Advances in simulation (London, England)最新文献

{"title":"Beyond reliability: assessing rater competence when using a behavioural marker system.","authors":"Samantha Eve Smith, Scott McColgan-Smith, Fiona Stewart, Julie Mardon, Victoria Ruth Tallentire","doi":"10.1186/s41077-024-00329-9","DOIUrl":"10.1186/s41077-024-00329-9","url":null,"abstract":"<p><strong>Background: </strong>Behavioural marker systems are used across several healthcare disciplines to assess behavioural (non-technical) skills, but rater training is variable, and inter-rater reliability is generally poor. Inter-rater reliability provides data about the tool, but not the competence of individual raters. This study aimed to test the inter-rater reliability of a new behavioural marker system (PhaBS - pharmacists' behavioural skills) with clinically experienced faculty raters and near-peer raters. It also aimed to assess rater competence when using PhaBS after brief familiarisation, by assessing completeness, agreement with an expert rater, ability to rank performance, stringency or leniency, and avoidance of the halo effect.</p><p><strong>Methods: </strong>Clinically experienced faculty raters and near-peer raters attended a 30-min PhaBS familiarisation session. This was immediately followed by a marking session in which they rated a trainee pharmacist's behavioural skills in three scripted immersive acute care simulated scenarios, demonstrating good, mediocre, and poor performances respectively. Inter-rater reliability in each group was calculated using the two-way random, absolute agreement single-measures intra-class correlation co-efficient (ICC). Differences in individual rater competence in each domain were compared using Pearson's chi-squared test.</p><p><strong>Results: </strong>The ICC for experienced faculty raters was good at 0.60 (0.48-0.72) and for near-peer raters was poor at 0.38 (0.27-0.54). Of experienced faculty raters, 5/9 were competent in all domains versus 2/13 near-peer raters (difference not statistically significant). There was no statistically significant difference between the abilities of clinically experienced versus near-peer raters in agreement with an expert rater, ability to rank performance, stringency or leniency, or avoidance of the halo effect. The only statistically significant difference between groups was ability to compete the assessment (9/9 experienced faculty raters versus 6/13 near-peer raters, p = 0.0077).</p><p><strong>Conclusions: </strong>Experienced faculty have acceptable inter-rater reliability when using PhaBS, consistent with other behaviour marker systems; however, not all raters are competent. Competence measures for other assessments can be helpfully applied to behavioural marker systems. When using behavioural marker systems for assessment, educators must start using such rater competence frameworks. This is important to ensure fair and accurate assessments for learners, to provide educators with information about rater training programmes, and to provide individual raters with meaningful feedback.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"55"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907902","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":"Facilitators' experiences with virtual simulation and their impact on learning.","authors":"Margaret Verkuyl, Efrem Violato, Theresa Southam, Mélanie Lavoie-Tremblay, Sandra Goldsworthy, Diane MacEachern, Lynda Atack","doi":"10.1186/s41077-024-00323-1","DOIUrl":"10.1186/s41077-024-00323-1","url":null,"abstract":"<p><strong>Background: </strong>Increasingly, virtual simulations are being integrated into higher education. A successful experience goes far beyond simply offering learners access to a virtual simulation; it requires a facilitator who understands the learners' needs and course objectives, choses the right virtual simulation for the learner, creates a welcoming space that promotes learning, and evaluates the experience.</p><p><strong>Methods: </strong>Facilitators from three different healthcare programs and six educational institutions and students from two different healthcare programs were included in this exploratory qualitative research study. Interviews and focus groups and thematic analysis were conducted to understand the role of the facilitator when using virtual simulations and their impact on student learning.</p><p><strong>Results: </strong>The facilitator themes were supported by the student focus groups. The first theme, the facilitator experience, included sub-themes of simulation pedagogy and debriefing with a practice partner. The second theme was virtual simulation: impact on learning and included sub-themes on student outcomes, technology and design, and repetitive play.</p><p><strong>Conclusion: </strong>Effective facilitation skills are integral to quality virtual simulation experiences. Trained facilitators help students achieve virtual simulation learning outcomes and prepare for clinical practice.