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Health simulation through the lens of self-determination theory — opportunities and pathways for discovery
Health simulation is broadly viewed as an appealing, impactful, and innovative enhancement for the education and assessment of health professions students and practitioners. We have seen exponential and global growth in programmes implementing simulation techniques and technologies. Alongside this enthusiasm and growth, the theoretical underpinnings that might guide the efficacy of the field have not always been considered. Many of the principles that guide simulation design, development and practice have been intuited through practical trial and error. In considering how to retrofit theory to practice, we have at our disposal existing theories that may assist with building our practice, expertise, identity as a community of practice, authority and legitimacy as a field. Self-determination theory (SDT) is an established and evolving theory that examines the quality of motivation and human behaviours. It has been applied to a variety of contexts and provides evidence that may support and enhance the practice of health simulation. In this paper, SDT is outlined, and avenues for examining the fit of theory to practice are suggested. Promising links exist between SDT and health simulation. Opportunities and new pathways of discovery await.
Journal Article
How social media data are being used to research the experience of mourning: A scoping review
Increasingly, people are using social media (SM) to express grief, and researchers are using this data to investigate the phenomenon of mourning. As this research progresses, it is important to understand how studies are being conducted and how authors are approaching ethical challenges related to SM data.
The aim of this review was to explore how SM data are being used to research experiences of mourning through the following questions: a) 'Which topics related to mourning are being studied?'; b) 'What study designs have been used to analyse SM data'; c) 'What type of data (natural or generated) have been used?'; and d) 'How are ethical decisions being considered?'.
The JBI Scoping Review methodology guided this review. Eligibility criteria were determined using the PCC framework, and relevant key words and phrases derived from these criteria were used to search eight databases in September 2021 (CINAHL, Embase, LILACS, OpenGrey, ProQuest, PsycINFO, PubMed and Scopus). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were used to report the results of this review.
Database searches resulted in 3418 records, of which, 89 met eligibility criteria. Four categories of grief and mourning were identified. Most records were qualitative in nature and used natural data. Only 20% of records reported ethics approval by an Institutional Review Board, with several including measures to protect participants, for example, using pseudonyms.
This unique review mapped the diverse range of mourning-related topics that have been investigated using SM data and highlighted the variability in approaches to data analysis. Ethical concerns relating to SM data collection are identified and discussed. This is an emerging and rapidly changing field of research that offers new opportunities and challenges for exploring the phenomenon of mourning.
Journal Article
Sound knowledge : music and science in London, 1789-1851
What does it mean to hear scientifically? What does it mean to see musically? This volume uncovers a new side to the long nineteenth century in London, a hidden history in which virtuosic musical entertainment and scientific discovery intersected in remarkable ways. Sound Knowledge examines how scientific truth was accrued by means of visual and aural experience, and, in turn, how musical knowledge was located in relation to empirical scientific practice. James Q. Davies and Ellen Lockhart gather work by leading scholars to explore a crucial sixty-year period, beginning with Charles Burney's ambitious General History of Music, a four-volume study of music around the globe, and extending to the Great Exhibition of 1851, where musical instruments were assembled alongside the technologies of science and industry in the immense glass-encased collections of the Crystal Palace. Importantly, as the contributions show, both the power of science and the power of music relied on performance, spectacle, and experiment. Ultimately, this volume sets the stage for a new picture of modern disciplinarity, shining light on an era before the division of aural and visual knowledge.
Book
What makes oncology nurses and registered nurses motivated to work in oncology specialty: a qualitative interview study
Background
Oncology nursing in Saudi Arabia faces unique challenges, including a shortage of local nurses, cultural and linguistic barriers, and insufficient support systems. Understanding the factors that motivate, and challenge oncology nurses is crucial to addressing these issues and improving retention.
Objectives
This study aims to explore the motivations and challenges of oncology nurses and registered nurses in Saudi Arabia, focusing on both intrinsic and extrinsic factors influencing their work in the oncology specialty.
Methods
A qualitative exploratory descriptive approach was employed, involving semi-structured interviews with 19 participants, including oncology registered nurses (ORNs) and registered nurses (RNs) from various specialties at King Saud University Medical City in Riyadh. The data were examined through thematic analysis to uncover patterns and insights related to the participants’ experiences.
Results
The study identified four primary themes: advantages of working in oncology, psychological difficulties, structural barriers, and workplace conditions affecting job satisfaction. Nurses reported a sense of achievement and personal fulfillment as key motivators. However, they also faced significant psychological challenges, including emotional exhaustion and inadequate psychological support. Structural barriers such as lack of specialized training and career pathways, as well as dissatisfaction with the salary scale, were major deterrents. Communication barriers and high workloads further reduced job satisfaction.
