bluuebunny/crossref_metadata_2025_split huggingface dataset:
202 High-Fidelity Simulated Bronchoscopy: Incorporating Simulator into A Mannequin
Authors: Keshtkar Fatemeh , Ellerton Laura , Kelly Ryan , Parr Tim , Mercer Simon 
Published: January 2022

Fiberoptic intubation (FOI) is a technique used to establish airway access in patients with anticipated and unanticipated difficult airways. Fiberoptic bronchoscopes are currently used to facilitate endotracheal intubation via either the nasal or oral route, in the positioning of endotracheal and endobronchial tubes and bronchial blocking devices, and in airway examination or evaluation. FOI is used in the management of awake spontaneously breathing patients with an anticipated difficult airway The aim of this project was to incorporate the ORSIM® simulator into a manikin for use in high-fidelity simulation. A basic resuscitation training manikin was used (A basic resuscitation training manikin is used. The silicone/rubber skin is removed.The ORSIM® black sensor box is placed over the head with an exit point towards the thorax.Place polystyrene to support head and cheek region. This could be substituted with other materials such as foam/wax.Optional: the use of inexpensive props such as wigs/hats/shirts.Position patient and monitor for high-fidelity simulation.We found that the ORSIM® simulator was a useful tool for training. The virtual video guidance can be used to familiarize clinicians with different pathology and improve technical skills. By incorporating the simulator into a manikin, a more realistic model can be created. Here we have used very inexpensive and often readily available equipment within a healthcare setting to achieve this. This model can be used as part of a high-fidelity simulated scenario to improve the learning experience.
56 ‘Abducted Baby’ Simulation: Testing the System to Optimize Patient Safety on a Neonatal Intensive Care Unit
Authors: Aguirre Diana , Nash Matthew 
Published: January 2022

Infant abductions are rare distressing events. The Care Quality Commission recently highlighted inadequate protective measures in other trusts as a cause of major concern The aim of the study was to test our existing patient safety system in a real-life situation looking at human factors and equipment functionality.An activated baby tag was placed on a mannequin which was then put into a pram. A member of staff in disguise (the ‘abductor’) pushed the pram out of the neonatal unit by ‘tailgating’ another member of staff so that the doors would not automatically lock, replicating a potential real-life scenario that exploited a known risk. The aim was to see whether the mannequin could leave the hospital. The ‘abductor’ was eventually stopped from leaving. A detailed timeline of events was recorded and analysed. Safety was ensured and participants were individually debriefed as emotions were high.Our simulation highlighted points of excellence including a quick and calm response, the use of the panic button and appropriate persistent challenge of the ‘abductor’ without aggression. Important human factors were highlighted. There is no security staff in the hospital. The ward clerks called the porters directly, rather than dialling 2222 and saying ‘lockdown’, which triggers a lock of all doors out of the hospital. There were several system failures. The baby tag system did not alert the front of house. The panic button was broken, and a set of doors out of the hospital did not lock.Simulation is an effective tool to identify system failures and patient safety risks. This scenario highlighted deficiencies in our system and a lack of established procedures and training. A detailed action plan has been put in place. The panic alarm, door locking mechanism and system linking the baby alarm system to the front of house are being addressed. The option of an automatic lockdown on activation of the baby tag alarm system is being explored. Finally, a standard operating procedure is being written and learning disseminated in the department. We are planning to run this simulation in other areas of the hospital to optimize patient safety.
145 Scenario-Based Perinatal Psychosis Simulation for Final-Year Midwifery Students: A Qualitative Study
Authors: Hall Verona 
Published: January 2022

