;display:none;369010display:none;11-10true1trueOriginal ResearchOriginal ResearchOriginal Researchoriginal-researchtoc-heading<_class/>/dataresources/articles/contents-1669131551342-87e055cc-de77-4aed-b154-f680142856b2/assets/juvj5939_f0001.jpg389 <h3 class="BHead" id="N65544">Introduction</h3> <p class="para" id="N65547">The aim of this study was to develop an adequate tracking method for open surgical training, using tracking of the instrument or hand motions.</p> <h3 class="BHead" id="N65552">Methods</h3> <p class="para" id="N65555">An open surgical training model and the SurgTrac application were used to track four separate suturing tasks. These tasks were performed with colour markings of either instruments or fingers, to find the most promising setting for reliable tracking.</p> <h3 class="BHead" id="N65560">Results</h3> <p class="para" id="N65563">Four experiments were used to find the optimal settings for the tracking system. Tracking of instruments was not usable for knot tying by hand. Tracking of fingers seemed to be a more promising method. Tagging the fingers with a coloured balloon-tube, seemed to be a more promising method (1.2–3.0% right hand vs. 9.2–17.9% left hand off-screen) than covering the nails with coloured tape (1.5–3.5% right hand vs. 25.5–55.4% left hand off-screen). However, analysis of the videos showed that redness of the hand was seen as red tagging as well. To prevent misinterpreting of the red tag by redness of the hand, white surgical gloves were worn underneath in the last experiment. The off-screen percentage of the right side decreased from 1.0 to 1.2 without gloves to 0.8 with gloves and the off-screen percentage of the left side decreased from 16.9–17.9 to 6.6–7.2, with an adequate tracking mark on the video images.</p> <h3 class="BHead" id="N65568">Discussion</h3> <p class="para" id="N65571">This study shows that tagging of the index fingers with a red (right) and blue (left) balloon-tube while wearing surgical gloves is a feasible method for tracking movements during basic open suturing tasks.</p> 171Feasibility of tracking in open surgical simulationArticletruecover.png1669137597653contents-1669131551342-87e055cc-de77-4aed-b154-f680142856b2ppj-n4QBEgXBsCdHQpIDppj-n4QBEgXBsCdHQpIDtrueFeasibility of tracking in open surgical simulation2022falseAdi Health+WellnessFeasibility of tracking in open surgical simulation110.54531/juvj5939<p>Department of Pediatric Surgery, Radboudumc – Amalia Children’s Hospital, Nijmegen, The Netherlands</p><p>Corresponding author: Vera Hillemans, <a href=""></a></p>vera-hillemansvera-hillemansAUTHORVera HillemansVera Hillemans3893443<p>Department of Pediatric Surgery, Radboudumc – Amalia Children’s Hospital, Nijmegen, The Netherlands</p>bas-verhoevenbas-verhoevenAUTHORBas VerhoevenBas Verhoeven3893444<p>Department of Pediatric Surgery, Radboudumc – Amalia Children’s Hospital, Nijmegen, The Netherlands</p>sanne-botdensanne-botdenAUTHORtrueSanne BotdenSanne Botden38934451-8true1trueEssaysEssaysEssaysessaystoc-heading<_class/>/dataresources/articles/contents-1669131819649-f4237717-96c2-49ed-9e4c-97ea40fc01f8/assets/fqzq4032_f0001.jpg391 <p class="para" id="N65542">Historically simulation-based education (SBE) has primarily focused on program development and delivery as a means for improving the effectiveness of team behaviours; however, these programs rarely embed formal evaluations of the programs themselves. Logic models can provide simulation programs with a systematic framework by which organizations and their evaluators can begin to understand complex interprofessional teams and their programs to determine inputs, activities, outputs and outcomes. By leveraging their use, organizational leaders of simulation programs can contribute to both <i>demonstrating value</i> and <i>impact</i> to healthcare teams, in addition to establishing a growing culture of evaluation at any health system level. This case study describes a complex program evaluation for improving team effectiveness <i>outputs</i> and <i>outcomes</i> across more than one simulation program, discipline, speciality, department in the largest health authority in Canada and provides considerations for other simulation programs globally to advance the science of program evaluation within the SBE community.</p> 171Improving team effectiveness using a program evaluation logic model: case study of the largest provincial simulation program in CanadaArticletruecover.png1669137590332contents-1669131819649-f4237717-96c2-49ed-9e4c-97ea40fc01f8qJgCoIQBEgXBsCdHWpI5qJgCoIQBEgXBsCdHWpI5trueImproving team effectiveness using a program evaluation logic model: case study of the largest provincial simulation program in Canada2022falseAdi Health+WellnessImproving team effectiveness using a program evaluation logic model: case study of the largest provincial simulation program in Canada110.54531/fqzq4032<p><sup>1 </sup>eSIM Provincial Simulation Program, Alberta Health Services, Calgary, Alberta, Canada</p><p>Corresponding author: Alyshah Kaba, <a href=""></a></p>alyshah-kabaalyshah-kabaAUTHORAlyshah KabaAlyshah Kaba3913437<p><sup>1 </sup>eSIM Provincial Simulation Program, Alberta Health