Transforming medical education: the impact of innovations in technology and medical devices.

INTRODUCTION: The rapid advancement of technology and the integration of innovative medical devices are significantly transforming medical education. This review examines the impact of these changes and the importance of adapting educational strategies to leverage these advancements. AREAS COVERED: This narrative review employs a qualitative approach. From an initial pool of 294 articles, researchers conducted independent screenings and identified 134 studies relevant to innovations in technology and their impact on medical education. Following a comprehensive review and consensus, studies deemed to be of low relevance were excluded, resulting in a final selection of 74 articles. An expert panel discussion was held, and the study concludes with a final section that presents the findings and offers brief, clear recommendations. EXPERT OPINION: This study indicates that the utilization of Innovative medical technologies has the potential to enhance learning outcomes. The use of simulations allows students to engage in hands-on practice without risking patient harm. Mobile devices afford students uninterrupted access to educational resources, thereby enabling efficient learning. Artificial intelligence (AI) has the potential to personalize education, enhance diagnostic skills, and foster critical thinking. Further research in this field has the potential to yield significant insights.

Exploring the impact of stuttering simulation-based learning and personality traits on clinical self-efficacy and professional interest among speech-language pathology students.

BACKGROUND: Research suggests that participating in a stuttering simulation-based learning (SBL) program could help speech-language pathology (SLP) students feel more at ease, less nervous and more capable while interacting with people who stutter. Personality traits may influence SLP students' self-efficacy beliefs as well as their level of interest in working with clients who stutter. In particular, we suggest that the combination of low neuroticism and high extraversion, previously linked with a more outgoing, emotionally stable and social personality, may enhance self-efficacy. AIMS: To examine the impact of participating in a stuttering SBL program on clinical self-efficacy (CSE) in managing stuttering therapy among SLP students, as well as its influence on their interest in working with fluency disorders and their associations with personality dimensions. The study also evaluated satisfaction with the SBL experience. METHODS & PROCEDURES: SLP students (n = 49) underwent a fluency disorders academic course, self-reported on CSE, and had an interest in working in the field of stuttering and NEO-Five-Factor Inventory (NEO-FFI). Post-stuttering SBL program participation, CSE and level of interest in practice of stuttering were reassessed. Satisfaction with the simulation was also gauged. OUTCOMES & RESULTS: Students interested in working with fluency disorders scored lower in neuroticism and higher in extraversion than their uninterested counterparts. Before the SBL activity, interest ratings were negatively correlated with neuroticism and positively correlated with extraversion. Pre-SBL neuroticism was negatively correlated with CSE. Following the SBL activity, increased CSE and interest in working with fluency disorders were evident, indicating robust and medium effects of the simulation on those indices, respectively. Post-SBL neuroticism was also negatively correlated with CSE. Overall, participants reported high satisfaction with the SBL experience. CONCLUSIONS & IMPLICATIONS: The study suggests SBL is an effective tool for enhancing motivation to work with fluency disorders. Consideration of personality traits and professional interests in designing educational interventions for SLP students, along with tailoring approaches to individual differences, may enhance learning outcomes. The study also highlights the need to differentiate between CSE and objectively assessed clinical competence and the fact that professional development is influenced by various factors. Nonetheless, the positive correlations between personality traits, CSE and satisfaction emphasize the potential of SBL programs in shaping not only clinical skills but also the attitudes and preferences of future SLPs. WHAT THIS PAPER ADDS: What is already known on this subject SLPs in the field of stuttering therapy reportedly experience low levels of comfort and professional confidence, possibly due to insufficient clinical experience. According to earlier research, taking part in SBL programs may elevate the CSE of SLP students and help them feel more confident about treating people with stuttering. What this study adds to the existing knowledge In addition to showing the beneficial effects of an SBL activity on SLP students' self-efficacy and interest in working in stuttering therapy, our research shows a significant relationship between personality traits and CSE. Specifically, the combination of high extraversion and low neuroticism was found to be associated with higher CSE and higher levels of satisfaction from the SBL. What are the potential or actual clinical implications of this work? The study shows that SBL is an effective tool for enhancing motivation to work with fluency disorders. Overall, students who exhibit high extraversion and low neuroticism show higher levels of CSE, greater motivation in stuttering treatment, and higher levels of SBL stratification. Development of future SBL activities and other educational interventions should take into consideration such personality traits, to enhance learning outcomes.

