bluuebunny/crossref_metadata_2025 huggingface dataset:
A115Developing a simulation course for Advanced Clinical Practice-Challenges of designing for a diverse interprofessional group
Authors: Stevens Lisa , John Sini
Published: October 2023

Background and aim:

There is increased availability and development of the advanced clinical practitioner (ACP) course to upskill allied health professionals in clinical, leadership and supervision areas [1]. Locally, ACPs and ACPs in training have not previously had simulation integrated into their training for this role despite this being considered an effective learning method for communication skills [2]. The simulation department was approached with funding to develop a course to add variation to their development programme and enhance learning in areas better targeted through simulation.

Activity:

A survey was sent to the ACP cohort to ascertain their desired learning objectives from simulation training. Then the team met a focus group of ACP trainees to further explore their varied roles and the expected changes moving to the ACP role. From this research, a 1-day course was developed to include scenarios with themes felt to be widely applicable across the umbrella of ‘advanced clinical practice’. Examples included; managing patient expectations, challenging hierarchy, safeguarding, learning disability, mental capacity assessment, difficult supervision. Two courses have been completed with a mix of ACP roles, and scenarios adapted to apply to the specific participants. The debriefs explored how the scenario theme could be applied cross discipline and gave an opportunity for these senior healthcare professionals to share experiences and their individual management strategies.

Findings:

This was a stimulating but challenging course to develop given the seniority and multidisciplinary background of the target group. This required significant creativity and adaptability from the organizing team and multiple scenarios to be designed for participants. The courses generated valuable discussion and all candidates reported the day to be a useful experience with specific learning and development taken from the day. Limitations included some allocated scenarios were felt to be outside the usual job remit of the allocated participant, which could impact on the authenticity and psychological safety of the scenario for that candidate. Despite this, useful discussion of the intended themes was still possible, and this was reinforced by the experience brought from the candidates present.

Conclusion:

Even though ACPs may have similar more complex learning needs in line with their required capabilities, this is challenging to translate into a transferable and valuable simulation course when targeting multiple disciplines with varying amounts of senior experience. We reflect on ways to approach this in the future and would be open to opinions from our esteemed education colleagues.

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.
A53Simulation equipment - What do you have? What do you do with it?
Authors: Moneypenny Michael , Glover Peter , Baker Andrea , Willey Karen , Kenny Lyndsay
Published: October 2023

Educators and workforce planners appreciate that clinical skills development and simulation-based learning are key strategic responses to safe and effective service provision and a sustainable workforce. However, some simulation-based experiences require simulators costing tens of thousands of pounds. In order to promote a ‘Once for Scotland’ approach, collaboration is essential to encourage sustainability by enabling sharing of equipment, training materials, processes, procedures and faculty between boards. Although there have been other scoping exercises [1], we believe that this the first to take place at a national level. This scoping exercise aimed to:

Establish what equipment is available in the territorial health boards;

Clarify the types of skills-based courses being run across NHS Scotland;

Connect and encourage collaboration between simulation providers

Information was gathered via Teams discussions and questionnaires. The responses were collated into Excel spreadsheets. These have been linked into an application to present the data in a more user-friendly manner online (

Interactive map of simulation resources in Scotland

Responses reveal that:

All health boards in Scotland have invested in simulation-based learning.

There is pioneering work with the establishment of medical and surgical bootcamps as well as national pharmacy simulation.

Additional work needs to be carried out to ensure that resources are invested wisely to areas of greatest need and that resources are shared within and between health boards.

It is clear where abundant simulation activities are taking place, as well as where there are gaps in equipment and faculty.

Distribution of the information gathered will reduce duplication of effort, increase collaboration and encourage the sharing of equipment between health and social care workers across Scotland. It is hoped that this scoping project will support the creation of new relationships between people, not just for their mutual benefit, but for the benefit of the people of Scotland. The results are a first step to providing a detailed inventory of the resources available to help ensure best value for money. We hope to see an increase in the sharing of equipment across Scotland similar to the use of the NES surgical cut suit which was purchased by the Scottish Centre for Simulation and Clinical Human Factors and recently used by the simulation team at NHS Lothian to provide a multi-professional immersive paediatric training session. The plan is to update this database on a regular basis and to widen the results to incorporate all health boards as well as universities.

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.
A83Assessment of the Use of Assorted Methods of Scenario Presentation in Communication Skills Simulation
Authors: Mckay Anne , Langridge Claire , McGowan Neil
Published: October 2023

FY2 doctors in Greater Glasgow and Clyde (GGC) participate in simulation-based learning [1] to improve communication skills in difficult consultations. COVID-19 pandemic restrictions from 2020 – 2022 meant actors could not be present in person for this. Scenarios were therefore adapted to run as remote consultations - two were conducted using Zoom video calls and one by telephone with professional actors, and one ward-based manikin scenario with faculty as actors. We compared the effectiveness of the session, and of each scenario, in improving confidence in communication.

