bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulation-Based Learning as an Effective Method of Practical Training of Future Translators
Authors: Kozyar Mykhaylo M. , Pasichnyk Susanna M. , Kopchak Marianna M. , Burmakina Nataliia S. , Suran Tamara
Published: January 2022

The research topicality is determined by the problem of lack of qualified specialists who have a high level of foreign language proficiency and the ability to carry out effective professional foreign language communication. The study involved the following methods: Rokich’s Value Orientations Test, Nemov’s methods for diagnosing the expectation of success level, the Self-Efficacy Scale (R. Schwarzer, M. Jerusalem); testing on the material taught on the Theory and Practice of English Translation, chi-squared test, Mann-Whitney U test. Results: Simulation of real conditions and situations of translation activity is used in almost every lesson (80%), promoting the development of future translators’ professional competencies. The final control in the experimental group found that all students had a high (48.10%) or medium (51.30%) level of foreign language proficiency, which confirms the effectiveness of the simulation method. In the experimental group, the percentage of students with a low level of foreign language proficiency at the end of the research decreased from 26.3% to 0.6%, and the percentage of students with a high level of foreign language proficiency almost tripled. At the same time, in the control group the number of students with a low level of foreign language proficiency decreased from 25% to 10%, while the percentage of students with a high level of foreign language proficiency increased by only 1.6 times. Therefore, the hypothesis of this scientific research was experimentally confirmed. Simulation training promotes the development of foreign language competencies of students majoring in Translation.
Erector Spinae Plane Blocks With Liposomal Bupivacaine for Pediatric Scoliosis Surgery
Authors: Stondell Casey , Roberto Rolando
Published: January 2022

Pain management in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion can be challenging. Various analgesic techniques are currently used, including enhanced recovery after surgery principles, spinal opioids or continuous epidural infusion, intravenous methadone, or surgical site infiltration of local anesthetic. Another recently developed technique, ultrasound-guided erector spinae plane blockade (ESPB), has been used successfully in spine surgery and may offer advantages because of its ease of placement, excellent safety profile, and opioid sparing qualities. Liposomal bupivacaine is a long-acting local anesthetic that was recently approved for infiltration and fascial plane blocks in pediatric patients of ages 6 years and older. This medication may prove to be beneficial when administered through ESPB in patients with AIS undergoing posterior spinal fusion because it can provide prolonged analgesia after a single injection. Here, we present a case report of two such patients, and we compare outcomes with a retrospective cohort of 13 patients with AIS who received IV methadone instead of ESPB. ESPB patients seemed to have less opioid use and shorter length of stay but higher pain scores, although the sample size is too small for meaningful statistical analysis. Future prospective trials are needed to see if differences in outcomes truly exist.
Estudio preliminar de teñido de fibra de alpaca utilizando extracto acuoso de molle (Schinus molle) como pigmento natural
Authors: Carrasco Bocangel José , Sucasaca Alexander , Sanchez-Gonzales Gloria , Morán Flores Geraldyne , Barriga-Sánchez Maritza
Published: January 2022

El teñido de prendas con pigmentos naturales es una alternativa para evitar utilizar colorantes químicos que a menudo resultan ser tóxicos para el medio ambiente y la salud humana. El objetivo del estudio fue realizar el proceso de teñido de la fibra de alpaca con pigmento natural a partir de molle fresco y seco. Para ello, se realizó la extracción líquida presurizada acuosa del pigmento de molle, se midió el color (L*, a* y b*), pH, sólidos totales y se evaluó la estabilidad del extracto en almacenamiento. Se realizó la evaporación parcial del agua y con el extracto concentrado se realizó el teñido de la fibra de alpaca utilizando los siguientes mordientes: ácido cítrico, sulfato de cobre, sulfato de hierro, sulfato de aluminio, bitartrato de potasio, sulfato de amonio, evaluándose la intensidad del color, así como la solidez de color al frote y al lavado. Los resultados indicaron que la mejor condición de almacenamiento del extracto fue 5°C en oscuridad y que la evaluación de solidez del color al frote como al lavado de las madejas mostraron valores de 4-5 utilizando los mordientes mencionados, aunque con el ácido cítrico se realizaron menos enjuagues. Se concluye que el ácido cítrico fue el mordiente con mejor afinidad al molle, y que para el teñido de fibra de alpaca fueron necesarios 21 y 4 ml de extracto concentrado de molle fresco y seco respectivamente fue satisfactorio.
Patient safety culture: a survey of private sector tertiary care hospital of Lahore, Pakistan
Authors: Hameed Sajid , Sheikh Ayesha Humayun , Yaqoob Muhammad , Latif Muhammad Zahid
Published: January 2022

