METHOD: The articles were searched through CINAHL, Scopus, Proquest, and OVID online database. Articles published from 2000, in English and among novice nurses were selected for review. Then, a narrative review was conducted guided by what are the existing simulation session been used and the impact on novice nurse.
RESULT: Total of 19 articles been selected for review out of 272 articles. The findings of the reviewed were divided into 3 main themes. The themes are the existing simulation session, simulation as a support tool in the transition program and the impact of simulation on novice nurses.
CONCLUSION: In summary, each simulation type has its learning domain. The effectiveness of the simulation will much depend on the appropriate simulation type selection.
METHODS: Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants' self-reported confidence, acceptance, and relevance of the simulated cases were measured.
RESULTS: Significant improvement was observed in participants' self-reported confidence (overall n = 204, p<0.001; adrenal n = 33, p<0.001; thyroid n = 37, p<0.001; pituitary n = 79, p<0.001; inflammatory bowel disease n = 17, p<0.001; acute medicine n = 38, p<0.001). Participants reported improvements in clinical competencies: patient care 52.0% (n = 106/204), professionalism 30.9% (n = 63/204), knowledge on patient management 84.8% (n = 173/204), systems-based practice 48.0% (n = 98/204), practice-based learning 69.6% (n = 142/204) and communication skills 25.5% (n = 52/204).
CONCLUSION: SIMBA is a novel pedagogical virtual simulation-based learning model that improves clinicians' confidence in managing conditions across various specialties.
METHODS: A newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures.
RESULTS: Fifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students' abilities to conduct a VC (t-test = 16.33, p
METHODS: Through the review of the literature, this paper discusses seven questions, (i) What is SLE? (ii) What are the types of SLEs? (iii) How is SLE classified? (iv) What is HF SLE? (v) What types of SLEs are available in audiology and their level of fidelity? (vi) What are the components needed for developing HF SLE? (vii) What are the possible types of HF SLEs that are suitable for audiology training? Publications were identified by structured searches from three major databases PubMed, Web of Knowledge and PsychInfo and from the reference lists of relevant articles. The authors discussed and mapped the levels of fidelity of SLE audiology training modules from the literature and the learning domains involved in the clinical audiology courses.
RESULTS: The discussion paper has highlighted that most of the existing SLE audiology training modules consist of either low- or medium-fidelity types of simulators. Those components needed to achieve a HF SLE for audiology training are also highlighted.
CONCLUSION: Overall, this review recommends that the combined approach of different levels and types of SLE could be used to obtain a HF SLE training module in audiology training.
MATERIALS AND METHODS: A randomised controlled trial (RCT) study involving 111 undergraduate medical students was conducted where the competency of skills was assessed by objective structured clinical examination (OSCE) in the first, fourth and seventh/eighth weeks. A cohort of 12-14 students was enrolled for each session. The randomisation of the participants into control (VAL-based teaching) and intervention (HFS-based teaching) groups was achieved by implementing the computer-based random sequence generation method. VAL-based teaching module was a fully interactive face-to-face teaching session where a prerecorded video clip was used. The video clip detailed the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression on a high-fidelity patient simulator (METIman). HFS-based teaching module was delivered as a fully interactive hands-on training session conducted on the same METIman to demonstrate the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression. OSCE scores were compared as the denominator of learning (enhancement and retention of skills) between two groups who underwent training with either VAL-based or HFS-based teachings. The OSCE assessments were used to evaluate the participants' performance as a group. These scores were used to compare the enhancement and medium-term retention of skills between the groups. The outcome was measured with the mean and standard deviation (SD) for the total OSCE scores for skills assessments. We used General Linear Model two-way mixed ANOVA to ascertain the difference of OSCE marks over assessment time points between the control and the intervention groups. ANCOVA and two-way mixed ANOVA were used to calculate the effect size and the partial Eta squared. p value less than 0.05 was taken to be statistically significant.
RESULTS: The two-way mixed ANOVA showed no statistically significant difference in mean OSCE scores between intervention and control groups (p=0.890), although the mean score of the intervention group was better than the control group.
