Advances in simulation (London, England)最新文献

{"title":"Exploring in-person self-led debriefings for groups of learners in simulation-based education: an integrative review.","authors":"Prashant Kumar, Susan Somerville","doi":"10.1186/s41077-023-00274-z","DOIUrl":"10.1186/s41077-023-00274-z","url":null,"abstract":"<p><strong>Background: </strong>Facilitator-led debriefings are well-established for debriefing groups of learners in immersive simulation-based education. However, there has been emerging interest in self-led debriefings whereby individuals or groups of learners conduct a debriefing themselves, without the presence of a facilitator. How and why self-led debriefings influence debriefing outcomes remains undetermined.</p><p><strong>Research aim: </strong>The aim of this study was to explore how and why in-person self-led debriefings influence debriefing outcomes for groups of learners in immersive simulation-based education.</p><p><strong>Methods: </strong>An integrative review was conducted, searching seven electronic databases (PubMed, Cochrane, Embase, ERIC, SCOPUS, CINAHL Plus, PsychINFO) for peer-reviewed empirical studies investigating in-person self-led debriefings for groups of learners. Data were extracted, synthesised, and underwent reflexive thematic analysis.</p><p><strong>Results: </strong>Eighteen empirical studies identified through the search strategy were included in this review. There was significant heterogeneity in respect to study designs, aims, contexts, debriefing formats, learner characteristics, and data collection instruments. The synthesised findings of this review suggest that, across a range of debriefing outcome measures, in-person self-led debriefings for groups of learners following immersive simulation-based education are preferable to conducting no debriefing at all. In certain cultural and professional contexts, such as postgraduate learners and those with previous debriefing experience, self-led debriefings can support effective learning and may provide equivalent educational outcomes to facilitator-led debriefings or self-led and facilitator-led combination strategies. Furthermore, there is some evidence to suggest that self-led and facilitator-led combination approaches may optimise participant learning, with this approach warranting further research. Reflexive thematic analysis of the data revealed four themes, promoting self-reflective practice, experience and background of learners, challenges of conducting self-led debriefings and facilitation and leadership. Similar to facilitator-led debriefings, promoting self-reflective practice within groups of learners is fundamental to how and why self-led debriefings influence debriefing outcomes.</p><p><strong>Conclusions: </strong>In circumstances where simulation resources for facilitator-led debriefings are limited, self-led debriefings can provide an alternative opportunity to safeguard effective learning. However, their true value within the scope of immersive simulation-based education may lie as an adjunctive method alongside facilitator-led debriefings. Further research is needed to explore how to best enable the process of reflective practice within self-led debriefings to understand how, and in which contexts, self-led debriefings are best employed and t","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"5"},"PeriodicalIF":2.8,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479698","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":"How simulated patients contribute to student learning in an authentic way, an interview study.","authors":"Annelies Lovink, Marleen Groenier, Anneke van der Niet, Heleen Miedema, Jan-Joost Rethans","doi":"10.1186/s41077-023-00277-w","DOIUrl":"10.1186/s41077-023-00277-w","url":null,"abstract":"<p><strong>Introduction: </strong>Simulated patients (SPs) play an instrumental role in teaching communication skills and enhancing learning outcomes. Prior research mostly focused on the SP's contribution to students' learning outcomes by providing feedback afterwards. A detailed understanding of the contribution of the SP during SP-student encounters is currently lacking although the majority of the interaction between SPs and students occurs during the SP-student encounter. Therefore, this study focuses on how SPs see their contribution to meaningful student learning experiences during SP-student encounters.</p><p><strong>Methods: </strong>We interviewed fifteen simulated patients from one institution. We explored their perspectives on meaningful learning experiences during SP-student encounters through in-depth, semi-structured interviews and analyzed using thematic analysis.</p><p><strong>Results: </strong>SPs view their contribution to meaningful student learning during SP-student encounters from two perspectives. A collective perspective as a member of the community of SPs and an individual perspective. From the collective perspective, SPs believe that the fact that students deal with multiple varied SP-student encounters over time is of value for meaningful learning. From the individual perspective, we noticed that SPs think, act, and react from three different positions. First, as the patient in the role description, second, as a teaching aid and third, as an individual with personal experiences, beliefs, and values. SPs mentioned that the ratio between these different positions can vary within and between encounters.