bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Performance of Stock and Sharia Stock
Authors: Sari Kharisma Novita , Maenadi Debi , Mutamimah Mimah , Maslihatin Maya Zulfa
Published: October 2023

The purpose of this study was to examine the differences in the performance of Islamic stocks with stocks based on the Sharpe and Jensen method for the 2010-2020 period in the Indonesian Capital Market. The research method is using a quantitative approach with the type of comparative research. The data used is secondary data from OJK. The population used in this study is the capitalization of sharia stock performance data compared to stocks, for the 2010-2020 period (monthly data) in the Indonesian Capital Market. Data analysis was carried out using the Sharpe and Jensen method and the Manova test with the help of the SPSS statistical program. The results of this study indicate that the performance of Islamic stocks with stocks has a significant difference and the performance of Islamic stocks is better than stocks based on the Sharpe and Jensen method. This shows that the return on the performance of sharia shares with shares based on the Sharpe and Jensen method that will be received will be relatively different. The implication of this research is that this research can contribute to the general public, both academics, investment players and the general public so that they better understand the performance of capital market investment instruments before they invest.
Ferricretes em arquivos fluviais quaternários: desdobramentos para a dinâmica fluvial recente no Quadrilátero Ferrífero/MG
Authors: Barros Luiz Fernando de Paula , Oliveira Fábio Soares de , Magalhães Júnior Antônio Pereira , Cota Guilherme Eduardo Macedo
Published: October 2023

Estudos anteriores mostram a ocorrência regional de ferricretes associados a sedimentos aluviais quaternários no Quadrilátero Ferrífero. Esses estudos também apontam que os ferricretes podem ter retardado a dissecação fluvial em alguns vales e que elas não se formam nas condições atuais. Para testar essas hipóteses, este estudo realizou novas análises nos vales dos rios Conceição e Mango. Amostras indeformadas de ferricrete foram coletadas para caracterização micromorfológica e amostras de sedimentos foram datadas por Luminescência Opticamente Estimulada (LOE). Os resultados confirmam as hipóteses anteriores. No vale do Rio Conceição, verificou-se que houve um longo tempo de acumulação no nível deposicional com ferricretes ainda encontrado no fundo do vale, em contraste com uma planície de inundação muito jovem e sem ferricretes, situação análoga à do vale do Ribeirão do Mango. As diferenças em termos de preservação do ferricrete em relação ao nível da água do Rio Conceição e a identificação de uma nova microestrutura de ferricrete no vale do Ribeirão do Mango mostram que esses materiais estão em lenta transformação e degradação, e não em construção.
Dörflinger, Bernd; La Rocca, Claudio; Louden, Robert; de Azevedo Marques, Ubirajara Rancan, Kant's Lectures / Kants Vorlesungen, Walter de Gruyter, Berlín, 2015. ISBN 978-3- 11-035147-7
Authors: Herszenbaun Miguel Alejandro , Martínez Luciana
Published: October 2023

Dörflinger, Bernd; La Rocca, Claudio; Louden,Robert; de Azevedo Marques, UbirajaraRancan, Kant's Lectures / Kants Vorlesungen,Walter de Gruyter, Berlín, 2015. ISBN 978-3-11-035147-7
Schiller crítico de Kant?
Authors: Pires Carlos Eduardo Moreno
Published: October 2023

Neste artigo, buscaremos mostrar que os epigramasas Escrúpulos da Consciência e Decisão não devem ser tomados como uma crítica por parte de Schiller à tese kantiana sobre o valor moral das ações moralmente exigidas, tal como apresentada nos famosos exemplos da primeira seção das Fundamentação; também não devem ser interpretados como uma forma de crítica à psicologia moral de Kant, mais exatamente, à sua teoria sobre a motivação moral. Ao invés disso, veremos que aqueles famigerados epigramas são uma espécie de sátira não da filosofia moral kantiana, mas de uma interpretação equivocada da mesma, muito difundida já à quela época.
O que exatamente o "eu penso" tem que poder acompanhar? Revisitando a dedução transcendental das categorias
Authors: Costa Rego Pedro
Published: October 2023

