bluuebunny/crossref_metadata_2025_split huggingface dataset:
A37Does simulation-based training increase perceived confidence to address demanding communication situations within critical care?
Authors: Jones Kathleen , Bonasera Simone , Flores Nicole , Murie Samantha 
Published: October 2023

Background and aim:
Training nurses to improve their ability and confidence to communicate effectively in difficult situations is beneficial [1]. Simulation is an effective method to replicate difficult communication situations with colleagues, family or patients and improves communication skills [2]. Iyasere et al., (2022) [2] determined improving perceived confidence to communicate increased team-performance specifically amongst nurses. The main purpose was to evaluate the effectiveness of using simulation-based communication scenarios to improve critical care nurses’ perceived confidence to communicate in difficult situations.
Methods:
Fourteen (Band 5 and Band 6) critical care nurses attended three sessions of communication simulation. Participants were invited based on manager feedback either requiring improved communication or demonstrating excellent communication skills, an equal number from both spectrums attended each session. A diamond debriefing model was used after each scenario as the debriefing model provides reflection resulting in improved practice [3]. Debriefing was conducted by training simulation faculty. A survey was used to measure perceived confidence and ability to communicate in three difficult situations: escalating concern, next-of-kin communication (NOK) and colleague interaction. The survey was presented pre-, post-simulation and at six-weeks post.
Results:
Results showed an increase in confidence and ability to communicate in all three communication situations, as shown in Figure 1-A37. The largest improvement was within NOK communication, increasing from 6.73 to 8.77 (1-10 scale), the smallest change was ‘ability to escalate a concern’, however pre-simulation it achieved the highest level of confidence. Six-week post scores remained higher than pre-session ratings in all situations, but did drop slightly from post-session. Difficult communication with a colleague had the lowest score at each measurement interval.
The average rating (1-10) of perceived confidence in each simulation element, at each interval
Conclusion:
Simulation-based training is an effective method to increase Critical Care nurses perceived confidence to communicate in demanding situations. Communication situations involving colleagues remains the most challenging communication scenario for nurses. Improving confidence to communicate is essential to effective team working and patient-centred nursing practice. Further study is needed but initial results suggest the method is beneficial to improve critical care nursing practice.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A9Immersive Technology Experience Measure (ITEM): pilot study on participant experience using novel questionnaire and VR scenario
Authors: Jacobs Chris , Vaidya Kriti , Old Tim , Medwell Lauren 
Published: October 2023

Background and aim:
A scoping review identified a significant growth in research with immersive technology in healthcare education. However, there are few validated measures that capture the user experience of participants [1]. This study aims to investigate the use of an immersive virtual reality (VR) simulation on sepsis management and measure user experience using a validated tool, the Immersive Technology Evaluation Measure (ITEM) [2]. ITEM was formulated on a learning theory called Model for Immersive Technology in Healthcare Education (MITHE), which borrows cognitive and behavioural theories to help explain our level of immersion and enjoyment that can be facilitated by technology (see Figure 1-A9).
Model of immersive technology in healthcare education (MITHE)
Methods:
This single-study quasi-experimental investigation was conducted at a single site. Nine participants were recruited, consisting of medical students and healthcare professionals. Participants were trained on varied immersive devices: sepsis management using an immersive VR simulation developed by Gogglemind, and augmented reality (AR) holographic patient with respiratory distress, which included realistic patient scenarios and interactive decision-making. User experience was measured using the ITEM, which assesses user; immersion, cognitive load, intrinsic motivation, debrief and technology usability.
Results:
Nine participants had high levels of immersion (mean 39.6, total 50), high levels of intrinsic motivation (mean 39.6, total 50), high technology score (mean 79.4, total 100), optimum cognitive load (average 59.5, optimum 39–61) and moderate score on debrief (mean 18.1, total 25). ITEM subscores indicated an enjoyable and immersive experience with good technology interface on usability scores. Self-directed debrief in VR had lower scores with emotional considerations and identifying domains of performance and learning.
Conclusion:
The use of the ITEM provided valuable insights into the user experience of the VR simulation, which can be used to improve the design and implementation of future simulations. This contributes to an ongoing ITEM validation process. This study highlights the importance of training in healthcare and the potential benefits of using immersive technologies such as VR and AR simulations.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A15Video review after simulation-based education – perception of participants
Authors: Batcha Mohammed , Makker Ratna , Winnett Georgia 
Published: October 2023

