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

{"title":"\"I Don't Speak English Well.\" Do Language Barriers Affect Automated External Defibrillator Use? A Randomized Simulation Study With Spanish-Speaking Laypeople.","authors":"Myriam Santos-Folgar, Roberto Barcala-Furelos, María Fernández-Méndez, Martín Otero-Agra, Joana Waffelaert-Pascual, Santiago Martínez-Isasi, Juan Eiroa- Bermúdez, Silvia Aranda-García","doi":"10.1097/SIH.0000000000000905","DOIUrl":"10.1097/SIH.0000000000000905","url":null,"abstract":"<p><strong>Introduction: </strong>Early defibrillation significantly improves survival following out-of-hospital cardiac arrest. Public access automated external defibrillators (AEDs) facilitate rapid shock delivery, enhancing survival rates and neurological outcomes. Language barriers may impede the effectiveness of these devices, particularly in multilingual environments. This study aimed to evaluate AED operation skills and time during a simulated cardiac arrest scenario, comparing native language instructions (Spanish: AEDnative) with foreign language instructions (English: AEDforeign).</p><p><strong>Materials and methods: </strong>A randomized pilot study was conducted with 50 Spanish-speaking university students (42% female, median age: 21 years) with no prior AED training and a minimum B1 level of foreign language proficiency (English). Participants were randomly assigned to either the AEDnative or AEDforeign group. The simulated cardiac arrest scenario was performed on a mannequin using a multilingual AED trainer. AED performance, response times, language proficiency, and demographic data were recorded. Participant actions were video-recorded and analyzed using observational methodology.</p><p><strong>Results: </strong>Both groups achieved high completion rates (>70%) in most AED operation steps. However, the AEDnative group performed significantly better in two critical safety actions: ensuring no one touched the victim before shock (96% vs. 12%) and initiating CPR after shock delivery (83% vs. 12%). No differences were found in the time to pad placement, but the AEDforeign group delivered the shock significantly faster after pad placement (19 s vs. 33 s; P  = 0.016).</p><p><strong>Conclusions: </strong>AED use remains feasible, even in a nonnative language; however, foreign-language instructions may compromise performance safety and delay or omit postshock CPR initiation.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"331-336"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821856","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":"Evaluating CPR Breast Attachment Impact on EMT Training: A Randomized Controlled Trial.","authors":"Deeya Sharma, Naeha Geogy, Victoria A Roach","doi":"10.1097/SIH.0000000000000906","DOIUrl":"10.1097/SIH.0000000000000906","url":null,"abstract":"<p><strong>Introduction: </strong>Males have higher odds of receiving bystander cardiopulmonary resuscitation (B-CPR) and surviving out-of-hospital cardiac arrest compared with females. Studies suggest that concerns about breast exposure, causing injury, or being accused of sexual harassment may contribute to gender disparities in B-CPR. This study examines whether using the ReviveHer breast attachment during CPR training impacts Emergency Medical Technician (EMT) students' willingness, comfort, confidence, and concerns when performing CPR on breasted and nonbreasted individuals.</p><p><strong>Methods: </strong>EMT students at North Seattle College participated in a 2-day CPR training and completed pre- and posttraining surveys assessing participants' willingness, confidence, and concerns specific to providing CPR to breasted and nonbreasted individuals. Participants were randomized into control or experimental groups. The control group used standard flat-chested manikins, whereas the experimental group trained with the ReviveHer breast attachment.</p><p><strong>Results: </strong>The experimental group showed significantly increased willingness to initiate CPR across all body types and settings: breasted public ( P  = 0.011), breasted private ( P  = 0.015), nonbreasted public ( P  = 0.009), and nonbreasted private ( P  = 0.024). They also reported greater comfort in unclothing a breasted body in a private setting to perform CPR ( P  = 0.017), increased confidence in providing compressions to an unclothed breasted body ( P  = 0.043), and decreased fear of sexual harassment accusations ( P  = 0.044).</p><p><strong>Conclusions: </strong>Incorporating the ReviveHer breast attachment into CPR training enhances EMT students' preparedness to administer CPR to both breasted and nonbreasted individuals. It increases comfort and confidence while reducing concerns related to social and legal repercussions, potentially addressing key barriers to equitable B-CPR delivery.