{"title":"Design and implementation of a digital medication optimization simulation (SimMed) using healthcare simulation standards of best practiceTM (HSSOBPTM)","authors":"Sharad Rayamajhi MSc , Amani Al Bayrakdar PhD, MSc, BSc, FHEA, PgCert HE , Amanda Mclean MPhil DProf MFRPSII MRPharmS GPhC , Seonaid McIntyre MSc , David Russel HND , Ruth Paterson PhD, MPhil, FHEA, RN","doi":"10.1016/j.ecns.2025.101838","DOIUrl":"10.1016/j.ecns.2025.101838","url":null,"abstract":"<div><h3>Background</h3><div>Medicines optimization requires healthcare professionals to develop and maintain safe medicine management skills and work collaboratively. Early exposure to interprofessional learning is essential for nursing students to develop these competencies. In response, we developed <em>SimMed</em>, an interprofessional digital simulation focused on medication safety. While digital simulation is increasingly recognized as an effective educational approach, its design often lacks consistency and rigor. This paper presents the development and initial implementation of <em>SimMed</em> within a healthcare education setting.</div></div><div><h3>Method</h3><div>The Healthcare Simulation Standard of Best Practice<sup>TM</sup> (HSSOBP<sup>TM</sup>) and Agile methodology underpinned the development, implementation, and piloting of the SimMed simulation for preregistration nursing students.</div></div><div><h3>Result</h3><div>The simulation was successfully developed and delivered to 130 students. It was affordable, user-friendly, and interactive. Its flexible design facilitated achieving learning objectives and enhanced student learning. Key insights included the value of using a standard framework, iterative design, and integration of user feedback.</div></div><div><h3>Conclusion</h3><div>The application of HSSOBP<sup>TM</sup> and Agile principles supported the structured, iterative development and successful implementation of an effective and scalable simulation tool for medicines optimization education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"109 ","pages":"Article 101838"},"PeriodicalIF":2.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dual-perspective and haptic feedback virtual reality simulation for labor care: A randomized controlled mixed-methods study","authors":"Pao-Ju Chen PhD , Wei-Kai Liou PhD","doi":"10.1016/j.ecns.2025.101836","DOIUrl":"10.1016/j.ecns.2025.101836","url":null,"abstract":"<div><h3>Background</h3><div>Labor care requires complex decision-making and pain management skills, yet current virtual methods, such as spherical video-based virtual reality (SVVR), lack haptic feedback and interactivity.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of a virtual reality synchronous haptic feedback system (VR-SHFS) compared with SVVR in improving nursing students’ labor care skills, knowledge, and empathy.</div></div><div><h3>Methods</h3><div>Randomized controlled mixed-methods study with students in VR-SHFS (<em>n</em>=40) or SVVR (<em>n</em>=40). VR-SHFS incorporated haptic feedback and dual-perspective learning, whereas SVVR employed 360° panoramic videos. Outcomes were assessed at baseline (T0), immediately after the intervention (T1), and at two-month follow-up (T2).</div></div><div><h3>Results</h3><div>VR-SHFS significantly improved labor care skills (T1: <em>P</em> < .001; T2: <em>P</em> < .001) and empathy (T1: <em>P</em> = .014; T2: <em>P</em> = .003), and enhanced knowledge retention at T2 (<em>P</em> < .001), compared with SVVR. Students valued its realism and interactivity, although they noted a need for guidance and familiarization.</div></div><div><h3>Conclusions</h3><div>VR with haptic feedback and dual perspectives enhances labor care training more effectively than SVVR and shows promise for broader clinical education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101836"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica E. Marsack PhD , Melissa A. Bathish PhD , Susan Wintermeyer-Pingel DNP
{"title":"Fostering equity in nursing education and practice: Inclusive simulation for weight bias reduction","authors":"Jessica E. Marsack PhD , Melissa A. Bathish PhD , Susan Wintermeyer-Pingel DNP","doi":"10.1016/j.ecns.2025.101840","DOIUrl":"10.1016/j.ecns.2025.101840","url":null,"abstract":"<div><h3>Background</h3><div>Weight bias impacts overweight/obese patients’ quality of care. Undergraduate nursing education lacks hands-on care of simulated patients with obesity. This project sought to address weight biases related to patients with obesity.</div></div><div><h3>Methods</h3><div>Sophomore students (N = 130) completed an educational intervention regarding care of overweight/obese patients using obesity suits during simulated patient care activities addressing weight bias. Pre- and immediate-post surveys assessed attitudes, beliefs, and cultural humility regarding overweight/obese persons.</div></div><div><h3>Results</h3><div>Paired t-tests showed significant prepost intervention improvement on the Attitudes Toward Obese Person scale. Preintervention Cultural Humility Scale scores were high and remained stable postintervention, as did scores for the Beliefs About Obese Persons scale. Regression analyses indicated the intervention was beneficial even when controlling for weight experiences.