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

{"title":"Integrating Technical and Nontechnical Skills Under Pressure: A Qualitative Observational Study of Obstetric On-Call Simulation.","authors":"Aditi Siddharth, Nadia Muspratt Tucker, Divya Nambiar, Ruth Houlden, Debbie Aitken, Helen Higham","doi":"10.1097/SIH.0000000000000978","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000978","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation is widely used in obstetric training; however, there is limited understanding of how early-stage trainees integrate technical and nontechnical skills under realistic clinical pressures. This study explored how early-stage trainees integrated technical and nontechnical skills while managing concurrent clinical demands during a simulated obstetric on-call shift.</p><p><strong>Methods: </strong>A qualitative observational study was conducted in a simulated labor ward during a regional training day. Fourteen obstetrics and gynecology trainees (years 1 to 2) participated in a 40-minute simulated on-call shift involving concurrent management of patients across multiple clinical areas, followed by a facilitated focus group discussion. Some participants were deliberately assigned roles with responsibilities beyond their actual training grade. Data were analyzed thematically, with triangulation across participant observation, field notes, movement-tracking diagrams, simulation transcripts, and focus group data.</p><p><strong>Results: </strong>Trainees completed familiar technical tasks, although some preparatory steps required prompting. Observed hesitation, requests for guidance, and reliance on prompting occurred during complex decision-making, obtaining consent for instrumental birth, and escalation of care. These behaviors occurred while some trainees were undertaking assigned roles with responsibilities beyond their training grade. Coordinated teamwork behaviors were observed alongside communication lapses and disrupted role allocation. Participants described the simulation environment as psychologically safe and valued the opportunity for experiential learning and reflection.</p><p><strong>Conclusions: </strong>The simulated obstetric on-call shift was practicable to deliver within a regional training day and was acceptable to participants as a learning activity. It provided a structured approach for observing the integration of technical and nontechnical skills during concurrent clinical demands. The findings describe behavior within assigned simulated roles and should not be interpreted as an assessment of competence or readiness at the participants' actual training level.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225385","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":"Rapid Cycle Deliberate Practice Versus Conventional Simulation for Neonatal Resuscitation Training: A Randomized Controlled Trial.","authors":"Chethan Nagaraju, Venkataseshan Sundaram, Jogender Kumar, Praveen Kumar","doi":"10.1097/SIH.0000000000000977","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000977","url":null,"abstract":"<p><strong>Introduction: </strong>Effective neonatal resuscitation at birth is crucial for survival and has the potential to reduce neurodevelopmental morbidities. While traditional simulation-based training in neonatal resuscitation shows greater skill attrition over time, the Rapid Cycle Deliberate Practice (RCDP) approach, a method involving repeated in-simulation practice with immediate feedback, may enhance skill acquisition and retention. However, evidence favoring RCDP in neonatal resuscitation is lacking, particularly in low-income and middle-income countries.</p><p><strong>Methods: </strong>In this randomized trial, pediatric residents (n=39) and nurses (n=9) with prior neonatal resuscitation training within 3 months to 2 years from the date of enrolment participated in simulation-based sessions using either RCDP or conventional simulation and debriefing (CSD). Simulation sessions were conducted utilizing a standardized approach developed by the simulation team. Three simulation scenarios with the same learning objectives were created by the simulation team; minor modifications were made during simulation conduct, assuring that different scenarios were used for training and assessment for the same group. Simulation sessions used for assessment were video recorded, and video raters were blinded to the group allocation. The primary outcome was skill and knowledge retention 1 month after training, assessed using the modified Neonatal Simulation Assessment Score (N-SAS) tool. The secondary outcome was skills and knowledge measured immediately. Performance between RCDP and CSD groups was compared utilizing using the Student t test. Both primary and secondary outcomes were tested in a simulation setting. While long-term retention is of interest, the feasibility of this study only allowed for a 1-month assessment.