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

{"title":"Comparing the Video-guided Intubation Skills of Competency and Mastery-trained Staff Physicians.","authors":"Leanne K Elliott, Nick Wattie, Jonathan Pirie, Kathy Boutis, Adam Dubrowski, Paul Yielder, Natasha Collia","doi":"10.1097/SIH.0000000000000962","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000962","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying the most effective simulation training approach for maintaining critical skills among staff physicians is essential, as this can affect patient safety and healthcare costs. While competency-based and mastery-based interventions have been studied independently, their effects on skill retention and transfer have not been directly compared. This prospective cohort study compared mastery-based and competency-based training for video laryngoscopy (VL) skill maintenance among staff physicians.</p><p><strong>Methods: </strong>Each intervention included a presimulation online module and a simulation-based training session differing only in performance standards. The competency group (n=8) followed an instructor-determined standard, while the mastery group (n=8) adhered to a higher Mastery Angoff-established standard. VL skills were assessed pre-, post-, and 6 months later (follow-up) in the mastery group; the competency group was assessed only at follow-up. Follow-up included a retention test (pediatric mannequin) and a transfer test (neonatal task trainer). Performance was evaluated using an 18-item checklist (max score: 36) and procedural time (seconds).</p><p><strong>Results: </strong>The mastery group significantly increased mean VL scores and decreased mean VL time from pretest (score=22.13; time=162.00 s) to post-test (34.38; 71.50 s) [(P<0.001, 95% CI: -17.44, -7.06);(P<0.001, 95% CI: 61.73, 119.27)]. All mastery-trained staff maintained skill mastery (≥32) at follow-up and outperformed the competency group at retention [(score=33.00 vs. 27.00; P<0.001, 95% CI: 3.40, 8.60);(time=60.63 s vs. 91.25s; P>0.05, 95% CI: -70.02,8.78)] and transfer [(score=34.38 vs. 26.13; P<0.001, 95% CI: 6.05, 10.45) (time=30.63s vs. 55.00 s; P>0.05,95% CI: -53.50, 4.75)].</p><p><strong>Conclusions: </strong>Simulation-based mastery learning may enhance staff physicians' maintenance of VL skills and procedural efficiency. However, given the absence of baseline data for the competency group, definitive conclusions regarding superiority cannot be drawn.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819835","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":"What Do Life-Support Trainers Mean When They Say They Use the Learning Conversation Debriefing Method? A Phenomenographic Study.","authors":"Jaime C Smal, Nigel M Turner, Rob M Moonen, Marije Hogeveen, Olle Ten Cate","doi":"10.1097/SIH.0000000000000961","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000961","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based medical education (SBME) can help health care professionals to perform effectively in high-stakes situations. Debriefing is a cornerstone of SBME, typically facilitated by trainers using structured frameworks. The post-simulation learning conversation (PSLC) has been described as a 7-step flexible debriefing model. Despite faculty training, PSLC is not always applied consistently. This study aimed to explore variation in how life-support trainers perceive and apply PSLC in simulation debriefing, to identify deviations from the original format, and to improve understanding of this variation.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with 15 life-support trainers. Transcripts of the audio recordings were analyzed using a phenomenographic approach.</p><p><strong>Results: </strong>The analysis yielded 3 descriptive categories: (1) perception of PSLC, (2) use of PSLC in practice, and (3) reasons for deviation from PSLC. PSLC was generally considered valuable but also challenging. Common reasons to deviate from the standard strategy are related to trainer and learner factors and time constraints.</p><p><strong>Conclusions: </strong>The PSLC is perceived as a flexible yet complex debriefing framework, with considerable variation in how it is understood and applied. Key principles of the PSLC, as originally described, are not always utilized, which may negatively impact learning outcomes. To enhance consistency in applying these principles and to improve effectiveness, further faculty development to improve understanding of PSLC is recommended.