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"289-297"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953756","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 Gone Sideways: Avoiding Common Design and Implementation Pitfalls.","authors":"Tonya Rutherford-Hemming, Alaina Herrington, Crystel Farina","doi":"10.1097/SIH.0000000000000926","DOIUrl":"10.1097/SIH.0000000000000926","url":null,"abstract":"<p><p>This manuscript focuses on mistakes and missteps that frequently occur in simulation-based learning. Using vignettes, problematic practices are highlighted and reviewed using current simulation standards and literature. Gaps in the literature are also addressed. Acknowledging and improving practices in simulation enhance learner outcomes, support novice educators, and assist individuals preparing for certification exams. Organizations that avoid deficiencies in simulation design and implementation, such as those presented in these vignettes, better align their simulation programs with core accreditation standards.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"317-322"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678137","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 Mesh-Polyvinyl Alcohol Hydrogel Composite Small Bowel for Small Bowel Anastomosis Training.","authors":"Hans B Erickson, Alex T Gong, Shi-Wen Olivia Yau, Rudolph J Toepfer, Jessica Zhang, Jess G Gonzaga, Judy Y Chen, Hyung C Kim, Conner J Parsey, Jack E Norfleet, Robert M Sweet","doi":"10.1097/SIH.0000000000000937","DOIUrl":"10.1097/SIH.0000000000000937","url":null,"abstract":"<p><strong>Introduction: </strong>In surgeries requiring small bowel anastomosis, postoperative anastomotic leak is an infrequent (3.02%) but devastating complication associated with increased morbidity and mortality. Simulation continues to advance as a method of practicing surgical technique. Given the delicate nature of the small bowel, a high-fidelity simulated model is critical for ensuring skill acquisition and training transfer. However, the most commonly used models-porcine tissue and commercial synthetic analogs-present notable limitations, including environmental concerns, limited longevity, and mechanical properties that do not accurately represent human tissue.</p><p><strong>Methods: </strong>This study aims to characterize and compare the mechanical properties of human, porcine, commercial off-the-shelf (COTS) tissue analogs, and a novel mesh-polyvinyl alcohol (PVA) hydrogel composite small bowel. Mechanical testing was conducted using a custom load frame (DEXTER) and uniaxial tensile tester to evaluate ultimate tensile strength, stretch ratio (SR), elastic modulus (EM), and suture pullout force (SPOF). In addition, 2 surgeons qualitatively evaluated the hydrogel simulant for its suitability for stapling and suturing, patency, and performance in anastomotic leak prevention.</p><p><strong>Results: </strong>Compared with human tissue, porcine small bowel yielded a significantly different SPOF ( P <0.001). The COTS synthetic small bowel exhibited significantly different EM ( P <0.001) and SR ( P <0.001). The hydrogel simulant tested similarly to human tissue with respect to tensile strength, SR, EM, and SPOF.</p><p><strong>Conclusion: </strong>The novel hydrogel small bowel simulant exhibited mechanical properties that more closely resembled human small bowel compared with porcine or COTS models.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"323-330"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870172","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":"Impact of Transport Team Simulations: A Qualitative Analysis of Debriefs From the ImPACTS Transport Simulation Study.","authors":"Devin A McKissic, Lauren M Maloney, Daniel J Scherzer, Ranna A Rozenfeld, Jessica J Wall, Ingrid M Anderson, Kamal Abulebda, Erin Montgomery, Christopher Kennedy, Snimarjot Kaur, Robyn Wing, Rachel Umoren","doi":"10.1097/SIH.0000000000000973","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000973","url":null,"abstract":"<p><strong>Introduction: </strong>An estimated 250,000 children each year are transported between hospitals, with many of these transports performed by pediatric critical care transport teams (PCCTs). The makeup and education of these teams varies widely, and many are incorporating simulation into their training. The purpose of this study was to examine postsimulation debrief sessions to better understand how programs experience PCCT education using simulation.</p><p><strong>Methods: </strong>Twelve transport centers and a total of 78 transport teams nationwide participated in the multicenter Improving Pediatric Acute Care Through Simulation (ImPACTS) transport simulation study in which simulation was utilized to measure and compare PCCT performance. Each team went through 3 simulated cases followed by debriefing sessions. Qualitative analysis was conducted on 23 debriefing sessions from 6 centers. A thematic analysis approach using both inductive and deductive techniques was used to identify themes representing elements of practices, thoughts, and beliefs to better understand debriefing approaches used by facilitators and the content of debriefings.</p><p><strong>Results: </strong>We identified themes in 4 major categories: (1) debriefing process elements (advocacy inquiry, directive feedback, learner self-assessment, shared mental model, and addressing learning objectives); (2) latent safety threats (personnel or staffing, protocol, workspace or environment); (3) response to simulation; and (4) team dynamics. Debriefing process elements reflected how facilitators conducted debriefings, while the remaining categories reflected the content and insights generated during debriefings.</p><p><strong>Conclusions: </strong>Simulation participants found simulation to be realistic and a helpful tool to identify latent safety threats in their work. Simulation facilitators used consistent strategies to meet learning objectives and support learners in processing their simulation experience. Debriefing also provided insights to system-level vulnerabilities, suggesting a role for simulation not only in education, but also as a quality improvement tool.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076446","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":"Cocreating Reels: New Prebriefing Insight.","authors":"Maggie Mee Kie Chan, Mei Li Khong","doi":"10.1097/SIH.0000000000000974","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000974","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017870","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 Medical Student Leadership Evaluation Through Standard Setting​​​​​: A Comparison of Test Centered Versus Examinee Centered Methods of Standard Setting.","authors":"Angela M Yarnell, Erin S Barry, Rebekah Cole, Dina Kurzweil, Karen Marcellas, James Schwartz, Leslie Vojta","doi":"10.1097/SIH.0000000000000970","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000970","url":null,"abstract":"<p><strong>Introduction: </strong>Physician trainees are increasingly expected to demonstrate leadership in complex, team-based clinical settings. However, assessing leadership performance in dynamic environments like simulation remains challenging, with limited consensus on valid, reliable standards. While some observational frameworks exist, few offer defensible methods for determining minimum passing thresholds, particularly in high-stakes contexts. Traditional test-centered approaches may not capture the behavioral complexity of leadership, whereas examinee-centered methods offer more context-sensitive evaluations. This study compares test-centered and examinee-centered standard-setting approaches to identify a fair, reproducible method for assessing leadership in simulation, offering a model that can be applied across medical education programs.</p><p><strong>Methods: </strong>This study had 3 phases: first, the extended Angoff method (a test-centered method) was used to identify characteristics of borderline performers to set a cut-score; then we used the borderline group method (an examinee-centered method) to identify the cut-score; and finally, the cut-score was used to identify failing performance in a new data set.</p><p><strong>Results: </strong>The expert panel in phase 1 determined 10.34 as the cut-score; therefore, a score of ≥11 would be required to pass the evaluation. Analyses conducted in phase 2 suggested that 13 should be the cut-score. The mean and SD for phase 3 were similar to those of phase 2, lending support for the cut score of 13.</p><p><strong>Conclusions: </strong>Setting a cut-score is essential to accurately evaluating student performance when observations and ratings are more subjective. Ultimately, we sought to compare the test-centered versus examinee-centered methods and conclude that the examinee-centered method was a more holistic, fair, and reliable approach to student assessment.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017995","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":"Pressure Points: Identifying Patterns of Stress in Medical Students' Responses to Clinical Situations Through Simulation.","authors":"William Lea, Shay Patel, Tracy McEwan, Kathryn Larkin, Jenny Tucker, Tina Duncalf, Lucy Ambrose, Vicki R LeBlanc","doi":"10.1097/SIH.0000000000000967","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000967","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based education plays a central role in preparing health care professionals for practice. Although psychological safety is emphasized, simulation can evoke significant stress. Existing research largely captures global or retrospective stress measures, offering limited insight into how stress unfolds during simulation. This study examined patterns of physiological stress in final-year medical students during simulated clinical scenarios, identified activities associated with heightened stress, and characterized inter-individual variability in stress trajectories.</p><p><strong>Methods: </strong>In this prospective observational study, 40 final-year medical students individually managed an acutely deteriorating simulated patient during formative ward-based scenarios. Heart rate variability was continuously recorded using Polar H10 chest straps, and the Stress Index was calculated in 10-second segments. Video recordings were time-matched to physiological data and coded into 16 clinical activities. Mixed-design analysis of variance examined differences in stress across activities and scenario phases (anticipation, start, during, presenting).