This study attempts to determine the future direction of simulation education in psychiatric mental health nursing by examining the results of psychological nursing simulation education from two perspectives: educational effects on students and simulated patient training. We conducted a “comparison between direct care students and observed students” and a study of the “feelings of reward perceived by nursing students”. Further, we conducted a study on “simulated patient education using video images” focusing on simulated patients. This study presents the results of the three studies.
The results showed that both direct care and observed students acquired self-confidence. Students also felt rewarded by receiving feedback, and simulated patients improved in acting as patients by watching the videos.
Feedback from the simulated patients, instructors, and professionals is very important as an educational effect, leading to the development of confidence and feelings of reward for the students. Group dynamics effects can be expected through the debriefing by the groups. Synergistic effects of scenarios and videos of the education using simulated patients also lead to a more realistic performance when simulating patients. The result showed that we can expect similar learning effects even if not all students perform role-play activities with simulated patients. These findings show that the current education program is almost complete, but it is necessary to continue study on simulation education in psychiatric mental health nursing to improve its quality.
Objective: This study aimed to find a way to shorten interruption time length in chest compressions by identifying factors that affect it. Methods: Using motion capture technology, we compared differences in interruption time length and posture by two groups (skilled and unskilled) during each step of chest compressions. Results: The mean duration of chest compression interruption in the skilled group was 5.82 seconds. In the unskilled group, the duration of interruption was 9.22 seconds (p < 0.05). By comparing the postures used in each instance of the procedure, significant differences were observed between the two groups. The most notable variations were related to the width of the knee opening during chest compressions, and the distance that the knee was moved for each compression (p < 0.05). Discussion: In order to minimize the duration of chest compression interruptions, it is important to extend the knee to shoulder-width and secure an adequate airway.
Simulated patients (SPs) participating in medical interview training have difficulty of acting. The purpose of this study is to clarify the details of the difficulty that the SPs feel when playing the role of the patients. We use KJ method to reveal SPsʼ details of the difficulty. As a results, SPs, difficulties formed three groups. 1Balancing the length of speaking time of the doctor and the patient so that the doctor can achieve learning goals, 2making SP quality the same, and 3performing an action suitable for the task even in situations where the SP does not anticipate. In summary, these indicate " considerations not to destroy the task of practical training " .
In nursing education, demonstration videos from a third-person perspective have traditionally been used as supportive teaching materials. However, the rapid development of wearable cameras makes it possible to capture the demonstration of a skilled nurse from a first-person perspective. In this study, we developed a virtual reality teaching material (VR-TM) for tracheostomy suctioning wherein a first-person demonstration video of an expert nurse was shown to participants via a head- mounted display (HMD). Here, thirty-six participants experienced VR-TM and evaluated their usability using a free description questionnaire. Descriptive data were processed using qualitative content analysis. The results identified three categories: positive evaluation, negative evaluation, and improvements. The positive evaluation category consisted of three subcategories: understandability of techniques and procedures, simulated experience and concentrated power, and expectation for effectiveness. The negative evaluation category consisted of two subcategories: dissatisfaction with VR system and VR sickness. The improvements category included two subcategories: need for improvements of immersion and need for rich additional information. The results suggested that the combination of the first-person demonstration video and HMD might be a sure and
efficient teaching material for nursing skill learning, although further improvements will be necessary.
Instructors have improved self-efficacy at Basic Life Support (BLS) workshops. However, we do not know precisely how the instructor affected the improvements. We conducted one-on-one semi-structured interviews with nine nurses who had participated in BLS workshops for junior high school students, and qualitatively analyzed the interview data using Steps for Coding and Theorization (SCAT). SCAT extracted 626 datapoints covering the following: BLS difficulty teaching; students’ learning attitudes; teaching junior high school students; teaching results; teaching how to use words; improvement points in workshops; teaching responsibilities; teaching according to students’ understanding; learning and using teaching methods; teaching with reason; we will continue to participate in BLS workshops; I believe in teaching; learning from reflection; your own growth; and 14 other groupings.Nurses showed five stages of behavior change: awareness, response, practice, maintenance, and establishment. It is suggested that these changes reflect Kolb's circular experience of learning, by continuing the instructor's lessons. These changes can be used for clinical work.