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819934","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 Team Training Effects on Clinical Performance and Patient Outcomes: Systematic Review of Controlled Studies.","authors":"Anders Schram, Kasper G Lauridsen, Kristian Krogh, Rasmus P Nielsen, Lise Brogaard, Lone Hvidman, Signe Thim, Morten S Lindhard","doi":"10.1097/SIH.0000000000000965","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000965","url":null,"abstract":"<p><p>Simulation-based team training is widely implemented across health care systems, yet its contribution to clinical performance and patient outcomes remains variably documented. This review synthesizes controlled studies of postgraduate simulation-based team training in acute care settings, focusing on how interventions and effects vary across contexts. Eighteen controlled studies were included, reporting outcomes related to clinical performance, morbidity, or survival. While many studies demonstrated improvements in at least one outcome domain, findings were inconsistent and varied across intervention format and baseline conditions. Reported benefits were more commonly observed in lower-resource or district hospital settings, whereas brief training interventions showed fewer effects. Overall certainty of evidence was low. Rather than supporting a binary interpretation of whether simulation-based team training \"works,\" the findings indicate that effects depend on how training is designed, implemented, and integrated within clinical systems, requiring interpretation at the level of individual studies.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800003","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":"Authorship Analysis of Studies on Simulation-based Education in Low and Middle-income Countries: Results From a Systematic Review.","authors":"Samuel J A Robinson, Angus Ritchie, Lamour Hansell, Maurizio Pacilli, Debra Nestel, Elizabeth McLeod, Ramesh Mark Nataraja","doi":"10.1097/SIH.0000000000000956","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000956","url":null,"abstract":"<p><p>Growing emphasis has been placed on the importance of local authorship in research from low and middle-income countries (LMICs). This study aimed to investigate local authorship of simulation-based education research conducted in LMICs through an in-depth authorship analysis of publications retrieved from a systematic review. After retrieving 27,738 records, 97 studies from 50 LMICs were included. The median number of authors was 8, ranging was from 2 to 18. Ninety-three studies (95%) included a local author, and local authors composed 145/291 (49%) of the total first, second, or final (FSF) authorship positions. Although there was a substantial increase in the number of published studies, there were no significant changes to the proportion of local FSF authors over time: 44% in 2002-2006; 63% in 2007-2011; 47% in 2012-2016; and 49% in 2017-2022 (P = 0.45). The representation of local FSF authors is lower compared with other fields, though this may be reflective of including only studies that conducted high-level evaluation, or the fact that simulation is a relatively new field. Simulation researchers should actively support and include local authors to ensure programs are appropriate, contextualized and impactful, while making concerted efforts to develop local research capacity in LMICs.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799892","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":"Artificial Intelligence in Simulation Design: The Effectiveness of a Customized Artificial Intelligence-based Scenario Development Tool.","authors":"Kriti Gupta, Megan Lavoie, Sabrina Guse, Khoon-Yen Tay, Michael Hrdy","doi":"10.1097/SIH.0000000000000953","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000953","url":null,"abstract":"<p><strong>Introduction: </strong>The creation of simulation scenarios is typically time-consuming and requires a high cognitive load. Artificial intelligence (AI) and large language models (LLMs) can generate text, including simulation scenarios, but the output quality can be very user-dependent. The goal of this study is to explore if a customized version of ChatGPT can create simulation scenarios that are comparable to those written by humans.</p><p><strong>Methods: </strong>In this observational cross-sectional study, simulation content experts scored 8 scenarios covering 4 pediatric emergency medicine (PEM) topics with one version written by health care educators and published on MedEdPORTAL, and another by a custom ChatGPT. Experts were blinded to the source of each case. The scenarios were assessed in 3 ways: an objective score from an established simulation scoring checklist, a subjective quality rating, and whether the experts would recommend the scenario for use.</p><p><strong>Results: </strong>Seven experts with an average of 11 years of PEM training and an average of 10 years of simulation work scored simulations. While all 4 AI-generated cases had lower average scores on both quantitative assessments than their human-written counterparts, these results were not statistically significant. The majority of experts recommended each case to colleagues, regardless of source. There was moderate to excellent intrarater reliability.</p><p><strong>Conclusion: </strong>Human-written cases received higher scores than the AI-written cases. While these scores were not statistically significant, these differences highlight the importance of keeping a human-expert influence when using AI to produce simulation cases. This ChatGPT tool can therefore be useful in assisting in the timely creation of scenarios, allowing facilitators, regardless of their technical skill with AI, to decrease cognitive load. Next steps should move beyond evaluating the scenario text to include evaluation of the experience of facilitating the ChatGPT-derived pediatric simulations as well as assessing the perspectives of simulation operators.