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"Simulated environment (Teaching method) Psychological aspects."
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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
Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale
Background
The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students’ satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale.
Methods
A multi-centre cross-sectional study was conducted. The scale was administered to a sample of 266 undergraduate nursing students from two Italian universities after attending a medium- and high-fidelity simulation session in November 2022 and March 2023. Cronbach’s alpha coefficient and item-total correlation were sorted out to assess internal consistency and reliability. The test-retest method was used as a measure of scale stability over time as well as the confirmatory factor analysis to verify construct validity.
Results
The Cronbach’s alpha value was 0.94 for the overall scale, indicating excellent reliability, and it was 0.84 or higher for each subscales, indicating good reliability. A large correlation coefficient of 0.60 or higher was found between each item and its subscale and between each item and the overall scale score. A medium test-retest correlation coefficient was found for most items (
r
> 0.30). The confirmatory factor analysis confirmed the factorial structure found in the original study.
Conclusions
Satisfaction is an important teaching and learning quality indicator along with the achievement of learning outcomes in simulation. The Satisfaction with Simulation Experience - Italian Version scale showed good reliability and validity; therefore, it could be a useful tool to assess simulation impact in Italian nursing students. The extensive utilization of the Satisfaction with Simulation Experience scale, along with its various validated versions, could facilitate assessing satisfaction in simulation across diverse contexts and enable comparisons of findings across studies in different countries.
Journal Article
Reducing Behavior Problems Among Students with Autism Spectrum Disorder: Coaching Teachers in a Mixed-Reality Setting
Most approaches aiming to reduce behavior problems among youth with Autism Spectrum Disorder (ASD) focus on individual students; however, school personnel also need professional development to better support students. This study targeted teachers’ skill development to promote positive outcomes for students with ASD. The sample included 19 teachers in two non-public special education settings serving students with moderate to severe ASD. Participating teachers received professional development and coaching in classroom management, with guided practice in a mixed-reality simulator. Repeated-measures ANOVAs examining externally-conducted classroom observations revealed statistically significant improvements in teacher management and student behavior over time. Findings suggest that coaching and guided practice in a mixed-reality simulator is perceived as acceptable and may reduce behavior problems among students with ASD.
Journal Article
The effect of simulation-based laboratory training on undergraduate nursing students’ clinical skill, satisfaction, and self-confidence
Background
The increasing complexity of healthcare highlights the need for experiential, evidence-based learning in nursing education. Simulation-based training offers a safe space to practice clinical skills and prepare for real-world scenarios. The present study aims to evaluate the effect of simulation-based laboratory training on undergraduate nursing students’ clinical skills, satisfaction, and self-confidence compared to those who did not receive such training.
Methods
This prospective, parallel-group, non-randomized controlled trial was conducted with 180 undergraduate nursing students in their in their 2nd, 3rd, and 4th academic years. Participants were selected using a stratified sampling method, with 90 students assigned to the intervention group and 90 to the control group. The control group received standard theoretical instruction, whereas the intervention group underwent additional training in a well-equipped simulation education laboratory. The training focused on five core nursing skills: colostomy care, insulin pen administration, nasogastric tube insertion, postpartum hemorrhage assessment, and mental status examination. Each student practiced the procedures until independent, accurate performance, and assessments were conducted at baseline, one week, and one month post-intervention. Data were collected using demographic characteristics form, skill checklists, and student satisfaction and self-confidence in learning questionnaire. Statistical analyses were performed using R software, and the Mann–Whitney U test was used to compare groups.
Results
Pre-intervention skill scores were comparable between groups (
p
> 0.05). The intervention group showed significantly higher clinical skill scores at one week and one month (
p
< 0.001). Satisfaction (
p
= 0.560) and self-confidence (
p
= 0.296) did not differ significantly between groups.
Conclusion
Simulation-based training enhances clinical skill acquisition and retention in nursing students. However, it does not significantly impact satisfaction or self-confidence, indicating a need for additional strategies to support holistic learning.
Journal Article
Social and Emotional Development in a Telehealth-Based Ambulatory Care Skills Course
Objective. To determine the impact of telehealth-based simulations on students' social and emotional development. Methods. First-year pharmacy students enrolled in a professional skills course were eligible to participate in the study. Before and after the course, students completed the Personal-Interpersonal Competence Assessment, which codes onto eight subcategories: situation monitoring, inspire others, intimacy, awareness of one's aptitude, initiative to pursue leadership, empathy, sociability, and awareness of one's emotions. Students participated in seven telehealth-based simulations. Prior to each simulation, students watched a role modeling video highlighting social and emotional competence techniques used by a pharmacist during a consultation. Students then participated in simulated consultations that occurred in Zoom breakout rooms. Each student completed one consult while a teaching assistant completed a rubric derived from the Personal-Interpersonal Competence Assessment. Teaching assistants then provided formative feedback related to the student's social and emotional competence. At the semester midpoint, students completed a video log reflecting on their social and emotional development. Statistical analyses compared different time points of students' scores on the Personal-Interpersonal Competence Assessment and scores given by teaching assistants, while qualitative analysis was used for the video logs. Results. At the end of the course, improvement was noted on all factors of the Personal-Interpersonal Competence Assessment. Scores given by teaching assistants showed significant improvement over the semester, with the highest improvement noted on the subcategories inspiration and situation monitoring. On the video log, 80% of students noted improvements in their consideration of others. Conclusion. These findings suggest value in using role modeling, telehealth-based simulations, and teaching assistant feedback on pharmacy students' social and emotional development. Keywords: emotional intelligence, social and emotional development, professional skills, simulation, telehealth
Journal Article
Debriefing and Palliative Care Simulation
Palliative simulation is a beneficial bridge between theory and practice; however, it can be emotionally laden. Often overlooked during a debrief session of a palliative simulation is ensuring that participants have the skills to process the feelings they may experience.