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"54"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907764","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":"More than a feeling: emotional regulation strategies for simulation-based education.","authors":"Vicki R LeBlanc, Victoria Brazil, Glenn D Posner","doi":"10.1186/s41077-024-00325-z","DOIUrl":"10.1186/s41077-024-00325-z","url":null,"abstract":"<p><p>Simulation-based education often involves learners or teams attempting to manage situations at the limits of their abilities. As a result, it can elicit emotional reactions in participants. These emotions are not good or bad, they simply are. Their value at any given moment is determined by their utility in meeting the goals of a particular situation. When emotions are particularly intense, or a given emotion is not aligned with the situation, they can impede learners' ability to engage in a simulation activity or debriefing session, as well as their ability to retain knowledge and skills learned during the session. Building on existing guidance for simulation educators seeking to optimize the learning state/readiness in learners, this paper explores the theory and research that underpins the practical application of how to recognize and support learners' emotions during simulation sessions. Specifically, we describe the impact of various emotions on the cognitive processes involved in learning and performance, to inform practical guidance for simulation practitioners: (1) how to recognize and identify emotions experienced by others, (2) how to determine whether those emotional reactions are problematic or helpful for a given situation, and (3) how to mitigate unhelpful emotional reactions and leverage those that are beneficial in achieving the goals of a simulation session.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"53"},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907765","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":"The Scottish Simulation 'KSDP' Design Framework: a sense-making and ordered approach for building aligned simulation programmes.","authors":"Nathan Oliver, Simon Edgar, Edward Mellanby, Alistair May","doi":"10.1186/s41077-024-00321-3","DOIUrl":"10.1186/s41077-024-00321-3","url":null,"abstract":"<p><p>Impactful learning through simulation-based education involves effective planning and design. This can be a complex process requiring educators to master a varied toolkit of analysis tools, learning methodologies, and evaluative strategies; all to ensure engagement of learners in a meaningful and impactful way. Where there is a lack of thoughtful design, simulation-based education programmes may be inefficiently deployed at best, and completely ineffective or even harmful to learning and learners at worst. This paper presents a useful sense-making framework, designed to support simulation educators in designing their learning activities in a systematic, stepwise, and learner centred way.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"52"},"PeriodicalIF":2.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900306","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":"A remote motion analysis of mass casualty incident simulations.","authors":"Boris Tolg","doi":"10.1186/s41077-024-00328-w","DOIUrl":"10.1186/s41077-024-00328-w","url":null,"abstract":"<p><strong>Background: </strong>Regular training for mass casualty incidents at physical simulation events is vital for emergency services. The preparation and execution of these simulations consume huge amounts of time, personnel, and money. It is therefore important to gather as much information as possible from each simulation while minimizing any influence on the participants, so as to keep the simulation as realistic as possible. In this paper, an analysis of GPS-based remote motion measurements of participants in a mass casualty incident simulation is presented. A combination of different evaluation methods is used to analyze the data. This could reduce the potential bias of the measurement methods.</p><p><strong>Methods: </strong>Movement patterns of participants of mass casualty incident simulations, measured by GPS loggers, were analyzed. The timeline of the simulation was segmented into event sections, based on movement patterns of participants entering or leaving defined areas. Movement patterns of participants working closely together were correlated to analyze their cooperation. Written logs created by observers on the ground were used to reconstruct the events of the simulation, to provide a comparative reference to validate the motion analysis.</p><p><strong>Results: </strong>Recorded motion patterns of the participants were found to be qualitatively related to observer logs and triage allocations, allowing a partial reconstruction of the behavior of the participants during the simulation. By analyzing the times the simulation patients left the site of events some possible misjudgments in the triage decisions were indicated.</p><p><strong>Conclusions: </strong>Analysis of movement patterns from GPS loggers and comparison with observations made on the ground showed that accurate information about the events during the simulation can be automatically delivered. Although the records of observers on the ground are vital to assess details, delegation of the automated analysis of individual and group motion could perhaps allow observers to concentrate on more specific tasks. The partially automated motion analysis methods presented should simplify the process of analyzing mass casualty incident simulations.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"51"},"PeriodicalIF":2.