Using clinical simulation to assess a new paediatric ESCALATION system education package: Empirical research mixed methods.

AIM: The aim of the study was to assess the suitability of an online education package to prepare health professionals to use a new paediatric early warning system. DESIGN: Quasi-experimental mixed methods using co-production. METHODS: Participants completed the Package and participated in up to four clinical scenarios. Data were collected using self-report surveys, and during clinical scenarios; escalation of care, documentation, family involvement, communication handovers were assessed, and recorded debriefings were thematically analysed. Data were integrated using tabulated joint displays. RESULTS: Eleven nurses and three doctors were recruited from three mixed adult and paediatric hospitals. Following completion of the Package and clinical scenarios 13/14 (93%) participants agreed preparedness and confidence to use the ESCALATION System had increased. For 53% handovers, the communication framework was followed, for 79% charts, documentation was complete. Participants engaged with the parent (actor) for 97% scenario interactions. The Package was effective and participation in clinical scenarios appeared to enhance learning. PATIENT OR PUBLIC CONTRIBUTION: Consumers participated in the steering group overseeing the study and in the expert panel who reviewed the education package and clinical scenarios.

Development and validity of serious game for teaching-learning in surgical site infection prevention / Desarrollo y validación de un juego serio para la enseñanza-aprendizaje sobre la prevención de infecciones del sitio quirúrgico / Desenvolvimento e validação de serious game para ensino-aprendizagem de prevenção de infecção de sítio cirúrgico

ABSTRACT Objective: To develop and validate serious game for teaching-learning regarding surgical site infection prevention. Method: This is a methodological study conducted in stages: game content development and validity based on virtual simulation (preparation, participation and debriefing) and challenges; game development, following the concept, pre-production, prototype, production and post-production stages; and usability validity, using an instrument called Heuristic Evaluation for Digital Educational Games. To assess the game content and usability, 12 nurses and 08 experts in digital games were involved. Results: The serious game script contained three sequential pre-, intra- and post-operative periods, focusing on nursing interventions aimed at preventing surgical site infections. A Content Validity Coefficient above 0.80 was obtained for game content. Regarding gameplay assessment using the assessed heuristics, all statements present in game script were considered adequate, and adjustments were implemented regarding feedback, access to the theoretical framework on preventing surgical site infections, the inclusion of images in the study material and directing players to the debriefing session. Conclusion: The serious game developed was considered valid and a potential pedagogical tool in nursing for learning how to prevent surgical site infections.

RESUMEN Objetivo: desarrollar y validar el serious game para la enseñanza-aprendizaje sobre la prevención de infecciones del sitio quirúrgico. Método: estudio metodológico realizado por etapas: desarrollo y validación del contenido del juego, basado en simulación virtual (preparación, participación y debriefing) y desafíos; desarrollo de juegos, siguiendo las etapas de concepto, preproducción, prototipo, producción y postproducción; y validación de usabilidad mediante el instrumento Heuristic Evaluation for Digital Educational Games. Para evaluar el contenido y usabilidad del juego participaron 12 enfermeros y 08 expertos en juegos digitales. Resultados: el guión del serious game contenía tres períodos pre, intra y postoperatorios secuenciales, centrándose en intervenciones de enfermería destinadas a prevenir infecciones del sitio quirúrgico. Se obtuvo un Coeficiente de Validez de Contenido superior a 0,80 para el contenido del juego. En cuanto a la evaluación de la jugabilidad mediante las heurísticas evaluadas, todas las afirmaciones presentes en el guión del juego fueron consideradas adecuadas y se implementaron ajustes en cuanto a retroalimentación, acceso al marco teórico sobre prevención de infecciones del sitio quirúrgico, inclusión de imágenes en el material de estudio y orientación del jugador en la sesión de debriefing. Conclusión: el serious game desarrollado se consideró válido y potencial herramienta pedagógica en el área de enfermería para aprender a prevenir infecciones del sitio quirúrgico.

