Advances in simulation (London, England)最新文献

{"title":"Frequency of team simulation and reduction in maternal deaths following Safer Births Bundle of Care implementation-a prospective observational study.","authors":"Kjetil Torgeirsen, Benjamin Kamala, Estomih Mduma, Florence Salvatory Kalabamu, Robert Moshiro, Doris Østergaard, Jan Terje Kvaløy, Hege Langli Ersdal","doi":"10.1186/s41077-025-00387-7","DOIUrl":"10.1186/s41077-025-00387-7","url":null,"abstract":"<p><strong>Background: </strong>Safer Births Bundle of Care (SBBC) is a continuous quality improvement (CQI) program, implemented in 30 facilities in Tanzania, resulting in a 75% reduction in maternal deaths. Simulation training was introduced as a component of the CQI efforts, targeting individual and team skills, focusing on identified clinical needs.</p><p><strong>Objective: </strong>The aim of this study was to describe the frequency of documented simulation sessions and the number of recurrent participants and associations with changes in maternal death.</p><p><strong>Methods: </strong>SBBC was a stepped-wedge cluster randomised implementation study in 30 facilities in 5 regions of Tanzania from 2020 through 2023. The SimBegin® facilitator training program was introduced to train facilitators and support implementation of a training cascade. Fifteen selected healthcare workers were trained in three levels of SimBegin® to become facilitators (level 1) and mentors (level 2). Eight were trained to become instructors (level 3). In total, 90 local facilitators were trained to review local clinical data, run simulation sessions, and document in logbooks. Clinical data were collected from patient files by independent data collectors and looped back to the facilities on a weekly basis. Training interventions were planned, conducted, and evaluated based on identified gaps. Output measures were the frequency of simulation sessions, the number of recurring participants, and maternal death within 7 days postpartum the following month.</p><p><strong>Results: </strong>Overall, 281,165 parturient women were included in this study. The SBBC implementation period was 24-32 months, and 1280 simulation sessions were documented. Maternal deaths declined from 240/100,000 births in the baseline to 60/100,000 after the start of SBBC. There was an association between the frequency of simulation sessions and the reduction in maternal deaths (23% reduction per each unit increase on the log scale, P = 0.0018), and between the number of recurring participants and the reduction in maternal deaths (16% reduction per each unit increase on the log scale, P = 0.0006).</p><p><strong>Conclusion: </strong>This study documents a significant and clinically relevant association between the frequency of and participation in simulation sessions and the reduction of maternal deaths the following month.</p><p><strong>Trial registration: </strong>SBBC main protocol ISRCTN Registry: ISRCTN30541755. Prospectively registered 12.10.2020.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"56"},"PeriodicalIF":4.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12619334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated-based training for ultrasound-guided popliteal sciatic nerve block: determining the learning curve and transference to real patient.","authors":"Pablo F Miranda, Andrea L Araneda, Natalia P Molina, Felipe G Miranda, Christopher Morrison, Marcia A Corvetto, Fernando R Altermatt","doi":"10.1186/s41077-025-00389-5","DOIUrl":"10.1186/s41077-025-00389-5","url":null,"abstract":"<p><strong>Background: </strong>The following study aims to determine the learning curve experienced by anesthesia residents when training for an ultrasound-guided popliteal sciatic block and the transference of this training to real patient situations.</p><p><strong>Methods: </strong>After approval by the ethics committee, eleven first-year anesthesia residents were recruited to participate in a simulation-based training program to perform a single shot in plane popliteal sciatic block. Training consisted of 10 individual sessions, with direct feedback from the instructor, with a specific Laerdal® popliteal sciatic block phantom, lasting one hour and distributed weekly. At the end of each session, the resident's performance was assessed. Residents were videotaped while performing the block, which was to be evaluated using a validated global rating scale (GRS). Additionally, a tracking motion device attached to the operator's hands (Imperial College Surgical Assessment Device, ICSAD) recorded the total distance traveled by both hands (Total path length, TPL), number of movements (NM), and total procedure time (TPT). One week later, the same assessment was done on a real patient.</p><p><strong>Results: </strong>Ten residents completed the training and the assessments. Median values of GRS scores significantly improved from 15 to 28.3 through the training (p = 0.006). Regarding ICSAD scores, TPT improved from 126 to 63.4 s (p = 0.002), and TPL improved from 11.07 to 9.4 m (p = 0.322). When comparing the last simulated session and the subsequent measurement in an actual patient, median values of GRS, TPL and NM were not different.</p><p><strong>Conclusions: </strong>This simulation-based training program significantly improved residents' proficiency in an ultrasound-guided popliteal sciatic block. The learning curve plateaued at session 7, and this improvement was transferred to the real patient setting. As expected, residents needed more time for the first block on a real patient than for the last simulated session.