Simulation in Healthcare-Journal of the Society for Simulation in Healthcare最新文献

{"title":"Simulation Device for Uterine Atony in the Identification of Postpartum Hemorrhage: Overview of Prototyping, Testing, and Design Instructions.","authors":"Jacklyn L Herzberg, Morgan A Bedingfield, Allison I Goehringer, Skylah N Connelly, Ashley R Rosen, Perisa S Ashar Bse, Ann Saterbak","doi":"10.1097/SIH.0000000000000879","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000879","url":null,"abstract":"<p><strong>Introduction: </strong>Women who experience postpartum hemorrhage (PPH) after giving birth rapidly lose blood, which may lead to shock or death without immediate intervention. PPH most often results from uterine atony, when the uterus fails to contract after delivery. Worldwide, PPH causes 10 deaths hourly, with most deaths occurring in low-income settings. In these settings, medical staff may lack the training to identify the complication. Although uterine atony training models exist, many cost >$5000.</p><p><strong>Methods: </strong>To address the need for affordable training models, the Hemorrhage Education Reimagined (HER) model was created to train medical professionals to identify an atonic uterus through a bimanual examination after vaginal delivery. Twenty-five obstetrics and gynecology residents and attendings from an academic hospital evaluated the stages of atony of the HER model. Participants were asked to physically evaluate the model and give feedback on improvements to the model.</p><p><strong>Results: </strong>More than 80% of medical professionals were able to correctly discern an atonic uterus from a healthy uterus, but many had difficulty differentiating the moderately atonic uterus model from the severely atonic uterus model. The model met established design criteria, including low cost (<$100) and durability (more than 100 uses).</p><p><strong>Conclusions: </strong>The HER model is a low-cost uterine atony model. Its implementation empowers medical professionals to practice identifying uterine atony, with potential implications to improve the diagnosis of PPH. Current limitations include use of high-cost fabrication methods, such as laser cutting and 3D printing. Lower-cost options could include constructing the abdomen using cardboard or wood and hand molding the vaginal canal using clay.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030788","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":"A Framework for Integrating Students From Communication Sciences and Disorders Into Simulation-Enhanced Interprofessional Education.","authors":"Richard I Zraick, Carol C Dudding","doi":"10.1097/SIH.0000000000000882","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000882","url":null,"abstract":"<p><strong>Summary statement: </strong>This article provides a framework for simulation educators to integrate students from Communication Sciences and Disorders (CSD) into simulation-enhanced interprofessional education (Sim-IPE). Despite their essential contributions to managing communication, hearing, and swallowing disorders, CSD students remain underrepresented in interprofessional simulations. Drawing on current literature and guided by a 4-step integration framework, the article outlines practical strategies for inclusive scenario design, role clarity, interprofessional reflection, and program refinement. It highlights the educational and clinical value of CSD participation, addresses common implementation barriers, and offers tailored assessment approaches for simulation-based contexts. This work aims to advance more inclusive, realistic, and collaborative simulation experiences that better prepare health care teams to meet complex patient needs.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001800","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":"Hands-on Distance Simulation of Technical Skills: A Systematic Review.","authors":"Wei Wei, Martine S Nielsen, Anders B Nielsen, Yuan Han, Lene Russell, Lars Konge, Kristoffer M Cold","doi":"10.1097/SIH.0000000000000881","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000881","url":null,"abstract":"<p><strong>Summary statement: </strong>Distance simulation in health care has advanced rapidly, offering potential to reduce geographical barriers, costs, and carbon emissions while increasing global access to medical education. This systematic review evaluated hands-on technical skills training via distance simulation compared to traditional on-site training. Following PRISMA guidelines, 104 studies were analyzed. Laparoscopic skills, suturing, and ultrasound were the most studied tasks. Distance simulation, using decentralized portable simulators and centralized telementoring, demonstrated comparable or superior outcomes to on-site training. However, only 2 studies assessed skill transfer to clinical settings, and 1 reported patient-related outcomes. Rigorous randomized controlled trials (RCTs) are needed to further evaluate skill retention and clinical impact.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001791","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":"Learning Activity Sequence, Simulation, and Productive Failure in Anti-Harassment Education.","authors":"Byunghoon Tony Ahn, Myriam M Johnson, Negar Matin, Ning-Zi Sun, Jason M Harley","doi":"10.1097/SIH.0000000000000867","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000867","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high prevalence of harassment in health professions education, empirical investigations into effective anti-harassment interventions remain scarce. Our study examined the effectiveness of an innovative anti-harassment intervention that featured instructional videos and high-fidelity simulation training for medical residents. We drew from the knowledge-learning-instruction framework and the idea of productive failure to conceptualize our research questions and discussion. We examined how the sequence of educational activities may be linked to simulation performance and increases in knowledge levels.</p><p><strong>Method: </strong>Our pretest posttest study contacted all 88 eligible internal medicine residents, randomly assigning them to the intervention (n = 60) or equivalent training later (n = 28). Of those assigned to the intervention, 52 (86.6%) consented and were further randomized to a video-first or simulation-first group. We provided educational activities in different sequences accordingly. We assessed knowledge via a questionnaire, and simulation performance via a performance checklist.</p><p><strong>Results: </strong>The video-first group demonstrated significantly better initial simulation performance compared with the simulation-first group, aligning with traditional learning sequential benefits. Both groups showed significant postintervention knowledge gains. Notably, the simulation-first group, despite starting with lower performance, ended with significantly higher knowledge levels than the video-first group, suggesting the efficacy of the productive failure approach in fostering deeper learning.</p><p><strong>Conclusions: </strong>The sequence of educational activities may impact the effectiveness of anti-harassment training. The video-first approach enhances immediate performance, while the simulation-first approach fosters better knowledge retention. Further research should investigate the long-term effects of such educational strategies and their applicability in diverse healthcare settings.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976428","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 Development of the Engagement Scale for Simulation-Based Education: Item Generation and Early Psychometric Findings.","authors":"Darla S Morton, Megan W Stuhlman, Elizabeth A Hawbaker","doi":"10.1097/SIH.0000000000000873","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000873","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education (SBE) is an essential teaching modality in healthcare; learner engagement in SBE is critical for knowledge retention. Numerous scales are validated to measure engagement, but none are specific for use in SBE. We present development and initial validation evidence for the Engagement Scale for Simulation-Based Education (ESSBE), a self-report tool measuring behavioral, cognitive, emotional, and social dimensions of the engagement construct within scenario-based SBE.</p><p><strong>Methods: </strong>A mixed methods approach included item generation, expert review, and cognitive pretesting. Learners already attending undergraduate and graduate healthcare education programs at a southeastern simulation center voluntarily completed an 18-item, 7-point frequency response questionnaire immediately after a simulation session (n = 402). Reliability was tested using Cronbach's alpha and Spearman's Rank (rho). Dimensionality was assessed via confirmatory factor analysis (CFA) and metric invariance testing.</p><p><strong>Results: </strong>From several structural models tested, best-fit was obtained using a 2nd order/4-dimensional model with 11 retained items (CMIN/3.3, CFI/0.945, TLI/0.91, SRMR/0.055, RMSEA/0.075). Additional empirical evidence supported scale reliability (alphas ≥ 0.610; rho r(401) ≥ 0.434, P < 0.01) and metric invariance (held for Δ SRMR and Δ RMSEA).</p><p><strong>Conclusion: </strong>Future studies are needed to strengthen the validation evidence for the ESSBE before the tool is ready for general use. For example, we have not yet tested convergent/divergent validity with existing metrics or whether ESSBE responses are associated with learner outcomes. We provide initial evidence supporting the 11-item, 4-dimension ESSBE as a potentially reliable and valid measurement of engagement in SBE.