</p><p><strong>Conclusions: </strong>According to SPs, we should value the variation between SPs, thereby creating meaningful variation in authentic interactions in SP-student encounters. SPs should be allowed to act and react from different positions during SP-student encounters, including their role description, as teaching aid, and based on their own experiences. In this way, SP-student encounters are optimized to contribute to meaningful student learning through authenticity.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10782599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139426190","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 simulation in healthcare education: a multi-professional, pan-Canadian evaluation.","authors":"Margaret Verkuyl, Efrem Violato, Nicole Harder, Theresa Southam, Mélanie Lavoie-Tremblay, Sandra Goldsworthy, Wendy Ellis, Suzanne H Campbell, Lynda Atack","doi":"10.1186/s41077-023-00276-x","DOIUrl":"10.1186/s41077-023-00276-x","url":null,"abstract":"<p><strong>Background: </strong>As we experience a shortage of healthcare providers in Canada, it has become increasingly challenging for healthcare educators to secure quality clinical placements. We evaluated the impact of virtual simulations created for the virtual work-integrated learning (Virtu-WIL) program, a pan-Canadian project designed to develop, test, and offer virtual simulations to enrich healthcare clinical education in Canada. Evaluation was important since the virtual simulations are freely available through creative commons licensing, to the global healthcare community.</p><p><strong>Methods: </strong>Students self-reported their experiences with the virtual simulations and the impact on their readiness for practice using a survey that included validated subscales. Open-ended items were included to provide insight into the students' experiences.</p><p><strong>Results: </strong>The evaluation included 1715 Nursing, Paramedicine and Medical Laboratory students enrolled in the Virtu-WIL program from 18 post-secondary universities, colleges, and institutions. Results showed most students found the virtual simulations engaging helped them learn and prepare for clinical practice. A key finding was that it is not sufficient to simply add virtual simulations to curriculum, careful planning and applying simulation pedagogy are essential.</p><p><strong>Conclusion: </strong>Virtual simulation experiences are increasingly being used in healthcare education. Results from this rigorous, large-scale evaluation identified ways to enhance the quality of these experiences to increase learning and to potentially decrease the number of hours healthcare students need in clinical practice to meet professional competencies. Further research is needed regarding many aspects of virtual simulations and, in particular, curriculum integration and the timing or sequencing of virtual simulations to best prepare students for practice.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10782638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418746","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":"Reflections on the design and application of 'Surveypura': a simulation-based pedagogical tool for quantitative research methods in public health and social sciences.","authors":"Adithya Pradyumna, Mukta Gundi","doi":"10.1186/s41077-023-00275-y","DOIUrl":"10.1186/s41077-023-00275-y","url":null,"abstract":"<p><p>It has been reported from various contexts that learning quantitative methods for public health and social research is challenging for students. Based on our observations of these challenges, we designed a simulation-based pedagogical tool called Surveypura to support classroom-based learning of quantitative research methods. The tool includes a large illustration of a fictional village with 155 houses, alongside data for each of the households. The features of the houses, household characteristics, and the village have been carefully designed to give the visual feel of an actual village and better assist the pedagogical process. The tool was used by five facilitators with their masters' students at our university in courses on social research and epidemiology. Our observations of the sessions and interactions with facilitators and students suggested that the tool supported more engaged learning of quantitative research methods in a non-intimidating manner. We believe that Surveypura can be a useful simulation-based pedagogical tool to teach quantitative research methods in epidemiology and social sciences even in other contexts.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378913","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 cardiopulmonary bypass: a high fidelity model for developing and accessing clinical perfusion skills.","authors":"Bruce E Searles, Jeffrey B Riley, Edward M Darling, Jason R Wiles","doi":"10.1186/s41077-023-00269-w","DOIUrl":"10.1186/s41077-023-00269-w","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, novice perfusionists learn and practice clinical skills, during live surgical procedures. The profession's accrediting body is directing schools to implement simulated cardiopulmonary bypass (CPB) into the curriculum. Unfortunately, no CPB simulation models have been validated. Here we describe the design and application of a CPB simulation model.