</p><p><strong>Clinical trial number: </strong>ClinicalTrials.gov, identifier NCT06081790.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"55"},"PeriodicalIF":4.7,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12607028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring trainee experiences in a structured virtual reality laparoscopic training programme for general surgeons: a longitudinal case study.","authors":"Aditi Siddharth, Sotiris Mastoridis, Michael Silva, Debbie Aitken, Helen Higham","doi":"10.1186/s41077-025-00359-x","DOIUrl":"10.1186/s41077-025-00359-x","url":null,"abstract":"<p><strong>Background: </strong>The acquisition and maintenance of technical skills in surgical specialties has become increasingly challenging for postgraduate trainees, exacerbated by factors such as the shift from traditional apprenticeship models, reduced operative time, and the impact of the COVID-19 pandemic. Virtual reality (VR) simulators offer a promising adjunct to traditional surgical training, though their integration into routine practice remain underexplored.</p><p><strong>Objective: </strong>This qualitative study investigates the experiences and motivations of general surgical trainees who engaged with a VR laparoscopic simulator as part of a structured training program.</p><p><strong>Methods: </strong>A case study methodology was chosen to explore the experiences of 22 general surgery trainees using a VR laparoscopic simulator over a period of 3 months. Each of the trainees were adviced to practise a minimum of five repetitions across 25 laparoscopic simulator exercises. The study was designed using Kopta's theory of technical skill learning, focusing on the cognitive phase, where trainees repetitively practised individual steps with feedback. Data collection involved qualitative questionnaires, semi-structured interviews (of seven of the trainees, 8 months later), and quantitative data from the simulator. The qualitative data was analysed using thematic analysis, and descriptive statistical tests were applied to the quantitative data for triangulation.</p><p><strong>Results: </strong>The study identified key factors influencing trainee engagement, including ease of access, the importance of periodic rather than frequent simulation sessions, Annual Review of Competency Progression (ARCP) overview and the value of setting specific performance goals. The findings suggest that simulation can effectively complement traditional surgical training when incorporated into routine practice, with potential for broader application if barriers such as time constraints and access issues are addressed.</p><p><strong>Conclusion: </strong>This study contributes to the literature on surgical education by highlighting the need for targeted strategies to enhance the use of simulation as an adjunct alongside more traditional training.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"54"},"PeriodicalIF":4.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12570560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of fluoroscopy time and procedure time of endovascular interventions with and without prior angiography simulator training: a meta-analysis.","authors":"Timo C Meine, Johannes M Dorl, Anselm A Derda, Nima Mahmoudi, Hans-Jonas Meyer","doi":"10.1186/s41077-025-00382-y","DOIUrl":"10.1186/s41077-025-00382-y","url":null,"abstract":"<p><strong>Background: </strong>Angiography simulator training (AST) can help to train important clinical aspects of complex angiography procedures before real patient contact. The aim of the present analysis was to synthesize the results of studies on endovascular interventions performed by interventionalists with and without AST in a meta-analysis.</p><p><strong>Methods: </strong>A systematic literature research was performed in PubMed, Web-of-Science and CINAHL to identify all relevant studies. Inclusion criteria were original research, English language and comparison of endovascular interventions in procedure time (PT) and fluoroscopy time (FT) performed by interventionalists with and without AST. Study quality was assessed using modified Downs-and-Black-instrument (maximum 8 points). Heterogeneity-analysis (study design and I²) was determined, and fixed- or random-effects model was applied to pool the effect, mean difference (MD), from the individual studies. All analyses were performed two-sided, and the level-of-significance was 0.05.</p><p><strong>Results: </strong>Overall, 9 studies with 10 datasets and 7774 interventions were included. Study quality was 7 ± 0 for both PT and FT. Heterogeneity was present in the studies on PT (I² = 61%) and FT (I² = 99%), and a random-effects model was applied. MD for PT was significant with -2.63 min between the AST-group and control-group among the included studies (p = 0.02). In contrast, MD was not significant with -1.33 min between the AST-group and control-group among the included studies for FT (p = 0.21).</p><p><strong>Conclusion: </strong>AST translates into an improved PT and similar FT in real interventions compared to conventional training. Angiography simulators offer a valuable, radiation-free alternative and expand training opportunities. Evidence is limited by study heterogeneity.