Simulation Training Research Articles

Implementing an obstetric simulation training protocol in a critical access hospital

BackgroundA high-fidelity (HF) simulation training protocol was implemented to improve nurses' knowledge, skills, and self-confidence to improve patient quality of care and safety, thus ultimately having an impact on decreasing maternal mortality rates. SampleThe sample consisted of 16 participants including nurses, a physician, emergency medical technicians (EMTs), and paramedics. MethodsThis project used a self-confidence and competence assessment prior to and following participation to determine statistical significance. In addition, review of the National League for Nursing Student Satisfaction and Self-Confidence in Learning tool data was done to determine the overall success of implementing a HF simulation training protocol. ResultsSuccess of the simulation and content was determined by a reported increase in self-confidence and competence post-simulation. The summative evaluation revealed that participants felt that implementing a HF simulation training protocol, in general, was useful for training. ConclusionWhile this project focused on obstetrics, the premise of the project can be applied to many subject areas to advance practice in rural health. Findings suggest that use of a high-fidelity simulation training protocol is beneficial.

Evaluating anxiety and self-confidence in nursing students: Adaptation and validation of the NASC-CDM scale for high-fidelity simulation training

BackgroundAnxiety and self-confidence impact performance and decision-making during high-fidelity simulation in nursing education. A validated tool to assess these factors is lacking. MethodsThe Nursing Anxiety and Self-Confidence with Clinical Decision-Making© scale (NASC-CDM) was translated, adapted for high-fidelity simulation and validated using a five-step approach. This included a Content Validity Index review by experts and pilot-testing with first-year nursing students. Construct validity and internal consistency were evaluated using Exploratory Factor Analysis and Cronbach's alpha. ResultsA total of 187 first-year nursing students participated. Exploratory Factor Analysis identified constructs for anxiety (two factors, 60.72% variance) and self-confidence (three factors, 61.22% variance). The tool demonstrated high internal consistency, with Cronbach's alpha values of 0.956 for anxiety and 0.955 for self-confidence. ConclusionThe 19-item Dutch Nursing Anxiety and Self-Confidence with Clinical Decision-Making for High-Fidelity Simulation scale is a valid and reliable instrument measuring anxiety and self-confidence in nursing students during high-fidelity simulation.

Simulation training for invasive cardiovascular procedures: the Heart-SIMS-1 study

Abstract Introduction Interventional cardiology training has a long learning curve and exposes patients and clinicians to undesirable procedural risks. We aim to assess whether mentored simulation-based training with three dimensional (3D) printed models can improve the procedural skills and safety performance of beginners in coronary diagnostic procedures. Methods Twenty-nine final-year medical students from a single centre were lectured in the basic principles of invasive coronary angiography (ICA) for one-hour, and then randomized to conventional training or simulation training. Conventional training (n=15) consisted in watching a 20-minute video demonstrating all ICA steps in a 3D-printed coronary simulator. Simulation training (n=14) offered the same explanations in a hands-on training session with the 3D-printed model, in pairs, for 20 minutes. The co-primary endpoint was efficacy and safety of performing a simulated ICA in the 3D-printed simulator, installed under sterile drapes, in a conventional angiography suite. Efficacy and safety were graded by a blinded investigator using a pre-specified performance checklist, including the identification of procedural "red flags", graded 0-100%. The secondary endpoint was theoretical knowledge, assessed in a 25-question multiple-choice quiz, graded 0-100%. Results All participants completed the training and evaluation phases. Both elements of the co-primary endpoint were superior in the simulation group: efficacy score of 91.5 ± 3.8 vs 64.6 ± 8.3% and safety score 100.0 (100.0-100.0) vs 62.5 (20.8-79.2) %, p<0.001. The median number of "red flags" were 2 (1-4) in conventional and 0 (0-0) in simulation training recipients (p<0.001). Secondary endpoint was higher in simulation training: 85.7 ± 9.0 vs 76.8 ± 12.7% (p=0.039). Conclusion Mentored simulation-based training of medical students in ICA with 3D-printed models resulted in improved performance regarding efficacy, procedural safety, and theoretical knowledge.ResultsSimulation and evaluation setup