Services, Calgary, Alberta, Canada</p>theresa-cronintheresa-croninAUTHORTheresa CroninTheresa Cronin3913438<p><sup>2 </sup>The Wilson Centre and Post MD Education, Post Graduate Medical Education &amp; Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada</p>walter-tavareswalter-tavaresAUTHORWalter TavaresWalter Tavares3913439<p><sup>3 </sup>Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada</p>tanya-horsleytanya-horsleyAUTHORTanya HorsleyTanya Horsley3913440<p><sup>1 </sup>eSIM Provincial Simulation Program, Alberta Health Services, Calgary, Alberta, Canada</p>vincent-j-grantvincent-j-grantAUTHORVincent J GrantVincent J Grant3913441<p><sup>1 </sup>eSIM Provincial Simulation Program, Alberta Health Services, Calgary, Alberta, Canada</p>mirette-dubemirette-dubeAUTHORtrueMirette DubeMirette Dube39134421-8true1trueEssaysEssaysEssaysessaystoc-heading<_class/>/dataresources/articles/contents-1669131811166-8135e9bf-bff7-4cc8-bd29-8c337d3d06b0/assets/mngy8113_f0001.jpg390 <p class="para" id="N65542">Simulation-based medical education (SBME) is often delivered as one-size-fits-all, with no clear guidelines for personalization to achieve optimal performance. This essay is intended to introduce a novel approach, facilitated by a home-grown learning management system (LMS), designed to streamline simulation program evaluation and curricular improvement by aligning learning objectives, scenarios, assessment metrics and data collection, as well as integrate standardized sets of multimodal data (self-report, observational and neurophysiological). Results from a pilot feasibility study are presented. Standardization is important to future LMS applications and could promote development of machine learning-based approaches to predict knowledge and skill acquisition, maintenance and decay, for personalizing SBME across healthcare professionals.</p> 171Personalizing simulation-based medical education: the case for novel learning management systemsArticletruecover.png1669137726473contents-1669131811166-8135e9bf-bff7-4cc8-bd29-8c337d3d06b0p5gCoIQBEgXBsCdHOJLlp5gCoIQBEgXBsCdHOJLltruePersonalizing simulation-based medical education: the case for novel learning management systems2022falseAdi Health+WellnessPersonalizing simulation-based medical education: the case for novel learning management systems110.54531/mngy8113<p><sup>1 </sup>Department of Anesthesiology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA</p><p><sup>2 </sup>Department of Bioengineering, College of Engineering, University of Toledo, Toledo, OH, USA</p><p><sup>3 </sup>Department of Electrical Engineering and Computer Science, College of Engineering, University of Toledo, Toledo, OH, USA</p><p><b>Corresponding author:</b> Scott Pappada, <a href=""></a></p>scott-pappadascott-pappadaAUTHORScott PappadaScott Pappada3903446<p><sup>3 </sup>Department of Electrical Engineering and Computer Science, College of Engineering, University of Toledo, Toledo, OH, USA</p>mohammad-hamza-owaismohammad-hamza-owaisAUTHORMohammad Hamza OwaisMohammad Hamza Owais3903447<p><sup>4 </sup>Department of Emergency Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA</p>shaza-aouthmanyshaza-aouthmanyAUTHORShaza AouthmanyShaza Aouthmany3903448<p><sup>4 </sup>Department of Emergency Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA</p><p><sup>5 </sup>Department of Public Health and Preventitive Medicine, School of Population Health, University of Toledo, Toledo, OH, USA</p>paul-regapaul-regaAUTHORPaul RegaPaul Rega3903449<p><sup>6 </sup>College of Medicine and Life Sciences, EMS Education, University of Toledo, Toledo, OH, USA</p>jeffrey-schneidermanjeffrey-schneidermanAUTHORJeffrey SchneidermanJeffrey Schneiderman3903450<p><sup>7 </sup>Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA</p>serkan-toyserkan-toyAUTHORSerkan ToySerkan Toy3903451<p><sup>8 </sup>Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA</p>adam-schiaviadam-schiaviAUTHORAdam SchiaviAdam Schiavi3903452<p><sup>8 </sup>Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA</p>christina-millerchristina-millerAUTHORChristina MillerChristina Miller3903453<p><sup>9 </sup>Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA</p><p><sup>10 </sup>Center for Simulation, Advanced Education and Innovation, Children’s Hospital of Philadelphia, Philadelphia, PA, USA</p><p><sup>11 </sup>Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA</p>rodrigo-daly-gurisrodrigo-daly-gurisAUTHORRodrigo Daly GurisRodrigo Daly Guris3903454<p><sup>1 </sup>Department of Anesthesiology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA</p>thomas-papadimosthomas-papadimosAUTHORtrueThomas PapadimosThomas Papadimos3903455A2-A2true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>/dataresources/articles/contents-1668490393065-86d404b9-3198-4ed4-be9f-afc8be340f75/assets/tfxw4282.003_f001.jpg222 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">Atypical sensory processing is described as a difficulty in regulating and managing sensory input in a meaningful, ordered way to make sense of the world and environment in which you find yourself. Sensory processing disorder (SPD) is common in individuals with autism, pervasive development disorders, and neurodivergent conditions [1,2,3]. The National Institute of Clinical Excellence (NICE) [2] suggest sensory processing disorders are often overlooked by education, social, and healthcare professionals, leading to health and social inequalities with individuals less able to access ‘support and services that they need to live independently’ [2 p5]. The Experiencing Sensory Overload Project (ESOP) aims to champion inclusive practice and reduce health inequalities by encouraging and enabling healthcare professionals to reconsider their approach, and their working environments to create sensorily safe spaces for individuals who may experience sensory overload.