The effect of high-fidelity simulation in medical nursing based on the healthcare simulation standards of best practice

Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.

A review of clinical reasoning in nursing education:based on high-fidelity simulation teaching method

Objective： Clinical reasoning is an essential feature of health care practice; it is also a crucial ability for providing patient care of high quality. It has been identified that graduate nurses may lack the clinical reasoning skills to deliver safe and effective patient cam. It is therefore of paramount importance to enhance nursing students＇ clinical reasoning ability. High-fidelity simulation （HFS） is proved to be an effective teaching and learning method, which may also have some advantages over other teaching methods. Methods： The authors retrospectively reviewed the related literature, illustrated the application of high-fidelity simulation teaching method in nursing education, putting the focus on the use of it in teaching with clinical reasoning. Results： The application of high-fidelity simulation to nursing education can simulate the clinical situation, thus to create a safe, continuous and efficient learning environment for students, and it can effectively improve students＇ clinical reasoning ability. Conclusions： high-fidelity simulation is effective for clinical reasoning teaching in nursing education. The extension of its application in China should be of great value. The relevant further study is suggested focusing on how to overcome its own limitations and have it better applied in nursing education in China.

Evaluation of undergraduate students’nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient

Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.

Nursing student perspectives of high-fidelity simulation in Macao

Objective The purpose of this study was to explore student perspectives of high-fidelity simulation.Methods A descriptive study with semi-structured focus group interviews was conducted in Macao.Twenty-one focus group interviews were held with 113 baccalaureate nursing students who had experienced 36-hour of simulation.Results Students perceived that simulation created a nonrisk learning environment,and was helpful in knowledge and skill enhancement and nurse role understanding.However,lack of realistic interactions in psychosocial responses made it difficult for students to relate simulation experience to real-working situations,and poor group contributions affected their learning.ConclusionInteracting with a human patient simulator does not replicate the experience of working with a live patient.Tutors need to come up with ideas about how to make scenarios more real and give more forthright responses to improve the realism of psychosocial responses during simulation.Students experienced uncertainty with clinical decision making and commented on the minimal contributions of some group members.Tutors should be prepared to provide students with substantial supports in developing their understanding of simulation and engaging in the learning process.

Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation:a Delphi consensus study

Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。

Molecular simulation study of the microstructures and properties of pyridinium ionic liquid[HPy][BF_(4)]mixed with acetonitrile

The microstructures and thermodynamic properties of mixed systems comprising pyridinium ionic liquid[HPy][BF_(4)]and acetonitrile at different mole fractions were studied using molecular dynamics simulation in this work.The following properties were determined:density,self-diffusion coefficient,excess molar volume,and radial distribution function.The results show that with an increase in the mole fraction of[HPy][BF_(4)],the self-diffusion coefficient decreases.Additionally,the excess molar volume initially decreases,reaches a minimum,and then increases.The rules of radial distribution functions(RDFs)of characteristic atoms are different.With increasing the mole fraction of[HPy][BF_(4)],the first peak of the RDFs of HA1-F decreases,while that of CT6-CT6 rises at first and then decreases.This indicates that the solvent molecules affect the polar and non-polar regions of[HPy][BF_(4)]differently.

The effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors

Objective： To investigate the effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors. Methods： A high-fidelity teaching simulation on clinical nursing practices using intelligent human analogues was conducted with 200 students, and The Simulation Design Scale, and the Student Satisfaction and Self-Confidence in Learning Scale developed by the National League for Nursing were used to evaluate the training effectiveness and its influencing factors. Results： For the high-fidelity teaching simulation, students gave scores of 4.36± 0.54 points for satisfaction and 4.33 ± 0.46 points for Self-Confidence. The students highly rated the five dimensions of teaching design, i.e., teaching objectives/information, assistance/support for students, problem solving, guided feedback, and fidelity. The teaching design was closely correlated with the satisfaction of the high-fidelity teaching simulation and self-efficacy, and the dimensions of teaching objectives/informa- tion and assistance/support for students were particularly strong predictors of teaching effectiveness. Conclusions： A high-fidelity teaching simulation based on Jeffries＇ theoretical framework improved student satisfaction with the simulation and their Self-Confidence. In planning simulations, teachers should take into account five characteristics, i.e., teaching objectives/information on simulation education, assistance/support for students, problem solving, guided reflection, and fidelity, to achieve better teaching effectiveness.

