The Outcomes of Integrating High Fidelity Simulation in Nursing Education: An Integrative Review

Purpose: The purpose of this review was to identify the best evidence on the effectiveness of using high fidelity simulation technology for learning outcomes in nursing education. Methods: An integrative review was used to assess the effectiveness of high fidelity simulation in nursing education. Data search was between 2008 to 2018 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, ERIC, Joanna Briggs Institute and EBSCO host. A total of 17 articles met the eligibility criteria. Results: The seventeen reviewed articles were adopted mixed method designs, randomized controlled trial, quazi-experimental, and correlational studies. Themes were: self-satisfaction and confidence, clinical decision-making, and clinical judgment. Conclusion: Nursing literature supports the importance of including high fidelity simulation in nursing education. HFS provides diverse learning experiences, promotes decision-making and clinical judgment, self-satisfaction and self-confidence to develop assessment and safe practice. Implication: Nursing educators can create a variety of patient conditions for collaborative nursing care for increasing learning outcomes.

The Impact of Simulation Education on Self-Efficacy in Pre-Registration Nursing Students

This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .

Application of Patient Simulators Combined with Internet plus Scenario Simulation Teaching Models on Intravenous Infusion Nursing Education in China

Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence for the implementation of advanced teaching models in future nursing education. Methods: Enrolled 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023 for research. 30 nurses who were trained in traditional teaching models from January to December 2022 were selected as the control group, and 30 nurses who were trained with simulation-based teaching models with methods including simulated patients, internet, online meetings which can be replayed and scenario simulation, etc. from January to December 2023 were selected as the experimental group. Evaluated the learning outcomes based on the Competency Inventory for Nursing Students (CINS), Problem-Solving Inventory (PSI), comprehensive learning ability, scientific research ability, and proficiency in the theoretical knowledge and practical skills of IV infusion therapy. Nursing quality, the incidence of IV infusion therapy complications and nurse satisfaction with different teaching models were also measured. Results: The scientific research ability, PSI scores, CINS scores, and comprehensive learning ability of the experimental group were better than those of the control group (P 0.05), and their assessment results of practical skills, nursing quality of IV infusion therapy during training, and satisfaction with teaching models were all better than those of the control group with statistical significance (P < 0.05). The incidence of IV infusion therapy complications in the experimental group was lower than that in the control group, indicating statistical significance (P < 0.05). Conclusions: Teaching models based on patient simulators combined with Internet Plus scenario simulation enable nursing students to learn more directly and practice at any time and in any place, and can improve their proficiency in IV infusion theoretical knowledge and skills (e.g. PICC catheterization), core competencies, problem-solving ability, comprehensive learning ability, scientific research ability and the ability to deal with complicated cases. Also, it helps provide high-quality nursing education, improve the nursing quality of IV therapy, reduce the incidence of related complications, and ensure the safety of patients with IV therapy.

Construction of a Virtual Simulation Practice Teaching System of the Chemical Industry Under the Background of Integration of Production and Education

With the development of the integration of production and education,chemical engineering and technology education is facing many new challenges and opportunities.The construction of a chemical virtual simulation practice teaching system under the background of integration of production and education aims to improve students’learning efficiency and innovation ability with the help of virtual simulation technology,so as to meet the needs of future industrial development.This paper discusses the significance of the construction of the system,analyzes the difficulties and challenges that may be encountered in the construction process,and evaluates the effective strategies to strengthen the construction of the system.Through the introduction of virtual simulation technology,students can improve their practical skills and innovation ability,and better adapt to the development needs of industrialization and informatization.

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.

