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This study evaluates the impact of high-fidelity simulation on the acquisition and retention of competencies in nursing students. High-fidelity simulation provides a realistic and risk-free environment allowing students to practice, which potentially enhances the acquisition and retention of required competencies. A blinded, randomised clinical trial with three arms was conducted with a pretest and a follow-up at 6 months (post-test 1) and 12 months (post-test 2). This study was conducted with 105 s-year nursing students, divided into three groups: control (6 low-fidelity simulations), intervention 1 (3 high-fidelity and 3 low-fidelity) and intervention 2 (6 high-fidelity simulations). Competencies were assessed using the Objective Structured Clinical Examination at baseline, 6 and 12 months. Student satisfaction was measured with the Simulated Clinical Experiences Scale. Initial competency scores were similar across groups. At 6 months, both intervention groups showed significant improvements in critical thinking (6.2 and 6.0, p < 0.05), clinical skills (6.8 and 6.6, p < 0.05), communication (8.0 and 8.3, p < 0.05) and ethics (7.6 and 7.5, p < 0.05) compared with the control group. Intervention group 1 demonstrated better competency retention at 12 months. Overall satisfaction with highfidelity simulation was high (9.13/10), with particular praise for the practical dimension (8.95/10), realism (8.02/10) and the cognitive dimension (9.43/10). High-fidelity simulation has the potential to enhance nursing competencies effectively. This approach supports long-term skill retention, highlighting the importance of a well-structured curriculum that integrates different simulation levels for optimal student preparation for clinical practice.

Background The use of an observer tool (OT) has been shown to improve learning of technical skills through observation in simulation. The objective was to assess the impact of a non-technical OT on anaesthesia residents’ learning of non-technical skills (NTS) during simulation. Methods After consent, residents were randomised into 2 groups: OT+ (with an OT based on NTS to be systematically completed during observation of others) and OT- (without OT). Both groups observed a high-fidelity simulation of crisis management (with or without OT), then were asked to perform actively another simulation. The primary outcome was NTS performance, assessed by an evaluator using the Anaesthesia Non-Technical Skills score (ANTS score out of 16) on video recording. Secondary outcomes were results of score items, satisfaction, team performance, and professional impact. Results No significant difference was found between OT + group ( n  = 33) and OT- group ( n  = 30) for the ANTS score (OT + 12 [9.5–12.5], OT- 10.5 [8.75–12]/16 ( p  = 0.13)). Among sub-items of the ANTS score, decision-making was significantly better in the OT + group (3 [2–3] versus 2 [2–3], p  = 0.01). Satisfaction, team performance and perception of professional impact were not significantly different between groups. Conclusions This study showed no significant difference in learning of observational anaesthesia resident’s NTS whether or not they were provided a non-technical OT during crisis management simulation. Decision-making was better with an OT. Further work is necessary to define the place of OT in observer-based learning.

Background Performance of sufficient cardiopulmonary resuscitation (CPR) by medical personnel is critical to improve outcomes during cardiac arrest. It has however been shown that even health care professionals possess a lack of knowledge and skills in CPR performance. The optimal method for teaching CPR remains unclear, and data that compares traditional CPR instructional methods with newer modalities of CPR instruction are needed. We therefore conducted a single blinded, randomised study involving medical students in order to evaluate the short- and long-term effects of a classical CPR education compared with a bilateral approach to CPR training, consisting of problem-based learning (PBL) plus high fidelity simulation. Methods One hundred twelve medical students were randomized during a curricular anaesthesiology course to a control ( n  = 54) and an intervention ( n  = 58) group. All participants were blinded to group assignment and partook in a 30-min-lecture on CPR basics. Subsequently, the control group participated in a 90-min tutor-guided CPR hands-on-training. The intervention group took part in a 45-min theoretical PBL module followed by 45 min of high fidelity simulated CPR training. The rate of participants recognizing clinical cardiac arrest followed by sufficiently performed CPR was the primary outcome parameter of this study. CPR performance was evaluated after the intervention. In addition, a follow-up evaluation was conducted after 6 months. Results 51.9% of the intervention group met the criteria of sufficiently performed CPR as compared to only 12.5% in the control group on the day of the intervention ( p  = 0.007). Hands-off-time as a marker for CPR continuity was significantly less in the intervention group (24.0%) as compared to the control group (28.3%, p  = 0.007, Hedges’ g  = 1.55). At the six-month follow-up, hands-off-time was still significantly lower in the intervention group (23.7% vs. control group: 31.0%, p  = 0.006, Hedges’ g  = 1.88) but no significant difference in sufficiently performed CPR was detected (intervention group: 71.4% vs. control group: 54.5%, p  = 0.55). Conclusion PBL combined with high fidelity simulation training leads to a measurable short-term increase in initiating sufficient CPR by medical students immediately after training as compared to classical education. At six month post instruction, these differences remained only partially.