基于Plant Simulation的化纤自动落丝系统仿真实验分析

基于Plant Simulation软件,构建一种化纤自动落丝系统的3D数字化模型,对系统效率关键输入因子进行参数化设置,将系统各工位三维数字模型导入软件中建立层次化运动机构图形结构,并运用Simltalk语言实现三维动作仿真,通过基础物理参数设置,保证了仿真数字化模型与现实系统更具一致性。通过多级实验设计分析了系统影响因子对于系统效率的影响特性曲线,并进一步通过动态参数化实验方法,计算出双输入因子对系统效能影响的敏感度。该实验结果可为化纤自动落丝系统的建设成本控制与可行性分析提供指导,具有较好的工程应用价值。

基于Simulation X的多轴转向系统功能安全仿真分析

基于ISO 26262《道路车辆功能安全》的标准要求,对特种车的多轴电液转向系统进行分析,以提高系统的安全性和可靠性。运用Simulation X软件建立详细的多轴特种车仿真模型,通过模拟故障模式注入进行仿真试验。对仿真结果和数据进行分析,评估得到故障的严重性、暴露度和可控性,从而确定相应的汽车安全完整性等级。基于故障注入仿真的汽车功能安全分析方法,在系统早期设计阶段可以作为评估架构安全性的重要手段。

基于Plant Simulation的压气机叶片型线加工产线分析与优化

运用专业仿真软件Plant Simulation,根据压气机叶片型线机械加工工艺特点和物料运行流程建立生产线仿真模型,从产能、设备利用率及产线瓶颈等多方面进行仿真分析与优化。结果表明:Plant Simulation仿真平台的仿真可以找出规划设计方案中存在的问题并验证方案的合理性。该仿真结果为型线机械加工产线的优化设计提供了可靠依据,达到了节约投资成本和缩短设计周期的目的。

Exhaustive review of acceleration strategies for Monte Carlo simulations in photon transit

Monte Carlo simulation techniques have become the quintessence and a pivotal nexus of inquiry in the realm of simulating photon movement within biological fabrics.Through the stochastic sampling of tissue archetypes delineated by explicit optical characteristics,Monte Carlo simulations possess the theoretical capacity to render unparalleled accuracy in the depiction of exceedingly intricate phenomena.Nonetheless,the quintessential challenge associated with Monte Carlo simulation methodologies resides in their extended computational duration,which significantly impedes the refinement of their precision.Consequently,this discourse is specifically dedicated to exploring innovations in strategies and technologies aimed at expediting Monte Carlo simulations.It delves into the foundational concepts of various acceleration tactics,evaluates these strategies concerning their speed,accuracy,and practicality,and amalgamates a comprehensive overview and critique of acceleration methodologies for Monte Carlo simulations.Ultimately,the discourse envisages prospective trajectories for the employment of Monte Carlo techniques within the domain of tissue optics.

Global hybrid simulations of soft X-ray emissions in the Earth’s magnetosheath

Earth’s magnetopause is a thin boundary separating the shocked solar wind plasma from the magnetospheric plasmas,and it is also the boundary of the solar wind energy transport to the magnetosphere.Soft X-ray imaging allows investigation of the large-scale magnetopause by providing a two-dimensional(2-D)global view from a satellite.By performing 3-D global hybrid-particle-in-cell(hybrid-PIC)simulations,we obtain soft X-ray images of Earth’s magnetopause under different solar wind conditions,such as different plasma densities and directions of the southward interplanetary magnetic field.In all cases,magnetic reconnection occurs at low latitude magnetopause.The soft X-ray images observed by a hypothetical satellite are shown,with all of the following identified:the boundary of the magnetopause,the cusps,and the magnetosheath.Local X-ray emissivity in the magnetosheath is characterized by large amplitude fluctuations(up to 160%);however,the maximum line-of-sight-integrated X-ray intensity matches the tangent directions of the magnetopause well,indicating that these fluctuations have limited impact on identifying the magnetopause boundary in the X-ray images.Moreover,the magnetopause boundary can be identified using multiple viewing geometries.We also find that solar wind conditions have little effect on the magnetopause identification.The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)mission will provide X-ray images of the magnetopause for the first time,and our global hybrid-PIC simulation results can help better understand the 2-D X-ray images of the magnetopause from a 3-D perspective,with particle kinetic effects considered.