Patient safety is a critical component to improving healthcare quality. Due to the potential of growing recognition and importance of establishing a patient safety culture within healthcare organizations, assessing existing patient safety culture is a prerequisite. Despite a vital role in delivering quality care, little attention has been given to describe healthcare professionals' perceptions and expectations of the patient safety culture in Pakistan. Objective:The current study aimed to assess the patient safety culture at a private tertiary hospital in Lahore from the perspectives of doctors and nurses. Methods: This cross-sectional study collected data from 120 nurses and doctors of the private hospital using the Hospital Survey of Patient Safety Culture (HSOPSC).The respondent's demographic characteristics and study variables influencing patient safety culture were presented through descriptive statistics, and a chi-square test was applied to identify the variable influencing patient safety.Results: The current study outcomes revealed a positive score for different dimensions ranging from 32.1% to 86.5%. The dimension of organizational learning-continuous improvement (86.5%) and teamwork within units (81.7%) had the highest scores as compared to teamwork across units (74.7%), feedback and communication about the error (73.7%), management support for patient safety (71.6%), supervisor/ manager expectations and actions promoting patient safety (69.8%), communication openness (65.4%), overall perceptions of patient safety (62%), frequency of events reported (53.7%), handoffs and transitions (49.9%), staffing (33.3%) and non-punitive response to errors (32.1%).Conclusion:  The current study's findings highlighted a less positive attitude of doctors and nurses towards patient safety culture within their organizations. The outcomes of the present study could be used for designing and establishing interventions to improve patient safety practices in similar tertiary care settings across Pakistan.
Carotid artery hemodynamics among diabetic and hypertensive patients
Authors: Fatima Hamnah , Madina Syeda Rabi , Asad Naveed , Malik Sajid Shaheen , Hanif Asif , Gilani Syed Amir , Fatima Wafa , Fatima Amsa , Amjad Shurooq , Ramzan Iqra
Published: January 2022

Diabetic and hypertensive patients are at increased risk of vascular complications. Carotid Doppler ultrasonography serves as a non-invasive gold standard technique/tool to access and monitor carotids hemodynamics and morphology. There is a need to predict difference in carotid artery hemodynamics among hypertensive and diabetic patients.Aim: Aim of this study is to find out the hemodynamics of carotid artery in diabetic and hypertensive patients. Method: Cross sectional study conducted at University Ultrasound Clinic Green Town. All patients were investigated with Toshiba Xario XG with 5-7.5MHz linear probe. Study included diabetic and hypertensive individuals, whereas patients with history of carotid endarterectomy, carotid stenting and co-morbidity were excluded. Total 200 participants were recruited, 41 were diabetic and hypertensive, while 159 were normal subjects. Statistical analysis was performed using SPSS version 21. Results: From 200 participants were recruited, out of them 41 patients with 20.5% were positive with diabetes and hypertension and 159 patients with 79.5% were negative with diabetes and hypertension. Right common carotid artery intima media thickness (IMT) mean ± S.D was 0.659±0.114mm with p-value (0.022). Left common carotid end diastolic velocity mean ± S.D was 16.719±6.303cm/s with p-value (0.002). Conclusion: The study highlighted that common carotid artery intima media thickness (IMT) and common carotid artery end diastolic velocity were significantly correlated with hypertension and diabetes. Our findings revealed that common carotid artery IMT and EDV were significant in hypertensive and diabetic patients. Indeed, hypertension and diabetes are mainly associated with vascular complications.
Awareness of Augmentative and Alternative Communication among Final Semester Students of SLP
Authors: Shahbaz Nimra , Rashid Amina , Khan Muhammad Azzam , Naz Arshad Mehmood , Masood Fahad , Noreen Hafsa , Hassan Syed Bilal
Published: January 2022

The ability to communicate with words is one of a person's distinguishing characteristics. People who have lost their ability to talk are unable to communicate effectively for whatever reason. The acquisition (AAC) approach was implemented as a viable alternative for assisting these individuals. Objective: To find out awareness of augmentative and alternative communication among final semester students of SLP. Methods: The cross-sectional study was conducted in seven major institutes of Lahore (University Of Lahore, Riphah International University, King Edward Medical University, School Of Allied Health Sciences, Fatima Memorial Hospital, Punjab University, NUR International University). Final semester students of BS or MS program in SLP were included in the study. The research employed the convenient sampling methodology and standardized questionnaire was used having 26 questions, with responses obtained through an online form and survey. SPSS17 was used to analyze data collected from 50 respondents. Results: Overall awareness was calculated of respondents regarding Augmentative and Alternative communication. Results indicated that 32(65.71%) of final semester students of speech language pathology have adequate knowledge about AAC technology, 10(18.40%) did not significant knowledge about AAC technology while 8(15.89%) totally unfamiliar about AAC technology. Conclusion: After analysis it was concluded that majority of students had awareness of AAC. Most of Lacking was seen in students who did not have good academic exposure and did not practice with patient of AAC.
A Nutraceutical and Therapeutic potentials of Stevia rebaudiana Bertoni
Authors: Jawad Maham , Rizwan Bahisht , Jawad Mahin , Khalid Filza , Ishaq Arifa
Published: January 2022