Post-simulation debriefing as a stepping stone to self-reflection and increased awareness - a qualitative study.

BACKGROUND: The voice of the students should be engaged in simulation curriculum development. Involving the students in the development of debriefing strategies might result in a deeper understanding of learning. However, few studies have investigated the students' perspectives on debriefing strategies. The aim of the study was to explore nursing students' perspectives on the post-simulation debriefing. METHODS: An explorative, descriptive design with a qualitative approach was used. Data were collected in December 2017 and May 2018 through focus group interviews with undergraduate nursing students in Norway immediately after a 2-day high-fidelity simulation course in the second year of their Bachelor of Nursing degree. Data were analysed using systematic text condensation. RESULTS: Thirty-two nursing students participated in the study. The data analysis identified two main categories. The category 'Facilitator as a catalyst for reflection' illustrated the facilitator's multifaceted and vital role in initiating and guiding the students' reflection process in the debriefing. The category 'A process towards increased awareness' encompasses the students' guided process of acquiring new insight into their professional development, and how they put parts together to see the wholeness in what was simulated. CONCLUSIONS: This study provides knowledge to facilitators regarding nursing students' perspectives on facilitating reflection and learning during debriefing discussions. The facilitator's multifaceted role in guiding the students' reflections and their process of acquiring new insight into their professional development were identified as critical to learning during debriefing.

Exploring the experiences of sonography students with simulation-based learning: A perspective from South Africa.

INTRODUCTION: Simulation-based learning (SBL) is widely used in healthcare education to provide a safe environment for students to practice clinical scenarios without causing patient harm. While established in developed countries, SBL's implementation is new in South Africa; there is a lack of research addressing sonography students' experiences. This study aimed to explore and describe the experiences of Bachelor of Science (BSc) second-year sonography students using SBL for clinical training at a local University of Technology (UoT). METHOD: An exploratory, qualitative and descriptive research study was conducted in 2020, with virtual one-on-one interviews due to COVID-19 restrictions. Eight BSc second-year sonography students, who had undergone SBL in their first year, participated. Data saturation was achieved, and interviews were audio recorded and transcribed verbatim. RESULTS: Thematic analysis revealed three themes: (1) Enhancing preparedness for the clinical environment, (2) Limitations of the tissue-equivalent phantom and (3) Suggestions for improving simulation. While students expressed positive feedback and enjoyment of the simulation tool, they also highlighted limitations, such as unrealistic representations of real patient scanning conditions. CONCLUSION: This study provides valuable insights into sonography students' experiences with SBL. Positive influence of SBL on clinical training was observed. To enhance SBL for future sonography students, consideration for high-fidelity simulators with advanced software is recommended. Funding options to invest in such simulators should be explored by radiography educators to promote more realistic training experiences.

Designing, implementing, and evaluating a basic surgical skills bootcamp: An effective approach to enhance competency in surgical residency training.

INTRODUCTION: Recent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. METHODS: This intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. RESULTS: The study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). CONCLUSION: The findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.

The impact of Anatomage table on writing of medical students' case reports: A comparative study.

Background and Aims: Academic performance is essential in medical education, yet comprehensive training programs addressing this need are lacking. Simulation-based learning has emerged as a valuable tool for developing clinical skills, with the Anatomage table offering a virtual platform to enhance learning experiences. This study aimed to assess the impact of utilizing the Anatomage table on the academic performance and similarity of case reports among seventh-semester medical students. Methods: A total of 68 students participated, with 25 using paper-based medical history and 43 using the Anatomage table. Descriptive statistics and Turnitin were employed for data analysis. Results: Students using the Anatomage table exhibited higher academic performance and lower similarity percentages compared to those using paper-based medical history. Conclusion: These findings highlight the benefits of integrating advanced technology into medical education to enhance learning outcomes and prepare students for clinical practice. Further investigation is required to improve the effectiveness of simulation-based learning in enhancing academic performance of medical students.

