Advances in simulation (London, England)最新文献

{"title":"Education alone is rarely enough: realising value from integrating simulation with quality improvement.","authors":"Farrukh N Jafri, Michael B Light, Rafael E Torres, Roger A Edwards","doi":"10.1186/s41077-026-00469-0","DOIUrl":"10.1186/s41077-026-00469-0","url":null,"abstract":"<p><p>The simulation community has invested heavily in educational rigour (validated debriefing methods, high-fidelity technology, faculty development), yet evidence linking simulation to sustained clinical improvement remains limited. We propose this gap exists not because simulation is ineffective, but because it is poorly positioned within organisational systems. Drawing on a decade of programmatic experience at a non-academic hospital, including multiple initiatives that did not produce sustained outcomes and subsequent methodological pivots, we argue that simulation achieves sustainable impact only when embedded within quality improvement infrastructure. Using the Donabedian model as a conceptual framework, we demonstrate that process-focused interventions (education, training) without corresponding structural supports (equipment, systems, protocols) produce transient change at best. Integrated approaches, where simulation serves as a quality improvement tool to identify system threats and monitor interventions through Plan-Do-Study-Act cycles and the SAFER-Matrix, produce measurable, sustained improvements. Evidence from in situ programmes across emergency departments and cardiac catheterisation laboratories, multi-site collaboratives, and AI-powered telehealth simulation demonstrates that this integrated approach succeeds where education alone falls short. We have formalised these principles in the Simulation-Quality Integration (SIM-QI) Framework, currently submitted for independent peer review, which provides a practical blueprint for embedding simulation within QI infrastructure. We present actionable implications for simulation educators, institutions, and researchers seeking to bridge the gap between educational excellence and clinical translation.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457912","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":"Simulator development using natural language: clinician-led innovation through artificial intelligence.","authors":"Federico Lorenzo Barra, Serena Ricci, Edoardo Moro, Jiří Travěnec, Alessandro Costa, Luca Carenzo, Giovanna Rodella, Rosanna Vaschetto","doi":"10.1186/s41077-026-00467-2","DOIUrl":"10.1186/s41077-026-00467-2","url":null,"abstract":"<p><strong>Background: </strong>Healthcare simulation training faces significant barriers due to the \"clinician-developer gap,\" where educators lack programming expertise to create customized digital simulators. Natural Language-Driven Development (NLDD) is an emerging paradigm that enables clinicians to develop educational technology through conversational artificial intelligence interfaces.</p><p><strong>Methods: </strong>We implemented NLDD methodology to develop Open Vent Sim, a comprehensive mechanical ventilation simulator designed to replace anesthesia machines and ventilators in educational contexts lacking dedicated equipment. A multidisciplinary team comprising anesthesiologists, residents, a research nurse, IT, and biomedical engineers collaborated using Google AI Studio to iteratively create a web-based application through natural language prompts. Development proceeded through conversational cycles in which clinical requirements were translated into functional code via large language model assistance.</p><p><strong>Results: </strong>Open Vent Sim was successfully developed in about 40 h over two weeks, featuring three simulation environments: anesthesia workstation, ICU ventilator, and high-flow oxygenation systems. The simulator incorporates physiological patient profiles (normal, ARDS, COPD) with dynamic compliance calculations and realistic waveform generation. Clinical validation was achieved through the integration of continuous resident feedback during iterative development. The application was successfully implemented in SimZone 1 as an interactive skill trainer and in SimZone 2 for team-based clinical scenarios during formal anesthesia and critical care education. Significant technical adaptation was required to transform the AI-generated prototype into a production-ready application.</p><p><strong>Conclusions: </strong>NLDD demonstrates the potential to democratize the creation of educational technology by empowering clinical domain experts to develop sophisticated simulation tools without traditional programming expertise. This approach addresses resource limitations while maintaining clinical authenticity, though professional technical oversight remains essential for production-ready implementations.