Global consensus statement on simulation-based practice in healthcare.

Simulation plays a pivotal role in addressing universal healthcare challenges, reducing education inequities, and improving mortality, morbidity and patient experiences. It enhances healthcare processes and systems, contributing significantly to the development of a safety culture within organizations. It has proven to be cost-effective and successful in enhancing team performance, fostering workforce resilience and improving patient outcomes.Through an international collaborative effort, an iterative consultation process was conducted with 50 societies operating across 67 countries within six continents. This process revealed common healthcare challenges and simulation practices worldwide. The intended audience for this statement includes policymakers, healthcare organization leaders, health education institutions, and simulation practitioners. It aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.Key recommendations Advocating for the benefits that simulation provides to patients, staff and organizations is crucial, as well as promoting its adoption and integration into daily learning and practice throughout the healthcare spectrum. Low-cost, high-impact simulation methods should be leveraged to expand global accessibility and integrate into system improvement processes as well as undergraduate and postgraduate curricula. Support at institutional and governmental level is essential, necessitating a unified and concerted approach in terms of political, strategic and financial commitment.It is imperative that simulation is used appropriately, employing evidence-based quality assurance approaches that adhere to recognized standards of best practice. These standards include faculty development, evaluation, accrediting, credentialing, and certification.We must endeavor to provide equitable and sustainable access to high-quality, contextually relevant simulation-based learning opportunities, firmly upholding the principles of equity, diversity and inclusion. This should be complemented with a renewed emphasis on research and scholarship in this field.Call for action We urge policymakers and leaders to formally acknowledge and embrace the benefits of simulation in healthcare practice and education. This includes a commitment to sustained support and a mandate for the application of simulation within education, training, and clinical environments.We advocate for healthcare systems and education institutions to commit themselves to the goal of high-quality healthcare and improved patient outcomes. This commitment should encompass the promotion and resource support of simulation-based learning opportunities for individuals and interprofessional teams throughout all stages and levels of a caregiver's career, in alignment with best practice standards.We call upon simulation practitioners to champion healthcare simulation as an indispensable learning tool, adhere to best practice standards, maintain a commitment to lifelong learning, and persist in their fervent advocacy for patient safety.This statement, the result of an international collaborative effort, aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.

A graduate medical education (GME) quality improvement curriculum leads to improved knowledge and participation in high quality improvement projects by trainees.

BACKGROUND: There is increased awareness about the need for quality improvement (QI) education for trainees within clinical training programs. However, formal integration of a QI curriculum into graduate medical education (GME) remains a work-in-progress. We describe the creation and implementation of a novel, virtual QI curriculum complemented by virtual-based workshops. OBJECTIVE: To determine the impact of a GME QI curriculum on 1) trainee QI knowledge; 2) Quality of QI projects. METHODS: The GME Quality Improvement curriculum was transitioned to an optional formal curriculum in 2020. It is led by three faculty with expertise in QI training and education. The team developed four, web-based learning modules that focused on fundamental QI concepts. These modules are completed monthly and are paired with virtual workshops that facilitate applying learned QI concepts to project development. We evaluated the effectiveness of the curriculum by assessing participants' performance on knowledge-based quizzes before and after each online module. We used IBM SPSS (version 28), to conduct a two-sided paired samples t-test, comparing each post-session test scores with their corresponding pre-session scores. The alpha, or statistical threshold significance threshold, was 0.05. Additionally, two independent judges with expertise in QI evaluated the quality of the projects presented at the annual QI showcase using a standardized scoring rubric. The poster evaluation forms included 8 questions, rated on a scale from 1 to 5. Projects were graded into 4 quartiles (poor, fair, good, excellent). RESULTS: In the knowledge assessment quiz, the difference between the mean pre- and post-session quiz scores was statistically significant (p < 0.01). The average score of the quality of the projects presented at the annual showcase was 31, in the fourth quartile which was graded as "excellent" quality. CONCLUSION: A GME-led QI curriculum was effective in improving knowledge of QI concepts and producing high-quality scholarly projects.

EPMO: A novel medical student assessment tool that integrates entrustable professional activities, prime, and the modified Ottawa coactivity scale.

