Evaluation of team communication in an interprofessional inpatient transition of care simulation.

Background: Interprofessional education (IPE) provides unique opportunities for students to better understand their roles, roles of other healthcare professionals, and prepare for teamwork for patient benefit. Interprofessional team education is recognized as a key element in the 2016 ACPE standards. Objective: Assess student self-perceived competence in four IPEC domains after an inpatient simulation activity. Methods: Pre/post-test design used the Interprofessional Education Collaborative Competency Survey. The activity included medical, nursing, social work, and pharmacy students working in healthcare teams to develop collaborative treatment plans for simulated patients with altered mental status. Results: Ninety-seven health profession students completed the activity, while 49 second-year (P2) student pharmacists participated in the study. All completed a pre-test and 47/49 (96%) completed a post-test. At pre-test, students ranked themselves highest in abilities to respect patient privacy (100% strongly agree) and acting with honesty and integrity in relationships (100% strongly agree). They reported lower ability in describing team development process. At post-test, significant increases were seen in managing ethical dilemmas (p < .002) and respect (p = .49), though decreases were seen in using appropriate or respectful language (p < .02). Conclusion: Significant differences in student perceptions of ethics and communication were observed after participation in a transition of care inpatient IPE simulation.

Development of a Simulation Scenario Evaluation Tool (SSET): modified Delphi study.

Introduction: One critical aspect of successful simulation facilitation is development of written scenarios. However, there are no validated assessment tools dedicated to the evaluation of written simulation scenarios available. Our aim was to develop a tool to evaluate the quality of written simulation demonstrating content validity. Methods: A comprehensive literature search did not yield a validated assessment tool dedicated for the evaluation of written simulation scenarios. A subsequent search yielded six templates published for written simulation scenario design. From these templates, critical scenario elements were identified to create an evaluation instrument with six components of scenario quality with corresponding anchors and rating scale. Subsequently, a national group of simulation experts were engaged via survey methodology to rate the content of the proposed instrument. Ultimately, a modified two-round Delphi approach was implemented to demonstrate consensus of the final assessment tool. Results: 38 responses were obtained in round 1, while 22 complete responses were obtained in round 2. Round 1 kappa values ranged from 0.44 to 1.0, indicating moderate to almost perfect rater agreement for inclusion of the six proposed components. Kappa values specifically regarding scale and anchors ranged from 0 to 0.49. After revisions, there was a significant level of agreement (p<0.05) of all items of the proposed assessment tool in the second-round survey except for item 10. Of note, all initial respondents indicated that they had never evaluated written scenarios with an assessment tool. Conclusions: The Simulation Scenario Evaluation Tool, developed using a national consensus of content experts, is an instrument demonstrating content validity that assesses the quality of written simulation scenarios. This tool provides a basis to guide structured feedback regarding the quality of written simulation scenarios.

Reliability and validity study of the Spanish adaptation of the "Creighton Simulation Evaluation Instrument (C-SEI)".

There are multiple advantages to using human patient simulation (HPS) as a teaching method for clinical nursing education. Valid, reliable tools that can be used when applying this teaching method are needed to evaluate nursing student skill acquisition. The aim of this study was to translate the Creighton Simulation Evaluation Instrument (C-SEI) into Spanish and to analyse the reliability and validity of the Spanish C-SEI version with nursing students. The study was conducted in two phases: (1) Adaptation of the instrument into Spanish. (2) Cross-sectional study in a sample of 249 nursing students who were evaluated by two observers. The psychometric properties were analysed in terms of reliability (internal consistency and inter-observer consistency) and construct validity using an exploratory factor analysis. Questionnaire internal consistency was 0.839 for the tool as a whole. Inter-observer concordance for the tool as a whole was 0.936 and greater than 0.80 for the majority of the items. The exploratory factor analysis showed a four-factor structure that explains 49.5% of the total variance. The results of this study show that the C-SEI-sp tool is a valid and reliable tool that is easy to apply in the monitoring of student performance in clinical simulation scenarios.

A modified Ester-branched thickener for rheology and wettability during CO2 fracturing for improved fracturing property.

The thickening performance of CO2 fracturing fluid was poor because of the low apparent viscosity. In this paper, the thickening performance of a modified silicone on liquid CO2 is measured, and a rheology was investigated according to the consistency coefficient K and rheological index n. Meanwhile, a reservoir model was established to evaluate the fracturing property. Results showed that the modified silicone contributes to improve the apparent viscosity of liquid CO2 and decrease the rheology of liquid CO2. With the thickener content or pressure increase, the apparent viscosity of liquid CO2 increases, and the rheological index n decreased obviously. A reduced apparent viscosity is shown as the flow rate or temperature rises, but the rheology increased gradually. The fracturing simulation herein shows that thickened CO2 fracturing fluid could improve obviously the fracture property. This modified thickener possesses the potential as a thickener and could be a reliable alternative to the thickener in CO2 fracturing technology, and the large contact angle improved the backflow property of this CO2 thickener from rock surfaces. The development of CO2 fracturing technology provides basic data for the improvement of greenhouse effect and clean mining of energy.