Short Text Mining for Classifying Educational Objectives and Outcomes

Most of the international accreditation bodies in engineering education(e.g.,ABET)and outcome-based educational systems have based their assess-ments on learning outcomes and program educational objectives.However,map-ping program educational objectives(PEOs)to student outcomes(SOs)is a challenging and time-consuming task,especially for a new program which is applying for ABET-EAC(American Board for Engineering and Technology the American Board for Engineering and Technology—Engineering Accreditation Commission)accreditation.In addition,ABET needs to automatically ensure that the mapping(classification)is reasonable and correct.The classification also plays a vital role in the assessment of students’learning.Since the PEOs are expressed as short text,they do not contain enough semantic meaning and information,and consequently they suffer from high sparseness,multidimensionality and the curse of dimensionality.In this work,a novel associative short text classification tech-nique is proposed to map PEOs to SOs.The datasets are extracted from 152 self-study reports(SSRs)that were produced in operational settings in an engineering program accredited by ABET-EAC.The datasets are processed and transformed into a representational form appropriate for association rule mining.The extracted rules are utilized as delegate classifiers to map PEOs to SOs.The proposed asso-ciative classification of the mapping of PEOs to SOs has shown promising results,which can simplify the classification of short text and avoid many problems caused by enriching short text based on external resources that are not related or relevant to the dataset.

Application of Simulation Technology in Military Education

Based on the teaching characteristics in military academies,simulation technology has been applied in their teaching methods.The issues faced in the application of virtual simulation technology to relevant professional teaching in armed police academies are analyzed in this article.Secondly,in view of the difficulties encountered in the organization and implementation of practical teaching as well as in the development of the current teaching,this article explores the impact of simulation technology in its application in teaching methods,training practices,and teaching channels.

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.

Medical simulation-based education improves medicos' clinical skills

Clinical skill is an essential part of clinical medicine and plays quite an important role in bridging medicos and physicians. Due to the realities in China, traditional medical education is facing many challenges. There are few opportunities for students to practice their clinical skills and their dexterities are generally at a low level. Medical simulation-based education is a new teaching modality and helps to improve medicos＇ clinical skills to a large degree. Medical simulation-based education has many significant advantages and will be further developed and applied.

The future of simulation in medical education

Simulation has made significant in-roads into the provision of medical education over the past twenty years. Simulation made its first impact in specialities such as emergency medicine and anaesthetics; however, it is now being used as an educational modality in a diverse range of specialities - from general practice to psychiatry. Perhaps the greatest pointer of the success of simulation is that it is now increasingly being seen as embedded in medical education and no longer something new and different. So now is probably an appropri- ate time to consider the future of simulation. Where will simulation go next？ It is likely that a number of different themes will emerge.

Simulation-a new educational paradigm?

Simulation is a modem educational tool that has recently gained in the field of medical education. The use of simulation continues to expand, and studies evaluating the effectiveness of simulation-based medical education are ongoing. The history of medical education and adult educational theory are reviewed, and the details of effective simulation techniques are described. Finally, outcomes of simulation-based medical education are summarized.

Bronchoscopy Simulation in Anesthesia Resident Education

Simulation in residency training is becoming more popular but there is limited evidence showing that it can improve a resident’s fund of knowledge, particularly in anesthesiology. We looked at whether a bronchoscopy simulation could improve performance on a thoracic anesthesia knowledge test administered both before and after using the simulator. Fourteen first-year anesthesiology residents completed the study with an average improvement on the test of 28% (p 0.05). We conclude that bronchoscopy simulation is an effective method of educating anesthesiology residents.

Review of simulation model for education of point-of-care ultrasound using easy-to-make tools

Point-of-care ultrasound(POCUS)is a powerful diagnostic tool and provides treatment guidelines in acute critical settings.However,the limitation of using POCUS is operator dependent.Appropriate and validated training for acquiring and using skills in practice must be conducted before using POCUS in clinical settings in order to keep patients safe.Simulation education models have been introduced as a way to solve and overcome these concerns.However,the commercial simulator with sufficiently secured fidelity is expensive and not always available.This review focused on the inexpensive and easily made simulators for education on POCUS in critical specific situations related to the airway,breathing,circulation,and disability.We introduced the simulators that used non-infectious materials,with easily transportable features,and that had a sonographic appearance reproducibility similar to human tissue.We also introduced the recipe of each simulator in two parts:Materials surrounding disease simulators(surrounding materials)and specific disease simulators themselves(target simulators).This review article covered the following:endotracheal or oesophageal intubation,lung(A-lines,B-lines,lung sliding,and pleural effusions such as hemothorax),central vein access,pericardial fluid(cardiac tamponade),the structure related to the eyes,soft tissue abscess,nerve(regional nerve block),and skull fracture simulators.

