Teaching Clinical Skills During Pandemic Times

Clinical simulation is a teaching strategy that replicates medical situations in controlled environments. The COVID-19 pandemic created disruptions for healthcare simulation centers. As a response, the Universidad Anáhuac designed online clinical simulation practices and assessments. The pre-intervention survey showed skeptical medical students (59.15%) to continue this learning format. The intervention included neurology, cardiology, and gynecology topics supported by five faculty members and staff. Instruments were examination checklists to evaluate the clinical competence based on a 100 score and the Debriefing Assessment for Simulation in Healthcare (DASH) with a 1 (extremely ineffective) to 7 (extremely effective) score. Students received individual training by Zoom, including simulation practices, debriefing, and assessment. Even though it seemed impossible to address clinical skills by distance, simulation practices continued with online resources. Collaborative participation between faculty, students, and staff facilitated learning during the COVID-19 conditions.

Clinical simulation as a Nursing Fundamentals teaching method: a quasi-experimental study

ABSTRACT Objectives: to evaluate students’ knowledge gain after the implementation of clinical simulation in Nursing Fundamentals disciplines. Methods: a quasi-experimental intervention was carried out with 60 students, distributed in comparison and intervention groups, who underwent traditional teaching and traditional teaching associated with simulated teaching, respectively. Pre-test and post-test instruments were applied to both groups. Results: after analyzing the students’ performance through the applied instruments, both groups had a cognitive evolution along with the taught content, however, when compared, the intervention group obtained a higher knowledge gain than the comparison group (p = 0.016), demonstrating progressive and increasing improvement with the use of the methodology. Conclusions: simulated teaching significantly helps students in gaining technical-cognitive knowledge. Therefore, it is recommended to adhere to the use of this methodology for teaching Nursing Fundamentals.

Telesimulation and Academic Continuity of Health Professions Education

Telesimulation, specifically in health areas, is an educational technique that combines clinical simulation and communication technologies. This definition has been constantly modified, but today more than ever it represents a valuable resource to provide academic continuity. The purpose of this chapter is to present the basic concepts of this strategy while reviewing its antecedents/history in the pre-COVID era, the experience with this technique in health sciences, as well as the processes and resources essential to carry it out with an analysis of the potential limitations that may entail. Likewise, concrete examples of telesimulation in various subjects will be shared, leaving readers the challenge of constant innovation in this field.

Scenario validation for clinical simulation: prenatal nursing consultation for adolescents

ABSTRACT Objectives: to validate a scenario for clinical simulation: prenatal nursing consultation for adolescents. Methods: methodological study developed from January to December 2019, in five stages (overview, scenario, scenario design, progression, debriefing and assessment). The validation involved four volunteer students, a teacher as a facilitator and four judges. The judges filled out a Likert scale with four responses. Data was analyzed using Microsoft Excel® software, version 2016. Absolute and relative frequencies and the content validity index were calculated, considering a minimum acceptable value of 1.0. Results: the preparation of the scenario was based on the proposed learning objectives. The scenario was validated with a global content validity index equal to 1.0. Final Considerations: the study achieved the proposed objective. This scenario can contribute to preparing nurses to work in the care of pregnant teenagers, a representative public in Brazil that requires specific care.

193 BALANCING EDUCATION AND PRACTICE: A REFLECTION FROM A SIMULATION EDUCATOR DURING THE COVID-19 PANDEMIC

What? I consider myself privileged to divide my work time between my roles as a clinical simulation educator and as an intensive care nurse in a large teaching hospital. I find that working alternate weeks in educational and clinical roles can be challenging because both demand complementary but different skills. However, I am thrilled to have the opportunity to continue caring for patients alongside supporting and learning with colleagues. Balancing these roles during a pandemic presented me with new challenges and rewards, and reflection on these experiences has given me some fascinating insights. As the COVID-19 pandemic progressed and the number of patients requiring admission to the Critical Care Unit increased, the units were expanded and staff were redeployed from other areas to provide support. These ‘surge’ staff required rapidly developed simulation-based training to allow them to work in this unfamiliar environment within a restricted scope of practice. Being involved with delivering this training as well as working with surge staff in Critical Care afforded me a deeper understanding of the surge role and the unique challenges it presented. Once surge training was completed and I returned to delivering our standard simulation-based education courses, my experiences of working clinically continued to enrich my teaching because I felt somewhat familiar with some of the challenges our learners were facing as the pandemic continued. So what? Over the last year, I have felt conflicted at times; when working clinically during the peak of the pandemic, there was very little time to facilitate learning at the bedside, and during my educator weeks I relished the opportunity to support and teach but felt guilty for spending time away from colleagues and patients in Critical Care Unit. However, continuing with both roles better equipped me to answer questions and to provide support during surge training, particularly for those staff who had not yet spent time on the units. When assisting with other courses as a faculty member, I was able to deeply empathize with participants who encountered situations that I had become familiar with in practice – for example, communicating with others when wearing full personal protective equipment – which helped me to validate and normalize some of the experiences shared during debrief discussions. Through continuing to reflect on my time spent working in these environments during the pandemic so far, I hope to present my learning and recommendations for optimizing practice under challenging circumstances.