Determinants in disaster preparedness of nurses in the Azores

Abstract Background Disasters are situations of complexity and unpredictability, increasingly frequent and more destructive. They require rapid and effective action from different teams from different contexts, with preparation and qualifications for an adequate response to victims, recovering the environment, and restoring living conditions, and nurses play a significant role in these events. Understanding the level of preparedness of nurses for disasters is fundamental for defining the competency framework in the disaster management cycle. Objectives To analyze the preparation of nurses in the Azores for a catastrophe. Methods A cross-sectional study was performed with 160 nurses from the Azores. The questionnaire validated for the Portuguese population “Disaster Preparedness Evaluation Tool (DPET ®): Preparation of nurses in the face of a catastrophe” was applied. It was approved by the Ethics Committee. Results More than half of respondents (n = 137, 71%) indicated that they were not fully prepared to respond to disasters, while 29% (n = 46) acknowledged that they felt adequately prepared. Of the 160 respondents, only 20% (n = 30) participated in the development of emergency plans and only 14% (n = 22) participated in the creation of emergency plans that contribute to improvements at the local level. Training through simulation training was cited as important in disaster preparedness (n = 129, 78%). Discussion The present study identified little involvement of RAA nurses in preparing emergency plans and less than half feel poorly prepared in responding to a catastrophe. This finding is consistent with studies by Baker, Alamri, & Aboshaiqah (2019) and Emaliyawati et al. (2021). Conclusions This study was conducted in a region prone to natural disasters. It is vital to invest in the training of these professionals throughout the disaster cycle so that they can contribute to reducing the impact that the catastrophe will have on the individual/family and community. Key messages • Strengthening capabilities through regular disaster training based on effective information. • Low participation in the development of emergency plans that contribute to improvements at the local level.

Risk perceptions and risk behavior among children attending a road safety education program in Greece

Abstract Background Road Traffic Injuries (RTI’s) are a significant public health concern for children, placing a considerable burden on their well-being. Greece has consistently recorded high numbers of RTI’s among adolescents. Methods A university lab (LaHeRS, HMU) offers a road safety education program for primary and secondary students in Heraklion, Greece. The program consists of two parallel sessions (practical training using a driving simulator and activity-based risk-perception training) aimed at enhancing competencies in resilience to peer influence, empowering children to engage in informed decision-making and fostering hazard perceptions skills. The current presentation reports on 800 students who attended the program between October 2023 and April 2024. A structured questionnaire was used to collect data on student’s beliefs, attitudes and practices on road safety. Results A total of 800 students attended the program from the broader Crete Region. 50.5% were girls with a mean age of 12.6 (SD = 2.3) years, 60.9% secondary education students, 58% resided in rural areas. 33.9% reported using a motorcycle and 33.8% a car without a driving license. 23.3% reported experiencing a road traffic incident while commuting. 57.1% identified road safety as a problem in their place of residence, only 26.5% felt safe on local streets and only 9.1% considered other road users as watchful. Additionally, 66.8% highly valued helmet use as a precaution in short distances. 71.6% reported always wearing seatbelt in front seats and 68.9% thought seatbelts are important at back seats. 52.1% did not identify themselves as risk takers on the street, and only 22.5% felt competent in avoiding road risks. 32.9% admitted experiencing peer pressure while commuting. Conclusions Risk taking behaviors and low use of protective measures are prevalent among school aged children and need to be addressed through targeted road safety education programs and interventions. Key messages • Promoting safe behaviors and enhancing risk perception is critical among children and young adolescents. • Road safety education should be integrated into school curricula, starting from pre-school education.

