BMJ Simulation and Technology Enhanced Learning

The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning-through simulation or direct patient contact-is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely. The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.

Natasha Houghton

Will Houstoun

Sophie Yates

Bill Badley

Roger Kneebone

BMJ Simulation & Technology Enhanced Learning

Cross-disciplinary perspectives on the transition to remote education

远程教育转型中的跨学科视角

Augmented reality (AR) has been studied as a clinical teaching tool, however eye-tracking capabilities integrated within an AR medical simulator have limited research. The recently developed Chariot Augmented Reality Medical (CHARM) simulator integrates real-time communication into a portable medical simulator. The purpose of this project was to refine the gaze-tracking capabilities of the CHARM simulator on the Magic Leap One (ML1). Adults aged 18 years and older were recruited using convenience sampling. Participants were provided with an ML1 headset that projected a hologram of a patient, bed and monitor. They were instructed via audio recording to gaze at variables in this scenario. The participant gaze targets from the ML1 output were compared with the specified gaze points from the audio recording. A priori investigators planned to iterative modifications of the eye-tracking software until a capture rate of 80% was achieved. Two consecutive participants with a capture rate less than 80% triggered software modifications and the project concluded after three consecutive participants' capture rates were greater than 80%. Thirteen participants were included in the study. Eye-tracking concordance was less than 80% reliable in the first 10 participants. The investigators hypothesised that the eye movement detection threshold was too sensitive, thus the algorithm was adjusted to reduce noise. The project concluded after the final three participants' gaze capture rates were 80%, 80% and 80.1%, respectively. This report suggests that eye-tracking technology can be reliably used with the ML1 enabled with CHARM simulator software.

Thomas J Caruso

Olivia Hess

Kenny Roy

Ellen Wang

Samuel Rodriguez

Coby Palivathukal

Nick Haber

Integrated eye tracking on Magic Leap One during augmented reality medical simulation: a technical report

Magic Leap One增强现实医疗模拟中的集成眼动追踪技术报告

Healthcare simulation has been used as a pedagogical strategy in nursing education. Evidence has shown one of the positive impacts that simulations replace clinical placement. These wide-ranging initiatives are essential, and they can guide a nursing school's simulation training. However, researching each innovation in the nursing field is beyond the scope.To focus our research and develop the capacity and capability to incorporate healthcare simulation in nursing education, we used a consensus building process to establish a school's research agenda. A modified Delphi process was adopted to reach a consensus among 10 nursing faculty members in one university with a visiting professor's support.The three themes were identified as (1) embedding simulation into the baccalaureate in nursing curriculum, (2) designing effective simulation-based education and (3) simulating education in the broader world (adolescents). These themes were further categorised into two areas that used simulation in the educational and community settings. Sixty per cent of the faculty members agreed that the question, 'How can simulation be incorporated into clinical placements to enhance students' learning?' should be the highest research priority.This study adds understanding to incorporate simulation-based education in the nursing curriculum and community provides insights into future research.

Suet Lai Wong

Baljit Kaur Gill

Jacky Hoi Man Chan

Alison Pui Han Cheung

Caroline Yee Chong Charm

Carmen Ka Man Fung

Ching Yee Lam

Mavis Ying Ting Tong

Cora Ka Yee Lo

Alan Yat Kwan Tsang

Debra Nestel

School-based research agenda on healthcare simulation for nursing education in Hong Kong

香港护理教育中基于学校的医疗模拟研究议程

Simulation in medical education teaches students to recognise patterns that can be life-saving. As an emergency medicine (EM) resident (LSS) and a medical educator (RF), we witness the ways in which patterns in the medical curriculum shape our future medical providers. The recognition of a dangerous pattern has brought us together to call for increased gender diversity in one of the most fundamental skills medical learners must master: cardiac life support training.