</p><p><strong>Results: </strong>The mean cumulative N-SAS score 1 month after training was significantly higher in the RCDP group compared with the CSD group [51.8 (4.3) vs. 47.1 (2.4), mean deviation (95% CI): -4.8 (-7.7, -1.8), P=0.003]. Out of the 6 domains in the N-SAS tool, the RCDP group performed better than the CSD group in the preparation domain [20.4 (2.4) versus 18.2 (2.4); mean deviation] (95% CI): -2.3 (-4.3, -0.2), P=0.03]. Regarding secondary outcomes, the RCDP group performed better than the CSD group immediately after training overall, with a statistically significant difference noted in the domains of chest compressions and epinephrine administration.</p><p><strong>Conclusions: </strong>The RCDP compared with the CSD simulation training resulted in improved performance in a simulated setting, as measured by the N-SAS tool, both immediately after the training and 1 month post-training.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225374","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-Based Education in Competency-Based Health Professional Training: A Scoping Umbrella Review.","authors":"Kristen M Brown, Marie Gilbert, Vivian T Obeso, Ashley E Franklin, Mindi Anderson, Penni I Watts, Matthew D Charnetski, Brian G Mann, Curtis Nickel, Sarah Allgood, S Barry Issenberg","doi":"10.1097/SIH.0000000000000976","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000976","url":null,"abstract":"<p><p>Statement: Competency-based education (CBE) has become a prevalent framework in health professions education, emphasizing observable outcomes, learner progression, and accountability to patient needs. This scoping umbrella review examined how simulation-based education (SBE) is being used to support and implement CBE across health care professions and disciplines. Across 44 reviews, SBE was used to support knowledge, skills, clinical reasoning, communication, teamwork, and confidence. High-fidelity simulation, virtual reality, standardized patients, and hybrid modalities were commonly used to support deliberate practice and competency-focused learning. Despite this alignment, SBE was frequently implemented as a discrete educational modality rather than as a longitudinally integrated component of competency-based curricula, with inconsistent reporting of competency frameworks, theory-informed design, debriefing approaches, and programmatic assessment strategies. This review synthesizes key findings, gaps, and recommendations and proposes a simulation-grounded CBE framework to guide the intentional integration of SBE within competency-based health care curricula.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225363","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 Space Between Action and Reflection: Nursing Students' Experiences of Debriefing Timing.","authors":"Jonathan Barrios","doi":"10.1097/SIH.0000000000000975","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000975","url":null,"abstract":"<p><strong>Introduction: </strong>Debriefing is widely regarded as a central component of simulation-based learning, yet limited attention has been given to how the timing of debriefing is experienced by learners in undergraduate courses that include graded simulation.</p><p><strong>Methods: </strong>An interpretive qualitative study situated within a constructivist epistemological perspective was conducted. Semi-structured interviews were completed with 10 third-year undergraduate nursing students enrolled in a course that included simulation-based learning. Interviews explored participants' experiences of simulation, perceptions of debriefing timing and structure, and the perceived influence of feedback. Data were analyzed primarily using inductive, semantic thematic analysis with iterative comparison within and across transcripts.</p><p><strong>Results: </strong>Six interrelated themes were identified: simulation as a high-pressure evaluative environment; temporal distance and difficulty recalling actions and reasoning; feedback focused on error identification without sufficient instructional guidance; temporally proximal feedback experienced as easier to connect to reasoning; peer presence as both supportive and anxiety-provoking; and instructor facilitation shaping psychological safety and engagement. Participants described difficulty recalling earlier decisions when later-session debriefing occurred after multiple scenarios and described temporally proximal feedback as easier to connect to their reasoning.</p><p><strong>Conclusions: </strong>Participants described simulation as an emotionally and cognitively demanding context in which the timing and structure of debriefing shaped their experiences of reflection. These findings reflect learner perceptions rather than objective learning outcomes. The timing of feedback may influence how learners engage in reflective discussion during simulation-based education. Further research examining relationships between debriefing timing and measurable learning outcomes is warranted.