Simulation-based medical education is expanding among undergraduate medical universities in Japan. For the curriculum of outcome-based medical education, simulation-based medical education is considered one of the beneficial learning strategies in medical school. In addition to the general simulation lessons using programmable simulators, we used a new virtual patient simulation software called Body Interact®in the small group discussion lesson, followed by debriefing by an experienced teacher. After the successful experience of clinical reasoning in virtual scenarios and supported debriefing, students’ cognitive competencies for problem-solving were assessed using a multiple-choice examination. The satisfaction and confidence of medical students were also assessed using a questionnaire. Virtual patient simulation combined with supported debriefing may contribute to the acquired competency in undergraduate medical education. To establish the simulation-based educational environment for medical school students, the combination of Body Interact®and supported debriefing in selected clinical categories may be one of the novel options added to the conventional simulation-based lessons.
Outcome-based clinical clerkships for medical students is a critical concept to consider and is a recent topic for medical education in Japan. It is essential for students to understand their learning objectives and to participate in the clinical clerkship voluntarily. Needless to say, in order to lead to active learning, and setting up the learning methods, environment, objectives, and assessment of students’ competency gained in clinical clerkship. We established original post-clinical clerkship examination to assess knowledge, skills, and attitudes in perioperative management which students acquired in clinical clerkship. A highly functional simulator equipped with physiology and anatomy and devices which we have used in clinical practice were used for the representative of a clinical situation for the examinations in order to show high fidelity. The results of the examination were very well excellent, which we feel satisfied as to be a medical doctor. Our examination was also useful and helpful because it indicated not only high competence which students gained in clinics but also the assignments that should be improved in clinical clerkship were very well done by students. We highly expect trial of examination leading to the development of outcome- based education for medical students in the near future.
We have conducted a simulation-based emergency resuscitation program which consists of two stages， task training and situation-based training for nurses belonging to our hospital in 2018.
The purpose of this report is to examine the effectiveness of the program using a questionnaire. We collected the questionnaires of 83 nurses took part in the program. The results showed that learning outcomes and needs differed depending on their mastery. In addition, it was suggested that the two-stage program promoted the acquisition of emergency resuscitation skills of the nurses. From these results, it is possible to improve the nursing skills by the program according to their proficiency level because of clarifying the purpose of the training.
[Objective]Our simulation laboratory holds four JRC-certified ICLS classes per year. In these classes we examined the depth and quality of chest compressions.
[Method] Ten residents, 4 clinical laboratory technicians, 15 nurses, and 1 doctor participated were studied. We measured the average depth of chest compressions and the ratio of compressions less than 5 cm on the ALS Simulator Ambu®man 2016 Advance (Ambu, Dnmark) for VF/PLVT, PEA/cardiac arrest, and Megacode scenarios (cardiac arrest 4 waveform composite cases).
[Results] Average chest compression depth was 5.53±0.54 cm for VF/PLVT, 4.94±0.81 cm for PEA/asystole. The percentage of compressions less than 5 cm was 24.6% for VF/PLVT, 47.0% for PEA/asystole. We observed a significant difference in the mean depth of VF/PLVT:PEA/asystole (p = 0.0297), and for the ratio of compressions less than 5 cm VF/PLVT:PEA/asystole (p = 0.0302).
[Discussion] In all groups, in cases of PEA/asystole, average chest compression depth was shallower and the proportion of compressions less than 5 cm increased, due to the differential diagnosis. Therefore, when the cause is not clear, CPR needs to be performed more carefully so that the depth of compressions does not become too shallow.
