This study aimed to consider the appropriateness of “environmental adjustment” as an introductory theme for simulation-based learning in basic nursing education. We analyzed reflective reports on the simulation exercise of eight second-year nursing students who had limited opportunities for face-to-face classes on nursing skills due to coronavirus disease-2019. The simulation exercise was conducted in a training room that replicates beds and surroundings in general wards, with three groups of six students and one faculty member per booth. The faculty member played the role of facilitator and simulated patient, and each booth ran the simulation for a total of 140 minutes. Results of analysis of reflective reports indicated that students not only prepared the environment of care through situation-based training in the theme of environmental adjustment but also made meaning of the environment in which the patient was placed, observed the patient from physical and mental aspects, and gained insight into their condition, perceptions, and values from what they observed. These observations and insights are required as the foundation of all nursing skills. In addition to these learning effects, the characteristics of environmental adjustment as a low-stress technology suggest that it is suitable as an introductory theme for simulation-based learning in basic nursing education.

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In the rapidly changing societal structure, it is essential for medical students to acquire the competencies necessary to revolutionize future regional healthcare. To achieve this, it is imperative for students to recognize their own "learning objectives" and refine their methods of study. In this context, we conducted a simulation called " Regional Medical Education Curriculum Development " as part of medical scientific research. This simulation targeted third-year students in the medical department of our university. After acquiring prior knowledge in regional healthcare, medical education models, core curricula, and other related subjects, the students engaged in field research involving visitations and outreach medical services in regions, including islands and mountainous areas, at four hospitals. Subsequently, a curriculum development simulation was implemented, focusing on medical interviews in regional healthcare, healthcare in remote islands, and participatory clinical practicums in the community. After the simulation, not only did medical students express a deepened understanding of regional healthcare, but there were also positive opinions indicating a sense of significance in self-reflection on their learning objectives. The experience of medical students in curriculum development has the potential to enhance their self-regulated learning.

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Background: Although the near-peer simulation medical education has been shown to be useful for learners、there are not many reports showing its effects on instructors. In this study、we investigated the effects of the near-peer simulation medical training on instructors. Methods: A questionnaire survey was conducted on second-year residents(R2), and sixth-year medical students(M6) at our university who participated as instructors in the " Clinical Starter Practicum " for fourth-year medical students at the Skills Simulation Center. The contents of the questionnaire were about advance preparation for the training, as well as their own learning and usefulness. Results: Advance preparation was performed by 52% of instructors, and the percentage of M6 instructors who had done advance preparation was higher than that of R2. The advance preparations rate was higher for techniques that instructorswere weaker at. The total percentage of instructors who answered that they had " learned " or " rather learned " from their own learning or useful was high at 91% and 96%, respectively. Discussion: In the clinical technique training for fourth-year students, the instruction by residents and sixth-year students was highly effective, strongly suggesting that " teaching is learning. "

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In recent years, simulation-based education has gained increasing importance. However, the impact of a 24-hour, year-round accessible simulation center on students’ skill development remains underexplored. This study retrospectively analyzed 799 usage records from 118 fourth-year medical students over two years and conducted a questionnaire survey to examine the purpose of use and student perspectives. Analysis of the usage records revealed a significant increase in simulation center usage during the two months preceding the objective structured clinical examination (OSCE), with OSCE-related equipment most frequently used. Although usage temporarily declined afterward, it increased again after the start of clinical clerkships. Survey responses indicated that equipment such as laparoscopic simulators was used in response to learning and assessment opportunities during clinical clerkships. Additionally, qualitative feedback highlighted high student satisfaction with unrestricted access while identifying areas for improvement, such as the need for clearer usage guidelines. These findings suggest that simulation center usage and equipment selection are strongly influenced by the curriculum. Furthermore, even in an unmonitored environment, students demonstrated autonomy in skill development. To further promote simulation-based learning, it is essential not only to maintain the current operational structure but also to introduce assessment opportunities enhancing extrinsic motivation and mechanisms fostering intrinsic motivation.

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This practical report focuses on the development of cardiopulmonary resuscitation (CPR) educational materials using VR and MR technologies. Standalone head-mounted display devices were utilized to create three variations of the materials, designed for adults, children, and infants. The VR material provides an immersive experience, offering real-time feedback on chest compressions and AED operation. The MR material places virtual objects in the real environment, offering a more practical learning experience. The differences between VR and MR are considered, along with their respective educational values and future applications.

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The utilization of simulation materials has been explicitly recommended in the " Guidelines for Practical Clinical Training" corresponding to the Model Core Curriculum for Pharmaceutical Education (2022 revision). In this study, we developed scenario programs that consistently support performance assessment from communication with patients to physical assessment using a hybrid simulator for multidisciplinary cooperation. The scenario program consists of 10 cases, enabling instructors to objectively assess learners’ skills and allowing learners to reflect on their own skills based on the assessment results.

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