Stevia is a unique ingredient rising in the world, valued for being calorie-free as it helps reduce energy intake and added sugar in food. Like all other natural sugars, Stevia is plant-based, belonging to the Asteraceae Family. The leaves of stevia are mainly used as a sweetener and flavor enhancer in the food and beverage industry. The chemical compound obtained from stevia is considered to be the best alternative source of sugar especially for diabetes and obese patients. Several studies have shown that steviosides and similar substances, such as rebaudioside A and isosteviol, may have therapeutic benefits in addition to its sweetness. These benefits include anti-hyperglycemic, anti-hypertensive, anti-inflammatory, anti-tumor, anti-diarrheal, antibacterial, diuretic, antiseptic, anti-inflammatory, anti-fertility, hypotensive, and immunomodulatory actions. The use of Stevia prevents hypertension, acts as a bactericidal agent, and stimulates insulin production and utilization which in turn helps to control type-II diabetes and obesity. The drying temperature affects the quality of the stevia product; high temperatures reduce the medicinal and economic value. Multiple worldwide regulatory authorities have concluded that consuming high-quality stevia products in specified amounts is safe for everyone.
Basic Website Creation Training for Muhammadiyah Mamala High School Students in Central Maluku Regency
Authors: Fathia Palembang Citra , Winston Talakua Mozart , Arthur Leleury Zeth , Andry Lesnussa Yopi , Yunito Rumlawang Francis , Esna Thomas Radjabaycolle Jefri , Zakharia Wattimena Abraham , Willyam M. Patty Henry
Published: January 2022

The team's implementation of community service activities provides materials and training to Muhammadiyah Mamala High School students on how to easily build a website from the ground up using a content management system (CMS) until the website is successfully uploaded to the Internet (hosting), both for free and for a fee. The goal of this community service activity is for students to gain information technology knowledge that is not limited to being able to access information, but also to being able to create a container/information medium in the form of a website and, hopefully, to help the school in developing the school website in the future
ANALISIS PENERAPAN LATIHAN SKIPPING UNTUK MENINGKATKAN KECEPATAN TENDANGAN ATAS PADA ATLET BELADIRI KARATE
Authors: Ahmad Yanuar Syauki  , Bambang Yunanto  , Siti Maesaroh
Published: January 2022

Penelitian ini bertujuan untuk menganalisis penerapan latihan skipping untuk meningkatkan kecepatan tendangan atas pada atlet beladiri karate, metode yang digunakan pada penelitian ini adalah studi literatur. Studi literatur bisa disebut juga studi pustaka yang sumber-sumbernya diambil dari penelitian terdahulu yang relevan baik secara variabel x, variabel y maupun variabel x dan y.  Berdasarkan sumber-sumber relevan yang dianalisis menyimpulkan bahwa penerapan latihan skipping mampu meningkatkan kecepatan tendangan, hal ini dilihat dari pengaruh yang dianaisis dari sumber-sumber yang relevan. Penelitian terdahulu yang relevan dibuktikan dengan uji keabsahan dapat disimpulkan  bahwa terjadinya peningkatan kecepatan tendangan atas pada atlet yang menerapkan latihan skipping dalam program latihannya. dapat disimpulkan juga bahwa latihan skipping secara signifikan terhadap keberhasilan mampu meningkatkan kecepatan tendangan.
Nghiên cứu mô hình phát hiện rác thải nhựa ven biển sử dụng ảnh máy bay không người lái và mạng nơ-ron tích chập sâu
Authors: Đỗ Thị Nhung , Nguyễn Thị Diễm My , Phạm Văn Mạnh , Phạm Vũ Đông , Bùi Quang Thành , Nghiêm Văn Tuấn , Phạm Minh Hải
Published: January 2022

Rác thải nhựa tại các khu vực ven biển có nguồn gốc do các hoạt động của con người và đang trở thành mối nguy cho môi trường biển bởi số lượng lớn và khó phân hủy. Chúng đe dọa đến hệ động vật biển và phá hủy hệ sinh thái biển, gây ô nhiễm môi trường và làm giảm giá trị cảnh quan của bãi biển. Các chương trình giám sát và các biện pháp giảm thiểu đã được đưa ra để giải quyết vấn đề này trên toàn thế giới, với sự hỗ trợ ngày càng nhiều của công nghệ hiện đại và tự động hóa các quá trình phân tích. Hình ảnh từ máy bay không người lái (UAV) và mạng nơ-ron tích chập sâu (DCNN) có thể được sử dụng hiệu quả để phát hiện, xác định và giám sát loại rác thải nhựa ven biển. Nghiên cứu này đề xuất một thuật toán phát hiện rác thải nhựa ven biển dựa trên cách tiếp cận mô hình DCNN có khả năng học từ dữ liệu không có cấu trúc hoặc không được gắn nhãn. Mô hình học máy dựa trên mạng nơ-ron tích chập sâu đã được đào tạo và thử nghiệm bằng cách sử dụng 95 hình ảnh được chụp từ Phantom 4 Pro với camera loại CMOS 1 inch có độ phân giải 20MP khu vực ven biển Hội An (Quảng Nam). Kết quả cho thấy, độ chính xác trong phân loại hình ảnh rác thải nhựa ven biển và xác nhận chéo lần lượt là 0,87 và 0,83. Nghiên cứu nhằm cung cấp một cách tiếp cận mới cho các nhà nghiên cứu, nhà quản lý vùng ven biển có ý định sử dụng ảnh UAV để giám sát và đánh giá mối đe dọa môi trường từ các mảnh rác thải biển. Tuy nhiên, việc giám sát tự động vẫn là một thách thức về công nghệ và cần có những nghiên cứu thêm để cải thiện độ chính xác của các thuật toán hiện tại trong tương lai.
Tạo lập đám mây điểm 3D của vật thể độc lập bằng máy quét Laser đơn tia Hokuyo UTM LX30
Authors: Phan Thị Anh Thư
Published: January 2022