Questionnaires were completed before and after simulation. Confidence levels were assessed using a Likert Scale (1 – 5) for each scenario. Participants were also asked to rank each scenario (1 – 4) for engagement, realism and relevance to practice at the end of the session, and for which of the three Intended Learning Objectives (ILOs) for each scenario they had gained most information.

Over 10 days, 126 FY2s (6 - 8 per group) and 23 Faculty members participated. 92 completed questionnaires were obtained. ‘Take Forward Messages’ (TFM) from scenario debriefs from 12 groups were correlated with the ILOs.

Overall, there was a significant improvement in confidence in dealing with difficult communication scenarios after the session; (mean ± SEM) score pre 2.87 ± 0.11, post 3.69 ± 0.08, p < 0.01. These values did not differ significantly from 2019 when actors were present in person.

When asked to rank which scenario was most effective in different aspects, the case on how to deal with an angry patient (Zoom video call) performed best overall (

Scenario Quality Assessment and Improvement in Participant Confidence Levels

Zoom and telephone consultations, and manikin-based scenarios can be used to provide effective simulation sessions to improve communication skills. Perception of scenario quality does not always correlate with success in achieving the learning objectives.

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.
A18Barriers and facilitators to the use of healthcare simulation to support the professional development of healthcare professionals: a systematic review of qualitative research.
Authors: Richardson Caroline , Madden Caoimhe , Byrne Dara , Lydon Sinead , O’Connor Paul
Published: October 2023

Background and aim:

The effectiveness of simulation-based education (SBE) in improving healthcare education among practising healthcare professionals (HCPs) is well recognized [1–3]. However, there is limited research available that explores the facilitators and barriers to the use of these activities amongst this population. The aim of this study was to determine those barriers and facilitators that exist to the use of healthcare simulation amongst practising HCPs through the systematic review of existing qualitative literature.

Methods:

Searches were performed using Medline and CINAHL from February to May 2022 with an updated search performed in June 2022. Reference list searches of included studies were also conducted. English-language, peer-reviewed studies that used qualitative methodology to examine barriers and/or facilitators to the use of SBE activities amongst HCPs practising in a hospital setting were included. Data were extracted and a quality appraisal tool was applied by the primary author, with 30% of included studies independently extracted and appraised by a second author to examine the agreement. Barriers and facilitators were coded inductively using thematic analysis.

Results:

Thirteen studies were included out of a total of 2109 screened. Four main themes related to facilitators and barriers were identified: (1) management and leadership; (2) resources; (3) perceived impact and (4) learning experience (see Table 1-A18). Amongst studies, positive learning experience was a commonly identified facilitator (n = 10), while leadership and management were a frequently cited barrier (n = 13).

Thematic analysis of facilitators and barriers to the use and uptake of SBE activities

Conclusion:

This study identified common barriers and facilitators to the use of SBE activities. By anticipating and addressing these adequately, the use and uptake of SBE activities amongst practising HCPs can be further enhanced.

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.
A46SPEED: an emergency department simulation training model which does not affect patient waiting times
Authors: Chong Sebastian , Phillips Michael , Malik Salwa
Published: October 2023

There is a well-recognized tension between clinical service provision and participation in learning events for junior doctors (JDs) in the UK [1]. JDs frequently report that they are unable to attend regular teaching due to departmental clinical pressures, representing lost opportunities for their training and development. Therefore, there is need for development of training methods which minimize impact on clinical service delivery.

To develop a simulation training model for Emergency Department (ED) JDs which would a) deliver tailored learning objectives according to the participants’ level of training and b) have minimal impact upon ED service provision.

The ‘Simulation and Personalised Education in the Emergency Department’ (SPEED) model was developed. On SPEED days, JDs and advanced clinical practitioners (ACPs) who were undertaking clinical duties in ED on that day were invited on an individual basis to participate in a twenty-minute clinical simulation. Upon completion, the participant underwent a ten-minute debrief to reinforce predetermined learning objectives and supply feedback to simulation tutors before returning to their clinical duties in ED. Pre- and post-session questionnaires were conducted to assess acquisition of learning objectives. Training days were conducted in EDs of a UK Major Trauma Centre (MTC) and an associated small teaching hospital (TH). Departmental data on time to be seen by an ED clinician were collected retrospectively for SPEED days and comparable non-SPEED days, with differentiation between the majors and urgent care (UC) MTC sub-departments.

A total of 7 SPEED days were conducted over 6 months between September 2022 and March 2023 – 5 in the MTC ED and 2 in the TH ED. 65 JDs and ACPs participated across the seven days. On asking about the usefulness of the SPEED session for day-to-day practice, 41 participants responded ‘strongly agree’ and 18 participants responded ‘agree’. 6 of the 7 SPEED days demonstrated a positive mean difference in post-session questionnaire score when compared to pre-test questionnaire. There was no statistically significant difference in time to see clinician between SPEED days and comparable non-SPEED days in MTC majors (1h11m vs. 48m), MTC UC (2h41m vs. 2h25m), or TH (1h15m vs. 1h8m) (Kruskal-Wallis test,

The SPEED model demonstrates acquisition of learning objectives which are relevant to day-to-day practice. There is no evidence that delivery of this model significantly affects waiting times in either a small or large ED. Adoption of this training strategy may improve training opportunities for other ED clinicians.

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.
A19Identification of clinical reasoning models commonly used in simulation-based education
Authors: Almomani Emad , Sullivan Jacqueline , Pattison Natalie , Alinier Guillaume
Published: October 2023

Background and aim:

Simulation can immerse learners in scenarios that mimic clinical situations, simultaneously mitigating safety risks and increasing standardization in healthcare education [1]. Through simulation, learners can get the chance to develop clinical reasoning with focused learning opportunities [2]. Clinical reasoning is multidimensional in nature, and underdeveloped clinical reasoning skills and the risk of cognitive overload can potentially threaten patient safety and delay care, so it is important to systematize, optimize and structure clinical reasoning for simulation-based education [3]. That can be achieved through using valid clinical reasoning models but with careful consideration to the contributing and influencing factors of case complexity, staff seniority, competence, scope of practice, specialty and subspecialty.

Methods:

A scoping review was undertaken to answer the questions: what are the best available valid and reliable clinical reasoning models for simulation-based education? We searched Medline, Scopus, Education Research Complete and Google Scholar to identify relevant recent primary research conducted on this topic from 2000 onwards. The search included MeSH topics of ‘Clinical reasoning’, ‘Simulation-based education’ and ‘Clinical Reasoning models’. The inclusion criteria were primary studies describing the clinical reasoning models developed for simulation-based courses. Two independent researchers agreed on the inclusion of the identified articles for full-text review. This review followed the review guidelines of Joanne Briggs Institute.

Results:

Five valid and reliable models to structure the clinical reasoning process while attending simulation-based training were identified and are reported in Table 1-19. However, their validity and reliability were tested on working and undergraduate student nurses, and there was no consideration for different seniority and competence levels, and applicability to other healthcare professions.

Identified clinical reasoning models based on the scoping review

Conclusion:

There is an adequate number of clinical reasoning models to be used while taking part in simulation-based training; however, there is a significant basis to test the reliability and validity of these models against different competence and seniority levels, and applicability to other healthcare professions. The authors are presently working on the development of a new model using an innovative and rigorous approach.

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.
A52Probing for Veins: A Cost-Effective, Reproducible Method for Teaching Ultrasound-Guided Peripheral Intravenous Access
Authors: Southall William , Torrilla Christopher , Chu James , Willers Johann , Tovell Nicholas
Published: October 2023

Repeated attempts at peripheral intravenous (PIV) access cause increased discomfort and delays in treatment for patients in hospital. The use of ultrasound can improve success in PIV access, benefitting patient experience. Medical professionals are increasingly expected to use ultrasound when landmark techniques fail [1]. We sought to improve confidence using ultrasound for PIV cannulation with low-cost simulation models made from ADAMgel [2] or tofu in multiple teaching sessions.

We organized teaching sessions with multiple specialties at St Richard’s Hospital. A total of 48 members of staff have been taught over four sessions. Prior to the teaching session learners were asked to complete a survey identifying previous ultrasound experience and rating confidence using ultrasound for PIV access. The teaching session consisted of an introductory multimedia presentation with a video demonstration, then practical experience. Models consisted of water-filled balloons placed in ADAMgel (Aqueous Dietary Fibre Antifreeze Mix gel) or tofu to simulate human tissue and veins,

Models used to deliver teaching sessions. After ADAMgel became available this has been used exclusively due to it being more reusable compared to the tofu modelsA: tofu model with ultrasound image underneath.B: ADAMgel model with ultrasound image underneath

The initial survey identified only 29% of staff had previously used ultrasound for PIV access, and half of these (15% overall) had only used it once or twice a year. Using a five-point Likert scale, 74% of respondents rated their confidence in using ultrasound as one or two out of five. All respondents thought they would benefit from further teaching in PIV access. Feedback after teaching sessions was favourable, with 95% of respondents finding the session very useful and 95% also believing it would increase their use of ultrasound in clinical practice. After the session, more than half rated their confidence in ultrasound cannulation as four or five out of five.

