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"Simulated environment (Teaching method)"
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Modeling of next generation digital learning environments : complex systems theory
The emergence of social networks, OpenCourseWare, Massive Open Online Courses, informal remote learning and connectivist approaches to learning has made the analysis and evaluation of digital learning environments more complex. Modelling these complex systems makes it possible to transcribe the phenomena observed and facilitates the study of these processes with the aid of specific tools. Once this essential step is taken, it then becomes possible to develop plausible scenarios from the observation of emerging phenomena and dominant trends. This book highlights the contribution of complex systems theory in the study of next generation digital learning environments.
Book
The affective component of learning in simulation-based education – facilitators’ strategies to establish psychological safety and accommodate nursing students’ emotions
Background
Active learning situations such as simulation-based education (SBE) are found to trigger a wide range of emotions among students. Facilitators have an important educational role in SBE which include being attentive and adaptive to students’cognitive and affective responses. Although the importance of emotions in SBE is recognized in facilitator guidelines, little is known about how facilitators accommodate student affect. Hence, this study explores facilitators’ strategies for addressing students’ emotions in SBE.
Method
Individual interviews with nine facilitators were performed and transcripts were subjected to qualitative analyses in accordance with interpretive description approach.
Results
Findings show that facilitators are attentive to and continuously assess students’ emotional responses in SBE. Both positive emotions, such as interest and surprise, and negative emotions such as anxiety are cultivated, yet adapted to the perceived needs of the individual student. Psychological safety was seen as a prerequisite for optimal learning, regardless of the students’ previous level of knowledge. Furthermore, significant learning was seen as something that might also arise from uncomfortable experiences, such as students realizing their own mistakes or uncertainty. Hence facilitators were found to balance levels of difficulty, emotional arousal and psychological safety during the various phases of SBE.
Conclusion
Facilitators recognize the emotional dimension of learning in SBE and have numerous strategies for accommodating students’ emotions. This study highlights the complexity of the facilitator’s role in adapting training to individual cognitive and emotional needs. These findings have implications for facilitator training which should include awareness of the role of emotions in learning and strategies for observing and accommodating training to meet emotional needs.
Journal Article
Developing a competency framework for training with simulations in healthcare: a qualitative study
Background
Simulation is a technique used to create an experience without going through the real event. Competency-based medical education focuses on outcomes and ensures professionals have the necessary knowledge, skills, and attitudes. The purpose of this study was to develop a set of competencies for the instructors providing basic and advanced levels of simulation-based training in healthcare.
Methods
We conducted a qualitative study in three steps, with each next step building on and influenced by the previous one. First, we conducted a literature review, then a consensus development panel, and finally a three-step Delphi process. The participants were experts in the fields of healthcare, education, and simulations.
Results
The six main competencies identified for the instructor providing simulation-based training at the basic level in healthcare include knowledge of simulation training, education/training development, education/training performance, human factors, ethics in simulation, and assessment. An instructor providing simulation-based training at an advanced level in healthcare should also possess the following five competencies: policies and procedures, organisation and coordination, research, quality improvement, and crisis management.
Conclusion
The identified competencies can serve as a valuable resource for simulation educators and organisations involved in simulation education, to plan curriculum and implement a continuous train-the-trainers programme.
Journal Article
Educational efficacy of high-fidelity simulation in neonatal resuscitation training: a systematic review and meta-analysis
Background
The training of neonatal resuscitation is an important part in the clinical teaching of neonatology. This study aimed to identify the educational efficacy of high-fidelity simulation compared with no simulation or low-fidelity simulation in neonatal resuscitation training.
Methods
The PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, Chinese databases (CBM, CNKI, WanFang, and Weipu), ScopeMed and Google Scholar were searched. The last search was updated on April 13, 2019. Studies that reported the role of high-fidelity simulation in neonatal resuscitation training were eligible for inclusion. For the quality evaluation, we used the Cochrane Risk of Bias tool for RCTs and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCTs. A standardized mean difference (SMD) with a 95% confidence interval (CI) was applied for the estimation of the pooled effects of RCTs.