As an EM resident, I (LSS) am the clay being shaped by the medical system. In the emergency department (ED), where I hope to spend my career, chest discomfort, nausea and diaphoresis set a series of actions into motion. I am taught to fear missing a classic presentation of myocardial infarction (MI) and to keep high suspicion for life-threatening conditions. MI in women often presents with symptoms other than chest pain, which the American Heart Association (AHA) details on a page separate from general MI symptoms.1 The page emphasises that symptoms in women can be subtle and are often overlooked as acid reflux or the influenza, making recognition of MI in women especially difficult.

In the ED, over two-thirds of physicians are men.2 “I am a woman in medicine” is an inescapable part of my daily inner monologue. I feel a solidarity with my female patients. I pay attention to how I approach their pain and I look for the ways in which women downplay their symptoms. It was initially easy for me to rationalise the 2018 study findings that women treated by male …

Larissa Spagnol Silverman

Rachel Fabi

Deadly bias: a call for gender diversity in cardiac life support simulation training

致命偏见：呼吁心脏生命支持模拟训练中的性别多样性

Many studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results.The objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes.We searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model.We selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (-0.19, 95% CI -0.44 to 0.06) and for time (-0.14, 95% CI -0.54 to 0.27).Simulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.

Fabrizio Consorti

Gianmarco Panzera

Low versus high level of physical resemblance in simulation for the acquisition of basic surgical skill: a meta-analysis

模拟中低与高物理相似度对基本外科技能获取的影响：一项元分析

Despite the increasing use of immersive technology (IT) in ophthalmology, the effectiveness of this approach compared to other teaching practices is unclear. This systematic review aimed to determine the value of IT to teach students ophthalmic skills and whether it can supplement or replace conventional teaching practices.

Shakeel Lowe

Kathryn Mares

Zarnie Khadjesari

Immersive technology in ophthalmology education: a systematic review

眼科教育中的沉浸式技术：系统综述

Age simulation can have a positive effect on empathic understanding and perception of ageing. However, there is limited evidence for its ability to replicate objectively the physical and functional challenges of ageing.To observe whether age suit simulation can replicate in healthy young adults the physical and physiological balance disturbance and falls risk experienced by older adults.Healthy young adults aged 20-40 years (16 male) were recruited to the study using convenience sampling from a student population. Participants performed three validated balance tests-Functional Reach Test (FRT), Timed Up and Go (TUG) and Berg Balance Scale (BBS)-first without the age suit and then with the age suit, using a standardised protocol, following the same sequence.30 participants completed all tests. Statistically significant differences between without-age-suit and with-age-suit performance were recorded for FRT distance (p<0.000005), time taken to complete the TUG (p<0.0005) and BBS score (p<0.001). A comparison of participant scores with normative FRT and TUG scores identified that the suit had 'aged' the majority of participants to the normative values for older adults (60+), with some reaching the values for individuals aged 70-89. However, no scores achieved the values indicative of increased falls risk.The age suit is a valid educational tool that extends the value of age simulation beyond a more general empathising role, enabling those working with an older population to experience and understand the functional challenges to balance experienced by older adults as part of their training.

Carole Anne Watkins

Ellie Higham

Michael Gilfoyle

Charley Townley

Sue Hunter

Age suit simulation replicates in healthy young adults the functional challenges to balance experienced by older adults: an observational study

年龄服模拟在健康年轻成人中再现了老年人所经历的平衡功能挑战：一项观察性研究

With the introduction of strict public health measures due to the coronavirus pandemic, we have had to change how we deliver simulation training. In order to reinstate the College of Anaesthesiologists Simulation Training (CAST) programme safely, we have had to make significant logistical changes. We discuss the process of reopening a national simulation anaesthesiology programme during a pandemic.We approached how to reinstate the programme with three distinct but intertwined projects, as in the following: (1) a survey of effects of the pandemic on training opportunities for anaesthesiology trainees, (2) proposals for methods of reinstating simulation were developed under the headings avoidance, compromise, accommodation and collaboration. A small online video-assisted simulation pilot was carried out to test the compromise method, (3) having opted for combined accommodation (onsite with smaller participant numbers and safety measures) and collaboration (with other regional centres), a postreinstatement evaluation during a 4-month period was carried out.(1) Eighty-five per cent of 64 trainees surveyed felt that they had missed out not only just on simulation-based education (43%) but also on other training opportunities, (2) when five trainees were asked to state on a 1 to 5 Likert scale (strongly disagree, disagree, undecided, agree and strongly agree) whether online video-assisted simulation was similar to face-to-face simulation in four categories (realism, immersion, sense of crisis and stress), only 9 (45%) of the 20 answers agreed they were similar, (3) When onsite simulation was reinstated, the majority of trainees felt that training was similar to prepandemic and were happy to continue with this format.In order to reinstate simulation, we have identified that accommodation and collaboration best suited the CAST while compromise failed to rank high among trainees' preferences. Onsite courses will continue to be delivered safely while meeting the high standards our trainees have come to expect.