Partindo de uma análise gramatical da conhecida primeira frase do §16 da Crítica da Razão Pura, proponho uma discussão sobre o sentido em que se deve compreender o objetivo do projeto da dedução transcendental das categorias avaliando e contrapondo duas teses interpretativas sobre no que consiste uma prova da validade objetiva das categorias. Em última instância, trata-se de investigar em que medida a prova dessa validade objetiva atenta contra o pilar crítico-idealista da irredutibilidade e independência dos poderes cognitivos receptivo e ativo, e em que medida a salvaguarda desse princípio de independência condena por antecipação ao fracasso o projeto de provar uma conexão necessária e a priori entre receptividade e espontaneidade.
Kant versus Constant: Sobre um suposto direito de mentir
Authors: Klein Joel Thiago
Published: October 2023

Neste artigo apresenta-se uma nova interpretação do ensaio de Kant Sobre um suposto direito de mentir por amor à humanidade (1797). Sustenta-se que a filosofia moral de Kant em sua totalidade e de maneira mais específica no ensaio escrito contra Constant rejeita, por um lado, definitivamente a possibilidade de se falar de um direito à mentira, por outro lado, permite legitimar a mentira como uma atitude de um agente moral prudente no caso desenhado por Constant.
A54Co-produced scenario-based simulations: Respect for, and understanding of, those from transgender and gender diverse communities
Authors: Hamilton Carrie , Miller Julie , Spencer Jess , Tomkins Caroline
Published: October 2023

In July 2018 the government launched the national LGBT action plan to advance the rights of LGBT people to improve the way that public services work for them, regardless of their sexual orientation, gender identity or sex characteristics [1]. Transgender and gender diverse (TGD) [2], individuals continue to experience discrimination and disadvantages in accessing healthcare whilst often having complex health needs, furthermore, there is a gap in undergraduate curriculums on TGD patient care [3].

A workshop was co-produced with members of the TGD community; scenario content was translated from their own experiences of prejudice and disrespect. In order to maximize participation, the scenario is delivered through forum theatre. It centres on an individual from the TGD community (played by a trans-actor) and the assumptions of a health professional (played by an actor). Audience members watch the scenario unfold; at closure of the first run through, the audience have a facilitated discussion. During the second run through, audiences are invited to change the behaviour of the health professional, leading to preferable, respectful and safe care. The actors have been trained to amend their actions as instructed by the audience members via the facilitator. After the simulation, the trans-actor de-roles and then describes the journey of transitioning their gender identity and presentation. The simulation and the lived experience are separated and treated as two separate elements of the training.

The co-produced scenario-based simulation has been successful in promoting respect and understanding of those from the TGD community. Audiences have been a broad range of professional groups: vocational, undergraduate and registrants. This session has been repeated over fifty times, with changes made to suit the audience background. Health professionals have had the opportunity to learn and practice appropriate communication skills. The lived experience component post-simulation was impactful in providing a personal insight into the challenges faced by TGD individuals. Participants reported an increase in knowledge of the needs of, and confidence in communicating with, members of the TGD community.

The co-produced, replicable, scenario-based simulation, featuring forum theatre and lived experience, is an effective method of promoting respect and understanding of those from the TGD community. The simulation provides healthcare professionals with the opportunity to learn and practice appropriate communication skills. Separating the simulation with lived experience is an essential component, due to ethical and safety issues, although linking the two, strengthens the authenticity of the session.

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.
A32Towards a taxonomy of scale: a sustainable approach
Authors: Rolfe Ursula , Holley Debbie
Published: October 2023

Background and aim:

Taking simulation from concept through to scalable delivery is complex, contested and an under-theorized process. The traditional approaches to scaling innovations, proposed by Everett Rogers in the 1960s is the notion of diffusion of innovation; we argue that this is of limited use in our context of working with NHS health professionals supporting their learning post-covid. Our approach to scaling draws the upon the well-tested seminal works on taxonomies by Coburn (2003) [1] and her dimensional framework, Dede et al (2007) [2], with their educational scaling model, plus the systematic review of Greenhalgh et al (2004) [3] in health services.

Activity:

By considering the ways in which our eight Health Education England (HEE) simulation projects have been delivered, this work presents an emerging framework, designed to enable the orchestration of team discourse about theory, the production of simulation artefacts as tools for design discourse and the identification of scalable systemic pain points. We pay particular attention to scaling innovations in practice and organizational change, which are in our view enabling factors in the sustainable adoption of learning technologies by end users in the workplace.

