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Background: The need to use innovative teaching and learning strategies in the nursing pedagogy is important in the 21st century. The challenges of clinical sites and opportunities for nursing students to gain clinical experience are a growing concern for many nurse educators. High-fidelity human patient simulators (HFHPS) are computerised mannequins that replicate a real-life patient, and when integrated into classroom teaching they allow students to become fully immersed into an almost real-life scenario. Objectives: The aim of this study was to describe how HFHPS can promote experiential learning following the management of postpartum haemorrhage as a midwifery clinical emergency. Method: A descriptive qualitative research approach was carried out in this study. The research setting was a local university in KwaZulu-Natal. The total population included all (N = 43) fourth-year baccalaureate of nursing undergraduate student midwives who participated as observers and/or role-players of a scenario role-play. An all-inclusive sampling was performed. There were 43 student midwives involved in the simulation teaching session with 6 of these students actively participating in each role-play at a time, while the remaining 37 observed. This occurred in two separate sessions and all the student midwives were involved in a debriefing session. These student midwives were then followed up and asked to participate in a focus group. The data in this article came from two separate focus groups which comprised 20 student midwives in total. Data were analysed using content analysis. Results: Four categories emerged from the data, namely HFHPS offers a unique opportunity for student midwives to manage complex real-life emergencies; promotes reflection by allowing student midwives to reflect or review their roles, decisions and skills; allows student midwives to learn from their own experiences and encourages student midwives to try out what they learnt in a real-life situation. Conclusion: High-fidelity human patient simulators can be used in a complex case scenario to promote experiential learning of a clinical emergency.

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 Simulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees’ outcomes is currently controversial and there are few data on the effects of these simulators on participants’ personal confidence and self-assessment. Methods One-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students’ performance in simulated scenarios was recorded and rated by experts. Results Participants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated. Conclusion The use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.

This meta-analysis was designed to systematically determine the effect of high-fidelity simulation teaching on nursing students' knowledge level, professional skill level and clinical ability. High-fidelity simulation is an increasingly popular pedagogical approach in nursing education. It provides students with opportunity to practice in a variety of simulations before entering clinical practice through a variety of real-life situational experiences and many institutions and educators have embraced this method for enhancing access to clinical skills. However, evidence for the effectiveness of the method in nursing teaching remains scarce. A meta-analysis and systematic review. The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wangfang. The search encompassed the establishment of these databases up until November 2021. Two reviewers separately entered the data into Review Manager Software 5.3. A total of 15 studies were included in this study. High-fidelity simulation significantly increased nursing students’ knowledge acquisition (SMD = 1. 37, 94％CI:0. 73–2. 00，P ＜0. 0001), enhanced nursing students’professional skills (SMD = 0. 90, 95％CI:0. 36–1. 44，P = 0. 0001). In terms of clinical practice ability outcomes, high-fidelity simulation significantly improved the levels of critical thinking ability (SMD = 0. 58, 95％CI:0. 09–1. 07，P ＜0. 00001), Clinical judgement ability (SMD = 1. 34, 95％CI:0. 38–2. 31，P＝0. 006) and communication skills (SMD = 2. 62, 95％CI:1. 84–3. 40，P ＜0. 001) of nursing students. We found that high-fidelity simulation have strong educational effects in nursing education, helping nursing students to increase knowledge acquisition, enhance professional skills and cultivate their clinical practice ability (critical thinking ability, communication skills and clinical judgement ability). These findings can provide guidance for nursing educators, indicating that the use of High-fidelity simulation teaching represents an effective solution for transitioning students from the learning environment to clinical practice.

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.

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.

To compare the effectiveness of high- and low-fidelity simulation, combined with theoretical foundations, in acquiring theoretical and practical knowledge, as well as in self-perceived gains from simulation. The administration of medication to critically ill patients is a complex and high-risk process that requires specialized knowledge and vigilance to prevent medication errors. In response, educational interventions have been widely implemented to enhance patient safety, with simulation-based education emerging as a key strategy. Randomized clinical trial, based on the CONSORT guidelines for simulation studies. Sixty nursing students were randomly assigned to either the experimental group (high-fidelity simulation) or the control group (low-fidelity simulation). Both groups received theoretical instruction, followed by simulation exercises. The study assessed theoretical knowledge, perceived gains from the simulation, practical performance and the evaluation of the simulation design. The study found significant improvements in theoretical knowledge and perceived gains in both groups, with the experimental group showing more substantial progress. Interestingly, practical performance was higher in the low-fidelity group. No significant differences were observed in the evaluation of the simulation design between the two groups. Both high- and low-fidelity simulations are effective in nursing education, though their impacts vary. High-fidelity simulations are more effective for enhancing theoretical understanding, while low-fidelity simulations tend to improve immediate practical skills.

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.

Training based on clinical simulation is an effective method of teaching in nursing. Nevertheless, there is no clear evidence about if it is better to use high- or medium-fidelity simulation. The aim is to analyse if students are more satisfied when their clinical simulation practices are based on high-fidelity simulation (HFS) or medium-fidelity simulation (MFS). Students´ satisfaction was assessed using the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation. The sample is composed of 393 students from two Spanish Universities. Satisfaction with simulation in nursing students is significantly greater in MFS than HFS. Simulation is beneficial for learning in all its forms, but for the acquisition of basic skills, and at a lower cost, MFS proves to be effective. However, high-fidelity is not always better than medium-fidelity as this depends on the student’s level of knowledge and clinical experience.

Simulation is an experiential learning process which provides a safe environment for learning, preventing the risk of patient harm. A review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach to explore the question: What is the state of the science on the evidence of learning outcomes in high-fidelity simulation in undergraduate nursing education? This synthesis included 20 research studies focusing on evaluating outcomes of high-fidelity simulation in undergraduate pre-licensure baccalaureate nursing students. Studies were excluded if they did not use high-fidelity simulation for the intervention group, or they evaluated faculty outcomes. Simulation design and practices are identified and discussed regarding dose and fidelity. Outcome measures reviewed include increasing levels of thinking: Remembering/Understanding/Applying (knowledge/skills), Analyzing/Perception, and Evaluating/Creating outcomes. Design of high-fidelity simulation in the nursing literature is being grounded in outcome variables with increasing levels of thinking (Bloom's Taxonomy) and based in pedagogical and nursing judgment theoretical frameworks. Reliable measurement tools are used. There is a need for a more comprehensive measurement of clinical competence that extends evaluation to clinical practice outcomes. Additional research is needed on retention of simulation learning over time and assessing transference of simulation learning into clinical nursing practice. •Design of high-fidelity simulation in nursing literature is grounded in theory.•Varied learning outcomes relating to clinical competence have positive outcomes.•Variables examined related to clinical competence lack comprehensiveness.•Study on retention of learning and transference into clinical practice is needed.