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799912","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 Acuity and Patient Prioritization: Development of a Checklist for Student Assessment.","authors":"Zoe I Listernick, Meghan E Mitchell, Mara M Bezerko, Oluwateniola Brown, Elaine R Cohen, Jenna Fleming, Jana Jaffe, Sonia Parikh, Adam L Payne, David H Salzman, Lindsay R Koressel","doi":"10.1097/SIH.0000000000000964","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000964","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying acuity and patient prioritization are essential but difficult skills to teach to medical students. This study aimed to develop and assess the initial validity evidence of a checklist to be used in simulation scenarios for fourth-year medical students addressing these skills.</p><p><strong>Methods: </strong>We applied the Kane validation framework to gather evidence supporting the use of this checklist in simulation-based assessment, focusing on the Scoring and Generalization domains. A modified Delphi method was used to create an ideal performance checklist to be used in simulation scenarios of patients requiring urgent or emergent care. Following development, a Mastery Angoff approach was used to establish a Minimum Passing Standard (MPS). Fourth-year medical students were recruited to participate in simulations, and performance was assessed using the created checklists. During the simulations, students received patient handoffs and were asked to prioritize acuity and manage evolving clinical situations across 2 simulated encounters. Simulations were scored by both real-time and video-observed raters and inter-rater reliability (IRR) was calculated.</p><p><strong>Results: </strong>Twenty-five students participated in the 2023 to 2024 academic year. The expert panel finalized a 10-item checklist and the MPS was determined to be 85%. Overall, IRR was excellent, with a Cohen kappa coefficient of 0.872. Cohen kappa coefficient for individualized checklist domains ranged from 0.65 to 1.</p><p><strong>Conclusion: </strong>This study describes the development of a performance checklist assessing students' abilities in identifying acuity and patient prioritization, with initial validity evidence supporting Kane Scoring and Generalization inferences.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799916","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":"An Interpretative Phenomenological Analysis of the Benefits of Being a Simulated Patient: Health Knowledge, Health Behaviors, and Well-Being.","authors":"Timothy R Thompson, William D Craun, Thomas S Creech, Jacqueline M Parks, James R Nolin","doi":"10.1097/SIH.0000000000000963","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000963","url":null,"abstract":"<p><strong>Intro: </strong>Simulated patients (SP) are individuals trained to portray patients in clinical encounters for health care education. This study explores potential health benefits and knowledge resulting from SP work.</p><p><strong>Methods: </strong>Ten SPs at the researchers' institution were invited to 1-on-1 semistructured interviews that were recorded and transcribed. The authors approached the study through the Interpretative Phenomenological Analysis (IPA) framework to explore how SPs make sense of their experiences and the meanings they attach to them. Themes and sub-themes were developed from participant experiences and reflected upon by the authors.</p><p><strong>Results: </strong>Three major themes emerged: Increased knowledge of the way medicine works, taking action, and personal and interpersonal well-being. SPs found that their knowledge of medical terms, healthy behaviors, and disease risks increased and resulted in changes to their lifestyle and experience in medical settings. They also noted a sense of purpose in their work, its intellectual rigor, and a newfound community, which made it a positive experience. The findings of this study align with models of health behavior while reinforcing and challenging prior qualitative studies of SPs.</p><p><strong>Conclusion: </strong>SPs can and do learn and apply knowledge obtained from their patient portrayals. They are also personally enriched by their role. Further analysis should examine quantitative health impacts and the specific experiences or scenarios that lead to changes in SPs' lifestyles and health behaviors. Community organizations may find simulated patient training and encounters to be a useful tool for teaching healthy behaviors and communication with physicians.