</p><p><strong>Methods: </strong>A CPB patient simulator was integrated into a representative operative theater and interfaced with a simple manikin, a heart-lung machine (HLM), clinical perfusion circuitry, and equipment. Participants completed a simulation scenario designed to represent a typical CPB procedure before completing an exit survey to assess the fidelity and validity of the experience. Questions were scored using a 5-point Likert scale.</p><p><strong>Results: </strong>Participants (n = 81) contributed 953 opinions on 40 questions. The participants reported that the model of simulated CPB (1) realistically presented both the physiologic and technical parameters seen during CPB (n = 347, mean 4.37, SD 0.86), (2) accurately represented the psychological constructs and cognitive mechanisms of the clinical CPB (n = 139, mean 4.24, SD 1.08), (3) requires real clinical skills and reproduces realistic surgical case progression (n = 167, mean 4.38, SD 0.86), and (4) would be effective for teaching, practicing, and assessing the fundamental skills of CPB (n = 300, mean 4.54, SD 0.9). Participants agreed that their performance in the simulation scenario accurately predicted their performance in a real clinical setting (n = 43, mean 4.07, SD 1.03) CONCLUSION: This novel simulation model of CPB reproduces the salient aspects of clinical CPB and may be useful for teaching, practicing, and assessing fundamental skills.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"9 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089546","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: 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/s41077-023-00272-1","DOIUrl":"10.1186/s41077-023-00272-1","url":null,"abstract":"","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833262","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: TIDES: examining the influence of temporal individual differences on multitasking in educational simulation.","authors":"Ashley E Franklin, Laura Thielke, Gregory E Gilbert, Mary Waller","doi":"10.1186/s41077-023-00271-2","DOIUrl":"10.1186/s41077-023-00271-2","url":null,"abstract":"","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833263","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 reflection levels between facilitator-led and student-led debriefing in simulation training for paramedic students.","authors":"Carl Robert Christiansen, Jeanette Viggen Andersen, Peter Dieckmann","doi":"10.1186/s41077-023-00273-0","DOIUrl":"https://doi.org/10.1186/s41077-023-00273-0","url":null,"abstract":"<p><strong>Background: </strong>Simulation in healthcare attempts to create relevant representations of patient encounters. It provides experiential learning, bridging typical classroom activities and clinical practice. This study aims to investigate whether the principle of Peer-Assisted Learning can be used in simulation by letting simulation-experienced paramedic students prepare, deliver, and debrief their own simulations, with minimal faculty assistance. This could be a way to support student learning by being involved in teaching, and it might at the same time optimise the cost-effectiveness of simulation-based training.</p><p><strong>Methods: </strong>This observational non-inferiority study compared reflection levels between facilitator-led and student-led simulation and debriefing, between scenario types, and compared the number of turns in which students are involved in both settings. Third-year Bachelor in Paramedic Science students' debriefings were filmed and transcribed. The degree of reflection in students' statements was rated according to a modified version of Fleck's analytical framework of reflection levels, assigning scores from lowest (R0 description) to highest (R4 critical reflection). Facilitator-led and student-led debriefings were compared using chi-square tests. Scenarios were also analysed according to type (paediatric emergencies and complex assessments) regardless of who led the simulation.</p><p><strong>Results: </strong>Ten facilitator-led and 12 student-led debriefings were analysed. Students gave 682 (49%) contributions in the facilitator-led debriefings, and 702 (51%) contributions in student-led debriefings. Comparison of reflection levels between facilitator-led and student-led debriefings was respectively: R0-level 32.7% vs 33.8%, R1-level 44.0% vs 44.3%, R2-level 14.7% vs 17.1%, R3-level 0.1% vs 1.3%, and R4-level 0.1% vs 0.1%. There were no statistically significant differences in reflection levels between facilitator-led and student-led debriefings (p = 0.178). Comparing the reflection levels between the scenarios on \"paediatric emergencies\" and \"complex assessments\", the results were respectively: R0-level 35.4% vs. 31.7%-level, R1-level 45.3% vs. 43.3%-level, R2-level 13.4% vs. 17.8%, R3-level 0.5% vs. 0.9%, and R4-level 0.0% vs. 0.3%. These differences were statistically significant (p = 0.010). No significant differences in engagement were found between debriefings led by a student or a facilitator, when measuring the number of turns in the conversations.</p><p><strong>Conclusions: </strong>Facilitator-led and student-led debriefings resulted in equivalent reflection levels amongst students. Student-led simulation is potentially a cost-effective supplement to regular simulation within a healthcare degree program. Since complex scenarios provided higher reflection levels than paediatric, scenario design might influence reflection levels.