RESUMO Objetivo: desenvolver e validar serious game para o ensino-aprendizagem referente à prevenção de infecção de sítio cirúrgico. Método: estudo metodológico conduzido por etapas: desenvolvimento e validação do conteúdo do jogo, baseados na simulação virtual (preparação, participação e debriefing) e desafios; desenvolvimento do jogo, seguindo as etapas de conceito, pré-produção, protótipo, produção e pós-produção; e, validação da usabilidade, por meio do instrumento Heuristic Evaluation for Digital Educational Games. Para avaliação do conteúdo e usabilidade do jogo, contou-se com 12 enfermeiros e 08 especialistas em jogos digitais. Resultados: o script do serious game conteve três períodos sequenciais pré, intra e pós-operatório, com enfoque em intervenções de enfermagem voltadas para prevenção de infecção de sítio cirúrgico. Obteve-se um Coeficiente de Validade de Conteúdo acima de 0,80 para o conteúdo do jogo. Referente à avaliação da jogabilidade pelas heurísticas avaliadas, todas as afirmativas presentes no script do jogo foram consideradas adequadas e houve a implementação de ajustes no que se refere ao feedback, ao acesso ao referencial teórico sobre prevenção de infecção de sítio cirúrgico, à inclusão de imagens no material de estudo e ao direcionamento do jogador à sessão de debriefing. Conclusão: o serious game desenvolvido foi considerado válido e potencial ferramenta pedagógica na área de enfermagem para aprendizagem da prevenção de infecção de sítio cirúrgico.

Through the lens of the American Association of Colleges of Nursing's (AACN) new Essentials: Integration of human trafficking education and simulation within baccalaureate nursing curricula.

With an increase in human trafficking in the United States, there is a need for nursing curricula to provide education and engagement in recognizing and appropriately caring for victims. The purpose of this article is to describe an undergraduate nursing simulation involving a human trafficking victim with a discussion of how the American Association of Colleges of Nursing's (AACN) Essentials were addressed by the simulation. The results of the course evaluation indicated that providing an opportunity for baccalaureate nursing students to engage in a simulation involving a victim of human trafficking allowed them to solidify classroom theory and education. Students reported increased confidence in recognizing victims after participating in the education and simulation. In addition, the simulation met many of the American Association of Colleges of Nursing's new Essentials further highlighting the importance of this clinical activity within the nursing curriculum. Nursing education is obligated to empower students to identify social determinants of health and advocate for social justice related to vulnerable populations. Because nurses are the largest group of healthcare providers, they are likely to encounter human trafficking victims and should be educated to identify victims in practice.

A Literature Review of Simulation-Based Nursing Education in Korea.

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.

The effect of simulation-based flipped classroom on acquisition of cardiopulmonary resuscitation skills: A simulation-based randomized trial.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is an essential skill required by critical care nurses. Evidence has shown that the use of a novel method called simulation-based flipped classroom (SBFC) can save training time in nursing laboratories and, to some extent, enhance social distancing during the current COVID-19 pandemic. AIM: To evaluate the effects of SBFC on nursing students' acquisition of CPR skills. STUDY DESIGN: A two-parallel prospective, single-centre, simulation-based, randomized, controlled trial. METHODS: The total sample size was 326 students. A CPR video was recorded and uploaded on Microsoft Teams channel for the SBFC group only. Thereafter, both groups demonstrated and redemonstrated the CPR procedure. Both groups were then compared according to the simulation experience satisfaction scale and CPR skills acquisition checklist. RESULTS: Two equally randomly selected groups of 163 undergraduate nursing students completed the study. The SBFC group had a significantly better satisfaction with the simulation experience than the traditional simulation (TS) group (p = 0.03). As regards the mean score of the CPR checklist after simulation, the SBFC group had a significantly higher score than TS group (p = 0.01). CONCLUSIONS: SBFC using a pre-recorded video can be an effective method that can reduce the time needed for CPR clinical simulation and can be used for the CPR simulation among critical care nurses. RELEVANCE TO CLINICAL PRACTICE: This study provides critical care nursing educators with a deep understanding regarding the benefits and value of utilizing the SBFC method in the clinical training of CPR skills. SBFC can be used to increase critical care nurses' satisfaction and skill acquisition during CPR training.

