bluuebunny/crossref_metadata_2025 huggingface dataset:
A study into the perceptions of pre-registration nurses’ use of mental simulation for learning cardiac arrest skills
Authors: White Nick , Rumbold James , Garner1 Iain
Published: November 2022

Pre-registration nurses (students) must be prepared to be part of a cardiac arrest team at a moment’s notice. Basic Life Support (BLS) must be performed proficiently and accurately. Proficient performance relies on repetitive practice, but time without practice results in skill decay [1]. Mental simulation offers the opportunity for repetitive, solitary, deliberate practice. Mental simulation is a quasi-perceptual experience in the absence of stimuli and overt physical movement [2]. Mental simulation has been well researched within healthcare education with promising results. Mental simulation has previously been shown to objectively improve performance of cardiopulmonary resuscitation (CPR) skills [3]. We aim to: 1) understand how participants integrate mental simulation into their busy lives over several weeks; 2) understand how the participants experience imagining a cardiac arrest and what this means to them; 3) and understand the value that students place on experiencing cardiac arrest and life-support education through mental simulation.

Phase-1 was the design of a mental simulation script. The protocol was engineered to assist the students in creating functionally equivalent, high-fidelity images. Phase-2 was a qualitative interview study undertaken from a constructionist perspective. Eleven pre-registration nurses were asked to use the mental simulation protocol for 4-weeks. At the end of this period, semi-structured interviews and thematic analysis were employed to co-construct an understanding of student perceptions.

Several themes were identified (

Theme and subtheme definitions

Representation of the learning process during mental simulation

Using mental simulation creates an authentic cardiac arrest learning experience. It creates self-efficacious, knowledgeable students who are ready for clinical practice. The author recommends mental simulation adjuncts mandatory BLS training within their organisation. Mental simulation could be rolled out to other staff groups, however, more mental simulation research into its efficacy is required.

1. Roel S, Bjørk IT. Comparing Nursing Student Competence in CPR before and after a Pedagogical Intervention. Nurs. Res. Prac. 2020;2020:1–6.

2. Arora S, Aggarwal R, Sirimanna P, Moran A, Grantcharov T, Kneebone R, Sevdalis N, Darzi A. Mental practice enhances surgical technical skills: a randomised controlled study. Ann Surg. 2011;253(2):265–70.

3. Fountouki A, Kotrotsiou S, Paralikas T, Malliarou M, Konstanti Z, Tsioumanis G, Theofanidis D. Professional Mental Rehearsal: the Power of ‘Imagination’ in Nursing Skills Training. Mater Sociomed. 2021;33(3):174–178
From virtual reality to first cataract surgery; trainee perspective from a developing country
Authors: Bilal Malik M.
Published: November 2022

Cataract surgery is one of the most performed procedure worldwide with a fascinating evolution in the use of technology [1]. EyeSi is a high-fidelity, task-oriented, virtual reality, intraocular surgery simulator widely adopted by residency programs across the developed world for skill development in cataract surgery, with proven effectiveness and decrease in complication rates [2]. We aim to provide a trainee’s reflective perspective on learning cataract surgery via virtual reality simulation and performing first real surgery from a low middle-income, developing country [3].

Simulation training as part of formal residency curriculum was documented, hence ethical approval was exempted. EyeSi course software (V3.0.6) was used for skill development as a self-learning tool, reinforced with real cataract surgery training, documented over a period of 8 months for a single participant. EyeSi provides a binocular microscopic viewing system, with hand-piece instruments and foot pedals of the same configuration as used in operating theatres. The software generates feedback reports for each task using microscopic calibrations inside the model eye.

By the end of the 8-month period, simulation data showed a logged time of 45.7 hours, 74 intraocular lenses injected, 1,581 intraocular tasks completed and 772 capsulorhexis done with complications including 679mm2 of injured corneal area, 113 mm2 of injured lens area and 862 posterior capsule ruptures. In comparison, the real surgery logbook noted 30 intraocular lenses injected, 86 intraocular tasks and 31 capsulorhexis complete with a total of 1 complication and 1 complete cataract case performed. Subjective comparison reported increased confidence, lower stress levels, good preparation of left-hand skills, and passive learning of surgical theory and technicalities (

Comparison of virtual reality and real surgery experience

Despite challenges of affordability and traditional surgical culture in a low middle-income country, simulation training provides safe learning alternatives to trainees which are effective and should be widely adopted. Although the learning curve is slightly longer, but skills acquired are replicable in operation theatre and significantly reduce the complication rate in the interest of patient safety.

1. Davis G. The Evolution of Cataract Surgery. Missouri Medicine. 2016;113(1):58.

2. Ahmed TM, Hussain B, Siddiqui MR. Can simulators be applied to improve cataract surgery training: a systematic review. BMJ Open Ophthalmology. 2020;5(1):e000488.