Infection preventionists' current and preferred training strategies and tools.

BACKGROUND: Educating health care staff on infection prevention and control (IPC) is an essential role of infection preventionists (IPs), but the COVID-19 pandemic diverted resources away from IPC education. METHODS: Association for Professionals in Infection Control and Epidemiology members were invited to complete an online survey from spring 2023 to assess current and preferred approaches and tools for training health care personnel on IPC. Vendors, retirees, APIC staff, or those not working in health care or public health were excluded. RESULTS: In all, 2,432 IPs participated. IPs were more likely to report engaging in impromptu health care worker training (ie, just-in-time teaching and team huddles) versus planned educational activities (ie, learning modules, formal presentations, train-the-trainer, or simulation; Kruskal-Wallis = 288, P < .001). IPs' top preferred teaching methodologies included simulation or interactive activity, and their lowest preferred approach was independent learning modules. IPC training apps were frequently requested technology. DISCUSSION: IPs ranked simulation as their top preferred teaching method; however, simulation was one of the least frequently used approaches. IP education should include strategies for delivering effective impromptu training and how to develop and implement interactive simulation-based education. CONCLUSIONS: The expressed needs and preferences of IPs should be considered when developing IPC-related teaching and training tools.

Effects of Immersive Technology-Based Education for Undergraduate Nursing Students: Systematic Review and Meta-Analysis Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Approach.

BACKGROUND: The adoption of immersive technology in simulation-based nursing education has grown significantly, offering a solution to resource limitations and enabling safe access to clinical environments. Despite its advantages, there are still diverse reports regarding the effectiveness of immersive technology. It is crucial to verify the effectiveness of immersive technology in nursing education to inform future educational programs. OBJECTIVE: This systematic review aimed to identify the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods. METHODS: A literature search was performed using 4 databases: PubMed, CINAHL, Embase, and Web of Science; the latest search was completed on January 19, 2023. The inclusion criteria were as follows: participants were undergraduate nursing students; studies were published in Korean or English; designs included randomized controlled trials (RCTs) or nonrandomized studies; and interventions involved virtual reality (VR), augmented reality (AR), mixed reality, or extended reality. Quality assessment was conducted using Cochrane Risk-of-Bias Tool version 2 for RCTs and the Risk-of-Bias Assessment Tool for Nonrandomized Studies. The main outcomes of the included studies were classified according to the New World Kirkpatrick Model (NWKM), ranging from level 1 (reaction) to level 4 (results). Meta-analysis was conducted using RevMan 5.4 software, and subgroup analysis was conducted due to heterogeneity of the results of the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was adopted for assessing certainty and synthesizing results of the relevant literature. RESULTS: A total of 23 studies were included, with participant numbers ranging from 33 to 289. Of these, 19 (82.6%) studies adopted VR to simulate various nursing scenarios, including disaster training, resuscitation, health assessments, and home health care; 4 (17.4%) studies used AR technologies; and 15 (65.2%) studies involved virtual patients in their scenarios. Based on the NWKM, the main outcome variables were classified as level 1 (usability and satisfaction), level 2 (knowledge, motivation, confidence, performance, attitude, and self-efficacy), and level 3 (clinical reasoning); level 4 outcomes were not found in the selected studies. Results of the subgroup analysis showed that immersive technology-based nursing education is more effective than traditional education in knowledge attainment (standard mean difference [SMD]=0.59, 95% CI 0.28-0.90, P<.001, I2=49%). Additionally, there were significant difference differences between the experimental and control group in confidence (SMD=0.70, 95% CI 0.05-1.35, P=.03, I2=82%) and self-efficacy (SMD=0.86, 95% CI 0.42-1.30, P<.001, I2=63%). CONCLUSIONS: These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies be conducted to evaluate the effects of immersive technology-based nursing education on NWKM level 4.

Raters and examinees training for objective structured clinical examination: comparing the effectiveness of three instructional methodologies.

