Clinical Simulation in Nursing最新文献

{"title":"Comparison of Debriefing for Cultural Humility© to PEARLS: A randomized controlled trial","authors":"Cynthia Foronda PhD, RN, CNE, CHSE, ANEF, FAAN,&nbsp;Kenya Snowden DNP, APRN, ACNP-BC, FNP-C,&nbsp;Nichole Crenshaw DNP, APRN, AGACNP-BC, ANP-BC, CHSE, FAANP,&nbsp;LaToya Lewis Ed.D-CI, MSN, RN,&nbsp;Brenda Owusu DNP, APRN, ANP-BC, FNP-BC,&nbsp;Karina A. Gattamorta PhD, EdS,&nbsp;Michelle Arrojo DNP, APRN, FNP-BC, ENP-C, PMHNP-BC, CHSE,&nbsp;Amauri Quintana DNP, APRN, AGPCNP-C, FNP-BC, PMHNP-BC, CHSE,&nbsp;Andrew Porter PhD","doi":"10.1016/j.ecns.2025.101779","DOIUrl":"10.1016/j.ecns.2025.101779","url":null,"abstract":"<div><h3>Background</h3><div>Health professions educators face new challenges to prepare learners to provide ethical and empathic care to patients of varied races and ethnicities with differing personal beliefs and values. The purpose of this randomized controlled trial (RCT) was to compare the effectiveness of <em>Debriefing for Cultural Humility</em> with a traditional method (PEARLS) after care of a patient of color to teach students about cultural humility.</div></div><div><h3>Methods</h3><div>This study employed a single-site, randomized controlled trial design with 52 nurse practitioner students over two to three months.</div></div><div><h3>Results</h3><div>Debriefing effectiveness did not differ based on method of debriefing <em>(p</em> = .409). Cultural humility scores significantly improved over time (<em>p</em> = .023) with an increase in scores from baseline to post-implementation across both debriefing groups. The main effect of the debriefing method was not significant, indicating that both debriefing methods led to comparable learning outcomes.</div></div><div><h3>Conclusion</h3><div>Debriefing for Cultural Humility and PEARLS are effective debriefing methods to promote the discussion and learning of challenging concepts, including diversity, equity, and racism.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101779"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633058","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":"The effectiveness of implicit bias training for simulated participants","authors":"Richard V. Thompson PhD, MDiv, RBCC,&nbsp;Jeff Barbee DMA,&nbsp;Nick Stancato,&nbsp;Sheryl Pfeil MD","doi":"10.1016/j.ecns.2025.101781","DOIUrl":"10.1016/j.ecns.2025.101781","url":null,"abstract":"<div><h3>Background</h3><div>Simulated Participants (SPs) are crucial in healthcare education, providing simulated patient encounters. However, SPs may unintentionally introduce implicit biases, affecting student assessments.</div></div><div><h3>Methods</h3><div>This study involved 69 SPs who completed pre- and post-surveys. The training program included classroom sessions, discussions, and case studies to raise awareness of biases and promote behavioral changes.</div></div><div><h3>Results</h3><div>Statistical analysis, including Wilcoxon signed-rank tests and Odds Ratios, showed significant improvements in all measured variables post-training, with effect sizes (<em>r</em>) ranging from 0.26 to 0.55. The training increased SPs’ awareness of their biases and ability to take corrective actions.</div></div><div><h3>Conclusions</h3><div>These findings highlight the importance of targeted training programs to enhance medical simulations’ objectivity and educational value. Ongoing research is needed to generalize these results and explore additional strategies.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101781"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633056","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":"Identifying Opportunities for Virtual Simulation to Bridge Gaps in Mental Health Nursing Education: A Qualitative Descriptive Study","authors":"Laura A. Killam RN, MScN ,&nbsp;Frances C. Cavanagh RN, MN ,&nbsp;Natalie Chevalier RN, MN ,&nbsp;Karen Henze MBA ,&nbsp;Kryslyn Mohan BSW, RSW ,&nbsp;Katherine E. Timmermans RN, MScN ,&nbsp;Marian Luctkar-Flude RN, PhD, CCSNE, FCNEI ,&nbsp;Jane Tyerman RN, PhD, CCSNE","doi":"10.1016/j.ecns.2025.101772","DOIUrl":"10.1016/j.ecns.2025.101772","url":null,"abstract":"<div><h3>Background</h3><div>Worldwide, mental health conditions are undertreated, under-resourced, and widespread. Virtual simulation can enhance nursing student preparation to provide person-centred care for individuals living with mental health conditions. To be meaningful, virtual simulation should be based on a needs assessment.</div></div><div><h3>Methods</h3><div>This qualitative descriptive study was conducted to identify gaps in mental health nursing education that could be addressed using virtual simulation. Data were collected through an open-ended researcher-constructed online survey. Participants (<em>n</em> = 23) included undergraduate nursing students (<em>n</em> = 10), theory educators (<em>n</em> = 5), clinical educators (<em>n</em> = 4), and others (<em>n</em> = 4).