This study aimed to evaluate the effects of the psychoacoustic learning method and high-fidelity simulation on the cardiac auscultation competence of nursing students. Cardiac auscultation is a crucial skill for nursing students, yet many struggle to develop proficiency. Simulation-based training has emerged as a potential solution, but the effectiveness of different simulation modalities remains unclear. A randomized controlled experimental study. A total of 52 s-year nursing students were randomly assigned to one of three groups: psychoacoustic learning (n = 18), high-fidelity simulation (n = 17) and control (n = 17). Cardiac auscultation competence was assessed through a success test administered at three-time points: pre-test, post-test and follow-up (four weeks later). Learning satisfaction and self-confidence in learning were measured post-intervention. The psychoacoustic learning group significantly improved cardiac auscultation scores from pre-test to post-test and follow-up (p < 0.05). The high-fidelity simulation group improved from pre- to post-test (p < 0.05) but not at follow-up. The control group showed no significant changes. No significant between-group differences in auscultation scores (p > 0.05), but high-fidelity simulation had higher learning satisfaction (p = 0.013) and total scale scores (p = 0.017) than psychoacoustic learning. Group-time interaction was not significant (p = 0.547). Psychoacoustic learning boosts short- and medium-term cardiac auscultation skills, while high-fidelity simulation enhances short-term performance and learning satisfaction. Combining psychoacoustic methods with simulation or traditional teaching may improve sustainable learning outcomes, balancing effectiveness, accessibility and cost.

Background Debriefing is the essential element of simulation teaching. Peer-led structured debriefing simulations could be a suitable approach because of the peers’ similarity in age and experience to the students. The purpose of this study was to compare the teaching effectiveness of peer-led debriefing versus instructor-led debriefing in high-fidelity simulation scenarios. Methods The study used a mixed-method approach, integrating quasi-experimental and qualitative components. A total of 88 third-year nursing students were randomly distributed into the instructor-led or peer-led group, with equal sample sizes in both cohorts. The study compared knowledge acquisition, simulation performance, student satisfaction and self-confidence in learning, and debriefing experience between the two groups. In addition, interviews were conducted with students in the peer-led group after the course. Results The scores of students’ simulation performance scale were higher in the peer-led group than in the instructor-led group, and both groups made significant gains in knowledge. The peer-led group and instructor-led group demonstrated similar performance in terms of knowledge, simulated performance, reporting experience, student satisfaction, and learning confidence. The semi-structured interview results indicated that students in the peer-led group expressed approval of peer facilitators. Conclusions Our study demonstrated that students in the peer-led group showed better performance in the simulation, and both groups demonstrated improved knowledge. Thus, with the premise of peers receiving training, the peer-led simulation teaching method can be regarded as a supplementary strategy for simulation teaching to enrich the form of simulation teaching and improve the effectiveness of simulation teaching.

The purpose of the current study was to determine if the amount of confidence in completing the Clinical Opiate Withdrawal Scale (COWS) varied among participants and whether consistency in scoring outcomes to patients occurred with COWS assessment among groups assigned to simulation and debriefing conditions. Sixty nursing staff were randomized into three groups: (a) scenario; (b) scenario and simulation; and (c) scenario, simulation, and debriefing. Staff were administered a questionnaire to assess their confidence before (i.e., pretreatment) and after (i.e., posttreatment) the simulation exercise and at 30-day follow up. The COWS assessment tool was completed by nursing staff during treatment and follow-up sessions. Significant improvements in confidence were found in all three treatment conditions. Highest consistency in scoring outcomes of the COWS to patients was found with the scenario, simulation, and debriefing condition. All participants reported having increased confidence completing the COWS. The amount of confidence among groups was not significant. Although nursing confidence did not differ among groups, increased scoring outcome reliability was found in groups using simulation and debriefing. [ Journal of Psychosocial Nursing and Mental Health Services, 56 (10), 27–35.]