Feasibility of novel robot-assisted, remotely-performed echocardiographic examination

Abstract Background Access to echocardiography services outside metropolitan areas is persistently limited. We sought to determine the feasibility and efficiency of performing remotely-controlled, semi-automated robot-assisted echocardiographic examinations (robot-assisted echo) by cardiac sonographers as a potential avenue to provide standard echocardiographic specialist services to remote and rural areas as well as permit expedited diagnoses enabling earlier management of disease. Methods Two accredited cardiac sonographers (Cardiac Investigations Unit) undertook 6 hours virtual training, and 10 hours hands-on robot-assisted echo simulation training; using a novel, semi-automated robotic arm system to remotely manipulate an ultrasound probe to acquire echocardiographic images. Sonographers then performed remotely-performed robot-assisted echo examinations on staff volunteers, and consenting inpatients in whom echocardiography was clinically indicated. Cameras, probe pressure sensors and an ultrasound platform remote console were utilised to support remote operation. Traditional echocardiography (manipulation of probe by hand) was also performed as a reference. Feasibility to obtain a comprehensive robot-assisted echo was compared to traditional echocardiography. Sonographer learning curve and efficiency (image acquisition time and offline measurement time) was also investigated. Results Total cohort was n=78 (age 51±15yrs; 57% male) with 63% patients. All participants had robot-assisted echo and traditional echocardiograms performed within 72hrs. Average feasibility (%) of robot-assisted echo as (a) 11 averaged assessments and (b) 38 averaged measures was 92±9 (a) and 86±11 (b), compared to (a) 99±1 and (b) 97±7 by traditional examination (all respectively). Sonographer learning curve was identified via 1:1 block subcohort analysis, with averaged assessment feasibility (n=33:31) being 86±19 (first block) to 98±3 (last block) and averaged measurement feasibility (n=32:31) being 77±11 (first block) to 92±7 (last block), all respectively. In the staff participant cohort (n=31), average image acquisition efficiency in robot-assisted echo was poorer than that of traditional examination (47+9 minutes compared to 19+2 minutes; p<0.0001), respectively. Average efficiency of offline measurement time was 13+7 minutes by robot-assisted echo; comparable (p=0.33) to traditional examination at 12+6 minutes. There was no learning curve effect on image acquisition efficiency; 42+10 vs 51+7 minutes (1:1; n=16:15; p=0.007). Conclusion Remotely-performed, robot-assisted echo using a commercially-available ultrasound platform performed by briefly-trained, cardiac sonographers is feasible, with reasonable efficiency even though less efficient in image acquisition compared to traditional echocardiograms. Further investigation of performance as a remote service is warranted in larger, clinically-indicated populations.

Tell me and I forget, teach me and I may remember, involve me and I learn: impact of simulation training on performance in electrophysiology

Abstract Background Interpretation of intracardiac electrograms plays a key role in electrophysiology (EP) training. However, there had been a substantial gap between theoretical knowledge and practical skills acquired in the clinical setting. With the development of an online life-like EP-simulator, interactive training has never been so easily accessible. Purpose The aim of this study is to assess the efficiency of simulation-based training in electrophysiology, with the help of EP-simulator, by comparing it to traditional-learning methods. Methods 340 participants attended a 3-hour, online video-lecture on basic electrophysiology. Then, they were randomised 1:1 into a traditional-learning and simulation-learning groups. Both groups received presentation slides from the lecture and two textbook recommendations. In addition, simulation-learning group obtained access to online EP-simulator. This was followed by one week of self-learning. At the end, their knowledge was assessed using an online multiple-choice test. Results Eventually, 91 participants from the traditional-learning group and 67 participants from the simulation-learning group took the final test. The simulation-learning group, which obtained additionally an access to EP-simulator, scored significantly better than the traditional-learning group (mean score=15.10 vs 13.16, p=0.022). Conclusion EP-simulator can possibly contribute to better learning results. Including simulation in training programs may have an impact on educational outcomes.Course of the studyEP-simulator interface