Hiện nay, công nghệ quét laser được xem như một công cụ hữu dụng nhằm thu dữ liệu trong thời gian ngắn. Phương pháp đo gián tiếp này có thể thu thập dữ liệu đám mây điểm dày đặc mô tả vẻ ngoài mà không làm tổn hại vật thể. Nhằm giảm chi phí thiết bị, máy quét laser đơn tia 2D Hokuyo UTM 30LX được sử dụng trong nghiên cứu này để tạo lập đám mây điểm 3D cho vật thể được chọn là một khối đá với hình dạng phức tạp. Máy quét được gắn trên một đường ray cố định trên khung nhôm. Tốc độ di chuyển của máy được điều khiển bởi mô tơ điện. Thiết bị được thiết lập để di chuyển theo hướng thẳng đứng với tốc độ ổn định không đổi và được đặt ở nhiều vị trí khác nhau nhằm thu đủ dữ liệu bao phủ quanh đối tượng. Một chương trình được phát triển trên ngôn ngữ R để tạo ra đám mây điểm từ dữ liệu được thu thập. Dựa trên những mốc phản quang được đánh dấu, 6 đám mây điểm được tạo thành từ dữ liệu quét của 6 trạm, và được ghép lại với nhau để tạo mô hình 3D đầy đủ của khối đá. Nhìn chung, một vài phần của khối đá bị che khuất bởi những vật thể khác. Tuy nhiên, đám mây điểm 3D thu được có mật độ dày đặc (3 triệu điểm), tương đồng về hình dạng và kích thước so với vật thể thực.
81 Debriefing the Debriefer; Developing an Inter-Professional Faculty for Emergency Medicine Simulation
Authors: Simpson Eilidh , Moulds Yvonne , Bell Linda
Published: January 2022

Previous research has described the importance of debriefing in Simulation-Based Medical Education; it is considered the most critical part of the teaching experience

The aim of this work was to develop an inter-professional faculty with a variety of backgrounds to assist on an inter-professional nursing-medical simulation course in Emergency Medicine. A further aim was to develop a novel formal debrief for the debriefer to help improve confidence in this skill.

A variety of professionals were invited to attend the course as faculty. Following their debrief of the scenario, the debriefer was invited to discuss their opinion on how they managed the debrief, from room set up to structure used. Troubleshooting advice was offered and an action plan was put in place for next steps of development. Faculty members were asked to complete a formal feedback form at the end of the session.

Inter-professional faculty members included Emergency Medicine consultants, trainees and clinical fellows, simulation technicians, emergency medicine nursing staff and resuscitation officers. 75% of faculty members had attended <5 simulation courses as faculty prior to this session. 81% of faculty members scored 4 and 5/5 for feeling confident at debriefing as a result of the session. 100% scored 4 and 5/5 for feeling supported during their debrief. 100% felt that the session had improved their debriefing skills. 87.5% felt appropriately challenged as a faculty member. 100% were willing to attend the course again in the future. Free-text comments included the best part of the day was ‘Personally observing and practicing debrief, brief and debrief of my debrief’, ‘Supportive atmosphere for faculty’ and ‘Debrief learning points’.

Overall, faculty members from varying clinical and simulation backgrounds were supported throughout the day and as a result were more confident in their debriefing abilities following the session. Future work aims to continue this incremental learning to allow all faculty members to feel confident and able to ‘debrief the debriefer’. This will ensure the quality of the debrief for learners, maximizing the impact of simulation-based medical education.
26 Mixed Realities Chest Drain Workshop: Integrating Hands-On and VR Learning
Authors: Glennie Deborah , Swain Cara
Published: January 2022

During the pandemic, several wards in our surgical wing became re-purposed for COVID patients. This resulted in patients who would usually be nursed in those wards being placed elsewhere. There were also many nurses and medical staff being redeployed to wards in unfamiliar specialities which required caring for patients outside their usual clinical areas. This resulted in some patients with chest drains being nursed outside the usual areas, and incidents being reported regarding their management.

The hour-long workshop was designed to simulate the management and understanding of the terminology around chest drains. The hands-on aspect was achieved by modifying a manikin to be able to demonstrate these actions and troubleshoot when things go wrong.

What is meant by a swinging chest drain?

How much bubbling is expected?