BACKGROUND: Utilizing the objective structured clinical examination (OSCE) ensures objectivity when it comes to the assessment of nursing students' skills and competency. However, one challenge in OSCE integration is rater and examinee training and orientation. AIM: This study employed a quasi-experimental design to evaluate the effectiveness of different instructional methodologies in training and preparing raters and examinees for the OSCE. METHODS: Participants were divided into three group of training methodologies: online, simulation, and traditional lecture (six raters and 18 examinees were assigned to each group). A total of 18 raters and 54 examinees partook. RESULTS: The study found that raters trained through simulation exhibited a slight agreement with their rates, compared to those who were trained online and in traditional lectures. Moreover, examinees who were trained through the simulation methodology performed better compared to those trained via the other methodologies. CONCLUSIONS: The study findings indicate that using simulation by training raters and examinees in the OSCE is the most effective approach.

Reducing the Gap in Knowledge and Expectations between Clinicians and People with Polycystic Ovary Syndrome or Adrenal Conditions: Simulation via Instant Messaging-Birmingham Advance: Patient and Public Involvement (SIMBA-PPI) Study.

BACKGROUND: To evaluate the efficacy of SIMBA as an educational intervention for both HCPs and people with either PCOS or adrenal conditions and to study the change in knowledge of people with PCOS or adrenal conditions about the conditions and expectations from the HCPs involved in their care following SIMBA-PPI sessions. METHODS: Two SIMBA-PPI sessions (SIMBA-PPI Polycystic ovary syndrome (SIMBA-PCOS) and SIMBA-PPI Adrenal conditions (SIMBA-Adrenal conditions)) were conducted in September 2021 and March 2022. In both sessions, HCPs interacted with moderators on patient management through WhatsApp. Patients with respective conditions underwent workshop-style learning in the same cases. SIMBA-PCOS transcripts were also translated into Brazilian Portuguese and workshops were held in both Brazilian Portuguese and English. The two groups (HCPs and patients) were then brought together to discuss exploring gaps in knowledge and expectations. The Wilcoxon Signed-Rank test compared differences in pre- and post-SIMBA self-reported confidence levels in HCPs and patients. Qualitative data from the online recordings were transcribed and analysed with inductive thematic analysis to identify gaps in knowledge and expectations from managing the cases. RESULTS: 48 HCPs and 25 patients participated in our study. When compared to pre-SIMBA confidence levels, SIMBA-PPI sessions effectively improved clinicians' confidence in managing PCOS (40.5%, p < .001) and adrenal conditions (23.0%, p < .001) post-SIMBA. Patient participants' confidence in HCPs significantly increased in the PCOS session (SIMBA-PCOS: 6.25%, p = 0.01). CONCLUSIONS: Integration of PPI into SIMBA improved HCPs' confidence in managing PCOS and adrenal conditions. SIMBA-PPI also improved patients' confidence in HCPs. Our findings suggest that participating in SIMBA-PPI sessions can reduce the gap in knowledge and expectations between patients and HCPs involved in their care.

The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement.

BACKGROUND: Practice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students' knowledge, attitude, and performance during practice placements with external providers. METHODS: This study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke's approach was utilised in this study. RESULTS: Twelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks. CONCLUSIONS: SBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators' and students' contact time.

Revolutionizing thoracic surgery education: a bibliometric analysis of the past decade's literature.

OBJECTIVES: Thoracic surgery is a complex field requiring advanced technical skills and critical decision-making. Surgical education must evolve to equip trainees with proficiency in new techniques and technologies. METHODS: This bibliometric analysis systematically reviewed 113 articles on thoracic surgery skills training published over the past decade, retrieved from databases including Web of Science. Publication trends, citation analysis, author and journal productivity, and keyword frequencies were evaluated. RESULTS: The United States contributed the most publications, led by pioneering institutions. Simulation training progressed from basic to sophisticated modalities and virtual reality emerged with transformative potential. Minimally invasive techniques posed unique learning challenges requiring integrated curricula. CONCLUSION: Ongoing investments in educational research and curriculum innovations are imperative to advance thoracic surgery training through multidisciplinary strategies. This study provides an evidentiary foundation to optimize training and address the complexities of modern thoracic surgery.

Simulation-based Bone Marrow Aspiration and Trephine Biopsy Education for Medical Students: A Non-randomized Controlled Trial.

Introduction Despite the critical role of bone marrow aspiration and a trephine biopsy (BMAT) in the diagnosis and management of hematological diseases, research on effective teaching methods is limited. Medical students traditionally learn to perform BMAT through observation and replication, which poses a risk to patient safety. Therefore, we developed a novel BMAT simulator for undergraduate medical students using a simulation-based education program. Methods This program, designed for fourth- and fifth-year medical students at Okayama University Medical School, included pre-study materials and one hour of simulation training. Internists practicing hematology served as the controls. Before and after the simulation training, the students completed questionnaires regarding self-confidence, self-evaluation, interest, and knowledge. The procedures were evaluated objectively using a checklist at the end of the program. Results There were significant improvements in self-evaluation, self-confidence, interest, and knowledge acquisition after the simulation program (p≤0.001). The checklist revealed that the mean overall proficiency level of the students was 76.9%, which was significantly higher than that of internists (63.5%) (p≤0.01). Conclusion Our simulation-based education program using the novel BMAT simulator improved medical students' BMAT knowledge and skills.

Exploring the potential of digital twin technology as a training tool for new radiographers.

INTRODUCTION: A digital twin is a virtual representation of the real world. This paper presents the concept of a digital twin system that reflects the movements of the human skeleton as the body is repositioned. Digital twin technology has the ability to be used as a training tool for new radiographers to build their competencies due to its ability to provide visual feedback without the use of radiation. This study aims to evaluate the perceptions of radiography trainers and trainees regarding the utility of digital twin technology. METHODS: The concept of digital twin technology was demonstrated to 46 trainers and trainees. Surveys were distributed online on the same day as the demonstration to gather feedback from the participants regarding the perceived usefulness of digital twin technology. For dichotomized and categorical variables, the relationships among these variables were examined using either the chi-squared test or Fisher's exact test. Inductive thematic analysis was used to analyze the open-ended questions. RESULTS: Most respondents were willing to use digital twin technology (91.1 %) and agreed that it would be useful for education and training purposes (95.5 %). They also felt that it would improve radiographic skills (84.4 %) and confidence (93.3 %). Concerns regarding the product included its sensitivity to capturing subtle changes in positioning and its user-friendliness in terms of customization, and potential dependence on technology when positioning patients. CONCLUSION: Digital twin technology has the potential to be a valuable training tool by allowing radiographers to hone their radiographic skills in a safe environment without the need for radiation exposure.

Comparing the impact of PASS-BAR handoff education for new nurses between simulation-based and case-based approaches: A quasi-experimental design.

AIM: To develop a patient, assessment, situation, safety concerns, background, action, recommendation (PASS-BAR) handoff training program and compare the educational effects of the program between simulation-based (experimental group) and case-based (control group) groups using repeated measures among new nurses. BACKGROUND: New nurses are not well prepared to provide clear handoff reports because nursing schools and healthcare institutions rarely offer structured programs or training for handoff communication practices. DESIGN: This study used a pretest-posttest quasi-experimental design with repeated measures with two non-randomized groups. METHODS: This study targeted new nurses with less than 12 months of experience and was conducted at a university hospital's clinical nursing education center in Seoul, South Korea, between September 2022 and April 2023. Seventeen participants were allocated to the experimental group and 17 participants to the control group. Both groups were given lectures and exercises for both scenarios. Participants were asked to complete a questionnaire on nursing handoff competency, handover performance competency and perceived self-efficacy of handoff at pre- and posttest and two weeks after training. Satisfaction with learning was measured after the intervention. RESULTS: We developed a simulation-based learning handoff program that includes a simulated handoff performance and debriefing and a case-based learning handoff program that includes discussion, handoff performance and feedback. This study found no immediate difference in the educational effect of PASS-BAR handoff training between simulation-based learning and case-based learning; however, over time, simulation-based learning was more effective than case-based learning in improving nursing handoff competency and handover performance competency. CONCLUSIONS: Based on the results of this study, a simulation-based handoff training program using PASS-BAR can enhance handoff competencies and help new nurses strengthen their communication skills to understand patients and convey important information. TWEETABLE ABSTRACT: Developing a simulation-based handoff training program using PASS-BAR helps nurses strengthen their communication skills with colleagues.