Approximately 20% of women will reach diagnostic thresholds for mood disorders during the perinatal period, and between 0.1% and 0.2% will experience a psychotic disorder The aim of the study was to explore final-year midwifery students’ experiences of a perinatal psychosis, scenario-based simulation (SBS).A 1-day SBS learning activity with two scenarios of women exhibiting psychotic symptoms. Each scenario included a background narrative, actors’ roles with partial scripts and comprehensive patient clinical information. Two midwifery students acted as assessment staff in each scenario whilst their colleagues took observer roles. Guided debriefing followed each scenario.The study was conducted in March 2020 at a UK Higher Educational Institute. It employed an exploratory, descriptive design to capture qualitative data from 11 final-year midwifery students who took part in the SBS. Data sources included semi-structured interviews and information shared during scenario debriefings. Data were thematically analysed following the seven-step process of Dahlgren and Fallsberg Three main themes emerged from the data. The SBS facilitated learning through different ways of knowing. Students drew on personal experiences to identify communication and care challenges, re-appraised assumptions they held about mental health and ethnicity and articulated the benefits of peer learning. Students held equivocal views concerning the adequacy of mental health content in existing curricula, and not all had encountered women with perinatal psychosis on clinical placements. Clinical environments were highly valued learning contexts for the observation of staff and the gradual, supervised application of practice skills. Both learning mechanisms were replicated in the SBS, which helped the students realize attributes and skills in themselves necessary for the care of women with perinatal psychosis. The SBS facilitated transformative learning through its realism and the development of skillsets not amendable to didactic teaching, e.g. teamwork and communication skills. Debriefing helped to cement learning in the minds of students.The SBS was an effective form of pedagogy that enabled invigorating and deep learning. It is recommended that other educators consider its use, particularly for conditions that students do not always encounter in clinical placements. Well-prepared, detailed scenarios are recommended to promote realism and each SBS should be followed by a structured debrief. Developments should be accompanied by evaluative methodologies to gauge their impact and further research is needed to better understand how SBS can be used more effectively throughout midwifery education.
61 Exercise Martian Attack!: Using VR Feedback as a Reflective Tool for Paramedic Science Students
Authors: Rolfe Ursula , Bancroft Adam , Holley Debbie , Moran John 
Published: January 2022

Paramedic students have had to overcome the restrictions COVID-19 with many of their clinical skills moving online, limiting opportunities to engage with clinical practice partners, a key requirement of their professional programme. Social distancing has been challenging to overcome and the paramedic teaching team’s solution was to offer the University underground carpark to stage a simulated Casualty Clearing Point for a Major Incident Martian Attack!The aim of the session was to reconceptualize our simulation practice at the university level and to
Engage our students with an authentic, reflective, and clinical skills-based assessment experienceTo draw upon lessons learned to improve our processes and guidelines for stakeholders involve in clinical skills assessmentsTo enhance the student learning with early familiarization and ‘hands on’ practice with the equipment utilized in the field of paramedic scienceThe paramedic teaching team created ‘Martian Attack!’ a short video to set the scene for the tasks the first-year students teams need to accomplish. The students were divided into pairs where they were tasked to triage at ‘stations’ treating mannequins with simulated injuries under time constraints. This was followed by demonstrating immobilization techniques and extracting a weighted mannequin from an enclosed space using a Saviour Technical Stretcher (STS). All these skills require a combined improvised approach towards casualty evacuation. Students were observed by critical care professionals and offered feedback. ‘There is only so much simulation that can be done in a room so I thought it was great to be able to get out and experience a “Real Life” event where we could put the skills and knowledge from the previous weeks into practice in a supported environment’. Student J.Three-hundred-and-sixty-degree film clips captured these simulated scenarios and debriefs and were added on a virtual platform hosted by Panopto so that students could reflect on the scenarios in their own time to aid their learning and reflection. The film clips made accessible by a range of technologies, from google cardboards to OCULUS Quest, added the high-fidelity aspect of realism to the student’s learning experience. The next steps will be to consult with our practice partners to streamline and identify further areas of practice that will enhance the skill mix of students on placement.
42 Updates to the International Nursing Association for Clinical Simulation and Learning Simulation Debriefing Standard of Best Practice
Authors: Alinier Guillaume , Decker Sharon , Crawford Scott , Jenkins Deborah , Gordon Randy , Wilson Cheryl 
Published: January 2022