Findings:

Successful scaling is more than just being about the number of users we can reach. It requires underpinning by an understanding about the changes in practice an innovation can bring about, and how valuable these changes are to stakeholders. Challenges remain as to whether such changes can be sustained over time, and the extent to which users and stakeholders are involved in co-creating the innovation. Individuals within the organizations – and their attitudes, beliefs, and habits – play an equally important role in exploring new technologies and practices with an open mind and perceiving these as an added value in their work environment and daily routines.

Conclusion:

This work illustrates the need to strategically involve the ‘missing middle’ and starts to identify the key role these people play in that space between where scaling factors reside between top-down strategy and bottom-up initiatives.

Ethics statement:

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.
A86Using Value Based Simulation to recruit high school students into the more difficult to fill roles within health and social care – contact author (Carla)
Authors: Dickson Jamie , Mardon Julie
Published: October 2023

Simulation based education (SBE) has been used to help attract school students into healthcare previously but commonly this is in a try it and see format using manikins to gain insight into history taking or physical examination. Also traditionally we tend to focus on more traditional healthcare professions such as nursing medicine and physiotherapy as common examples.

In our region we have been working closely with our national youth academy looking at novel ways to attract and recruit our young people into more difficult to fill roles within health and social care such as home care roles and healthcare support worker roles.

There are many good examples across the general workforce where simulation training can aid successful transition into the work place [1]. We are aware that certain areas of health and social care are more difficult to recruit to and wondered if values-based simulation could aid successful recruitment in this area?

An immersive simulation session was designed based on 2 scenarios with space for reflection on who am I and what matters to me as a human. The first scenario was based on a reablement opportunity and focussed in on mutual goal setting giving space to express needs in the social care environment. The young learner was able to explore what skills they had and whether they were true to their own values. The second scenario was based in a hospital and looked at a health care support worker accompanying a patient to theatre. The school students had a chance to practice active listening and looking after a person who was anxious. It was amazing to see the skill set that the young people brought to both scenarios.

The session has been delivered in schools, colleges and a national event. There are plans to bring the immersive simulation session to recruitment fairs.

The take home messages from the sessions have been in alignment with the individuals and social care core values reflecting compassion, motivational techniques and mutual goal setting. Comments such as ‘I am astonished that I could make a difference to that person’ and ‘I hadn’t thought about a career in social care before but now I know how rewarding it feels I’m considering it’ reflect these findings. We will also look at the effect on recruitment as we roll out and scale up the work.

Immersive simulation respects the young person’s core values when enabling them to make meaningful and lasting choices about careers in health and social care.

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.
A80Simulation: a tool to improve the confidence of International Medical Graduates transitioning into working in the NHS
Authors: Jones Samuel , Premchandran Divya , Smalley Benjamin
Published: October 2023

International medical graduates (IMGs) are doctors that have graduated from a medical university outside of the UK and subsequently employed by the NHS. The transition to working within the NHS presents them with many new challenges including communication, cultural differences, healthcare system differences, NHS policies and UK legal frameworks, and the expectations attributed to a doctor practicing in the UK. They often commence work with little training about these practical challenges and as a result encounter a steep learning curve. IMGs are significantly more likely to receive complaints and face fitness to practice investigation [1]. Therefore, developing educational opportunities to help them adapt to working in the NHS is a necessity.

Simulation has been shown to improve the confidence, knowledge and provides an ethically and educationally safe setting for doctors to develop their practice [2,3]. We therefore created an IMG oriented simulation programme that focussed on some of the key challenges they face.

We delivered simulation sessions on four separate days with 6-8 IMG candidates at each. Sessions consisted of two clinical scenarios divided into sections, approximately 20 minutes long, each targeting a key educational outcome. We used a combination of a computerized simulation manikin (SimMan Essential) and live actors. Key educational outcomes included managing an acutely deteriorating patient, escalating to a senior, obtaining a collateral history, breaking bad news and duty of candour. Each candidate had the opportunity to participate in a part of the simulation whilst the others observed. The candidates were then debriefed and learning objectives explored by a trained faculty member. The candidates were asked to complete pre-simulation, immediate post-simulation and 3-month post-simulation feedback forms using a nominal Likert scale. They scored 1-10 (10 being ‘strongly agree’) on their confidence around each component of the educational outcomes.

We had 21 candidates complete the simulation day, with 19 responses to the immediate post simulation survey and 9 responses to the 3-month post simulation survey. The results showed a significant increase in the confidence of the candidates for each educational outcome, with mean scores increasing from 6-7 to >9. We also demonstrated that the candidate’s confidence remained and they were still using the skills they had learned 3 months later.