The Use of Global Rating Scales and Checklists in Clinical Simulation-Based Assessments: A Protocol for a Scoping Review

Background Assessment in health sciences education remains a hotly debated topic, with measures of competency and how to determine them in simulation-based assessments enjoying much of the focus. Global rating scales (GRS) and checklists enjoy widespread use within simulation-based education but there is a question regarding how the two strategies are used within clinical simulation assessment. The aim of this proposed scoping review is therefore to explore, map and summarise the nature, range and extent of published literature available relating to the use of GRS and checklists in clinical simulation-based assessment. Methods We will follow the methodological frameworks and updates described by Arksey and O’Malley, Levac, Colquhoun and O'Brien, and Peters, Marnie and Tricco et al and will report using the PRISMA extension for Scoping Reviews. We will search PubMed, CINAHL, ERIC, Cochrane Library, Scopus, EBSCO, ScienceDirect, Web of Science, the DOAJ, and several sources of grey literature. We developed a search strategy in collaboration with an experienced research librarian and include an example of a full electronic search in this article. We will screen all titles and abstracts and relevant full-text articles and extract the relevant data using the data extraction form. Quantitative data will be presented as will a narrative account of all included studies. We will import the narrative into Atlas.ti and use thematic analysis to identify themes and map the data. We will be including all identified sources published in English after 1 January 2010 that relate to the use of GRS and/or checklists in clinical simulation-based assessments. Discussion The overview of literature produced will help to identify knowledge gaps and inform future research in the use of GRS and checklists in clinical simulation-based assessments. This information will be valuable and useful for all stakeholders that are interested in clinical simulation-based assessments. Scoping review protocol registration: Open Science Framework (OSF) submitted on 26 November 2021 and available at https://osf.io/7yfbq.

Mapping Trends and Hot-spots of Virtual Simulation Research in Nursing: A Bibliometric Analysis

Background: Virtual simulation has been widely used in nursing education and nursing training. This study aims to characterize the publications in terms of countries, institutions, journals, authors, collaboration relationships, and analyze the trends of virtual simulation in nursing research.Methods: Publications regarding virtual simulation in nursing were retrieved from Web of Science core collection. Microsoft Excel 2010, VOSviewer were used to characterize the contributions of the authors, journals, institutions, and countries. The trends, hot-spots and knowledge network were analyzed by Citespace and VOSviewer.Results: We identified 611 papers between 1999 and 2021. The number of publications grew slowly until 2019, after that, it got a sharp increase in 2020 and 2021. The USA, Canada and Australia were three key contributors to this field. Centennial College, University of Ottawa, and Ryerson University were three major institutions with a larger number of publications. Verkuyl M was the most productive and highest cited author. Clinical Simulation in Nursing, Nurse Education Today, Journal of Nursing Education were the three productive journals. "virtual patients," "nursing students," "clinical simulation," and "communication skills" were the frontier topics in recent years.Conclusion: Using the Virtual patients to train nursing students, developing more reliable and objective assessment methods to validate learning outcomes might be the recent and future hot-topics.

Effectiveness of applying clinical simulation scenarios and integrating information technology in medical-surgical nursing and critical nursing courses

Background To determine the impact of combining clinical simulation scenario training and Information Technology Integrated Instruction (ITII) on the teaching of nursing skills. Methods 120 4th-year students in a nursing program who were enrolled in medical and surgical nursing courses. 61 received innovative instruction (experimental group) and 59 received conventional instruction (control group). The ADDIE model, systematic method of course development that includes analysis, design, development, implementation, and evaluation,was used to build simulation teaching and clinical scenarios and to create and modify objective structure clinical examination (OSCE) scenario checklists for acute myocardial infarction (AMI) care, basic life support and operation of automated external defibrillator (BLS), and subdural hemorrhage (SDH) care. The modified OSCE checklists were assessed for reliability, consistency, and validity. The innovative training included flipped classrooms, clinical simulation scenarios, ITII and blended learning formats. Results The reliability and validity of the OSCE checklists developed in this study were acceptable and comparable or higher than checklists in past studies and could be utilized as an OSCE performance tool. Students in innovative instruction obtained significantly better OSCE performance, lab scores and improvements from the previous year’s grades. Significant differences were found in situational awareness (SA). No strong correlations were found between OSCE scores and clinical internship scores, and no significant differences were found between the groups in overall clinical internship performance. Conclusions Innovative instruction showed better performance than conventional methods in summative evaluation of knowledge components, OSCE formative evaluation and clinical nursing internship scores, as well as improved situational awareness in nursing students.