Commentary on a participatory inquiry paradigm used to assess EOL simulation participant outcomes and design.

Care at the end-of-life has attracted global attention, as health care workers struggle with balancing cure based care with end-of-life care, and knowing when to transition from the former to the latter. Simulation is gaining in popularity as an education strategy to facilitate health care provider decision-making by improving communication skills with patients and family members. This commentary focuses on the authors' simulation evaluation process. When data were assessed using a participatory inquiry paradigm, the evaluation revealed far more than a formative or summative evaluation of participant knowledge and skills in this area of care. Consequently, this assessment strategy has ramifications for best practices for simulation design and evaluation.

Assessing simulation-based clinical training: comparing the concurrent validity of students' self-reported satisfaction and confidence measures against objective clinical examinations.

Introduction: Simulation-based education (SBE) literature is replete with student satisfaction and confidence measures to infer educational outcomes. This research aims to test how well students' satisfaction and confidence measures correlate with expert assessments of students' improvements in competence following SBE activities. Methods: N=85 paramedic students (mean age 23.7 years, SD=6.5; 48.2% female) undertook a 3-day SBE workshop. Students' baseline competence was assessed via practical scenario simulation assessments (PSSAs) administered by expert paramedics and confidence via a questionnaire. Postworkshop competence and confidence plus self-reported students' satisfaction were remeasured. Results: PSSA scores increased significantly between baseline and post workshop (35.7%→53.4%, p<0.001), as did students' confidence (55.7%→60.5%, p<0.001), and their workshop satisfaction was high (71.0%). Satisfaction and postworkshop confidence measures were moderately correlated (r=0.377, p=0.001). However, competence improvements were not significantly correlated with either satisfaction (r=-0.107 p=0.344) or change in confidence (r=-0.187 p=0.102). Discussion: Students' self-reported satisfaction and confidence measures bore little relation to expert paramedics' judgements of their educational improvements. Satisfaction and confidence measures appear to be dubious indicators of SBE learning outcomes.

The effect of simulation courseware on critical thinking in undergraduate nursing students: multi-site pre-post study.

BACKGROUND: The use of simulations has been considered as opportunities for students to enhance their critical thinking (CT), but previous studies were limited because they did not provide in-depth information on the working dynamics of simulation or on the effects of the number of simulation exposures on CT. OBJECTIVES: This study examined the effect of an integrated pediatric nursing simulation used in a nursing practicum on students' CT abilities and identified the effects of differing numbers of simulation exposures on CT in a multi-site environment. DESIGN: The study used a multi-site, pre-test, post-test design. PARTICIPANTS AND SETTINGS: A total of 237 nursing students at three universities enrolled in a pediatric practicum participated in this study from February to December 2013. METHODS: All three schools used the same simulation courseware, including the same simulation scenarios, evaluation tools, and simulation equipment. The courseware incorporated high-fidelity simulators and standardized patients. Students at school A completed one simulation session, whereas students at schools B and C completed two and three simulation sessions, respectively. Yoon's Critical Thinking Disposition tool (2008) was used to measure students' CT abilities. RESULTS: The gains in students' CT scores varied according to their numbers of exposures to the simulation courseware. With a single exposure, there were no statistically significant gains in CT, whereas three exposures to the courseware produced significant gains in CT. In seven subcategories of critical thinking, three exposures to the simulation courseware produced CT gains in the prudence and intellectual eagerness subcategories, and the overall simulation experience produced CT gains in the prudence, systematicity, healthy skepticism, and intellectual eagerness subcategories. CONCLUSIONS: Simulation courseware may produce positive learning outcomes for prudence in nursing education. In addition, the findings from the multi-site comparative study may contribute to greater understanding of how patient simulation experiences impact students' CT abilities.

Simulation and rubrics: technology and grading student performance in nurse anesthesia education.

The use of simulation technology has introduced a challenge for simulation nurse educators: evaluation of student performance. The subjectivity of student performance evaluation has been in need of improvement. It is imperative to provide clear and consistent information to the learner of expectations for their performance. Educators use objectives to define for the learner what the primary focus will be in the learning activities. Creation of rubrics to replace checklists to evaluate learner performance is a team task. Improved rubrics assist instructors in providing valuable, immediate, and postactivity feedback and consistency among instructors, and improved inter-rater reliability.