Videotaped Simulation Research Articles

Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting

BackgroundWe sought to develop a low-fidelity simulation-based curriculum for pediatric residents in Rwanda utilizing either rapid cycle deliberate practice (RCDP) or traditional debriefing, and to determine whether RCDP leads to greater improvement in simulation-based performance and in resident confidence compared with traditional debriefing.MethodsPediatric residents at the Centre Hospitalier Universitaire de Kigali (CHUK) were randomly assigned to RCDP or traditional simulation and completed a 6 month-long simulation-based curriculum designed to improve pediatric resuscitation skills. Pre- and post- performance was assessed using a modified version of the Simulation Team Assessment Tool (STAT). Each video-taped simulation was reviewed by two investigators and inter-rater reliability was assessed. Self-confidence in resuscitation, pre- and post-simulation, was assessed by Likert scale survey. Analyses were conducted using parametric and non-parametric testing, ANCOVA and intra-class correlation coefficients (ICC).ResultsThere was a 21% increase in pre- to post-test performance in both groups (p < 0.001), but no difference between groups (mean difference − 0.003%; p 0.94). Inter-rater reliability was exceptional with both pre and post ICCs ≥0.95 (p < 0.001). Overall, self-confidence scores improved from pre to post (24.0 vs. 30.0 respectively, p < 0.001), however, the there was no difference between the RCDP and traditional groups.ConclusionsCompletion of a six-month low-fidelity simulation-based curriculum for pediatric residents in Rwanda led to statistically significant improvement in performance on a simulated resuscitation. RCDP and traditional low-fidelity simulation-based instruction may both be valuable tools to improve resuscitation skills in pediatric residents in resource-limited settings.

Will jurors correct for evidence interdependence in their verdicts? It depends

Throughout an investigation, pieces of evidence are likely to contaminate one another, yet at trial jurors are expected to treat pieces of evidence as if they are independent. Are jurors able to understand potential evidence contamination? The present study showed mock jurors a videotaped trial simulation. Participants were randomly assigned to hear testimony regarding one piece of evidence, two pieces of independent evidence, or two pieces of interdependent evidence. The study tested the hypothesis that jurors who hear evidence that is interdependent will be just as likely to find the defendant guilty as jurors who hear about two pieces of independent evidence. When an eyewitness's identification was the uncontaminated piece of evidence, our hypothesis was supported. However, when the confession was the uncontaminated piece of evidence, jurors seemed to understand that one piece of evidence had been influenced by another and adjusted their beliefs about the defendant's guilt accordingly. This study supports the conclusion that jurors can sometimes identify and correct for evidence contamination in their perceptions of a defendant's guilt. Implications for reform support are discussed.

The Golden Hour: Care of the LBW Infant During the First Hour of Life One Unit’s Experience

Care practices during the first hour of life, the Golden Hour, can have a significant impact on outcomes of low birth weight infants. Although the latest edition of the Neonatal Resuscitation Program added guidelines for preterm infants, additional care is often indicated. Complications that could potentially be impacted by care in the first hour of life include thermoregulation, intraventricular hemorrhage, chronic lung disease, and retinopathy of prematurity. Our unit has implemented and revised a Golden Hour evidence-based care process that includes the use of realistic videotaped simulations, followed by team debriefing sessions. Early results of the revised process show reductions in the targeted complications.

Teaching communication skills with the help of actresses and video-tape simulation.

Teaching communication skills with the help of actresses and video-tape simulation.

The impact of customer education on customer participation, functional service quality and trust in restaurant services

Previous studies have provided evidence that customer education play an important role in building service quality, customer trust and relationship commitment, but these studies have focused almost exclusively on complex services, such as financial services. This study extends the current work to examine the impact of customer education in restaurant services. A conceptual framework is proposed to explain how customer education affects customer participation, functional service quality and trust. Data were collected by using a videotape simulation of a cooking education program in a real restaurant, 258 participants were asked to be involved in a role-playing process and then complete the questionnaire. The results of a structural equation model suggest that the main effect of customer education on customer participation, functional quality and trust were significant; customer participation also affects functional service quality and trust, but not the relationship between customer participation and trust. Implications of the study and future research are discussed.

