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The quality of healthcare varies significantly from one country to another. This variation can be attributed to several factors, including the level of healthcare professionals’ professionalism, which is closely linked to the quality of their education. Medical and healthcare education is unique in its need for students to learn and practice various clinical skills, algorithms, and behaviours for clinical situations. However, it is challenging to ensure these educational experiences do not compromise the quality of healthcare and patient safety. A simulation-based educational (SBE) approach offers a solution to these challenges. However, despite the widespread adoption of the SBE approach in medical and healthcare education curricula; its recognition for its high value among students, educators, and healthcare professionals; and evidence showing its positive impact on reducing risks to both patients and healthcare professionals, there is still an absence of a standardized approach and guidelines for integrating simulations, which includes determining when, how, and to what ex-tent they should be implemented. Currently, there is no regulation on the need for SBE integration in medical and healthcare curricula. However, the framework of this article, based on the results of the analysis of the legal framework, which includes a set of laws, regulations, principles, and standards set by various government, administrations, and authoritative institutions, will determine the fundamental aspects of the integration of the SBE approach that justify and argue the need to (1) incorporate simulation-based education across all levels of medical and healthcare education programs and (2) adhere to certain standards when integrating the SBE approach into medical and healthcare programs. This is an area that needs to be developed with the involvement of legal, health, and education experts.

Objective Although simulation-based education is now commonly utilized in medicine, its use in the instruction of congenital heart disease remains limited. The objective of this study is to evaluate whether heart models created with three-dimensional printing technology can be effectively incorporated into a simulation-based congenital heart disease and critical care training curriculum for pediatric resident physicians. Design Utilizing heart models created with a three-dimensional printer, pediatric residents participated in a 60-minute simulation seminar with three consecutive components: (1) didactic instruction on ventricular septal defect anatomy; (2) didactic/simulation-based instruction on echocardiographic imaging of ventricular septal defects and anatomical teaching/operative simulation of ventricular septal defect repair; (3) simulation-based instruction on postoperative critical care management of ventricular septal defects. Setting Academic, free-standing, children's hospital with quaternary care referrals. Participants Twenty-three pediatric resident physicians. Outcome Measures Subjective, Likert-type questionnaires assessing knowledge acquisition, knowledge reporting, and structural conceptualization of ventricular septal defects. Results Three-dimensional printing technology was successfully utilized to create heart models of five common ventricular septal defect subtypes. After using these models in a simulation-based curriculum, pediatric residents were found to have improvement in the areas of knowledge acquisition (P = .0082), knowledge reporting (P = .01), and structural conceptualization (P < .0001) of ventricular septal defects, as well as improvement in the ability to describe and manage postoperative complications in ventricular septal defect patients in the critical care setting. Conclusions The utilization of three-dimensional printing in a simulation-based congenital heart disease and critical care training curriculum is feasible and improves pediatric resident physicians' understanding of a common congenital heart abnormality.

[Display omitted] Malignant hyperthermia (MH) is a life‐threatening anesthetic emergency that requires rapid recognition and intervention to prevent severe complications. Delays in treatment can result in poor patient outcomes, making MH preparedness crucial in perioperative care. The aim of this quality improvement project was to enhance perioperative team preparedness for MH crises through in situ simulation using rapid cycle deliberate practice. The project was implemented over five days in a 14‐room operating suite and a 31‐bed postanesthesia care unit at an academic medical center in the United States. Interprofessional perioperative staff engaged in high‐fidelity simulation drills with real‐time feedback. The intervention significantly improved team response times and adherence to MH treatment protocols (P < .001), with notable reductions in time to dantrolene administration (P = .018) and cooling measure initiation (P = .011). Results from this project support integration of structured simulation training to enhance preparedness for rare anesthetic emergencies.

Cognitive Load Theory (CLT) is one of the key cognitive theories that have been used to assess learners' information and working memory load. CLT has been applied to Simulation Based Education (SBE) and optimizing instructional design. However, a challenge that occurs is that these high-fidelity simulations and mannequins of critically ill patients can elicit negative emotions in learners which can unfavorably impact the learning process. There is also a potential for cognitive overload if the simulation is more authentic and requires more dynamic interactions and lead to high levels of anxiety due to a novel learning environment, which can also have detrimental effects on learning process. Hence, it is critical for health professional educators (HPE) to know how to minimize cognitive load to improve learning as a professional in a workplace setting. The literature on the role of emotions, intrinsic motivation, cognitive load is scarce in HPE literature. Specifically when not being studied together at once since they move dynamically together and affect the learning for the learner. Therefore, the purpose of this perspective paper is to cover the gap in the literature and propose a framework and recommendation for future HPE research.

Over the past 30 years surgical training, including urology training, has changed from the Halstedian apprenticeship-based model to a competency-based one. Simulation-based education (SBE) is an effective, competency-based method for acquiring both technical and non-technical surgical skills and has rapidly become an essential component of urological education. This article introduces the key learning theory underpinning surgical education and SBE, discussing the educational concepts of mastery learning, deliberate practice, feedback, fidelity and assessment. These concepts are fundamental aspects of urological education, thus requiring clinical educators to have a detailed understanding of their impact on learning to assist trainees to acquire surgical skills. The article will then address in detail the current and emerging simulation modalities used in urological education, with specific urological examples provided. These modalities are part-task trainers and 3D-printed models for open surgery, laparoscopic bench and virtual reality trainers, robotic surgery simulation, simulated patients and roleplay, scenario-based simulation, hybrid simulation, distributed simulation and digital simulation. This article will particularly focus on recent advancements in several emerging simulation modalities that are being applied in urology training such as operable 3D-printed models, robotic surgery simulation and online simulation. The implementation of simulation into training programmes and our recommendations for the future direction of urological simulation will also be discussed.

