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

{"title":"Shaping the Future: Scaling Entrustable Professional Activities to Nonclinical Simulation Operations Specialist Training.","authors":"Anjali Jagannathan, Otto Sanchez, Adam Dubrowski","doi":"10.1097/SIH.0000000000000945","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000945","url":null,"abstract":"<p><p>Simulation is essential for health professions education, but a rising demand for simulation operations personnel strains an already overextended workforce. In response, we are developing a competency-based minor pathway within an undergraduate degree designed to train students without clinical backgrounds as nonclinical simulation operations specialists (SOS). This work exposed challenges in competency-based education, where assessing competence and determining readiness for autonomous professional practice remain difficult. To strengthen competency assessment and ensure workforce readiness, we propose scaling entrustable professional activities (EPAs), originally designed for medical education, to nonclinical SOS training. To accomplish this, we propose a 4-phase research process guided by the Medical Research Council framework for the design of complex interventions: (1) theory and evidence identification; (2) framework modeling; (3) piloting; and (4) hybrid evaluation and implementation. We anticipate that the resulting EPA-based assessment framework will hold the potential to enable rigorous, defensible assessment in nonclinical SOS training, providing a replicable model for future EPA-based program development in emerging competency-based nonclinical professional fields.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hands-on Distance Simulation of Technical Skills: A Systematic Review.","authors":"Wei Wei, Martine S Nielsen, Anders B Nielsen, Yuan Han, Lene Russell, Lars Konge, Kristoffer M Cold","doi":"10.1097/SIH.0000000000000881","DOIUrl":"10.1097/SIH.0000000000000881","url":null,"abstract":"<p><p>Distance simulation in health care has advanced rapidly, offering potential to reduce geographical barriers, costs, and carbon emissions while increasing global access to medical education. This systematic review evaluated hands-on technical skills training via distance simulation compared to traditional on-site training. Following PRISMA guidelines, 104 studies were analyzed. Laparoscopic skills, suturing, and ultrasound were the most studied tasks. Distance simulation, using decentralized portable simulators and centralized telementoring, demonstrated comparable or superior outcomes to on-site training. However, only 2 studies assessed skill transfer to clinical settings, and 1 reported patient-related outcomes. Rigorous randomized controlled trials (RCTs) are needed to further evaluate skill retention and clinical impact.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":"172-179"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Frequency Simulation-Based Assessment to Improve Clinical Competence in Paramedicine Education.","authors":"Jean-Paul Veronese, Nancy Jakstas, Malcolm Boyle, Patricia Lee","doi":"10.1097/SIH.0000000000000943","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000943","url":null,"abstract":"<p><strong>Background: </strong>Clinical competence is essential for paramedicine graduates, who must make rapid, high-stakes decisions in unpredictable environments. Ensuring students reach a practice-ready standard requires structured, evidence-informed assessment strategies. Although simulation-based education is widely used, few studies have explored how high-frequency simulation combined with structured performance-based assessment (PBA) tracking supports competence development over time.</p><p><strong>Aim: </strong>The aim was to determine the effect of high-frequency simulation with structured formative assessment on developing simulation-based clinical competence and summative practical exam outcomes in paramedicine education.</p><p><strong>Methods: </strong>This secondary analysis examined 2024 performance data from 2 undergraduate paramedicine courses at Griffith University. High-frequency simulation was combined with graded formative PBAs to support competence development. Weekly simulations were assessed using the Clinical Competence Assessment Tool (CCAT), providing real-time grading and structured feedback. Associations between formative performance and summative practical exam outcomes were analyzed using paired t tests, mixed ANOVA, and hierarchical regression. Ethics approval was granted (GUHREC: 2024/073).</p><p><strong>Results: </strong>Students completed an average of 4.6 simulations (SD=1.4 and 1.7), with 222 simulations recorded in second year (n=48) and 187 in third year (n=41). Both cohorts showed significant improvement in mean practice scores over time, with higher final exam scores observed (P<0.05). Practice frequency had incremental effects on performance over time (P<0.05) and was an independent predictor of exam outcome (B=3.46, P<0.05).</p><p><strong>Conclusions: </strong>High-frequency simulation with structured PBA tracking significantly improves competence and exam performance. This scalable formative strategy supports accreditation standards in paramedicine education.