</div></div><div><h3>Results</h3><div>Four main themes highlighted gaps in 1) approaches to education, 2) holistic philosophies of care, 3) understanding mental health conditions, and 4) foundational skills. Gaps were evident in student preparation to care for and partner with persons living with mental health conditions.</div></div><div><h3>Conclusion</h3><div>Findings emphasize the need to develop innovative interventions, such as virtual simulations, to strengthen nursing competencies before and after entry into practice.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101772"},"PeriodicalIF":3.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614049","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":"Comparing artificial intelligence-enhanced virtual reality and simulated patient simulations in undergraduate nursing education","authors":"Nicole Harder RN, PhD ,&nbsp;Fiha Ali MSW ,&nbsp;Sufia Turner RN, MN ,&nbsp;Kimberly Workum RN, MEd ,&nbsp;Lawrence Gillman MD, MMEd","doi":"10.1016/j.ecns.2025.101780","DOIUrl":"10.1016/j.ecns.2025.101780","url":null,"abstract":"<div><h3>Introduction</h3><div>Simulation-based learning (SBL) is foundational in nursing education, traditionally employing simulated patients (SPs) to create realistic clinical scenarios. Recent technological advances have introduced Artificial Intelligence-Enhanced Virtual Reality (AI-VR) as a scalable, cost-effective alternative.</div></div><div><h3>Aim and Methods</h3><div>This qualitative descriptive study explored undergraduate nursing students’ experiences with both AI-VR and SP simulations, focusing on perceptions of realism, psychological safety, and skill development.</div></div><div><h3>Findings</h3><div>While 240 students participated overall (120 in each simulation modality), in-depth qualitative data were collected from 20 third-year nursing students who experienced either approach through four focus groups. Findings revealed that SP simulations excel in fostering emotional engagement and hands-on learning, whereas AI-VR provides an intuitive, judgment-free environment conducive to rapid decision-making and iterative practice.</div></div><div><h3>Conclusions</h3><div>The study indicates implications for curriculum design, faculty development, and future research, advocating for an integrated approach that leverages the strengths of both modalities.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101780"},"PeriodicalIF":3.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605363","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":"Employing systems-based simulation to increase patient safety and maintain efficiency during the transfer of NICU patients","authors":"Shari L. Casey MSN, RN, RNCNIC, CHSE ,&nbsp;Rebecca DeBra MSN, RN, CHSE ,&nbsp;Kristin M. Portaleos MSN, RN, RNCNIC ,&nbsp;Beth Ann Johnson MD, MA","doi":"10.1016/j.ecns.2025.101773","DOIUrl":"10.1016/j.ecns.2025.101773","url":null,"abstract":"<div><h3>Background</h3><div>A free-standing Children’s Hospital with a Level IV NICU prepared to open a 635,000 sq. ft. critical care building (CCB) by using simulation to ensure the safe transport of 70 critically ill neonates.</div></div><div><h3>Method</h3><div>Facilitators and stakeholders were trained in Systems Focused Simulation (SFS) and Debriefing. A move simulation, representative of the types of patients to be moved and proposed pathways to the new unit, were utilized to identify latent safety threats. Suggestions from participants were tested to hone initial patient move plans.</div></div><div><h3>Results</h3><div>Simulation highlighted the need for a mid-route resuscitation space and alternate pathways for ECMO patients and babies in isolates with the GE Shuttle. Additional adjustments included updated checklists for emergency equipment, including syringes in the medication box, the availability of sedation for preidentified patients, and extra move teams.</div></div><div><h3>Conclusion</h3><div>Our NICU safely moved 70 critically ill patients to their new location in the CCB within 6.5 hours. Patients moved ranged from those on room air to critically unstable. No patients required resuscitation.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101773"},"PeriodicalIF":3.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588176","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":"Using unfolding OSCEs across a graduate nursing curriculum to implement competency-based education assessment","authors":"Sean Sibley PhD ,&nbsp;Nima Sajedi Sabegh MSc ,&nbsp;Valerie Herbert DNP","doi":"10.1016/j.ecns.2025.101771","DOIUrl":"10.1016/j.ecns.2025.101771","url":null,"abstract":"<div><h3>Aim</h3><div>This study investigated the relationship between learner reactions and objective learning, and using scaffolded objective structured clinical examinations (OSCE) to demonstrate competency mastery.