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

{"title":"Simulation Process, Outcomes, and What I Failed to See.","authors":"Anders Lund Schram","doi":"10.1097/SIH.0000000000000912","DOIUrl":"10.1097/SIH.0000000000000912","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"139-140"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935937","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":"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":"91-100"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","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":"Identification of Key Performance Indicators in Simulation-Based Studies for Hospital-Wide Efficiency: A Systematic Review.","authors":"Mitra Bazrafshan, Vahid Alipour","doi":"10.1097/SIH.0000000000000915","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000915","url":null,"abstract":"<p><strong>Summary statement: </strong>This systematic review synthesizes 34 key performance indicators (KPIs) from 36 hospital-wide simulation studies (2000 to November 2025), adhering to the PRISMA 2020 guidelines. Using PubMed, Scopus, and Web of Science, studies were assessed via the Critical Appraisal Skills Programme checklist, with discrete event simulation dominating (83%). Departmental stratification revealed coverage of the emergency department in 78%, inpatient units in 56%, operating rooms in 31%, and outpatient clinics in 22% of studies. KPIs were categorized into structural (eg, utilization rate), process (eg, length of stay), and outcome (eg, patient throughput) indicators. A novel impact metric (% KPI improvement per simulation effort) and hybrid models integrating qualitative KPIs (eg, patient satisfaction) are proposed. This framework guides simulationists in designing validated models for hospital efficiency, with applications in logistics and manufacturing.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167738","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 Alternative Scoring Approach to the Script Concordance Test for Evaluating the Effect of Clinical Simulation on Clinical Reasoning in Kinesiology Students: A Pilot Study.","authors":"Jorge J Mauro-Navarro, Arturo González-Olguín, Luz María Trujillo","doi":"10.1097/SIH.0000000000000920","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000920","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical reasoning is fundamental in kinesiology education, but its assessment remains a challenge. The Script Concordance Test (SCT) is a tool for assessing reasoning under conditions of uncertainty. This study assesses the feasibility of using the SCT to evaluate clinical reasoning in kinesiology students and gathers preliminary validity evidence for its application in simulation-based education.</p><p><strong>Methods: </strong>An observational analytic study with a pretest and posttest design was used. Fifty-two kinesiology students participated in 7 simulated tele-rehabilitation scenarios in neurokinesiology, cardiorespiratory rehabilitation, and musculoskeletal rehabilitation. SCTs were administered before and after the simulations to measure changes in reasoning. The Wilcoxon signed-rank test and Cohen's effect size (d) were used to evaluate differences in scores.</p><p><strong>Results: </strong>Three of the 7 SCTs met reliability criteria (Cronbach's α > 0.7). Postsimulation SCT scores significantly improved (P = 0.021), with a small effect size (Cohen's d = 0.22). A new Script Concordance Simulation Index was developed, showing high discriminatory ability (AUC = 0.989) between student reasoning categories.</p><p><strong>Conclusions: </strong>The SCT can be utilized as a tool to evaluate clinical reasoning in kinesiology students within simulation-based education. Our study contributes to the generation of evidence supporting the feasibility and potential validity of the SCT in this context. The Simulation Script Concordance Test Index introduces an innovative approach to tracking cognitive trajectories after simulation. Future studies should provide additional evidence to strengthen the validity of the SCT in simulation-based education, and by deepening the understanding of the reasoning that underlies students' decision-making changes.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144452","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":"Student Experiences of Virtual Simulation Outside the Classroom: A Scoping Review.","authors":"Erin Ziegler, Laura A Killam, Tania M Kristoff, Yamini Bhatt, Yemisi Onilude, Jane Tyerman, Marian Luctkar-Flude","doi":"10.1097/SIH.0000000000000922","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000922","url":null,"abstract":"<p><strong>Summary statement: </strong>Virtual simulations are a promising teaching strategy, but little is known about the barriers to their use. This scoping review examines health professions students' experiences with asynchronous virtual simulations outside traditional classrooms, highlighting key barriers, benefits and outcomes. We included 34 reports. Barriers included technical difficulties, time and motivation constraints, limited feedback or interaction, complex structure, and lack of realism. Faculty also struggle with adapting to digital methods due to time constraints, inadequate training, and a reliance on lecture-based approaches. Identified benefits included learning, realism, flexibility and accessibility, improved scores, psychological safety, and improved communication and teamwork through immersive scenarios. Key outcomes included cognitive gains, positive reactions, perceived readiness for practice, and performance improvements. Overall, the review underscores the promise of asynchronous virtual simulations while emphasizing the need for further research to refine their design and implementation across diverse health programs.