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"53"},"PeriodicalIF":4.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally adapted meta-debriefing: a mixed-methods study of reflective practice in Spanish-speaking simulation faculty development in Chile.","authors":"Soledad Armijo-Rivera, Karen Vergara, Scarlett Vicencio-Clarke, Brynjar Foss, Marcia Maldonado Holtheuer","doi":"10.1186/s41077-025-00380-0","DOIUrl":"10.1186/s41077-025-00380-0","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education has expanded across Latin America, creating demand for contextually relevant faculty development. Meta-debriefing, defined as a facilitated conversation following a debriefing, can strengthen debriefer performance. However, its implementation and effectiveness in Spanish-speaking settings remain underexplored. The CORE model (context, observation, reflection, and enhanced practice) provides structural guidance, but its adaptation to regional cultures has not been studied.</p><p><strong>Methods: </strong>We conducted a concurrent mixed-methods study of one experienced meta-debriefer interacting and facilitating 15 remote meta-debriefing sessions with interprofessional novice debriefers. Quantitative data were derived from audio-recorded sessions using DASH, SET-M, a CORE-aligned checklist, and a meta-debriefing pillars tool. Qualitative data consisted of written observer reports, analyzed using inductive content analysis, and triangulated across sources.</p><p><strong>Results: </strong>Quantitative analysis revealed high adherence to the CORE model and consistent demonstration of the four meta-debriefing pillars. Peer-assessed DASH scores ranged from 6.8 to 7.0, while SET-M items were consistently marked as achieved. Qualitatively, the meta-debriefer demonstrated behaviors aligned with psychologically safe, context-dependent, theoretically grounded, and formative facilitation. The meta-debriefer used cultural metaphors (e.g., \"boli,\" \"cazuelas,\" and a prisoner's song) to clarify structure and normalize reflection. Five reflection strategies emerged as central to generating debriefer insight: (1) Structured reorientation, (2) constructivist linkage to clinical identity, (3) metaphorical framing, (4) strategic questioning (e.g., advocacy & inquiry, circular inquiry), and (5) emotional normalization.</p><p><strong>Conclusion: </strong>This study demonstrates how meta-debriefing, when implemented through culturally sensitive and structured approaches like CORE, supports transformative learning among simulation debriefers. Meta-debriefer's relational style, use of shared narratives, and context-sensitive scaffolding activated learner-centered reflection. As meta-debriefing models gain traction in Latin America and beyond, this study highlights the value of culturally responsive faculty development strategies that integrate local language, values, and pedagogical traditions into simulation-based education.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"51"},"PeriodicalIF":4.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging anaesthesia professionals as co-faculty in stroke thrombectomy simulation training: associations with clinical care and patient outcomes.","authors":"Caroline Guldberg Fugelli, Hege Langli Ersdal, Soffien Ajmi, Jan Terje Kvaløy, Lars Fjetland, Cecilie Grøtteland, Snorre Eikeland, Victoria Brazil, Martin Wilhelm Kurz","doi":"10.1186/s41077-025-00383-x","DOIUrl":"10.1186/s41077-025-00383-x","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based training for endovascular thrombectomy (EVT) may improve care for patients with acute ischaemic stroke. This study investigated whether engaging anaesthesia professionals as co-faculty in an established in situ simulation programme influenced EVT care and patient outcomes.</p><p><strong>Methods: </strong>This single centre pre-post interventional study (2017-2023) evaluated the impact of revising an EVT simulation training programme by engaging anaesthesia professionals in its design, delivery, and debriefing. Outcomes were measured by changes in: (1) anaesthetic management (relative and absolute time systolic blood pressure was outside protocol thresholds, hypoxic time, and protocol adherence), (2) workflow process (time metrics, successful revascularisation rates, and intraprocedural complications), and (3) patient outcomes (intracerebral haemorrhage, National Institute of Health Stroke Scale scores and modified Rankin Scale scores).</p><p><strong>Results: </strong>A total of 275 stroke patients were treated with EVT during the study period (189 pre- and 86 postintervention). Anaesthetic management improved significantly in the postintervention group, with a decrease in the proportion of time that systolic blood pressure remained outside thresholds (37.0% to 27.7%, p = 0.02), increased compliance with recommended anaesthetics (27.5% to 100.0%, p < 0.001), and a reduction in hypoxia (5 to 0 min, p < 0.001). Time from suite arrival to groin puncture increased from 15 to 20 min in the postintervention group (p = 0.003). No significant differences were observed between the groups in the remaining workflow time metrics, reperfusion rates, or procedural complications. The proportion of patients with an excellent outcome (modified Rankin Scale 0-1) improved significantly from 23.4% to 42.6% in the postintervention group (p = 0.01).