Efetividade da simulação virtual no ensino de enfermagem para aprender o raciocínio clínico: uma revisão integrativa / Effectiveness of virtual simulation in nursing teaching to learn clinical reasoning: an integrative review / Eficacia de la simulación virtual en la enseñanza de enfermería para el aprendizaje del razonamiento clínico: una revisión integradora

Introdução: Nas duas últimas décadas, os meios de ensino vêm mudando na área da saúde, no qual o ensino tradicional já não é capaz de suprir as necessidades atuais. Assim, a simulação virtual passou a ter um papel fundamental na educação superior de enfermagem, sendo um meio ativo de aprendizado. Objetivo: Analisar na literatura científica a efetividade da simulação virtual no ensino de enfermagem. Metodologia: Trata-se de uma pesquisa bibliográfica do tipo revisão integrativa da literatura. Resultados: 10 artigos foram incluídos nesta revisão, a maior parte com abordagem quantitativa dos dados, publicados no ano de 2021, todos estavam na língua inglesa, houve predomínio de estudos realizados na Coreia do Sul e Estados Unidos, sendo a maioria estudos transversais em que todos os estudos recomendavam (grau de recomendação "A") o uso da simulação virtual para o ensino de enfermagem. Conclusão: A simulação virtual no ensino de enfermagem tem potencial para melhorar a retenção do conhecimento e o raciocínio clínico numa fase inicial e ao longo do tempo, e aumenta a satisfação com a experiência de aprendizagem entre os estudantes de enfermagem.

Introduction: In the last two decades, the means of teaching have been changing in the health area, in which traditional teaching is no longer able to meet current needs. Thus, virtual simulation began to play a fundamental role in higher education in nursing, being an active means of learning. Objective: To analyze the effectiveness of virtual simulation in nursing education in the scientific literature. Methodology: This is a bibliographic research of the integrative literature review type. Results: 10 articles were included in this review, most with a quantitative approach to the data, published in the year 2021, all were in English, there was a predominance of studies carried out in South Korea and the United States, most of which were cross-sectional studies in which all studies recommended (degree of recommendation "A") the use of virtual simulation for teaching nursing. Conclusion: Virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning at an early stage and over time, and increases satisfaction with the learning experience among nursing students.

Introducción: En las últimas dos décadas, las formas de enseñanza han ido cambiando en el área de la salud, en la que la enseñanza tradicional ya no es capaz de suplir las necesidades actuales. Así, la simulación virtual pasó a jugar un papel fundamental en la educación superior en enfermería, siendo un medio activo de aprendizaje. Objetivo: Analizar la efectividad de la simulación virtual en la educación de enfermería en la literatura científica. Metodología: Se trata de una investigación bibliográfica del tipo revisión integradora de literatura. Resultados: se incluyeron en esta revisión 10 artículos, la mayoría con enfoque cuantitativo de los datos, publicados en el año 2021, todos en inglés, hubo predominio de estudios realizados en Corea del Sur y Estados Unidos, la mayoría de los cuales fueron transversales -estudios seccionales en los que todos los estudios recomendaron (grado de recomendación "A") el uso de simulación virtual para la enseñanza de enfermería. Conclusión: La simulación virtual en la educación de enfermería tiene el potencial de mejorar la retención de conocimientos y el razonamiento clínico en una etapa temprana y con el tiempo, y aumenta la satisfacción con la experiencia de aprendizaje entre los estudiantes de enfermería.