We have demonstrated that there is a desire from medical staff to increase their competency in ultrasound-guided PIV cannulation. Using low-cost, high-fidelity simulation models with a blended learning method, we can deliver teaching sessions to a large number of medical staff. We hope to continue this teaching in collaboration with our sister sites throughout Sussex to increase confidence with ultrasound-guided PIV cannulation in this region.

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.
A99Designing and implementing e-noting for use in simulation scenarios for sustainability and realism
Authors: Philpott Lauren
Published: October 2023

Due to the nature of simulation-based education, large amounts of blank paperwork are used and disposed of in any given scenario. As many trusts are now moving towards e-noting, including e-obs and e-prescribing, the use of these in simulation can be extremely beneficial for the learners. These were highlighted by the author as areas for sustainability and increased realism throughout the simulation sessions run by the team at Dartford and Gravesham NHS Trust [1].

This initiative was developed to cut down on the amount of paper waste used during scenarios and increase the realism for the learners taking part. E-obs, e-prescribing and e-noting templates were created using Microsoft Excel and Microsoft Word that mirrored the programmes used throughout the trust, and were made readily available for the learners taking part in the simulation scenarios. These were then saved as templates, and a new version created for each existing patient throughout the scenarios. On top of this, each new scenario created also required a new set of e-noting, including a NEWS, prescription and the relevant paperwork. ‘Patients’ who had progressed through ED, for example, had a completed CAS card, and their NEWS chart reflected the several sets of observations already taken. The NEWS chart template was also adapted for patients with COPD, and PEWS charts for each paediatric age group were also created, alongside separate e-prescribing to mirror the paediatric version of the drug charts throughout the trust.

Learners who participated in the scenarios using e-noting provided positive feedback, highlighting the realism and relevance to practice. 43 learners were asked to complete a short survey after taking part in 1 or more scenarios using the new e-noting system. 79% of learners reported that they found the system easy to use, 90% reported the relevance to clinical practice, 81% reported that it was realistic and 95% were happy that this is a feasible and sustainable way to utilize prescribing, observations measurement and note writing/history taking throughout the simulation sessions. 4% reported not using the e-noting system during their scenario.

Although the creation of the e-noting system required additional time and resources at the start, they quickly became easy to implement and adapt to each new patient or scenario. The use of this system leads to much less paperwork being destroyed and increased the realism for the participants who use e-noting throughout the trust.

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.
A101Adult Critical Transfer Simulation: Technology In Motion
Authors: Blackburn Verity , Tennant Beth , Paschoud Dan , Nash Luke , O’Dwyer Anthony
Published: October 2023

Transfer medicine is evolving into a more visible, necessary sub-specialty, particularly since the COVID-19 pandemic, during which the need for proficiency in critical care transfers became apparent. As such, there exists a requirement for the provision of good training in this domain, especially for effective simulation-based learning given the dynamic nature of critical transfers, in tandem with the relative scarcity of experience of the average non-specialist practitioner.

The creation of meaningful simulation training is already well recognized as posing numerous challenges [1], often in balancing fidelity with practicality, for achieving engagement of learners and transfer of learning to practice [2]. When adding the dynamism involved in a transfer - such that simulation requires movement of a critically monitored patient from one point to another - this task becomes more complex. Importantly, the integrity of the exercise is lost when provided in a stationary environment, as with much simulation traditionally. This was the focus when designing the Adult Critical Transfer Simulation (ACTS) course - a multi-disciplinary team-based day with pre-course e-learning, focused around assorted simulated scenarios performed in motion across an education suite. Additionally, it incorporates reflexive debriefing, interactive workshops and group discussion sessions to support learning.

The greatest technical challenge of ACTS - modified repeatedly now over two years - was the delivery of mobile, multi-environment scenarios that provide an equivocal experience to that of traditional, stationary lab-based simulation. This was addressed utilizing wireless, remotely controlled patient models and monitoring alongside a network of strategically placed cameras and microphones to provide immersive simulation for both active and observing participants. In addition, considerable attention was given to audio-visual cues at all points of transition for creating the ambience of a moving transfer, the efficacy of which is reflected in positive course feedback.

Feedback on ACTS was collated from all participants, with significantly favourable responses in every domain and 100% overall score of 5/5 for both enjoyment and recommendation, and 93.8% score of 5/5 for relevance to professional needs (

Feedback from participants of the 2023 Winter run

Although there is no substitute for real-life experience, ACTS has demonstrated multi-disciplinary need for critical transfer proficiency can be met successfully through the provision of dynamic simulation when facilitated by technology, with great scope for future development given the rapidly advancing nature of technological resources.