Simulation in endoscopy:Practical educational strategies to improve learning

In gastrointestinal endoscopy, simulation-based training can help endoscopists acquire new skills and accelerate the learning curve. Simulation creates an ideal environment for trainees, where they can practice specific skills, perform cases at their own pace, and make mistakes with no risk to patients. Educators also benefit from the use of simulators, as they can structure training according to learner needs and focus solely on the trainee. Not all simulation-based training,however, is effective. To maximize benefits from this instructional modality,educators must be conscious of learners' needs, the potential benefits of training,and associated costs. Simulation should be integrated into training in a manner that is grounded in educational theory and empirical data. In this review, we focus on four best practices in simulation-based education: deliberate practice with mastery learning, feedback and debriefing, contextual learning, and innovative educational strategies. For each topic, we provide definitions,supporting evidence, and practical tips for implementation.

Orthopaedic education in the era of surgical simulation: Still at the crawling stage

Surgical skills education is in the process of a crucial transformation from a master-apprenticeship model to simulation-based training. Orthopaedic surgery is one of the surgical specialties where simulation-based skills training needs to be integrated into the curriculum efficiently and urgently. The reason for this strong and pressing need is that orthopaedic surgery covers broad human anatomy and pathologies and requires learning enormously diverse surgical procedures including basic and advanced skills. Although the need for a simulationbased curriculum in orthopaedic surgery is clear, several obstacles need to be overcome for a smooth transformation. The main issues to be addressed can be summarized as defining the skills and procedures so that simulation-based training will be most effective; choosing the right time period during the course of orthopaedic training for exposure to simulators; the right amount of such exposure; using objective, valid and reliable metrics to measure the impact of simulation-based training on the development and progress of surgical skills; and standardization of the simulation-based curriculum nationwide and internationally. In the new era of surgical education, successful integration of simulation-based surgical skills training into the orthopaedic curriculum will depend on efficacious solutions to these obstacles in moving forward.

A Review: Embedding a Simulation Training Program in Labor and Delivery to Improve Healthcare Quality, Clinical Outcomes, and Patient Satisfaction

In response to maternal deaths being three-fold higher for black women than other races in New York City, Governor Andrew M. Cuomo created a taskforce which met for a year. In March 2019, the taskforce published ten recommendations to address the current healthcare disparities. The taskforce recommended utilizing medical simulation training to improve skills and communication. Peer-reviewed literature was explored for evidentiary support for embedding a simulation program in a NYC public hospital. In addition, obstacles to and advantages of in-situ simulation programs were discussed. Steps for garnering executive leadership support, improving teamwork, defining outcome measures, and identifying beneficiaries of in-situ simulation programs were explored.

The Effectiveness of Virtual Reality-Based Simulation in Health Professions Education Relating to Mental Illness: A Literature Review

The proliferation of Virtual Reality-based tools has led to its increased usage in the field of education over the last decades owing to its increasingly realistic simulation and greater control over the 3D simulated environment. The unique features of Virtual Reality (VR) simulation can provide learners with a hazard-free simulated environment allowing limitless failure attempts. Yet, good quality research to verify the effectiveness of VR simulation in training students of the health profession is still lacking. This literature review focuses on the effectiveness of virtual reality-based simulation in enhancing health profession students’ empathetic attitude relating to mental illness. Four databases were searched from January 1, 2007 to December 31, 2018. Of 1034 articles identified eligible in the databases, a total of 6 articles have met the criteria for inclusion in this review. Findings suggested that there is a clear relationship between VR simulation and an improvement on users’ empathy, attitudes, and knowledge relating to mental Illness. With the unique characteristic of experiential learning of VR simulation, there is a potential development of the VR simulation on empathy and attitude in healthcare education. Also, VR stimulation is found having a larger impact on the users’ empathy of users with a healthcare background compared to those without. Future studies should include more in-depth examination on the effect on the specificity of empathy and attitude of people with healthcare background, and in teaching a wider range of mental illnesses such as depression and general anxiety disorder.