3. Aga Khan University. Simulation success story: Eye surgery.
Developing a simulated general practice environment to improve clinical reasoning and non-technical skills in junior medical students
Authors: Prendergast Andrew
Published: November 2022

Simulation in medical education is often associated with acute specialities, however there is evidence in the literature to suggest exposing medical students to a simulated General Practice (GP) environment can be beneficial to their clinical reasoning and non-technical skills [1] and that this may even be superior to that gained from a GP practice placement [2].

22 junior medical students participated in a simulated GP clinic where they reviewed 4 simulated patients. Patients were faculty members who also acted as assessors to ask 3 pre-defined questions and provide feedback after each station, rotating between candidates. The session was concluded with a presentation to clarify correct diagnoses and management for each case. Candidates completed a feedback form to evaluate the session.

In terms of clinical reasoning, >85% of students reported the session greatly improved their history taking, recognition of red flags, and ability to formulate management plans in the community. For non-technical skills, >75% reported a great improvement in their professionalism, communication, and decision-making ability. However, 2 students (~10%) reported their professionalism had not been affected at all. Individual feedback after each station and the concluding presentation were reported as useful aspects of the session. 3 students (~14%) requested to include examination practice in future sessions.

The majority of students felt that they benefited significantly from participating in the simulated GP clinic, both with respect to their clinical reasoning and non-technical skills. This may be due to the combined immersive nature of the simulation and the psychological safety provided by the absence of formal assessment [1]. The aspect which candidates felt least improved by the session was their professionalism, which may be in part due to an inability to suspend their disbelief. The benefit of adding clinical examination to this activity is not clear.

A simulated GP surgery environment can be used to improve history taking ability, recognition of red flags, and formulation of management plans in primary care, as well as non-technical skills in junior medical students. However, more research is required to establish whether this is transferable to clinical practice.

1. Young JE, Williamson MI, Egan TG. Students’ reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic. Advances in Health Sciences Education. 2016;21(1): 63–77.

2. Lytton K, Woolley T, Rasalam R, Gorton S, Heggarty P. Benefits of simulated General Practice clinics in the preparation of medical students for primary healthcare. Education for Primary Care. 2019;30(5): 275–281.
CUSTOMised return to training: supporting trainers and trainees with bespoke simulation courses
Authors: Berg Richard , Anpananthar Amutha
Published: November 2022

10% of 50,000 doctors in postgraduate training programmes in England are taking approved time out of training at any time [1]. The NHS People Plan [2] aims to welcome back colleagues who want to return, which can be a stressful experience for trainees. It is our duty as educators to provide support. Health Education England offer SuppoRTT funding to create opportunities for trainee development. Despite regional courses, returning trainees felt their individual needs were not met. We aimed to provide additional, bespoke 1:1 training within a psychologically safe environment to paediatric trainees in our hospital before their return to training.

Trainee participants had email and phone correspondence with a consultant paediatrician prior to their return date. A half-day bespoke simulation course was co-designed with the participant at a mutually convenient date. Teaching was delivered by a consultant or senior registrar trained in simulation and debriefing. The bespoke course included a variety of activities to meet personal goals, including basic procedures, scenarios in the simulation centre, and if ready, a short in-situ simulation with multidisciplinary staff (if available). In addition, trainees were signposted to existing courses and resources. The simulation centre also offered support to the Educational Supervisor in completing SuppoRTT Funding applications. Afterwards, returning trainees were asked to provide feedback via email. This experience has led us to develop a framework for future learners from different specialities and the wider multidisciplinary team; the CUSTOM framework, Creating Unique Support for Trainees and Others with the Multidisciplinary team.

In three years, we provided bespoke training to six paediatric doctors, four of whom were returning after maternity leave and two from research. Five trainees had bespoke sessions, one trainee chose to attend a simulation course with additional support and feedback rather than requesting an individualised course which would have had to be created. Themes from feedback included a positive learning environment, appreciation for bespoke training opportunities, increasing trainee confidence and appreciation for general support (

Feedback received from trainees

Our bespoke courses were successful and well received by paediatric trainees. We are launching a new framework, CUSTOM, Creating Unique Support for Trainees and Others with the Multidisciplinary Team. CUSTOM will support other departments to offer bespoke courses. Going forward, we aspire to expand this support to returners from the multidisciplinary team.

1. Health Education England. SuppoRTT. Health Education England. 2022.

2. NHS England. NHS England NHS People Plan. England.nhs.uk. 2022.
HEE placement project –paramedics in the driving seat
Authors: Wilford Amanda , Wheatley Sean
Published: November 2022

Creating additional placements for undergraduate paramedic learners is being driven by Health Education England (HEE). With the increase in numbers undertaking paramedic training by education providers, there is limited additional capacity for placements within the current placement areas (e.g. Ambulance Trusts).