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.
A76Quality assurance of high-fidelity simulation courses at University Hospitals Birmingham (UHB)
Authors: Merchant Azhar , Mathew Ashwin , Simkin Mark , Muir Cheryl
Published: October 2023

The Clinical Education department at UHB has been running high fidelity simulation courses for undergraduates and postgraduates across three hospital sites for several years. Feedback from faculty and candidates has led to enhancement of all courses, yet a deliberate method of Quality Assurance (QA) was deemed requisite for educational governance, standardization and to attain accreditation with ASPiH.

Drawing on ASPiH Standards [1], the departmental leads for simulation designed a framework with seven domains (

The 7 domains used for quality assurance of simulation courses at UHB

Five undergraduate and four postgraduate courses were evaluated. Seven courses met or exceeded departmental standards in all seven domains, whilst the other two courses met or exceeded standards in six of the seven domains.

All courses had robust purposes, organization and resources at their disposal, which exceeded departmental expectations with their consistent focus on how human factors affect patient safety, and sound adherence to the relevant curricula and learning objectives. Scenario designs also incorporated a range of human and technological resources and moulage.

Despite an array of technology at the Trust’s disposal, its functioning did not always meet the departmental standards, with recurring audio difficulties and occasional software tethering issues. In response, microphone positions were changed, and the department’s Digital Innovation team consulted specialists to facilitate further improvements.

In the courses observed, debriefs were conducted in a holistic manner and candidate evaluation was always discussed. However, many courses lacked enough faculty members resulting in Objective Structured Assessments of Debriefing (OSADs) being performed infrequently. Swift changes were made, with a tightening of procedural behaviours within the courses, and a decision was taken for postgraduate courses to run with a minimum of four faculty members.

This comprehensive QA process demonstrated that high-fidelity simulation courses at UHB are predominantly being delivered at a good standard. Some recommended changes have already been implemented for aspects found to be substandard, with implementation of additional changes planned at annual course reviews. Annual QA must then take place to guarantee maintenance of high standards and to provide a solid foundation for appraising novel simulation courses throughout the Trust.

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.
A75Strengthening simulation quality assurance through the ‘Sim QA bundle’
Authors: Diaz-Navarro Cristina , Hawker Clare , Jones Bridie , Mitra Suman , Catrin Cook Sara
Published: October 2023

The All Wales Simulation-Based Education and Training Strategy 2022 – 2027 specifies as one of its aims to promote quality assured simulation-based education and training across healthcare in Wales underpinned by standards and evaluated to ensure best practice in safe learning environments [1].

The Simulation Team at Health Education and Improvement Wales (HEIW) has been working closely with the simulation community in Wales to identify their needs through iterative consultation during meetings, focussed discussions and webinars.

In 2021 stakeholders agreed that HEIW would promote the application of the Association for Simulated Practice in Healthcare (ASPiH) standards [2] and professional regulatory and statutory body standards relevant to SBET. Since then, a number of quality assurance tools as well as faculty development opportunities have been developed in order to embed these standards into simulation faculty development programmes and cascade their routine inclusion into everyday SBET practice.

Quality assurance (QA) resources developed by the Simulation Team at HEIW between August 2021 and February 2023 were packaged as the ‘Sim QA Bundle’ (

HEIW Simulation Quality Assurance Bundle

The ‘Sim QA Bundle’ consists of four components:

Faculty development and continuous professional development (CPD): available resources include free access to the Essential Faculty Development Course, regular webinars, workshops and conferences.

Content development: guidance provided includes a standardized scenario scripting template, with links to relevant literature.

Content delivery: a standardized approach to debriefing has been developed which is supported by education opportunities and cognitive aids.

Evaluation tools: generic evaluation forms have been designed to assess the learners’ experience, faculty perspectives and adherence to standards.

The Simulation Quality Assurance Bundle provides a wide range of resources available to simulation practitioners in order to promote and support the delivery of high-quality simulation-based education and training across the healthcare workforce in Wales.

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.
A103The Future of Aiding Student Placement Expansion: is it simulation, is it sustainable?
Authors: Hill Shona , Hester Ben , Duzy Ashley , Kistler Lenny , Bolton Racheal
Published: October 2023

In recent years many Higher Education Institutions (HEIs) have recognized the benefits of Simulation Based Education (SBE) and incorporated it into their teaching programs, in some cases utilizing it to replace traditional ‘clinical placement’ hours [1]. This has been catalysed by the COVID-19 pandemic whereby there has been unprecedented demands on NHS services, forcing the industry to offer alternative placement models [2].