Sinead Campbell

Sarah Corbett

Crina L Burlacu

Reinstating a national simulation programme in anaesthesiology during the coronavirus pandemic

在新冠疫情期间恢复国家麻醉模拟项目

Lumbar drain insertion is a common procedure that is performed by anaesthesiologists, radiologists and neurosurgeons that is generally taught through supervised learning that can place patients at risk. We describe in detail the creation and considerations of a novel lumbar drain simulator designed to allow learners to rehearse the complete lumbar drain insertion procedure from start to finish. A lumbar drain simulator was designed with the goal of simulating drain placement on a patient including identifying physical landmarks, sterile field preparation, technical steps of the procedure, troubleshooting and securing and connecting the drainage system. Emphasis was placed on simulating the structural components of the anatomic compartments encountered during needle insertion and accurate reproduction of the tactile aspects of the procedure. The simulator is able to reproduce the critical aspects of drain placement, allowing for learners to practice a complete lumbar drain placement from start to finish. A complete simulation of lumbar drain placement can be created that allows learners to practise all aspects of the lumbar drain procedure. Learners can rehearse all steps of the procedure allowing them to be more confident and facile with the procedure, which can lead to improved patient safety and satisfaction.

Nikhil Krishna Murthy

Ellie O’Brien

Nader S Dahdaleh

Conception and design of novel lumbar drain insertion simulator

新型腰椎引流插入模拟器的构思与设计

Simulation-based training (SBT) is often evaluated based on the transfer of specific knowledge and skills. In contrast, the degree to which reflective practice is inculcated by SBT is rarely considered. Because reflection is a pillar of adult learning theories, we sought to examine the degree to which participation in SBT was associated with increased reflective practice.Eighty one healthcare professionals completed a survey which included the number of SBTs they participated in during the past two years, content- and administrative-related features of those SBTs, and a key aspect of reflective practice (i.e., self-appraisal).The number of SBTs healthcare professionals participated in during the past two years was positively associated with reflective self-appraisal. This relationship was not moderated by the inclusion of reflection components in SBTs nor by the voluntary/mandatory nature of participation in SBTs. Furthermore, the facilitator was ranked as the most important feature of the overall learning experience in SBTs. Also, no significant differences were found between the number of technical skills-based and non-technical skills-based SBTs.These findings demonstrate the importance (of evaluating) SBTs for facilitating reflective learning mindsets that healthcare practitioners can apply beyond the specific skills trained by SBTs.

短名	BMJ Simul Technol Enhanc Learn
Journal Impact	0.94

ISSN	2056-6697
h-index	17

涉及主题	医学心理学医学教育政治学法学经济计算机科学护理部数学经济增长统计社会学社会心理学医疗保健工程类生物业务管理精神科物理汇报地理哲学教育学操作系统地质学万维网医疗急救广告古生物学
出版信息	出版商: BMJ Publishing Group，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2015，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 7.01%

BMJ Simulation and Technology Enhanced Learning

期刊引文格式

有 1 位以上作者的期刊

有 2 位作者的期刊

有 3 位作者的期刊

有 5 位以上作者的期刊

书籍引用格式

学位论文引用格式

网页引用格式

专利引用格式

手工熬夜修改参考文献？研飞自动匹配期刊，一键轻松成稿，支持 Word/WPS

投稿经验分享