Evaluating the implementation of person-centred care and simulation-based learning in a midwifery education programme in the Democratic Republic of Congo: a study protocol.

BACKGROUND: Investing in midwives educated according to international standards is crucial for achieving Sustainable Development Goals in maternal and newborn health. Applying a person-centred care approach and using simulation-based learning to improve the learning experience for midwifery students may enhance the quality of childbirth care. This protocol describes a study evaluating the implementation of person-centred approach and simulation-based learning in childbirth as part of a midwifery education programme at the Evangelical University in Africa, DRC. METHODS: The research will be exploratory and guided by an implementation research framework. Ethical approval has been obtained. Facilitators working at the programme's five clinical practice sites will be trained in: 1) Introducing person-centred childbirth care using a training programme called'Mutual Meetings'; and 2) integrating simulation-based learning, specifically by using the three courses: Essential Care of Labor, Bleeding after Birth, and Vacuum Extraction. Data will include interviews with midwifery students, facilitators and clinical preceptors, and maternal and neonatal outcomes from birth registers. DISCUSSION: By integrating a validated and culturally adapted person-centred care training programme and simulation-based learning into a midwifery education programme and clinical practice sites, the findings from the study anticipate an improvement in the quality of childbirth care. Training facilitators in these methodologies aim to effectively mitigate maternal and neonatal adverse outcomes. The findings are expected to provide valuable recommendations for governments, policymakers, and healthcare providers in the DRC and beyond, contributing to significant improvements in midwifery education and aligning with global health priorities, including the Sustainable Development Goals. TRIAL REGISTRATION: The study was registered retrospectively with the ISRCTN registry on the 23rd of February 2024. The registration number is: ISRCTN10049855.

Main findings: It is anticipated that the implementation of both person-centred care and simulation-based learning in a midwifery education programme will improve the quality of care in childbirth practice.Added knowledge: The use of facilitators has the potential to enhance the implementation of person-centred care and simulation-based learning in a midwifery education programme, both at campus and in clinic.Global health impact for policy and action: The expected findings could inform global health policy development and practice, promising advancements in midwifery education and consequently enhance the maternal and newborn health outcomes.

The effect of non-immersive virtual reality radiographic positioning simulation on first-year radiography students' image evaluation performance.

INTRODUCTION: Optimal radiographic image quality is critical because it affects the accuracy of the reporter's interpretation. Radiographers have an ethical obligation to obtain quality diagnostic images while protecting patients from unnecessary radiation, including minimizing rejected and repeated images. Repeated imaging due to positioning errors have increased in recent years. METHODS: This study evaluated the effectiveness of non-immersive virtual reality (VR) simulation on first-year students' evaluation of positioning errors on resultant knee and lumbar spine images. Crossover intervention design was used to deliver radiographic image evaluation instruction through traditional lecture and guided simulation using non-immersive VR to 33 first-year radiography students at a single academic institution located across four geographic program locations. Pre- and post-test knowledge assessments examined participants' ability to recognize positioning errors on multiple-choice and essay questions. RESULTS: Raw mean scores increased on multiple choice questions across the entire cohort for the knee (M = 0.82, SD = 3.38) and lumbar spine (M = 2.91, SD = 3.69) but there was no significant difference in performance by instructional method (p = 0.60). Essay questions reported very minimal to no raw mean score increases for the knee (M = 0.27, SD = 2.78) and lumbar spine (M = 0.00, SD = 2.55), with no significant difference in performance by instructional method (p = 0.72). CONCLUSION: Guided simulation instruction was shown to be as effective as traditional lecture. Results also suggest that novice learners better recognize image evaluation errors and corrections from a list of options but have not yet achieved the level of competence needed to independently evaluate radiographic images for diagnostic criteria. IMPLICATIONS FOR PRACTICE: Non-immersive VR simulation is an effective tool for image evaluation instruction. VR increases access to authentic image evaluation practice by providing a simulated resultant image based off the students' applied positioning skills.

Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review.

BACKGROUND: Equality, diversity and inclusion initiatives seek to embed the concept of inclusive pedagogy to promote inclusive educational environments. However, no evidence synthesis exists which examines whether and how the concept of inclusive pedagogy is addressed in online simulation-based learning in the undergraduate nursing education literature. AIMS: To map the evidence regarding the adoption of inclusive pedagogy in online simulation-based learning in undergraduate nursing education. DESIGN: A scoping review. METHODS: Data were extracted, synthesized and presented in narrative and table format. DATA SOURCES: A systematic search of five databases and five sources of grey literature was conducted to search literature published between 1st January 2010 to 1st June 2022. RESULTS: Thirty-eight papers published between 2011 and 2022 were included. The results are presented under three identified themes: (1) Learner diversity; (2) Theoretical frameworks promoting equality, diversity and inclusion in online simulation and (3) Online simulation feedback. CONCLUSION: Inclusive pedagogy has not been considered or embedded in its entirety in online simulation in undergraduate nursing education literature. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Utilizing an inclusive pedagogy framework may prove advantageous in generating inclusive teaching approaches to support all students. IMPACT: This review will interest educators and managers that wish to incorporate equality, diversity and inclusion initiatives in nursing education. REPORTING METHOD: This scoping review has adhered to the EQUATOR guidelines: the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Preparing healthcare professional students for rural, regional and remote practice: demonstrating the effectiveness of an interprofessional simulation learning experience.

Undertaking an authentic interprofessional simulation experience may be a useful and consistent strategy for healthcare professional students to build competencies required for a rural healthcare context. An observational comparative study design was adopted to evaluate a clinical simulation experience created to develop the interprofessional competencies of a sample of healthcare professional students at a regional university situated on multiple campuses in New South Wales (NSW), Australia. Over 200 students across three campuses of the university were involved in a simulation experience that included four interprofessional activities. Of these students, 189 (89%) agreed to participate in the study. The healthcare professional students who participated in the study were from second year occupational therapy, physiotherapy, and podiatry, and third year speech pathology programs. Retrospective pre and post self-assessed interprofessional collaborative competencies were compared for all students using the revised Interprofessional Collaborative Attainment Survey (ICCAS). Results demonstrated a statistically significant improvement in self-perceived scores using the validated revised ICCAS survey. The findings of this study suggest that carefully designed and authentic interprofessional simulation experiences can facilitate the development of competencies required for effective interprofessional practice, which are necessary for successful rural practice.

Comparing the efficacy of single-skill and multiple-skill simulation scenarios in advancing clinical nursing competency.

Aim: This study aims to compare the effectiveness of single-skill and multiple skills patient care simulation scenarios in enhancing nursing competency and to evaluate nurses' perceptions of these different simulation scenarios. Methods: A mixed-method design was used. In the quantitative part, 130 newly hired nurses with less than one year of experience participated in this study. For the qualitative part, a subset of 26 of these nurses was selected for in-depth interviews until data saturation was achieved. The study was conducted in the simulation-based learning (SBL) lab in a specialized Jordan cancer center. Data collection took place between June 2022 and March 2023. Results: A significant difference was found in the IV skill between single and multiple skills scenarios; the mean score for the single-skill group was 44.42 (SD = 3.85), the mean score for the multiple-skill group was 45.63 (SD = 2.26) (P = 0.014). Moreover, a significant difference was found between the pre-and post-test scores for single-skill and multiple-skill groups. The mean score for the medication skill scenario pre-intervention single group was (M = 23.90, SD = 5.33); however, the score was increased post-intervention (M = 45.38, SD = 3.33), (P = <.001). Furthermore, the mean score was raised in the multiple skills medication scenario from (M = 22.92, SD = 5.44) to (M = 45.72, SD = 2.75), (<.001). Conclusion: Participants in both groups reported similar findings regarding physical exhaustion, scenario management, and overall satisfaction with the simulation experience. Loss of concentration and memory was reported more with multiple competencies simulation scenarios; this might indicate that this scenario has more cognitive load than the Single Competency Scenario.