bluuebunny/crossref_metadata_2025 huggingface dataset:
A57Simulated Practice as a Method to Promote Legitimate Peripheral Participation
Authors: Eckley Buddug , Cooper Richard , Buratti Lucia , Brayshay Linda , Barrington Jack , Purchase David
Published: October 2023

Simulated sessions are widely used within medical education. Despite the potential benefits of simulated learning, it suffers from a narrow scope of practice; acute, emergency presentations and procedural skills. There is less research for its utility in sub-acute and chronic disease management.

To develop expertise in medical practice, learners require sufficient foundational knowledge to facilitate more complex behaviours [1]. Within ward environments, lack of foundational knowledge in both ‘hard’ (knowledge) skills, and ‘soft’ (organizational) skills can limit learners’ potential for development. Considering legitimate peripheral participation theory, learners require ‘enculturing’ into an institution to develop ‘soft’ skills. Examples of ‘soft’ skills include understanding problem solving approaches, language, values and norms of the profession [2].

To design and assess the educational impact of simulated ward round teaching sessions on medical students in semi-acute settings, focussing on ‘enculturing’ skills.

This was a prospective study. We created a ward round-based simulation session, with six simulated patient scenarios, designed for clinical placement level medical students. Ten students were included in the study.

We utilized an induction exercise to familiarize students with medical documentation, a simulated ward round, and a consolidation exercise reviewing discharge paperwork and prescriptions. A simulated patient was present in each scenario, with a member of faculty facilitating. Simulated ward round entries, nursing handover queries and investigations were provided to students. Scenarios were 20 minutes; with objectives to produce ward round documentation and generate holistic clinical management decisions. Students participated in a ‘board round’, which served as a forum for station specific feedback.

Enculturing values were assessed via a 40-point, knowledge based formative assessment, covering the main themes of the session: appropriate documentation, medical abbreviations, and clinical decision-making. Assessment was administered both pre- and post-session. Qualitative feedback of the session was obtained from learners to identify themes for further development.

There was a significant improvement in knowledge following the session (see

Results of pre- and post-intervention knowledge assessment

Our results demonstrate an increased sense of empowerment in the study population.

Simulated practice can be used effectively to enhance learning in sub-acute medical situations. Enculturing skills were particularly enhanced; promoting future learning through orientation within zones of legitimate peripheral participation.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A82‘Simulation for Finals and Real Life’ – is it ever too early to jump in the deep end?
Authors: Shipley Zoe , Ali Naeem Mohamed Azraq
Published: October 2023

Surveying University of Nottingham (UoN) medical students in their final year with regards to applying an A-E approach in a medical emergency context, we found that they lacked confidence. In order to address this curriculum gap, we designed a low-fidelity simulation-based workshop which has been shown to improve confidence in developing key skills relating to medical emergencies [1].

This consists of a 2-hour session for groups of 6, for all students undertaking their medical placements at Nottingham University Hospitals (NUH).

After successfully implementing this workshop for students in their final year, we asked ourselves ‘when is it too early for medical students to cover A-E assessments in medical training?’

Considering this is an essential skill to develop and part of their intended learning outcomes (ILOs) that is also tested in their 3rd year examinations, we introduced an adapted version of this workshop for the more junior cohort.

We constructed this workshop with alignment to both the final and third year UoN curriculum ILOs. Google forms were used to survey students’ confidence pre and post-session.

We used a low-fidelity simulation mannequin, focusing on an otherwise realistic clinical environment using medical notes, a portfolio of investigations and props. This included an observation monitor, a real-time display with altering vital parameters and a fully equipped emergency trolley.

Pre‐reading handouts on A-E assessment by the Resuscitation Council UK [2] were provided. We watched a pre‐recorded demonstration video of the management of hypoglycaemia prior to students working in pairs on three scenarios.

During the simulation scenarios, faculty members acted as either the patient or team members, including as a nurse and medical registrar.

We showed that participation in our workshop significantly improved student confidence in the specific domains (see

Summary of the student questionnaire results

Written feedback from students suggested active participation in a simulated learning environment together with a detailed debrief and facilitated discussion was a powerful learning experience.

This workshop has now been embedded into the teaching timetable at NUH. A-E assessment is a key template doctors of all grades use when facing the most critical situations.