Background and aim:
Simulation debriefing plays an important role in knowledge synthesis [1]. Although there is evidence to suggest that video-assisted debriefing improves outcomes, at least in nursing simulations, there is a wide variability in the practice and perceived effectiveness of video-assisted debriefing [2,3]. There is a paucity of literature about participants’ perspectives on the use of video review for simulation debriefing. The aim of this study is to explore participants’ perceptions and experience of the use of video review post-simulation.
Methods:
The study received ethical approval from the ethics committee at Anglia Ruskin University. We used qualitative research methodology to answer our research question. Foundation year trainees attending simulation as part of the curriculum were included in the study. This study involved focus group interviews with simulation participants prior to their simulation-based education. Post-simulation training, participants reviewed their simulation video clip in their own time and filled in a structured qualitative questionnaire about their video review experience.
Results:
This is an ongoing research and initial results are presented here. Data were collected from 13 participants over a period of 3 months from February 2023 to April 2023 in the simulation centre of a tertiary teaching hospital in the UK. The audio recording and the questionnaire were pseudonymized and analysed using inductive thematic content analysis. Important themes identified were the emotional aspects of watching their video, the learning opportunities available with video review, level of support needed for video review and ideal time to review the video. Unexpected emergent themes included foundation doctors’ views about simulation education, reflective practice post-simulation and peer pressure during simulation.
Conclusion:
This study explored foundation trainees’ perceptions (cognitive, kinetic and affective) about video review after simulation and several interesting themes were identified. We believe this study adds value to simulation-based medical education in helping to understand foundation doctors’ views about simulation and video-assisted debriefing.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A30Safe Interdepartmental Learning from clinical incidents using a Quality Improvement Framework
Authors: Kaja Mohammad Rasheed , Jones Nicola , Khan Zilley 
Published: October 2023

Background and aim:
Mistakes are an inherent learning opportunity within healthcare that can be used to prevent future loss of lives and reduce suffering. We aim to create a safe learning space within our organization that can be embedded within our quality improvement (QI) process.
Methods:
We have designed a bespoke framework (Figure 1-A30) to integrate our organizational QI process [1] with a 6-month iterative simulation programme. This utilizes multidisciplinary co-creation, embedded faculty development, and reflective practice to facilitate learning from each other.
Safe Interdepartmental Learning with a Quality Improvement Framework
Our tertiary hospital clinical governance team in collaboration with the multi-professional education, simulation, and patient safety departments has identified 5 topics based on the root cause analysis of serious clinical incidents. This description from our recent cohort involves the recruitment of 5 different specialty teams, each consisting of 1 experienced consultant faculty and 3 other facilitating clinicians with different levels of experience in healthcare simulation.
The teams prepared and designed the most suitable clinical scenario progression to address the learning objectives based on their allocated topics. Learner and peer feedback along with reflections on the session, highlighted possible change ideas to modify the subsequent scenario running. Over a period of 6 months, different learner sets were involved in the same simulation exercise with 2 further iterative modifications.
Results:
The 5 teams have generated a total of 15 hours of simulation sessions using standard pre-briefing, debriefing, and evidence-based simulation techniques. The level of independent facilitation and mentoring by more advanced debriefers has been adjusted to fit the individual pace of experiential learning. To further enhance the embedded faculty development a total of 270 minutes of online discussion, reflections, and 15 topics were presented by the facilitators to create a multi-professional learning experience. The content was structured to reflect the national outcome’s framework for faculty development and the ASPIH standards guidance for simulation-based education. The recorded simulation sessions, debriefing, and topic discussions have generated a useful asynchronous online reference for the current and future cohorts.
Conclusion:
The feasibility of implementing this simulation programme integrated with a QI framework is a major step for our future prospective evaluation of the impact of translational simulation as theorized in the current literature [2] on patient outcomes and healthcare performance indicators.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A72Using Simulation as a Method of Assessment in Further Education
Authors: Sunderland Ann , Weeks Rebecca 
Published: October 2023