To contribute to placement expansion by offering a simulation-based student placement.

We created a six week non-clinical, simulation placement designed to host two Physiotherapy students. The overarching objective of this placement was to enable students to create and run their own simulation training session by their final week. They were based in the simulation team and networked with other students and clinicians to guide their research and planning.

We collated feedback from the students at the end of their six-week placement via anonymous, online Microsoft feedback forms.

Throughout 2022 we ran this placement twice and collated data from the 4 Physiotherapy students, all who were in their second year of study.

Thematic analysis suggested the most common skills students felt they gained were soft skills (i.e. organization and prioritization) and development of varied communication styles. Additional themes that were mentioned included simulation specific skills. There were two areas where students felt they were unable to develop due to the placement communicating with ‘real’ patients and clinical note writing.

Students were asked to score their clinical knowledge relating to their chosen simulation topic area at the beginning and end of the placement. Scores increased from ‘Good’ (2 students) and ‘Average’ (2 students) at the beginning of the placement to ‘Good’ (1 student) and ‘Very Good’ (3 Students) at the end of the placement.

Qualitative themes suggested the students felt the overall variety of activities and exposure to clinical scenarios/teams they may not have seen before was unique to this placement and both enjoyable and valuable.

Previous studies have identified misconceptions relating to the purpose of simulation and its aims [1]. Our data reflected this concept as students rated their knowledge of simulation at the beginning of the placement as ‘Very Minimal’. However, our placement offering has proven to successfully increase this awareness and offer the opportunity to develop transferable skills and clinical knowledge in a way that is both exciting and aids placement expansion whilst incurring minimal cost.

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.
Paddy Storage Status at Rice Mill and Farm Household Levels of Mymensingh Division in Bangladesh
Authors: Shihab Md , Ahamed Sahabuddin , Ali Md , Awal Md , Gope Shibendra , Saha Chayan , Hasan Md , Alam Md , Nelson Alex
Published: October 2023

Long time storage of paddy is a concerning issue at farm households and rice mills of Bangladesh due to inadequate sustainable storage technologies. Hence, paddy storage facilities of 20 rice mills and 40 farm households of Mymensingh division were investigated following semi-structured questionnaires to know the existing paddy storage technologies, problems, and future needs. Traditional gunny bags are used in rice mills for storing consumable paddy whereas 77.5%, 20%, and 2.5% farmers use dole, gunny bag and plastic bag, respectively. About 60%, 17.5%, and 7.5% farmers under the study use GrainPro bag, metal/plastic drum, and motka, respectively for storing paddy seed. Despite using preventive chemicals about 2.4%, 3.4%, and 3.3% paddy loss occurs during storage in automatic, semi-automatic, and major rice mills, respectively. To solve problem, about 80% of rice mill owners demanded for hermetic cocoon.
Study of association of endothelial nitric oxide synthase gene intron 4a/b polymorphism in smokers with ischemic heart disease
Authors: Metta Sandhya , V Prasad , S Jayabalakrishnan , M Syamala , D Joya
Published: October 2023

Background: Endothelial nitric oxide synthase (eNOS) enzyme plays a key role in maintaining optimal cardiovascular health. Furthermore, the literature review suggests the prominence eNOS gene polymorphisms in pathophysiology of ischemic heart disease (IHD).

Aim and Objectives: The aim of this study was to evaluate the association of eNOS gene intron 4a/b polymorphism with IHD in smokers.

Materials and Methods: Two hundred male patients presenting with IHD and 100 and 27 age-matched healthy males from the same demographic area were recruited for the study. Based on the history of smoking habit (≥20 pack years of smoking), the subjects were further categorized into non-smokers and smokers. All the subjects were analyzed for the eNOS gene 4a/b polymorphism and other relevant parameters.

Results: While studying the association of “aa” genotype with smoking in the patient group as well as in control group, there was no significant association observed between smoking behavior and genotype frequencies (for aa vs. ab+bb, odds ratio [OR] 1.5682, 95% confidence interval [CI] 0.6119–4.0191, P = 0.3457) in patient smokers versus patient non-smokers, OR 0.59, 95% CI 0.1349–2.581, P = 0.479 in control smokers versus control non-smokers.