Working in partnership with a dedicated simulation team, the paramedic science lecturers co-created a simulated placement. One aspect included the students undertaking a one-day ‘Train the trainer course’ prior to the day of facilitating led by the simulation lecturer and this course referred to research and best practice standards [1]. Seventy-six third-year students across two different cohorts undertook this activity. From two cohorts, eleven different simulation activities were created. Three focused on trauma injuries (e.g., a severed arm in a factory). In the remaining eight simulation designs, the paramedic students chose areas of their professional practice they wanted to focus on, including a lady with domestic violence.

All students were asked to complete an online evaluation tool that focused on their learning both as a facilitator and as a learner undertaking their peers’ simulation activities. Overwhelmingly all seventy-six learners rated their own experiences as a facilitator highly, citing that to create their own designs, they had to revisit course work and search for evidence and guidelines. This aspect they felt improved their knowledge and confidence. Reviewing the data as a learner, the paramedic students felt the scenarios were richer and closer to practice and provided a richer discussion. Participating in debriefing as both the facilitator and learner, the participants reported that they felt more comfortable about critiquing care that learning how to use open questions.

The students created their own community of practice [2] and actively sought literature and evidence-based practice to create the designs and the parameters and behaviours for their own cases that they facilitated. The debriefing sessions evolved into reflection surrounding their identity and the agency of practice in the clinical arena. As faculty, the expectations prior to this project were that the designs created would be trauma only and found all were authentic and professionally written. The faculty will be implementing this project across all years of undergraduate training for paramedics. Supporting students to write and deliver their own SBES at intervals allows them to be involved in their own learning. This additional knowledge and skills will assist them into professional practice.

1. Persico L, Belle A, DiGregorio H, Wilson-Keates B, Shelton C. Healthcare simulation standards of best practice

2. Wenger E. Communities of practice: learning, meaning, and identity. 1999. Cambridge, UK, Cambridge University Press.
Where do I start? Introducing simulation in a hospice environment
Authors: Rata Vikki , Ireland Sarah
Published: November 2022

Simulation is widely recognised as a safe, valuable learning modality [1]. However, it is greatly underutilised in End of Life (EoL) care [2] where the majority of learning has been theoretical. A plethora of challenges exist around introducing a simulation programme in a hospice environment, both organisational and psychological [3], including implementing a new idea at a time when healthcare workers are experiencing unprecedented levels of burnout following a pandemic. As part of a one-year project funded by Health Education England, we sought to create and introduce a comprehensive simulation-based programme for rollout across the Hospice with clear benefits and relevant subject matter that engages our wide range of MDTs as well as non-clinical staff.

Posters were used to begin to introduce the concept of simulation. A mixture of questionnaires, interviews and online sessions were held to establish current knowledge and views of staff on simulation-based learning. Time was set aside to thoroughly outline the project and its benefits to teams throughout the Hospice, clinical and non-clinical staff.

Questionnaire results from 52 respondents show that 35% of staff had no knowledge of simulation prior to the information given as part of this project. Despite this, when simulation was explained more clearly, all respondents felt that they would be able to gain something positive from introduction of a simulation-based programme as shown in

Participants’ response to the question: What participants expect simulation-based learning to improve in their practice?

Teams amongst the hospice recognise that simulation provides a valuable learning opportunity. By ensuring understanding of the project, encouraging involvement of all teams, and recognising their unique concerns, thoughts and pressures, it is possible to implement a successful simulation-based programme in the Hospice environment leading to quality improvement in End-of-Life care.

1. Randall DC. Pragmatic children’s nursing: A theory for children and their childhoods. Routledge; 2015.

2. Bassah N, Seymour J, Cox K. A modified systematic review of research evidence about education for pre-registration nurses in palliative care. BMC Palliative Care. 2014;13(1):1–10.

3. Patterson MD, Blike GT, Nadkarni VM. Advances in Patient Safety. Situ Simulation: Challenges and Results. In: Kerm Henriksen, James B. Battles, MA Keyes und ML Grady (Hg.): Advances in Patient Safety. New directions and alternative approaches, 3, p.4. 2008
Using online simulation to prepare mental health nursing students for practice
Authors: Rolfe Ursula , Lacey Andrea , Ortega-Vega Marta , Bignell Anita , Saunders Aleks
Published: November 2022

Demand for mental health nursing staff is rising with a drop-in staff of 8% in the last 10 years [1]. Preparing the future NHS healthcare workforce is therefore a vital component of educational delivery for Higher Education Institutions [2]. With funding Health Education England, the aim of this pilot project was to evaluate whether an online simulated learning programme helped students feel more prepared for their final placement in practice before qualifying.

19 final year mental health nursing students participated in a one-day online simulated learning environment programme which focused on difficult conversations and complex communication scenarios, in partnership with an external organisation. It focused on introducing a bespoke context to develop clinically relevant skills, knowledge, and experience, complementing the range of clinical placements opportunities required by the nurses training curriculum. They were then asked to complete the Human Factor Skills for Healthcare Instrument [3].

