprofessional birthing simulation workshop. The findings indicated that the icebreaker activity enhanced the students’ awareness and appreciation of learning about each other’s perspectives, values and roles for future collaboration in the clinical workplace.

PA-rticipating in simulation: developing a novel teaching programme mapped to the physician associate curriculum, using simulation and interactive workshops to cover core conditions and non-technical skills

PA-rticipating in simulation: developing a novel teaching programme mapped to the physician associate curriculum, using simulation and interactive workshops to cover core conditions and non-technical skills

Education and training of thoracic and cardiovascular surgeons: Academic aspects in France

Over the last 15 years, there have been notable advancements in healthcare services, as well as teaching and organizational aspects, within thoracic and cardiovascular surgery in France. Traditionally, residents would enter a general surgery program before proceeding to a thoracic and cardiovascular surgery fellowship. However, starting from 2017, residents now directly enrol in a six-year thoracic and cardiovascular program, which is divided into three phases: “basic training”, “in-depth development”, and “consolidation”. Theoretical knowledge is taught during regional and national biannual seminars. To improve surgical skills, simulation workshops are organized during these seminars and on dedicated days. Finally, to further diversify their experience, residents benefit from visiting referral centres through a national tour.This article seeks to document the conventional training route for residents specializing in thoracic and cardiovascular surgery in France. We provide an overview of the training structure and methodologies employed in France for these residents, outlining the national framework that oversees their local and day-to-day training activities.

Maximizing Learning in Caring for Older Patients Through a Multi-Specialty Simulation Approach

Background: Simulation-based learning has been utilized in medical education and studied to enhance its educational impact since the 1960s (Hallinger, & Wang, 2020). However, there is a lack of multispecialty simulations in the literature (Fisher, & Walker, 2014; Age UK. 2023; NHS England, 2021; Romero-Ortuno, Stuck, & Masud, 2022; Keijsers, et al., 2016). We developed and delivered simulations on Orthopaedics and Geriatric topics. Simulation mannequins, role players, imaging, and simulated clinical documentation were incorporated into scenarios. We evaluated the effectiveness of this approach on students’ knowledge and confidence when caring for older patients. Methods: Fourth-year medical students at the University of Nottingham received simulation-based teaching during their Geriatrics placement at Queens Medical Centre. Their knowledge and confidence levels were assessed before and after the simulations. We utilized six knowledge-based and six confidence-level questions mapped to their learning outcomes for hip fractures, pressure ulcers, and discharge planning stations. In addition, we asked students to provide scenario-specific feedback and their thoughts on whether the simulation workshop was pitched at the right level. Results: Students’ knowledge and confidence levels improved significantly following the simulation workshop. About 75% of the students displayed enhanced results in the knowledge-based category. In terms of their confidence level, there was improvement seen across all simulation stations, with most learners feeling four times more confident when comparing proportions pre and post-simulation. Furthermore, 99% of the students thought the simulations had positively impacted their learning. Conclusion: Our findings demonstrate the effectiveness of the multispecialty simulation approach in undergraduate geriatrics teaching. Given significant improvements in students’ knowledge, confidence levels, and positive feedback, we aim to continue delivering this multispecialty simulation-based teaching to our students. To measure the long-term efficacy of this approach, we can perhaps re-evaluate students learning after a month to assess the efficacy of this simulation workshop.

Innovating Flexor Tendon Repair Training with a Three-dimensional Printed Model.

Flexor tendon repair is a technically demanding procedure, with functional outcome directly proportional to skillful execution. A repair must be strong to manage early mobilization and precise to allow for gliding through the tendon sheath. As a result, junior residents face a steep learning curve that may be mitigated by exposure to surgical simulators. To facilitate flexor tendon repair training, a surgical training device and accompanying instructional video were developed. Simulation workshops were held for junior orthopedic and plastic surgery residents (n = 11). To objectively assess validity of the curriculum, study participants performed cadaveric flexor tendon repairs before and after the workshop. Anonymous recordings of these repairs were graded by two certified hand surgeons. Additionally, a tensometer was used to measure strength of repair. Model realism, educational utility, and overall usefulness rated high: 4.6 ± 0.52 95% confidence interval (CI) for realism, 4.9 ± 0.42 95% CI for device, 4.7 ± 0.96 95% CI for video, and 4.9 ± 0.66 95% CI overall. Subjective confidence increased after the training session (73% ranked "moderately" or "extremely"). Likewise, scores given by the surgeons grading the repairs improved for overall quality and time of repair (pre: 2.77 ± 0.61, post: 4.22 ± 0.56, P= 0.0002). Strength of repair did not change (P = 0.87). The proposed three-dimensional surgical simulator for flexor tendon repair is realistic and useful, with improved surgical technique and improved confidence demonstrated after use. This design can be three-dimensionally printed en masse and provide value to hand surgery training curriculum.

The “scenario” as a key educational tool in the simulation centre

ABSTRACT Using simulations is considered an effective tool in training and instructional processes. At the core of the process is the ‘scenario’. The objective of the current research was to shed light on the elements that affect the development of the scenario topic and all that relate to its operation during a simulation. With a mixed method based on grounded theory, we analysed the characteristics of 74 simulation workshops and 150 scenarios between the years 2019–2020 carried out in our college’s simulation centre. Findings point to a need to construct clear criteria and rules for preparing scenarios for simulation training. Issues such as the active simulation participants’ selection process, the scenario writer’s identity, the time of exposure to the scenario before arriving at the simulation centre, and how the scenario is mediated may also contribute to the simulation’s effectiveness.

Simulation-Based Enhancement of Patient Safety During Intrahospital Transport of Trauma Patients With COVID-19: A Helipad Scenario.

Trauma resulting from accidents, violence, or war claims over five million lives annually, with traffic accidents and falls being predominant causes. The COVID-19 pandemic has posed unprecedented challenges in trauma care. Even though the number of injuries decreased during the lockdown period, the transportation of trauma patients became even more challenging due to concerns aboutinfection control and the need for enhanced protective measures. This simulation workshop was conducted in a controlled environment to test and refine protocols for the safe transport of trauma patients with COVID-19. Our goal was to develop comprehensive guidance on the intrahospital transportation of these patients, ensuring the highest level of patient care and safety. We detail a five-step approach from preparation to the pre-landing, initial assessment, patient transfer, and patient handover phases, emphasizing adherence to protocols, equipment readiness, and personal protective equipment (PPE) use. The primary issues we encountered were related to time management, the decision-making process for applying lifesaving procedures in an open environment, and the risk of cross-infection. The workshop underscored the importance of swift and coordinated care, balancing life-saving interventions with efficient transport to a definitive care facility.

The Use of Silicone Simulators for Bile Duct Anastomosis Education in Medical Conferences for the Purpose of Improving the Canadian Medical Education Directives for Specialists (CanMEDS) Competencies.

This technical report explores the potential of including silicone bile duct simulators for the purpose of completing a bile duct anastomosis (BDA)in medical conferences. The purpose is to target the need for exposure to more surgical skills and to contribute to the Canadian Medical EducationDirectives for Specialists (CanMEDS) requirements, as per the Royal College of Physicians and Surgeons of Canada. Data collection was completed at the 2023 Canadian Conference for the Advancement of Surgical Education (C-CASE) in Montreal, Canada. For several years, the quality improvement feedback received at the end of these conferences suggested a few areas of improvement, one of which was related to the concept of return on investment (ROI). The participants spend a considerable amount of funds to travel to the conferences but feel that the only measurable gains are at a research capacityand thus only relate to two CanMEDS competencies. By leveraging C-CASE, the aim is to enhance students' educational experience during events they already intend to attend. Initially, students participated in a five-part simulation workshop and engaged in a think-aloud protocol (TAO). From there, nine participants were recruited for a focus group to further understand the perceived educational valueand feedback on both the simulators and the conference structure.

550 Implementation of Inclusive Initiatives at a Grassroot Level to Ensure Long-Term Equality, Diversity, and Inclusivity in Surgery

Abstract Aim Promoting equality, diversity and inclusion in surgery begins at ensuring accessible initiatives are executed at a grassroot level for prospective students. The Royal College of Surgeons illustrated that 20% of their surgical leadership positions were from BAME communities. SGUL MedEd Society aims to support students from widening participation (WP) backgrounds in their medical application by addressing disparities and providing support within these areas. Method We conducted free sessions aimed at different aspects of the medicine application with the intention of facilitating understanding and support for WP students. Multiple domains were covered such as a UCAT webinar, an ‘Experience into medicine’ simulated workshop covering the key learning styles employed in university as well as multiple mini-interview (MMI) preparation through an online webinar and in-person mock. Feedback forms were implemented before and after sessions using 5-Point Likert scales to measure changes in confidence. Results An increase in confidence applying to medical school was observed in the ‘Experience into medicine’ workshop (n=25) with a 60% rise in students rating 4/5. Statistical analysis was carried out on the results obtained from the MMI webinar (n=169) using the Wilcoxon signed-rank test which suggested the initiative significantly improved students’ confidence (w=14, a=0.005). This was followed by a practice MMI session (n=68) whereby 50% of students reported feeling more prepared for a real MMI. Conclusions These results suggest there is a substantial improvement in confidence in WP students after the event, increasing the likelihood of inclusivity in medicine. This has wider implications in supporting applications into surgery in the future.

Feasibility of Holographic Team Training Simulation: An Information Technology (IT) Perspective for Healthcare and Educational Institutions.

Introduction This study examines the feasibility and practicality of holographic display technology (HDT) in health professions educationfrom an information technology (IT) support staff perspective. Considering a lack of feasibility studies for introducing newer technologies, it focuses on feasibility's acceptance and practicality dimensions during a simulation-based team training workshop. Method A multimethod design feasibility study assessed the acceptability and practicality of HDT for the IT staff through a Unified Theory of Acceptance and Use of Technology (UTAUT)-based survey and a focus group discussion after a team training simulation workshop. Results Quantitative results showed a reliability coefficient (α=0.83) and a positive correlation between facilitating conditions (FC) and effort expectancy (EE), self-efficacy (SE) and social influence (SI), SI and attitude toward technology (AT), SE and attitude to use, and behavioral intention (BI) and EE. Negative correlations included SE and performance expectancy (PE), comfort with technology and FC, comfort and anxiety, and attitude to use and experience. Qualitative findings yielded four key themes from the focus group discussions that corroborated the quantitative findings. Discussion The study findings highlight the promising potential for HDT feasibility in educational settings. Future research should extend to diverse contexts to validate these preliminary findings and explore broader educational applications.

Breaking Silo Thinking within the South African Water-Energy-Food Nexus via Systems Thinking and Simulation Workshops

Despite their inextricable interlinkage commonly known as Water-Energy-Food nexus, the current disconnect in policy development and management of the water, energy, and food resources threatens their security of supply. The security of these basic human needs is aggravated by the cross-cutting role of climate change which impacts their availability. These apprehensions suggest that contemporary methods are required to improve and enhance integrated approaches and systems in the management of the food, water, and energy sectors within the discourse of climate change. This study applied Systems Thinking methodologies to foster collaboration amongst key stakeholders within Eskom, electricity generating sector in South Africa. This was done through several simulation workshops held amongst these value chain sectors. The workshops have demonstrated the ability of these systems to enable stakeholders to apply the “nexus thinking” approach in managing the sectors of water, food, energy, and climate change within the power utility. The study concluded by recommending application of this simulation within the policy development and other key sectors to enable a broader application of nexus thinking.

A Qualitative and Quantitative Analysis of a Pilot Psychotherapy Training and Simulation Workshop for a Cohort of Psychiatry Core Trainees Starting Their Long Case in SABP Foundation Trust

A Qualitative and Quantitative Analysis of a Pilot Psychotherapy Training and Simulation Workshop for a Cohort of Psychiatry Core Trainees Starting Their Long Case in SABP Foundation Trust

Evaluation de l’enseignement par les étudiants : exemple d’un atelier de simulation sur l’ECG