</div></div><div><h3>Conclusion</h3><div>This educational intervention improved undergraduate nursing students' attitudes toward patients with obesity, which could ultimately improve inclusive practice skills, reduce weight biases, and improve patient care.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101840"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual synchronous role-play simulation pilot: Lessons and insights","authors":"Jayne Josephsen EdD","doi":"10.1016/j.ecns.2025.101839","DOIUrl":"10.1016/j.ecns.2025.101839","url":null,"abstract":"<div><div>Affective competencies in person-centered care, communication, collaboration, and understanding others’ perspectives are needed by graduate nurses. Experiential learning is often used to develop affective competency, which can be challenging to deliver in the virtual learning environment (VLE). A virtual synchronous role-play (VSRP) simulation was developed focusing on affective competencies and delivered in an online course. Utilizing Zoom™, students recorded simulation participation and brief peer debriefing, followed by an individual reflection. Lessons learned included the need for detailed instructions and resources concerning timeframes, environmental expectations, and technology. Student feedback indicated the simulation contributed to affective competency development.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101839"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D.A. Díaz PhD , M. Anderson PhD , F. Guido-Sanz PhD , S. Talbert PhD , A. Medina-Rodriguez BS , A. Marano MSN , M.M. Lino PhD
{"title":"Enhancing maternal/child content with augmented reality during simulation-based education: A study with prelicensure nursing students","authors":"D.A. Díaz PhD , M. Anderson PhD , F. Guido-Sanz PhD , S. Talbert PhD , A. Medina-Rodriguez BS , A. Marano MSN , M.M. Lino PhD","doi":"10.1016/j.ecns.2025.101831","DOIUrl":"10.1016/j.ecns.2025.101831","url":null,"abstract":"<div><h3>Background</h3><div>Obstetric (OB) education faces challenges due to limited clinical placements and observation-only opportunities. Simulation-based experiences (SBE) can help bridge these gaps, providing realistic scenarios to enhance nursing students' understanding. Although Augmented Reality (AR) holds promise in nursing education, limited research evaluates its impact on OB content.</div></div><div><h3>Aim</h3><div>To evaluate completion time, post-simulation knowledge, perceived effectiveness, and side effects.</div></div><div><h3>Methods</h3><div>A post-test-only descriptive design was used with 119 prelicensure nursing students in a maternal/child course. Participants completed AR simulation scenarios of normal delivery and postpartum hemorrhage. Data collection included a researcher developed Knowledge Test, the simulation effectiveness tool-modified (SET-M) effectiveness tool-modifieas used with 11reality sickness questionnaire (VRSQ), and open-ended questions.</div></div><div><h3>Results</h3><div>Most students (94%) found the AR simulation beneficial prior to clinicals. The average post-simulation knowledge score was 7.95/10. SET-M results indicated an effective learning experience. VRSQ scores revealed mild oculomotor symptoms. No data could be analyzed for completion time or open-ended responses.</div></div><div><h3>Conclusions</h3><div>AR-enhanced Simulation-based experiences (SBE) is a valuable tool in OB education and may help address knowledge gaps. Further research is needed to explore its broader educational impact.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101831"},"PeriodicalIF":2.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marta Mencarelli M.Sc , Marco De Luca MD , Lorenzo Torzini M.Sc , Luca Puggelli PhD , Francesco Severi M.Sc , Vincenzo Abagnale M.Sc , Yary Volpe PhD
{"title":"Cost-effective task trainers for mastering drill handling in pediatric intraosseous procedure","authors":"Marta Mencarelli M.Sc , Marco De Luca MD , Lorenzo Torzini M.Sc , Luca Puggelli PhD , Francesco Severi M.Sc , Vincenzo Abagnale M.Sc , Yary Volpe PhD","doi":"10.1016/j.ecns.2025.101829","DOIUrl":"10.1016/j.ecns.2025.101829","url":null,"abstract":"<div><h3>Background</h3><div>Intraosseous (IO) access is a life-saving procedure when intravenous access is impossible in pediatric emergencies. Proficiency in IO technique, particularly drill handling, patient positioning, and site identification, is essential to minimize complications and improve outcomes.</div></div><div><h3>Methods</h3><div>To address the high cost and limited accessibility of commercial simulators, low-cost task trainers were developed using 3D printing and silicone casting. These trainers focused on drill handling, allowing trainees to progressively acquire procedural skills.</div></div><div><h3>Results</h3><div>Initial validation was conducted with experts at Meyer Children’s Hospital during a European Pediatric Immediate Life Support (EPILS) course. Structured feedback indicated high satisfaction with tactile realism and educational value. Based on this feedback, a second prototype with a fluid simulation system was implemented to enhance realism further. Nursing professionals, often first responders in emergencies, particularly benefited from the improved version, reporting increased confidence and competence.</div></div><div><h3>Conclusion</h3><div>The cost-effective IO task trainers offer a scalable, realistic alternative to commercial models, expanding access to essential training. Their affordability and usability make them suitable for diverse healthcare settings, enhancing preparedness for pediatric emergencies.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101829"},"PeriodicalIF":2.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicholas Wee Siong Neo MSc, RN , Joko Gunawan PhD, RN , Tracy Levett-Jones MEd, PhD, RN , Eng Tat Khoo PhD , Wei Ling Chua PhD, RN , Sok Ying Liaw PhD, RN