Considering the feedback, introducing more junior students to the structure of an A-E assessment early is essential for creating a scaffold in their long-term memory, ingraining this into their professional practice. This will prepare them for their OSCEs and the new GMC mandated MLA examinations [3] and, more importantly, for when they start their roles as foundation doctors.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A107Mental Health Simulation for Foundation Doctors: Bridging the gap of placement variation
Authors: Stevens Lisa , Sterling John
Published: October 2023

There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs.

Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations.

2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year.

This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A60A Simulation Based Quality Improvement Project to improve patient care in the Urgent Care Environment
Authors: Cree Claire , Soares-Preece Marta
Published: October 2023

In the two years prior to commencement of the project, data suggested that incidents related to patient safety were high on one Urgent Care Ward. Evidence also suggested that staff turnover and the number of junior staff in post were also higher than usual with little support available.

A series of monthly, clinical Simulation Based Education, (SBE) Sessions were held over eight months with the aim of allowing staff to practice, in a safe space, the specific clinical skills required to work in that environment ultimately resulting in safer patient care by increasing knowledge, skills and confidence, [1].

Training consisted of monthly 3-hour sessions, 3 scenarios per session, each followed by a structured debriefing cementing understanding and learning. Scenarios were relevant to Urgent Care and as realistic as possible using High Fidelity Simulators.

A mixed methodology was used to collect qualitive and quantitative data over 11 months allowing for robust analysis, [2]. Pre and Post session Confidence Scales were completed by candidates as well as a feedback form to identify key learning points and to advise on the suitability. A comparison study was made, collecting patient safety data at the beginning and end of the project.

26 candidates attended. 3 attended twice. Candidates were qualified and student Nurses and Health Care Assistants with varying levels of Urgent Care experience. Following sessions all candidates reported that they felt more confident managing deteriorating patients and that they felt more confident to summon assistance. They all reported that scenarios were relevant to practice. 65 learning points were identified with 7 common themes.

The most useful part of sessions was realism and relevance.

Patient Safety Data indicates some improvement in the number of reported incidents. Some variables could have influenced data and further study is required.

Results were positive and the project has been adopted throughout Urgent Care across the Trust to improve patient safety and retain staff

The project aimed to improve patient safety by providing SBE to staff on one Urgent Care Ward. Analysis of data suggests there was some benefit to patient care and demonstrated a positive impact on staff confidence. It also identified key learning themes.

The educational program will be offered across the Trust and further study will enable more persuasive data.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A85Jake’s story: Teaching interprofessional working through the delivery of a live patient multi-disciplinary team meeting
Authors: Bryant Jodie
Published: October 2023

The World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice (2010), states ‘Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes’ [1]. When healthcare students enter the practice workplace, they are required to work in an interprofessional team and make collaborative decisions to provide safe and effective patient care. With the increasing complexity of patient presentation, increase in life expectancy and disability years coupled with the challenges of resource and delivery within the healthcare system it is vital that practitioners have solid foundational skills in interprofessional working.

To facilitate this healthcare educators are being required to think of innovative, authentic and contemptuous pedagogical tools to demonstrate interprofessional working, collaboration and interdisciplinary role awareness.

To provide healthcare students with meaningful exposure to interpersonal working educators at Birmingham City University embarked on the design and delivery of a live simulated patient case conference. To promote authenticity the case conference was designed (with consent) around a living patient (Jake) with complex medical and social needs. A team of healthcare educators each took the roles of clinicians from both health, social and tertiary care service. A round table discussion was held related to Jakes’s inpatient care and decisions regarding hospital discharge. Jake has quadriplegic cerebral palsy and substantial medical, social and occupational needs. Jake’s mum is also present, demonstrating the need to have patient and carer collaboration. The session was observed live by students but also filmed and edited into an ongoing simulation learning resource with both clinical and non-clinical learning objectives. A facilitated debrief was held after the session.

Feedback and anecdotal analysis of the session showed greater student engagement and understanding of the needs for interprofessional collaboration when discussing patient care and decision-making. The use of a real and living patient meant students could immerse themselves in Jake’s story and feel true empathy with his clinical case. For some students’ knowledge of interprofessional working and the roles of other disciplines proves a challenging concept to master.