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457614","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":"Utilising simulation to address national workforce and quality priorities: learning from the first four years of the NHS Scotland Academy.","authors":"Victoria Ruth Tallentire, Clair Elizabeth Graham, Jeanette Karen Stevenson","doi":"10.1186/s41077-026-00466-3","DOIUrl":"10.1186/s41077-026-00466-3","url":null,"abstract":"<p><p>NHS Scotland Academy functions as a national mechanism for translating Scottish Government workforce and quality priorities into deployable, simulation-enabled interventions. This article is presented in three parts. The first section describes how NHS Scotland Academy operationalises simulation within a commissioning-to-closure infrastructure comprising staged initiation and approvals, collaborative co-design, structured delivery supported by embedded faculty development, iterative evaluation, proportionate change control, annual review, and formal close/transfer processes. Part 2 presents two exemplar programmes which illustrate how this lifecycle connects simulation to healthcare quality and safety through a translational simulation lens: the Accelerated Anaesthetic Practitioner Programme, commissioned to address prolonged anaesthetic practitioner training and perioperative service pressures; and the National Endoscopy Training Programme, designed as a simulation-powered workforce and quality driver within endoscopy recovery. Building on the broader evolution of IPO (inputs-processes-outputs) in team science, Part 3 suggests the ways in which the learning from NHS Scotland Academy may contribute to the development of translational simulation theory, particularly through recognition of mediating mechanisms, episodic temporality, and cross-level causation. NHS Scotland Academy's infrastructure and exemplars make these features more visible and suggest how the theory might be refined while retaining the pragmatic utility of IPO. Overall, this Advancing Simulation Practice article positions NHS Scotland Academy both as an effective national delivery platform for simulation-enabled workforce and quality programmes and as a testbed for advancing translational simulation conceptual models.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450762","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":"Evaluating the impact of implementing an ECPR protocol on prehospital resuscitation quality: a randomized controlled simulation study.","authors":"Frederik Marynen, Marco Garcia van Bijsterveld, Kathleen Van Loon, Sander Kempenaers, Simon Buelens, Jorg Roosen, Steffen Fieuws, Iwan C C van der Horst, Walther Nka van Mook, Philippe Dewolf","doi":"10.1186/s41077-026-00458-3","DOIUrl":"10.1186/s41077-026-00458-3","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal Cardiopulmonary Resuscitation (ECPR) is increasingly considered for prehospital cardiac arrest management; however, its impact on resuscitation performance remains unclear. This study aimed to determine whether integrating an ECPR protocol into prehospital cardiac arrest care affects the quality of resuscitation compared to application of the standard Advanced Life Support (ALS) protocol.</p><p><strong>Methods: </strong>A randomized controlled simulation study was conducted at the University Hospital Leuven in Belgium using standardized pre-hospital cardiac arrest scenarios. Participants, who were physicians functioning as part of resuscitation teams, were randomized into intervention and control groups. The study included a pre- and post-intervention phase. In the pre-phase, all participants followed the standard ALS protocol. Only the intervention group received training in the additional ECPR protocol between the phases. In the post-phase, the intervention group combined this protocol with standard ALS, whereas the control group continued with ALS alone. The primary outcome was overall resuscitation quality, which was assessed using the modified Peltonen score. The secondary outcomes included occurrence and timing of critical resuscitation actions.</p><p><strong>Results: </strong>A total of 40 physicians participated in the study. Resuscitation quality was not affected by the ECPR protocol; the modified Peltonen score showed no difference in the pre-post change between the groups (0.02, CI: -0.15; 0.19, p = 0.83). However, secondary outcomes showed delayed actions related to the identification and management of the presumed cause of cardiac arrest in the intervention group, such as significantly later verbal suggestions to initiate causal treatments including PCI or thrombolysis.</p><p><strong>Conclusions: </strong>In this simulation study, combining a prehospital ECPR protocol with standard ALS resulted in resuscitation performance comparable to ALS alone. Nonetheless, the protocol was associated with delayed diagnostic and therapeutic actions concerning the reversible causes of cardiac arrest, highlighting the need for ECPR training that integrates diagnostic and therapeutic vigilance with procedural execution.</p><p><strong>Trial registration: </strong>Clinical Trial Center UZ Leuven, S65846 - September 2021.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427023","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":"Conceptions of human factors in simulation-based education: a phenomenographic study.","authors":"Alice Kitt, Ranjev Kainth","doi":"10.1186/s41077-026-00462-7","DOIUrl":"10.1186/s41077-026-00462-7","url":null,"abstract":"<p><strong>Background: </strong>Human factors (HF) are integral to patient safety. Simulation-based education (SBE) is widely used to teach HF, yet facilitators conceptualise HF in varied ways. This study explored facilitators' conceptions of HF.