BackgroundA serious game (SG) is a useful tool for nurse training. The objectives of this study were to assess validity evidence of a new SG designed to improve nurses’ ability to detect patient clinical deterioration.MethodsThe SG (LabForGames Warning) was developed through interaction between clinical and pedagogical experts and one developer. For the game study, consenting nurses were divided into three groups: nursing students (pre-graduate) (group S), recently graduated nurses (graduated < 2 years before the study) (group R) and expert nurses (graduated > 4 years before the study and working in an ICU) (group E). Each volunteer played three cases of the game (haemorrhage, brain trauma and obstructed intestinal tract). The validity evidence was assessed following Messick’s framework: content, response process (questionnaire, observational analysis), internal structure, relations to other variables (by scoring each case and measuring playing time) and consequences (a posteriori analysis).ResultsThe content validity was supported by the game design produced by clinical, pedagogical and interprofessional experts in accordance with the French nurse training curriculum, literature review and pilot testing. Seventy-one nurses participated in the study: S (n = 25), R (n = 25) and E (n = 21). The content validity in all three cases was highly valued by group E. The response process evidence was supported by good security control. There was no significant difference in the three groups’ high rating of the game’s realism, satisfaction and educational value. All participants stated that their knowledge of the different steps of the clinical reasoning process had improved. Regarding the internal structure, the factor analysis showed a common source of variance between the steps of the clinical reasoning process and communication or the situational awareness errors made predominantly by students. No statistical difference was observed between groups regarding scores and playing time. A posteriori analysis of the results of final examinations assessing study-related topics found no significant difference between group S participants and students who did not participate in the study.ConclusionWhile it appears that this SG cannot be used for summative assessment (score validity undemonstrated), it is positively valued as an educational tool.Trial registrationClinicalTrials.gov ID: NCT03092440

BackgroundSimulation, as an activity in speech-language pathology training, can increase opportunities for students to gain required skills and competencies. One area that has received little attention in the simulation literature, yet is a growing area of clinical practice, is alternative and augmentative communication (AAC). Also growing, is the use of telepractice to deliver services. This exploratory study investigated graduate entry speech-language pathology student perceptions of a simulation learning experience working with an adult with complex communication needs via telepractice.MethodsFirst year Master of Speech Pathology students completed a 1-day simulation using a videoconferencing delivery platform with an actor portraying an adult client with motor neurone disease requiring AAC. Quantitative and qualitative survey measures were completed pre- and post-simulation to explore students’ confidence, perceived impact on clinical performance, and perceived extent of learning, specifically, their interest, competence, and tension. Further, students’ perceptions about the telepractice system useability were explored. Fifty-two responses were received and analysed using descriptive statistics and content analysis.ResultsPost-simulation, students reported increased confidence and perceived positive impacts on their confidence and clinical skills across communication, assessment, and management domains. They felt better prepared to manage a client with a progressive neurological condition and to make AAC recommendations. For telepractice delivery, technology limitations were identified as impacting its use, including infrastructure (e.g., weak internet connection). In addition, some students reported feeling disconnected from the client.ConclusionThis study supports the use of simulation in AAC through telepractice as a means of supporting Masters-level speech pathology student learning in this area of practice.

The original article [1] contains a previous iteration of author, Chen Zhang’s name.

The original article [1] contains an error in the Ethics approval statement of the Declarations regarding approval of the study.

BackgroundTraining emergency medical services (EMS) workforce is challenging in rural and remote settings. Moreover, critical access hospitals (CAHs) struggle to ensure continuing medical education for their emergency department (ED) staff. This project collected information from EMS and ED providers across Nebraska to identify gaps in their skills, knowledge, and abilities and thus inform curriculum development for the mobile simulation-based training program.MethodsThe needs assessment used a three-step process: (1) four facilitated focus group sessions were conducted in distinct geographical locations across Nebraska to identify participants’ perceived training gaps; (2) based on the findings from the focus group, a needs assessment survey was constructed and sent to all EMS and ED staff in Nebraska; and (3) 1395 surveys were completed and analyzed.ResultsThematic areas of training gaps included cardiopulmonary conditions, diabetes management, mass casualty incidents (MCI), maternal health and child delivery, patient assessment, pediatric care (PC), and respiratory emergency care. Gaps in non-clinical skills were related to crisis management such as maintaining effective teamwork. Participants frequently identified cardiopulmonary care, PC, and MCI as highly needed trainings. Other needs included life support-related retaining courses, sessions informing protocol updates, the availability of retraining tailored for rural areas, substance use-related emergencies, and farming-related injuries.ConclusionEMS and ED staff identified several skill gaps and training needs in the provision of emergency services in rural communities. These results allow for the development of customized training curricula and, with the help of an on-site simulation-based program, can identify gaps in health professionals’ skills, knowledge, and abilities and thus help them respond to acute healthcare needs of rural communities.