</p> <h3 class="BHead" id="N65551">Activity:</h3> <p class="para" id="N65554">The authors recognised there was insufficient education on SPD within the current nursing curriculum. To address this theory/practice gap, training was sought externally. This consisted of a short simulation-based activity with training delivered by carers who had experience of sensory overload. This was well evaluated by the student participants; however lecturing staff felt the training did not meet our university teaching and learning standards. The positive student feedback provided the impetus to forge links with digital arts colleagues to co-create a robust, pedagogically sound and immersive learning experience.</p> <h3 class="BHead" id="N65560">Findings:</h3> <p class="para" id="N65563">The collaborative journey of ESOP has been led and facilitated by academics from the School of Nursing and Midwifery and the School of Arts in a cross-school alliance (<a href="#F1">Figure 1</a>). Nursing academics acted as ‘clients’ whilst the creative media team worked as ‘creatives’ developing a high-fidelity Virtual Reality (VR) experience that gives users an insight into sensory overload. Post-pandemic, this project has relaunched with the creation of a film of two young people with SPD, frankly, discussing their life opportunities and challenges. Further work continues on immersive learning experiences. These resources have been scaffolded to form a cohesive simulation programme that draws on sound pedagogical approaches and blended learning for healthcare professionals. </p> <h3 class="BHead" id="N65574">Conclusion:</h3> <p class="para" id="N65577">Immersive learning experiences that recognise and champion diversity must be integrated into the curricular of all healthcare professionals to promote the highest standards of patient care. Meeting this demand with innovative, immersive technology demands collaborative working. This cross-school alliance has produced a learning experience that can work towards reducing health inequalities, promoting independence, and championing inclusive practice.</p> <div class="section" id="F1"><div class="img"><div class="imgeVideo"><div class="img-fullscreenIcon" onClick="javascript:showImageContent('F1');"><img src="/public/images/journalImg/fullscreen.png"/></div><div class="imageVideo"><img src="/dataresources/articles/contents-1668490393065-86d404b9-3198-4ed4-be9f-afc8be340f75/assets/tfxw4282.003_f001.jpg" alt="The experiencing sensory overload project (ESOP) collaborative journey 2019–2022"/></div></div><div class="imgeVideoCaption" id="N65580"><div class="captionTitle">Figure 1:</div><div class="captionText">The experiencing sensory overload project (ESOP) collaborative journey 2019–2022</div></div></div></div> <h3 class="BHead" id="N65594">References</h3> <p class="para" id="N65597">1. Walbam KM. The relevance of sensory processing disorder to social work practice: An interdisciplinary approach. Child and Adolescent Social Work Journal. 2014;31(1):61–70.</p> <p class="para" id="N65600">2. National institute Clinical Excellence. Autism spectrum disorder in adults: diagnosis and management. London: NICE; 2012. 1–42. CG142</p> <p class="para" id="N65603">3. Bolaños C, Gomez MM, Ramos G, Rios del Rio J. Developmental risk signals as a screening tool for early identification of sensory processing disorders. Occupational therapy international. 2016;23(2):154–164.</p> 176The experiencing sensory overload project (ESOP): developing an immersive simulation experience for healthcare professionals.Articletruecover.png1668490393703contents-1668490393065-86d404b9-3198-4ed4-be9f-afc8be340f75_5jGeYQBEgXBsCdH9ZFe_5jGeYQBEgXBsCdH9ZFetrueThe experiencing sensory overload project (ESOP): developing an immersive simulation experience for healthcare professionals.2022falseAdi Health+WellnessThe experiencing sensory overload project (ESOP): developing an immersive simulation experience for healthcare professionals.110.54531/NYVJ3930<p><sup>1</sup>University of Worcester, Fladbury, United Kingdom</p>susan-poultneysusan-poultneyAUTHORSusan PoultneySusan Poultney2222813<p><sup>1</sup>University of Worcester, Fladbury, United Kingdom</p>kirsty-wedgburykirsty-wedgburyAUTHORtrueKirsty WedgburyKirsty Wedgbury2222814A2-A3true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>/dataresources/articles/contents-1668490397453-6a8e61f6-8b80-42a8-97cb-af998c20ba51/assets/tfxw4282.004_t001.jpg223 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">Cataract surgery is one of the most performed procedure worldwide with a fascinating evolution in the use of technology [1]. EyeSi is a high-fidelity, task-oriented, virtual reality, intraocular surgery simulator widely adopted by residency programs across the developed world for skill development in cataract surgery, with proven effectiveness and decrease in complication rates [2]. We aim to provide a trainee’s reflective perspective on learning cataract surgery via virtual reality simulation and performing first real surgery from a low middle-income, developing country [3].