</p><p><strong>Methodology and methods: </strong>A qualitative phenomenographic study was conducted with 12 SBE facilitators from diverse professional backgrounds. Purposive maximum-variation sampling sought participants from different professions, simulation roles, and educational contexts. Semi-structured interviews were conducted via Microsoft Teams, transcribed verbatim, and analysed iteratively to identify categories of description and an outcome space capturing qualitatively different conceptions.</p><p><strong>Results: </strong>Four conceptions of HF were identified: (1) HF as a patient-safety science, (2) HF as human-to-human interactions, (3) HF as optimisation of individual performance, and (4) HF as reducing error ('To Err is Human'). Participants sometimes drew on more than one conception, but usually foregrounded one dominant way of understanding HF. The conceptions differed in scope and alignment with HF theory rather than in simple legitimacy. Dimensions influencing conceptions included professional experience, simulation pedagogy, continuous professional development, and approaches to measuring educational quality.</p><p><strong>Discussion: </strong>SBE facilitators hold heterogeneous conceptions of HF, risking inconsistent educational practice. In phenomenographic terms, broader conceptions encompassed aspects visible in narrower ones; this should not be read as a claim that one conception is always the 'best' for every simulation objective. Rather, different educational aims may legitimately foreground different aspects of HF, while systems-informed conceptions align more fully with contemporary HF science. Clearer definitions, stronger faculty development, and closer collaboration between simulation educators and HF specialists may enhance educational design and patient-safety outcomes.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407033","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":"Development and validation of a distance-based training program of basic cardiac life support for laypersons and comparison with traditional in-person methodology: a non-inferiority study.","authors":"Marcia Corvetto, David Acuña, Andrés Schneider, Jerónimo Rojas, Julián Varas, Elga Zamorano, Fernando Altermatt","doi":"10.1186/s41077-026-00457-4","DOIUrl":"10.1186/s41077-026-00457-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine whether a distance-based CPR training program with asynchronous feedback for laypersons is non-inferior to the traditional in-person Heartsaver® First Aid CPR AED course.</p><p><strong>Methods: </strong>After approval by the ethics committee, 192 non-medical personnel were recruited to participate in this study. Participants were randomly assigned to two different training methods: Traditional in-person Heartsaver® First Aid CPR AED course (T-course). Distance-based course offering asynchronous feedback through an online platform (D-course). For the distance-based course, materials for practice were available at the participants' workplace (pad, resuscitation torso, an automated external defibrillator). The video-based assessment and feedback platform C1DO1 was used ( https://c1do1.ai/ ). The course was structured in 9 stages on the platform, with theoretical and practical steps. Participants reviewed the videos and practiced unsupervised, uploading video recordings of their practice, and instructors assessed and provided feedback asynchronously on these videos. Participants then reviewed their own videos with the feedback and practiced again until approval. Both groups completed a pre-training (PRE) and post-training assessment (POST). During both assessments, participants were recorded performing CPR. Videos were evaluated by two independent, blinded reviewers who rated participants' performance using the AHA Heartsaver Adult CPR and AED skills testing checklist. Additionally, the quality of chest compressions (CC) was measured with the Prestan simulator application.</p><p><strong>Results: </strong>Of the 192 participants recruited, 172 completed the training, and 158 took the PRE and POST assessments. (83 finished the T-course and 75 the D-course). Median Heartsaver Adult CPR and AED skills testing checklist scores increased from 2 (0-3) to 15 (14-16.5) points in the T-course and from 1 (0-2.5) to 16 (15.5-17) points in the D-course. The difference in POST assessment median scores between groups was -1 (95% CI: [-1.5, -0.5]), with the lower bound above the pre-established non-inferiority margin, confirming the non-inferiority of the D-course. The median CC rate increased from 82 (0-106)/min to 105 (102-110)/min in the T-course and from 86 (0-109.5)/min to 105 (105-108)/min in the D-course. The median CC depth rose from 38 (0-57.5) mm to 58 (49.5-60) mm in the T-course and from 32 (0-56) mm to 59 (55-60) mm in the D-course.</p><p><strong>Conclusions: </strong>Both training programs significantly improve participants' proficiency in CPR. The distance-based course with asynchronous platform feedback was non-inferior to the traditional Heartsaver® First Aid CPR AED course.