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900136","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":"Readiness planning: how to go beyond \"buy-in\" to achieve curricular success and front-line performance.","authors":"Christopher J Roussin, Grace Ng, Mary K Fey, James A Lipshaw, Henrique P Arantes, Jenny W Rudolph","doi":"10.1186/s41077-024-00317-z","DOIUrl":"10.1186/s41077-024-00317-z","url":null,"abstract":"<p><p>Simulation program staff and leadership often struggle to partner with front-line healthcare workers, their managers, and health system leaders. Simulation-based learning programs are too often seen as burdensome add-ons rather than essential mechanisms supporting clinical workforce readiness. Healthcare system leaders grappling with declining morale, economic pressure, and too few qualified staff often don't see how simulation can help them, and we simulation program leaders can't seem to bridge this gap. Without clear guidance from front-line clinicians and leaders, the challenge of building and maintaining sustainably relevant simulation offerings can seem overwhelming. We argue that three blind spots have limited our ability to see the path to collaborations that support front-line workforce readiness: We wrongly assume that our rigor in designing and delivering programs will lead to front-line participant engagement and positive impact, we overestimate the existence of shared priorities, mindsets, and expertise with our would-be partners, and we contribute to building a façade of superficial education compliance that distracts from vital skill development. How do we design simulation-based training programs that are valued, supported, and sustained by key partners over time? (1) By seeing ourselves as partners first and designers second; (2) by using a boundary spanning design process that shifts the primary psychological ownership of training outcomes to our partners; and (3) by focusing this shared design process on workforce readiness for the situations that our healthcare partners care about most. Drawing on lessons from more than 800 readiness plans developed by participants in our courses and the authors' successes and mistakes in partnering with healthcare teams for front-line readiness, we introduce the concepts, commitments, and practices of \"readiness planning\" along with three detailed examples of readiness planning in action.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"50"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883747","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":"PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education.","authors":"Niki Soilis, Elizabeth Anne Kinsella, Walter Eppich, Adam Cheng, Lindsay Beavers, Farhan Bhanji","doi":"10.1186/s41077-024-00320-4","DOIUrl":"10.1186/s41077-024-00320-4","url":null,"abstract":"<p><p>Addressing health inequities in health professions education is essential for preparing healthcare workers to meet the demands of diverse communities. While simulation has become a widely recognized and effective method for providing safe and authentic clinical learning experiences, there has been limited attention towards the power of simulation in preparing health practitioners to work with groups who experience health disparities due to systems of inequality. Balancing technical proficiency with educational approaches that foster critical reflection and inform action oriented towards social accountability is essential. Transformational learning promotes the development of critical consciousness through critical reflection. Debriefing plays a crucial role in fostering learning in this direction by providing a structured opportunity to critically reflect on taken for granted assumptions, examine power and privilege embedded within systems and structures, and empower learners to take action toward changing those conditions. Building on the Promoting Excellence and Reflective Learning in Simulation (PEARLS) Healthcare Debriefing Tool, we propose a PEARLS Debriefing for Social Justice and Equity (DSJE) Tool that specifically directs attention to systems of inequality that contribute to health disparities for vulnerable groups across a range of simulation scenarios. This approach has two aims: (a) to transform debriefings into a critically reflective space by engaging learners in dialogue about social and structural determinants of health that may create or perpetuate inequities and (b) to foster critical reflection on what actions can be taken to improve the health and well-being of identified at risk and vulnerable groups. From this perspective, we can use the adapted PEARLS Tool to incorporate conversations about systems of inequality, equity, diversity, and inclusion (EDI) into our existing educational practices, and make concentrated efforts towards community-driven and socially conscious simulation-based education (SBE).