Participants showed a 7% increase in confidence in Human Factors Skills measured by the Human Factors Skills for Healthcare Instrument from their pre-course (M=93.54) and post-course (M=102.27) scores. Participants also showed a 9% increase in scores in the course specific questions relating to the learning objectives from their pre-course (M=50.86) and post-course (M=57.15) scores. We were unable to conduct paired samples t-tests due to the limited number of participants completing both the pre- and post-evaluation survey. Lastly, 100% of participants responded that they would recommend this course to others.

The course is a novel and innovative training method for providing clinical experience to undergraduate nursing students to develop relevant skills and knowledge that complement their placements. The findings demonstrate that participants achieved a variety of learning outcomes including improved confidence in human factors skills and improved confidence across the learning objectives, covering de-escalation skills, working in a multidisciplinary team, identifying mental illness presentation, handover, and referral among other skills. This raft of benefits following training are likely to have a positive impact on interactions with service users or those experiencing mental illness, although further research into this impact would be of great interest.

1. Royal College of Nursing (2022) ‘There is no quick solution to the nurse staffing crisis’.

2. Topal review: NHS (Feb 2019) Preparing the healthcare workforce to deliver the digital future.

3. Reedy G, Lavelle M, Simpson T, Anderson J. Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings. BMJ Simulation and Technology Enhanced Learning. 2017;3(4):135–141.
The lived experiences of educators involved in medical education simulation
Authors: Davis Sarah
Published: November 2022

Simulation has been part of medical education for many years. It has evolved and advanced alongside training needs and practice. Although student experiences within simulation have been well documented, educators’ experiences are lacking in the literature. Most of the literature around this topic relates to educators learning experiences, the development and planning of simulation in general, and faculty development [1,2]. Consequently, this gap in the literature forms the basis of this study.

A qualitative phenomenological approach of Interpretive Phenomenological Analysis (IPA) was adopted for this study. This was so that the lived experiences of educators involved in a simulation day for final year medical students could be analysed and interpreted. Ethical Committee Approval was obtained, and 6 educators involved in this day were interviewed using semi-structured interviews. The transcripts were then analysed for themes and interpreted.

Analysis of the interview transcripts identified four main themes. Journey into simulation, which focused on passion for simulation and training needs; what simulation means, which included topics around fidelity and debriefing; developing in simulation, which described personal and faculty development, imposter syndrome, and technology; and the culture of simulation, of which teamwork, hierarchy, and the wider community featured.

The lived experiences and themes presented carry with them the processes that facilitate the growth and development of our medical simulation educators, as well as some of the barriers and stressors. These facilitators include passion, apprenticeship and immersive experiences, teamwork, and reflection, with barriers and stressors being technology, developing debriefing skills, and imposter syndrome. Implications for practice include recognising and making time for formal and informal reflection as a team, understanding the role workplace learning has in faculty development and debriefing, ensuring faculty understand the objectives of each simulation-based activity, and developing coaching and mentoring opportunities to explore feeling around imposter syndrome and hierarchy.

1. Dieckmann P, Birkvad Rasmussen M, Issenberg SB, Søreide E, Østergaard D, Ringsted C. Long-term experiences of being a simulation-educator: a multinational interview study. Medical teacher. 2018;40(7):713–20.

2. Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, Thammasitboon S, Park S, Pawlikowska T, Rees EL, Doyle AJ. Developments in medical education in response to the COVID-19 pandemic: a rapid BEME systematic review: BEME Guide No. 63. Medical teacher. 2020;42(11):1202–15.
In-situ simulation: educational tool and a clinical system test
Authors: Henwood Matthew , Cox Andrea , Paramsothy Remi , Barron James
Published: November 2022

Simulation-based clinical systems testing (SbCST) is a process that allows clinicians and hospital stakeholders to evaluate work carried out in new environments. Unlike work-as-imagined, SbCST takes into account the complex interactions resulting from human performance limitations [1]. These factors can result in errors that may even lead to patient harm [2]. Therefore, we used SbCST to evaluate a newly built children’s emergency department with the aim of identifying latent errors and implementing changes to minimise the risk of their occurrence, whilst also ensuring that the simulation experience was an independently valuable educational opportunity.

Scenarios were created according to two criteria. Firstly, that they tested at least one specific environmental issue and secondly, that they focused on topics that the paediatric and Accident and Emergency departments felt would be educationally valuable to the participants. Once created, these scenarios were then carried out as un-announced in-situ simulations during the first 8-weeks of departmental opening. The participants were instructed to treat the scenarios as real, including the manner in which they called for help. Any equipment required came from the department and if single use, it was exchanged for training equipment. The participants then undertook a hot debriefing before feedback was gathered about both the educational value of the scenarios as well as any issues identified within the new department.