{"title":"Generative artificial intelligence in healthcare simulation-based education: A scoping review","authors":"Nicholas Wee Siong Neo MSc, RN , Joko Gunawan PhD, RN , Tracy Levett-Jones MEd, PhD, RN , Eng Tat Khoo PhD , Wei Ling Chua PhD, RN , Sok Ying Liaw PhD, RN","doi":"10.1016/j.ecns.2025.101819","DOIUrl":"10.1016/j.ecns.2025.101819","url":null,"abstract":"<div><h3>Aims</h3><div>This review aimed to explore the current state of generative artificial intelligence (GenAI) use in simulation-based healthcare education through a comprehensive examination of GenAI types, applications and reported outcomes.</div></div><div><h3>Methods</h3><div>A scoping review was conducted utilizing the Joanna Briggs Institute’s methodological guidance. Six databases were searched from their inception until February 2025.</div></div><div><h3>Results</h3><div>We included 28 articles that were published between 2023 and 2025. Articles were mainly in the fields of medicine (<em>n</em> = 14) and nursing (<em>n</em> = 10). OpenAI’s GPT models were most frequently used to portray simulated characters and deliver automated feedback. GenAI-enhanced simulation was generally perceived as accurate, realistic and feasible, with some evidence supporting its use as a supplement to conventional simulation and to enhance learning outcomes. Perspectives, ethical considerations and recommendations for GenAI-enhanced simulation were also highlighted.</div></div><div><h3>Conclusion</h3><div>GenAI-enhanced simulation is gaining popularity and is likely to evolve alongside human-facilitated simulation. Future developments should focus on building AI expertise among simulation educators and harnessing the synergy between human intelligence and GenAI. Further rigorous research is needed to establish best practices.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101819"},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Simulation in healthcare: Navigating the space between quality improvement and research","authors":"Anders L. Schram MPH","doi":"10.1016/j.ecns.2025.101824","DOIUrl":"10.1016/j.ecns.2025.101824","url":null,"abstract":"<div><div>Simulation-based initiatives are increasingly integrated into healthcare settings, often responding to local concerns while also producing insights that contribute to wider scholarly and professional debates. In this context, the distinction between quality improvement and research is often blurred, and many projects incorporate elements of both. This paper argues that instead of treating quality improvement and research as fixed categories, it is more productive to reflect on how simulation initiatives are positioned in relation to their intended contributions to practice and knowledge. Drawing on insights from implementation science, I outline recurring challenges that arise when this reflection is absent, including difficulties with ethics, contextual transparency, and accessibility of findings. To support a more deliberate approach, the paper introduces a reflective illustration that helps situate simulation work without reducing it to predefined labels, thereby enhancing both its local value and its broader relevance.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101824"},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a prompt template to support simulation design: Maximizing the potential of generative artificial intelligence","authors":"Elizabeth Robison EdD, MSN, RN, CNE, CHSE-A , Theresa Cooney MSN, RN , Tammy Schwaab DNP, RN, CHSE , Sami Rahman MEd, MSN, RN","doi":"10.1016/j.ecns.2025.101822","DOIUrl":"10.1016/j.ecns.2025.101822","url":null,"abstract":"<div><h3>Background</h3><div>Generative AI tools like ChatGPT are rapidly changing academia and healthcare, particularly in nursing education through their ability to assist in creating clinical simulation scenarios. The key to effectively using these tools lies in prompt engineering, the careful crafting of inputs to guide AI outputs.</div></div><div><h3>Aim</h3><div>An initiative by nurse educators explored how prompt engineering, aligned with established simulation standards, could streamline scenario design.</div></div><div><h3>Findings</h3><div>The findings revealed variations in output quality and focus among different AI platforms (ChatGPT, CoPilot, Claude), highlighting the need for careful selection and human oversight to ensure accuracy and relevance in AI-generated simulation content.</div></div><div><h3>Conclusions</h3><div>This iterative process of prompt refinement holds significant promise for creating more engaging and effective learning experiences, but AI serves as a tool that augments, not replaces, the expertise of nursing simulationists.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101822"},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}