Debriefing is a key component of all simulation-based educational (SBE) activities and is an activity for which a multitude of approaches and models have been developed and implemented (Oriot & Alinier, 2016). To improve SBE practice in general, the International Nursing Association for Clinical Simulation and Learning (INACSL) has outlined a set of Simulation Standards of Best Practice first published in 2013. Revisions to these standards have occurred every few years, including expanding the topics covered as developments in this domain have occurred and the use of simulation has expanded.The aim of this study was to present the changes in the Simulation Debriefing Standard in comparison to those last published (INACSL Standards Committee, 2016).From 2019 to 2021, a group of simulation educators and researchers, the authors of this abstract, representing multiple specialities, simulation societies and geographic areas began meeting to review and revise the Simulation Debriefing Standard based on the latest literature. This group identified several items that would benefit from being updated, including expanding the terminology of this Standard to encompass Feedback, Debriefing and Guided reflection as distinct but integral components of this key phase of simulation-based experiences.An updated version of the Simulation Debriefing Standard of Best Practice will soon be published by INACSL in Clinical Simulation in Nursing. Some of the updates include expansion to understand and allow electronic systems to be recognized as components of the debriefing process and emphasizing the need for practice and review of the skill of facilitators in the techniques of debriefing. The new Simulation Debriefing Standard provides clear information and guidance to the simulationists. It includes four as opposed to the five criteria in the 2016 version (INACSL Standards Committee, 2016). The updated criteria can still be matched to those from the previous edition (see colour coding in Criteria of the 2016 and 2021 INACSL debriefing standards of best practiceIt is expected that the revised Simulation Debriefing Standard of Best Practice will be welcomed by the simulation community, which includes the healthcare educators and simulation technology developers, but also the learners. It has been designed as a guide to help educators in all the key aspects of debriefing, providing feedback and facilitating guided reflection conversations that will ultimately benefit learners. It includes an updated list of useful references readers can consult to find additional information.
188 Community Simulation Program Designed to Improve Recognition of The Deteriorating Patient and Escalation of Care Pathways
Authors: Baker Katy , Hester Ben , Wilson Esther , Richards Pippa , Coombes Jennifer , Vast Sarah , Newton Stephanie , Duzy Ashley 
Published: January 2022

This abstract looks at how we implemented physical health simulations within community hospitals in late 2020 and more recently physical health simulation in mental health units.The objectives of these simulations were to improve the recognition of deteriorating patients and the appropriate escalation and/or transfer of care as well as ‘identifying latent errors through simulation’ We have run simulations in the community since October 2020 and in the mental health units in February 2021. These sessions have covered four main themes:
SepsisHypoglycaemiaAnaphylaxisOpioid overdoseThese sessions were taken from pre-existing incidents such as the hypoglycaemic relative and anaphylaxis. We also added opioid overdose as this topic is relevant to both mental health units and community hospitals. We delivered a package of four simulations across 1 month at each unit. This allowed for a different simulation each week, regular learning outcomes and wider opportunity of contact with the staff working within these areas. These sessions were always well attended with staff even committing to learning on days off. This level of commitment shows a real desire to improve not only their own knowledge but also patient safety. We engaged over 50 staff on 9 separate sites (five community hospitals, four mental health wards). Staff have been very engaging and have really got behind these simulation sessions as well as the ward managers. By engaging both mental and physical health, it has helped to provide a wider audience of staff and helped to gain a parity of esteem across the trust in the provision of safety training and simulation. We have also identified a number of latent errors such as non-standardized provision of anaphylaxis adrenalin across the trust, staff unfamiliar with resuscitation equipment bags and equipment location within and identifying the lack of Glucagon within a Hypo box.The data collected from these sessions have shown a growth in confidence in identifying deteriorating patients and how to correctly implement and use escalation tools such as the sepsis pathway, electronic observations (E-Obs), anaphylaxis algorithms and the SBAR communication tool.These simulations have really allowed us to bridge the gap between the acute and community site, allowing for a greater parity of esteem for all patients. Further steps in this program will be delivering mental health simulations to all mental health units and community hospitals to further bridge the learning between physical health and mental health.
48 Use of Simulation to Introduce Delivery Room Cuddles as Standard Practice in a Neonatal Intensive Care Unit
Authors: Aguirre Diana , Henderson Amy , Cornes Helen , Holder Gemma , Fernandez Cecilia Perez , