Advances in simulation (London, England)最新文献

{"title":"Development and validation of a simulation-based assessment tool in colonoscopy.","authors":"Claudia Jaensch, Rune D Jensen, Charlotte Paltved, Anders H Madsen","doi":"10.1186/s41077-023-00260-5","DOIUrl":"10.1186/s41077-023-00260-5","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is difficult to learn. Virtual reality simulation training is helpful, but how and when novices should progress to patient-based training has yet to be established. To date, there is no assessment tool for credentialing novice endoscopists prior to clinical practice. The aim of this study was to develop such an assessment tool based on metrics provided by the simulator. The metrics used for the assessment tool should be able to discriminate between novices, intermediates, and experts and include essential checklist items for patient safety.</p><p><strong>Methods: </strong>The validation process was conducted based on the Standards for Educational and Psychological Testing. An expert panel decided upon three essential checklist items for patient safety based on Lawshe's method: perforation, hazardous tension to the bowel wall, and cecal intubation. A power calculation was performed. In this study, the Simbionix GI Mentor II simulator was used. Metrics with discriminatory ability were identified with variance analysis and combined to form an aggregate score. Based on this score and the essential items, pass/fail standards were set and reliability was tested.</p><p><strong>Results: </strong>Twenty-four participants (eight novices, eight intermediates, and eight expert endoscopists) performed two simulated colonoscopies. Four metrics with discriminatory ability were identified. The aggregate score ranged from 4.2 to 51.2 points. Novices had a mean score of 10.00 (SD 5.13), intermediates 24.63 (SD 7.91), and experts 30.72 (SD 11.98). The difference in score between novices and the other two groups was statistically significant (p<0.01). Although expert endoscopists had a higher score, the difference was not statistically significant (p=0.40). Reliability was good (Cronbach's alpha=0.86). A pass/fail score was defined at 17.1 points with correct completion of three essential checklist items, resulting in three experts and three intermediates failing and one novice passing the assessment.</p><p><strong>Conclusion: </strong>We established a valid and reliable assessment tool with a pass/fail standard on the simulator. We suggest using the assessment after simulation-based training before commencing work-based learning.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10327000","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":"All professions can benefit - a mixed-methods study on simulation-based teamwork training for operating room teams.","authors":"Cecilia Escher,&nbsp;Hans Rystedt,&nbsp;Johan Creutzfeldt,&nbsp;Lisbet Meurling,&nbsp;Leif Hedman,&nbsp;Li Felländer-Tsai,&nbsp;Ann Kjellin","doi":"10.1186/s41077-023-00257-0","DOIUrl":"https://doi.org/10.1186/s41077-023-00257-0","url":null,"abstract":"<p><strong>Background: </strong>Operating rooms have become more technically complex due to new advanced procedures, which has increased demands on teamwork in the operating room. In response, team training has been proposed to improve team performance, workplace culture, and patient safety. We developed and delivered a simulation-based team training course for entire professional surgical teams. This type of intervention has been proposed by researchers but has not been widely published. The aims of this intervention study were to examine participants' reactions to the course in terms of their motivation for the training and their self-efficacy in relation to their performance, as well as their views on transferring the lessons learned in the course to their workplace.</p><p><strong>Methods: </strong>In a prospective mixed-methods intervention study, operating room professionals participated in a full-day simulation-based teamwork training course. Learning objectives were nontechnical skills, specifically communication and collaboration across the team. Seventy-one staff members representing 5 operating room professions were included, and the average work experience of participants was 6 years. Quantitative data on self-efficacy and situational motivation were collected by questionnaires before and after training. Qualitative data were collected through 5 focus group interviews that took place in direct relation to the courses and included a total of 31 participants. Transcripts were coded and analyzed using thematic analysis.</p><p><strong>Results: </strong>All occupations showed a similar pattern in terms of increases in self-efficacy and intrinsic motivation after the training. Analysis of the qualitative data showed that training in one's profession and in authentic multiprofessional teams was important factors for motivation. Participating staff described an awareness of undesirable communication barriers in surgical teams that can lead to risks for patients. Systematic training was definitely perceived as a means to reduce barriers and improve communication and collaboration.</p><p><strong>Conclusion: </strong>Simulation-based training was equally well received by all professional groups. Our results confirm the feasibility of this type of training for professional teams and promising opportunities for improving teamwork skills. The qualitative data reveal both opportunities and limitations for transferring the learning experiences to the workplace.