The Probability Density Function Related to Shallow Cumulus Entrainment Rate and Its Influencing Factors in a Large-Eddy Simulation

The process of entrainment-mixing between cumulus clouds and the ambient air is important for the development of cumulus clouds.Accurately obtaining the entrainment rate(λ)is particularly important for its parameterization within the overall cumulus parameterization scheme.In this study,an improved bulk-plume method is proposed by solving the equations of two conserved variables simultaneously to calculateλof cumulus clouds in a large-eddy simulation.The results demonstrate that the improved bulk-plume method is more reliable than the traditional bulk-plume method,becauseλ,as calculated from the improved method,falls within the range ofλvalues obtained from the traditional method using different conserved variables.The probability density functions ofλfor all data,different times,and different heights can be well-fitted by a log-normal distribution,which supports the assumed stochastic entrainment process in previous studies.Further analysis demonstrate that the relationship betweenλand the vertical velocity is better than other thermodynamic/dynamical properties;thus,the vertical velocity is recommended as the primary influencing factor for the parameterization ofλin the future.The results of this study enhance the theoretical understanding ofλand its influencing factors and shed new light on the development ofλparameterization.

Frontogenesis and Frontolysis of a Cold Filament Driven by the Cross-Filament Wind and Wave Fields Simulated by a Large Eddy Simulation

The variations of the frontogenetic trend of a cold filament induced by the cross-filament wind and wave fields are studied by a non-hydrostatic large eddy simulation. Five cases with different strengths of wind and wave fields are studied.The results show that the intense wind and wave fields further break the symmetries of submesoscale flow fields and suppress the levels of filament frontogenesis. The changes of secondary circulation directions—that is, the conversion between the convergence and divergence of the surface cross-filament currents with the downwelling and upwelling jets in the filament center—are associated with the inertial oscillation. The filament frontogenesis and frontolysis caused by the changes of secondary circulation directions may periodically sharpen and smooth the gradient of submesoscale flow fields.The lifecycle of the cold filament may include multiple stages of filament frontogenesis and frontolysis.

Propagation Properties of Shock Waves in Polyurethane Foam based on Atomistic Simulations

Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of porosity on the shock waves is studied with classical molecular dynamics simulations.Firstly,shock Hugoniot relations for different porosities are obtained,which compare well with the experimental data.The pores collapse and form local stress wave,which results in the complex multi-wave structure of the shock wave.The microstructure analysis shows that the local stress increases and the local velocity decreases gradually during the process of pore collapse to complete compaction.Finally,it leads to stress relaxation and velocity homogenization.The shock stress peaks can be fitted with two exponential functions,and the amplitude of attenuation coefficient decreases with the increase of density.Besides,the pore collapse under shock or non-shock are discussed by the entropy increase rate of the system.The energy is dissipated mainly through the multiple interactions of the waves under shock.The energy is dissipated mainly by the friction between atoms under non-shock.

基于Simulation的薄壁桶搬运过程的形变研究

桶料的搬运方式主要有托底式、夹取式和挂取(吊取)式,文中针对薄壁桶的搬运方式进行模拟分析,通过模拟分析的具体数值来进行合理的选择。主要对挂取(吊取)和夹取2种薄壁桶的搬运方式进行模拟分析,基于Soildworks中的Simulation进行计算,并得出具体数值,选取合理的薄壁桶搬运方式。模拟分析表明:在同等桶壁厚的情况下,夹取式桶料搬运形式薄壁桶的变形程度较大,主要体现在薄壁桶的夹持部位,如特定场景需夹持薄壁桶的桶身进行搬运时,还需适当加厚薄壁桶的桶壁来抵抗夹持板的夹持力,使薄壁桶不会产生较大的形变量。

Microwave-induced thermoacoustic elastic imaging:A simulation study

Microwave-induced thermoacoustic imaging(MTI)has the advantages of high resolution,high contrast,non-ionization,and non-invasive.Recently,MTI was used in the¯eld of breast cancer screening.In this paper,based on the¯nite element method(FEM)and COMSOL Multiphysics software,a three-dimensional breast cancer model suitable for exploring the MTI process is proposed to investigate the in°uence of Young's modulus(YM)of breast cancer tissue on MTI.It is found that the process of electromagnetic heating and initial pressure generation of the entire breast tissue is earlier in time than the thermal expansion process.Besides,compared with normal breast tissue,tumor tissue has a greater temperature rise,displacement,and pressure rise.In particular,YM of the tumor is related to the speed of thermal expansion.In particular,the larger the YM of the tumor is,the higher the heating and contraction frequency is,and the greater the maximum pressure is.Di®erent Young's moduli correspond to di®erent thermoacoustic signal spectra.In MTI,this study can be used to judge di®erent degrees of breast cancer based on elastic imaging.In addition,this study is helpful in exploring the possibility of microwave-induced thermoacoustic elastic imaging(MTAE).

