Healthcare Simulation Research Update September 2023
The field of healthcare simulation has made tremendous strides forward over the past several decades. One way this revolution is made possible is through clinical simulation research being conducted across the globe. The journal Clinical Simulation in Nursing is constantly sharing updates that include article research reviews, more information on standards of best practice, research briefs, and overall innovations in medical simulation. The journal has an impact factor of 2.6 for 2022 and 2.9 for a 5-Year impact factor. Clinical simulation should be designed, developed, implemented, and evaluated based on the latest research and evidence-based practices that are supported by the Healthcare Simulation Standards of Best Practice. This HealthySimulation.com article provides an overview of the latest clinical simulation highlights as of September 2023 and explains how these updates impact the healthcare simulation community overall.
PEARLS debriefing compared to standard debriefing effects on nursing students’ professional competence and clinical judgment: a quasi-experimental study: Debriefing is an important learning component of simulation-based education (SBE) for nursing students. The evidence-based, scripted, and structured debriefing model—Promoting Excellence and Reflective Learning in Simulation (PEARLS) is meeting the standard of best practice by using a blended approach in the debriefing process with appropriate integration of feedback, debriefing, and/or guided reflection. Evidence demonstrating that PEARLS promotes better outcomes than other debriefing strategies is lacking. Our study compared PEARLS to a standard debriefing on nursing students’ professional competence and clinical judgment abilities. A quasi-experimental design was applied to compare differences in the effects of PEARLS (intervention group) and standard debriefing (control group) on nursing students’ self-reported professional competence and clinical judgment in SBE and clinical placement. No significant differences in nursing students’ self-reported professional competence or clinical judgment were found between the two groups. Professional competence and clinical judgment increased significantly within the intervention group, but not the control group. The results provide some support for implementation of PEARLS debriefing in nursing education. Faculty should receive the training and resources necessary for implementation.
The Use of Racial and Ethnic Health care Disparities in Simulation-Based Experiences: A Systematic Review: The need to better address racial and ethnic disparities has been thrust into the forefront of health professions education. Simulation activities are well suited to teach health care learners about racial and ethnic disparities. The purpose of this systematic review was to explore how racial and ethnic diversity has been represented in simulation-based education (SBE). Following preferred reporting items for systematic reviews and meta-analyses guidelines, a systematic search of APA, PsycInfo, Applied Science & Technology Source, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and Medline was conducted by a team of researchers supported by a health science library scientist. From a pool of 1418 articles, 30 articles were included in the review. The evidence supports a need for simulationists who conduct research in health care disparities (HCD) to standardize the reporting of key characteristics of the SBE. International health care simulation standards and formal debriefing methods should be used to guide and facilitate simulations surrounding HCD. Future studies should seek to unify terms, evaluate instruments, and specify methodology related to the representation of HCD within SBE.
Using Web-based Training and Low-fidelity Simulation to Provide Education and Support to Emergency Nurses Undertaking Non-Urgent Paediatric Inter-Hospital Transfers: Paediatric interhospital transfers have been associated with significant clinical risk and one of the causative factors identified is insufficient educational preparation for nursing staff involved with non-urgent interfacility transfers. A single group pretest-posttest design was used to evaluate knowledge acquisition and participant perceptions of an education package (PEANUT: Paediatric Education and Assessment for Non-urgent Transfers) using the Kirkpatrick evaluation model. Simulation targeting non-urgent interhospital transfer increased participant’s knowledge of transfer processes and confidence when required to undertake a transfer. A comparison of pre- to post-education learning scores detected a significant difference (p<.001), the average total score increased by 3.49 (95% CI:3.04, 3.93) points after training. Simulation education in paediatric non-urgent inter-hospital transfer, demonstrated an improvement in the confidence and knowledge of staff transferring children between facilities.
Educational 360-video development for clinical practice improvement toward Deaf and Hard-of-Hearing Population: Empathy of clinical providers is necessary for patient-centered care. Virtual reality, such as 360-videos, may enable empathy development with thoughtful design. We describe our process and outcomes developing an educational innovation for clinical providers to work with the challenges experienced by the deaf and hard-of-hearing population using 360-videos. A user-centered design-informed process was used to (a) empathize with our patient population using a focus group and stakeholder input, (b) design content for videos with iterative feedback from stakeholders, and (c) feasibility and usability test the innovation. We found multiple areas of concern of our patient population and subsequently created educational scripts for the videos to address these, with iterative refinement by stakeholders. Innovation delivery in the classroom setting with advanced practice nurse students was feasible and had good usability. While initial testing of this 360-video educational innovation was promising, further testing and dissemination strategies are needed.