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803082","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":"Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach.","authors":"Melanie Barlow,&nbsp;Kate J Morse,&nbsp;Bernadette Watson,&nbsp;Fiona Maccallum","doi":"10.1186/s41077-023-00256-1","DOIUrl":"https://doi.org/10.1186/s41077-023-00256-1","url":null,"abstract":"<p><strong>Background: </strong>Within healthcare, the barriers and enablers that influence clinicians' ability to speak up are well researched. However, despite the receiver of the message being identified as a key barrier to a speaker voicing a concern, there have been very few receiver-focused studies. As a result, little is known about the barriers and enablers that influence message reception. Understanding these can help inform speaking up training and ultimately enhance patient safety through more effective clinical communication.</p><p><strong>Objectives: </strong>To identify enabling or inhibiting factors that influence the receiver's reception and response to a speaking up message, and if the identified barriers and enablers are related to speaker or receiver characteristics.</p><p><strong>Design and methods: </strong>Twenty-two interdisciplinary simulations were video recorded and transcribed. Simulation participants formed the patient discharge team and were receivers of a speaking up message, delivered by a nurse at the patient's bedside. How the message was delivered (verbose or abrupt wording), was manipulated and counterbalanced across the simulations. Within the post simulation debriefs, barriers and enablers of being a receiver of a message were explored using content analysis.</p><p><strong>Setting/participants: </strong>This study took place in a large Australian tertiary healthcare setting. Participants were qualified clinicians of varying disciplines and specialties.</p><p><strong>Results: </strong>A total of 261 barriers and 285 enablers were coded. Results showed that how the message was delivered (differing tone, phases, and manner) influenced what receivers identified as barriers and enablers. Additionally, the receiver's own cognitive processes, such as making positive attributions of the speaker and attempting to build rapport and collegiality, better enabled message reception and response. Receiver behaviour was negatively impacted by listening to fix, rather than understand, and not knowing in the moment how to manage their own reactions and appropriately frame a response.</p><p><strong>Conclusion: </strong>The debriefings identified key barriers and enablers to receiving a speaking up message that differ from those previously identified for senders of the speaking up message. Current speaking up programs are predominately speaker centric. This study identified that both speaker and receiver behaviour influenced message reception. Therefore, training must place equal attention on both the speaker and receiver and be inclusive of experiential conversational rehearsal of both positive and challenging encounters.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10324134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809242","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 white-box model for real-time simulation of acid-base balance in blood plasma.","authors":"Timothy A J Antonius,&nbsp;Willem W L van Meurs,&nbsp;Berend E Westerhof,&nbsp;Willem P de Boode","doi":"10.1186/s41077-023-00255-2","DOIUrl":"https://doi.org/10.1186/s41077-023-00255-2","url":null,"abstract":"<p><p>Maintaining an optimal acid base is important for the patient. The theory underlying acid-base balance can be challenging for clinicians and educators. These considerations justify creating simulations that include realistic changes to the partial pressure of carbon dioxide, pH, and bicarbonate ion concentration in a range of conditions. Our explanatory simulation application requires a model that derives these variables from total carbon dioxide content and runs in real time. The presented model is derived from the Stewart model, which is based on physical and chemical principles, and takes into account the effects of weak acids and strong ions on the acid-base balance. An inventive code procedure allows for efficient computation. The simulation results match target data for a broad range of clinically and educationally relevant disturbances of the acid-base balance. The model code meets the real-time goals of the application and can be applied in other educational simulations. Python model source code is made available.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10268443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10010980","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":"Measuring cognitively demanding activities in pediatric out-of-hospital cardiac arrest.","authors":"Nathan Bahr, Jonathan Ivankovic, Garth Meckler, Matthew Hansen, Carl Eriksson, Jeanne-Marie Guise","doi":"10.1186/s41077-023-00253-4","DOIUrl":"10.1186/s41077-023-00253-4","url":null,"abstract":"<p><strong>Background: </strong>This methodological intersection article demonstrates a method to measure cognitive load in clinical simulations. Researchers have hypothesized that high levels of cognitive load reduce performance and increase errors. This phenomenon has been studied primarily by experimental designs that measure responses to predetermined stimuli and self-reports that reduce the experience to a summative value. Our goal was to develop a method to identify clinical activities with high cognitive burden using physiologic measures.