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383368","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":"Comparing two post-resuscitation debriefing frameworks: a randomized cross-over simulation study.","authors":"Frederik Marynen, Marco Garcia van Bijsterveld, Jill Van In, Jorg Roosen, Steffen Fieuws, Domien Vanhonacker, Walther Nka van Mook, Iwan C C van der Horst, Philippe Dewolf","doi":"10.1186/s41077-026-00460-9","DOIUrl":"10.1186/s41077-026-00460-9","url":null,"abstract":"<p><strong>Background: </strong>Post-resuscitation debriefing (PRD) enhances individual and team performance in emergency care, thereby improving patient outcomes and provider well-being. Despite support from the European Resuscitation Council and the American Heart Association, the optimal PRD framework remains undefined. This study compares how team members experience PRD when conducted using either the DISCERN or Post-Code Pause (PCP) debriefing framework in pre-hospital cardiac arrest simulations.</p><p><strong>Methods: </strong>In a randomized cross-over study, 40 medical doctors participated in four advanced life support (ALS) simulation scenarios. Participants acted exclusively within their usual roles as team leaders, while the remaining team members performed standardized roles in accordance with the scenario scripts. Each participant experienced two DISCERN and two PCP debriefings, with the order randomized. The primary outcome was the total score on the Debriefing Experience Scale (DES), with item scores as secondary outcomes. Linear models with generalized estimating equations (GEE) were used to account for repeated measures when comparing the mean scores between the debriefing frameworks.</p><p><strong>Results: </strong>A total of 158 DES questionnaires were analyzed. Mean total DES scores were 4.15 (4.02; 4.28) for PCP and 4.16 (4.02; 4.29) for DISCERN (p = 0.93 for the comparison). These scores indicate a favorable debriefing experience for both frameworks. At the DES item level, no statistically significant differences were observed between frameworks, except for perceived physical comfort in the debriefing environment, which was rated significantly higher for DISCERN (DISCERN = 4.44 (4.27; 4.62), PCP = 4.13 (3.96; 4.30), p = < 0.0001).</p><p><strong>Conclusion: </strong>DISCERN and PCP provide similarly favorable debriefing experiences following simulated cardiac arrest scenarios, with no significant difference in overall DES scores. These findings suggest that both frameworks can be implemented without compromising perceived debriefing quality. Further research should include more professionally diverse participant samples and assess long-term debriefing outcomes.</p><p><strong>Trial registration: </strong>Clinical Trial Center UZ Leuven, S65846 September 2021.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378276","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 realism in high-fidelity ambulance simulation: ambulance clinicians' perspectives on correspondence with everyday practice.","authors":"Wivica Kauppi, Magnus Andersson Hagiwara, Hanna Maurin Söderholm, Anders Sterner","doi":"10.1186/s41077-026-00461-8","DOIUrl":"10.1186/s41077-026-00461-8","url":null,"abstract":"<p><strong>Background: </strong>High-fidelity simulation (HFS) provides a controlled environment for training, allowing ambulance clinicians'(ACs) to practice and refine their skills without risking patient safety. Additionally, it enables the replication of complex scenarios, ensuring comprehensive preparedness for real-life emergencies. However, there remains a need to understand how frontline professionals in ambulance services experience these simulation-based activities. This is especially true when using high-fidelity modalities that aim to replicate real-world scenarios for research purposes.</p><p><strong>Aim: </strong>To explore clinically active ACs´ experiences of participating in HFS.</p><p><strong>Methods: </strong>A qualitative design involving dyadic interviews with 16 ACs participating in a simulation scenario was conducted. The data were analyzed using the inductive content analysis method outlined by Elo and Kyngäs.</p><p><strong>Results: </strong>Participants emphasized the importance of adopting the right mindset from the start of the scenario, as mental readiness was crucial for immersion. Although the scenario felt realistic, achieving full psychological fidelity remained challenging, as participants' awareness of the simulation setup influenced their behavior during the scenario.</p><p><strong>Conclusions: </strong>The study underscores the importance of carefully designed HFS scenarios that prioritize psychological and environmental fidelity to support authentic engagement among clinically active ACs. This is particularly important in pre-hospital care, where direct access to real clinical situations is often restricted by ethical, practical, and organizational constraints. The findings indicate that well constructed simulations with coherent workflow sequences, professional actor-based patient representation, and realistic settings can function as a methodological bridge for capturing complex cognitive and emotional processes that are otherwise difficult to study in real world practice. Further refinement of simulation design, focusing on psychological presence rather than complete physical or technical realism, may strengthen simulation-based research as a method for investigating experiential aspects of pre-hospital care.