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Patient outcomes in critical care have long been linked to provider experience, but with older providers retiring, it is becoming difficult to maintain a high-level of experience among the ICU staff. Innovative training methods that improve providers' knowledge and confidence may be able to make up for deficiencies in clinical experience. High-fidelity simulation training mimics clinical experience and has been extensively studied in the training of procedural skills, but what is the effect of this type of training on knowledge and confidence? To answer this question, we conducted a review of the literature for studies examining the effect of simulation training on knowledge and confidence among critical care providers. Seventeen papers were identified that met the inclusion criteria and a systematic approach was used to review the papers and synthesize the data. All 17 studies demonstrated an improvement in knowledge and while only 13 of the included studies examined the effect on provider confidence, all found an improvement. We conclude that high-fidelity simulation is a useful tool for improving knowledge and confidence among critical care providers and merits consideration for inclusion in critical care training programs.

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.

The purpose of this study is to evaluate the effects of a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment. Seventy-seven students were randomized to either a non-technical skills seminar (NTS group, n=43) or a medical seminar (control group, n=34). The human patient simulation was used as an evaluation tool. Before the seminars, all students performed the same simulated emergency scenario to provide baseline measurements. After the seminars, all students were exposed to a second scenario, and behavioural markers for evaluating their non-technical skills were rated. Furthermore, teamwork-relevant attitudes were measured before and after the scenarios, and perceived stress was measured following each simulation. All simulations were also evaluated for various medical endpoints. Non-technical skills concerning situation awareness (p<.01, r=0.5) and teamwork (p<.01, r=0.45) improved from simulation I to II in the NTS group. Decision making improved in both groups (NTS: p<.01, r=0.39; control: p<.01, r=0.46). The attitude 'handling errors' improved significantly in the NTS group (p<.05, r=0.34). Perceived stress decreased from simulation I to II in both groups. Medical endpoints and patients´ outcome did not differ significantly between the groups in simulation II. This study highlights the effectiveness of a single brief seminar on non-technical skills to improve student's non-technical skills. In a next step, to improve student's handling of emergencies and patient outcomes, non-technical skills seminars should be accompanied by exercises and more broadly embedded in the medical school curriculum.

Purpose: The purpose of this paper was to explore techniques used successfully for human simulation exercises in nursing education. Design and Methods: An integrated review of current literature was completed using the Cumulative Index to Nursing and Allied Health Literature (CINAHL) with Full Text and PubMed databases to identify studies that used simulation successfully in nursing curriculum. Findings and Conclusions: Human patient simulation can be used successfully as an instructional method in nursing education. While no single process was proven to be superior, there are techniques which have been used effectively. Clinical Relevance: Nursing educators are challenged with discovering ways to facilitate the education of their students. Human patient simulation can be a valuable tool. More research is needed to fully develop this promising educational avenue.

Professional nurses must have the knowledge and skills to safely administer blood products and monitor for life-threatening complications. Nurse educators should ensure that student nurses also learn how to safely administer blood products; however students rarely have the opportunity to witness and manage adverse transfusion reactions. Despite the low incidence of rare adverse transfusion reactions, nursing students must be able to immediately recognize transfusion reactions, implement appropriate interventions, and communicate effectively with health care providers. To reinforce blood transfusion knowledge, practice technical skills, and promote management of adverse reactions, a human patient simulation experience was created for baccalaureate nursing students to provide application of related classroom content. Using a quasi-experimental design, students who received a related didactic lecture preceding the simulation were compared with students who did not receive the lecture. The lecture group's pre/posttest mean scores (n = 42) were significantly higher than the no lecture group's mean scores (n = 44). This simulation design included proper blood administration procedures, patient monitoring, management of transfusion reactions, and practice with interdisciplinary communication. Participation in a human patient simulation following a related didactic lecture may be useful to strengthen cognitive learning and help bridge the didactic-clinic gap. •Simulation provided students with standardized learning and the opportunity to witness rare blood transfusion reactions.•Attending a related didactic lecture prior to the blood transfusion simulation seemed to improve students' knowledge.•Human patient simulation after lecture may strengthen learning outcomes and help to bridge the didactic-clinic gap.

Objective. To determine whether human patient simulation (HPS) is superior to case-based learning (CBL) in teaching diabetic ketoacidosis (DKA) and thyroid storm (TS) to pharmacy students. Design. In this cross-over, open-label, single center, randomized control trial, final-year undergraduate pharmacy students enrolled in an applied therapeutics course were randomized to HPS or CBL groups. Pretest, posttest, knowledge retention tests, and satisfaction survey were administered to students. Assessment. One hundred seventy-four students participated in this study. The effect sizes attributable to HPS were larger than CBL in both cases. HPS groups performed significantly better in posttest and knowledge retention test compared to CBL groups pertaining to TS case (p<0.05). Students expressed high levels of satisfaction with HPS sessions. Conclusion. HPS was superior to CBL in teaching DKA and TS to final-year undergraduate pharmacy students.

Providing clinical opportunities for students to gain experience in managing cardiac dysrhythmias is a challenge for nursing faculty. High-risk experiences are often not available for all students or are too life-threatening to entrust to students. Faculty shortages and increasing enrollments add to declines in clinical opportunities. The use of human patient simulation (HPS) has added opportunities to experience high-risk, low-frequency clinical situations. HPS may be employed in the classroom setting to teach content related to dysrhythmia treatments. This innovative approach to HPS utilization engages students and helps them apply theory into clinical nursing practice.

The most common types of assessment of human patient simulation are satisfaction and/or confidence surveys or tests of knowledge acquisition. There is an urgent need to develop valid, reliable assessment instruments related to simulation-based learning. Assessment practices for simulation-based activities in the pharmacy curricula are highlighted, with a focus on human patient simulation. Examples of simulation-based assessment activities are reviewed according to type of assessment or domain being assessed. Assessment strategies are suggested for faculty members and programs that use simulation-based learning.

This paper discusses using human patient simulation (HPS) to expose students to complex dynamic patient cases that require clinical judgment, problem-solving skills, and teamwork skills for success. An example of an HPS exercise used to teach multifaceted clinical concepts in a therapeutics course also is provided.

This article describes a successfully piloted method for facilitating rapid psychometric assessments of three simulation evaluation instruments: the Lasater Clinical judgment Rubric, the Seattle University Evaluation Tool, and the Creighton-Simulation Evaluation Instrument. To provide valid and reliable evaluations of student performance in simulation activities, it is important to assess the psychometric properties of evaluation instruments. This novel method incorporates the use of a database of validated, video-archived simulations depicting nursing students performing at varying levels of proficiency.A widely dispersed sample of 29 raters viewed and scored multiple scenarios over a six-week period. Analyses are described including inter- and intrarater reliability, internal consistency, and validity assessments. Descriptive and inferential statistics supported the validity of the leveled scenarios.The inter- and intrarater reliability and internal consistencies of data from the three tools are provided.The article provides information and resources for readers to access in order to assess their own simulation evaluation instruments using the described methods.