In total there were 38 multidisciplinary participants including nurses, operating department practitioners, and doctors from 6 different specialties. The feedback from the sessions was positive with an average ranking of >4 out of 5 in 8 out of the 9 measured domains, including; realism, enhancement of knowledge, and usefulness of in-situ simulation in a new environment. We also identified greater than 50 problems spanning all 5 of the categories from the ‘SHEEP’ model [3]. Approximately 60% of issues were resolved within the 8 weeks, whilst the remaining are on the risk register and awaiting review at a stakeholder level.

In-situ simulation is an excellent mechanism for carrying out clinical systems testing of new environments due to the fact that it simulates realistic events which are prone to the same errors as the real events, without the risk of patient harm. Once the source of an error is exposed the debriefing can help to identify methods to minimise the risk of future reoccurrences. At the same time, with appropriate planning, the scenarios can also provide an opportunity to deliver multidisciplinary training.

1. Colman N, Doughty C, Arnold J, Stone K, Reid J, Dalpiaz A, Hebbar KB. Simulation-based clinical systems testing for healthcare spaces: from intake through implementation. Advances in Simulation. 2019;4(1):1–9.

2. Reason J. Human error: models and management. Br Med J. 2000;320:768–770.

3. Rosenorn-Lanng D. Human factors in healthcare: level one. Oxford: Oxford university press. 2014.
The importance of simulation technicians’ involvement in educators’ conferences and educational events
Authors: Koniuszaniec Katarzyna , Howie Lyz
Published: November 2022

Simulation technicians are a vital part of simulation teams and facilitating simulation sessions. Additionally, they help to materialize the educators’ vision [1]. There is a gap between what educators expect from technicians and how well technical staff perform based on the instructions given. To support simulation-based education understanding of the educational philosophy underpinning simulation processes used by educators would improve and enhance the abilities of the technician. A survey-based review recommended exploring opportunities that simulation technicians have and to create more opportunities for technicians to get involved [2]. Not having sufficient knowledge and understanding can impact on the overall preparation and requirements from the technician. Full understanding between instructional and educational principles will close the gap and allow simulation technicians to have a deeper role and active part of simulation-based education. This allows simulation technicians to go beyond the technical skills and technical terminology especially for those whose background is non-clinical. The overall aim is to explore what opportunities simulation technicians have to participate in educational simulation events to enhance their knowledge, skills, and effectiveness of their role.

Interestingly the Society in Europe for Simulation Applied to Medicine (SESAM) 2022 conference was attended by 607 delegates from 51 countries with only 36 simulation technicians attending. This meant that only 6% of the delegates were Simulation Technicians compared to other professionals, which is a small number. This data was never previously collected by SESAM so we do not know if this number has changed over the years [3].

The study is presently being submitted for ethical approval. It is the expectation that the data will be collected and analysed upon receiving the ethical approval.

We will gain new understanding from the technicians’ perspective on the attendance at simulation-based educational events from the Simulation Technicians network across the United Kingdom. It will help us identify how often simulation technicians attend and what benefits there were to this continual professional development opportunity. Simulation technicians should have more opportunities to participate in conferences and educational events. This will close the technicians-educators’ educational gap and allow them to have a more meaningful part within the simulation community, resulting in more equity, parity, and diversity.

1. Bailey R, Taylor R, FitzGerald M, Kerrey B, LeMaster T, Geis G. Defining the Simulation Technician Role. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2015;10(5):283–287.

2. Nicklin J. Review of Clinical Skills and Simulation Technicians/Technologists in the UK: Results of a Survey-Based Study. Aspih.org.uk. 2016.

3. SESAM personal communication by email 27/06/2022
Meaningful simulation: service user and academic collaboration supporting physiotherapy students with healthy conversations
Authors: Drummond Helena
Published: November 2022

Lifestyle factors are a significant cause of mortality and morbidity in England [1]. Physiotherapists are well placed to help people to make healthy lifestyle choices, however junior physiotherapists do not feel well equipped to have these conversations [2]. An innovative teaching session was carried out with physiotherapy students to 1) increase their confidence in addressing lifestyle choices and 2) equip them with communication skills to decrease fear of these difficult conversations. The session was grounded in the theory of motivational interviewing [3].

Teaching staff created role play scenarios. These were reviewed by service users for authenticity. The scenarios included a teenager with cystic fibrosis who was not compliant with chest clearance exercises and a person suffering falls secondary to alcohol misuse. The final scenario involved a discussion about smoking with a person recently diagnosed with a chronic lung condition and their partner. In a face-to-face immersive fishbowl setting, students took part in the scenarios with experienced actors as service users. The session was collaborative, where students could ‘time out’ to seek guidance from their peers. The actors adapted their communication depending on how they felt in the conversation. After each scenario the actors provided feedback from the service user perspective.