</p><p><strong>Results: </strong>Stress varied significantly across participants (η2 = 0.40) and activities (η2 = 0.06), with a significant participant-by-activity interaction (η2 = 0.26). Higher stress occurred during activities involving uncertainty and socioevaluative elements (heading to the simulation room, receiving nurse handover, presenting to senior clinician, gathering additional information during questioning). Lower stress occurred during history taking, physical examination, and ordering investigations. Stress was highest during the \"start and anticipation\" phases and lower \"during and presenting.\" Learner clusters showed phase-specific stress patterns.</p><p><strong>Conclusions: </strong>Physiological stress during simulation is dynamic, individualized, and clustered around identifiable \"pressure points.\" These findings extend simulation research beyond global measures and highlight the importance of simulation facilitation that recognizes individual variability in learners' experiences.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018423","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":"\"My Body Thinks This is Real\": A Qualitative Study of Fourth Year Medical Student Perspectives on Learning and Realism in Complex Simulation.","authors":"Jennifer McConnell, Cameron Wynn, Ailyn Clara, Prachi Singh, Jeanne Carey, Rory Nicolaides, Ngoc Kim Van Horn, Jenny K R Francis","doi":"10.1097/SIH.0000000000000972","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000972","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based education is important to medical training, yet the relationship between realism, learner engagement, and learning remains debated. Realism is often equated with technological sophistication, though contemporary frameworks emphasize realism as multifactorial. This qualitative study aimed to explore how graduating medical students perceive realism, characterize engagement, and describe learning in a complex simulation.</p><p><strong>Methods: </strong>Fourth-year medical students at an academic center participated in The Shift Change, a complex multi-room inpatient simulation during a pediatrics transition-to-residency course in March 2024. Semi-structured individual and group virtual interviews were conducted with 20 students within 3 weeks of the simulation. Verbatim transcripts underwent iterative qualitative analysis using a constant comparative method to identify categories and organize broader themes describing how realism, engagement and learning were experienced.</p><p><strong>Results: </strong>Students described experiences through 4 interrelated themes, summarized as the \"5 Ps\": preparation, production, presence and participation, and processing. Background experiences prepared students for learning. The production of the simulation through narrative coherence, a physical simulation space, and thoughtful facilitation was described as supporting presence and authentic participation, thereby generating engagement that students perceived as shaping realism and learning. Processing through emotions, observation and debriefing was described as solidifying lessons and extending perceived learning to future practice.</p><p><strong>Conclusions: </strong>In this study, graduating medical students described experiences of realism and engagement in a complex simulation through the 5 Ps: preparation, production, presence and participation, and processing. The 5 Ps represent an interpretative analysis of student experiences, highlighting perceived realism, engagement, and learning. These findings may help inform future exploration of simulations designed for undergraduate to graduate medical education transitions.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991935","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":"Progress OSCEs for Longitudinal Competence Assessment: A Scoping Review.","authors":"Nelson G de Oliveira, Fabrizio F Borelli, João P Góes Alves, Gabriela O Biondi, Diancarlos P de Andrade, Gerson A Pereira Júnior","doi":"10.1097/SIH.0000000000000969","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000969","url":null,"abstract":"<p><p>Progressive objective structured clinical examinations (OSCEs) are increasingly used to extend simulation-based performance assessment across time, yet repeated OSCE administration alone does not create a longitudinal assessment system. This scoping review shows that the literature often blurs the boundary between serial OSCEs and true progress OSCEs. The central contribution of this review is to clarify that progress OSCEs require intentional design features, including stable construct representation, terminal blueprint anchoring, rater calibration, and linking/equating strategies, to support defensible developmental interpretation. For simulation educators and researchers, the practical implication is clear: repetition creates assessment opportunities, but only longitudinal comparability by design supports claims about learner growth.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984037","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}