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383352","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":"Self-efficacy in mass casualty incident training using mixed reality.","authors":"María Del Carmen Cardós-Alonso, Miguel Inzunza, Lina Gyllencreutz, Salvador Espinosa-Ramírez, Ana María Cintora-Sanz","doi":"10.1186/s41077-026-00456-5","DOIUrl":"10.1186/s41077-026-00456-5","url":null,"abstract":"<p><strong>Introduction: </strong>Throughout Europe, Emergency Medical Services (EMS) rely heavily on Medical First Responders (MFR) to ensure early stabilization and appropriate handling of complex Mass Casualty Incidents (MCI). Mixed Reality (MR), also known as Augmented Reality (AR), provides interactive training by integrating real environments with digital components. This technology enables MFR to practise complex decision-making and hands-on interventions in high-stress, simulated scenarios. However, assessing its genuine effectiveness remains challenging, as true competency is often difficult to demonstrate outside real-life emergencies. This study aims to measure pre- and post-test changes in perceived self-efficacy among MFR following a targeted MR intervention focused specifically on the initial management of MCI.</p><p><strong>Method: </strong>A pre-test/post-test survey design was employed with 274 MFR who underwent detailed MR training simulating complex, early-stage MCI scenarios. To analyze the intervention's precise impact on participant confidence, data were analyzed using both within- and between-subjects ANOVA, providing information about the change in self-efficacy across the cohort.</p><p><strong>Results: </strong>The analysis revealed a statistically significant increase in perceived self-efficacy among the 274 participants following the training (F(1,270)=169.36, p<.01, η²=.385). The mean score increased from 34.45 (SD=6.27) to 38.38 (SD=5.40), representing an absolute increase of 3.93 points. This corresponds to an 11.41% increase relative to baseline scores and an 8.19% increase when calculated against the maximum possible score (48 points), indicating a strong practical effect of the intervention. The MR intervention could detect change and indicate a positive influence on confidence and how a combined approach including MR training can improve MFR perceived preparedness.</p><p><strong>Conclusion: </strong>Findings suggest that MR training significantly enhances MFRs' perceived self-efficacy in managing MCIs. Consequently, integrating immersive MR technologies into emergency training programs may represent a valuable complementary strategy for strengthening organizational disaster preparedness and improving MFR confidence and decision-making skills in high-stakes situations.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371006","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":"Artificial intelligence to support debriefing in simulation-based healthcare education: a scoping review.","authors":"Aseelah Alnazawi, Mohammed Almarhabi","doi":"10.1186/s41077-026-00447-6","DOIUrl":"10.1186/s41077-026-00447-6","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence is increasingly being integrated into healthcare education and simulation-based education. However, its role in supporting the debriefing phase of simulation remains underexplored and inconsistently described. This scoping review aimed to map the existing literature on the use of artificial intelligence to support debriefing in simulation-based healthcare education.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with Arksey and O'Malley's framework and Joanna Briggs Institute guidance and reported in line with PRISMA-ScR. MEDLINE, Scopus, Web of Science, and CINAHL were searched without date restrictions. Eligible studies examined the use of artificial intelligence to support debriefing-related processes within healthcare simulation. Data were charted using a structured extraction form and synthesised descriptively and thematically.</p><p><strong>Results: </strong>Seven studies published between 2023 and 2026 met the inclusion criteria. Studies were conducted in the United States, Switzerland, Chile, and South Korea. Artificial intelligence applications clustered into three domains: communication and performance analytics using speech recognition and natural language processing; generative artificial intelligence systems supporting facilitator feedback and structured report generation; and learner-facing reflective dialogue systems. Across the included studies, artificial intelligence was mainly positioned as an adjunct to human facilitation rather than as a replacement for facilitators. Reported outcomes focused primarily on feasibility, usability, technical accuracy, and perceived educational value, with limited evidence of objective improvements in learner performance or clinical outcomes.</p><p><strong>Conclusions: </strong>Artificial intelligence is emerging as a supportive tool for debriefing in simulation-based healthcare education. Current evidence remains limited, exploratory, and largely single-institutional, indicating the need for more rigorous research on educational effectiveness, ethical implementation, and the continuing role of human facilitation.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334951","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}