Conclusion: Although genotype frequencies for eNOS 4 b/b, eNOS 4 a/b and eNOS 4 a/a and “a” allele frequency differed between IHD patients and controls, it was not statistically significant indicating “a” allele of eNOS intron 4 a/b variable number of tandem repeat polymorphism was not an independent predictor of IHD.
Virtuous Debate Against Liberalist Muslims in Indonesia
Authors: Damyati Akhmad Rofii , Hajad Shohebul
Published: October 2023

Due to different worldviews on knowledge, various parties often debate each other. In Indonesia, anti-mainstream groups often appear to challenge a common thought in Islam, whether religious, scientific, political, or philosophical. Liberal Islam is one of the prototypes that engage in debate in all sectors of already established thought in society, especially in Islamic issues, even fundamental issues such as faith. Due to its anti-mainstream nature, the emergence of Liberal Islam has drawn controversy and debate, especially among Liberalists from the West who brought ideas of freedom of thought. Some confronted their ideas with lengthy debates but often ended in protracted animosity. It is because the method of debate used tends not to consider the adab of arguing as taught by Islamic intellectuals. Yet, attempts at confrontation with them by taking a wiser path have been carried out by some activists of Islamic thought. Among them is INSISTS Jakarta, a research and publishing institution that has confronted the Liberal Islam discourse since the 2000s, not by way of confrontation but by counterarguments through scientific publications and seminars. This article will reveal the virtuous debate that has been carried out by these scientific institutions.
Reconstruction of the gaps in malfunction Landsat7 images: Review
Authors:   Department of Computer Science, College of Science, Mustansiriyah University, Baghdad, Iraq, Sadiq Asmaa , Sadeq Zinah ,   Department of Computer Science, College of Science, Mustansiriyah University, Baghdad, Iraq, AAli Huda Abdul ,   Department of Computer Science, College of Science, Mustansiriyah University, Baghdad, Iraq
Published: October 2023

The Landsat satellite series program has been developed and managed by the United States Geological Survey (USGS) since 1972, representing the longest temporal record of space-based terrestrial observation and taking into account the primary forces advancing the science concept in the global earth systems. Despite the malfunction images of Landsat 7 in 2003, the malfunction imagery preserves its important value in both technical studies and applications. Thus, there are numerous approaches and algorithms that have been presented to solve the SLC-off trouble by finding appropriate methods and approaches to predict the pixel reflectance values at gap locations accurately. This work aims to familiarize the reader with the concepts related to recovering the gap locations of the Landsat 7 SLC-off imagery approaches.
AFET KİTLE FONLAMASI: PAZARLAMA PERSPEKTİFİNDEN BİR MODEL ÖNERİSİ
Authors: KARAARSLAN Mustafa Halid , ALTUNTAŞ Başar
Published: October 2023

Afetler doğaya ve insanoğluna ciddi zarar verebilen olaylardır. Afetlerden sonra afetin zararlı etkilerinin yok edilebilmesi ve normal duruma yeniden dönebilmek için bağışlar önemli bir rol oynamaktadır. Makalede afetlerde bağış yapan kişilerin nelerden motive oldukları açıklanmıştır. Sonrasında ise tüm dünyada oldukça başarı ile uygulanan kitle fonlama platformlarının afet fonlaması için uyarlanmasını içeren bir afet fonlama modeli önerisinde bulunulmuştur. Önerilen modelde koordinatör kurum, ilgili kurumlar, bankalar, kampanya sahipleri ve bağışçılar bulunacaktır. Modelde bağış platformunun kurulması kritik öneme sahiptir. Platform kurulduktan sonra dört temel süreç öngörülmektedir: i) afetle ilgili ihtiyaçların tespit edilmesi: ilgili kurumlar tespitlerde bulunacak kampanya sahibi ve bağışçılar ise ihtiyaç önerisinde bulunabilecektir, ii) kampanya tasarlama ve onaylama: kampanya sahibi kampanyayı işbirliği yaptığı taraflarla hazırlayacak ve koordinatör kuruma onaylatmak için gönderecektir, iii) kampanya süreci: bağış yapacaklara ihtiyaç ve ihtiyacın nasıl giderileceği açıklanacak, maliyetler hakkında bilgilendirme yapılacak, toplanan bağışlar anlık olarak takip edilebilecektir, iv) kampanya sonrası: kampanya vaatlerinin gerçekleşmesi hakkında bilgilendirmeler yapılacaktır. Çalışmanın sonuç bölümünde ise önerilen afet fonlama modeli ve platformunun bağış motivasyonları ile olan uyumları açıklanmış, platformun başarıya ulaşabilmesi için dikkat edilmesi gereken hususlar ile başarısızlığa sebep olabilecekler tartışılmıştır. Ayrıca platformun afet fonlaması yanında afet bilinci oluşturma, afetlerdeki hasarı azaltma çalışmaları ve yeni teknolojiler geliştirme konusunda da kullanılabileceği üzerinde durulmuştur.
Effects of Selected Plants Against Rice Weevil (Sitophilus oryzae)
Authors: Mohd Arafah Nur Syamiila , Jun Chia Yong , Mohamed Shariff Sharizainor Sharina , Mohd Noor Nor Qhairul Izzreen , Zaharudin Nazikussabah
Published: October 2023