</p><p><strong>Methods: </strong>Teams of emergency medical responders were recruited from local fire departments to participate in a scenario with a shockable pediatric out-of-hospital cardiac arrest (POHCA) patient. The scenario was standardized with the patient being resuscitated after receiving high-quality CPR and 3 defibrillations. Each team had a person in charge (PIC) who wore a functional near-infrared spectroscopy (fNIRS) device that recorded changes in oxygenated and deoxygenated hemoglobin concentration in their prefrontal cortex (PFC), which was interpreted as cognitive activity. We developed a data processing pipeline to remove nonneural noise (e.g., motion artifacts, heart rate, respiration, and blood pressure) and detect statistically significant changes in cognitive activity. Two researchers independently watched videos and coded clinical tasks corresponding to detected events. Disagreements were resolved through consensus, and results were validated by clinicians.</p><p><strong>Results: </strong>We conducted 18 simulations with 122 participants. Participants arrived in teams of 4 to 7 members, including one PIC. We recorded the PIC's fNIRS signals and identified 173 events associated with increased cognitive activity. [Defibrillation] (N = 34); [medication] dosing (N = 33); and [rhythm checks] (N = 28) coincided most frequently with detected elevations in cognitive activity. [Defibrillations] had affinity with the right PFC, while [medication] dosing and [rhythm checks] had affinity with the left PFC.</p><p><strong>Conclusions: </strong>FNIRS is a promising tool for physiologically measuring cognitive load. We describe a novel approach to scan the signal for statistically significant events with no a priori assumptions of when they occur. The events corresponded to key resuscitation tasks and appeared to be specific to the type of task based on activated regions in the PFC. Identifying and understanding the clinical tasks that require high cognitive load can suggest targets for interventions to decrease cognitive load and errors in care.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"15"},"PeriodicalIF":2.8,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500340","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":"Building low-cost simulators for invasive ultrasound-guided procedures using the V-model.","authors":"Vilma Johnsson,&nbsp;Martin Grønnebæk Tolsgaard,&nbsp;Olav Bennike Bjørn Petersen,&nbsp;Morten Bo Søndergaard Svendsen","doi":"10.1186/s41077-023-00254-3","DOIUrl":"https://doi.org/10.1186/s41077-023-00254-3","url":null,"abstract":"<p><p>The use of medical simulators for training technical and diagnostic skills has rapidly increased over the past decade. Yet, most available medical simulators have not been developed based on a structured evaluation of their intended uses but rather out of expected commercial value. Moreover, educators often struggle to access simulators because of cost or because no simulators have been developed for a particular procedure. In this report, we introduce \"the V-model\" as a conceptual framework to illustrate how simulator development can be guided by the intended uses in an iterative fashion. Applying a needs-based conceptual framework when developing simulators is important to increase the accessibility and sustainability of simulation-based medical education. It will minimize the developmental barriers and costs, while at the same time improving educational outcomes. Two new simulators for invasive ultrasound-guided procedures are used as examples, the chorionic villus sampling model and the ultrasound-guided aspiration trainer. Our conceptual framework and the use cases can serve as a template for future simulator development and documentation hereof.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857886","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":"Correction: Effect of repeat refresher courses on neonatal resuscitation skill decay: an experimental comparative study of in-person and video-based simulation training.","authors":"Julia M McCaw,&nbsp;Sarah E Gardner Yelton,&nbsp;Sean A Tackett,&nbsp;Rainier M L L Rapal,&nbsp;Arianne N Gamalinda,&nbsp;Amelia Arellano-Reyles,&nbsp;Genevieve D Tupas,&nbsp;Ces Derecho,&nbsp;Fides Ababon,&nbsp;Jill Edwardson,&nbsp;Nicole A Shilkofski","doi":"10.1186/s41077-023-00252-5","DOIUrl":"https://doi.org/10.1186/s41077-023-00252-5","url":null,"abstract":"","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9330993","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":"Data-driven resuscitation training using pose estimation.","authors":"Kerrin E Weiss,&nbsp;Michaela Kolbe,&nbsp;Andrina Nef,&nbsp;Bastian Grande,&nbsp;Bravin Kalirajan,&nbsp;Mirko Meboldt,&nbsp;Quentin Lohmeyer","doi":"10.1186/s41077-023-00251-6","DOIUrl":"https://doi.org/10.1186/s41077-023-00251-6","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary resuscitation (CPR) training improves CPR skills while heavily relying on feedback. The quality of feedback can vary between experts, indicating a need for data-driven feedback to support experts. The goal of this study was to investigate pose estimation, a motion detection technology, to assess individual and team CPR quality with the arm angle and chest-to-chest distance metrics.