There was excellent engagement in the session. Students found the final scenario the most challenging as they struggled to gain a rapport with the patient actor due to the partner frequently interrupting. The cohort expressed different ideas of how to manage this situation. Feedback from the actors helped the students to consider the perspective of the partner and how their interference was due to worry. Pre- and post-session data on a five-point Likert scale demonstrated improved knowledge of motivational interviewing and improved confidence to have lifestyle change conversations (

Likert scores to the pre- and post-motivational interviewing simulation training

The immersive simulation experience motivated and empowered the physiotherapy students to talk about lifestyle change with service users. The participative forum felt ‘real’ and students left the session better equipped to have lifestyle change conversations with service users. This should help to create future physiotherapists who can help people to live healthy lives.

1. Office for National Statistics. What is happening to life expectancy in England? England: The King’s Fund; 2022.

2. Walkenden S, Walker KM. Perceptions of physiotherapists about their role in health promotion at an acute hospital: a qualitative study. Physiotherapy. 2015;101(2):226–231

3. Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Health Care. London: The Guildford Press, 2008.
Exploding silos: hacks in creating national simulation networks
Authors: Oliver Nathan , Marks Kirsty , Connolly Siobhan , Meldrum Ashley
Published: November 2022

Silos of work are a reality in virtually every large organisation and invariably create duplicated workloads, inefficiencies, and in some cases a sense of ‘tribalism’ which risks the integrity and effectiveness of teams [1]. As simulation-based education gains traction and momentum as a teaching approach across Scotland and the UK, silos of work have emerged and risk the effectiveness and efficiency of programme delivery. Our aim was to create an effective simulation user network across the 14 Health Boards of Scotland to eliminate silos and create a collaboration of work across the country.

Thanks to an investment from NHS Education for Scotland (NES), insight from the NHS Scotland Academy, and the expertise of the Clinical Skills Managed Education Network (CSMEN), a team of regional Senior Educators were recruited to create a functional regional and national collaborative for simulation in Scotland. The story here is how the team have come together and the lessons learned in networking, negotiating, and establishing a new and growing sense of collegiately across the country. Starting in the East of Scotland, a questionnaire was designed and delivered across simulation teams and stakeholders across four Health Boards. The data collected was used to feed discussion at an East Scotland Simulation Collaborative scoping meeting which was attended by representatives of all four Health Boards and included medics, nurses, physiotherapists, and pharmacist teams delivering simulation to both undergraduate and postgraduate teams.

An East Scotland Simulation Collaborative has been formally established with its inaugural meeting in Autumn 2023. An online space has been established to promote communication and the sharing of resources, and both a quarterly meeting and annual faculty development day designed for the group. Discussions are now ongoing for the development of an East Scotland Simulation Research group to develop new opportunities to conduct multisite studies for the first time. From a national perspective, North and West Scotland Simulation Collaborative groups are now in their formation stages.

Like weeds in a garden, silos of work will grow all by itself. Like roses in a garden, an effective network takes both time and tending, but the investment pays dividends.

1. Beattie A. War and peace among the health tribes. 1995. In: Soothill K, Mackay L, Webb C (Eds). Interprofessional relations in health care. London: Edward Arnold.
Occurrence of Methicillin Resistant Staphylococcus Aureus in Cats and Man
Authors: Zafir Zafir , Alsadi Ibrahim , Gomaa Amir , Saleh Abdulsalam , Hamad Randa
Published: November 2022

This study was carried out to isolate Methicillin-resistant Staphylococcus aureus (MRSA) strains from cats as well as human. Nasal, ear and skin swabs were collected from 50 cats either diseased or apparently healthy animals as well as 50 swabs were obtained from diseased and apparently healthy individuals with or without cats’ contact. Swabs were streaked on Oxacillin Resistance Screening Agar Base (a selective medium for detection of MRSA). It was found that the overall rate of isolation of MRSA from cats was 20% with significant association between the rates of isolation from diseased cats (21.4%) and apparently healthy cats (18.4%). In addition, the highest rate of isolation was recorded in the age group from 1 to 2 years (29.4%) followed by the age group > 2 years (26.7%) and finally, the age group ≤ 1 year (5.6%) with non-significant association between the rates of isolation. On the other side, the overall rate of isolation of MRSA from human was 32% with significant association between the rates of isolation from diseased individuals (28.6%) and apparently healthy individuals (40%). Moreover, individuals exceed 60 years old showed the highest rate (40.9%) followed by those of the age group extend from 30 to 60 years (30.8%) and lastly the age group less than 30 years old (20%) with significant association between the rates of isolation. Molecular characterization of MRSA strains recovered (n=26) from cats and human for detection of nuc and mecA genes by PCR was performed. It was recorded that nuc gene was detected in 65.4% of isolates while mecA gene was detected in 80.8% of the recovered isolates. Finally, it was found that the presence of human with animals in the same community and in close contact increases the opportunity of zoonotic transmission of MRSA between cats, humans, and the environment.
Phytochemicals Combating Antibiotics Resistance: Updated Review
Authors: Adekunle Olutoyin , Idris Oluwatoyin , Sule Ismaila , Olorunfemi Akanmidu , Adekunle Adeniran
Published: November 2022