Resuscitative thoracotomies are a time-sensitive emergency surgical procedure with an immediate risk of mortality. We hypothesize that a high-fidelity whole-body donor simulation model, referred to as a Knowledge Donor (KD), with mechanical lung ventilation and expired human blood perfusion could increase learner confidence in performing this critical procedure. General surgery residents and faculty were invited to participate in KD training. Surveys were collected to track participation and confidence. Simulated resuscitative thoracotomies were performed involving PGY levels I-IV. Mean confidence was highest for residents with both KD and Live Patient experience (5.6 ​± ​1.7), followed by Live Patient only (4.3 ​± ​2.5), and KD only (2.6 ​± ​1.3). The mean confidence rating for residents with neither training opportunity was 1.4 ​± ​1.0. The KD platform is a hyper-realistic training modality that closely replicates live surgery. This platform allows residents to practice complex surgical procedures in a safe environment, without risking patient safety. This pilot program yielded early results in improving resident procedural confidence for high-risk surgical procedures, specifically resuscitative thoracotomies. •Knowledge Donor provides hyper realistic training nearly replicating a live patient.•A unique perfusion-based platform with high-fidelity whole-body donors is the basis.•Knowledge Donor can revolutionize procedural training for medical learners.•Can be applied across any medical specialty with procedural learning.

Simulation is an integral component of health care education. Research suggests a positive relationship between simulation and learning outcomes. Kirkpatrick's framework is a four-level model based on the premise that learning resulting from training programs can be classified into four levels: reaction, learning, behavior, and results. Evaluation of educational impact provides valuable feedback to educators that may assist with development and improvement of teaching methods. This review is based on the PRISMA guidelines for conducting a systematic review. Inclusion criteria included articles (a) written in the English language, (b) published between 2000 and 2016, (c) describing a debriefing intervention after high-fidelity patient simulation, and (d) based in health care. Thirteen studies met criteria for inclusion in the review. Results indicated a paucity of studies at the highest levels of evaluation, indicating an area where future research is needed to assist with the development and improvement of simulation education. [J Nurs Educ. 2018;57(7):393-398.].

Curriculum integration and high-fidelity simulation (HFS) were used separately in nursing education. Little is known about their combined effect on undergraduate nursing students' competence. To assess the impact of HFS and curriculum integration on nursing students' competence and satisfaction. A quasiexperimental study design was employed. Using convenience sampling, two groups of undergraduate nursing students were compared in their management of pregnant women undergoing normal vaginal delivery and immediate newborn care. The intervention group (n = 30) received the HFS/curriculum-integrated session, while the control group (n = 30) received the traditional curriculum. The HFS/curriculum-integrated intervention consisted of five three-hour sessions, with six students participating in each session. The intervention was conducted in the simulation laboratory of Fakeeh College for Medical Sciences in December 2023 over one week, and study data were collected two weeks after the completion of the educational intervention. Students' competence was assessed using a structured written examination and an objective structured clinical examination (OSCE), while satisfaction was evaluated using a self-reported questionnaire. Independent t-tests were used to examine differences in competency between the two groups. Students who participated in the HFS/curriculum-integrated sessions demonstrated significantly higher performance in both written knowledge examinations and clinical skills assessments compared to the control group. Knowledge scores were higher for management of normal vaginal delivery (86% vs. 46%) and immediate newborn care (80% vs. 54%), and OSCE scores were also significantly greater for vaginal delivery management (81% vs. 50%) and immediate newborn care (95% vs. 56%) (p ≤ 0.05). Students' satisfaction with the integrated session using HFS was high (91% ± 7.6). The use of HFS and curriculum integration significantly enhanced nursing students' competency and satisfaction levels. These findings underscore the value of incorporating HFS and curriculum integration as an effective strategy in nursing education. However, further large-scale and longitudinal studies are warranted to more comprehensively evaluate the long-term impact of HFS and curriculum integration on diverse nursing learning outcomes. Nursing management should facilitate the use of HFS and curriculum integration in nursing education, as this approach significantly enhances students' clinical competence while bridging the gap between theory and practice.

Patient safety education is necessary for the provision of high-quality medical services. A significant aspect of patient safety education is simulation training, which allows medical students to experience realistic clinical environments. This study aimed to verify the effectiveness of patient safety education using simulation training. We retrospectively analyzed the results of a 30-question questionnaire survey on the perceptions of patient safety before and after simulation training, which was completed by 40 medical students who participated in clinical practice between June and December 2021. A paired t-test was performed by calculating the mean and standard deviation for each item. We found that students’ overall perceptions of patient safety improved after training. Specifically, after simulation training, attitudes toward patient safety were maintained at the same level as before training, while students’ self-efficacy of patient safety increased. Simulation training is effective in improving students’ perceptions of patient safety, and increasing students’ confidence can improve their clinical performance. To maintain this effect, repeated learning is required, and theoretical classes and simulation training should be used appropriately for patient safety education in the future.