CONCLUSION: Our study demonstrated that HFS was not significantly effective over VAL-based education in enhancing skills and consolidating retention among undergraduate medical students. Further research is needed to determine its suitability for inclusion in the course curriculum considering the cost-effectiveness of implementing HFS that may supplement traditional teaching methods.
SUBJECTS AND METHODS: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals.
RESULTS: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05).
CONCLUSIONS: The SP training (with/ without feedback) is a beneficial learning tool for history taking to students in audiology major.
METHOD: A quasi-randomized controlled trial was conducted recruiting students from two different higher learning institutions in Kuantan, Pahang, Malaysia. Students are selected after fulfilling the criteria such as body mass index (BMI) of ≥23kg/m2, no chronic diseases that may influence by exercise, no significant changes in body weight within two months and not taking any medications or supplements. One institution was purposely chosen as a simulation-based group and another one control group. In the simulation-based group, participants were given a booklet and CD to do aerobic and resistance exercise for a minimum of 25min per day, three times a week for 10 weeks. No exercise was given to the control group. Participants were measured with the International Physical Activity Questionnaire (IPAQ), BMI, waist circumference (WC), body fat percentage before and after 10 weeks of simulation-based exercise.
RESULTS: A total of 52 (control: 25, simulation-based: 27) participants involved in the study. There was no baseline characteristics difference between the two groups (p>0.005). All 27 participants in the simulation-based group reported performing the exercise based on the recommendation. The retention rate at three months was 100%. No adverse events were reported throughout the study. Better outcomes (p<0.001) were reported among participants in the simulation-based group for BMI, WC and body fat percentage.
CONCLUSIONS: The findings of this study indicate that the simulation-based exercise programme may be feasible for an overweight adult in higher learning institutes. As a feasibility study this is not powered to detect significant differences on the outcomes. However, participants reported positive views towards the recommended exercise with significant improvements in body mass index, body fat percentage and reduced the waist circumference.
OBJECTIVE: Our aim was to create and describe a homemade, high-fidelity ultrasound phantom model for demonstrating pneumonia with pleural effusions for teaching purposes.
DISCUSSION: An ultrasound phantom was constructed using a water-filled latex glove with a sliver of meat in it, covered over by a palm-sized piece of meat (skin and ribs are optional to increase ultrasonographic details and realism). This would appear like parapneumonic effusions with organized pneumonia under ultrasound examination. Creamer (or talc) can be added to the water in the glove to simulate empyema. The model can also be used to teach simple effusions and for ultrasound-guided thoracentesis and in clinical decision making.
CONCLUSIONS: Easily prepared, homemade high-fidelity ultrasound phantom models for instructions on identification of pleural effusions and ultrasound-guided pleural tap of parapneumonic effusion were made.
APPROACH: The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.
OUTCOMES: A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.
NEXT STEPS: Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.
METHODS: Three areas of priority were identified as follows: staff safety, patient movement, and possible clinical scenarios based on simulation principles in health care education. Staff was rostered and rotated through stations for rapid-cycle deliberate practice to learn donning and doffing of personal protective equipment (PPE) and powered air-purifying respirator (PAPR). For difficult airway management, Peyton's 4 steps for skills training and Harden's Three Circle model formed the structure in teaching the core skills. Several clinical scenarios used system probing to elicit inadequacies followed by formal debriefing to facilitate reflection. Finally, evaluation was both immediate and delayed with an online survey after 1 month to examine 4 levels of reaction, learning, behavior, and impact based on the Kirkpatrick Model. Frequency and thematic analysis were then conducted on the quantitative and qualitative data, respectively.
RESULTS: A total of 15 of 16 (93%) consultants, 16 (100%) specialists, and 81 (100%) medical officers in the department completed training within 2 consecutive weeks. Reaction and part of the learning were relayed immediately to trainers during training. In total, 42 (39%) trained staff responded to the survey. All were satisfied and agreed on the relevance of training. A total of 41 respondents (98%; 95% confidence interval [CI], 87-99) answered 16 of 20 questions correctly on identifying aerosol-generating procedures (AGP), indications for PPE, planning and preparation for airway management to achieve adequate learning. About 43% (95% CI, 27-59) and 52% (95% CI, 36-68) recalled donning and doffing steps correctly. A total of 92 responses from 33 respondents were analyzed in the thematic analysis. All respondents reported at least 1 behavioral change in intended outcomes for hand hygiene practice (20%), appropriate use of PPE (27%), and airway management (10%). The emerging outcomes were vigilance, physical distancing, planning, and team communication. Finally, the impact of training led to the establishment of institutional guidelines followed by all personnel.