Simulation study of the performance of the Very Large Area gamma-ray Space Telescope

The Very Large Area gamma-ray Space Telescope(VLAST)is a mission concept proposed to detect gamma-ray photons through both Compton scattering and electron–positron pair production mechanisms,thus enabling the detection of photons with energies ranging from MeV to TeV.This project aims to conduct a comprehensive survey of the gamma-ray sky from a low-Earth orbit using an anti-coincidence detector,a tracker detector that also serves as a low-energy calorimeter,and a high-energy imaging calorimeter.We developed a Monte Carlo simulation application of the detector using the GEANT4 toolkit to evaluate the instrument performance,including the effective area,angular resolution,and energy resolution,and explored specific optimizations of the detector configuration.Our simulation-based analysis indicates that the current design of the VLAST is physically feasible,with an acceptance above 10 m^(2)sr which is four times larger than that of the Fermi-LAT,an energy resolution better than 2%at 10 GeV,and an angular resolution better than 0.2◦at 10 GeV.The VLAST project promises to make significant contributions to the field of gamma-ray astronomy and enhance our understanding of the cosmos.

Magnetopause properties at the dusk magnetospheric flank from global magnetohydrodynamic simulations,the kinetic Vlasov equilibrium,and in situ observations--Potential implications for SMILE

We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscale 2(MMS2)spacecraft.We used global magnetohydrodynamic(MHD)simulations of the Earth’s magnetosphere(publicly available from the NASA-CCMC[National Aeronautics and Space Administration–Community Coordinated Modeling Center])and local Vlasov equilibrium models(based on kinetic models for tangential discontinuities)to extract spatial profiles of the plasma and field variables at the Earth’s MP.The global MHD simulations used initial solar wind conditions extracted from the OMNI database at the time epoch when the MMS2 observes the MP.The kinetic Vlasov model used asymptotic boundary conditions derived from the same in situ MMS measurements upstream or downstream of the MP.The global MHD simulations provide a three-dimensional image of the magnetosphere at the time when the MMS2 crosses the MP.The Vlasov model provides a one-dimensional local view of the MP derived from first principles of kinetic theory.The MMS2 experimental data also serve as a reference for comparing and validating the numerical simulations and modeling.We found that the MP transition layer formed in global MHD simulations was generally localized closer to the Earth(roughly by one Earth radius)from the position of the real MP observed by the MMS.We also found that the global MHD simulations overestimated the thickness of the MP transition by one order of magnitude for three analyzed variables:magnetic field,density,and tangential speed.The MP thickness derived from the local Vlasov equilibrium was consistent with observations for all three of these variables.The overestimation of density in the Vlasov equilibrium was reduced compared with the global MHD solutions.We discuss our results in the context of future SMILE(Solar wind Magnetosphere Ionosphere Link Explorer)campaigns for observing the Earth’s MP.

Numerical simulation on sand sedimentation and erosion characteristics around HDPE sheet sand barrier under different wind angles

For the safety of railroad operations,sand barriers are utilized to mitigate wind-sand disaster effects.These disasters,characterized by multi-directional wind patterns,result in diverse angles among the barriers.In this study,using numerical simulations,we examined the behavior of High Density Polyethylene(HDPE)sheet sand barriers under different wind angles,focusing on flow field distribution,windproof efficiency,and sedimentation erosion dynamics.This study discovered that at a steady wind speed,airflow velocity varies as the angle between the airflow and the HDPE barrier changes.Specifically,a 90°angle results in the widest low-speed airflow area on the barrier’s downwind side.If the airflow is not perpendicular to the barrier,it prompts a lateral airflow movement which decreases as the angle expands.The windproof efficiency correlates directly with this angle but inversely with the wind’s speed.Notably,with a wind angle of 90°,wind speed drops by 81%.The minimum wind speed is found at 5.1H(the sand barrier height)on the barrier’s downwind side.As the angle grows,the barrier’s windproof efficiency improves,extending its protective reach.Sedimentation is most prominent on the barrier’s downwind side,as the wind angle shifts from 30°to 90°,the sand sedimentation area on the barrier’s downwind side enlarges by 14.8H.As the angle grows,sedimentation intensifies,eventually overtakes the forward erosion and enlarges the sedimentation area.