The emergence of resistance to antibiotics in microorganisms has been a matter of public health concern. This resistance could be caused by mutation, acquisition of extra genetic materials and indiscriminate or persistent use of antibiotics which has rendered these therapeutic agents less effective and less Potent. To overcome this therapeutic challenge several Phytochemicals have been reported to possess significant antibiotics properties that could serve at alternative therapy as against synthetic agents. This review is focused on reporting the various investigation relating to Phytochemicals as potential therapy against antibiotics resistance.
STUDY OF PLATELET INDICES IN ACUTE CORONARY SYNDROME AND STABLE ISCHEMIC HEART DISEASE AND THEIR CORRELATION WITH ANGIOGRAPHIC SEVERITY OF CORONARY ARTERY DISEASE
Authors: Das Dipak , Das Biswajit , Anoumandane Selvabharathi
Published: November 2022

Aims: To investigate platelet volume indices (PVI) in the spectrum of coronary artery disease and ischemic heart disease.
Methods: There were 283 instances evaluated, with 86 patients having stable coronary artery disease (stable CAD) or being admitted for a coronary artery bypass graft or coronary angiography operation. On the basis of history, specific electrocardiographic alterations, and elevated cardiac enzyme activity, 72 patients were diagnosed with unstable angina (UA) and 68 patients with acute myocardial infarction (AMI). The fourth group included 57 healthy individuals with no history of cardiac disease and an ECG that was normal.
Results: Mean platelet volume, platelet distribution width, and platelet large cell ratio- were higher in patients with AMI and UA compared with those with stable CAD and the control group.
Conclusions: Platelets are a risk factor for acquiring coronary thrombosis, which leads to myocardial infarction. Patients with higher platelet counts can be easily diagnosed during standard haematological testing and may benefit from preventive medication. Thus, PVI is a critical, and cost-effective technique that should be used and researched widely to predict the possibility of imminent acute events.
Role of Women Empowerment in achieving social transformation and sustainable development
Authors: Kumari Dr. Pallavi
Published: November 2022

Educated women have a high level of morality, a high potential for earning, and live life with a lot more confidence and courage to face any challenging situation. They might grow into an independent businessperson who can maintain the family's financial independence. They can maintain good health and hygiene for the family members. If there exists a lack of education for women the entire society will face a lot of setbacks in terms of development. Even today in rural areas there is a low acceptance of girl children in society. The paper will discuss the Women empowerment and different ways of boosting the women empowerment. There are a lot of studies that talk about the crucial role of educated women in bringing about socioeconomic and political progress in our country. Thus, the empowerment of rural women plays an important role in building up the economic and social pillars of sustainability. It is essential to empower women to achieve gender equality in order to secure the country's sustainable development. Education not only provides women with economic empowerment but also helps to solve issues like gender inequality and removes poverty to foster inclusive economic growth. This paper will bring out the positive outcome that due to education, there has been a changing role of women in society and the family, economic independence, changing attitude, increasing confidence, and the gradual rising of their social and economic status. The paper will also bring out the discussion on challenges faced by women. The paper will also attempt to discuss future suggestions for facilitating women with education and empowerment of women.
SANEAMENTO BÁSICO NO BRASIL E NO MUNICÍPIO DE SOUSA-PB
Authors: Lima José Rodrigo Alves de , Pereira Maria da Conceição Araújo , Silva Cícero Joelson Vieira , Ibiapina Kevin Bezerra , Souza Caylanne Mendes de
Published: November 2022

No Brasil, a população sofre com o déficit de atendimento por serviços de saneamento básico, devido, principalmente, a cinco fatores: lentidão nas políticas públicas voltadas ao saneamento, falta de investimento no planejamento urbano, indisponibilidade de recurso, legislações ineficazes e um processo de urbanização acelerado. Existem vários fatores limitantes no desenvolvimento do saneamento básico no Brasil. Os próprios indicadores apontam as relações entre falta de saneamento básico e saúde, como o crescimento de doenças atribuídas à falta de água potável e ausência de serviço de esgoto, principalmente. O referido trabalho busca propiciar uma revisão da literatura acerca do saneamento básico no Brasil e no município de Sousa-PB, através da leitura de artigos, livros, dissertações e teses. Por fim, foi obtido um levantamento histórico dos acontecimentos históricos considerados mais relevantes e evoluções da legislações que tratam sobre o saneamento no Brasil e no município de Sousa-PB.
Eukaryotic Microorganisms as Biological Factories for the Preparation of Metal Nanoparticles
Authors: Miškovská Anna , Čejková Alena
Published: November 2022