It is feasible and effective to utilize simulation (live and virtual) as a method of teaching hard to grasp but vital concepts of healthcare practice including interprofessional working and interdisciplinary role awareness.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A65Development and Impact of a Simulation Community of Practice across Nursing and Allied Health Professions in a Higher Education Institution
Authors: Batty Helen , Mottram Lucy
Published: October 2023

The Nursing and Allied Health Professions (AHP) Departments of one of the largest providers of health and social care education in the UK, have implemented simulated practice-based learning placements across a range of their pre-registration healthcare courses. These simulated placements aim to improve students’ preparedness to practice, enhance the student experience and increase placement capacity. The simulation leads from each department identified that there was no cross-department collaboration around these new innovations. They developed and introduced a Simulation Community of Practice (CoP) across the three nursing fields and eight AHP professions. The aims were to share knowledge and best practice, enhance skills, creation of new knowledge and improve practice. A CoP is defined as a ‘group of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis’ [1].

The development of the CoP was led by the nursing and AHP simulation leads and was based on Wenger’s (2002) CoP framework [1]. Support was gained from senior management to ensure commitment and resources. Terms of reference for the group were developed with clear aims and objectives. Relevant staff across all professions were identified and invited to join. Meetings occur every two months for a duration of two hours, initially online and more recently face to face or hybrid format. Agenda items include sharing and reflections of practice, challenges and solutions; demonstrations of simulated scenarios, online learning packages and virtual reality. Guest speakers are invited to share simulation expertise and research. A Teams site is used to house information, share new developments and opportunities and to allow staff to ask questions and maintain communication between meetings.

Staff have gained valuable professional development by learning from others, sharing designs and experiences of simulated placements and learning about best practice. They have enjoyed networking and connecting with others from different professions. They have valued seeing examples of simulated scenarios and innovations and having dedicated time to reflect and discuss innovations and research opportunities. They have found it a supportive environment and a creative space. 100% of staff involved would recommend the CoP to others.

The successful introduction of a multidisciplinary Simulation CoP has enabled collaboration and development of knowledge and skills around simulated practice-based learning, including the underpinning pedagogies of simulation design and debriefing.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A55‘Who’s in charge? Me!’ Using simulation for band 5 nurses who are learning to lead
Authors: Spencer Jess , Curzen Alison , Evison Mike , Trott Chloe , Hamilton Carrie
Published: October 2023

The ‘Standards Framework for Nursing and Midwifery Education’ set out by the Nursing and Midwifery Council states that nurses are expected to develop ‘supervision and leadership skills’ [1]. However, band 5 nurses at a NHS Trust indicated their reticence about taking on ‘nurse in charge’ roles and wanted to build their confidence in engaging in challenging conversations with an assertive approach. As an education provider, we worked alongside the Trust nursing practice development team to develop and deliver a simulation-based workshop to help improve band 5 nurses leadership skills through simulated scenarios. The workshop was integrated into a leadership development day.

To encourage all nursing staff to ‘embrace their inner leader’, The Royal College of Nursing described five ways to do so – be a role model, show emotional intelligence, motivate others, create shared goals and display courage [2]. Scenarios, with actors, were developed to allow practice of these strategies whilst having difficult conversations from within a leadership role and included: listening to a colleague with personal difficulties, dealing with angry relatives, supporting a patient after unwelcome news and discussing with a clinician concerns about professionalism and kindness. Participants were provided a communication framework (STEPS: start, time, empathy, provision of support, sense check)) to assist their preparation, pacing, framing and summarizing.

Of the 12 sessions completed (

Everyone was so brilliant! I was so nervous about the simulation but (the facilitator) has been wonderful. Actors were amazing.

Facilitators have been so kind and knowledgeable.

Attending this study day has given me better confidence in my own ability to be in charge and deal with challenging situations.

STEPS has given me a very good guide in dealing with professional communication as a nurse in charge.

Live actors are very beneficial for us as it gives us real life actions to follow and deal with daily situations in the ward.

Immersive and interactive.

This simulation-based workshop developed with RCN leadership values in mind, has supported 180 band 5 nurses with their leadership roles. It has been immensely well received and has assisted these nurses in their workplaces. Based on the success of the first 12 sessions, 12 additional sessions are planned with pre and post feedback data from attendees being collated for analysis.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A63The use of simulation based education (SBE) to improve recognition and management of patients in the transition from acute to end of life care
Authors: Brundish Jane , Russell Genevieve
Published: October 2023

Recognizing and managing a deteriorating patient, in any setting, can be a challenging and distressing event for health care providers (HCPs). End of life care is a core component of nursing and medical education, yet historically has received minimal focus. Simulation Based Education (SBE) has been shown to be an effective tool for enhancing HCPs competence and confidence when involved with complex clinical scenarios and advocating patient-centred care [1]. The national drive to increase recognition and provision of timely, individualized end of life care is catalysing the need for multidisciplinary team education [2] [3].