Conclusions
This study, the first of its kind in Saudi Arabia, highlights the complex interplay of factors influencing oncology nurses' experiences. Addressing these issues through targeted interventions, improved training programs, competitive salaries, and better psychological support can enhance job satisfaction and retention of oncology nurses in Saudi Arabia.
Journal Article
Recommendations for embedding simulation in health services
Aspirations to achieve quality and safety goals in health services through simulation have led to significant investments in simulation equipment, space and faculty. However, the optimal governance and operational models through which these resources are expertly applied in health services are not known. There is growing evidence supporting ‘service’ models for simulation. In these models, simulation activities are co-designed and delivered by a team of simulation experts in partnership with health service units, specifically targeting quality and safety goals. Embedded simulation specialist teams working within these programs offer benefits not fully captured by traditional models of health education or by traditional systems for quality and safety.
In this article, we explore broad and specific recommendations for establishing a simulation consultancy service within an Australian metropolitan health service. We base these recommendations on a review of current Australian practice and healthcare simulation literature, and on a specific example within a large outer metropolitan health service. The broad domains discussed include (1) governance and leadership; (2) human resources; (3) principles and planning; (4) operationalise and evaluate and (5) look to the future.
The recommendations recognise that healthcare simulation is moving beyond solely addressing individual learning outcomes. The value of simulation addressing organisation and system objectives through various simulation modalities is increasingly being explored and demonstrating value. There is a growing demand for translational simulation in these contexts, and a consequent requirement for organisations to consider how simulation services can be successfully operationalised. Recommendations included in this paper are discussed and described with the intent of facilitating a deeper appreciation of the complexities associated with, and opportunities afforded by, a well-integrated simulation service.
Journal Article
Are we ready yet? A qualitative study exploring undergraduate medical students’ readiness for psychiatry placements
Background
The purpose of this study was to better understand students’ experiences of readiness for their psychiatry clinical placement and eventual clinical practice in mental health units.
Methods
Interviews with fourth year undergraduate medical students were conducted and analysed using reflexive thematic analysis. Themes were identified that describe participant experiences of preparation and readiness for placements in mental health units.
Results
Eight participants provided detailed accounts of experiences prior to medical school, during medical school and during placements in mental health units that influenced their perceptions and attitudes towards people who experience mental illness and mental distress. Themes identified in this study included:
Conceptual readiness (and unreadiness)
,
Procedural readiness (and unreadiness)
and,
Dispositional readiness (and unreadiness).
Findings indicate that students do not approach their mental health placements in the same way as they do for other placements. They fear many components of mental health environments, including their own capacity to engage with people without causing further harm. Students had varied attitudes and experiences that shaped their conceptual ideas relating to psychiatry and their procedural readiness to undertaken tasks such as communicating with, and assessment of people experiencing mental distress and mental illnesses.
Conclusion
Medical students will encounter people who experience mental illness and mental distress regardless of which discipline they choose to specialise. We have an obligation to support students to feel conceptually, procedurally
and
dispositionally ready to learn and practice when they prepare for clinical placement in mental health units, and indeed for their future practice.
Trial registration
Not applicable.
Journal Article
Enhancing Authentic Learning in Simulation-Based Education Through Electronic Medical Record Integration: A Practice-Based Commentary
As new technologies, such as electronic medical records (EMRs), are introduced into healthcare services, we need to consider how they may be incorporated into simulated environments, so as to maintain and enhance authenticity and learning opportunities. While EMRs have revolutionised clinical practice, many education settings continue to rely on paper-based documentation in simulation, creating a widening gap between educational environments and real-world clinical workflows. This disconnect limits learners’ ability to engage authentically with the tools and resources that underpin contemporary healthcare, impeding the transfer of knowledge to the clinical environment. This practice-based commentary draws on institutional experience from a large, multi-disciplinary simulation-based education facility that explored approaches to integrating EMRs into simulation-based education. It describes the decision points and efforts made to integrate an EMR into simulation-based education and concludes that while genuine EMR systems increase fidelity, their technical rigidity and data governance constraints reduce authenticity. To overcome this, Adelaide Health Simulation adopted an academic EMR (AEMR), a purpose-built digital platform designed for education. The AEMR maintains the functional realism of clinical systems while offering the pedagogical flexibility required to control data, timelines, and learner interactions. Drawing on this experience, this commentary highlights how authenticity in simulation-based education is best achieved not through technological replication alone, but through deliberate use of technologies that align with clinical realities while supporting flexible, learner-centred design. Purpose-built AEMRs exemplify how digital tools can enhance both fidelity and authenticity, fostering higher-order thinking, clinical reasoning, and digital fluency essential for safe and effective contemporary healthcare practice. Here, we argue that advancing simulation-based education in parallel with health service innovations is required if we want to adequately prepare learners for contemporary clinical practice.
Journal Article