Followed by the procedure of inserting a large-bore chest drain using immersive virtual reality

Ward nursing staff, operating theatre staff and junior doctors were invited to attend the workshop. Six sessions each with five participants ran over the course of a month. The first part of the workshop was a hands-on session with a modified defunct manikin. We had the locally available kit for people to be able to interact with and understand the mechanics of chest drains Introducing people to the Royal Marsden manual of clinical nursing procedures

Questionnaires were completed before and after the workshop for attendees to evaluate their confidence to independently manage a chest drain. Every attendee reported an increase in confidence because of the session (

As a result of this session, the ward areas created a ‘chest drain box’ which had everything needed to manage and replace a chest drain included as locating where kit was kept was identified as an issue. This box will be at the side of the patient being managed with the chest drain and will be checked for completeness regularly. This workshop would be useful to repeat because 50% of junior doctors have now rotated placements and many of the ward staff have been re-deployed to other areas.
6 Assessment of The Creation of a New Course
Authors: Mahalingam Jeevahan , Claiandro Francesca
Published: January 2022

Although commonly used in the clinical environment, insertion of peripherally inserted central catheters (PICC) is not routinely taught to clinical staff. As the procedure requires knowledge in relevant anatomy, sonography skills, and understanding of complications management, it requires dedicated time for teaching. In 2018 no PICC line insertion courses were found in London County.

The Harefield educational team has therefore created a PICC line insertion course delivered by a multi-disciplinary faculty. This course aimed to increase understanding and confidence of PICC insertion.

Using Miller’s pyramid of clinical competence, the course was structured to provide learners with the knowledge and understanding of the procedure through interactive lectures and demonstrations, before progressing to hands-on practise in the workshops using high-fidelity models to increase dexterity and confidence

The results have shown the achievement of all the course objectives such as increased understanding of indications, relevant anatomy, equipment uses, complications and their management relating to the procedure. With increased confidence in the theoretical and practical aspects of PICC insertions, we hope the course attendees will have better performances in practicing the procedure, thus reaching the highest level of clinical competence on Miller’s pyramid.

As soon as face-to-face teaching will be allowed again, the PICC insertion course will be resumed as proven well-received and effective.
100 ACUTE MEDICINE MEETS ‘KNIGHTMARE’: ‘CHOOSE YOUR OWN ADVENTURE’ FORMAT FOR REGISTRAR COURSE DELIVERY
Authors: Hayes Thomas , Chan Lai Man (Lilian) , Stock Nadia
Published: January 2022

Ongoing social distancing restrictions have greatly limited opportunities for registrars to attend regional acute medicine teaching. Basing the project on previous work within the trust running simulation via Microsoft Teams (using a one-to-one method of delivery) this project set about opening this up to a much larger group using a ‘choose your own adventure’ (‘CYOA’) format depicted in the children’s television show ‘Knightmare’.

The aim of the study was to deliver a simulation-based training course for a large number of participants simultaneously using an online platform.

Scenarios were as follows:

Patient with an exacerbation of COPD

Patient with a life-threatening overdose

Patient presenting with undifferentiated unconsciousness

The clinical room featured an audio-visual set-up for debrief with three cameras and patient observations from Laerdal Learning Application (LLEAP) combined with an audio mix shared via video-stream to VLC media player; then from the host laptop via Teams. Teams used audio mixer input from room via USB. This included phone audio allowing calls to relatives, other specialists, etc. to be heard. Teams accessed from the following locations:

Host (control room)

Faculty (control room)

Faculty (clinical room)

Faculty (debrief room)

Participants (remote) × 14

Teams host laptop was pre-loaded with all scenario information which allowed ECGs, CTs, Toxicology reports to be shared as requested throughout the scenarios. The multi-screen set-up allowed for monitoring of chat from a control room and clinical space meaning all users could access key information shared on screen. Faculty had radio communication to control room for prompts and questions. Scenarios would be led by a member of faculty playing the role of a clinician in the scenario. The scenario would progress with input from the participants via that Teams chat. At key points, the scenario would pause and a question would be put to the group and an option would be voted on to continue. After each scenario, using Teams break-out rooms for debrief allowed the large group of participants to have a more focussed debrief session led by one of the medical faculty.

Using the structure of ‘CYOA’ encouraged users to take part in key interventions, whilst chat function within teams allowed for continuous dialogue. Participant feedback stated that the discussion format and expertise within the group was very useful in their training and would have a positive impact on working practice. Faculty found virtual simulation more demanding to facilitate than face-to-face simulation, but feasible to run the session annually.
25 Unmuting Regional Paediatric Simulation Training Throughout the COVID-19 Pandemic
Authors: Nahabedian Lucine , Copeman Annabel , Holt Ashley , Patel Ashish , Hamilton Stuart , Hamilton Elaine , Belfitt Alison
Published: January 2022

The National Health Service endured significant strains during the COVID-19 pandemic to the point where all face-to-face training had to be paused. Our team delivers simulation-based training face to face and offers support for those returning to work, stepping up to senior roles and addressing important aspects of general paediatric care such as acute mental health crises and end of life care.

The aim of the study was to deliver our courses virtually without compromising the quality of content.

Initially, we reviewed all scenarios to appraise whether they could be delivered online. Scenarios that involved acute clinical decisions were recorded with the faculty acting as the candidates. This also allowed scripting to ensure that key discussion points could be raised within the debrief. Scenarios mainly involving communication skills with standardized patient role player were retained, and briefs were adapted so that the candidates were aware that the scenarios began when the actor appeared on screen.