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139341","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":"Navigating Harassment as Bystanders: A Thematic Analysis of Internal Medicine Residents' Responses in Simulation-Based Training During Simulation After Video-Based Training.","authors":"Myriam Johnson, Byunghoon Tony Ahn, Cassandra Dutil, Negar Matin, Ning-Zi Sun, Keerat Grewal, Jason M Harley","doi":"10.1097/SIH.0000000000000900","DOIUrl":"10.1097/SIH.0000000000000900","url":null,"abstract":"<p><strong>Introduction: </strong>Harassment is a persistent issue in medical training, negatively impacting trainees' well-being, learning, and professional development. Although bystander intervention programs aim to address harassment, little is known about how medical residents respond in real-time situations. This study examines internal medicine (IM) residents' bystander responses during a simulation-based anti-harassment training.</p><p><strong>Methods: </strong>We used an interpretivist thematic analysis to address our research questions in this article as part of a larger anti-harassment research study. Seventeen IM residents watched an educational anti-harassment video and then participated in a standardized simulation of a central line procedure, where they witnessed a senior resident (SR) harassing a medical student (MS), both portrayed by actors. Video and audio recordings captured verbal and nonverbal responses, which were coded iteratively. Descriptive frequency analysis tracked response patterns over time.</p><p><strong>Results: </strong>All residents used all 3 main categories of responses in the following order of frequency: MS-centered (reassuring, empathetic, or knowledge driven), passive (education focused, reattribution, avoidant, or unreactive), or SR-related (immediate direct, immediate indirect, or delayed responses). All residents used both reassuring and unreactive responses. Residents' use of the 3 main response categories varied over the course of the simulation. MS-centered responses were used throughout the simulation, whereas SR-related responses only started to appear midway through the simulation.</p><p><strong>Conclusion: </strong>IM residents used varied intervention strategies, yet many defaulted to passive responses, potentially indicating hesitancy, uncertainty, or deference to hierarchy. These findings highlight the need for structured bystander training to build confidence in active intervention and improve responses to harassment in medical training.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"275-282"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357294","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 Ripple Effect of Readiness: How Simulation Changed One Patient's Story.","authors":"Priscilla Aguirre","doi":"10.1097/SIH.0000000000000921","DOIUrl":"10.1097/SIH.0000000000000921","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"337-338"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259718","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 Use of Deliberate Practice in Simulation-Based Surgical Training for Open General and Subspeciality Surgery: A Systematic Review.","authors":"Dakshitha Praneeth Wickramasinghe, Jonathan Vincent","doi":"10.1097/SIH.0000000000000908","DOIUrl":"10.1097/SIH.0000000000000908","url":null,"abstract":"<p><p>Simulation-based surgical training (SBST) provides a risk-free environment for surgical skill development. Integrating deliberate practice (DP) into SBST may enhance training effectiveness. This systematic review examines the application of DP elements in SBST for open general and subspecialty surgery, and their effectiveness in improving surgical skills. It aims to systematically synthesize the use of DP elements within SBST and evaluate effects on trainee performance. To preserve methodological comparability, this review focused on open procedures in general surgery and its subspecialties. The search identified 22 studies for inclusion, predominantly from North America and Europe. Most studies incorporated feedback and allowed repetition but commonly lacked structured assessments of learner motivation and individualized task design. Studies generally reported improvements in surgical skills after DP-informed SBST; however, the correlation between the number of DP elements used and learning outcomes was inconsistent. Kirkpatrick levels 1 and 2 evaluations were most common. The results suggest that DP-informed SBST improves skill acquisition in open surgery, although variations in DP implementation limit direct comparison across studies. Enhanced instructional design aligning closely with DP principles may bridge gaps in training quality, providing a structured pathway.