63 Virtual Community Outreach Simulation Programme

The community outreach programme paused during the global pandemic as schools were closed and we were unable to go into schools and colleges to use simulation-based training to educate and inspire young adults to consider a career in the National Health Service. Now that schools and colleges are open it is still difficult to go into schools and colleges due to COVID-19 restrictions. We needed a way to continue to reach out to these schools and colleges using simulation to educate and inspire young adults.The aim was to continue the outreach programme but virtually, via live streams and some pre-recorded simulations. Aiming to help to increase awareness of the different careers, routes into the National Health Service and skills required to work in healthcare. ‘A virtual learning environment is intended not simply to reproduce a classroom environment -’on-line’, but to use the technology to provide a new way of learning’, Britain and Liber [1]. By continuing to provide the outreach simulation project I hope to be able to engage with a larger number of learners at a single time.Streaming live simulations sessions with tutor groups from schools and colleges via platforms such as Microsoft Teams and Zoom using a variety of simulation scenarios. These simulations will be mainly focussing on human factors with some teaching on specific subjects depending on the need of the learners. Example: Virtual work experience for young adults interested in medicine. We plan to mock up our simulation centre to replicate an accident and emergency department and have three admissions of different severity. We will be streaming this to two schools simultaneously and they will have the chance to help prioritize the three patients and explain their choice. The simulations will display good teamwork, good communications skills and leadership. One of the simulations will not include these skills and display poor communication, this will be intentionally included in a simulation for the learners to identify.Feedback forms will be given to all learners to complete asking them if the session has inspired them to consider a career in the National Health Service, feedback will then be used to adjust the way we deliver the virtual side of the outreach programme and perfect the programme so we can continue to educate and inspire young adults.

Teaching palliative care skills via simulation-based learning

Background: The scarcity of palliative care (PC) services in Morocco, and their absence in Settat, limits the opportunities for nursing students at the Higher Institute of Health Sciences (HIHS) to benefit from clinical placements. As a consequence of this, most students feel underprepared to care for patients with PC needs. Aim: The purpose of this study is to share a simulation-based learning experience in a PC context and to evaluate the effectiveness of this learning method. Methods: The simulation experience took place in the simulation centre of the HIHS and involved 20 nursing students in their second year. The main goal of the simulation session was to simulate the support given to patients going through the five stages of grief. A post-simulation survey was conducted to explore the nursing students reflections on this learning experience. Findings: The simulation is recommended as a powerful learning approach to compensate for the lack of PC clinical placements available to nursing students. Conclusion: The simulation-based training was an excellent opportunity for nursing students to experience caring for patients in extreme end-of life-situations, which was not possible before due to the lack of specialised PC services.

Using Augmented Reality to Enhance Medical Education in Heart Diseases: Action Design Research

Augmented reality (AR) is one of the leading communication technologies being investigated and applied in several contexts. Medical training and health education are two of the fields pioneering the innovation of AR to improve the quality of medical outcomes. In this action design research (ADR), we developed an android mobile application called “CardioSim” for medical educational simulation that helps students enhance and improve their understanding and learning process. Functions are implemented to explain specific scenarios of heart failure disease and the symptoms associated with this disease, in addition to the sounds of different heartbeats and models of heart anatomy. CardioSim’s usability has been evaluated by 10 experts from the simulation centre using the System Usability Scale (SUS) and the results were acceptable.