A Longitudinal and Repeated Cross-sectional Study on the Effectiveness of the Transition of Clinical Teaching from Traditional to Simulation Era: Nursing students must possess considerable knowledge and expertise in clinical procedures, particularly in advanced courses such as critical care, along with proper competence in dealing with various scenarios in real clinical settings. This study examined the effectiveness of integrating high-fidelity simulation (HFS) training in the skills laboratory and clinical hours of a critical care nursing course, with four cohorts of nursing students from the academic year (AY) 2019-2020 to AY 2022-2023. This was a longitudinal study, wherein a repeated cross-sectional analysis was conducted. Participants comprised 139 nursing students who were randomly selected. The findings show remarkable progress and an increase in students’ final marks in the critical care nursing course for the AY 2019-2020 cohort, with a 10% simulation exposure reporting an average of 80.82 with a standard deviation (SD) of 7.48 compared to those with 40% simulation exposure in the AY 2022-2023 cohort, who reported an average of 93.24 with an SD of 4.29. The study results indicate that HFS can replace up to 40% of traditional skill lab sessions and clinical training only if the clinical simulated scenarios are well-planned and properly structured. However, the effectiveness of HFS also depends on students’ exposure to it. HFS can help refine students’ knowledge and skills.
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Virtual Simulation Education Using Multiuser Virtual Environments and Standardized Patients for Child Healthcare in the Community Setting: A Multisite Pilot Study: To improve child health promotion in the community, pediatric nursing education should provide appropriate learning environments and resources. A multisite, pretest-posttest design with a mixed-methods approach was used to evaluate the effects of simulation in a multiuser virtual environment. Nursing competencies scores significantly increased. The major themes of participants’ experience were identified: Performing and thinking like a nurse, Experiencing realistic nursing encounters, Interesting learning experiences, Helpful learning processes, and Difficulties and adaptation. Virtual simulations using multiuser virtual environments and standardized patients can effectively prepare nursing students for primary healthcare and children’s health promotion in the community.
More About Clinical Simulation in Nursing
Clinical Simulation in Nursing is an international, peer-reviewed journal published online monthly. Clinical Simulation in Nursing is the official journal of the International Nursing Association for Clinical Simulation and Learning (INACSL) and reflects the organization’s mission to advance the science of healthcare simulation. Articles are indexed in the Science Citation Index Expanded, Journal Citation Reports/Science Edition, Social Science Citation Index, Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Health Sciences. INACSL reviews and accepts articles from other health provider disciplines, if they are determined to be of interest to the INACSL readership. The journal accepts manuscripts meeting one or more of the following criteria:
- Research articles and literature reviews (e.g. systematic, scoping, umbrella, integrative, etc.) about simulation
- Innovative teaching/learning strategies using simulation
- Articles updating guidelines, regulations, and legislative policies that impact simulation
- Leadership for simulation
- Simulation operations
- Clinical and academic uses of simulation
More About INACSL
The International Nursing Association for Clinical and Simulation Learning (INACSL) is an association dedicated to advancing the science of healthcare simulation. With over 1,800 members worldwide, the organization’s mission is to be the global leader in the art and science of healthcare simulation through excellence in nursing education, practice, and research.
INACSL’s goal is also to advance the science of nursing simulation by providing professional development, networking resources, and leadership in defining healthcare simulation standards of best practice. INACSL membership provides the education, resources, and tools that best address current challenges and help support learners, educators, and professional goals related to the learning of healthcare simulation’s latest developments. This is while ensuring that these individuals are enabled to provide the most comprehensive education and training for high-quality patient care. Whether someone is new to healthcare simulation and is looking to understand the fundamentals or is experienced and seeking the latest updates and research, INACSL can provide them with the support they need. Membership in INACSL is based on connection, engagement, support, and inspiration.
Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN – Dr. Gore has experience in educating future nurses in the undergraduate and graduate nursing programs. Dr. Gore has a PhD in Adult Education, a DNP as a family nurse practitioner, and a certificate in Simulation Education. Dr. Gore is an innovative, compassionate educator and an expert in the field of healthcare simulation. In 2007l Teresa started her journey in healthcare simulation. She is involved in INACSL and SSH. She is a Past-President of INACSL and is a Certified Healthcare Simulation Educator Advanced (CHSE-A). In 2018, she was inducted as a Fellow in the American Academy of Nursing (FAAN). In 2021, she was inducted as a Fellow in the Society of Simulation in Healthcare Academy (FSSH) and selected as a Visionary Leader University of Alabama at Birmingham School of Nursing Alumni. During her career, Dr. Gore has led in the development and integration of simulation into all undergraduate clinical courses and started an OSCE program for APRN students. Her research interests and scholarly work focus on simulation, online course development and faculty development. She has numerous invited presentations nationally and internationally on simulation topics.