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127169","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":"Improving Door-to-Treatment Times: The Role of an Integrated Simulation and Workflow Program in a Community Hospital's Acute Ischemic Stroke Care.","authors":"John N Cram, Allen D Primero, Allison M Kling, Cecilia Chang, Carolyn A Beck, Bridget Wild","doi":"10.1097/SIH.0000000000000913","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000913","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke requires rapid intervention to optimize patient outcomes, yet community hospitals often face challenges in minimizing door-to-needle time (DNT) and door-to-groin time (DGT). Simulation-based education offers a structured approach to enhancing workflow efficiency and interdisciplinary coordination. This quality improvement initiative evaluates the impact of a targeted simulation and workflow optimization program on stroke treatment times at a community hospital.</p><p><strong>Methods: </strong>A quality improvement initiative was implemented at Northwest Community Hospital, part of the Endeavor Health System. The intervention consisted of 6 multidisciplinary simulation sessions conducted over 9 weeks to train emergency department and interventional radiology teams on an optimized stroke workflow. Pre- and postintervention data were collected on stroke response times from actual patient cases over 3 time periods: preintervention (12 months), during intervention (3 months), and postintervention (10 months). The primary outcome was DNT, with DGT as a secondary outcome.</p><p><strong>Results: </strong>A total of 58 stroke cases were analyzed preintervention, 13 during intervention, and 70 postintervention. The mean DNT improved from 46 minutes preintervention to 39 minutes postintervention (P = 0.0209), whereas the mean DGT improved from 106 to 79 minutes (P = 0.0001). Simulation participants reported increased confidence in stroke response tasks, with postsession surveys indicating strong agreement in preparedness and safety measures.</p><p><strong>Conclusion: </strong>The integration of a structured simulation-based education program significantly reduced stroke treatment times in a community hospital setting. This initiative highlights the value of simulation in refining clinical workflows and improving time-sensitive emergency care. Further research is warranted to explore long-term patient outcomes and the broader applicability of this approach in nonacademic hospitals.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107922","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 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":"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":"41-47"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","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":"Development and Evaluation of a Multimodal Debriefing Dashboard for Virtual Reality Cardiac Arrest Simulation.","authors":"Bryan Harmer, Jacob Erickson, Shane Ross, Dhruv Bhatnagar, Stephen Dowker, Hyunmin Park, Alanson P Sample, Sarah Hartley, James Cooke, Michael Cole, Vitaliy Popov","doi":"10.1097/SIH.0000000000000901","DOIUrl":"10.1097/SIH.0000000000000901","url":null,"abstract":"<p><strong>Introduction: </strong>Wearable sensing technologies incorporated into virtual reality (VR) headsets can provide a number of unique, previously hidden insights into individual and team learning and performance in complex environments. However, the most impactful and efficient mechanisms for conveying multimodal data (e.g., gaze, mental workload, etc) allowing for unique insights are not well understood. This study used a human-centered design process to develop and evaluate a multimodal debriefing dashboard.</p><p><strong>Methods: </strong>Twelve Advanced Cardiac Life Support (ACLS) Instructors completed VR cardiac arrest simulations and participated in interviews and design thinking workshops to identify dashboard features, leading to high-fidelity mock-ups and an interactive prototype. A second group of 6 ACLS instructors then evaluated the prototype by providing mock feedback on simulation performance with and without the dashboard in a pre-post format, followed by surveys assessing usability, acceptability, appropriateness, feasibility, trust, and perceived accuracy.</p><p><strong>Results: </strong>The final prototype dashboard features a video, a timeline of clinical actions, automatic error identification, mental workload, and visual attention data. It also generates closed-loop communication reports on a separate webpage. The evaluation study showed that participants provided performance analysis and feedback to students when using the dashboard, targeting specific (non)technical skills aligned with ACLS learning objectives. Participants rated the dashboard highly, with a System Usability Scale score of 88.9%, reflecting above-average usability.</p><p><strong>Conclusions: </strong>An interactive multimodal debriefing dashboard prototype was developed using a user-design framework with prototyping and iterative feedback. Use of the dashboard resulted in improved evaluation and debriefing practices targeting learning outcomes, with participants rating the dashboard favorably. This dashboard has the potential to enhance simulation-based learning by offering near real-time analytics that promote a deeper understanding of individual and team technical and nontechnical skill acquisition and mastery.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"48-56"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806296","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":"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":"32-40"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","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":"IMSH as a Mirror: What the 2026 Program Reflects About the State of Healthcare Simulation.","authors":"Nicole Harder","doi":"10.1097/SIH.0000000000000916","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000916","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":"21 1","pages":"e1-e2"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054591","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}