</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">Simulation training as part of formal residency curriculum was documented, hence ethical approval was exempted. EyeSi course software (V3.0.6) was used for skill development as a self-learning tool, reinforced with real cataract surgery training, documented over a period of 8 months for a single participant. EyeSi provides a binocular microscopic viewing system, with hand-piece instruments and foot pedals of the same configuration as used in operating theatres. The software generates feedback reports for each task using microscopic calibrations inside the model eye.</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">By the end of the 8-month period, simulation data showed a logged time of 45.7 hours, 74 intraocular lenses injected, 1,581 intraocular tasks completed and 772 capsulorhexis done with complications including 679mm2 of injured corneal area, 113 mm2 of injured lens area and 862 posterior capsule ruptures. In comparison, the real surgery logbook noted 30 intraocular lenses injected, 86 intraocular tasks and 31 capsulorhexis complete with a total of 1 complication and 1 complete cataract case performed. Subjective comparison reported increased confidence, lower stress levels, good preparation of left-hand skills, and passive learning of surgical theory and technicalities (<a href="#T1">Table 1</a>).</p> <div class="section"><div class="img" alt="Comparison of virtual reality and real surgery experience"><div class="tableCaption"><div class="captionTitle"><div id="T1-no">Table 1:<div class="fullscreenIcon" onclick="javascript:showTableContent('T1');"><img src="/images/journalImg/maximize-2.png"/></div></div></div><div class="captionText" id="T1-text">Comparison of virtual reality and real surgery experience</div></div><div class="tableView" id="T1-content"><table class="table"> <tbody> <tr> <td align="center"><div class="imageVideo"><img src="/dataresources/articles/contents-1668490397453-6a8e61f6-8b80-42a8-97cb-af998c20ba51/assets/tfxw4282.004_t001.jpg" alt=""/></div></td> </tr> </tbody> </table></div></div></div> <h3 class="BHead" id="N65599">Conclusion:</h3> <p class="para" id="N65602">Despite challenges of affordability and traditional surgical culture in a low middle-income country, simulation training provides safe learning alternatives to trainees which are effective and should be widely adopted. Although the learning curve is slightly longer, but skills acquired are replicable in operation theatre and significantly reduce the complication rate in the interest of patient safety.</p> <h3 class="BHead" id="N65607">References</h3> <p class="para" id="N65610">1. Davis G. The Evolution of Cataract Surgery. Missouri Medicine. 2016;113(1):58. https://pmc/articles/PMC6139750/</p> <p class="para" id="N65616">2. Ahmed TM, Hussain B, Siddiqui MR. Can simulators be applied to improve cataract surgery training: a systematic review. BMJ Open Ophthalmology. 2020;5(1):e000488.</p> <p class="para" id="N65619">3. Aga Khan University. Simulation success story: Eye surgery. [Accessed on 26/08/2022]</p> 176From virtual reality to first cataract surgery; trainee perspective from a developing countryArticletruecover.png1668490398062contents-1668490397453-6a8e61f6-8b80-42a8-97cb-af998c20ba51AJjHeYQBEgXBsCdHBpJwAJjHeYQBEgXBsCdHBpJwtrueFrom virtual reality to first cataract surgery; trainee perspective from a developing country2022falseAdi Health+WellnessFrom virtual reality to first cataract surgery; trainee perspective from a developing country110.54531/EMWL4836<p><sup>1</sup>Aga Khan University, Karachi, Pakistan</p>m.-bilal-malikm.-bilal-malikAUTHORtrueM. Bilal MalikM. Bilal Malik2232815A4-A5true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>227 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">A simulation-based programme was developed for the Medical Support Workers (MSW) within the Trust. The MSW role was created in response to the COVID-19 pandemic, providing an opportunity for doctors seeking GMC registration to gain clinical experience within a supervised NHS placement [1]. This project explored the MSWs’ perceptions and previous experience of simulation and their overall confidence working within the NHS before and after the teaching programme. The aim was to assess if simulation is a useful tool to help international medical graduates transition into working in the NHS.