We have demonstrated that IMG oriented simulation is a valuable educational tool for doctors transitioning into working within the NHS. Confidence around a variety of difficult topics increases and the lessons learned have a lasting impact.

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.
A100Simulating to manage post thyroidectomy haematoma safely: Improving fidelity whilst reducing cost
Authors: Vale Owen , Hadfield Andrew , Maidment Catrin , Huckle Danielle , Diaz-Navarro Cristina
Published: October 2023

Simulation training sessions were designed at the University Hospital of Wales in order to implement the new national guidelines for the management of suspected haematoma following thyroid surgery [1].

Opportunities included on site portable training with a part task trainer and high-fidelity scenarios simulating patient deterioration following thyroid surgery in an immersive environment.

Our initial design for the high-fidelity set-up included a simulated neck haematoma achieved by using a second generation supraglottic airway device (SAD) with an inflatable cuff placed in the manikin’s neck with the laryngeal opening outwards and tubing inside the chest. The opening was filled with red jelly, covered by simulated strap muscles (made from simulated small bowel with interrupted sutures) and simulated neck skin (which presented a sutured incision complete with steri-strips). Ongoing bleeding was simulated by injecting liquid jelly through the SAD’s gastric port via a long connecting tube in the manikin’s thorax.

This simulation training increased confidence and familiarity with the steps required to manage post thyroid surgery haematomas in 100% (15/15) of candidates, with 73% grading the mannikin ≥4/5 for realism. However, it was costly to provide and time-consuming to set up.

It was decided to try to make the set-up cheaper and easier to reproduce without impairing quality.

Equipment costs were reviewed and alternative options identified. Expensive components included the SAD and bowel material, which were replaced with a cheaper SAD and a disposable tourniquet fashioned as shown in

Making the simulation larynx and strap muscles. A step by step guide

The cost of disposable props used in each session was reduced from £133.04 to £8.52 with the new equipment. The designers also felt it was significantly more robust and easier to reproduce. This approach could also be easily adapted for mobile part-task training, improving multi-disciplinary access to training.

Feedback showed 47% of candidates felt the new set-up to be better, and 47% reported non-inferiority.

Changing to new equipment resulted in a design that was significantly cheaper, easier to source and set-up, while being at least as realistic and offering training opportunities outside the high-fidelity environment.

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.
A24Calculating the cost of simulation based education. What to include?
Authors: Byrne Dara , Fitzgerald Laura , O’Dea Angela
Published: October 2023

Background and aim:

The cost of developing simulation-based education (SBE) facilities is high. However, the cost of sustaining SBE activities is often not considered in the initial outlay and facilities and centres can find themselves in financial difficulty early on. In addition to the cost of the initial capital and technology costs, there are many other costs incurred when running and sustaining SBE programmes. These are often not apparent or considered by simulationists when establishing new programmes. Research to date has focused on cost effectiveness and a return on investment [1]. However, the sustainability of a SBE programme is related to the ability to meet these costs. The aim of this work is to develop a simulation cost calculator that considered all costs incurred in skills programme development.

Methods:

Following consultation with experienced simulation faculty, the finance office, human resources and buildings office and equipment providers, a cost calculator template was devised to categorize the items required for SBE. The template allows for the calculation of the cost of teaching a procedural skill per person based on the total cost of all of the items in the template plus the number of attempts required for teaching and/or assessment.

Results:

The cost calculator categories for procedural skills teaching in a simulated environment included recurrent costs such as heating, light and cleaning of the simulation space/facility, consumables, single use simulators, fixed equipment/initial outlay, waste disposal, depreciation costs and staff costs. To illustrate, the calculated cost for a bowel anastomosis workshop using biological materials is approx. €235 per person while the equipment cost for a basic skill such as venepuncture is €161.17.

Conclusion:

Adequate resourcing is critical to establish, run and sustain SBE programmes. A cost calculator template will help new facilities to project their budget requirements and to decide what skills education they can support and sustain long term.

Ethics statement:

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.
A62Mini in Disruption, Major in Impact: The Use and Sustainability of ‘Mini-Sims’
Authors: Tang Cary , Tarhini Mariam , Wilson Esther , Hester Benjamin , Redwood Vanessa , Duzy Ashley
Published: October 2023

Simulations can be important for wider learning and patient safety [1]. However, the delivery of traditional simulations is not always feasible [2]. We developed an alternative ‘Mini-Sim’ to deliver high quality teaching with a sustainable approach, aimed to save time and resources.