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"298-305"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821937","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":"Emotions in Simulation-Based Education Through the Eyes of the Colour Monster.","authors":"Emma Claire Phillips","doi":"10.1097/SIH.0000000000000914","DOIUrl":"10.1097/SIH.0000000000000914","url":null,"abstract":"<p><p>Learners in simulation-based education (SBE) experience a kaleidoscope of emotions, which shape learning, performance, and professional identity formation. This article provides a conceptual commentary of the emotional landscape in SBE, using the children's book The Colour Monster as an illustrative lens, while also highlighting the complexities of emotions in adult learners. Lessons drawn from this book highlight that feeling emotions is a normal and expected part of the learning process, the critical importance of the facilitator in helping participants work with their emotions, and the potential role of emotional regulation strategies in optimizing emotions for learning and performance. Deepening appreciation of these concepts may facilitate more consistent appreciation and integration of emotion into simulation design and delivery.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"314-316"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013007","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":"Mastery Learning Improves Simulated Distal Radius Fracture Management by Emergency Medicine Teaching Faculty.","authors":"Nicholas Pokrajac, Michael A Gisondi, Alexandria Jensen, Kelly N Roszczynialski, Carl Preiksaitis, William Dixon","doi":"10.1097/SIH.0000000000000902","DOIUrl":"10.1097/SIH.0000000000000902","url":null,"abstract":"<p><strong>Background: </strong>Emergency medicine (EM) physicians must be competent in managing distal radius fractures, yet training gaps exist. This study evaluated academic EM physician proficiency in managing a simulated distal radius fracture and the impact of a simulation-based mastery learning (SBML) intervention.</p><p><strong>Methods: </strong>We conducted a pretest-posttest study of board-certified or board-eligible EM physicians at a university-based training hospital between August and December 2023. Four trained facilitators assessed participants on distal radius fracture management using a task trainer and a 41-item checklist with a minimum passing standard (MPS) of 37/41 (90.2%). The SBML intervention included baseline assessment, individualized feedback, deliberate practice, and reassessment.</p><p><strong>Results: </strong>Fifty-one physicians participated in the pretest, with a median score of 32/41 (78.0%) and 10 (19.6%) achieving the MPS initially. Of the 20 participants who completed the posttest, 19 (95%) achieved the MPS after SBML intervention. The intervention resulted in a significant mean score improvement of 8.4 points (95% confidence interval: 6.92-9.78; P  < 0.01). Only performing a distal radius fracture reduction in the past year significantly predicted higher pretest performance (3.3 points higher, P  = 0.04). Participant comfort with all aspects of distal radius fracture management significantly improved after SBML.</p><p><strong>Conclusions: </strong>Academic EM physicians demonstrated performance gaps in distal radius fracture management that were effectively addressed by SBML. Few clinical experience metrics predicted performance, suggesting a need for targeted educational interventions to maintain skills in this important procedural area.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"283-288"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806270","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":"Cost Analysis of the OSCE: Scoping Review.","authors":"Milena Colonhese, Sara F Lima, Elaine C Negri, Fernanda B Girão, Rosimeire S D Giovanazzi, Gerson A Pereira Júnior","doi":"10.1097/SIH.0000000000000910","DOIUrl":"10.1097/SIH.0000000000000910","url":null,"abstract":"<p><p>This scoping review examined the economic components of implementing Objective Structured Clinical Examinations (OSCEs) in health professions education. Forty-nine studies published between 1986 and 2024, spanning multiple countries, professions, and simulation modalities, were analyzed. Key cost categories included standardized patients, evaluator compensation, infrastructure, logistics, and digital resources. Reported costs ranged from less than US$7 per student to more than US$150,000 per cycle. Traditional in-person OSCEs incurred higher recurring operational expenses, whereas online and hybrid formats concentrated spending in initial infrastructure and showed potential for scalability and cost containment. Significant inconsistencies in cost definitions and reporting practices limited comparability across studies. The findings highlight the urgent need for standardized economic frameworks, cost-reporting tools, and context-sensitive strategies to guide sustainable OSCE implementation, particularly in low- and middle-income countries where resource allocation must be strategic and aligned with institutional capacity.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"306-313"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047142","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}