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

To transform the assessment methodology within further education (FE) via the use of immersive technologies
To facilitate collaborative development of bespoke virtual reality (VR) scenarios incorporating course learning outcomes (T level and Care Certificate)
For digital technology students to work jointly with industry in VR development
To gain feedback from students, employers and other key stakeholders with regards to using immersive technology as a method of assessment.

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

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

iRIS proved to be an invaluable platform for scenario development across organizations greatly aiding communication and decision-making
Both students and faculty need have reached a minimum competency with the VR equipment and environment prior to assessment
Course learning outcomes can be readily incorporated into bespoke VR scenarios
VR would be a suitable mode for assessment for some learning outcomes but not all
The prototype scenarios provided adequate realism, face and construct validity for assessing the identified learning outcomes
VR simulation has the potential to be suitable and acceptable mode of delivery for assessment in health and social care. Funding applications have been submitted for phase two of the project which would include an impact study.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A33A novel form of communication training for Medical Support Workers at a large teaching hospital
Authors: Rawlinson Sadie , Hay Natalie , Pordes Rosalie , Jones Ingrid 
Published: October 2023

Background and aim:
The Medical Support Worker (MSW) Programme, funded by NHSEI, enables International Medical Graduates (IMG) and refugee doctors to work in the NHS, whilst acquiring General Medical Council (GMC) registration [1]. MSWs and IMGs have a recognized set of learning needs, with communication difficulties the most reported challenge amongst IMGs [2]. North Bristol Trust (NBT) employed a second cohort of 30 MSWs in July 2022, all of whom previously practiced medicine in Myanmar. NBT enlisted the assistance of a local Community Theatre to create and deliver a novel training programme with an emphasis on improving confidence in communication.
Methods:
Reflective pieces completed by MSWs one month in to post, alongside two probing questionnaires, highlighted the demand for communication training. A local Community Theatre, with prior experience of working with migrants, refugees, and vulnerable groups, was contacted. The Community Theatre met with both current and former MSWs to further identify development needs. Subsequently four two-hour workshops, with specific focuses, were designed:
Session 1: Informal conversation, talking about yourself
Session 2: Voicing opinions and interpretations, acknowledging mistakes
Session 3: Talk about yourself, interview practice, body language
Session 4: Public speaking, dealing with conflict

Session 1: Informal conversation, talking about yourself
Session 2: Voicing opinions and interpretations, acknowledging mistakes
Session 3: Talk about yourself, interview practice, body language
Session 4: Public speaking, dealing with conflict
Workshops consisted mostly of games and small group activities with an element of performance. The programme was evaluated using a feedback form, consisting largely of Likert scale questions, completed after the 4th session.
Results:
Communication, social skills or cultural change were highlighted as the biggest challenges by MSWs (64%). Confidence in tasks that involved speaking in front of groups, dealing with conflict, or speaking to relatives was low (13.6-22%). Only 52% of MSWs felt confident speaking to colleagues.
The sessions were well received with 100% of respondents reporting both to have enjoyed the sessions and that they would recommend the sessions to other MSWs.
Results showed improvements in confidence, specifically with regards to: conversing with colleagues (94%), informal conversation (87.5%), public speaking (88%), raising concerns (100%) and offering opinions (100%).
Conclusion:
This novel locally developed communication training addresses some of the unique learning needs of MSWs and improves communication skills in a range of areas. The programme is being considered for expansion to international nurses and IMGs at NBT.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A95UCLH Simulation Centre - Let us show you around: A digital hybrid approach to simulation environment familiarization
Authors: Nash Luke , Findley Rochelle , Paschoud Daniel 
Published: October 2023