Rice weevils (Sitophilus oryzae) have caused significant damage and losses in rice storage. The use of chemical pesticides to control them has had negative environmental effects and limited efficacy. To address this issue, natural plant-based insect-control alternatives were investigated. This study aimed to assess the effectiveness of (Pandanus amaryllifolius), kaffir lime leaves (Citrus hystrix), and “asam gelugor” (Garcinia atroviridis) in repelling, inhibiting feeding, and reducing the offspring of rice weevils. Plant samples were extracted using the soxhlet extraction method, and the crude extracts were concentrated using a rotary evaporator. The extract solutions were then tested for their effects on rice weevils. The results showed that pandan leaves were the most effective, with a repellency percentage of 46.67% and a better anti-progeny effect of 2.175%. Kaffir lime leaves had no effect on rice weevils, while asam keping only showed an anti-progeny effect of 6.525%. The study revealed that low concentrations (0.002 - 0.006 g/mL) of insecticides from pandan extracts could provide a repellency effect against rice weevils. Therefore, plant extracts from Pandanus can be used as botanical insecticides to manage S. oryzae infestations.
A Study on an Active Functional Group and Antimicrobial Properties From Rhizophora apiculata Extracts Used in Traditional Malay as Medicine
Authors: Ramya Razanah , Kamoona Suhair , Mohd Hatta Farah Ayuni , Wan Sulaiman Wan Syibrah Hanisah , Mohd Latiff Nur Hanie , Othman Rashidi
Published: October 2023

A mangrove plant known as Rhizophora apiculata is employed by Malay for treating skin diseases, diarrhea, vomiting, and nausea, as an antiseptic, for tanning, and also as fuelwood and fodder. Its large-scale use can be attributed to its high-quality timber, availability as well and the presence of a chemical named tannin that is employed for reinforcing fishing lines, nets, and ropes. The tannin content of R. apiculata's roots, bark, and leaves is regarded to be a natural inhibitor of fungal infections. This study is focused on determining the different kinds of functional groups, as well as individual phenolic compounds present in R. apiculata for identifying new bioactive compounds via decoding of the traditional values of Malay remedies. There is a high demand for such natural bioactive compounds, particularly in the healthcare and pharmaceutical markets. Alkaline fractional extracts were employed to design an analytical extraction method for R. apiculata. As per the HPLC results, there were three phenolic acids detected namely Caffeic acid, 4-Hydroxybenzoic acid, and Vanillic acid. Meanwhile, ten volatile compounds were identified by the GCTOF-MS. With regards to antibacterial activity, S. aureus, S. epidermidis, and E. coli were inhibited by R. apiculata leaf extract, while C. albicans and Fusarium sp. were inhibited by their antifungal activity.
FEATURES OF LANGUAGE MEANS OF ROLE MODELS IN DIGITAL JOURNALISM OF KAZAKHSTAN
Authors: Ormakhanova E. N.
Published: October 2023

Over the past decades, the development of the digital system has gradually led to the transformation of the information and communication space and interactive interaction with the audience. As a result, traditional journalism is being replaced by digital journalism with a new communication model. The structure of traditional journalism is undergoing changes under the influence of the introduction of digital technologies. The paper most widely covers the key aspects of the activities of a digital journalist, many of which have not yet been described in academic publications. A new phenomenon is considereddigital journalism, and new role models in the socio-cultural status are studied. The goal is to describe the features of the language means of role models in digital journalism in Kazakhstan. According to the author of the study, the neo-digital environment has enriched the communicative space of journalists, which manifests itself primarily in the deviation from the professional ethical standards of traditional journalism. The study of the features of the language means of the role models of communicants in digital journalism makes it possible to create the prerequisites for the formation of a new formula for virtual communication in the process of covering events. The scientific findings and practical significance of this paper lie in the presentation of new role models in modern digital journalism and their application in the study of media discourse in digital format. In the process of writing the paper, the following methods were used: analysis and review of individual cases in the digital space. Based on the results of individual cases in social networks, the following conclusions were made: role models in the digital environment will continue to change, as the digitalization of media is developing at a rapid pace; given the new trends in the transition of traditional journalism to the digital space, Kazakhstani journalism should adopt the experience of advanced countries in training personnel, namely, master new functions of digitalization; language means of digital journalism must meet the standards of new media and train personnel, taking into account the features of the role models of modern digital journalism; various language means are described on the example of cases of digital communication of journalists and network users, forming public consciousness. The study results can be a theoretical foundation for further research in the field of media and linguistics.