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823044","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":"Exploring AI Hallucinations of ChatGPT: Reference Accuracy and Citation Relevance of ChatGPT Models and Training Conditions.","authors":"Adam Cheng, Vikhashni Nagesh, Susan Eller, Vincent Grant, Yiqun Lin","doi":"10.1097/SIH.0000000000000877","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000877","url":null,"abstract":"<p><strong>Introduction: </strong>Large language model-based generative AI tools, such as the Chat Generative Pre-trained Transformer (ChatGPT) platform, have been used to assist with writing academic manuscripts. Little is known about ChatGPT's ability to accurately cite relevant references in health care simulation-related scholarly manuscripts. In this study, we sought to: (1) determine the reference accuracy and citation relevance among health care simulation debriefing articles generated by 2 different models of ChatGPT and (2) determine if ChatGPT models can be trained with specific prompts to improve reference accuracy and citation relevance.</p><p><strong>Methods: </strong>The ChatGPT-4 and ChatGPT o1 models were asked to generate scholarly articles with appropriate references based upon three different article titles about health care simulation debriefing. Five articles with references were generated for each article title-3 ChatGPT-4 training conditions and 2 ChatGPT o1 training conditions. Each article was assessed independently by 2 blinded reviewers for reference accuracy and citation relevance.</p><p><strong>Results: </strong>Fifteen articles were generated in total: 9 articles by ChatGPT-4 and 6 articles by ChatGPT o1. A total of 60.4% of the 303 references generated across 5 training conditions were classified as accurate, with no significant difference in reference accuracy between the 5 conditions. A total of 22.2% of the 451 citations were classified as highly relevant, with no significant difference in citation relevance across the 5 conditions.</p><p><strong>Conclusions: </strong>Among debriefing articles generated by ChatGPT-4 and ChatGPT o1, both ChatGPT models are unreliable with respect to reference accuracy and citation relevance. Reference accuracy and citation relevance for debriefing articles do not improve even with some degree of training built into ChatGPT prompts.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795978","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":"Assessment of Basic Orthopedic Surgical Skills in a Low-Cost Simulation-Based Setting: A Validation Study.","authors":"Jacob J Schmidt, Anders B Nielsen, Thomas B Christensen, Mette Kallesen, Amandus Gustafsson, Bjarke Viberg","doi":"10.1097/SIH.0000000000000878","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000878","url":null,"abstract":"<p><strong>Introduction: </strong>Basic orthopedic surgery skills (BOSS) have been identified as critical in resident surgeons' training. Costs and limited evidence hinder integrating simulation training into resident surgeons' curricula. This study aimed to gather validity evidence for a low-cost simulation-based test to assess BOSS.</p><p><strong>Method: </strong>We modified 5 practical stations testing BOSS from a previous study. All stations were made of standard items from hardware stores and 3D prints. The Messick framework was used to gather validity evidence for the tests. A novice and an expert group were invited to participate and repeated testing each station until the plateau score was reached. The Levene test and Student t test were applied to compare performances. The expert group's mean plateau score was used as pass/fail score. Another novice group was invited to perform the test.</p><p><strong>Results: </strong>The total costs were less than 900 USD for all stations. We included 11 novices and 9 experts yielding an interclass correlation coefficient (ICC) of 0.40 to 0.95, demonstrating moderate to high reliability. The mean plateau scores for the 5 stations were 2.6 to 17.9 mm for the novice group. The expert group performed statistically significantly better (0.9-6.9 mm, P-value of 0.002-0.022) and the mastery standard was defined as the experts' mean. A second novice group (n = 10) all achieved the mastery standard across all stations after a median of 53.5 attempts (IQR: 33-85.5) and 61.5 minutes (IQR: 45.2-111.2).</p><p><strong>Conclusion: </strong>We modified a low-cost, practical test to assess BOSS with supporting validity evidence. A credible mastery standard was established enabling evidence-based and objective testing for assessing BOSS.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776742","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":"Incorporating Augmented Reality Patients Into Online Trauma Training to Support Mental Model Development: An Experimental Study.","authors":"Lauren Mansour, Christen Sushereba, Christopher E San Miguel, Laura G Militello, Theodore T Allen, Emily S Patterson","doi":"10.1097/SIH.0000000000000839","DOIUrl":"10.1097/SIH.0000000000000839","url":null,"abstract":"<p><strong>Introduction: </strong>Medical students find translating lessons from traditional lectures to caring for trauma patients challenging. We assess whether adding video-based virtual flashcards and videos of augmented reality-based trauma patients in an online learning environment improves performance.