Results
Fifteen studies (10 RCTs and 5 single arm pre-post studies) were ultimately included. Performance bias existed in all RCTs because participant blinding to the simulator is impossible. The assessment of the risk of bias of single arm pre-post studies showed only one study was of high quality with a low risk of bias whereas four were of low quality with a serious risk of bias. The pooled results of single arm pre-post studies by meta-analysis showed a large benefit with high-fidelity simulation in skill performance (SMD 1.34; 95% CI 0.50–2.18). The meta-analysis of RCTs showed a large benefit in skill performance (SMD 1.63; 95% CI 0.49–2.77) and a moderate benefit in neonatal resuscitation knowledge (SMD 0.69; 95% CI 0.42–0.96) with high-fidelity simulation when compared with traditional training. Additionally, a moderate benefit in skill performance (SMD 0.64; 95% CI 0.06–1.21) and a small benefit was shown in knowledge (SMD 0.39; 95% CI 0.08–0.71) with high-fidelity simulation when compared with low-fidelity simulation.
Conclusions
Improvements of efficacy were shown both in resuscitation knowledge and skill performance immediately after training. However, in current studies, the long-time retention of benefits is controversial, and these benefits may not transfer to the real-life situations.
Journal Article
Enhancing forensic clinical competence through scenario-based simulation: A comparative study of educational outcomes in Chinese medical students
Forensic clinical medicine examines injuries in living individuals and plays a critical role in criminal violence cases, trauma compensation, and judicial rulings. In China, this field contributes substantially to upholding social justice. Current educational approaches struggle to bridge the gap between theory and practice, largely due to privacy constraints during forensic examinations, leaving students ill-prepared to assess real cases and identify key evaluation criteria. Scenario-based simulation training presents a promising alternative to conventional case-based teaching.
We compared the efficacy of traditional case-based teaching with scenario-based simulation in a forensic clinical medicine course. Two cohorts of undergraduate forensic science students from consecutive academic years underwent each teaching method. Post-course assessments included theoretical examinations and practical evaluations as quantitative measures of knowledge acquisition. Professional instructors graded students' performance, while self-evaluation surveys captured learning experiences.
Scenario-based simulation teaching yielded superior learning outcomes. The simulation group (2020 cohort) achieved higher scores than the traditional group (2019 cohort) in both theoretical (*p < 0.05) and practical assessments, with notably better knowledge retention (subjective questions: **p < 0.01; objective questions: *p < 0.05). The simulation group also demonstrated stronger theory-practice integration (r = 0.9622 vs. 0.9115). Instructor evaluations (n = 11) demonstrated that scenario-based simulation teaching improved students' learning motivation (81.8%), theoretical application (72.7%), communication skills (81.8%), analytical abilities (63.6%), and teamwork competencies (54.5%). All instructors reported enhanced professional image, with 90.9% noting increased teaching motivation. Student self-assessments reinforced these results: over 80% of the simulation group reported gains in theoretical learning effectiveness, analytical/operational capabilities, and professional self-assurance, versus ≤31.9% in the traditional group. Classroom metrics favored the simulation group (self-study interest: 65% vs. 45.5%; engagement: 90% vs. 45.5%; collaboration: 80% vs. 36.4%), though 10% cited challenges with preparatory workload.
Scenario-based simulation teaching significantly enhances forensic clinical education by strengthening the connection between theory and practice while improving student competencies. Addressing teaching costs and adapting to student needs will further refine its effectiveness.
Journal Article
Collaborative virtual reality environment in disaster medicine: moving from single player to multiple learners
Background
The use of virtual reality (VR) in healthcare education is on the increase. In disaster medicine, it could be a solution to the cost and logistic constraints for a “full-scale” scenarios. However, VR is mainly designed for single players, which is not appropriate for the objectives pursued in disaster medicine. We decided to evaluate the educational value of using individual VR simulation in disaster medicine on a group of learners.
Methods
The VR scenario used was a reproduction of a major train crash, with 21 victims and whose objectives were START triage and first aid techniques. The sessions were carried out in multi-participant groups with different roles (active and immersed with headset, paper triage without headset, and active for communications not immersed in the headset). Their perceived self-efficacy was assessed before (T0), after (T1) and 2 months (T2) after the training. Satisfaction and confidence in learning were also measured.