</p><p><strong>Conclusions: </strong>The engagement of anaesthesia professionals in the EVT simulation training faculty was associated with improved EVT anaesthesia care and improved patient outcomes. The multidisciplinary nature of the EVT team should be reflected in faculty composition for EVT simulation training.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"52"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimisation of systems, safety and efficiency using simulation: a qualitative exploration of the value proposition for healthcare leaders.","authors":"Sharon Clipperton, Leah McIntosh, Sarah Janssens","doi":"10.1186/s41077-025-00378-8","DOIUrl":"10.1186/s41077-025-00378-8","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based testing (SBT) is increasingly recognised as a strategic tool for enhancing healthcare safety, efficiency, and system readiness. Despite its growing use, the perspectives of healthcare leaders-key stakeholders in sustaining simulation services-remain underexplored. This study aimed to understand how healthcare leaders perceive the value of SBT, identify drivers for engagement, and explore how simulation activities can be aligned with leadership priorities to support quality improvement.</p><p><strong>Methods: </strong>A qualitative, phenomenological approach was used, involving semi-structured interviews with nine healthcare leaders from executive, clinical, and infrastructure roles within a large Australian health service. Thematic analysis was conducted to identify key themes from the interview data.</p><p><strong>Results: </strong>Three major themes emerged: Optimising operations-Leaders valued SBT for its ability to test real-world workflows, uncover latent safety threats, and ensure regulatory and licensing readiness. SBT was seen as a diagnostic tool that supports operational assurance and futureproofing. Collaborative design-Leaders emphasised the importance of engaging end users in simulation activities to ensure relevance, foster shared understanding, and support implementation. SBT was also valued for its role in experiential orientation and team cohesion. Reporting and recommendations-Timely, structured, and risk-stratified reporting was critical for decision-making. Leaders preferred concise executive summaries and actionable recommendations aligned with project goals and resource constraints.</p><p><strong>Conclusion: </strong>Healthcare leaders demonstrated a sophisticated understanding of SBT's strategic applications beyond education. They recognised its value in improving routine operations, supporting compliance, and informing high-stakes decisions. Simulation faculty can enhance the impact and sustainability of SBT by aligning activities with leadership priorities, ensuring timely communication, and delivering focused, actionable insights. These findings offer guidance for embedding SBT into broader quality improvement and organisational strategies. Future research should explore the generalisability of these findings across less mature simulation services and further investigate SBT's role in regulatory compliance.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"50"},"PeriodicalIF":4.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12548102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating non-technical skills into undergraduate medical simulation: a scoping review and thematic analysis of current practices.","authors":"Shen Chuen Khaw, Lexzion Chung, Nigel Fancourt","doi":"10.1186/s41077-025-00377-9","DOIUrl":"10.1186/s41077-025-00377-9","url":null,"abstract":"<p><strong>Background: </strong>Non-technical skills (NTS) play a crucial role in reducing patient harm. In light of this, medical schools are now integrating NTS into their undergraduate curricula to encourage efficiency and reduce human errors, particularly during highly stressful scenarios. Utilising medical simulations has become prevalent for honing these skills in a controlled environment. However, a lack of guidance on how best to design and deliver effective NTS training leads to inconsistencies in quality and outcomes. Therefore, this review aims to examine current practices in simulation-based NTS training for medical students to collate evidence-informed strategies for enhancing its effectiveness.</p><p><strong>Methods: </strong>A scoping review was carried out according to PRISMA-ScR guidelines. A search strategy was performed on PubMed, Scopus and Web of Science databases from inception to 17th June 2025. A thematic analysis of eligible studies identified recurring themes, leading to a conceptual model for the current delivery of NTS training.</p><p><strong>Results: </strong>The screening process yielded 51 articles and commonly occurring themes were synthesised: Simulation setup, simulation modality, post-simulation activity, observational tools for NTS and learning environment. We identified several key practice points that are essential for the successful implementation of NTS training. These include pre-simulation briefings, appropriate fidelity, and debriefing sessions which collectively form the foundation for effective training outcomes.</p><p><strong>Conclusion: </strong>The resulting themes highlight the effective strategies currently employed for NTS training in undergraduate medical simulation. Educators will be able to use these to design and implement consistent, effective NTS training.