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057894","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":"Haptic Feedback's Role in Dental Implantology Virtual Simulations: A Multicohort Analysis.","authors":"Sayed Azher, Samer Abi-Nader, Keerat Grewal, Lizianne Zini, Jason M Harley","doi":"10.1097/SIH.0000000000000924","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000924","url":null,"abstract":"<p><p>This study explores the role of haptic feedback in dental virtual simulations by examining its effects on learner performance, usability, and self-confidence across novice and advanced students. Using a randomized crossover design, participants engaged with an implantology-related virtual simulation using Virteasy Dental software and Haply Robotics' haptic arm in both haptic-enabled and haptic-disabled conditions. Advanced students significantly outperformed novices, supporting construct validity, though all other performance effects were nonsignificant. Usability and self-confidence were significantly higher for students who experienced the haptic-enabled simulation after first using the haptic-disabled version, indicating an order effect. However, no other usability or self-confidence interactions reached significance. Agreement between expert-generated and software-generated scores was moderate to poor, highlighting limitations in automated scoring and the need for expert oversight during student assessment. Findings show the value of portable haptics and call for better validated assessment and usability tools, and that trainees may benefit from first trying haptic-disabled virtual simulations before learning with haptics.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018522","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 High-Fidelity Simulation on Undergraduate Nursing Students' Attitudes Toward Older Adults: A Scoping Review.","authors":"Mohamed Toufic El-Hussein, Dawson S Sheehan","doi":"10.1097/SIH.0000000000000944","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000944","url":null,"abstract":"<p><p>This scoping review examined the impact of high-fidelity simulation on undergraduate nursing students' attitudes toward older adults. Fifteen studies were included, representing diverse simulation modalities such as standardized patients, Mask-Ed, manikin-based, hybrid, and electronic formats. Across settings, simulation consistently improved attitudes toward older adults, reduced stereotyping, and fostered empathy and respect. Standardized patients and Mask-Ed were most effective for relational outcomes, whereas manikin-based and hybrid approaches supported technical skills alongside attitudinal change. Electronic simulation demonstrated potential for remote and resource-limited contexts. Despite these positive outcomes, measurement tools and analytic approaches varied, and only one study evaluated retention beyond 6 weeks. The long-term impact of simulation on professional practice remains unclear. Future research should apply standardized measures, compare modalities, and conduct longitudinal evaluations. Simulation designed with intentional affective objectives can help prepare a nursing workforce that values older adults and delivers person-centered gerontological care.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989837","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":"Trauma-Informed Virtual Reality Simulation for Pediatric De-Escalation: An Early Evaluation.","authors":"Laila M Strazds, Tanja Samardzic, Bonnie M Fleming-Carroll, Darryl Yates","doi":"10.1097/SIH.0000000000000939","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000939","url":null,"abstract":"<p><p>To address a critical gap in trauma-informed de-escalation training for interprofessional pediatric staff and trainees, a virtual reality (VR) simulation program was developed and implemented at a Canadian tertiary care hospital. This early-stage evaluation assessed the feasibility, acceptability, and usability of immersive VR as a psychologically safe and engaging learning modality as part of a formally approved quality improvement initiative. Developed through multidisciplinary collaboration, the simulation integrated trauma-informed pedagogy within a realistic, emotionally complex scenario in which staff practiced responding to escalating patient distress. The mixed-method evaluation included posttraining surveys, facilitated debriefs, and learner-generated summaries guided by the New World Kirkpatrick Model. Participants from diverse patient-facing roles reported high engagement, psychological safety, and commitment to applying learned skills. Findings suggest trauma-informed VR simulation can support early indicators of capacity building across cognitive (decision-making), affective (emotional awareness and confidence), and interpersonal (communication and collaboration) learning domains. Immersive VR simulation shows promise as an effective learning strategy for preparing pediatric health care teams for complex behavioral escalation scenarios.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943498","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-Powered Simulation for Telehealth Communication Training: Bridging Traditional Simulation and Artificial Intelligence.","authors":"Farrukh Nadeem Jafri, Michelle Elsener, Anshul Kumar, Suzan Kardong-Edgren, Roger A Edwards","doi":"10.1097/SIH.0000000000000940","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000940","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional simulation-based communication training remains resource-intensive and difficult to scale. While artificial intelligence (AI), particularly large language models, offers promising solutions for health care education, no blueprint exists for integrating AI-powered simulation training within operational quality improvement (QI) frameworks. This paper presents a 5-phase methodological blueprint, with evaluatory evidence, for implementing AI-powered simulation training to enhance transitional care communication skills.</p><p><strong>Methods: </strong>We developed a 5-phase methodological framework integrating AI simulation with QI and educational principles, grounded in the Donabedian model. The phases comprised: (1) content validation using Lawshe's methodology, (2) simulation development applying cognitive load theory, (3) platform selection through expert consensus evaluation, (4) structured implementation including structural foundations and sequential deployment, and (5) outcome measurement using statistical process control.