Participants were recruited using newsletters and subsequently directed to a website to collate email addresses where invites to the virtual meeting space and pre-course material were sent. The scenarios were combined with contracting rules and links to interactive polls to form a presentation that could be shared on the screen throughout the day. Links to post-course feedback surveys were also included to evaluate participant satisfaction of the course design. From October 2020 to May 2021, we delivered eight virtual teaching sessions to a total of 67 multi-professional candidates ranging from nursing staff, police officers and doctors. Candidates were asked whether the course addressed their learning objectives or whether the course had increased their knowledge and 53 (79%) candidates ‘strongly agreed’ with these statements. Including those who ‘agreed’ with these statements, 66 out of 67 (98%) of the candidates perceived this course addressed their learning outcomes or improved their knowledge. The results from the evaluation of these courses indicate that the adaptation of our face-to-face courses have not impaired the quality of the content and have been beneficial to the targeted audience. Despite the challenges that online teaching can pose, we have overcome these by ensuring that we contract behaviour to ensure psychological safety, included interactive aspects such as live word clouds and polls and used a modality of learning such as the use of role players and modified scenarios to guide debriefs and learning.
43 Learning from COVID-19 and Supporting Staff Using Human Factors and Simulation
Authors: Scaffardi Suzanne , Wiltshire Michaella , Shah Maria
Published: January 2022

The full impact of working in the COVID-19 pandemic surge on NHS staff is yet to be understood. Simulations were run to explore the staff experience following the second COVID surge. From these, it was clear that the staff had powerful stories to tell. A series of further simulation sessions were then delivered, designed to allow staff to explore their experiences and assist with organizational learning within the trust debrief strategy.

Firstly, to use simulation to recreate working with uncertainty and unfamiliar staff as a platform within the debrief to explore their experiences of working during the pandemic surges. Secondly, to employ a human factors framework, SEIPS model

Simulation sessions, open to all staff, were advertised throughout the organization. In total, 8 sessions were delivered for 38 staff. Multi-disciplinary attendance was encouraged, and a wide range of staff groups participated. During the session, staff were given a brief presentation on human factors, a simulation pre-brief and a pre- and post-simulation questionnaire. A simple patient deterioration scenario unrelated to COVID-19 was used to maintain psychological safety. A system-focussed debrief using the PEARLS model took place after the scenario. Insights shared by candidates were captured by a facilitator and anonymously grouped into the six SEIPS themes.

Pre- and post-questionnaires show a general theme of improved confidence post-simulation. Findings were reviewed and the impact on care processes and staff, patient and organizational outcomes were summarized. Information captured within the SEIPS framework showed recurring themes that were condensed into four main categories: psychological trauma and burnout, communication, re-deployment and training, and infection control and PPE.

It was clear from facilitating sessions that staff were concerned about patient experience but were also suffering their own trauma from working through the surge. Feedback from participants was positive, emphasizing their sense of validation in sharing their experiences and of feeling part of the hospital community. Staff also had experiences to share about what had helped them and where things could be improved. These insights were synthesized into practical recommendations for managing future pandemic surges that were fed back to the wider organization.
27 Use of Live Patient Simulation to Train Providers on Sexual Assault Response
Authors: Polonko Isle
Published: January 2022

Sexual assault is a worldwide epidemic. According to the World Health Organization (WHO), 35% of women worldwide have experienced sexual violence

The aim of the work being conducted in the field was to develop an effective protocol for training sexual assault responders that supports goals of trauma-informed care and provides a standardized protocol to obtain certification through simulation.

SANE/SAFE training requires an initial 40-hour didactic with anatomy skills training specific to trauma care. Trainees subsequently practice the sexual assault forensic evidence collection kit on simulated patients. They practice communication skills designed to build rapport with trauma survivors, the specialized urogenital examination techniques involved in sexual assault care and have opportunities for speculum insertions to competency. Additionally, they practice documentation/chain of custody procedures critical to the admissibility of evidence in court. Stations are developed to provide practical experience with the kit and with providing specialized care to patients in a variety of demographics; age, gender (or transgender), socio-economic backgrounds, etc.

This work is based on findings of previous studies that highlight the efficacy of live patient simulation in SANE training to implement safe, effective methods of trauma response via collaboration between SANE/SAFE directors and GTA programming.

GTA methodology is proved to be an effective method for training the well-patient gynaecologic examination. One of the identified benefits is a reduction in learner anxiety. Because GTAs act as both instructor and patient, they can teach trauma examination skills and provide a unique opportunity for feedback from a simulated sexual assault victim’s perspective. Developing protocol in the field is crucial as more programmes utilize simulation to train new SANEs. It is critical to meet standards of best practices and to maintain safety and reduce risk.

This protocol has influenced the way SANEs and SAFEs learn trauma-informed care. The benefits to trauma patients are numerous. The methodology, utilized across the USA, was recently brought to Brazil to train new SANEs. More work must be done internationally to bring this method to areas of the world where no standardized method of sexual assault response exists. Additionally, safety measures and better collaboration are paramount to the continued success of this method.
187 A Virtually Perfect Debrief? The Undergraduate COVID-19 Simulation Challenge
Authors: Wells Lyndon , Frost Emily , Waller Annabelle , Newbold David , Gray Victoria
Published: January 2022

Feedback from undergraduate medical students recognizes high-fidelity immersive simulation-based education (SBE) as an opportunity to put clinical reasoning and behavioural skills into practice whilst guaranteeing patient safety. The tool used in SBE to bridge event experiences with meaningful reflection is the debrief. Debriefing is a facilitated reflection to guide learners through a process of detecting performance issues and exploring rationales for behaviours

The aim of the study was to create pre-recorded high-fidelity simulation scenarios with the involvement of course participants, final-year medical students. Use the recorded scenarios to observe simulation, create meaningful discussion and explore both clinical and human factors.