Exploring Empathy Dynamics in Virtual Patient Training

Abstract Background This study investigates the manifestation of empathy among nursing students and teachers during virtual patient training with VR glasses at the Medical Simulation Training Centre of Medical University - Plovdiv. The pilot training, conducted from March 22 to April 12, 2024, was part of the Erasmus+ project ‘Caring violent child safely in child psychiatric and residential units (Safe4Child) 2021-1-FI01-KA220-HED-000032106.’ Participants were divided into two focus groups: third-year nursing students and lecturers teaching specialized academic disciplines in nursing. Results A total of 34 participants partook in the study, comprising 16 instructors with basic nursing education and 16 third-year nursing students. Students exhibited considerable empathy towards the virtual child patient, expressing an inclination to provide assistance, acknowledging the necessity for personalized care, and displaying a curiosity about the patient’s experiences. They conveyed sentiments such as ‘I felt the need to help the child/patient’, ‘the child needs individual work with a nurse’ and ‘I want to understand the child’s experiences.’ In contrast, instructors demonstrated more reserved emotional responses, characterized by professionalism and a focus on offering comfort. They expressed, ‘Normal feelings...but you want to hug the child and comfort him.’ Conclusions The study unveiled a marked difference in empathy expression between students and instructors, with students displaying stronger emotional reactions. These findings underscore the need to recognize and address individual variances in empathy expression within nursing education. Tailored strategies should be devised to bolster empathy development in both students and instructors during virtual patient training. Further investigation is warranted to explore effective methodologies for optimizing empathy development and fostering compassionate patient care in nursing education. Key messages • A Comparative Analysis of Nursing Students and Instructors Using VR Glasses. • Erasmus+ project (Safe4Child) 2021-1-FI01-KA220-HED-000032106.

Employee’s Security and Health Augmentation in the Hotel Sector

The vibrant and quick-paced environment that defines the hotel sector is defined by a strong emphasis on employee welfare. This study examines the various aspects of worker health and safety in the context of the hospitality sector with the goal of identifying problems, prevalent behaviors, and appropriate remedial measures. The study uses a mixed-methods approach, combining quantitative analysis of safety event data with qualitative interviews with important industry players. In-depth interviews with hotel managers, staff members, and safety specialists are conducted as part of the qualitative component to elucidate the myriad difficulties faced by hotel staff in upholding their health and safety. The effects of irregular work schedules and sleep patterns, workplace stress, and ergonomic considerations all emerge as major themes. The study also examines how well the current training and safety practices work, looking for flaws and potential improvement areas. The study examines historical safety event data from a wide range of hotels on the quantitative front. The goal of this analysis is to spot trends, prevalent accident causes, and geographic regions with a higher prevalence of safety concerns. The results offer a data-driven framework for creating focused interventions and preventive actions. The research also examines how technology can support initiatives to increase employee safety in hotels. We investigate the possibilities for real-time monitoring systems, wearable technology, and enhanced training simulations to improve safety awareness and reactivity. A series of suggestions for enhancing employee health and safety in the hotel business are provided as part of the study's conclusion. The incorporation of technical solutions, specialized training programs, and changes to policy are all included in these suggestions. The hotel business may cultivate a safer and healthier work environment by resolving the issues mentioned, enhancing overall employee well-being and assisting in the industry's long-term success.

Students' perceptions of knowledge reinforcement on indirect prosthetic dental material choices by a translational approach.