To design, deliver and modify SBE programme to enhance quality of patient care as they deteriorate. SBE will be utilized to achieve this by increasing both confidence and competence of a cohesive multidisciplinary team when involved in the care of deteriorating patients.

Three SBE study days are held each year which are booked through an online portal. The sessions are facilitated by HCPs from intensive care, palliative medicine, and the practice development team. A handbook outlining SBE scenarios and learning objectives is distributed in advance, this pre-brief allows learners to prepare and understand the format of the day. The teaching day is structured with three clinical scenarios following a patient through different stages of their illness: initially an acute assessment and escalation, leading to consideration of individual treatment escalation plans and ultimately their end-of-life care. Learning through simulation is multifaceted through evidence-based role play, with observers as learners and collective debriefing through facilitated feedback after every scenario.

Online feedback provided by all learners has been collated throughout the four-year course development process. Evaluations revealed three main themes; learners valued SBE in terms of replicating practice, de-briefing discussions consolidated learning and enabled learners the opportunity to understand how it will improve their practice and value was placed on multidisciplinary team learning.

SBE is an effective method of enhancing the quality of individualized and coordinated care delivered to a deteriorating patient in any setting by HCPs. As an effective tool it also stands aligned with the national drive to improve recognition of patients at the end of their life with proactive advance care planning discussions and holistic care for the dying and their families.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A91Integrating Simulation Based Education to Trauma & Orthopaedic Training: A Regional Experience
Authors: Moffatt Ryan , Napier Richard
Published: October 2023

In recent years we have seen an exponential increase in the use of simulation-based education (SBE) within surgical training. Early evidence supported initial integration of simulation to Trauma & Orthopaedic (T&O) training [1] with more contemporary evidence focused on refining training methods and technology usage [2,3]. We aim to assess the integration of established as well as novel SBE components within our T&O training programme in Northern Ireland.

Simulation sessions were introduced to the Northern Ireland (NI) T&O Core Curriculum in academic year 2022/23:

Trauma Simulation Scenario Training: Pelvic trauma scenarios were delivered to all T&O specialist trainees as part of Core Curriculum teaching in a regional simulation centre. Multi-professional input was sought and delivered by Blood Transfusion Service (Major Haemorrhage Protocol training) and Urological micro-teaching session (traumatic urological injuries in setting of pelvic trauma).

Arthroscopy Simulation Course: A knee arthroscopy course was developed in conjunction with industry for all T&O trainees in NI utilizing passive haptic feedback arthroscopy simulators. Pre + post simulation surveys were completed assessing educational value, engagement with SBE as method of teaching, desire for further SBE content and suggestions for topics of same. Focus groups of lead educators were set up to plan development of further SBE training within T&O curriculum.

Trainees reported increased confidence in management of pelvic trauma. Overwhelmingly positive response to integration of SBE sessions to core curriculum with 89% in favour of further multi-specialty simulation training sessions. There was a preference seen within feedback for a variety of SBE iterations with in-situ and operative/ procedural simulation being slightly preferred to scenario-based training. With majority of trainees requesting procedural SBE training as topic for future sessions, Knee Arthroscopy Simulation Course was subsequently developed (to be delivered as part of Core Curriculum in May 2023).

From lead educator focus groups further simulation-based training sessions are planned for development in 2023/24 including shoulder arthroscopy simulation course, rare approaches simulation and advanced supracondylar simulation sessions. Feedback will be sought throughout to ensure training is tailored to needs of trainees as well as curriculum requirements. Recognition of benefits and scope of SBE training within T&O has prompted development of formal simulation trainee role as result of initial regional experience.

Our experience of integrating SBE training methods to T&O core curriculum has been hugely positive with demand amongst trainees high for a wide range of further sessions and courses.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A71Evaluation of a co-produced Simulation Based Perinatal Mental Health Programme
Authors: Hussain Labib , Malik Maaz , Cooke Jennifer
Published: October 2023

NHS England’s Long-Term Plan for Mental Health highlights need to develop PNMH services and train staff ensuring service user involvement [1]. Women experiencing PNMH disorders often initially present to non-specialist healthcare professionals (NSHCP), meaning that they need specific training in assessment and management of PNMH disorders. A co-produced and co-facilitated simulation-based training programme in perinatal mental health was developed in 2019 by Sussex Partnership Specialist Perinatal Service in conjunction with University Hospital’s Sussex Simulation team.