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800794","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":"Making Sense of Simulation as a Complex Intervention in Health Care Systems.","authors":"Anders Lund Schram, Andrew Petrosoniak","doi":"10.1097/SIH.0000000000000960","DOIUrl":"10.1097/SIH.0000000000000960","url":null,"abstract":"<p><p>Statement: Simulation is increasingly used not only to train clinicians but also to explore how clinical systems function in practice. As simulation becomes embedded in everyday health care settings, it is shaped by the conditions of clinical work. This raises questions about how simulation should be understood once it becomes part of the systems it is intended to influence. Drawing on concepts from complexity science and implementation research, this article examines simulation as a complex intervention introduced into complex health care systems. Rather than focusing on how simulation is designed or implemented, it offers a conceptual perspective for interpreting how simulation changes after becoming embedded in clinical practice. From this viewpoint, differences in how simulation sessions unfold are not necessarily signs of poor implementation but may instead reveal how simulation interacts with local clinical conditions.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726652","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":"Mental Workload and Handover in Paramedics and Paramedicine Students Following Simulated Emergency Responses: Pilot Study.","authors":"Daniel F Malone, Alexander MacQuarrie, Christopher Irwin, Darren Wishart, Matthew J Stainer","doi":"10.1097/SIH.0000000000000959","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000959","url":null,"abstract":"<p><strong>Introduction: </strong>Clear and accurate handover from paramedics to emergency department staff is crucial to patient outcomes, but mental workload experienced throughout an emergency response may impair paramedics' ability to retain key clinical details for handover. This pilot study used a mixed factorial design to examine whether mental workload experienced throughout a simulated emergency response and clinical experience influences handover performance and physiological responses in paramedics and paramedicine students.</p><p><strong>Methods: </strong>Ten paramedicine students and 6 experienced paramedics completed 2 full-scale simulated cases from dispatch, response drive, patient care, patient transport, and handover, under high and low mental workload conditions. Participants delivered verbal handovers at the conclusion of each case. Heart rate and heart rate variability were recorded across all phases as exploratory measures of physiological arousal. Subjective workload and handover performance were assessed after each scenario.</p><p><strong>Results: </strong>A significant workload by experience interaction was observed for handover performance, although follow-up comparisons were not statistically significant. Descriptively, students recalled fewer case-relevant details at handover after a high-workload case, whereas experienced paramedics appeared unaffected, and a moderate effect size was observed for students. Physiological data indicated greater autonomic arousal during patient care than other phases; however, movement and postural differences across phases may have contributed to this pattern, limiting attribution to the mental workload manipulation.</p><p><strong>Conclusions: </strong>These preliminary findings highlight the need for further research with larger samples and suggest paramedicine training may benefit from supporting students in developing strategies to manage mental workload and retain key information during high-demand emergency responses.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708363","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 Impact of Simulation-Based Spaced Training for Skills Acquisition on Learning and Performance Outcomes Among Healthcare Professionals: A Systematic Review.","authors":"Catherine Patocka, Ingrid Anderson, Erin Brennan, Lauren Lacroix, Anjali Pandya, Heather Ganshorn, Andrew K Hall","doi":"10.1097/SIH.0000000000000898","DOIUrl":"10.1097/SIH.0000000000000898","url":null,"abstract":"<p><p>Spaced learning is increasingly used in simulation-based education, yet its impact on learning, performance, and patient outcomes is unclear. We compared spaced training (several discrete sessions) with massed training (a single session) for skills acquisition in health professionals. We systematically reviewed randomized or prospective comparative studies. Of 4572 citations screened, 15 met inclusion criteria. Studies covered resuscitation and surgical procedures, most with spacing intervals of about 1 week. Despite heterogeneity in study design, participants, and outcomes, spaced training was generally as effective as massed training. Some evidence suggested advantages for spaced training in skill retention, particularly for time to complete procedures. Findings were inconsistent across other outcomes. No studies demonstrated improvements in patient care practices, patient outcomes, or broader educational effects. These results suggest spaced simulation may offer retention benefits for certain skills, but more research is needed to assess its impact on clinical and system-level outcomes.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"241-246"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679220","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}