</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"47"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856996","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":"When common cognitive biases impact debriefing conversations.","authors":"Michael J Meguerdichian, Dana George Trottier, Kimberly Campbell-Taylor, Suzanne Bentley, Kellie Bryant, Michaela Kolbe, Vincent Grant, Adam Cheng","doi":"10.1186/s41077-024-00324-0","DOIUrl":"10.1186/s41077-024-00324-0","url":null,"abstract":"<p><p>Healthcare debriefing is a cognitively demanding conversation after a simulation or clinical experience that promotes reflection, underpinned by psychological safety and attention to learner needs. The process of debriefing requires mental processing that engages both \"fast\" or unconscious thinking and \"slow\" intentional thinking to be able to navigate the conversation. \"Fast\" thinking has the potential to surface cognitive biases that impact reflection and may negatively influence debriefer behaviors, debriefing strategies, and debriefing foundations. As a result, negative cognitive biases risk undermining learning outcomes from debriefing conversations. As the use of healthcare simulation is expanding, the need for faculty development specific to the roles bias plays is imperative. In this article, we hope to build awareness about common cognitive biases that may present in debriefing conversations so debriefers have the chance to begin the hard work of identifying and attending to their potential detrimental impacts.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"48"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857008","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":"Virtual reality simulation for facilitating critical reflection and transformative learning: pedagogical, practical, and ethical considerations.","authors":"Niki Soilis, Farhan Bhanji, Elizabeth Anne Kinsella","doi":"10.1186/s41077-024-00319-x","DOIUrl":"10.1186/s41077-024-00319-x","url":null,"abstract":"<p><p>There is growing recognition that preparing health professionals to work with complex social issues in the delivery of healthcare requires distinct theoretical and pedagogical approaches. Recent literature highlights the significance of employing simulated environments which aim to immerse learners in the experiences of diverse populations and bridge the gap between academic learning and lived realities across a diverse society. Virtual Reality (VR) is gaining traction as a promising pedagogical approach in this context. VR has been argued to offer distinct advantages over traditional educational methods by allowing learners to see the world through the eyes of diverse populations, and to learn about social injustices while immersed in a mediated environment. It also has practical benefits in its capacity to expose large number of students to these topics with relatively modest resources compared to other approaches. This debate article explores VR as an innovative pedagogical approach for facilitating critical reflection, dialogue and transformative learning about social issues in health professions education (HPE). It examines the potential affordances as well as risks and dangers of integrating VR into educational programs and highlights key pedagogical, practical, and ethical considerations. Emphasis is placed on the importance of these considerations in efforts toward ethical, safe, and respectful use of VR in educational settings. This paper contributes to the ongoing dialogue on VR simulation as an innovative approach to HPE and highlights the importance of creating conditions that maximize its educational benefits and minimize potential harms.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"49"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857003","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 virtual reality simulation to address racism in a healthcare setting.","authors":"Lindsay Beavers, Tin Vo, Julia Lee, Thanya Duvage, Hollie Mullins, Aradhana Tewari, Allison Needham, Ryan Brydges","doi":"10.1186/s41077-024-00322-2","DOIUrl":"10.1186/s41077-024-00322-2","url":null,"abstract":"<p><p>Racism continues to plague Western societies' institutions, including the healthcare system. Despite the evidence of racism's negative impacts on healthcare providers, administrators, patients, and families, healthcare workers report hesitancy in taking action to address racism in the workplace. Simulation, with its experiential pedagogy and foundation in psychological safety, may be an educational tool to support practical training. Guided by a social cognitive view of regulation of learning, we piloted virtual reality (VR) modules focused on addressing bias, privilege, and microaggressions. We used pre-/post-surveys, reflective journals, built-in VR platform data, and simulation debriefing session notes to better understand the effectiveness and usability of these VR modules in our organization. Overall, participants found the VR modules highly valuable, and we noted a shift in participants' reported intentions to take action to address racism in the workplace. Participants also noted the importance of a multifaceted plan that goes beyond education to ensure a meaningful culture shift toward addressing racism at work. Practical lessons from this pilot study included the necessity of an informed debriefing plan focused on participants' positionality and power and the need to deeply understand our institution's information technology (IT) environment to ensure successful deployment of VR technology.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"46"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787894","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}