The use of microorganisms as reducing and stabilizing agents in biogenic syntheses of metal nanoparticles is an attractive approach. There is a large number of potential bioagents able to yield big amounts of various biomolecules, and to prepare nanoparticles of diverse physicochemical properties. Microscopic fungi and algae are widely studied for the preparation of nanoparticles, mainly because of their ability to produce vast amounts of extracellular proteins, enzymes, and other metabolites that can actively participate in the metal reduction and also contribute to the nanoparticle stabilization. This results in highly stable metal nanoparticles with interesting properties that can be used, for example, as antimicrobial agents (especially Ag or Cu nanoparticles) or as catalysts. This review summarizes the main, promising representatives of microscopic fungi, yeasts, and algae used for the preparation of nanoparticles of various metals.
Mixed Matrix Membranes for Carbon Dioxide Capture
Authors: Hamalová Kateřina , Kolská Zdeňka
Published: November 2022

Mixed-matrix membranes, MMM, have been a very popular research topic for many scientists in many fields during the last few years. This work provides an overview of general properties, interesting structural components, potential applications, as well as pitfalls and drawbacks in the preparation of membranes of this type. MMM, especially when combined with ionic liquids, IL, and/or organometallic frames, MOF, represent one of the best and very promising options for industrial applications, specifically for the capturing and separation of CO2. As a result, the properties of these two fillers (IL and/or MOF) can enable us to prepare membranes with a higher separation and permeability efficiency, chemical and mechanical resistance, and thermal stability. Unfortunately, the toxicity and stability of the individual components of the membranes and the resulting mixed matrix membranes have not yet been investigated in detail and further research is needed. One of the main drawbacks is a very high cost of the production of the individual parts and the subsequent assembly of these composite membranes. This is the reason why we still do not see these MMM being used widely in industry.
A Website for Your PC Benchmarks
Authors: Singh Ekjot
Published: November 2022

Nowadays, everyone has/wants a computer system, but does not have sufficient knowledge to build one. And those who have some knowledge, face difficulties while selecting the hardware as the market for hardware is very huge. There are people who are looking to build or want to know more about computer hardware/ components. We provide users with detailed sections of various components like CPU, GPU, RAM and SSD. The user can see the specifications of the required component and learn more about that component. We compute and analyze the benchmarks of various components and systems such that the user can quickly size up their PCs and explore real world performance. Each and every component can be compared with one another individually as well as the whole computer system to have a better understanding of which one is better for someone. Keywords – Computer System, Benchmarks, PC Building, PC Comparison, Hardware Comparison
Initial Public Offering – Conceptual study on Chemcon Speciality Chemical Company
Authors: Maheshwari Harshita
Published: November 2022

The global Initial public offering of a leading manufacturing company Chemcon speciality chemical company, came in September 2020 with price of Rs338-Rs340, was oversubscribed 79.35 times in the primary market. The study was conducted to understand how the IPO operates and why it has been oversubscribed. The article also explores the cause of the company's value, including whether it was due to the IPO or for any other reason. In order to understand about IPO operation the following study has been conducted. The Chemcon speciality chemical company has been used as a case study and analysis was done for two financial year starting from 2019-2021. Key words:- IPO, valuation, oversubscribed, primary market.
Experimental Study on Flexural Behavior of Pre- Loaded RC T- Beam Strengthened with CFRP Laminate under NSM Technique
Authors: Qureshi Md Huzaifa
Published: November 2022

The RC structures are subjected to several loads under adverse environmental conditions, which may cause the structures to deteriorate before their designed service life. In such circumstances, dismantling and rebuilding the structure is a time-consuming and costly operation. As a result, in order to increase the serviceability of the RC structure and satisfy design criteria, the structures are reinforced with CFRP composites. The current experimental effort attempts to study the flexural behavior of pre-loaded Reinforced concrete T- beams strengthened with CFRP strips under NSM Technique with different orientation of CFRP strips i.e., horizontal and vertical. In comparison with control beams, the working and ultimate loads of T-beams strengthened with NSMLV and NSMLH technique enhanced by up to 23.69% and 25.43% respectively. The load deflection behavior and failure mechanisms of all reinforced and control T-beams are also investigated. The percentage of quantity of CFRP laminates used in NSMLH technique was almost double than that in the NSMLV technique. Hence the NSMLV technique is more economically then NSMLH technique. The deflection at the failure load in the NSMLV reinforced beams was more than two to three times that at the working load, indicating that the requisite level of deflection ductility was reached. Key Words: Reinforced concrete, T-Beams, CFRP Laminate, Flexural Strengthening, NSM, Experimental.