Primary Aim: Evaluate self-reported changes in confidence and competence of learners attending perinatal mental-health (PNMH) simulation training across multiple domains relating to assessment and management of PNMH problems.

Secondary Aims: Evaluate impact of service user co-facilitation on PNMH simulation training; Assess whether participant demographics reflect training’s target professional groups.

Service User Consultants (SUCs) were employed as faculty members and trained in simulation facilitation alongside professional faculty. Scenarios were developed in a multidisciplinary workshop, and aligned to the Health Education England (HEE) Competency framework in PNMH. Courses were co-facilitated by a Perinatal Psychiatrist and SUC. Data on participants’ confidence and knowledge across the competency framework domains was collated using a survey monkey questionnaire, pre and post-course.

242 responses were collected from participants from more than ten different staff groups e.g. junior doctors, (18%), health visitors (17%) & midwives (26%). Participant confidence improved significantly across all training domains. 93.5% of participants graded contribution of SUCs either useful or very-useful. 99.2% found the simulation training useful or very-useful, with all participants agreeing their future practice would consequently change.

The simulation-based training programme increased confidence and understanding of NSHCPs from across the PNMH care pathway, on a number of domains set by HEE PNMH competency framework. Participants were overwhelmingly in support of SUC involvement in the provision of valuable training which resembled real-life clinical encounters via scenarios.
A108Using a high-fidelity part-task model as a replacement for animal models to enhance emergency medicine thoracotomy training
Authors: Stevens Lisa , John Sini , Latheef Saleel
Published: October 2023

A local course has been delivered since 2018 to provide training in rare, time-critical, life-saving procedures that emergency medicine trainees may need to perform, including emergency lateral thoracotomy. Previously pig thoraxes have been used to provide thoracotomy training in this course. In 2022 a part-task model was purchased for thoracotomy training to replace this. We compare the use of this to animal models in our provision of simulation teaching of this skill.

Animal models are useful due to availability, low cost, and provision of hands-on experience for learners. However, there are associated ethical, religious, psychological limitations with using animals for educational purposes. They may less accurately represent human anatomy and pathology. Their timely acquisition can pose a challenge with defrosting requirements and variable condition which can impact on the quality of training. There are infection risks due to fluid leakage, associated unpleasant odour and animal products require incineration for disposal.

The high-fidelity part-task mannequin can anatomically and physiologically replicate the thoracotomy experience to provide realistic simulation training. The mannequin is equipped with realistic external human features and internal organ anatomy, including a beating heat and blood, to provide an immersive training experience. It is reusable with repair, which could be cost-effective long term and more environmentally-friendly. This model enables thoracotomy skill practice in a safe, controlled environment without infection risk. Another advantage is the ability to provide standardized training, better allowing for objective evaluation of performance which can be challenging with animal models.

This model (

The immersive lateral thoracotomy model we are using, which is fully repairable to be used multiple times for authentic learner experience

There are disadvantages to use of this model for the department, but the overall learning experience and sustainability is felt to be superior to animal models for training in emergency thoracotomy.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A96Whole System Transformed: Making Discharge Everyone’s Business
Authors: McNally Lucy , Mardon Julie
Published: October 2023

Delayed discharges are a challenge in every hospital. The Scottish Government are ‘committed to significantly reducing the number of people who are waiting to move from hospital wards to more appropriate settings [1]. This transformative simulation has been designed for all multidisciplinary team members involved in a patient’s care to engage in discharge planning; and to ‘respond to health service needs [2]. This simulation was created to break down barriers between acute and community care, reduce silo mentality and share the decision-making and risk around discharge.

Empower any member of staff to have discharge conversations.

Emphasis on early discharge conversations.

Join up acute and community staff involved in the discharge process.

The simulation involves a three-hour session with three scenarios. The session has run in both acute and community hospitals. Participants are multidisciplinary, and have included doctors, nurses, allied-health professionals (AHP), flow team, carers representatives, social workers, social care staff, home care staff and NHS Education for Scotland (NES) staff. The participants, in pairs, have a simulated conversation with a patient’s relative about discharge. The learning objectives from the scenarios are around realistic medicine, managing risk and dealing with anxious families.

To assess the immediate impact of the simulation, participants complete a pre-simulation questionnaire on arrival and a post-simulation questionnaire at the end of the session.

The results were from the pilot session pre and post simulation questionnaires in March 2023. Participants (

Prior to the simulation participants were asked ‘What makes it difficult to have these conversations?’ Themes from the qualitative answers were family expectations and managing uncertainty, both of which were learning objectives in the scenarios.