The simulation team delivered traditional ward-based simulations every Wednesday. Where this was not possible, due to timing or staffing constraints, we delivered ‘Mini-Sims’. This involved participant verbalizing their assessments to a pre-written scenario with a facilitator asking follow-up questions as opposed to physically acting out. Data collected over 5 months included the type and duration of simulation, how many participants were involved, and resources required.

Across the 5 months, between 0 to 16 participants were reached monthly using traditional simulations, whereas ‘Mini-Sims’ reached 4 to 14,

Comparing participant numbers from ‘Traditional Sims’ with ‘Mini-Sims’ delivered between October 2022 to February 2023

Where resources and time are limited, the minimalistic approach of ‘Mini-Sims’ provide consistent teaching opportunities and promotes sustainability in man-power, time, and costs. Whilst humble in appearance, ‘Mini-Sims’ show sizeable potential for sustainable learning.

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.
A37Does simulation-based training increase perceived confidence to address demanding communication situations within critical care?
Authors: Jones Kathleen , Bonasera Simone , Flores Nicole , Murie Samantha
Published: October 2023

Background and aim:

Training nurses to improve their ability and confidence to communicate effectively in difficult situations is beneficial [1]. Simulation is an effective method to replicate difficult communication situations with colleagues, family or patients and improves communication skills [2]. Iyasere et al., (2022) [2] determined improving perceived confidence to communicate increased team-performance specifically amongst nurses. The main purpose was to evaluate the effectiveness of using simulation-based communication scenarios to improve critical care nurses’ perceived confidence to communicate in difficult situations.

Methods:

Fourteen (Band 5 and Band 6) critical care nurses attended three sessions of communication simulation. Participants were invited based on manager feedback either requiring improved communication or demonstrating excellent communication skills, an equal number from both spectrums attended each session. A diamond debriefing model was used after each scenario as the debriefing model provides reflection resulting in improved practice [3]. Debriefing was conducted by training simulation faculty. A survey was used to measure perceived confidence and ability to communicate in three difficult situations: escalating concern, next-of-kin communication (NOK) and colleague interaction. The survey was presented pre-, post-simulation and at six-weeks post.

Results:

Results showed an increase in confidence and ability to communicate in all three communication situations, as shown in Figure 1-A37. The largest improvement was within NOK communication, increasing from 6.73 to 8.77 (1-10 scale), the smallest change was ‘ability to escalate a concern’, however pre-simulation it achieved the highest level of confidence. Six-week post scores remained higher than pre-session ratings in all situations, but did drop slightly from post-session. Difficult communication with a colleague had the lowest score at each measurement interval.

The average rating (1-10) of perceived confidence in each simulation element, at each interval

Conclusion:

Simulation-based training is an effective method to increase Critical Care nurses perceived confidence to communicate in demanding situations. Communication situations involving colleagues remains the most challenging communication scenario for nurses. Improving confidence to communicate is essential to effective team working and patient-centred nursing practice. Further study is needed but initial results suggest the method is beneficial to improve critical care nursing practice.

Ethics statement:

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.
A9Immersive Technology Experience Measure (ITEM): pilot study on participant experience using novel questionnaire and VR scenario
Authors: Jacobs Chris , Vaidya Kriti , Old Tim , Medwell Lauren
Published: October 2023

Background and aim:

A scoping review identified a significant growth in research with immersive technology in healthcare education. However, there are few validated measures that capture the user experience of participants [1]. This study aims to investigate the use of an immersive virtual reality (VR) simulation on sepsis management and measure user experience using a validated tool, the Immersive Technology Evaluation Measure (ITEM) [2]. ITEM was formulated on a learning theory called Model for Immersive Technology in Healthcare Education (MITHE), which borrows cognitive and behavioural theories to help explain our level of immersion and enjoyment that can be facilitated by technology (see Figure 1-A9).

Model of immersive technology in healthcare education (MITHE)

Methods:

This single-study quasi-experimental investigation was conducted at a single site. Nine participants were recruited, consisting of medical students and healthcare professionals. Participants were trained on varied immersive devices: sepsis management using an immersive VR simulation developed by Gogglemind, and augmented reality (AR) holographic patient with respiratory distress, which included realistic patient scenarios and interactive decision-making. User experience was measured using the ITEM, which assesses user; immersion, cognitive load, intrinsic motivation, debrief and technology usability.