The aim of this study is to evaluate students' perceptions of the reinforcement of knowledge via innovative, case-based, hands-on learning regarding indirect prosthetic material choice. Six different clinical cases that represented common prosthetics were used in this simulation training. In each case, clinical pictures were associated with three-dimensional (3D)-printed replicates of final restorations and PolyJet polychromatic models with the goal of enabling students to deliberate and exchange ideas in small groups. After a debriefing session regarding the therapeutic potentialities of the first three cases alongside teachers, a lecture concerning prosthetic material choices was provided, and a zirconia crown was stained by each student to enable them to obtain a better understanding of the dental technician profession. Finally, the latter three cases were studied and analyzed in the same manner. The students' perceived reinforcement of knowledge was recorded before and 1 month after the hands-on simulation training experience, and their satisfaction was evaluated immediately thereafter on Likert scales. Students' perceived reinforcement of knowledge was subjected to statistical evaluation. A high level of overall satisfaction was observed (4.60). All of the items pertaining to students' satisfaction received scores >3. One month after this hands-on approach, students' confidence in their ability to choose a material on the basis of its mechanical, optical, and luting properties increased significantly (from 2.58 to 3.64; from 2.83 to 3.64; and from 2.72 to 3.58, respectively) (p<0.05). This innovative, hands-on approach had a significant positive effect on students' perceived reinforcement of knowledge.

Teaching Strategies in Interventional Radiology: A Narrative Review of the Literature.

Interventional radiology (IR) is a rapidly developing speciality where innovation-especially in teaching practices-is vital. With workforce and capacity shortages, synthesis of classical educational theories and novel strategies utilising virtual reality (VR) and artificial intelligence (AI) provide opportunities to make teaching as efficient and effective as possible. The aim of this review is to examine the literature on different approaches in IR teaching and learning in undergraduates and postgraduates. Literature was reviewed using a comprehensive search strategy with relevant keywords. Articles were limited to 2013-2023. Databases searched included MEDLINE, Embase, British Education Index and ERIC, in addition to a manual review of references. Of the 2903 unique abstracts reviewed by the authors, 43 were relevant to the purpose of this study. The major pedagogical approaches identified were categorised into the following-traditional master-apprentice mentoring, virtual reality/simulation, physical models, and remote teaching. VR simulations enable practise free from the limits of time and risk to patients, as well as potential for standardised formal curricula. AI has the capability to enhance training simulations and assessment of trainees. With recent events necessitating innovation in online remote teaching, programs that are accessible whilst arguably imparting just as much clinical knowledge as in-person education have now been developed. Mentoring has conventionally been the standard for radiology teaching, however there are now several alternative pedagogical approaches available to the IR community. Acombination of the most effective ideas within each is the optimal method by which IR should be taught.

Quantification of training in educational methodology among teachers on the degree course in medicine: a pilot study

BackgroundMedical education has undergone significant changes over the last decades. Scientific and technological progress alongside contemporary society’s changing requirements have driven demand for highly trained, competent doctors. In response to this need, university faculties of medicine have sought innovative forms of teaching and evaluating the students on their degree courses. The aim of this study was to quantify the characteristics and extent of academic training in teaching methods, of participation in innovative teaching initiatives, and training in simulation and debriefing among the teaching personnel on the degree course in medicine at the University of Granada (Spain).MethodsThis transversal descriptive study was conducted among a population of 121 educators teaching on the medical degree course at the University of Granada, Spain. All responded to a specially designed CoRe-Content Representation questionnaire. This consisted of various parts: (a) demographic data; (b) teaching experience and qualifications; (c) specific information about training in teaching skills received. The Fisher test was applied whenever the dependent variable had two values (dichotomous) and the Chi-square test when it had more than two values (polytomic). Statistical significance was established with an alpha error of 5%.ResultsThe results showed that 87.60% of the educators had received no training in debriefing. There was a notable gender gap, whereby women held fewer management posts, fewer were engaged in clinical activity, and fewer had undergone training in clinical simulation. Teachers with degrees in medicine had undergone less regulated training than educators with other degree qualifications.ConclusionThe main areas of medical training that require improvement (and so present challenges to be met in the years to come) are as follows: a definitive solution to the existing gender gap, general implementation of new educational models and methods (especially learning based on clinical problem-solving and simulation), closing generation gaps, and improved training processes for educators with clinical attachment.