</p><p><strong>Methods: </strong>We performed a between-subject experimental study. Thirty-five medical students were randomly assigned to the control and experimental groups. The control group viewed a traditional online lecture. The experimental group viewed the same online lecture and received virtual flashcard training. Each virtual flashcard consisted of a video of a virtual patient, and examination questions about diagnoses, treatment, and disposition. The experimental group also viewed a video of a physician coach providing an expert assessment of the virtual patient. Simulation-based assessment was used to measure performance and knowledge. The evaluation consisted of the following 3 scenarios: a video of a simulated patient followed by multiple-choice questions, a free-text examination, and the writing of a Subjective, Objective, Assessment and Plan note. Differences in performance for 3 measures (diagnoses, therapeutic interventions, and disposition) were assessed for pre-post change in accuracy. For these 3 measures, we used a binary logistic regression model. We assessed perceptions of performance and the training experience with a survey.</p><p><strong>Results: </strong>The training intervention statistically significantly improved accuracy for diagnosis ( P = 0.01) and self-reported performance ( P < 0.01) compared with the control group. The themes for the experience were engaging, innovative, and valuing the expert's assessment, with 17 of 19 positive statements.</p><p><strong>Conclusions: </strong>Adding virtual flashcards to traditional training significantly improved diagnostic accuracy while being engaging and innovative.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"267-276"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848203","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":"Call to Action: Honoring Simulated Participants and Collaborating With Simulated Participant Educators.","authors":"Lou Clark, Andrea Doyle, Melih Elcin, Nancy McNaughton, Cate Nicholas, Tamara Owens, Cathy Smith, Karen Szauter, Kuan Xing, Debra Nestel","doi":"10.1097/SIH.0000000000000840","DOIUrl":"10.1097/SIH.0000000000000840","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"211-214"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Print-It-Yourself Bone Marrow Biopsy Simulator Compared With Human Cadavers.","authors":"Jean-Francois Leclerc, Tristan Samson-Roy, Maxime Chénard-Poirier, Marie-Laurence Tremblay, Alexandre Lafleur","doi":"10.1097/SIH.0000000000000857","DOIUrl":"10.1097/SIH.0000000000000857","url":null,"abstract":"<p><strong>Introduction: </strong>Bone marrow biopsy is a critical skill in hematology-oncology and internal medicine training. Less experienced practitioners more frequently obtain suboptimal specimens, leading to misdiagnoses, delays, or repeated procedures; rare but serious complications can occur during training on actual patients. Although cadaveric simulation and commercial simulators are valuable training tools, they present significant cost and accessibility challenges. Current 3-dimensional (3D)-printed simulators lack essential features necessary for widespread implementation.</p><p><strong>Methods: </strong>Based on the biomedical properties of the posterior superior iliac spine, we designed a 3D-printed procedural simulator to democratize bone marrow biopsy training. Key features include functional fidelity to enhance learner confidence and rapid acquisition of high-quality specimens (at least 15 mm in length), ease of printing and assembly, low cost, and durability. We compared this simulator to cadaveric practice in a randomized crossover study.</p><p><strong>Results: </strong>Thirty-eight first-year internal medicine residents participated in the simulation. Residents reported similar levels of appreciation and confidence in performing a biopsy after practicing on the novel 3D-printed simulators and human cadavers. Within 10 minutes of practice with the simulator, 86% successfully obtained lifelike specimens of at least 15 mm (2.5 specimens, mean 27 mm), compared to 60% with cadaver practice (2.1 specimens, mean 17 mm).</p><p><strong>Conclusions: </strong>Using this 3D-printed simulator, residents obtained higher quality specimens than with cadaveric practice, allowing them to focus on mastering the controlled drilling motion through the bone cortex and marrow, the key challenge of this procedure. Democratizing biopsy simulation, educators can easily assemble this low-cost simulator for use in diverse training settings.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"245-249"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051862","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}