Results:

Nine participants had high levels of immersion (mean 39.6, total 50), high levels of intrinsic motivation (mean 39.6, total 50), high technology score (mean 79.4, total 100), optimum cognitive load (average 59.5, optimum 39–61) and moderate score on debrief (mean 18.1, total 25). ITEM subscores indicated an enjoyable and immersive experience with good technology interface on usability scores. Self-directed debrief in VR had lower scores with emotional considerations and identifying domains of performance and learning.

Conclusion:

The use of the ITEM provided valuable insights into the user experience of the VR simulation, which can be used to improve the design and implementation of future simulations. This contributes to an ongoing ITEM validation process. This study highlights the importance of training in healthcare and the potential benefits of using immersive technologies such as VR and AR simulations.

Ethics statement:

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.
A15Video review after simulation-based education – perception of participants
Authors: Batcha Mohammed , Makker Ratna , Winnett Georgia
Published: October 2023

Background and aim:

Simulation debriefing plays an important role in knowledge synthesis [1]. Although there is evidence to suggest that video-assisted debriefing improves outcomes, at least in nursing simulations, there is a wide variability in the practice and perceived effectiveness of video-assisted debriefing [2,3]. There is a paucity of literature about participants’ perspectives on the use of video review for simulation debriefing. The aim of this study is to explore participants’ perceptions and experience of the use of video review post-simulation.

Methods:

The study received ethical approval from the ethics committee at Anglia Ruskin University. We used qualitative research methodology to answer our research question. Foundation year trainees attending simulation as part of the curriculum were included in the study. This study involved focus group interviews with simulation participants prior to their simulation-based education. Post-simulation training, participants reviewed their simulation video clip in their own time and filled in a structured qualitative questionnaire about their video review experience.

Results:

This is an ongoing research and initial results are presented here. Data were collected from 13 participants over a period of 3 months from February 2023 to April 2023 in the simulation centre of a tertiary teaching hospital in the UK. The audio recording and the questionnaire were pseudonymized and analysed using inductive thematic content analysis. Important themes identified were the emotional aspects of watching their video, the learning opportunities available with video review, level of support needed for video review and ideal time to review the video. Unexpected emergent themes included foundation doctors’ views about simulation education, reflective practice post-simulation and peer pressure during simulation.

Conclusion:

This study explored foundation trainees’ perceptions (cognitive, kinetic and affective) about video review after simulation and several interesting themes were identified. We believe this study adds value to simulation-based medical education in helping to understand foundation doctors’ views about simulation and video-assisted debriefing.

Ethics statement:

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.
A30Safe Interdepartmental Learning from clinical incidents using a Quality Improvement Framework
Authors: Kaja Mohammad Rasheed , Jones Nicola , Khan Zilley
Published: October 2023

Background and aim:

Mistakes are an inherent learning opportunity within healthcare that can be used to prevent future loss of lives and reduce suffering. We aim to create a safe learning space within our organization that can be embedded within our quality improvement (QI) process.

Methods:

We have designed a bespoke framework (Figure 1-A30) to integrate our organizational QI process [1] with a 6-month iterative simulation programme. This utilizes multidisciplinary co-creation, embedded faculty development, and reflective practice to facilitate learning from each other.

Safe Interdepartmental Learning with a Quality Improvement Framework

Our tertiary hospital clinical governance team in collaboration with the multi-professional education, simulation, and patient safety departments has identified 5 topics based on the root cause analysis of serious clinical incidents. This description from our recent cohort involves the recruitment of 5 different specialty teams, each consisting of 1 experienced consultant faculty and 3 other facilitating clinicians with different levels of experience in healthcare simulation.

The teams prepared and designed the most suitable clinical scenario progression to address the learning objectives based on their allocated topics. Learner and peer feedback along with reflections on the session, highlighted possible change ideas to modify the subsequent scenario running. Over a period of 6 months, different learner sets were involved in the same simulation exercise with 2 further iterative modifications.

Results:

The 5 teams have generated a total of 15 hours of simulation sessions using standard pre-briefing, debriefing, and evidence-based simulation techniques. The level of independent facilitation and mentoring by more advanced debriefers has been adjusted to fit the individual pace of experiential learning. To further enhance the embedded faculty development a total of 270 minutes of online discussion, reflections, and 15 topics were presented by the facilitators to create a multi-professional learning experience. The content was structured to reflect the national outcome’s framework for faculty development and the ASPIH standards guidance for simulation-based education. The recorded simulation sessions, debriefing, and topic discussions have generated a useful asynchronous online reference for the current and future cohorts.