Our participant feedback has shown that this Discharge without Delay Simulation has ‘made discharge everyone’s business.’ This simulation can provide transformative change to help healthcare professionals have early discharge conversations. This provides better patient-centred care by returning the patient to a homely environment, to reduce delayed discharges and increase patient safety.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A59Midlands Simulation and Immersive Learning Census 2023: A Cross-sectional study to inform regional TEL strategy
Authors: Whittaker Joshua , Crichton Alexander , Ahmed Usman
Published: October 2023

National Health Service England (NHSE) is committed to providing the highest quality, evidence-based and sustainable Technology Enhanced Learning (TEL) to the workforce of tomorrow [1]. Over the past 20 years, simulation-based education (SBE) facilities have developed across many NHS trusts, universities, and training programmes using different models of delivery and funding to match their local needs. More recently, technological advances and a pandemic-driven need for remote and supplementary training experiences has expanded the remit of TEL.

Our objective was to complete a wide-ranging census to map simulation and immersive learning (SimImm) resources across an entire NHSE region and how these are delivered. Most importantly, we aim to gather stakeholder opinions on the perceived challenges faced by the SimImm community in the coming 3-5 years.

In December 2022, we launched a multi-phased regional online survey of SimImm providers. Phase one distribution included members of the two regional simulation networks. Phase two was distributed to simulation leads for postgraduate schools, training programmes and higher education institutions. Throughout, other stakeholders in the SimImm community had the opportunity to complete the ‘future challenges’ section only.

35 organizations had completed the full census, with a further 47 stakeholders completing the ‘future challenges’ section. Of the full census, 14 were secondary care simulation centres, 18 training programmes and 3 universities. The most common resources used were High-fidelity simulation (

Thematic analysis of the ‘future challenges’ section, revealed 5 primary areas of perceived challenges: Faculty development, maintenance, and retention; resources funding; collaborative working; strategy and equitable opportunities and adoption of new technology.

Provisional results already demonstrate a huge variety of resources which are distributed widely across the region. Many of these are not necessarily in contact with regional simulation networks, particularly individual training programmes. The stakeholder opinions collated through this exercise will form the bedrock on which regional SimImm strategy and decision-making can be based.

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
Exploring Science Learning Anxiety in the New Normal - An Exploratory Factor Analysis
Authors: Degorio Niño Jay D , Diaz Patricia Anne Nicole E , Ando Clauden V , Diquito Tomas Jr A , Panerio Conrado Jr
Published: October 2023

This study utilizes descriptive and exploratory research design to determine the factor structure of science learning anxiety in the new normal. Qualitative data collection was carried out first by interviewing twenty (20) participants from different strands of the Senior High School department of UM Digos College. The identified items were transformed into a questionnaire for the quantitative phase and implemented to the two-hundred thirty-five (235) Senior High School students. Statistically, four factors of Science Learning Anxiety in the new normal were explored, these are; Attitude, Learner’s Interaction Towards Assessment and Activities, Learning Environment, and Disappointment. From this result, conducting a confirmatory analysis is recommended to confirm the dimensionality of science learning anxiety in the new normal and to review the explored factors in different contexts.
Monoclonal antibody utilization in medical college, Kolkata: A retrospective study
Authors: Roy Monalisa , Gangopadhyay Tanmoy , Nath Sarmila , Sarkar Suhena , Nandy Manab
Published: October 2023

Background: The introduction of monoclonal antibodies (mAbs) in therapeutics has permitted targeted treatments for various diseases. As the utilization of mAbs continues to grow, understanding their drug utilization patterns becomes crucial for optimizing treatment strategies, improving patient outcomes, and ensuring cost-effectiveness in health-care systems. However, there is limited information on the real-world utilization patterns of mAbs in clinical practice. This retrospective study aims to analyze and summarize current knowledge on the drug utilization of mAbs.

Aims and Objectives: The primary objective of the study is to analyze the utilization of mAbs across four departments (medical oncology, hematoncology, radiation oncology, and rheumatology) of Medical College, Kolkata. The secondary objective is to study the cumulative change in trend in the utilization of mAbs in these departments over the last 3 years (2020–2023).