Debriefing virtual: uma análise da percepção dos estudantes de enfermagem sobre sua utilização* / Debriefing virtual: un análisis de la percepción de los estudiantes de enfermería sobre su utilización / Virtual debriefing: an analysis of nursing students' perception of its use

Objetivo: avaliar o debriefing virtual, realizado com estudantes de enfermagem que participaram como observadores em um cenário de simulação, gravado, sobre rebaixamento do nível de consciência por hipoglicemia. Método: estudo com delineamento transversal descritivo na fase quantitativa, e exploratório-descritivo na fase qualitativa entre 2020 e 2021, com 60 estudantes de graduação em enfermagem que assistiram a um cenário gravado e vivenciaram um debriefing virtual. Foram aplicados dois instrumentos de avaliação do debriefing, e na abordagem qualitativa utilizou-se análise pelo Iramuteq. Resultados: na Escala de Avaliação do Debriefing Associada à Simulação, a média geral de avaliação foi 4,25, mostrando que os participantes tiveram uma percepção positiva. Na Escala de Experiência com o Debriefing, a avaliação geral foi 4,38 sugerindo que foi uma estratégia útil. Conclusão: os estudantes apontaram o debriefing virtual como uma estratégia positiva para o aprendizado.

Objective: to evaluate the virtual debriefing, performed with nursing students who participated as observers in a simulation scenario, recorded, on lowering the level of consciousness by hypoglycemia. Method: study with descriptive cross-sectional design in the quantitative phase, and exploratory-descriptive in the qualitative phase between 2020 and 2021, with 60 nursing graduate students who attended a recorded scenario and, after, experienced a virtual debriefing. Two instruments were applied to evaluate the debriefing, and the qualitative approach used analysis by Iramuteq. Results: on the Simulation-Associated Debriefing Evaluation Scale, the overall mean of evaluation was 4.25, showing that the participants had a positive perception. And in the Debriefing Experience Scale, the overall assessment was 4.38, suggesting that debriefing was a useful strategy. Conclusion: students pointed to virtual debriefing as a positive strategy for learning.

Objetivo: evaluar el debriefing virtual, realizado con estudiantes de enfermería que participaron como observadores en un escenario de simulación, grabado, sobre descenso del nivel de conciencia por hipoglucemia. Método: estudio con delineamiento transversal descriptivo en la fase cuantitativa, y exploratorio-descriptivo en la fase cualitativa entre 2020 y 2021, con 60 estudiantes de graduación en enfermería que asistieron a un escenario grabado y, después, experimentaron un debriefing virtual. Se aplicaron dos instrumentos de evaluación del debriefing, y en el enfoque cualitativo se utilizó el análisis del Iramuteq. Resultados: en la Escala de Evaluación del Debriefing Asociada a la Simulación, la media general de evaluación fue 4,25, mostrando que los participantes tuvieron una percepción positiva. En la Escala de Experiencia con Debriefing, la evaluación general fue 4,38 sugiriendo que fue una estrategia útil. Conclusión: los estudiantes señalaron el debriefing virtual como una estrategia positiva para el aprendizaje.

Using Real-Time Data to Develop and Improve Teaching of Clinical Skills in Virtual Nursing Simulation Laboratories During COVID-19 Pandemic.

During COVID-19 pandemic public health measures, face-to-face simulation laboratories were cancelled. A rapid transition to online teaching environments required staff and students to rapid upskilling in digital literacy. The purpose of this article is to describe a model of virtual nursing simulation laboratory implemented in graduate entry to practice Master's nursing program to teach clinical skills. The model used cloud-based communication app Zoom and real time feedback data to improve content delivery, student engagement and confidence in skill development. This model was co-designed with the student cohort to ensure students, as stakeholders, had a voice in having their education needs met during these challenging times.

Correlations and predictors of nursing simulation among Saudi students.