</p><p><strong>Methods: </strong>After mandatory basic life support training, 91 healthcare providers performed a simulated CPR scenario in teams. Their behaviour was simultaneously rated based on pose estimation and by experts. It was assessed if the arm was straight at the elbow, by calculating the mean arm angle, and how close the distance between the team members was during chest compressions, by calculating the chest-to-chest distance. Both pose estimation metrics were compared with the expert ratings.</p><p><strong>Results: </strong>The data-driven and expert-based ratings for the arm angle differed by 77.3%, and based on pose estimation, 13.2% of participants kept the arm straight. The chest-to-chest distance ratings by expert and by pose estimation differed by 20.7% and based on pose estimation 63.2% of participants were closer than 1 m to the team member performing compressions.</p><p><strong>Conclusions: </strong>Pose estimation-based metrics assessed learners' arm angles in more detail and their chest-to-chest distance comparably to expert ratings. Pose estimation metrics can complement educators with additional objective detail and allow them to focus on other aspects of the simulated CPR training, increasing the training's success and the participants' CPR quality.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9671112","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 equity, diversity, and inclusion in a simulation program using the SIM-EDI tool: the impact of a reflexive tool for simulation educators.","authors":"Eve Purdy,&nbsp;Ben Symon,&nbsp;Ruth-Ellen Marks,&nbsp;Chris Speirs,&nbsp;Victoria Brazil","doi":"10.1186/s41077-023-00250-7","DOIUrl":"https://doi.org/10.1186/s41077-023-00250-7","url":null,"abstract":"<p><strong>Background: </strong>There have been increasing calls for awareness and action related to equity, diversity, and inclusion (EDI) in simulation but a lack of practical guidance for how simulation delivery teams (SDTs) might move towards meaningful transformation. The gap between academic conversations about EDI and how to practically impact SDT attitudes, behaviors, and performance remains considerable. We designed a conversational tool, the SIM-EDI, to bridge the gap between theory and practice for SDTs by enhancing reflexivity and studied its impact locally.</p><p><strong>Methods: </strong>We engaged in a collaborative autoethnography to explore EDI within our emergency department SDT shortly after implementing the SIM-EDI. The 12-month ethnography is informed by our team's collection and analysis of data about ourselves and our own experiences using the tool. Data included serial interviews, field notes from simulations and SDT meetings, SDT documents, and self-reflections.</p><p><strong>Results: </strong>We found the SIM-EDI tool could be implemented with a team with a high level of readiness. Use of the tool had several meaningful impacts including enhanced team reflexivity, normalization of conversations related to EDI and increased confidence to engage in EDI conversations with participants. Key themes throughout the process included (1) individual and team growth, (2) fear of \"getting it wrong\", and (3) tension between bias towards action and need for slow reflection.</p><p><strong>Conclusion: </strong>The SIM-EDI tool can effectively promote reflexivity among faculty in an emergency department simulation program. The tool is easy to use and implement, impacts attitudes and behaviors, and facilitates individual and team growth.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9593877","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":"Three perspectives on learning in a simulated patient scenario: a qualitative interview study with student, simulated patient, and teacher.","authors":"Sten Erici,&nbsp;Daniel Lindqvist,&nbsp;Mats B Lindström,&nbsp;Christina Gummesson","doi":"10.1186/s41077-023-00249-0","DOIUrl":"https://doi.org/10.1186/s41077-023-00249-0","url":null,"abstract":"<p><strong>Introduction: </strong>Patient simulation can be useful for medical students in developing communication skills for vulnerable situations. Three participants are primarily involved in the patient simulation activities: the student, the simulated patient (SP), and the teacher. We here aimed to explore these participants' perceptions of learning in a patient simulation scenario.</p><p><strong>Methods: </strong>We conducted individual interviews with eight students, three teachers, and one SP at a psychiatry placement of a Medical Doctor Program (5th year). During the interviews we asked the participants to watch a video of their participation in a patient simulation session. Thus, we obtained three perspectives on each of the eight recordings. We analysed our data with qualitative content analysis.</p><p><strong>Results: </strong>Three themes were generated: identity formation, collaborative learning, and learning intentions. This highly emotional scenario forced students out of their comfort zone, to the intersection of their roles as private person and professional. The SP perceived the collaborative creation of the scenario as significant learning. The teacher took a professional position and perceived the learning in the perspective of a future colleague.</p><p><strong>Conclusions: </strong>The mutually created emotionally loaded scenario was found to be important from all three perspectives, forcing the students to identify unexpected ways of communicating. This possibly enhanced their professional identity development. Implications for future research can be to explore the process of skills transfer.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10029280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513436","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}