BackgroundBased on common geography, sociopolitics, epidemiology, and healthcare services, the Nordic countries could benefit from increased collaboration and uniformity in the development of simulation-based learning (SBL). To date, only a limited overview exists on the Nordic research literature on SBL and its progress in healthcare education. Therefore, the aim of this study is to fill that gap and suggest directions for future research.MethodsAn integrative review design was used. A search was conducted for relevant research published during the period spanning from 1966 to June 2016. Thirty-seven studies met the inclusion criteria. All included studies were appraised for quality and were analyzed using thematic analysis.ResultsThe Nordic research literature on SBL in healthcare revealed that Finland has published the greatest number of qualitative studies, and only Sweden and Norway have published randomized control trials. The studies included interprofessional or uniprofessional teams of healthcare professionals and students. An assessment of the research design revealed that most studies used a qualitative or a descriptive design. The five themes that emerged from the thematic analysis comprised technical skills, non-technical skills, user experience, educational aspects, and patient safety.ConclusionThis review has identified the research relating to the progress of SBL in the Nordic countries. Most Nordic research on SBL employs a qualitative or a descriptive design. Shortcomings in simulation research in the Nordic countries include a lack of well-designed randomized control trials or robust evidence that supports simulation as an effective educational method. In addition, there is also a shortage of studies focusing on patient safety, the primary care setting, or a combination of specialized and primary care settings. Suggested directions for future research include strengthening the design and methodology of SBL studies, incorporating a cross-country comparison of studies using simulation in the Nordic countries, and studies combining specialized and primary care settings.

BackgroundThe use of simulation-based education (SBE) in health professions, such as physical therapy, requires faculty to expand their teaching practice and development. The impact of this teaching on the individual faculty member, and how their teaching process changes or develops, is not fully understood. The purpose of this study was to explore individual physical therapist faculty members’ experience with SBE and how those experiences may have transformed their teaching practice to answer the research questions: How do physical therapist faculty develop through including SBE and are there commonalities among educators?MethodsAn interpretive phenomenological analysis approach was used with a small sample of subjects who participated in three individual semi-structured interviews. Interview questions were created through the lens of transformative learning theory to allow faculty transformations to be uncovered. A two-step thematic coding process was conducted across participants to identify commonalities of faculty experiences with SBE in physical therapist education. Credibility and trustworthiness were achieved through member checking and expert external review. Thematic findings were validated with transcript excerpts and research field notes.ResultsEight physical therapist faculty members (25% male) with a range of 3 to 16 years of incorporating SBE shared their individual experiences. Four common themes related to faculty development were identified across the participants. Themes identified are the following: faculty strengthen their professional identity as physical therapists, faculty are affected by their introduction and training with simulation, faculty develop their interprofessional education through SBE, and faculty experiences with SBE facilitate professional growth.ConclusionPhysical therapist educators had similarities in their experiences with SBE that transformed their teaching practice and professional development. This study provides insight into what physical therapist faculty may experience when adopting SBE.

Healthcare simulation has been widely adopted for health professional education at all stages of training and practice and across cognitive, procedural, communication and teamwork domains. Recent enthusiasm for in situ simulation—delivered in the real clinical environment—cites improved transfer of knowledge and skills into real-world practice, as well as opportunities to identify latent safety threats and other workplace-specific issues.However, describing simulation type according to place may not be helpful. Instead, I propose the term translational simulation as a functional term for how simulation may be connected directly with health service priorities and patient outcomes, through interventional and diagnostic functions, independent of the location of the simulation activity.

This paper presents a description of, and some reflections around, the experience of implementing simulation-based education within a nursing education programme in a low-income context. The students in the nursing education programme found the simulation sessions to be useful, motivating and a realistic learning method. Our experience may provide useful insight for other nursing education programmes in low-income contexts. It looks like a deeper knowledge about the feasibility of simulation-based education from both the teacher and student perspective is necessary.