This study reviewed the papers that studied the effect of simulation nursing education in the nursing field and examined the trend of simulation nursing education for nursing college students in Korea. Background: Simulation-based education started receiving attention as a pedagogical method in order to provide medical service of high quality in an ethical and safe environment. This has been of great importance during the coronavirus disease 2019 global pandemic. This literature review was conducted to suggest a direction for simulation-based nursing education in Korea. Methods: For literature searches, the authors used the following search terms in the Web of Science, CINAHL, Scopus, PubMed—‘utilization’, ‘simulation,’ ‘nursing student’, ‘nursing education’. A final search was conducted on 6 January 2021. The materials for this study were collected through literature searches according to the PRISMA guidelines. Results: 25 papers were selected as the final literature for analysis. The study was conducted for 48 percent of senior students in nursing college students in Korea (N = 12). High fidelity (HF) as the simulation type was 44 percent (N = 11). The simulation education subjects were composed of 52 percent adult health nursing (N = 13). According to educational goals described by Benzamine Bloom (1956), 90% in the psychomotor domain is considered a positive learning achievement. Conclusions: Effectiveness in the psychomotor domain through simulation-based training is correlated with expert nursing. It is essential to develop a systematic debriefing model and methods to evaluate performance and learning in the short- and long-term to expand the effectiveness of simulation-based education in nursing.

This study aimed to evaluate the outcomes of a hands-on simulation-based course with emphasis on procedural techniques, clinical reasoning, and communication skills developed to improve junior Otolaryngology - Head and Neck Surgery (OHNS) residents' preparedness in managing otolaryngologic emergencies. Junior OHNS residents and faculty from residency programs in California, Nevada, and Arizona participated in this workshop in 2020 and 2021. The stations featured airway management techniques, ultrasound-guided needle aspiration, nasoseptal hematoma evacuation, and facial fracture repair using various models and cadavers. Participants completed a pre-workshop survey, post-workshop survey, and 2-month follow-up survey that assessed resident anxiety and confidence in three OHNS emergency situations across knowledge, manual skills, and teamwork using a 5-point Likert scale. Pre-workshop surveys reported the least anxiety and most confidence in teamwork, but the most anxiety and least confidence in technical skills and knowledge related to foreign body retrieval and airway management. Immediately post-workshop participants reported significant reductions in anxiety and increases in confidence, largest in the manual skills domain, in foreign body retrieval (anxiety: -0.99, confidence: +0.95,  < .01) and airway management stations (anxiety: -0.68, confidence: +1.07,  < .01). Data collected for the epistaxis station showed decreasing confidence and increasing anxiety following the workshop. Our findings demonstrate the effectiveness of a workshop in preparing junior residents in potentially lifesaving otolaryngologic techniques that residents will encounter. Optimizing use of simulation centered training can inform the future of residency education, improving confidence and decreasing anxiety in residents responsible for the safety of patients. III.

This study aimed to develop a mental health nursing simulation education programme for non‐psychiatric nurses and verify its effects on mental health care competence, burden, and anxiety. To verify the effects of the simulation, we applied a non‐equivalent control group pre‐posttest research design. We developed a mental health nursing simulation using a standardized patient who presented moderate levels of anxiety and depressive mood during chemotherapy after mastectomy. The participants were nurses working at non‐psychiatric wards of a general hospital in Seoul, Korea. Participants' mental health care competency scores increased by 80% in the experimental group and 15% in the control group from pre‐test to posttest. Burden scores decreased by 42% in the experimental group and 4% in the control group from pre‐test to posttest, and anxiety scores decreased by 77% in the experimental group and 24% in the control group. This study demonstrated the nursing simulation education programme's effectiveness as a complementary tool to improve mental health nursing care for non‐psychiatric nurses.

Background In-situ simulation is increasingly employed in healthcare settings to support learning and improve patient, staff and organisational outcomes. It can help participants to problem solve within real, dynamic and familiar clinical settings, develop effective multidisciplinary team working and facilitates learning into practice. There is nevertheless a reported lack of a standardised and cohesive approach across healthcare organisations. The aim of this systematic mapping review was to explore and map the current evidence base for in-situ interventions, identify gaps in the literature and inform future research and evaluation questions. Methods A systematic mapping review of published in-situ simulation literature was conducted. Searches were conducted on MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, MIDIRS and ProQuest databases to identify all relevant literature from inception to October 2020. Relevant papers were retrieved, reviewed and extracted data were organised into broad themes. Results Sixty-nine papers were included in the mapping review. In-situ simulation is used 1) as an assessment tool; 2) to assess and promote system readiness and safety cultures; 3) to improve clinical skills and patient outcomes; 4) to improve non-technical skills (NTS), knowledge and confidence. Most studies included were observational and assessed individual, team or departmental performance against clinical standards. There was considerable variation in assessment methods, length of study and the frequency of interventions. Conclusions This mapping highlights various in-situ simulation approaches designed to address a range of objectives in healthcare settings; most studies report in-situ simulation to be feasible and beneficial in addressing various learning and improvement objectives. There is a lack of consensus for implementing and evaluating in-situ simulation and further studies are required to identify potential benefits and impacts on patient outcomes. In-situ simulation studies need to include detailed demographic and contextual data to consider transferability across care settings and teams and to assess possible confounding factors. Valid and reliable data collection tools should be developed to capture the complexity of team and individual performance in real settings. Research should focus on identifying the optimal frequency and length of in-situ simulations to improve outcomes and maximize participant experience.