Nurse responsiveness to cancer patient expressions of emotion

Objective This theoretically based study examined nurse responses to cancer patient expressions of emotion using a videotaped, simulated cancer patient. Methods This study used an experimental crossover design with a videotaped patient expressing anger, sadness, and neutral emotion to elicit nurse responses. Seventy-four nurses from eight sites participated. Responses were coded using Roter interaction analysis system. Correlations explored relationships between variables that impact communication (age, gender, work experience, trait anxiety, work stress, self-efficacy). Regression models explored the effect of variables on nurse affective responsiveness. Results Patient expressions of sadness elicited more affective responses than anger. Expressions of anger or neutral emotion elicited more instrumental behaviors than sadness. Variables such as age, work stress and work experience were significantly correlated. No variables predicted affective responsiveness to patient expressions of anger or sadness. Conclusion Nurse communication showed significant variation in response to patient emotional expressions. Understanding the relationships between demographic, personality, and work variables, and identification of new variables that influence nurse–patient communication, has implications for interventional studies. Practice implications Over 90% of the participants indicated that the videotape simulation would be a useful method for teaching and practicing communication skills with patients expressing emotions.

Beyond Role-Playing: Using Technology to Enhance Modeling and Behavioral Rehearsal in Group Work Practice

Videotape and computer simulation are sophisticated technological applications that have great potential to enhance group work practice. Computer simulation has been harnessed for entertainment and business purposes but has not been adequately utilized for teaching social skills. This article describes strategies for integrating video and computer simulation into group work practice. These technologies can contribute new vitality to traditional group activities that involve modeling and behavioral rehearsal. Issues involved in creating and using computer simulations are reviewed, barriers to implementation are discussed, and recommendations for group work practice are proposed.

Beyond Role-Playing: Using Technology to Enhance Modeling and Behavioral Rehearsal in Group Work Practice

Videotape and computer simulation are sophisticated technological applications that have great potential to enhance group work practice. Computer simulation has been harnessed for entertainment and business purposes but has not been adequately utilized for teaching social skills. This article describes strategies for integrating video and computer simulation into group work practice. These technologies can contribute new vitality to traditional group activities that involve modeling and behavioral rehearsal. Issues involved in creating and using computer simulations are reviewed, barriers to implementation are discussed, and recommendations for group work practice are proposed.

Problem-solving skills of senior student nurses: an exploratory study using simulation

The Stages Model of problem-solving as evidenced in the use of the nursing process is the key vehicle for the operationalisation of problem-solving in current nursing practice. An expanded variant of the model formed the theoretical framework for this study which aimed to explore and compare the problem-solving skills of senior student nurses ( n=253) from three pre-registration nurse education programmes (RGN, diploma RN, integrated degree). Students’ care planning skills were explored using a video-tape simulation exercise and data were subjected to statistical testing. Findings indicated a large range in the global care plan scores and while performance was similar in a number of areas independent of programme type, certain key differences also emerged. The findings are discussed in the wider context of professional education and practice and the potential for further development of problem-solving skills in pre-registration nurse education is explored.

Psychiatric leadership and the clinical team: simulated in vivo treatment planning performance as teamwork proxy and learning laboratory.

Leadership is an important consideration at many levels within behavioral healthcare systems. The authors developed a training program in a large public hospital system that focused on psychiatric leadership and clinical team functioning. In a learning laboratory format, they used videotaped patient simulations as a stimulus for multidisciplinary treatment planning sessions. Structured self-assessments were performed using a preliminary Scale for Leadership Assessment and Team Evaluation (SLATE). Videotaping the sessions provided an additional team self-assessment tool. Other educational activities supplemented the sessions, and teams proposed steps for transferring their learning to other units. The authors emphasize that leadership must foster team learning, which involves developing adaptive capacities and applying them to new clinical situations.

Clinical problem-solving using video simulation: an investigation

This paper examines the use of videotape simulation as a research method for the exploration of clinical problem-solving. The challenges posed and the strategies employed to overcome the difficulties encountered are discussed. The simulation forms part of a larger comparative study of outcomes of pre-registration nurse education programmes, commissioned by the English National Board for Nursing, Midwifery and Health Visiting.

The impact of protective shields and videotape testimony on conviction rates in a simulated trial of child sexual abuse.

In Experiment 1 mock jurors watched a videotape simulation of a sexual abuse trial that included a 10-year-old child witness testifying in one of three different modalities: (1) The child testified in court while directly confronting the defendant (open court condition). (2) The child testified in court with a protective shield placed between the child and the defendant (shield condition). (3) The child testified outside the courtroom and the child's testimony was presented to the jury and the defendant on a video monitor (video condition). The mock jurors judged the guilt of the defendant after watching the entire trial. The modality of the child's testimony had no impact on conviction rates. In Experiment 2 subjects watched the same trial that was used in Experiment 1. The trial was stopped immediately after the child testified (the child was the first witness to take the stand), and subjects judged the guilt of the defendant. The modality of the child's testimony had a significant impact on conviction rates. Subjects in the open court condition were more likely to convict the defendant than subjects in the shield and videotape conditions. These findings are relevant to Supreme Court decisions regarding the use of protective devices with child witnesses.

The Effects of Counselor Fee and Title on Perceptions of Counselor Behavior

This study examined the effects of a counselor's fee level and title on perceptions of counselor behavior. Three levels of fee were compared: high fee, low fee, and sliding scale; and two levels of title were compared: counseling psychologist versus professional counselor. Sixty female undergraduate participants rated the credibility, attractiveness, and effectiveness of a counselor after observing her in a brief videotaped counseling simulation and reading a background description of her. The results indicate that fee level significantly affected the perceptions of counselor credibility, attractiveness, expertness, and overall counselor behavior. Title had no significant effect on perceptions of counselor behavior. Implications and limitations of these findings are discussed, and areas requiring future research are suggested.

Interviewers' Decisions Related to Applicant Handicap Type and Rater Empathy

The purposes of this study were to investigate whether different types of physical handicaps are reacted to differently by raters and to determine the effects of rater empathy on evaluations of handicapped applicants. Seventy undergraduates were randomly assigned to one of five experimental conditions, each of which viewed a single videotape simulation of an employment inter- view. The five videotapes involved an applicant who was: in a wheelchair, using Canadian crutches, hard of hearing, a leg amputee, or a nonhandicapped control. Prior to viewing the videotape, each rater's level of empathy was as- sessed using the Hogan Empathy Scale (Hogan, 1969). Results indicated that the applicant using Canadian crutches was rated significantly higher than all other applicants on a Positive Affect Scale, and significantly higher than the applicant who was hard of hearing on an Applicant Qualification Scale. There was a significant inverse relationship between rater empathy and the ratings given on both scales. Int...

A nutrition education workshop for managers of nutrition centers for the elderly utilizing videotaped simulations for assessment.

As funds become increasingly scarce, an effective nutrition education method which reaches large numbers of elderly individuals is appropriate. A nutrition workshop was provided for 30 managers of government-sponsored nutrition centers for the elderly in a 5-county area. The workshop curriculum, determined after interests of both center managers and participants at the nutrition centers were assessed, was presented in a packet of materials to each workshop attendee and supplemented with explanations and demonstrations. A pre- and post-test evaluation instrument, which included videotaped simulations of typical nutritional situations encountered with elderly persons at the centers, was used to measure attitudes and knowledge before and after the workshop. As a result of the workshop, knowledge increased significantly as measured by the test instrument and 75% of the managers reported use of materials and ideas during the 5 months following the workshop.