</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">29 MSWs (28 of whom were from Myanmar) worked in acute and medical specialties across the Trust, performing roles including: writing in medical notes, taking collateral histories, examining patients under supervision, procedures such as venepuncture and writing discharge summaries. Each MSW was invited to attend three training days between January and March 2022. We provided a programme incorporating medical and surgical simulation, communication workshops, and procedural skills, supported by human factors teaching. We delivered the sessions in our learning and research building, including our simulation suite. We collated data by sending out pre- and post-training surveys. There were 22 and 18 responses to the two initial surveys and 20 responses to the post-training survey.</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">44% had prior experience of clinical simulation and only 9% had previous experience working as a doctor in the NHS. On further analysis, 50% felt either quite unconfident, or neither confident or unconfident working in the NHS. A minority felt confident dealing with medical emergencies (18%) and surgical emergencies (13%) and with their communication (32%) and leadership skills (23%). In the post-simulation feedback, 100% reported that simulation was a useful method to help doctors transition into working in the NHS and felt it improved their confidence in the workplace. Furthermore, 100% stated that the simulation sessions had changed their clinical practice and addressed their learning needs. The participants reported that the sessions had improved their stepwise approach to emergencies (100%), communication (95%), teamwork (100%), leadership (70%), and decision-making skills (95%).</p> <h3 class="BHead" id="N65569">Conclusion:</h3> <p class="para" id="N65572">This project demonstrated that simulation is a popular and useful educational resource in helping improve international doctors’ confidence when transitioning into working in the NHS. Given that 100% of our participants wanted further simulation sessions, our Trust plans to employ a dedicated MSW simulation fellow to support further cohorts.</p> <h3 class="BHead" id="N65577">Reference</h3> <p class="para" id="N65580">1. Temporary Medical Support Worker (MSW) Secondary Care – Job description and person specification. NHS England and NHS Improvement. [Accessed 17/06/2022]</p> 176Does simulation help medical support workers transition into working in the NHS?Articletruecover.png1668490414859contents-1668490414311-ba5a3841-531a-485f-b563-d5c802020ff5BJjHeYQBEgXBsCdHSJI4BJjHeYQBEgXBsCdHSJI4trueDoes simulation help medical support workers transition into working in the NHS?2022falseAdi Health+WellnessDoes simulation help medical support workers transition into working in the NHS?110.54531/SSCG9628<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>hope-thomashope-thomasAUTHORHope ThomasHope Thomas2272822<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>ygraine-clarkeygraine-clarkeAUTHORYgraine ClarkeYgraine Clarke2272823<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>paul-karamurapaul-karamuraAUTHORPaul KaramuraPaul Karamura2272824<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>revathi-whittaker-jainrevathi-whittaker-jainAUTHORRevathi Whittaker-JainRevathi Whittaker-Jain2272825<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>kitt-waringkitt-waringAUTHORKitt WaringKitt Waring2272826<p><sup>1</sup>North Bristol NHS Trust, Bristol, United Kingdom</p>abigail-nyeabigail-nyeAUTHORtrueAbigail NyeAbigail Nye2272827A3-A4true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>225 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">Simulation-based education has been shown to improve clinical practice [1]. It offers an environment whereby complex real world situations can safely be practised facilitating learning through immersion, reflection, and feedback [2].There has been an increasing awareness amongst the medical profession as to the importance of simulation, we therefore created a sustainable simulation programme for the multidisciplinary team (MDT) at the Horton General Hospital (HGH) Emergency Department (ED) – Oxford University Hospitals NHS Foundation Trust.</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">Several simulations were designed involving trauma, airway management, and acute adult and acute paediatric presentations. The focus of the simulations was based on identifying errors due to human factors. The simulations were designed utilising feedback forms as well as analysing information from clinical incident forms. These provided a platform to understand areas of improvement and targeted scenarios were created. A weekly simulation programme was then created involving the ED MDT (doctors, nurses, allied healthcare professionals) as well as other specialities (Paediatrics, Trauma and Orthopaedics, Anaesthetics and Acute General Medicine). The session was run every week for 2 hours in the ED as an ‘in-situ’ educational activity to provide a higher level of fidelity and provide an immersive environment for the participants. These scenarios were then debriefed by senior members of the team including speciality registrars and consultants trained on debriefing and human factors.