Developing an educational framework for the teaching of simulation within nurse education

The use of simulations as a teaching and learning tool within health care has increasing importance;simulations are seen as the major teaching method for practicing and assessing developing skills, knowledge, attitudes and meaningful decision-making within the field of nursing. Certainly the utilisations of simulations feature widely within many aspects of health care;a greater understanding of the key conceptual notions will serve to benefit all of those engaged within their application. This literature review has enabled the construction of a conceptual model for the teaching of simulation and can serve to promote the continued positive development of simulations within education. Through a consistent and insightful approach to teaching, dynamic learning will be assured within this very important aspect of engaging the nursing student within the learning process.

Merging Drama with Medical Education: Simulation in Learning Breaking Bad News Pre- and Post-Study

Objective: Using simulation in medical education was introduced in the 17th century, applying different techniques. The introduction of using simulated patients (SP) was also of great importance in both learning and evaluation processes. Aims: This current study aims at assessing medical students’ perception about the use of well-trained drama students from the school of Arts in simulated session of breaking bad news encounter. Study Design: This is a per- and post-test study. Methods: 112 students were asked to fill a pre-validated questionnaire, who trained from January 2017 till the end of July 2017 pre- and post-exposure to simulated clinical encounter, where one well trained senior drama student played the role of patient, one student played the doctor who would break the bad news (BBN), debriefing before the encounter, and discussion after took place. Another validated questionnaire was distributed after the encounter, to assess the students’ experience. Statistical analysis was done using SPSS version 20. Results: Scores of all questions showed statistically significant improvement after the simulation session (p-value Conclusion: Simulation encounter, using drama students who are well-trained in human grief reaction, making BBN learning more positive and effective, merging two faculties improved the learning experience of both medical and Drama students.

Simulation training in contemporary obstetrics education

AIM: To investigate the use of the Gaumard's Noelle S550.100 Maternal and Neonatal Simulators for teaching forceps delivery.METHODS: Twenty two(n = 22) resident physicians were enrolled in a simulation course on operative forceps deliveries. The physicians enrolled in the course were all part of an accredited Obstetrics and Gynecology residency program and ranged in their training from post graduate year(PGY) 1-4. Each participant received simulation based teaching on the indications, contraindications, proper application, delivery and removal of forceps by a single teacher. The Gaumard's simulator and Simpson forceps were used for this course. Statistical analysis using SPSS statistical software was performed after the completion of the simulation training program. A paired student t-test was performed to compare the cohort's mean pretest and post simulation training scores. Follow up skills assessment scores at one month, 3 mo and 6 mo were compared to thebaseline pretest score using a paired student t-test. RESULTS: There was statistically significant improvement in the post simulation training performance evaluations compared to the pretest, 13.7(SD = 3.14) vs 7.9(SD = 4.92), P < 0.05. Scores at 1 mo, 3 mo, and 6 mo were compared to the pretest score and showed retention of skills: 4.6(SD = 5.5, 95%CI: 2.21-7.07), 4.4(SD = 5.2, 95%CI: 2.13-6.70), and 5.6(SD = 4.8, 95%CI: 3.53-7.75) points, respectively. There were statistically significant differences between residents by post graduate training year on pretest scores, however these differences were not present after simulation training. Pretest scores for PGY 1, 2, 3, 4 were 3.5(SD = 2.27, 95%CI: 2.13-5.00), 7.25(SD = 6.70, 95%CI: 1.50-13.00), 10.75(SD = 1.5, 95%CI: 9.50-12.00), 12.17(SD = 2.57, 95%CI: 10.33-14.00). After simulation training PGY 1 residents did as well as well as the upper level residents. Posttest mean test scores for PGY 1, 2, 3, 4 were 13.75(SD = 1.49, 95%CI: 12.75-14.63), 10.25(SD = 0.24, 95%CI: 4.25-14.00), 15.00(SD = 1.16, 95%CI: 14.00-16.00), 15.17(SD = 0.75, 95%CI: 14.67-15.67). CONCLUSION: Our simulation based training program not only produced short term gains, but participants were able to retain the skills learned and demonstrate their knowledge months later.