</p><p><strong>Results: </strong>Iterative testing across multiple AI platforms revealed that traditional debriefing approaches (advocacy-inquiry, plus-delta) could not be reliably delivered by AI systems. Microdebriefing with rubric-focused feedback emerged as optimal for AI-mediated learning, leveraging AI's strengths in consistent, structured feedback delivery while working within limitations in complex facilitation. Clinical outcomes derived from rubric-based evaluations of recorded patient calls will be reported separately to allow for a more detailed analysis of communication quality and training effectiveness, which falls outside the scope of the present methods-focused study.</p><p><strong>Conclusions: </strong>This 5-phase methodological blueprint provides an approach for health care organizations seeking to implement cost-effective, scalable AI-powered communication training. By embedding simulation within QI infrastructure, institutions can systematically enhance communication skills while maintaining educational rigor. This work contributes to simulation science, telehealth education, and QI by demonstrating how AI can serve as a scalable alternative to traditional facilitator-led training for foundational communication skills.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822880","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":"Examining the Validity of the Implementation Quality Rubric for Simulation (IQR-SIM) for Assessing Implementation Quality of Simulation-based Programs.","authors":"Leizl Joy Nayahangan, Adam Dubrowski, Krystina Clarke, Lindsay Beavers, Mikkel Lønborg Friis, Rachel Yudkowsky, Lars Konge, Amandus Gustafsson","doi":"10.1097/SIH.0000000000000928","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000928","url":null,"abstract":"<p><strong>Introduction: </strong>The lack of reliable tools for measuring implementation processes and outcomes weakens confidence in study findings and strategy effectiveness. This study aimed to gather validity evidence for the previously published Implementation Quality Rubric for Simulation (IQR-SIM) from 2 sources: response process and internal structure.</p><p><strong>Methods: </strong>The IQR-SIM is structured into 3 phases of implementation, each divided into themes. Within these themes are items representing actionable steps for effective implementation. It employs a 3-point rating scale (1, 2, and 3), along with nonscored options \"don't know/can't assess\" and \"not applicable.\" Semistructured interviews were conducted to collect detailed program descriptions from international simulation centers. Three trained raters evaluated these interview-derived implementation data using the IQR-SIM. The frequency of using the scores and the nonscored options was calculated to evaluate rater use of the scale. Inter-rater reliability was assessed to examine variability in ratings, while internal consistency reliability was analyzed to determine whether all items measured the same construct.</p><p><strong>Results: </strong>Twenty simulation-based programs from 7 international simulation centers participated. Phase 1 (stakeholder engagement and context exploration) had the highest proportion of fully accomplished items (54.6% received a rating of 3/3). Theme 1b (Obtaining buy-in from relevant stakeholders) was predominantly rated as fully accomplished (68.3%). Item 9 (planned for human resource needs) received the highest proportion of rating 3/3 (83.3%). Internal consistency reliability was good (Cronbach alpha=0.85). Inter-rater reliability analysis showed a moderate intraclass correlation coefficient (ICC=0.57). ICC values between raters ranged from 0.39 to 0.52.</p><p><strong>Conclusions: </strong>Multisite validity evidence regarding the response process and internal structure of the IQR-SIM was established, supporting its use in evaluating the implementation quality of simulation-based programs. The study demonstrates that the IQR-SIM can be applied across diverse simulation centers and program types, enhancing its broad use for implementation evaluation.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Doorway Into Power: Debriefing and Reflection in Virtual Reality Health Policy Education.","authors":"Victoria Williams","doi":"10.1097/SIH.0000000000000941","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000941","url":null,"abstract":"","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786912","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 Training in Patient, Family, and Caregiver Education: A Scoping Review.","authors":"Emily Boltey Milko, Mary Ellen Elias, Rebecca Fazio, Patricia Lasher, Heidi Patterson, Jenny O'Rourke","doi":"10.1097/SIH.0000000000000938","DOIUrl":"https://doi.org/10.1097/SIH.0000000000000938","url":null,"abstract":"<p><p>Simulation training in patient, family, and caregiver education has gained attention from the health care simulation community more recently. This scoping review aimed to describe the current state of the science surrounding the application of simulation training in patient, family, and caregiver education in comparison to more traditional learners like health professionals and their trainees. The final review included 41 articles describing the application of simulation training in both adult and pediatric patient populations across a variety of care settings. The opportunities to use simulation training in patient and caregiver education are vast; however, standards of best practice to guide the use of simulation in this unique population are currently lacking.</p>","PeriodicalId":49517,"journal":{"name":"Simulation in Healthcare-Journal of the Society for Simulation in Healthcare","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787111","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}