The Effects of Order of Stimulus Presentation on Ratings of Counseling Performance

This study was designed to examine the effects of order of stimulus presentation on observer ratings of counseling performance. Two videotaped counseling simulations, determined by judges to represent either high or low quality performance, served as the stimuli. Participants were randomly assigned to one of two levels of the order effect: Group 1 viewed the videotape with low quality performance first, followed by the high quality performance videotape; Group 2 viewed the high quality performance videotape first, followed by the low quality performance videotape. Four widely used measures of counseling performance served as dependent measures. Results revealed a statistically significant interaction between quality of performance and the order in which the performances were rated.

Affect and neutrality in physician behavior: a study of patients' values and satisfaction.

Physicians' emotional expressivity was contrasted with emotional neutrality in a study of consumers' preferences regarding physician behavior in the medical encounter. Two hundred twenty-seven health-science students completed instruments designed to measure the values they held regarding physicians' emotional expressions as well as their perceptions of and satisfaction with the emotional behavior of a physician presented in a videotape simulation. Overall, consumers attached a low value to neutrality and preferred affective behavior to it, although their previously held values did significantly influence their degree of satisfaction with neutral behavior by the physician. Values did not influence recognition of or satisfaction with the nonneutral emotions. This research also shed light on consumer reactions to other emotions including reassurance and humor.

Hospital Design and Wayfinding

A videotape simulation of the entrance drive to the new University of Michigan Hospital was used to test the effect on turning behavior of constructing a parking deck entrance directly off the hospital's drop-off circle. One hundred randomly sampled visitors were shown this videotape and asked where they would turn, if they were coming alone to visit a patient and needed to park their car. There were several turn-off areas along the entrance drive before the parking deck turn-off. Each turn-off had a sign listing its respective functions and directed drivers to continue straight ahead for parking. Half the visitors saw a videotape in which there was an entrance to the deck from the drop-off circle, and half saw a tape in which the entrance from the drop-off circle was absent. Each visitor saw two scenarios, one having the drop-off circle crowded with cars, and one uncrowded. The results of the study showed that the presence of the entrance to the deck from the drop-off circle did make a significant difference in reported turning behavior. The results of this study had a direct impact on the subsequent design decision. In addition, the results of this study are meaningful beyond the data themselves. The study used an inexpensive, simple, and highly imageable research technique, yet one rarely used in environment-behavior research. It was a "quick turn-around" research effortthat resolved a specific design dilemma. The study also demonstrates that signs alone are not sufficient to guide wayfinding behavior in large complex environments like hospitals.

Microteaching: A model for employee counseling education

An instructional model for the implementation and use of videotape simulation to improve dietetic students' skills in employee counseling was explored in the coordinated undergraduate program at the University of Tennessee, Knoxville. A five-day intensive workshop was conducted for senior students in the program, utilizing the microteaching technique. Students and actors simulated an employee counseling session on videotape; then, a small group and a clinical instructor evaluated the session. Suggestions from these evaluations were used in a repeat of the situation on videotape. A team of experts randomly viewed all the situations, judging a significant improvement in composite scores for the workshop participants. The students indicated on a Self-Perception of Confidence (SPOC) scale that they felt a higher degree of comfort in handling potential employee counseling after completing the workshop. They were pleased with the workshop and suggested expansion of the technique to other phases of their dietetic education.

The Effects of Ambient Illumination, Aircraft Velocity and Feedback on Absolute Distance Judgments during Simulated Night Nap-of-the-Earth Flight

A study was conducted to determine the effects of illumination, velocity and knowledge of results on distance judgment accuracy in simulated night NOE flight. Twenty subjects were randomly divided into KOR and NK groups and then shown a part task, video tape simulation of NOE flight which contained 45 target presentations. The subject's task was to approach the obstacle on a collision course until he reached his minimum safe breakaway distance, then make an avoidance response with his simulated control stick. Illumination, velocity and feedback conditions were varied while measuring the accuracy of response in terms of mean error distances from the analytically determined breakaway point. The results indicated that reductions in illumination, given that the object is visible at all, had no significant effect on distance judgment while both feedback and reduced velocity produced improved accuracy. The results were interpreted in terms of their interactions and then translated to operational suggestions concerning training for NOE pilots.