</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">The debriefings involved the discussion of human factors pertaining to the simulations and were learner-led. The feedback from the MDT was grossly positive; nursing staff and healthcare professionals in particular felt more empowered after the sessions to raise concern. Feedback was collected using an online survey which was sent to the participants following the session. Feedback obtained from participants aided improvement of targeted learning points and therefore aided debriefing.</p> <h3 class="BHead" id="N65569">Conclusion:</h3> <p class="para" id="N65572">Our simulation programme has been run over 18 months and has had excellent feedback. We continue to improve our simulations and increase the participant numbers through the use of video links for the sessions; thereby engaging a wider audience. This has been crucial throughout the pandemic due to various reasons (room constraints, staff isolation).</p> <h3 class="BHead" id="N65577">References</h3> <p class="para" id="N65580">1. Al-Elq AH. Simulation-based medical teaching and learning. Journal of Family &amp; Community Medicine. 2010;17(1):35–40.</p> <p class="para" id="N65583">2. Datta R, Upadhyay KK, Jaideep CN. Simulation and its role in medical education. Medical Journal of the Armed forces India. 2012;68(2):167–72</p> 176Creating a sustainable weekly interprofessional simulation for the emergency department (ED) cliniciansArticletruecover.png1668490406160contents-1668490405602-e9c2e8f9-4ec3-4a60-8e0f-5825a57d643bApjHeYQBEgXBsCdHJpJlApjHeYQBEgXBsCdHJpJltrueCreating a sustainable weekly interprofessional simulation for the emergency department (ED) clinicians2022falseAdi Health+WellnessCreating a sustainable weekly interprofessional simulation for the emergency department (ED) clinicians110.54531/SRPJ9548<p><sup>1</sup>Oxford University Hospital NHS Foundation Trust, Banbury, United Kingdom</p>celia-diazcelia-diazAUTHORCelia DiazCelia Diaz2252817<p><sup>1</sup>Oxford University Hospital NHS Foundation Trust, Banbury, United Kingdom</p>rupali-shahrupali-shahAUTHORRupali ShahRupali Shah2252818<p><sup>1</sup>Oxford University Hospital NHS Foundation Trust, Banbury, United Kingdom</p>neil-dawsonneil-dawsonAUTHORNeil DawsonNeil Dawson2252819<p><sup>1</sup>Oxford University Hospital NHS Foundation Trust, Banbury, United Kingdom</p>james-rayjames-rayAUTHORtrueJames RayJames Ray2252820A3-A3true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>224 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">Simulation in medical education is often associated with acute specialities, however there is evidence in the literature to suggest exposing medical students to a simulated General Practice (GP) environment can be beneficial to their clinical reasoning and non-technical skills [1] and that this may even be superior to that gained from a GP practice placement [2].</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">22 junior medical students participated in a simulated GP clinic where they reviewed 4 simulated patients. Patients were faculty members who also acted as assessors to ask 3 pre-defined questions and provide feedback after each station, rotating between candidates. The session was concluded with a presentation to clarify correct diagnoses and management for each case. Candidates completed a feedback form to evaluate the session.</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">In terms of clinical reasoning, &gt;85% of students reported the session greatly improved their history taking, recognition of red flags, and ability to formulate management plans in the community. For non-technical skills, &gt;75% reported a great improvement in their professionalism, communication, and decision-making ability. However, 2 students (~10%) reported their professionalism had not been affected at all. Individual feedback after each station and the concluding presentation were reported as useful aspects of the session. 3 students (~14%) requested to include examination practice in future sessions.</p> <h3 class="BHead" id="N65569">Discussion:</h3> <p class="para" id="N65572">The majority of students felt that they benefited significantly from participating in the simulated GP clinic, both with respect to their clinical reasoning and non-technical skills. This may be due to the combined immersive nature of the simulation and the psychological safety provided by the absence of formal assessment [1]. The aspect which candidates felt least improved by the session was their professionalism, which may be in part due to an inability to suspend their disbelief. The benefit of adding clinical examination to this activity is not clear.</p> <h3 class="BHead" id="N65578">Conclusion:</h3> <p class="para" id="N65581">A simulated GP surgery environment can be used to improve history taking ability, recognition of red flags, and formulation of management plans in primary care, as well as non-technical skills in junior medical students. However, more research is required to establish whether this is transferable to clinical practice.</p> <h3 class="BHead" id="N65586">References</h3> <p class="para" id="N65589">1. Young JE, Williamson MI, Egan TG. Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic. Advances in Health Sciences Education. 2016;21(1): 63–77.