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809547","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":"Simulation-based development: shaping clinical procedures for extra-uterine life support technology.","authors":"J S van Haren, M B van der Hout-van der Jagt, N Meijer, M Monincx, F L M Delbressine, X L G Griffith, S G Oei","doi":"10.1186/s41077-023-00267-y","DOIUrl":"10.1186/s41077-023-00267-y","url":null,"abstract":"<p><strong>Background: </strong>Research into Artificial Placenta and Artificial Womb (APAW) technology for extremely premature infants (born < 28 weeks of gestation) is currently being conducted in animal studies and shows promising results. Because of the unprecedented nature of a potential treatment and the high-risk and low incidence of occurrence, translation to the human condition is a complex task. Consequently, the obstetric procedure, the act of transferring the infant from the pregnant woman to the APAW system, has not yet been established for human patients. The use of simulation-based user-centered development allows for a safe environment in which protocols and devices can be conceptualized and tested. Our aim is to use participatory design principles in a simulation context, to gain and integrate the user perspectives in the early design phase of a protocol for this novel procedure.</p><p><strong>Methods: </strong>Simulation protocols and prototypes were developed using an iterative participatory design approach; usability testing, including general and task-specific feedback, was obtained from participants with clinical expertise from a range of disciplines. The procedure made use of fetal and maternal manikins and included animations and protocol task cards.</p><p><strong>Results: </strong>Physical simulation with the active participation of clinicians led to the diffusion of tacit knowledge and an iteratively formed shared understanding of the requirements and values that needed to be implemented in the procedure. At each sequel, participant input was translated into simulation protocols and design adjustments.</p><p><strong>Conclusion: </strong>This work demonstrates that simulation-based participatory design can aid in shaping the future of clinical procedure and product development and rehearsing future implementation with healthcare professionals.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479533","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":"Observation of behavioural skills by medical simulation facilitators: a cross-sectional analysis of self-reported importance, difficulties, observation strategies and expertise development.","authors":"Lars Mommers, Daniëlle Verstegen, Diana Dolmans, Walther N K A van Mook","doi":"10.1186/s41077-023-00268-x","DOIUrl":"https://doi.org/10.1186/s41077-023-00268-x","url":null,"abstract":"<p><strong>Background: </strong>The association between team performance and patient care was an immense boost for team-based education in health care. Behavioural skills are an important focus in these sessions, often provided via a mannikin-based immersive simulation experience in a (near) authentic setting. Observation of these skills by the facilitator(s) is paramount for facilitated feedback with the team. Despite the acknowledgement that trained facilitators are important for optimal learning, insight into this observation process by facilitators is limited.</p><p><strong>Objectives: </strong>What are the self-reported current practices and difficulties regarding the observation of behavioural skills amongst facilitators during team training and how have they been trained to observe behavioural skills?</p><p><strong>Methods: </strong>This cross-sectional study used a pilot-tested, content-validated, multi-linguistic online survey within Europe, distributed through a non-discriminative snowball sampling method. Inclusion was limited to facilitators observing behavioural skills within a medical team setting.</p><p><strong>Results: </strong>A total of 175 persons filled in the questionnaire. All aspects of behavioural skill were perceived as very important to observe. The self-perceived difficulty of the behavioural skill aspects ranged from slightly to moderately difficult. Qualitative analysis revealed three major themes elaborating on this perceived difficulty: (1) not everything can be observed, (2) not everything is observed and (3) interpretation of observed behavioural skills is difficult. Additionally, the number of team members health care facilitators have to observe, outnumbers their self-reported maximum. Strategies and tools used to facilitate their observation were a blank notepad, co-observers and predefined learning goals. The majority of facilitators acquired observational skills through self-study and personal experience and/or observing peers. Co-observation with either peers or experts was regarded as most learn some for their expertise development. Overall, participants perceived themselves as moderately competent in the observation of behavioural skills during team training.</p><p><strong>Conclusions: </strong>Observation of behavioural skills by facilitators in health care remains a complex and challenging task. Facilitators' limitations with respect to attention, focus and (in)ability to perform concomitant tasks, need to be acknowledged. Although strategies and tools can help to facilitate the observation process, they all have their limitations and are used in different ways.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"8 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10685611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464704","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}