Simulation in healthcare : journal of the Society for Simulation in Healthcare
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The use of simulation in graduate medical education affords unique opportunities for increasing the quality of a resident's educational experiences. Additionally, simulation poses a set of challenges that must be met to realize the full potential on learning and assessment practices. ⋯ The SMARTER methodology is discussed in detail and 3 examples of scenario content and measurement tools generated with the SMARTER approach are provided. Additionally, results from an initial evaluation of the practicability and utility of the SMARTER measurement tools are discussed.
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Photorealistic simulations may provide efficient transfer of certain skills to the real system, but by being opaque may fail to encourage deeper learning of the structure and function of the system. Schematic simulations that are more abstract, with less visual fidelity but make system structure and function transparent, may enhance deeper learning and optimize retention and transfer of learning. We compared learning effectiveness of these 2 modes of externalizing the output of a common simulation engine (the Virtual Anesthesia Machine, VAM) that models machine function and dynamics and responds in real time to user interventions such as changes in gas flow or ventilation. ⋯ Schematic simulations that transparently allow learners to visualize, and explore, underlying system dynamics and relations among components may provide a more effective mental model for certain systems. This may lead to a deeper understanding of how the system works, and therefore, we believe, how to detect and respond to potentially adverse situations.
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The leading causes of pregnancy-related death are embolism (20%), hemorrhage (17%), and pregnancy-induced hypertension (16%).The Obstetric and Mechanical Engineering Departments at Stanford University worked together to create inexpensive devices that were used in high fidelity simulations to replicate 2 of the leading causes of maternal mortality: hemorrhage and eclampsia (seizure). ⋯ The use of remote controlled mechanical devices designed to accurately replicate the visual, auditory, and tactile cues of hemorrhage and eclampsia enhanced high fidelity simulation training in obstetrical emergencies.
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Simulation is a technique-not a technology-to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner. The diverse applications of simulation in healthcare can be categorized by 11 dimensions: aims and purposes of the simulation activity; unit of participation; experience level of participants; healthcare domain; professional discipline of participants; type of knowledge, skill, attitudes, or behaviors addressed; the simulated patient's age; technology applicable or required; site of simulation; extent of direct participation; and method of feedback used. ⋯ Various driving forces and implementation mechanisms can be expected to propel simulation forward, including professional societies, liability insurers, healthcare payers, and ultimately the public. The future of simulation in healthcare depends on the commitment and ingenuity of the healthcare simulation community to see that improved patient safety using this tool becomes a reality.
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Randomized Controlled Trial
Enhancing graduate nurses' health assessment knowledge and skills using low-fidelity adult human simulation.
Although simulation technology in nursing education is becoming increasingly commonplace, a review of the literature reveals a paucity of rigorous, high-level research comparing the effectiveness of simulation with other traditional education methods in the acquisition of clinical knowledge and skills. This research aimed to investigate the impact of three learning interventions on graduate nurse health assessment knowledge and skills. It was hypothesized that the patient assessment skills of graduate nurses who completed a simulation learning activity would be superior to those who completed traditional education activities. ⋯ Simulation appears to be an effective educational tool for teaching patient assessment knowledge and skills to graduate nurses. Incorporation of such technology into graduate nurse education may decrease the time required to become clinically proficient, resulting in more confident and work-ready practitioners.