PURPOSE: Alignment of workplace-based assessments (WPBA) with core entrustable professional activities (EPAs) for entering residency may provide opportunities to monitor student progress across the continuum of undergraduate medical education. Core EPAs, however, reflect tasks of varying degrees of difficulty and faculty assessors are not accustomed to rating students based on entrustability. Expectations of student progress should vary depending on the complexity of the tasks associated with the EPAs. An assessment tool that orients evaluators to the developmental progression of specific EPA tasks will be critical to fairly evaluate learners. METHODS: The authors developed an EPA assessment tool combining the frameworks of Professionalism, Reporter, Interpreter, Manager, Educator (PRIME), and Modified Ottawa coactivity scales. Only those EPAs that could be repeatedly observed and assessed across clinical clerkships were included. From July 2019 to March 2020, third-year medical students across multiple clerkships were assessed using this tool. The authors hypothesized that if the tool was applied correctly, ratings of learner independence would be lower with higher complexity tasks and that such ratings would increase over the course of year with ongoing clinical learning. RESULTS: Assessment data for 247 medical students were similar across clerkships suggesting that evaluators in diverse clinical contexts were able to use this tool to assign scores reflective of developing entrustability in the workplace. Faculty rated student entrustability highest in skills emphasized in the pre-clerkship curriculum (professionalism and reporter) and progressively lower in more advanced skills (interpreter and manager). Students' ratings increased over time with more clinical exposure. CONCLUSIONS: The authors developed a composite WBPA tool that combines the frameworks of EPAs, PRIME, and Modified Ottawa Co- Activity and demonstrated the usability of applying it for learner assessments in clinical settings. Further multicenter studies with cohorts of pre- and post-clerkship students may provide additional validity evidence for the tool.

The Purpose, Design, and Promise of Medical Education Research Labs.

Medical education researchers are often subject to challenges that include lack of funding, collaborators, study subjects, and departmental support. The construct of a research lab provides a framework that can be employed to overcome these challenges and effectively support the work of medical education researchers; however, labs are relatively uncommon in the medical education field. Using case examples, the authors describe the organization and mission of medical education research labs contrasted with those of larger research team configurations, such as research centers, collaboratives, and networks. They discuss several key elements of education research labs: the importance of lab identity, the signaling effect of a lab designation, required infrastructure, and the training mission of a lab. The need for medical education researchers to be visionary and strategic when designing their labs is emphasized, start-up considerations and the likelihood of support for medical education labs is considered, and the degree to which department leaders should support such labs is questioned.

The Effects of Simulation-Based Advanced Life Support Education for Nursing Students.

Advanced life support education for nursing students is very important because nurses are first responders in emergency situations. The purpose of this study was to identify the effects of simulation-based advanced life support education on nursing students' knowledge, performance, self-efficacy, and teamwork. A nonequivalent control group posttest-only design was used. Fourth-year nursing students were randomly assigned to either simulation-based Korean Advanced Life Support (n = 30) or lecture-based education (n = 30) groups. Data were analyzed using descriptive statistics and the Mann-Whitney U test. The experimental group showed statistically significant higher scores in knowledge (P < .001), performance (P < .001), and self-efficacy (P = .049) when compared with the control group. However, there was no significant difference in teamwork scores between the two groups (P = .529). The 4.5-hour simulation-based Korean Advanced Life Support education was more effective than the 4.5-hour lecture-based education for nursing students in terms of knowledge, performance, and self-efficacy. Nurse educators should adopt simulation-based advanced life support education into the curriculum for the optimal competence of nursing students.

Training and simulation for patient safety.

BACKGROUND: Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an independent practitioner. RESULTS: Simulation-based training initially began with life-like manikins and now encompasses an entire range of systems, from synthetic models through to high fidelity simulation suites. These models can also be used for training in new technologies, for the application of existing technologies to new environments and in prototype testing. The level of simulation must be appropriate to the learners' needs and can range from focused tuition to mass trauma scenarios. The development of simulation centres is a global phenomenon which should be encouraged, although the facilities should be used within appropriate curricula that are methodologically sound and cost-effective. DISCUSSION: A review of current techniques reveals that simulation can successfully promote the competencies of medical expert, communicator and collaborator. Further work is required to develop the exact role of simulation as a training mechanism for scholarly skills, professionalism, management and health advocacy.