The Influence of Physical Training on Breast Cancer: The Role of Exercise-Induced Myokines in Regulating Breast Cancer Cell Growth and Survival

The beneficial impact of physical training in lowering cancer risk is well known. However, the precise mechanisms linking physical training and cancer are not fully understood. Skeletal muscle releases various myokines that seem to possess a direct anti-tumor effect. Although breast cancer (BC) is the prevalent form of cancer among women on a global scale, only limited data are available about the secretion of myokines following exercise in patients with BC. To study the effects of exercise on BC, the blood samples of patients with varied stages of BC were analyzed after 12 weeks of resistance training with whole-body electromyostimulation (WB-EMS). Following the training period, we observed that resistance training helps these patients to improve their physical characteristics and performance function by increasing skeletal muscle mass and strengthening their hand grip. Notably, the patient’s serum was found to inhibit the growth and promote the apoptosis of BC cells in vitro. Moreover, the conditioned medium collected from in vitro stimulated human myotubes using electric pulse stimulation (EPS), an in vitro simulation of WB-EMS training, induced the cell death of BC cells. These results highlighted the direct cancer-protective effects of activated skeletal muscle. In line with our observed effects of serum from exercise-trained pancreatic and prostate cancer patients, the growth of BC cells was notably inhibited when supplemented directly with recombinant myokines C-X-C motif ligand 1 (CXCL1), Interleukin 10 (IL10), and C-C motif chemokine ligand 4 (CCL4). Notably, treatment with these myokines also increased the expression of caspase 3/7 (Casp3/7), resulting in enhanced BC cell death. Our data strongly suggest that physical exercise has a positive impact on skeletal muscle mass and hand grip strength in BC patients, along with a significant anti-tumor effect in BC cells. This shows promising potential for considering sports and physical training as supportive therapies for achieving more impactful cancer treatment.

Nursing and midwifery simulation training with a newly developed low-cost high-fidelity placenta simulator: a collaboration between Italy and Ethiopia

BackgroundSimulation training provides safe environment for skill acquisition and retention. This study addresses a critical challenge in Africa – umbilical cord and placenta management after childbirth – aiming to bridge theoretical learning with practical experiences through simulation. We realized a new low-cost high-fidelity simulator of placenta and umbilical cord. We conducted a needs-based training course for nursing and midwifery students at St. Luke Hospital of Wolisso, Ethiopia, to validate our new simulator and compare its acceptability and teaching effectiveness with other two simulators (conventional low-fidelity model and human placenta).MethodsWe surveyed St. Luke Hospital medical experts to obtain their feedback on the new simulator’s face, content, and usability. We carried out a simulation training course for 67 students who received theoretical lectures and simulation courses being divided into three groups according to the simulator used. We assessed the simulators’ user acceptability using the Technology Acceptance Model (TAM) and compared the final objective evaluations by tutors between groups.ResultsExperts confirmed the new simulator’s fidelity, material quality, and usability. Students training on the new simulator demonstrated higher objective scores and perceived it as more useful and user-friendly compared to human placenta, while there was no difference between conventional simulator and human placenta in the TAM items.ConclusionWe validated a new high-fidelity simulator developed by the Sant’Anna School of Advanced Studies in Pisa, Italy, using the TAM scale and robust statistical methods, thanks to a successful collaboration with St. Luke’s Hospital in a simulation training course where students achieved higher objective scores and perceived the simulator as more useful and easier to use than a real human placenta, suggesting significant educational benefits and potential for future research.

High precision accelerator for our hybrid model of the redshift space power spectrum