</div></div><div><h3>Background</h3><div>Simulation-based education that employs best practices provides a mechanism for teaching and learning in a competency-based education paradigm. Evidence-informed practices specifically in graduate nursing education are lacking.</div></div><div><h3>Methods</h3><div>A quasi-experimental design assessed learner reactions and objective learning outcomes of graduate nursing students.</div></div><div><h3>Results</h3><div>While student satisfaction and self-confidence in learning were strongly related to each other, they showed only weak correlations with OSCE grades. Patient-centered competency grades increased across OSCE experiences.</div></div><div><h3>Conclusion</h3><div>To promote learning, faculty should use best-practices to execute simulation in graduate education. Scaffolded OSCEs can demonstrate progressive competency mastery.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101771"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549740","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":"The virtual reality embedded instructor: Transforming nursing education one innovation at a time","authors":"Tiffani Chidume DNP, RN, CHSE-A, CHSOSa,&nbsp;Judith Caroline Quick MSN, RN, CCRNb,&nbsp;B. Clay Young MSN, RN, FNP-Cc","doi":"10.1016/j.ecns.2025.101764","DOIUrl":"10.1016/j.ecns.2025.101764","url":null,"abstract":"<div><h3>Background</h3><div>Virtual reality simulations (VRS) in nursing education typically promote independent learning with limited faculty involvement. This study investigated how embedding clinical instructors within VR environments influences nursing learners' experiences.</div></div><div><h3>Methods</h3><div>This descriptive qualitative study implemented a novel Virtual Reality Simulation Embedded Instructor Model with junior nursing students (<em>n</em> = 213) across two semesters. Learners participated in a chest pain emergency department simulation with instructors present virtually. Data collection utilized the validated Simulation Effectiveness Tool-Modified (SET-M) questionnaire and qualitative feedback.</div></div><div><h3>Results</h3><div>Most learners reported increased confidence (76.6%) and better preparation for patient condition changes (90.7%) following VR simulation. The spring 2025 cohort showed improvement over the Fall 2024 cohort after prebriefing modifications. Qualitative feedback revealed that learners valued instructor presence for immediate feedback, guidance, and critical thinking prompts. Debriefing sessions were highly rated (93.9%) for contributing to learning.</div></div><div><h3>Conclusion</h3><div>The VRS Embedded Instructor Model effectively enhanced learner confidence, preparedness, and clinical judgment. Despite resource intensity, embedding instructors in virtual environments provides essential guidance that mirrors real-world clinical practice, addressing limitations of traditional VR implementations in nursing education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101764"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549741","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":"The effect of high-fidelity simulation training in preeclampsia and eclampsia management: A single-blind randomized controlled study","authors":"Betül Uncu PhD, RM ,&nbsp;Rumeysa Özayabakan PhD, RM ,&nbsp;Ebru Solmaz PhD(c), RN ,&nbsp;Elif Doğan PhD(c), RM","doi":"10.1016/j.ecns.2025.101766","DOIUrl":"10.1016/j.ecns.2025.101766","url":null,"abstract":"<div><h3>Background</h3><div>Midwifery students often have limited exposure to real-life preeclampsia and eclampsia cases during clinical training, which may hinder the development of essential decision-making and clinical skills. Simulation can provide a controlled, risk-free environment for students to practice and improve their competencies in high-risk obstetric emergencies. This study aims to examine the effects of two different simulation models on midwifery students' problem-solving abilities, clinical skills, and anxiety levels in managing preeclampsia and eclampsia cases.</div></div><div><h3>Methods</h3><div>A total of 30 midwifery students, randomly assigned to two groups, participated in the study: High-Fidelity Simulation Training (HFST) Group (experimental) and Low-Fidelity Simulation Training (LFST) Group (control). Data were collected using the Problem-Solving Inventory and the State Anxiety Inventory before and after the simulations. The Clinical Skills Checklist was specifically employed during simulations to evaluate real-time clinical performance in managing preeclampsia and eclampsia cases.