Three partially scripted scenarios were recorded involving medical, surgical and COVID-19-specific cases. This included intentionally scripted learning points, as well as unintended developments which generated additional learning. These videos were designed to be shown in a virtual setting or limited number group, therefore allowing for continued simulation training during the height of the pandemic. The virtual simulation session involved a moment-by-moment analysis of each scenario facilitated by a faculty member. This allowed for an observer-led debrief and more in-depth reflection.

Most participants gave positive feedback on the perceived quality of this training modality, recognizing its potential to create an engaging environment for learning. There was recognition of its limitations; it cannot replace immersive simulation, however involving service users in the design and implementation enhanced the learning opportunities. The videos created a springboard for discussion encouraging the formation of emergent objectives, including reflecting on behaviours and attitudes. Faculty noted that students were more confident to identify and critique errors as well as challenge poor behaviours when they were not observing a peer. The participants represent a unique cohort of students whose training has been disproportionately affected by the pandemic. We hope that this course has gone some way to address this shortfall.
161 Absent in Body But Present in Spirit: Battling on When Both Learners and Faculty are Remote from the Simulation Centre
Authors: Bailey Paul , Evans Laura , Thorpe Amelia , McDonald Chris , Johnson Mike , Knight Paul , Howick Katie
Published: January 2022

Over the last year, COVID-19 has constrained the capacity of education centres to deliver face-to-face simulation-based education (SBE). Restrictions on travel between NHS trusts necessitated development of remote simulation to allow learners to participate in training safely. The challenge to maintain training provision was increased due to the imposition of shielding requirements on a member of the education faculty requiring them to isolate at home over a 2-month period (February–April 2021).

The aim of the study was to allow educators isolating at home to continue to support SBE, despite their physical absence from the training centre, by:

Simulating the patient role remotely.

Facilitating debrief from home. Observing SBE within the simulation suite and supporting subsequent discussions using video conferencing platforms.

Supporting delivery of human factors teaching sessions to Trust staff remotely.

To deliver SBE remotely for learners with remote faculty rested on three key requirements:

Collaborative and iterative development of scenarios that could be delivered effectively for learners remotely utilizing expertise from the simulation centres education and technical teams. The creation of scenarios optimized for remote delivery.

Effective communication and observation between remote faculty, centre-based staff and remote participants over Microsoft Teams (MST) to allow remote facilitation of debrief

Controlling and voicing the patient simulator from isolation at home via a desktop PC linked with simulation centre systems via a virtual private network (VPN) and utilizing the Zoom platform.

Faculty member shielding requirements lasted for approximately 8 weeks and during that period they were able to support a range of SBE courses;

Foundation years doctors (supported 14 courses)

Final-year medical students (supported 6 courses)

Surgical nurses (supported 1 course)

Burns speciality (supported 1 course)

Acute care skills: Nurse OSCE provision (supported 4 courses)

Human Factors teaching to trust staff (delivered 5 lectures)

Key equipment:

PC with dual screens to allow MST and Zoom software to be managed simultaneously to allow response to participant communication and interactions in real time.

Headset-Microphone to support effective fidelity within audio exchanges.

The facility to contribute to educational provision was mutually advantageous to all members of the educational faculty:

Off-loading some of the burden of training from those within the centre.

A positive influence on the mental health for the isolated.

Making remote simulation work possible was through whole team collaborative working.
58 Neonatal Critical Care Communication Training Through Simulation: A Novel Regional Course for Neonatal Trainees
Authors: Aguirre Diana , Evans Davy , Negrine Robert , Philpott Alex , Nash Matthew
Published: January 2022

Challenging conversations occur frequently within neonatology

The aim of the study was to design a communication skill simulation course for neonatal trainees.

We collected feedback from 10 neonatal trainees and 15 consultants regionally. 53% of consultants and no trainees had received formal communication skills training. Lack of confidence was the highest discussing end of life, post-mortem consent, breaking bad news and conflict resolution. Further feedback from 21 parents and 45 staff locally highlighted lack of privacy, sensitivity, clarity, consistency and empathy as areas to develop. We first trialled a virtual simulation workshop on antenatal counselling during the COVID-19 pandemic. A pre-recorded scenario was played and debriefed live. Two candidates then took part in a scenario, in break-out rooms, followed by a smaller group debrief. A face-to-face course was then developed. The day, designed for eight candidates, began with an introduction session focussed on psychological safety followed by ‘trauma-informed communication’ by a clinical psychologist. The candidates were then split into two groups for scenarios. Each had the opportunity to lead a scenario. Faculty utilized role play with a standardized faculty ‘parent’ and block simulation with an actor. The Diamond Model was used for debrief. A workshop on ‘post-mortem consent’ and a talk from a parent about their neonatal journey were also included.