BACKGROUND: In middle eastern countries, most nursing colleges use simulation-based learning activities. However, Saudi nursing students' correlators and predictors for simulation learning have been underreported. AIM: This study investigated the variables that correlate to and predict Saudi nursing students' simulation learning competencies. METHODS: A descriptive cross-sectional design guided this study's understanding of simulation learning among nursing students (n = 461). We used three National League of Nursing instruments to collect data: the 13-item student satisfaction and self-confidence in learning scale (SCLS), 20-item simulation design scale (SDS), and 16-item educational practices questionnaire (EPQ). We applied analysis of variance, t tests, χ 2 tests, and linear regression to analyze the data. RESULTS: The SCLS and EPQ revealed significant differences in the participants' year level, gender, fidelity of simulation experience, number of nursing courses with simulation, and grade point average (GPA). Only GPA was insignificant in SDS. The number of nursing courses with simulations and GPA were significant predictors of the three instruments. Finally, year level and gender were important predictors of SDS and SCLS, respectively. CONCLUSION: Our findings explain Saudi students' experiences of simulations in nursing education. Simulation is an important pedagogical approach that enhances students' achievements when implemented in nursing schools.

Interprofessional learning in social and health care-Learning experiences from large-group simulation in Finland.

Aim: This study aimed to describe the learning experiences of social and healthcare students and professionals of an interprofessional large-group simulation. A simulation on sudden infant death syndrome (SIDS) was organized in collaboration between a Finnish university, university hospital and university of applied sciences. Design: A case study. Methods: The research data were collected at the large-group simulation with a questionnaire containing variables on a five-point Likert scale and open questions. The questionnaire was filled out by 350 students and professionals participating in the simulation. The quantitative data were analysed using descriptive statistical methods and the open-ended questions by inductive content analysis. Results: The large-group simulation proved to be a valid teaching and learning method for collaborating with other professionals and interacting with clients and the method can be considered as cost-effective compared with small-group simulations. The produced knowledge can be used in planning simulations in basic and in-service training.

Repeated Simulation Experience on Self-Confidence, Critical Thinking, and Competence of Nurses and Nursing Students-An Integrative Review.

BACKGROUND: Simulation is the most adopted teaching methodology in nursing education. OBJECTIVES: This article investigated the outcome of repeated simulation experience on self-confidence, critical thinking, knowledge, competence, and satisfaction of nurses and nursing students. METHODS: The Scholarly literature published in English for the period of 2011 to 2019 was reviewed. RESULTS: Repeated simulation enhances students' self-confidence, knowledge, competence, critical thinking, and satisfaction. CONCLUSIONS: Repetitive simulation experience is valued by the nurse educators as a valuable teaching methodology to reinforce the student's learning outcomes.

Pré-simulação, pré-briefing ou briefing na simulação em enfermagem: quais as diferenças? / Pre-simulation, pre-briefing or briefing in nursing simulation: what are the differences?

Objetivo: Identificar as evidências científicas disponíveis na literatura quanto aos elementos que compõem as fases de pré- simulação e pré-briefing/briefing e suas diferenças para desenvolver competência clínica em enfermagem. Método: Revisão integrativa, de janeiro de 2009 a maio de 2020, nas bases PubMed/MEDLINE®, LILACS, Scopus e CINAHL, com os descritores: enfermagem, estudante de enfermagem, equipe de enfermagem, pré-simulação, pré-briefing, briefing e competência clínica. Resultados: Identificaram-se 687 estudos e incluíram-se 7. Elaboraram-se as categorias: Elementos que compõem as fases de pré- simulação e pré-briefing/briefing na simulação clínica em enfermagem e Diferenças das fases de pré-simulação e pré-briefing/briefing na simulação clínica em enfermagem. Destacaram-se quatro elementos: conceito da fase, objetivos, ações e os recursos necessários. As diferenças foram quanto ao período de cada fase, quanto aos objetivos e os recursos instrucionais. Conclusão: Sintetiza e esclarece os elementos da etapa de preparação e suas diferenças e possibilita, desta forma, elaborar roteiros educacionais para a simulação clínica.