Junior doctors rate online simulation as ‘good enough’ but not as good as face to face sessions

AimsTo compare the feasibility and acceptability of delivering a simulation-based learning (SBL) programme for Junior Doctors virtually versus face to face.MethodThe Nottinghamshire Healthcare Simulation Centre has been delivering a SBL programme for Foundation Year 2 doctors on behalf of Health Education East Midlands for the past three years. Since face to face teaching was not possible during the COVID-19 pandemic the programme was delivered online using the same content and format as for prior cohorts. Feedback questionnaires from 128 face to face participants (F2F) and 133 virtual participants (V) were compared.ResultThere was a decrease in Likert scale ratings across all domains in the virtual group. This was most apparent when examining the ‘strongly agreed’ responses: the venue/remote format was suitable for the session 34% decrease, the course length was appropriate 24% decrease, the pace of the course was appropriate 20% decrease, the simulation was helpful and relevant 15% decrease, the content of the course was organised and easy to follow 13% decrease, the learning objectives were met 10% decrease, the presenters were engaging 6% decrease, the trainers were well prepared 3% decrease. The virtual group included responses in the ‘strongly disagree’ and ‘disagree’ categories relating to the virtual format, length and pace, which did not occur in any domain for the F2F group.Combining the ‘strongly agree’ and ‘agree’ statements also showed a decrease in satisfaction with 72.5% of responses falling into this category for the V group and 88.3% for the F2F group. Fewer participants in the V group would recommend the course to a colleague (98% V vs 99% F2F).ConclusionProviding the SBL programme using an online format was feasible while also being acceptable to most participants. However, participants did not rate this experience as highly as face to face teaching. The largest decreases in satisfaction were in areas related to the virtual format. An interesting finding is that participants rated the pace and length of the online course as less agreeable, despite the content and scheduling being the same as for the face to face group.Based on these findings face to face teaching should resume when practicable. In the meantime, the virtual delivery may be improved if the course length was reduced. Analysis of qualitative feedback may provide insights into why participants did not rate the virtual simulation as highly as the face to face equivalent.

Use of simulation in teaching haematological aspects to undergraduate medical students improves student’s knowledge related to the taught theoretical underpinnings

Background Simulation is an educational method which has several modalities and applications. In the last few decades Simulation-Based Medical Education (SBME) has become a significant influence in medical education. Despite the recognized potential of simulation to be used widely in support of healthcare education, there are no studies focused on the role of simulation in teaching haematology. Moreover, the reaction level is the most commonly reported in medical education. This study evaluates, at two levels of Kirkpatrick’s model, the effectiveness of incorporating SBME in teaching haematological aspects to medical students. Methods A total of 84 second year medical students from two cohorts received theoretical components of Haematopoietic and Immune System in 4 credits course, delivered using lecture approach. First cohort students (n = 49) participated in interactive learning tutorials to discuss clinical vignettes. Second cohort (n = 35) students participated in simulation sessions where the tutorial’s clinical vignettes were developed to clinical simulation scenarios conducted in the simulation centre. The potential influence of the simulation in learning enhancement was evaluated using Kirkpatrick’s Evaluation Framework. Results The students rated the simulation sessions highly and found them to be a valuable learning experience. The category performance summary, generated by the assessment platform, demonstrates improvement in the student’s knowledge enhanced by the SBME. Conclusions Adaptation of SBME in teaching haematological aspects is a feasible way to improve the student’s knowledge related to the taught theoretical foundations. SBME has the potential to enhance the undergraduate medical curriculum and it is expected, in the near future, to be an increasingly recommended educational strategy to bridge the gap between theory and practice.

Hybrid-virtual simulations for Canadian medical students during the COVID-19 pandemic

Implication Statement: Given the efficacy of simulations as a medical education tool, the inability to provide them during the COVID-19 pandemic may be detrimental to pre-clinical medical student learning. We developed hybrid simulations, where remote learner participants could direct an in-person assistant. This offered a learning opportunity that was more realistic than fully virtual simulations and abided by public health guidelines. Hybrid simulations provided an opportunity for medical students to practice real-time clinical decision making in a remote, high-fidelity, simulated environment. This approach could be adapted for rural healthcare students and professionals to participate in simulations without a local simulation centre.

Using a simulation centre to evaluate preliminary acceptability and impact of an artificial intelligence-powered clinical decision support system for depression treatment on the physician–patient interaction

Background Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction. Aims Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction. Method Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback. Results All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction. Conclusions The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.