</div></div><div><h3>Results</h3><div>No significant difference was found between the HFST and LFST groups in terms of clinical skills, and problem-solving skills. However, within the HFST group, a significant difference was found between the pre- and post-test results, indicating that HFST increased the students' state anxiety levels (t_(paired) = −3.626, <em>p</em> = .003). In the self-confidence subscale of the problem-solving inventory, it was found that students in the HFST group experienced a decrease in self-confidence over time (t_(paired) = −3.048, <em>p</em> = .009).</div></div><div><h3>Conclusion</h3><div>Both simulation models were found to have a similar impact on student performance. However, the increased anxiety and reduced self-confidence observed in the HFST group highlight the need for emotional support and debriefing during high-fidelity training. These findings suggest that simulation-based education, when appropriately structured, can be an effective method in preparing students for managing obstetric emergencies.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101766"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534917","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":"Leveraging generative artificial intelligence to enhance ICU novice simulation instructors’ case design: A qualitative study","authors":"Jingbang Liu ,&nbsp;Li Wang ,&nbsp;Xuehua He,&nbsp;Yeru Xia,&nbsp;Xiaoyan Gong,&nbsp;Ruijuan Wu,&nbsp;Shan Li,&nbsp;Lili Wu","doi":"10.1016/j.ecns.2025.101770","DOIUrl":"10.1016/j.ecns.2025.101770","url":null,"abstract":"<div><h3>Background</h3><div>Generative Artificial Intelligence (Gen AI) is increasingly being integrated into nursing simulation education; however, little is known about how ICU novice simulation instructors experience using Gen AI for case design.</div></div><div><h3>Methods</h3><div>A descriptive qualitative approach was employed, utilizing semi-structured interviews with 13 ICU novice simulation instructors who participated in a simulation instructor training program incorporating Gen AI for case design. Thematic analysis was used to identify key themes.</div></div><div><h3>Results</h3><div>Three main themes emerged: (a) Perceived value and benefits; (b) Potential for expansion; and (c) Concerns and limitations.</div></div><div><h3>Conclusion</h3><div>ICU novice simulation instructors perceive Gen AI as a valuable tool for enhancing case design efficiency and fostering innovative teaching strategies. However, concerns regarding over-reliance on AI, content validation, and ethical considerations must be addressed. Future research should focus on refining AI-assisted simulation case design while maintaining a balance between AI support and instructor-led critical thinking to ensure the quality and sustainability of AI-integrated simulation education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101770"},"PeriodicalIF":3.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523778","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":"The effect of hot and cold debriefing on BLS competence in undergraduate nursing students: A randomized controlled trial","authors":"Fahad Zeed Alanezi PhD, MSc, RN ,&nbsp;Robin Wagner DNP, APRN-CNS, CHSE ,&nbsp;Benjamin Kelcey PhD, MA, BS ,&nbsp;Caroline F. Morrison PhD, RN, CNL ,&nbsp;Elaine Miller PhD, RN, CRRN, FAAN, FAHA","doi":"10.1016/j.ecns.2025.101768","DOIUrl":"10.1016/j.ecns.2025.101768","url":null,"abstract":"<div><h3>Background</h3><div>Annually, there are over 290,000 in-hospital adult cardiac arrests in the United States. Basic Life Support (BLS) is essential in nursing simulation training, and effective debriefing enhances individual and team performance. “Hot” debriefing occurs shortly after simulation, while “Cold” debriefing happens after one-day. However, the optimal method for nursing students remains unclear. This study aimed to compare the efficacy of hot versus cold debriefing on BLS competence and debriefing experience in undergraduate nursing students.</div></div><div><h3>Method</h3><div>A randomized controlled trial with 44 BLS-certified nursing students assigned to Hot (<em>n</em> = 22) or Cold (<em>n</em> = 22) debriefing groups. BLS competence was assessed using the American Heart Association BLS competency checklist, and the Debriefing Experience Scale measured debriefing experience.</div></div><div><h3>Results</h3><div>Both groups showed significant improvement in BLS competence from pre to post-test, with no statistical differences in competence or debriefing experience scores between methods.</div></div><div><h3>Conclusion</h3><div>While neither debriefing method proved superior, simulation with debriefing was beneficial. All students were BLS-certified, yet their mean baseline competence score was 10 out of 15, underscores the need for simulation-based BLS training in nursing curricula.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"105 ","pages":"Article 101768"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523777","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}