Objective: To identify the scientific evidence available in the literature on the elements of pre-simulation and pre-briefing/briefing phases and their differences for the development of clinical competence in nursing. Method: Integrative review conducted from January 2009 to May 2020, on the PubMed/MEDLINE®, LILACS, Scopus and CINAHL databases, with the descriptors: nursing, nursing student, nursing team, pre-simulation, pre-briefing, briefing and clinical competence. Results: 687 studies were identified and seven were included. The following categories were created: Elements of the pre-simulation and pre-briefing/ briefing phases in clinical simulation in nursing and Differences of the pre-simulation and pre-briefing/briefing phases in clinical simulation in nursing. The following four elements were highlighted: the concept of the phase, objectives, actions and required resources. The differences were identified as the period of each phase, the objectives and the instructional resources. Conclusion: This review synthesizes and clarifies the elements of the preparation stage and their differences, thus enabling the creation of educational scripts for clinical simulation.

Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication.

Simulation is used with greater frequency by nursing programs to strengthen the learning process of student nurses. Best practices suggest active learning with the addition of standardized patients engages the student in realistic lifelike scenario. Therefore, the aim of the research study was to have nursing student's self-evaluate classroom learned communication skills through practical application on a standardized mental health patient simulated scenario. Undergraduate nursing students registered for three successive mental health nursing courses during one academic year were recruited. A self-reported pre/post survey measured the nursing student's level of confidence of learned therapeutic communication skills, preparation to engage their skills in clinical experience, and satisfaction with the standardized patient simulated experience. The self-reported online pre/post questionnaire return rate was 72.5% (N-116). The pre/post results suggest the standardized simulated experience enhanced nursing student confidence  p < .001; the nursing students felt prepared for clinical as noted by the mean score of 7.78 of 10 and overall were satisfied with the simulation process with a mean score of 8.04 of 10. The addition of the standardized patient in a mental health simulated experience promoted an active learning environment that highlighted individualized confidence in therapeutic communication skills through a realistic application process.

Enhancing Nursing Students' Competency Skills With a Workplace Violence Nursing Simulation: Translating Knowledge Into Practice.

The phenomenon of workplace violence (WPV) is prevalent in clinical settings affecting nurses and nursing students. Mental health nursing simulations may be used to impart knowledge and skills to nursing students to manage and prevent incidents of WPV. This article presents attained competency skills by nursing students after attending a simulation, and how they implemented their knowledge learned in their clinical rotations. Students attended a Mental Health Nursing Simulation on WPV and completed surveys. The simulation enhanced the students' communication skills, empathy, ability to manage verbally aggressive patients, ability to set personal boundaries, and ability to seek support from others. Participants reported physical and verbal forms of WPV and application of learned evidence-based skills in their clinical rotations. Evidence-based skills to manage and prevent WPV taught to nursing students via mental health nursing simulations can enhance their clinical competency, and they should be embedded in a nursing curriculum.

Three-dimensional needs of standardized patients in nursing simulations and collaboration strategies: A qualitative analysis.

Simulation-based education using standardized patients is recognized as an effective education method from which students can learn in a safe and controlled environment, and instructors can provide consistent education. It has been reported that the level of standardized patients' satisfaction in the simulation experience positively affects to their case mastery and providing feedback to learners. This study aimed to explore standardized patients' lived experiences on nursing simulation using qualitative research to provide empirical resources to facilitate collaboration with standardized patients for efficacious nursing simulation. Study participants were recruited from simulation centers and had experience with nursing simulation education as standardized patients within the last 3 years. Focus group interviews were conducted to explore experiences of the 12 standardized patients in nursing simulations. The focus group interviews were conducted with structured four steps of opening, transition, key, and ending questions, from which additional questions and discussions followed. They were recorded electronically and transcribed for analysis. Qualitative content analysis was used to analyze the data. Two researchers read the interview transcripts several times to become familiar with the content, and then interpreted them systematically. From the qualitative analysis of standardized patients' experiences on nursing simulation, 23 codes, 10 sub-categories, 4 categories, and a theme were derived. It would be concluded that standardized patients have serving, learning, and interpersonal needs on their simulation, which may be related to their experiences in the simulation that affects learning outcomes of the students' as well. By facilitating positive experiences of standardized patients, quality of nursing simulation could be increased to provide more active and effective learning opportunities for students.