Conclusion:

The feasibility of implementing this simulation programme integrated with a QI framework is a major step for our future prospective evaluation of the impact of translational simulation as theorized in the current literature [2] on patient outcomes and healthcare performance indicators.

Ethics statement:

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.
A72Using Simulation as a Method of Assessment in Further Education
Authors: Sunderland Ann , Weeks Rebecca
Published: October 2023

While the use of simulation-based education (SBE) is embedded within clinical courses delivered in higher education, it’s use within further education is extremely limited, leading to a perception that students may be at a disadvantage, particularly those from a neurodiverse background, where kinesthetic learning is their preferred style [1]. The same principles also apply to assessment. Supported through funding from the NCFE (originally known as the Northern Council for Further Education), a pilot project was developed with the following objectives:

To transform the assessment methodology within further education (FE) via the use of immersive technologies

To facilitate collaborative development of bespoke virtual reality (VR) scenarios incorporating course learning outcomes (T level and Care Certificate)

For digital technology students to work jointly with industry in VR development

To gain feedback from students, employers and other key stakeholders with regards to using immersive technology as a method of assessment.

Three prototype scenarios were developed in the iRIS platform to aid adherence to ASPiH and INACSL standards as well as collaboration across the development and project teams. The VR development was undertaken in Unity by digital students led by industry experts.

The University of Huddersfield led on the evaluation of the project using a qualitative approach encompassing the three degrees of validity [2], using student and employer/stakeholder focus groups and 1:1 interviews both pre and post scenario testing. Discussions were transcribed and template analysis [3] applied.

While final evaluation is still ongoing, initial findings are as follows:

iRIS proved to be an invaluable platform for scenario development across organizations greatly aiding communication and decision-making

Both students and faculty need have reached a minimum competency with the VR equipment and environment prior to assessment

Course learning outcomes can be readily incorporated into bespoke VR scenarios

VR would be a suitable mode for assessment for some learning outcomes but not all

The prototype scenarios provided adequate realism, face and construct validity for assessing the identified learning outcomes

VR simulation has the potential to be suitable and acceptable mode of delivery for assessment in health and social care. Funding applications have been submitted for phase two of the project which would include an impact study.

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.
A33A novel form of communication training for Medical Support Workers at a large teaching hospital
Authors: Rawlinson Sadie , Hay Natalie , Pordes Rosalie , Jones Ingrid
Published: October 2023

Background and aim:

The Medical Support Worker (MSW) Programme, funded by NHSEI, enables International Medical Graduates (IMG) and refugee doctors to work in the NHS, whilst acquiring General Medical Council (GMC) registration [1]. MSWs and IMGs have a recognized set of learning needs, with communication difficulties the most reported challenge amongst IMGs [2]. North Bristol Trust (NBT) employed a second cohort of 30 MSWs in July 2022, all of whom previously practiced medicine in Myanmar. NBT enlisted the assistance of a local Community Theatre to create and deliver a novel training programme with an emphasis on improving confidence in communication.

Methods:

Reflective pieces completed by MSWs one month in to post, alongside two probing questionnaires, highlighted the demand for communication training. A local Community Theatre, with prior experience of working with migrants, refugees, and vulnerable groups, was contacted. The Community Theatre met with both current and former MSWs to further identify development needs. Subsequently four two-hour workshops, with specific focuses, were designed:
Session 1: Informal conversation, talking about yourself
Session 2: Voicing opinions and interpretations, acknowledging mistakes
Session 3: Talk about yourself, interview practice, body language
Session 4: Public speaking, dealing with conflict

Session 1: Informal conversation, talking about yourself

Session 2: Voicing opinions and interpretations, acknowledging mistakes

Session 3: Talk about yourself, interview practice, body language

Session 4: Public speaking, dealing with conflict

Workshops consisted mostly of games and small group activities with an element of performance. The programme was evaluated using a feedback form, consisting largely of Likert scale questions, completed after the 4th session.

Results:

Communication, social skills or cultural change were highlighted as the biggest challenges by MSWs (64%). Confidence in tasks that involved speaking in front of groups, dealing with conflict, or speaking to relatives was low (13.6-22%). Only 52% of MSWs felt confident speaking to colleagues.