The purpose of this mixed-methods concurrent triangulation study was to understand the perceived value and usefulness of debriefing in palliative simulation process feelings and emotions.
The simulation modality affects the intensity of feelings. A debriefer who is skilled in both debriefing simulation and coping with emotionally stressful situations allowed students to feel prepared to cope with their own feelings about palliative care. Having other students talk about their feelings in debriefing helped students to normalize their feelings.
The debriefing in palliative-based simulations requires additional considerations regarding modality and the skill set of the debriefer to adequately assist students to process feelings and emotions. [J Nurs Educ. 2019;58(10):569-576.].
Journal Article
Influence of virtual reality simulation (excluding augmented reality) on endodontic learning experiences of undergraduate dental students: a systematic review
Background
Virtual Reality (VR) technology has demonstrated a promising prospect for enhancing endodontic learning in undergraduate dental students by boosting their procedural skills, accuracy, and confidence.
Aim
To systematically evaluate the effectiveness of virtual reality (VR) simulation in endodontic education among undergraduate dental students, with a specific focus on four key outcomes: procedural accuracy, enhancement of student confidence, reduction in procedural errors, and overall learner satisfaction.
Methods
An exhaustive literature search was carried out in December 2024 in PubMed, Cochrane Library, Embase, Scopus, and ClinicalTrials.gov. Randomized controlled trials (RCTs), quasi-experimental studies, and cross-sectional studies published between 2010 and 2024 were included in the review. Risk of bias was appraised as follows: Cochrane Risk of Bias 2.0 (RoB2) tool for RCTs; Newcastle-Ottawa Quality Assessment Scale adapted for cross-sectional studies; National Institute of Health (NIH) Quality Assessment Tool for before-and-after studies; and the Methodological Index for Non-Randomized Studies (MINORS) tool for non-randomized studies without a comparator group.
Results
Fifteen studies were included in the final analysis. VR-based training showed statistically significant differences between the pre and post-test scores regarding procedural accuracy and efficiency for tasks at the end of endodontics. These results showed that VR training leads to greater confidence and skill levels in students than traditional approaches, improved retention of knowledge, and a reduction in errors. Advantages notwithstanding, limitations around cost and accessibility were observed.
Conclusion
VR simulation is an effective, valuable tool in the endodontic education toolbox. Further studies should assess cost-effectiveness and long-term clinical performance effects.
Journal Article
End-of-Life Nursing Knowledge Among Nursing Students
The U.S. health care system is poorly designed to meet the needs of patients at the end of life (EOL) and their families. Nursing students often have reported feeling inadequate to provide EOL care.
Following an EOL simulation, reflective journals were collected from junior and senior nursing students and analyzed for themes using qualitative content analysis. The condensed meaning units were abstracted into codes based on Carper's fundamental patterns of knowing.
Thirty-one junior and senior nursing students (mean age, 21.04 ± 0.52 years, 96.2% female) in a baccalaureate program participated in the study. The broad themes of student reflections included empirics (theoretical or natural historical) aesthetics (transformative nursing action), personal (interpersonal process of nurse-patient interaction), and ethics (emotion influences actions).
Student perception and participation in all roles contributes to the gestalt of the experience of a highly emotional EOL simulation for both students and faculty. [J Nurs Educ. 2020;59(3):154-157.].
Journal Article
Pre-clerkship EPA assessments: a thematic analysis of rater cognition
Background
Entrustable Professional Activities (EPAs) assessments measure learners’ competence with an entrustment or supervisory scale. Designed for workplace-based assessment EPA assessments have also been proposed for undergraduate medical education (UME), where assessments frequently occur outside the workplace and may be less intuitive, raising validity concerns. This study explored how assessors make entrustment determinations in UME, with additional specific comparison based on familiarity with prior performance in the context of longitudinal student-assessor relationships.
Methods
A qualitative approach using think-alouds was employed. Assessors assessed two students (familiar and unfamiliar) completing a history and physical examination using a supervisory scale and then thought-aloud after each assessment. We conducted a thematic analysis of assessors’ response processes and compared them based on their familiarity with a student.
Results
Four themes and fifteen subthemes were identified. The most prevalent theme related to “student performance.” The other three themes included “frame of reference,” “assessor uncertainty,” and “the patient.” “Previous student performance” and “affective reactions” were subthemes more likely to inform scoring when faculty were familiar with a student, while unfamiliar faculty were more likely to reference “self” and “lack confidence in their ability to assess.”
Conclusions
Student performance appears to be assessors’ main consideration for all students, providing some validity evidence for the response process in EPA assessments. Several problematic themes could be addressed with faculty development while others appear to be inherent to entrustment and may be more challenging to mitigate. Differences based on assessor familiarity with student merits further research on how trust develops over time.
Journal Article