Materials and Methods: A retrospective analysis was done by collecting relevant data on mAb use in four disciplines (medical oncology, hematoncology, radiation oncology, and rheumatology) from electronic health records and pharmacy databases. The study included patients who received mAb therapy between June 01, 2022, and May 31, 2023. The collected data included demographic data of the patients and data on mAb, including utilization patterns (frequency, duration, and indications for mAb use). Changes in the pattern of usage of mAbs, if any, across the preceding 3 years (2020-21, 2021-22, 2022-23), were also assessed. Descriptive data has been represented in percentages.

Results: The commonest indications of mAbs across the four departments were chronic lymphocytic leukemia, breast carcinoma, and ovarian carcinoma in hemt-oncology, radiation oncology, and medical oncology departments, respectively. Rituximab, trastuzumab, and bevacizumab were identified as the most frequently prescribed mAbs in the mentioned departments. It was also observed that total consumption of mAbs has significantly increased over the last 3 years.

Conclusion: This retrospective study provides insights into the drug utilization patterns of mAbs in a real-world clinical setting.
INTEGRAÇÃO DAS AÇÕES DE VIGILÂNCIA EM SAÚDE: IMPLANTAÇÃO DOS NÚCLEOS REGIONAIS DE VIGILÂNCIA EM SAÚDE NA SECRETARIA DE ESTADO DA SAÚDE PÚBLICA DO RIO GRANDE DO NORTE
Authors: Tritany Érika Fernandes , De Souza Filho Breno Augusto Bormann , Melo Deborah Zuleide de Farias , Da Silva Márcia Andréia Pereira , Dos Santos Bruno Sueliton , Lima Adila Lorena Morais , Costa Daniella Mylena Paiva de Oliveira , Maia Kelly Kattiucci Brito de Lima
Published: October 2023

Objetiva-se descrever a experiência de organização do Ciclo de Oficinas de Vigilância em Saúde da Secretaria de Estado da Saúde Pública do Rio Grande do Norte (SESAP-RN). As oficinas foram realizadas virtualmente e objetivaram apresentar proposta para implantação dos Núcleos Regionais de Vigilância em Saúde (NUREVS) no estado do Rio Grande do Norte (RN). Utilizaram-se metodologias ativas para estimular a participação dos profissionais. As oficinas demonstram-se espaços potentes para reflexão e construção coletiva; e conduziram a implantação dos NUREVS nas Regiões de Saúde do Rio Grande do Norte.
Analysis of academic norms and copyright cognition of scientific and technological journals: Questionnaire survey based on authors and editors
Authors: Yu Jing , Wu Jiajia , Qi Fangfang , Sun Huilan , Xu Jie
Published: October 2023

Background: Clarify the connection and difference between academic norms and copyright, to provide a reference for constructing an academic ethics system. Methods: This study designed a questionnaire through expert interviews and adopted a closed-question approach. The questionnaire adopts closed-ended questions, with single-choice questions and multiple-choice questions. Publish questionnaires on the Questionnaire Star platform and disseminate them through WeChat Moments, WeChat Groups, WeChat Side-text, and QQ. A total of 256 people submitted questionnaires. Results: Among the participants, 128 (50%) were editors, 89 (34.77%) were teaching and research posts, and 39 (15.23%) were graduate students. Most of the interviewees are not clear about the concept of academic norms and copyright, especially the senior teaching and research workers. However, most of the interviewees can sensitively detect that the case has academic misconduct, but it is not clear whether the case of academic misconduct violates academic norms or copyright. Conclusions: Editors of scientific and technological journals should particularly grasp the concepts of both, accurately grasp academic norms when reviewing manuscripts, propose reasons for using or not using manuscripts, build a defense line for purifying the academic environment, and provide better publishing platforms and management services for researchers.
Non Suicidal Self-Injurious Behavior And Emotional Dysregulation Among College Students: Karnataka India
Authors:   Department of Psychiatric Nursing, Institute of Nursing, Brainware University,  Kolkata, West Bengal, India, Samanta Manisha
Published: October 2023