Holistic Nursing Simulation: A Concept Analysis.

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

Simulação de realidade virtual imersiva no procedimento de punção venosa periférica para coleta de sangue a vácuo / Immersive virtual reality simulation in the peripheral venipuncture procedure for vacuum blood collection

A punção venosa periférica é a inserção de dispositivos por veia periférica para acesso à corrente sanguínea, como na coleta de sangue para exames; embora seja um procedimento comum no tratamento intra-hospitalar, é complexo e exige competência profissional. A realização desse procedimento de forma inadequada pode colocar em risco a saúde do paciente, podendo provocar diversas complicações ao seu tratamento. A pesquisa teve como objetivo desenvolver e validar a primeira versão de um simulador de realidade virtual (RV) imersiva para o procedimento de punção venosa periférica para coleta de sangue a vácuo no paciente adulto. Revisão integrativa da literatura permitiu verificar as estratégias de ensino de punção venosa periférica na enfermagem. Procedeu-se, em seguida, um estudo com delineamento metodológico para desenvolver e validar a primeira versão do simulador. O uso de recursos tecnológicos como estratégias de ensino em enfermagem está em expansão, porém a simulação com RV, principalmente no ensino de punção venosa periférica, ainda é um vasto campo a ser explorado. Foi desenvolvida a primeira versão de um simulador de RV para a coleta de sangue à vácuo no adulto - o VIDA-Enfermagem v1.0, o qual foi avaliado por profissionais e graduandos de enfermagem. Foram considerados válidos 79,6% dos itens avaliados pelos profissionais e 66,7% dos itens avaliados pelos graduandos. As sugestões propostas pelos sujeitos da pesquisa para melhorias do sistema, em sua maioria, são passíveis de aceitação no decorrer do incremento das versões seguintes. Mesmo havendo necessidade de revisão de diversos itens, na avaliação dos participantes, o simulador foi considerado uma ferramenta promissora e inovadora para o ensino do procedimento de punção venosa periférica para coleta de sangue a vácuo em paciente adulto, para graduandos de enfermagem que estão se iniciando no estudo da temática e da técnica, como estratégia a ser combinada com os recursos já utilizados atualmente no ensino do procedimento. É relevante que se invista em estratégias inovadoras e motivadoras para aplicação no ensino de enfermagem, principalmente com o uso da realidade virtual imersiva

Peripheral venipuncture is the insertion of a peripheral venous device to access bloodstream, such as in blood collection for tests; although it is a common procedure in in-hospital treatment, it is complex and requires professional competence. Failure to perform this procedure may put the patient's health at risk, and may cause several complications to his/her treatment. This study aimed to develop and validate the first version of an immersive virtual reality (VR) simulator for the peripheral venipuncture procedure for vacuum blood collection in adult patient. Teaching strategies of peripheral venipuncture in nursing were verified through an integrative literature review. Then, a study with a methodological design was performed to develop and validate the first version of the simulator. The use of technological resources such as teaching strategies in nursing is expanding; however, the simulation with VR, mainly in the teaching of peripheral venipuncture, is still a vast field to be explored. The first version of a VR simulator for vacuum blood collection in adult patient was developed - VIDA-Enfermagem v1.0, which was evaluated by professionals and undergraduate nursing students. 79.6% of the items evaluated by the professionals and 66.7% of the items evaluated by the undergraduate students were considered valid. The suggestions proposed by the research subjects for system improvements, for the most part, may be included in the following versions. Although it was necessary to review several items, in the evaluation of the participants, the simulator was considered a promising and innovative tool for the teaching of the peripheral venipuncture procedure for vacuum blood collection in adult patients, for nursing undergraduate students who are beginning the study of the subject and technique, as a strategy to be combined with the resources already used in the teaching of the procedure. It is relevant to invest in innovative and motivating strategies for application in nursing teaching, especially with the use of immersive virtual reality

[Construction and Application of Innovative Education Technology Strategies in Nursing].