The sessions were well received with 100% of respondents reporting both to have enjoyed the sessions and that they would recommend the sessions to other MSWs.

Results showed improvements in confidence, specifically with regards to: conversing with colleagues (94%), informal conversation (87.5%), public speaking (88%), raising concerns (100%) and offering opinions (100%).

Conclusion:

This novel locally developed communication training addresses some of the unique learning needs of MSWs and improves communication skills in a range of areas. The programme is being considered for expansion to international nurses and IMGs at NBT.

Ethics statement:

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.
A95UCLH Simulation Centre - Let us show you around: A digital hybrid approach to simulation environment familiarization
Authors: Nash Luke , Findley Rochelle , Paschoud Daniel
Published: October 2023

It is well established that familiarization with the simulation environment is integral to the pre-brief [1]. This fosters psychological safety and creates optimal learning conditions for participants and faculty. We sought to enrich our visitors’ psychological safety by providing a digital preview of our simulated environment, prior to the face-to-face familiarization they receive when attending a course.

Combining 360 and 2D video production techniques we have produced an online experience hosted on the CenarioVR platform. This gives visitors an opportunity to explore the simulated environment, patient and equipment, in their own time, while introducing aspects of the fiction contract. We believe accessibility is key to the utilization of this resource. So we have ensured it can be used on a range of devices including:

Virtual Reality Headsets (HTC/Meta)

Desktops/ Laptops

Mobiles/ Tablets (enhanced with accelerometer controls)

The content is cloud-based and accessed via an internet browser across all platforms, requiring no additional app. One limitation is that the experience requires a stable internet connection.

A link to the tour was embedded in our pre-simulation communication to participants and faculty, and its usage and impact was evaluated over a period of 2 months using additional questions in our post-course questionnaire. 50 feedback responses to CenarioVR were received. 24 delegates viewed it 26 did not. Of the 24 that viewed 58.3% agreed virtual tour strengthened their experience, 12.5% strongly agreed, 20.8% neutral, 4.2% disagreed and 4.2% strongly disagreed.

From our data we concluded that over 70% of delegates that viewed the virtual familiarization found it to be beneficial to their simulation experience. With simulation being used more in education it is imperative that those with less experience in this setting are provided with resources they need to feel psychologically safe.

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.
A77Translational simulation in practice: an enhanced orthopaedic induction for new trainees
Authors: Alsawada Osama , Brara Amrita , Savaridas Terence , Mardon Julie
Published: October 2023

The gap between imagined and realized healthcare practice is indisputable. For trainees who rotate between departments, the challenges of navigating complex healthcare systems are unmet by standard induction programmes [1,2]. Our simulation centre and orthopaedic department collaborated to create an enhanced departmental induction using immersive simulation.

Following a thorough needs assessment for new trainees rotating to trauma and orthopaedics. We looked at previous trainee feedback, adverse event data from our safeguarding reporting system, and expert opinion from orthopaedic staff. It became clear that at times of transition, the process of accessing timely and appropriate support was challenging. Furthermore, there were a myriad of clinical duties and patient cohorts covered by the trauma team. Working within this dynamic and complex structure was difficult for new trainees. We used team-informed process mapping to define the escalation systems in place, and the distinct roles within the team.

We identified key learning objectives for a simulation induction session. We used a case vignette of an unwell trauma patient and aligned the scenario design to the required learning objectives on clear escalation pathways and whole team working within a complex environment.

Following a successful pilot run, this enhanced induction is routinely delivered four monthly for junior doctors rotating to the orthopaedic department. Current trainees, orthopaedic consultants, and senior managers also attend this trainee induction as an open forum for dialogue on service improvements. All participants have rated these sessions as good or excellent; they value the whole team approach and repeatedly ask for further simulation sessions. Feedback from other members of the trauma team following these sessions commented on increased connection within the team, which included junior trainees attending departmental meetings. The orthopaedic team also felt that, following the induction programme, new trainees had demonstrated improved handover skills when escalating unwell patients.

This whole team simulation-enhanced approach to orthopaedic induction is novel, and in contrast to the majority of standardized induction programmes [3]. This work provides a template that can be applied to different healthcare systems. By delivering constructively aligned simulation sessions, we can improve team training and enable new trainees to flourish during periods of transition.

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.