Abstract Upcoming Large Scale Structure surveys aim to achieve an unprecedented level of precision in measuring galaxy clustering. However, accurately modelling these statistics may require theoretical templates that go beyond two-loop order perturbation theory, especially for achieving precision at smaller scales. In our previous work, we introduced a hybrid model for the redshift space power spectrum of galaxies. This model combines two-loop order templates with N-body simulations to capture the influence of scale-independent parameters on the galaxy power spectrum. However, the impact of scale-dependent parameters was addressed by precomputing a set of input statistics derived from computationally expensive N-body simulations. As a result, exploring the scale-dependent parameter space was not feasible in this approach. To address this challenge, we present an accelerated methodology that utilizes Gaussian processes, a machine learning technique, to emulate these input statistics. Our emulators exhibit remarkable accuracy, achieving reliable results with just 13 N-body simulations for training. Our emulators can reproduce the set of statistics we are interested in with less than 0.1% error in the parameter space within 5σ of the Planck ΛCDM predictions, specifically for scales around k &amp;gt; 0.1 h Mpc−1. Following the training of our emulators, we can predict all inputs for our hybrid model in approximately 0.2 seconds at a specified redshift. Given that performing 13 N-body simulations is a manageable task, our present methodology enables us to construct efficient and highly accurate models of the galaxy power spectra within a manageable time frame.

Trial of an Inexpensive Training Simulation Model for Laparoscopic Appendicectomy.

Introduction Laparoscopic surgery is now the gold standard for many common procedures; however, there has been a lack of emphasis on laparoscopic training at the junior level. Simulation is an effective form of training in surgery, but surgical simulation models and courses can be expensive and inaccessible to medical students and foundation doctors. With procedures becoming more minimally invasive, it is key that we train laparoscopic skills at an earlier stage; and to do so, we need to remove the barriers of cost and accessibility. Our study aims to develop and assess the effectiveness of a simulated laparoscopic appendicectomy training model in developing laparoscopic knowledge, skills, and confidence in a cohort of foundation doctors. Methods A simulated mesoappendix model was fashioned from supermarket chicken wings with the bone removed, and it was put inside a laparoscopic box trainer with laparoscopic tools and equipment. This was trialed in a surgical-themed hub day for foundation doctors in the East of England Deanery, UK, and the simulated model was set up as a workshop following a teaching session detailing the steps of a laparoscopic appendicectomy. Participants completed questionnaires pre- and post-session to assess perceived skills, experience, and confidence in laparoscopic surgery, laparoscopic skills, and the usefulness of this training model. Results A total of 29 foundation doctors with limited formal surgical training completed the survey. The model is quick to prepare and assemble, costing around £0.30 ($0.40). Trainees found the model acceptable and helpful in developing their laparoscopic skills and knowledge of laparoscopic surgery. There was also an increase in self-perceived confidence in performing laparoscopic procedures under supervision. Discussion This modification to the model allows the dissection and division of a simulated mesoappendix using only laparoscopic scissors and forceps in a box trainer. This simulation model is a promising and inexpensive tool which can be used for early-stage laparoscopic training for medical students and junior doctors.

Research and innovation of the “ship navigation radar” course based on the four‐in‐one approach in engineering education accreditation

AbstractTo achieve the strategic goal of marine and transportation power, it is imperative to cultivate highly skilled navigation professionals with a strong theoretical foundation and practical expertize. Seizing the opportunity by the “Double Thousand Plan” first‐class undergraduate courses initiated by the Ministry of Education, a four‐in‐one experimental teaching model is developed for ship navigation radar courses that integrate virtual reality technology under the context of engineering certification. The model encompasses land laboratory real training, maritime radar simulator training platform, comprehensive real‐ship training at sea, and virtual laboratory teaching and training. Through this innovative approach, students can acquire essential knowledge of ship navigation radar required for practical activities in navigation practice while honing their operational skills in positioning, navigation, and collision avoidance using radars. Furthermore, an analysis of course attainment and future development trends is conducted to provide insights into enhancing maritime education and fostering internationally competitive shipping talents.

Randomized Controlled Trial Comparing Training of Transseptal Puncture With or Without Intracardiac Echocardiography.