It is well established that familiarization with the simulation environment is integral to the pre-brief [1]. This fosters psychological safety and creates optimal learning conditions for participants and faculty. We sought to enrich our visitors’ psychological safety by providing a digital preview of our simulated environment, prior to the face-to-face familiarization they receive when attending a course.
Combining 360 and 2D video production techniques we have produced an online experience hosted on the CenarioVR platform. This gives visitors an opportunity to explore the simulated environment, patient and equipment, in their own time, while introducing aspects of the fiction contract. We believe accessibility is key to the utilization of this resource. So we have ensured it can be used on a range of devices including:

Virtual Reality Headsets (HTC/Meta)
Desktops/ Laptops
Mobiles/ Tablets (enhanced with accelerometer controls)
The content is cloud-based and accessed via an internet browser across all platforms, requiring no additional app. One limitation is that the experience requires a stable internet connection.
A link to the tour was embedded in our pre-simulation communication to participants and faculty, and its usage and impact was evaluated over a period of 2 months using additional questions in our post-course questionnaire. 50 feedback responses to CenarioVR were received. 24 delegates viewed it 26 did not. Of the 24 that viewed 58.3% agreed virtual tour strengthened their experience, 12.5% strongly agreed, 20.8% neutral, 4.2% disagreed and 4.2% strongly disagreed.
From our data we concluded that over 70% of delegates that viewed the virtual familiarization found it to be beneficial to their simulation experience. With simulation being used more in education it is imperative that those with less experience in this setting are provided with resources they need to feel psychologically safe.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A77Translational simulation in practice: an enhanced orthopaedic induction for new trainees
Authors: Alsawada Osama , Brara Amrita , Savaridas Terence , Mardon Julie 
Published: October 2023

The gap between imagined and realized healthcare practice is indisputable. For trainees who rotate between departments, the challenges of navigating complex healthcare systems are unmet by standard induction programmes [1,2]. Our simulation centre and orthopaedic department collaborated to create an enhanced departmental induction using immersive simulation.
Following a thorough needs assessment for new trainees rotating to trauma and orthopaedics. We looked at previous trainee feedback, adverse event data from our safeguarding reporting system, and expert opinion from orthopaedic staff. It became clear that at times of transition, the process of accessing timely and appropriate support was challenging. Furthermore, there were a myriad of clinical duties and patient cohorts covered by the trauma team. Working within this dynamic and complex structure was difficult for new trainees. We used team-informed process mapping to define the escalation systems in place, and the distinct roles within the team.
We identified key learning objectives for a simulation induction session. We used a case vignette of an unwell trauma patient and aligned the scenario design to the required learning objectives on clear escalation pathways and whole team working within a complex environment.
Following a successful pilot run, this enhanced induction is routinely delivered four monthly for junior doctors rotating to the orthopaedic department. Current trainees, orthopaedic consultants, and senior managers also attend this trainee induction as an open forum for dialogue on service improvements. All participants have rated these sessions as good or excellent; they value the whole team approach and repeatedly ask for further simulation sessions. Feedback from other members of the trauma team following these sessions commented on increased connection within the team, which included junior trainees attending departmental meetings. The orthopaedic team also felt that, following the induction programme, new trainees had demonstrated improved handover skills when escalating unwell patients.
This whole team simulation-enhanced approach to orthopaedic induction is novel, and in contrast to the majority of standardized induction programmes [3]. This work provides a template that can be applied to different healthcare systems. By delivering constructively aligned simulation sessions, we can improve team training and enable new trainees to flourish during periods of transition.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.