CONCLUSIONS: Simulation-based training was a useful preparation tool for small institutions with limited time, resources, and manpower in developing nations. These recommendations represent the training experience to address issues of "when" and "how" to initiate urgent "medical education" during an outbreak.
METHODS: An intermediary trainee was subjected to an 8-week structured self-practice program. The program was divided into 2 parts of nonbeating and beating practices with a minimum number of timed anastomoses. Each part was followed by an assessment using an objective skills assessment tool score. The beating-heart simulator was built using motorized toy blocks connected wirelessly to a smartphone application. This was coded to enable rate selection. A junior consultant was compared to the subject at the end of the program. Both were tasked to perform 1 coronary anastomosis for both off-pump coronary artery bypass (OPCAB) and minimally invasive CAB (MICS) setup. The primary outcomes were anastomotic time and score compared with the junior consultant. Secondary outcomes were progression of anastomotic time and score throughout the program.
RESULTS: Overall performance of the studied subject approached the performance of the junior consultant in terms of time (OPCAB, 489 vs 605 s; MICS, 712 vs 652 s) and scores (OPCAB, 21 vs 20.7; MICS, 19 vs 20.6). There were inverse correlations between anastomosis time and number of practices for both nonbeating and beating anastomoses. Overall improvement was observed in terms of assessment scoring by 26.6%.
CONCLUSIONS: A structured self-practice program using an affordable and accessible simulator was able to help trainees overcome the MICS anastomosis learning curve quicker when introduced earlier. This may encourage earlier adoption of MICS among surgeons.
METHODOLOGY: Study participants included a total of 60 final year medical undergraduates during their rotation in Medical Senior Posting. They participated in a simulation exercise using a high fidelity simulator, and their confidence level measured using a self-administered questionnaire.
RESULTS: The results found that the confidence levels of 'Assessment of an Emergency Patient', 'Diagnosing Arrhythmias', 'Emergency Airway Management', 'Performing Cardio-pulmonary Resuscitation', 'Using the Defibrillator' and 'Using Emergency Drugs' showed a statistically significant increase in confidence levels after the simulation exercise. The mean confidence levels also rose from 2.85 to 3.83 (p<0.05).
CONCLUSION: We recommend further use of High Fidelity Simulation in medical education to improve the confidence levels of medical undergraduates.
METHODS: We designed an interactive web-based educational module in the Malay language wherein videos were combined with text and pictorial visual cues. Malaysians aged 18-40 years old who underwent the module had their knowledge and attitudes assessed at baseline, post-intervention and at 6-month follow-up using a selfadministered validated questionnaire.
RESULTS: Sixty-five participants: 47 Malays (72.3%), 15 Chinese (23.1%), three Indians (4.6%) underwent the module. Questionnaires were completed at baseline (n=65), postintervention (n=65) and at 6-month follow-up (n=60). Out of a total knowledge score of 21, significant changes were recorded across three time-points- median scores were 12 at pre-intervention, 19 at post-intervention and 16 at 6-month follow-up (p<0.001). Post-hoc testing comparing preintervention and 6-month follow-up scores showed significant retention of knowledge (p<0.001). Compared to baseline, attitudes at 6-month follow-up showed an increased acceptance for "marriage avoidance between carriers" (pre-intervention 20%, 6-month follow-up 48.3%, p<0.001) and "prenatal diagnosis" (pre-intervention 73.8%, 6-month follow-up 86.2%, p=0.008). Acceptance for selective termination however, remained low without significant change (pre-intervention 6.2%, 6-month follow-up 16.7%, p=0.109).
CONCLUSION: A web-based educational module appears effective in improving knowledge and attitudes towards thalassaemia prevention and its incorporation in thalassaemia prevention programs is potentially useful in Malaysia and countries with a high internet penetration rate.