The electrocardiogram (ECG) is a fundamental tool in medical practice. At the Faculty of Medicine of Tunis (FMT), it is usually taught during a lecture. FMT's Physiology Department has innovated its teaching by introducing simulation workshops. This study aimed to assess the students' satisfaction with teaching ECG by simulation. This was a cross-sectional descriptive study, carried out in April 2018, including 160 students in the first year of the first cycle of medical studies, divided into 10 groups. The students attended an ECG simulation workshop at the FMT media library and then answered a satisfaction form and a self-assessment questionnaire for the workshop. More than 50% of the students answered either satisfied or very satisfied with the duration of the course, the room, the method of the teacher, and their participation in the course of the session. Regarding teaching support, 19.3% of the students were very satisfied with the practice of the ECG on a mannequin versus 25% for the practice on a voluntary student. For the number of students per group, 42.1% of students were dissatisfied. This study highlights the weak points of this simulation workshop in order to improve it. Then, it helps to build students' confidence and encourage their adherence to the feedback process. Finally, it shows students' enthusiasm for new teaching methods such as simulation. It would be interesting to generalize this evaluation process for the improvement of medical education and the training of future doctors.

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

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

Tips for Organizing a Dyslexia Simulation Workshop for Pre-Service Teachers

The impact of dyslexia on literacy has gained much attention in recent years, resulting in the need for additional training for teachers at all levels of the educational system. Therefore, the purpose of this paper is to provide tips on how to organize a dyslexia simulation. Authors recount their experiences building a team, identifying participants, selecting a simulation, planning, organizing, setting up, and implementing a dyslexia simulation workshop for pre-service elementary and special education teachers. Initial expectations, challenges, and successes are highlighted. Final reflections, lessons learned, tips, and resources (Table 3) are shared. Overall, the facilitators and participants found the experience beneficial.

Validating a New Surgical Gouge for Autogenous Ear Reconstruction During Simulated Microtia Workshops

Autologous ear reconstruction remains a gold standard surgical technique for the treatment of external ear deformities. This highly technical procedure requires experience, an understanding of aesthetic principles, and a surgical approach that can consistently produce optimal results. As an experienced microtia surgeon having trained under Dr Satoru Nagata, the senior author has emphasized the importance of appropriate surgical tools during this procedure. Here, we present results of a novel surgical handle and gouge meant to optimize complex cartilage carving. The senior author regularly holds microtia workshops to help train individuals around the United States. During 2 of such workshops held in 2022, participants were given access to both the standard, commercially available surgical gouge as well as a prototype of a novel surgical gouge developed by the authors. Participants were then given a Likert-scale survey to assess their subjective feedback for both tools. Twenty-seven total participants completed the postworkshop survey. Cumulatively, the results demonstrated that participants rated the custom gouge significantly higher than its counterpart (4.2 versus 3.2, P<0.001). They also had a significantly higher likelihood of using the custom gouge again (4.1 versus 3.2, P=0.023). The custom gouge designed by the senior author demonstrated higher subjective ratings when compared with what is currently available on the market. This serves as a primary validation study that demonstrates feasibility for further assessment in a true operative setting.

A Follow-Up Study on the Clinical Impact of Pre-Registration Extended Immersive Ward-Based Simulation

AimTo explore how extended immersive ward-based simulation influenced graduate nurses’ experiences six-months post-registration. BackgroundGraduates of nursing training programs are expected to enter the workforce meeting the role of a registered nurse. Extended immersive ward-based simulation has been adopted by nurse educators as a means of easing the transition to professional practice. To what degree transfer of learning occurs from these experiences is yet to be determined. DesignA qualitative descriptive design was used to conduct a series of face-to-face focus groups. MethodsParticipants were nine former students who had participated in a series of ward-based simulation workshops before graduating. A semi-structured interview process explored participants’ transition experiences. ResultsPast simulation experiences were used as a base for practice in areas of teamwork, communication, conflict, and time management. Simulations were used as a point of reference and built confidence for transition to practice. ConclusionsTransition to professional practice was supported by simulated experiences. Transfer of learning was demonstrated among participants.