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"49"},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Kane's validity framework to examine the implications of feedback in simulation-based assessments.","authors":"Kathryn Hodwitz, Sherryn Rambihar, Gillian Nesbitt, Ara Tekian, Ryan Brydges","doi":"10.1186/s41077-025-00375-x","DOIUrl":"10.1186/s41077-025-00375-x","url":null,"abstract":"<p><strong>Background: </strong>Simulation modalities have been increasingly used within programmatic assessment systems, yet educators typically have not collected and appraised validity evidence to justify such uses. Kane's validity framework offers a contemporary approach to conducting validation studies of assessment practices. Under the framework, educators collect and appraise validity evidence according to four inferences: the scoring of performance, the generalization of scores to other assessment contexts, the extrapolation of assessment performance to real-world contexts, and the implications or consequences of assessment decisions for learners, educators, programs, patients, and society. We developed a simulation-based echocardiography competence assessment tool (ECAT) and collected validity evidence to evaluate its use as an assessment for learning. We applied Kane's validity framework to evaluate the utility of the ECAT, with a focus on the implications of the assessment for promoting trainees' learning.</p><p><strong>Methods: </strong>We implemented the ECAT in 2017, collecting simulation-based performance data and subsequent interview data. Fourteen cardiology trainees were assessed using the ECAT by four raters, and their performance was video-recorded. After trainees reviewed their performance videos and feedback, we conducted individual interviews with them and the raters who provided feedback. Directed content analysis generated implications and scoring evidence, and quantitative analyses generated scoring and extrapolation evidence. All evidence was critically appraised to form a validity argument about using ECAT as an assessment for learning.</p><p><strong>Results: </strong>Participants reported that ECAT scores accurately represented trainees'performance, and that the feedback helped identify learning opportunities. Inter-rater reliability was high at ICC = 0.913 (95% CI 0.81-0.97). Participants' ECAT scores correlated with their end-of-rotation cardiology exam scores (r = 0.66, p = 0.02) and had positive associations with raters' judgments of the diagnostic quality of their scans, and with their reported numbers of echocardiograms seen, performed, and interpreted.</p><p><strong>Conclusions: </strong>Our integrated analysis produced a data-informed validity argument supporting the use of the ECAT as a simulation-based assessment for learning. The findings also highlighted multiple areas for further research to optimize the ECAT. Our illustrative example of Kane's validity framework aims to support simulation educators as they are increasingly called on to justify the use of simulation-based assessments in programmatic and competency-based assessment systems.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"48"},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering success stories: how to resuscitate in situ simulation initiatives in Canadian emergency departments.","authors":"Laurence Baril, Kyla Caners, Melanie Walker, Damon Dagnone, Tim Chaplin, Éliane Raymond-Dufresne, Jared Baylis, Eve Purdy, Samantha Britton, Christine Cash","doi":"10.1186/s41077-025-00376-w","DOIUrl":"10.1186/s41077-025-00376-w","url":null,"abstract":"<p><p>In situ simulation (ISS) has long been recognized as a powerful tool for identifying latent safety threats, enhancing teamwork, and ultimately improving patient safety in Emergency Departments (EDs). However, the challenges of operationalizing ISS training in the current clinical environment in Canadian EDs have become increasingly evident. While many EDs face hurdles in implementing ISS, some teams have proven resilient and successful in their ISS endeavors. This study aims to determine which factors are associated with the successful maintenance of ISS programs within Canadian EDs. Using a positive deviance approach, we conducted a qualitative study of ED teams engaged in ISS projects, using interviews as a data collection tool. We recruited 14 healthcare providers who had participated in successful ISS initiatives in Canadian EDs. Participants highlighted the importance of engaging interprofessional stakeholders, flexibility from the simulation team, and buy-in from participants and colleagues as key factors contributing to the success of ISS programs. Challenges identified included lack of buy-in, space constraints, high patient volume and acuity, and staff shortages. Strategies for managing these challenges included scheduling simulations during less busy times and having alternative spaces for simulations. ISS was found to have a significant impact on patient safety, improving teamwork, crisis resource management, and overall patient care. These findings provide valuable insights for EDs looking to start or improve their ISS programs, emphasizing the importance of collaboration and adaptability in overcoming challenges to ensure the success of ISS initiatives.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"10 1","pages":"47"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}