Results
The median levels of satisfaction and confidence in learning were of 21/25 and 32/40 respectively. Their perceived self-efficacy increased significantly between T0 and T1 (
p
< 0.001), and remained stable until T2. The different roles of participant showed no difference in terms of satisfaction, confidence in learning or changes in perceived self-efficacy. One third of the participants agreed that the number of participants had interfered with their learning. A significant negative correlation (r
S
= -0.51,
p
= 0.002) was found between satisfaction and the fact of having been hindered by the number of participants. Around 90% of participants found the activity entertaining and found the new technologies appropriate for learning technical skills.
Conclusions
This first experience of VR in a group setting is satisfactory and shows its positive effects. The limitations highlighted here will enable areas of improvement to be identified for the use of VR in disaster medicine, pending the development of multi-player tools. It would now be appropriate to analyse the impact of this type of simulation on learning and its retention over time.
Journal Article
Application of the online teaching model based on BOPPPS virtual simulation platform in preventive medicine undergraduate experiment
Background
As online teaching gains prevalence in higher education, traditional face-to-face methods are encountering limitations in meeting the demands of medical ethics, the availability of experimental resources, and essential experimental conditions. Consequently, under the guidance of the BOPPPS (bridge-in, objective, preassessment, participatory learning, postassessment, summary) teaching model, the application of virtual simulation platform has become a new trend. The purpose of this study is to explore the effect of BOPPPS combined with virtual simulation experimental teaching on students’ scores and the evaluation of students’ participation, performance and teachers’ self-efficacy in preventive medicine experiment.
Methods
Students from Class 1 and Class 2 of 2019 preventive medicine major in Binzhou Medical University were selected as the research objects. The experimental group (class 2) (
n
= 51) received the teaching mode combined with BOPPPS and virtual simulation platform, while the control group (class 1) (
n
= 49) received the traditional experimental teaching method. After class, the experimental report scores, virtual simulation scores, students’ engagement scale (SES), Biggs questionnaires, and teachers’ sense of self-efficacy (TSES) questionnaires were analyzed.
Results
The experimental report results demonstrated a significant increase in the total score of the experimental group and the scores of each of the four individual experiments compared to the control group (
P
< 0.05). To investigate the impact of the new teaching model on students’ learning attitudes and patterns, as well as to evaluate teachers’ self-efficacy, a questionnaire survey was administered following the course. The SES results showed that students in the experimental group had high performance scores on the two dimensions of learning methods and learning emotions (
t
= 2.476,
t
= 2.177;
P
= 0.015,
P
= 0.032). Furthermore, in the Biggs questionnaire, the total deep learning score of the experimental group was higher than that of the control group (
t
= 2.553,
P
= 0.012), and the deep learning motivation score of the experimental group was higher than that of the control group (
t
= 2.598,
P
= 0.011). The TSES questionnaire shows that most teachers think it is easier to manage students and the classroom and easier to implement teaching strategies under this mode.
Conclusions
The combination of BOPPPS and the virtual simulation platform effectively enhances the experimental environment for students, thereby improving their academic performance, engagement and learning approach in preventive medicine laboratory courses.
Journal Article
Virtual reality simulation training in laparoscopic surgery – does it really matter, what simulator to use? Results of a cross-sectional study
Background
Virtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training “on the patient”. However, there are no data comparing different commercially available high-end virtual reality simulators.
Methods
Trainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination.
Results
All trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (
p
< 0.001), median time taken improved from 305 to 167 s (
p
< 0.001).
Conclusions
All Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.
Journal Article
Analysis of Undergraduate Nursing Students' Sensitivity to Microethical Dilemmas During Simulation
Simulation can extend ethics education in undergraduate nursing programs beyond the cognitive domain. However, the degree to which nursing students recognize and respond to microethical dilemmas in simulation is unknown.
Using a mixed-methods convergent parallel design, 68 third- and fourth-year undergraduate nursing students completed a sensitivity questionnaire. Twelve students also participated in an interview. Data were compared to create meaning.
Many students reported having a high level of ethical sensitivity toward microethical dilemmas during simulation. However, some students expressed uncertainty in their ability to identify microethical dilemmas during nurse-patient interactions. Students also reported limited confidence in being able to transfer their ethical knowledge to the practice setting.
Nurse educators must be moral agents during simulated learning experiences by helping students learn what microethical dilemmas are and strategies to manage them. [J Nurs Educ. 2020;59(2):88-92.].
Journal Article