Bridging the theory-practice gap in pharmacy education using an authentic learning approach: A cross-sectional study

Background: Authentic learning environments highlight real-world relevance to students, contributing to readiness for practice. This study evaluated the impact of an educational activity on student pharmacist learning and personal/professional development. Methods: An activity similar to that used by practising pharmacy professionals to record errors during dispensing was included in simulated community pharmacy workshops delivered to Year-2 students as part of a Professional Practice Module. Students were instructed to complete entries when academic staff identified errors during final accuracy checks. Student evaluation surveys were analysed at the end of terms one and two of the academic year. Descriptive statistics were used for closed questions, and thematic analysis for open-ended responses. Results: Of the 75 student pharmacists who completed both evaluation surveys, 64% (n=48) recorded fewer errors in term two. Respondents considered the exercise helpful in highlighting the need for more attention to detail and identifying negative trends in their dispensing process. A positive response to personal/professional development was noted, with student pharmacists commenting that the activity facilitated reflection. Conclusion: This activity has allowed students to experience real-world working situations, extending their learning experience, facilitating personal/professional development, and encouraging best practices.

Evaluation of a high-fidelity cleft alveolar bone graft simulator

IntroductionCleft alveolar bone graft surgery is technically challenging to perform as well as difficult to learn and teach. A high-fidelity cleft alveolar bone graft simulator was previously developed. However, further evaluation of the simulator is necessary to assess its efficacy. MethodsTwo cleft simulation workshops were conducted in which participants were led through a simulated cleft alveolar bone graft. The first simulation workshop involved six plastic surgery trainees. The second workshop involved 43 practicing cleft surgeons. The participants were provided with a Likert-type questionnaire assessing the simulators’ features, realism, and value as a training tool. The change in self-reported confidence was assessed by providing each participant with a pre- and post-simulation confidence questionnaire. ResultsThere was overall agreement in the realism of the simulators’ features (average score of 4.67 and 3.80 out of 5 for the trainees and surgeons, respectively). There was overall agreement to strong agreement in the simulators value as a training tool (average score of 5 and 4.43 out of 5 for the trainees and surgeons, respectively). The self-reported confidence increased for all questionnaire items for both the trainees and surgeons. This was significant (p < 0.05) for five out of eight and all questionnaire items for the trainees and surgeons, respectively. The magnitude of the confidence increase was generally greater for less experienced participants. ConclusionThe cleft alveolar bone graft simulator was found to be realistic and valuable as a training platform. Use of the simulator improved self-reported confidence in cleft alveolar bone graft surgery.

Program evaluation and early outcomes of a severe preeclampsia and eclampsia maternal safety bundle in a single institution in the Philippines

BACKGROUND: To reduce maternal morbidity and mortality associated with hypertension, standards for maternal safety and efforts to implement a structured team approach have been undertaken. Following the formulation of a policy document, a maternal safety bundle was developed. The implementation of bundle components including eclampsia kits, clinical pathways, and educational module occurred in phases due to pandemic restrictions. An eclampsia kit and clinical pathways were implemented in 2020. An online lecture was launched in 2021 followed by in-person eclampsia simulation workshop beginning 2022. OBJECTIVES: This paper aims to report the early outcomes of a severe preeclampsia and eclampsia maternal safety bundle implementation in a private hospital between 2020 to 2023. MATERIALS AND METHODS: Demographic information, posttest knowledge assessment and pre- and post- eclampsia workshop confidence scores were recorded. Structure, process, and outcome measures were determined. Descriptive statistics were used for participant demographics and score percentages. Paired t-Test with a significance level of P&lt;0.05 was used to compare the pre- and post-simulation confidence scores. Summary data for outcome and process metrics were manually calculated. Summary categorical data was used for structure metrics. RESULTS: Two hundred eighty-eight (288) participants completed the online didactic lecture. Average posttest knowledge assessment score was 88.1%, 88.88%, and 82.6% from 2020 to 2023. Ninety-nine participants completed the eclampsia simulation workshops. Mean post-simulation confidence scores were greater than mean pre-simulation confidence scores (42.3 vs. 39, p=0.0259 in 2022 and 41.975 vs 36.65, P=0.0035 in 2023). There is 100% compliance with timely management of severe hypertension and eclampsia prevention and a decreasing trend in hypertension related severe maternal morbidity rates. CONCLUSION: A severe preeclampsia and eclampsia maternal safety bundle is a feasible quality improvement initiative that promotes peer learning, strengthens clinical competencies, and improves access to emergency resuscitation supplies. The results of this program evaluation may serve as a framework for implementing quality improvement initiatives on maternal safety.