Intracardiac echocardiography (ICE) has been widely used in the catheter ablation of atrial fibrillation (AF). However, the value of ICE in the training of transseptal puncture (TSP) is unclear. ICE-Training Study was a single-center, parallel-group, unmasked, randomized controlled trial registered in ChineseClinicalTrials.gov. Participants were randomly assigned (1:1) to different groups (1) the ICE simulator training group (ICE-ST), in which TSP was trained and performed under the guidance of both ICE and x-ray; and (2) the conventional simulator training group (Con-ST), in which TSP was trained and performed only under the guidance of x-ray. The trainees need to undergo the training stage and the evaluation stage. From October 2022 to December 2022, 18 consecutive fellows (age 32.4±4.4years, 12 males) without experience of TSP were included. The training period (16.9±6.6 vs. 29.6±8.7 times, p=0.003) and the fluoroscopy time (120.3±25.3 vs. 189.3±40.2s, p<0.001) of the ICE-ST group was significantly shorter than that of the Con-ST group. No significant difference was found in the comprehensive performance of TSP in the ICE-ST group (composite score 96.7±5.7) and the Con-ST group (composite score 95.9±6.3, p=0.62), but the selection of TSP sites in the ICE-ST group was commonly better than that in the Con-ST group. ICE could improve the efficiency of TSP training and optimize the site of TSP to facilitate catheter manipulation in the ablation. ChineseClinicalTrials.gov identifier: ChiCTR2200058377.

Effect of standardized patient simulation with BCG vaccination on nursing students' skills, knowledge and satisfaction, and self-confidence: A randomized controlled study

AimTo examine the effect of standardised patient simulation training on nursing students' skills and knowledge in administering the Bacillus Calmette-Guérin vaccine, as well as their satisfaction and self-confidence. BackgroundThe Bacillus Calmette-Guérin vaccine is administered by nurses to prevent tuberculosis. However, there have been reports of complications arising from inadequate knowledge and skills related to Bacillus Calmette-Guérin vaccine administration. DesignA randomised controlled experimental design. MethodThis experimental study was conducted between October 2022 and January 2023 at a university, Medical Training and Simulation Centre. The fourth-year nursing students enrolled in their intern term were asked to participate in this experimental study. Participants were allocated to the intervention group (n=45) and the control group (n=45). The control group received only theoretical training and then BCG application on the model. The socio-demographic survey was conducted to collect demographic data. The Bacillus Calmette-Guérin Vaccine Knowledge Form, Bacillus Calmette-Guérin Vaccine Administration Checklist, and the student satisfaction and self-confidence scale in learning were used. The intervention group received simulation training using a standardized patient. All students' knowledge and skills were measured before and 3 months after the theoretical training. ResultsSimulation training using standardized patients significantly increased nursing students' Bacillus Calmette-Guérin vaccine knowledge (intervention group=21.57±5.12; control group=15.33±5.61), skills (intervention group=20.88±4.29; control group=10.22±4.56), confidence and satisfaction (intervention group=4.61±0.30; control group=4.17±0.3) compared with the control group (p < 0.05). ConclusionTraining with standardized patient techniques provides students the opportunity to practice realistically in a safe environment, enabling repetitive practice, which enhances self-confidence and satisfaction.

Bibliometric analysis of research hotspots and global trends in patient safety education for nursing students.

Patient safety education for nursing students has recently garnered interest. However, there is a paucity of data on the key areas and global trends over time. This study aims to analyze research patterns in the field of patient safety education for nursing students, identifying key contributors and global trends. A descriptive bibliometric approach was employed to analyze 782 articles related to patient safety education using data from the Web of Science Core Collection and CiteSpace 6.2. R4. Co-occurrence and co-citation analyses were conducted to identify prominent authors, institutions, countries, and common keywords. The analysis revealed contributions from 335 authors and 302 institutions across 78 countries. Levett-Jones T emerged as the most prolific author with 12 articles. The United States and the University System of Ohio were identified as the most productive countries and institutions, with 276 and 26 articles, respectively. Frequently occurring keywords included patient safety, education, medical education, simulation training, and standardized patients. This study provides valuable insights into the global research landscape of patient safety education in nursing, highlighting key contributors and trends. These findings can assist nursing students, educators, and researchers in identifying potential collaborators and informing future research to advance patient safety education in nursing.