Background: It is necessary to understand that self-harm is the most common behavior in both suicide and non-suicidal self-injury (NSSI) though those are not interrelated. Both result in physical damage to better or cope, whereas behaviors related to suicide are undertaken to end the capacity to feel at all by ending one’s life. Aim: The aim of the study was to explore NSSI behavior and emotional dysregulation among college students and find relationship between NSSI behavior and emotional dysregulation. Methods: A descriptive cross-sectional survey was carried out and total 896 college students were selected by multistage cluster sampling method from one district of Karnataka, India. The data was collected using FASM and DERS tool. Results: The study revealed that 21.9% of the participants were found to have NSSI behavior. Participants were having both minor behavior (66.84%) and severe behavior (71.94%) of NSSI. Mean age of onset of NSSI behavior was 16.88 years. The present study found significant relationship between NSSI behavior and emotional dysregulation (t value: 4.19, p value: <0.01). Participants were having emotional dysregulation with mean value of 100.32. International Journal of Scientific Research in Engineering and Management (IJSREM) Volume: 07 Issue: 10 | October - 2023 SJIF Rating: 8.176 ISSN: 2582-3930 © 2023, IJSREM | www.ijsrem.com DOI: 10.55041/IJSREM26329 | Page 2 Conclusion: The findings of the study show the need to increase the awareness and understanding of NSSIs and to plan targeted interventions among college youth. An information booklet on emotion regulation strategies was developed by the researcher to improve students’ knowledge and awareness. Keywords NSSI (Non-suicidal self-injury), Emotional dysregulation, FASM (Functional Assessment of Self-Mutilation) questionnaire, DERS (Difficulties in Emotional Regulation Scale)
The Implications of Human Identity Chips
Authors:   Institute of Distance and Open Learning Vidya Nagari, Kalina, Santacruz East – 400098. University of Mumbai, Rahul Rahul
Published: October 2023

In an era characterized by rapid technological advancements, the concept of implanting identity chips in humans has emerged as a topic of significant interest and debate. This abstract provides an overview of the multifaceted implications associated with the implementation of human identity chips. These chips, embedded under the skin, are designed to securely store personal and biometric data, ultimately offering a seamless and secure means of verifying one’s identity. While proponents argue that this technology could enhance security, streamline transactions, and revolutionize healthcare, critics raise concerns about privacy, surveillance, and potential misuse. This paper explores the various dimensions of human identity chips, from their technical aspects to their ethical, legal, and societal consequences. It aims to shed light on the potential benefits and risks associated with this technology, offering a foundation for informed discussions and policy decisions in an increasingly digital and interconnected world. Key Words: Identity chips, Biometric data, Implantable technology, Security, Privacy, Surveillance, Ethical concerns, Legal implications, Society, Technology adoption, Healthcare, Data protection, Human augmentation, Authentication, Biotechnology, Social impact, Personal data, Regulatory framework, Information security, Technological ethics.
Isolation of Lactic Acid Bacteria (LAB) from Mimosa pudica (Semalu) for Production of Bacterial Cellulose
Authors: Min Lim Bei , Zakaria Junaidi , Mortan Siti Hatijah , Mohamad Shahril , Ab Rahim Mohd Hairul
Published: October 2023

Bacterial cellulose (BC) is a potential eco-friendly biopolymer. BC has higher crystallinity and purity compared to plant cellulose. Scientific studies on the production of BC from lactic acid bacteria (LAB) are minimal compared to other common bacteria such as Acetobacter xylinum. LAB was screened and isolated from different tissues of Mimosa pudica (medicinal plant) using MRS broth and agar as the selective medium. LAB isolates were subjected to 16S rRNA gene sequencing of all the bacterial isolates. BC was produced from all LAB isolates by incubating at 30 °C for 14 days in herbal tea medium (Strobilanthes crispus) and HS medium (control) with 130 r.p.m agitation. BC produced by two selected bacterial isolates was characterized using FESEM, FTIR, XRD, and TGA. Molecular analysis of the 16S rRNA gene of all the potential LAB isolates shows 99.86 - 100% identity to 16S rRNA sequences of other Lactobacillus plantarum strains. Two selected L. plantarum strains (LBM001 & LBM004) produce BC in sphere-like particles with a 1.4 to 2.2 µm diameter range of microfiber. FTIR analysis shows that BC produced by LBM001 and LBM004 have four similar cellulose regions identified in cellulose from other sources, which are O-H stretch (3400-330 cm-1), C-H stretch (2970-2800 cm-1), O-H bending (1620cm-1) and C-O-C stretch (1100-1073 cm-1). XRD analysis shows BC produced by the L. plantarum strains consists of two different XRD peaks at the 2θ angle of 21.53° and 21.85° instead of a single peak (22.76°) identified in the BC produced by A. xylinum and plant cellulose. A similar TG and DTG curved pattern was detected in the BC produced by the L. plantarum strains with the BC produced by A. xylinum and plant cellulose. The LAB isolates from M. pudica have potential in BC production based on the multiple characterization studies.