Osaka Medical College’s nursing students confirmed the movement of blood vessels by the utilization of visualization technology (AccuVein®and ultrasound) in the skills labs. This study aimed to evaluate the effectiveness of the practice of drawing blood using the visualization technology. A survey was distributed the day after 81 nursing students who joined the practice. It had 12 questions to obtain data on their thoughts regarding the use of visualization technology for the practice of drawing blood, including a Likert scale and free comments. Results of responded 37 students revealed that over 90% participants answered that AccuVein®and ultrasound were “very good” or “good” and AccuVein®was helpful in understanding the movement of blood vessels while ultrasound was helpful in understanding the size and depth of blood vessels. Students believed that AccuVein®and ultrasound were effective to some extent before drawing blood. Drawing blood led them to develop a greater awareness about and motivation to purse the nursing profession and confidence in their skills. Overall, it appears meaningful to use the visualization technology to understand the movement of blood vessels when students draw blood amongst themselves in the skills lab.
The Department of Physiotherapy at Griffith University has implemented simulation-based education since 2012 and focused on "the learning of clinical reasoning."
In particular, a one-week simulation-based education immediately before clinical practice has been suggested to be effective for improving the students' self-confidence in clinical practice and skill learning.
These findings indicate that on-campus simulation-based education is a useful methodology for clinical practice and can be an educational tool for improving the outcomes of clinical practice education.
Meanwhile, the use of simulated patients has been limited by the requirement of training standardized simulated patients and costs.
Many physical therapist-training schools should work together to promote the simulation-based education in Japan.
Effective interprofessional work is basic component for developing competent medical team improves medical safety and patient outcome. In order to promote smooth interprofessional work in clinical environment, effective interprofessional education (IPE) is essential component in undergraduate medical education. Various attempts for IPE have been done worldwide. However, ethical, spatial, and economical problems are all barriers to IPE. We believe that simulation-based education can be a potential solution to resolve this problem.
Scenario programs were created for the representative eight diseases shown in the model core curriculum for pharmacy education. "SimMan3G" is used for the patient simulator, and each disease was classified into nine series of chronic myelogenous leukemia, essential hypertension, hyper and hypoglycemia, congestive heart failure, subarachnoid hemorrhage, epilepsy, anaphylactic shock and urinary tract infection. In addition, various materials were created to facilitate the implementation of these scenarios, and opened on the website as simulation materials. As a result, it was possible to repeatedly experience in the simulator about the reappearance of the various disease states, the effect of pharmacotherapy, and the confirmation of adverse effects.
A total of 22 teachers engaging in simulation-based medical education in medicine, dentistry, nursing and health sciences had a second seminar and workshop on September 21st in 2019. Three sophisticated and informative seminars on simulation- based education in the US and Taiwan and in nursing field in Japan were conducted. Participants had active discussion in the workshop considering a certification system for the individual and an accreditation system for the institute for our country, in which there seems a variety of different learning and teaching environment.
IMSH is, as the name implies, an international conference with attendees from many countries. A total of 3,156 participants from 58 countries participated in IMSH2020. I will report on the presentation session of the research session that I participated in and also on the opportunity to talk about SSH (Society for Simulation in Healthcare) membership, authentication, and facility accreditation with SSH faculties. In addition to the SSH certification, we also discuss the medical simulation education society network, personal certification system, and facility certification in Japan. The purpose of this report would be making IMSH known so that many medical simulation educators will pay attention to the international conference on medical simulation education and want to participate and discuss in IMSH next year or later.
The 7th annual meeting was held on September 21, 2019 at Nippon Medical School.
The theme of this meeting was "Near future of simulation-based medical education: where is singularity". A total of 43 general presentations were performed. In addition, there were many special programs such as special lectures, educational lectures, panel discussions, class demonstrations. Four session rooms were set up, making full use of ICT equipment and effective simultaneous relaying. Sessions on the latest high-performance simulator, VR equipment and ICT equipment, and our own Android-type simulated patient robot were organized. In addition to these, the enthusiastic efforts of each facility were introduced and active discussions took place. Through these programs, I think it was a day for participants to feel the advent of singularities in medical education.