The evolution of information and communication technologies has deeply impacted education reform, promoted the development of digital-learning models, and stimulated the development of diverse nursing education strategies in order to better fulfill needs and expand in new directions. The present paper introduces the intelligent-learning resources that are available for basic medical science education, problem-based learning, nursing scenario-based learning, objective structured clinical examinations, and other similar activities in the Department of Nursing at Chang Gung University of Science and Technology. The program is offered in two parts: specialized classroom facilities and cloud computing / mobile-learning. The latter includes high-fidelity simulation classrooms, online e-books, and virtual interactive simulation and augmented reality mobile-learning materials, which are provided through multimedia technology development, learning management systems, web-certificated examinations, and automated teaching and learning feedback mechanisms. It is expected that the teaching experiences that are shared in this article may be used as a reference for applying professional wisdom teaching models into nursing education.

Capacitação em cirurgia robótica no programa de residência em enfermagem perioperatória / Robotic surgery training in the perioperative nursing residency program / Capacitación en cirugía robótica en el programa de residencia en enfermería perioperatoria

Objetivo: Desenvolver um programa de treinamento para enfermeiros residentes em cirurgia robótica. Método: Trata­se de um relato de experiência em um hospital filantrópico privado de grande porte no município de São Paulo. Para o programa de residência em Enfermagem foi desenvolvido um treinamento para enfermeiras residentes com foco na especialização em cirurgia robótica com carga teórico­prática para o sistema do robô Da Vinci. Resultados: As enfermeiras residentes desenvolveram o conhecimento cognitivo com o treinamento virtual e a habilidade técnica durante a simulação com o manuseio do robô, dos instrumentais e dos equipamentos. Foram liberadas para iniciação prática com supervisão de enfermeiro especialista até que possuam segurança na execução do procedimento de montagem do robô Da Vinci. Conclusão: O treinamento foi avaliado pelas residentes como satisfatório para aquisição de conhecimento teórico­prático. A capacitação de profissionais especialistas em cirurgia robótica é um diferencial na residência de Enfermagem perioperatória.

Objective: To develop a training program in robotic surgery addressed to resident nurses. Method: This is a case report conducted in a major private, philanthropic hospital in the city of São Paulo. For the Nursing Residency Program, resident nurses were trained focusing on the specialization in robotic surgery, including theory and practice, to use the Da Vinci robot system. Results: The resident nurses developed cognitive knowledge through virtual training, and technical skills during the simulation of robot handling, as well as the instruments and the equipment. They were referred to practical initiation, supervised by an expert nurse, until they were confident to execute the procedure of assembling the Da Vinci robot. Conclusion: The residents considered the training satisfactory to acquire theoretical and practical knowledge. The training of professionals specialized in robotic surgery is a differential in perioperative Nursing residency.

Objetivo: Desarrollar un programa de capacitación para enfermeros residentes en cirugía robótica. Método: Se trata de un relato de experiencia en un hospital filantrópico privado de grande porte en el municipio de São Paulo. Para el programa de residencia en Enfermería fue desarrollada una capacitación para enfermeras residentes con enfoque en la especialización en cirugía robótica con carga teórico­práctica para el sistema del robot Da Vinci. Resultados: Las enfermeras residentes desarrollaron el conocimiento cognitivo con la capacitación virtual y la habilidad técnica durante la simulación con el manejo del robot, de los instrumentos y de los equipos. Fueron liberadas para iniciación práctica con supervisión de enfermero especialista hasta que posean seguridad en la ejecución del procedimiento de montaje del robot Da Vinci. Conclusión: La capacitación fue evaluada por las residentes como satisfactorio para adquisición de conocimiento teórico­práctico. La capacitación de profesionales especialistas en cirugía robótica es un diferencial en la residencia de Enfermería perioperatoria.