</p> <p class="para" id="N65592">2. Lytton K, Woolley T, Rasalam R, Gorton S, Heggarty P. Benefits of simulated General Practice clinics in the preparation of medical students for primary healthcare. Education for Primary Care. 2019;30(5): 275–281.</p> 176Developing a simulated general practice environment to improve clinical reasoning and non-technical skills in junior medical studentsArticletruecover.png1668490402163contents-1668490401551-b75e844d-3b1d-4c5b-867f-6e3bdf353aebAZjHeYQBEgXBsCdHFpKGAZjHeYQBEgXBsCdHFpKGtrueDeveloping a simulated general practice environment to improve clinical reasoning and non-technical skills in junior medical students2022falseAdi Health+WellnessDeveloping a simulated general practice environment to improve clinical reasoning and non-technical skills in junior medical students110.54531/HZNF2491<p><sup>1</sup>NHS, Birmingham, United Kingdom</p>andrew-prendergastandrew-prendergastAUTHORtrueAndrew PrendergastAndrew Prendergast2242816A4-A4true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>226 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">This simulation aimed to meet the indicative content of a communication module, which focused on breaking bad news. The aim of this session was for first year paramedic students to observe bad news being given in a simulated environment. The objectives were for students to understand the emotive realism [1] behind breaking bad news, highlight the importance of integrating service users into simulated healthcare education, and to recognise the impact of observation and feedback.</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">The first-year paramedic students were introduced to the SPIKES [2] model prior to the event being commended due to its ability to allow patients and relatives to have their own reaction to bad news. The first year students then observed the second and third year students undertake two simulations and used the SPIKES tool to structure feedback on how they broke the bad news. One of the simulations was a cardiac arrest case in which the patient was pronounced deceased by the paramedics, and the second was the treatment of a patient that was suffering from a myocardial infarction. Within both simulations the students were expected to treat the patient utilising best practice and then break the bad news. The final element to this simulation was the inclusion of service users who acted as patients and relatives, and were given the opportunity to feedback as to how they felt during the communication [3].</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">We gathered feedback via a Microsoft form from all parties with a total of 23 responses: 11 first year students, five 2<sup>nd</sup> and 3<sup>rd</sup> year students, and four service users. 17/23 of the participants ‘strongly agreed’ that the day was beneficial to their clinical practice. All participants stated they would want to take part in this educational intervention event again. Service users reported that there was a collegiate atmosphere that was developed between them and the staff. They also appreciated the opportunity to feedback to the students. The main feedback from the observing students was the realistic nature of the day and that they learnt by watching the more experienced students doing the simulation. Students involved in the simulation highlighted that they learnt a lot from the feedback they received and being involved in a realistic simulated environment.</p> <h3 class="BHead" id="N65575">Conclusion:</h3> <p class="para" id="N65578">Overall, this simulation-based activity brought together the theoretical subject matter of communication and created an inclusive learning space for a variety of people to learn.</p> <h3 class="BHead" id="N65583">References</h3> <p class="para" id="N65586">1. Buckman R. How to break bad news: a guide for health care professionals. University of Toronto Press; 1992 Aug 8</p> <p class="para" id="N65589">2. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES – a six-step protocol for delivering bad news: application to the patient with cancer. The oncologist. 2000;5(4):302–11.</p> <p class="para" id="N65592">3. Orr F, Kellehear K, Armari E, Pearson A, Holmes D. The distress of voice-hearing: The use of simulation for awareness, understanding and communication skill development in undergraduate nursing education. Nurse Education in Practice. 2013;13(6):529–35.