Ten trainees attended the virtual workshop. Nine strongly agreed that the pre-recorded and 10 that the live sessions were useful. All strongly agreed/agreed that the virtual learning environment worked well, was safe and comfortable, the debriefs were structured and educational, and that attendees’ confidence in antenatal counselling had improved. Seven candidates attended the face-to-face course. All strongly agreed/agreed that the sessions were relevant to their practice and skills learnt were transferrable. Self-rated confidence improved in all communication themes. All candidates strongly agreed that the learning environment was safe and supportive. Candidates found both methods of simulation valuable, four preferred block simulation. All would recommend the course to their colleagues. We addressed a training gap by developing this course. Despite using different styles of teaching and adapting to virtual training during the COVID-19 pandemic, feedback was consistently positive suggesting that flexibility enhances learning. A similar course could be developed in other regions to continue to strengthen communication skills training.
106 How the COVID-19 Pandemic has Changed Departmental Teaching in a Tertiary Hospital
Authors: Powell Sarah , Kasfiki Eirini , Blackmore Andrew , Wright David
Published: January 2022

Pressure from the COVID-19 pandemic on healthcare has had a detrimental effect on the delivery of teaching to junior doctors. During a time when teaching is needed more than ever the constraints of a pandemic have made this challenging. Parallel to this patient safety remains a cause for concern in healthcare systems worldwide

The aim of the study was to create an educational programme for the acute medical unit to allow flexibility of learning whilst incorporating key lessons from significant incidents.

Our initial approach was to gain an understanding of the problem by consulting the multi-disciplinary team. We spoke with a range of healthcare professionals working on the acute medical unit to identify concerns relating to SIs: in particular, the governance lead was key in this. Following this, we consulted junior doctors using questionnaires to explore the challenges they faced working on AMU. The design of the scenarios is based around two SIs per scenario for a total of five scenarios and all scenarios were based around the management of common conditions seen on AMU. We opted for an interactive ward round style teaching with a particular focus on key skills such as prescribing and taking bloods. With the help of our colleagues at Hull Institute of Learning & Simulation (HILS) the scenarios were filmed in 1 day and later edited to produce a short video.

We have designed and created a VR360 teaching programme that combines with departmental induction allowing junior doctors to access learning from anywhere in the world and immerse themselves on AMU. Feedback has been positive so far and we hope to expand this simulation-based learning to allow to include additional topics.
76 Benefits and Challenges of Inter-Professional Education Within the Emergency Department in situ Simulation
Authors: Gooding Sarah
Published: January 2022

A comprehensive literature review was performed to critically evaluate the benefits and challenges of inter-professional education (IPE) in the Emergency Department (ED) and within

A literature review was carried out for manuscripts within my institution’s high-quality online library, as part of a post-graduate assignment. Search terms included keywords: ‘interprofessional education’, ‘interprofessional teams’, ‘simulation’, ‘emergency medicine’, and ‘healthcare’. A total of 23 peer-reviewed manuscripts were identified spanning a publication range of 22 years (1998 to 2020). Analysis of the literature resulted in the identification of 7 subject headings as most relevant to IPE. These subject headings were ‘patient safety’, ‘patient flow’, ‘learning outcomes’, ‘professional identities’, ‘organization’, ‘technology enhanced learning’ and ‘faculty’.

EDs are demanding

IPE occurs frequently in
33 Infant Abduction: Live Simulation Drills Explore The Risk in The Maternity Unit
Authors: Quayle Alexandra , Harrison Nick , Gaunt Keeley , McGuffie Rochelle
Published: January 2022

Child abduction is poorly defined in the UK. Legislation varies, defining offences of child abduction, kidnapping and child stealing/plagium. Rabun

Proactive planning, security and staff training are required to reduce this risk, and a live simulation was utilized to test these elements, identify risks and provide solutions.

A staff member, unknown to the maternity team, was admitted to the ward and gave birth (simulated to a baby girl). Ward staff were informed that there was a restraining order on her partner who was not permitted to visit. An educator from the Clinical Simulation team was tasked with gaining access to the maternity unit, abduct the baby and make their way to a hospital exit and to the car. With the support of Clinical and Governance Midwives, an unannounced live drill was conducted to analyse:

Security of the unit

Staff adherence to local policy – proactive planning

Conflict management and challenge

Observation analysis identified:

Access to the maternal unit was gained through tailgating with no challenge from staff.

Access to the mother’s room, despite being in close proximity to the midwives’ station, went unchallenged.

Staff did not engage or challenge abductor despite a team member identifying concern.

Activation of local policy was slowed due to handover time. Lack of awareness of who has called who.

Communications between staff members occurred through non-secure social media applications.

Security cameras ineffective due to relay of images to a different location

Escape from the unit made easy by unlocked corridors.

Certain staff groups unsure of their role.

The identification of latent risks in resources and staffing alongside having confidence with protocols and decision-making has illustrated potential serious risks to both mother and baby. This clinical simulation has allowed us to address and provide recommendations to resolve these by highlighting urgent reassessments of security, proactive planning and staff development to ensure the reality of abduction is minimized.