</p> 176Breaking bad news: a multiple cohort student paramedic simulation event with integrated service usersArticletruecover.png1668490410452contents-1668490409884-2f7ae3a3-3638-4477-9dea-86580827a23aA5jHeYQBEgXBsCdHNpLfA5jHeYQBEgXBsCdHNpLftrueBreaking bad news: a multiple cohort student paramedic simulation event with integrated service users2022falseAdi Health+WellnessBreaking bad news: a multiple cohort student paramedic simulation event with integrated service users110.54531/TBTJ1706<p><sup>1</sup>Staffordshire University, Stafford, United Kingdom</p>emma-geisemma-geisAUTHORtrueEmma GeisEmma Geis2262821A7-A8true1trueEditorialEditorialEditorialeditorialtoc-heading<_class/>/dataresources/articles/contents-1668490440378-1d1cebcd-0922-417f-91be-749710cfd9da/assets/tfxw4282.014_f001.jpg233 <h3 class="BHead" id="N65542">Background:</h3> <p class="para" id="N65545">Simulation is increasingly being used in allied health professional and nursing education. There is evidence that student satisfaction with simulation is high, but limited research regarding educators’ attitudes and no existing review of this [1]. Placement capacity is an increasing issue and simulation could be used to address this, but adoption of this involves acceptance by educators and other stakeholders [2]. Therefore, the aim of this literature review was to explore the attitudes and experiences of allied health professional and nursing educators regarding the use of simulation in relation to practice education with the objectives of making recommendations for future practice and identifying areas for future research.</p> <h3 class="BHead" id="N65551">Methods:</h3> <p class="para" id="N65554">A qualitative systematic review was completed. Scopus, CINAHL, Medline, and AMED databases were searched in March 2022 using relevant search terms and subject headings where available. Inclusion/exclusion criteria were applied to identify appropriate peer-reviewed studies. The quality of articles was appraised using the Critical Appraisal Skills Programme qualitative studies checklist and data extracted using a table. NVivo 1.5 software was used to support the analysis of data using a simplified approach to thematic analysis to inform the discussion of the results [3].</p> <h3 class="BHead" id="N65560">Results:</h3> <p class="para" id="N65563">Five studies were included from a variety of professions and countries (<a href="#F1">Figure 1</a>) and overall quality of these was judged to be good. Three main themes were identified: Preparation, Educator Factors, and Outcomes. Each of these included several sub-themes and can be discussed in relation to the existing evidence. Educators value the opportunities simulation can provide such as standardisation, but this requires careful preparation and constructive alignment. Resources are required to achieve this, and more robust evidence is needed. The use of simulation is a change and educators noted that motivation to embrace this is needed and expectations regarding what can be achieved differs and should be clear. Outcomes recognised for students relate to what students themselves report. Educators see potential for simulation to increase placement capacity but there is concern that educators and students will need to work harder if time in practice is decreased. <div class="section" id="F1"><div class="img"><div class="imgeVideo"><div class="img-fullscreenIcon" onClick="javascript:showImageContent('F1');"><img src="/public/images/journalImg/fullscreen.png"/></div><div class="imageVideo"><img src="/dataresources/articles/contents-1668490440378-1d1cebcd-0922-417f-91be-749710cfd9da/assets/tfxw4282.014_f001.jpg" alt="Prisma Flow Diagram of the literature review exploring the attitudes and experiences of allied health professional and nursing educators regarding the use of simulation in relation to practice education"/></div></div><div class="imgeVideoCaption" id="N65570"><div class="captionTitle">Figure 1:</div><div class="captionText">Prisma Flow Diagram of the literature review exploring the attitudes and experiences of allied health professional and nursing educators regarding the use of simulation in relation to practice education</div></div></div></div> </p> <h3 class="BHead" id="N65586">Conclusion:</h3> <p class="para" id="N65589">Overall attitudes towards simulation and practice education were found to be positive. Benefits and risks from educators’ points of view were identified and can be used to inform practice. Areas for future study were identified for example exploring these concepts within the UK and other health professions.</p> <h3 class="BHead" id="N65594">References</h3> <p class="para" id="N65597">1. Beveridge J, Pentland D. A mapping review of models of practice education in allied health and social care professions. British Journal of Occupational Therapy. 2020;83:488–513.</p> <p class="para" id="N65600">2. Buckley S, Hensman M, Thomas S, Dudley R, Nevin G, Coleman J. Developing interprofessional simulation in the undergraduate setting: Experience with five different professional groups. Journal of Interprofessional Care. 2012;26:362–369.</p> <p class="para" id="N65603">3. Aveyard H. Doing a literature review in health and social care: a practical guide. Open University Press; 2018.</p> 176Using simulation for practice education: attitudes and experiences of allied health professional and nursing educatorsArticletruecover.png1668490440894contents-1668490440378-1d1cebcd-0922-417f-91be-749710cfd9daCpjHeYQBEgXBsCdHrpI7CpjHeYQBEgXBsCdHrpI7trueUsing simulation for practice education: attitudes and experiences of allied health professional and nursing educators2022falseAdi Health+WellnessUsing simulation for practice education: attitudes and experiences of allied health professional and nursing educators110.54531/WGLT7791<p><sup>1</sup>Coventry University, Coventry, United Kingdom</p>teresa-cookteresa-cookAUTHORtrueTeresa CookTeresa Cook233284717469369truefalse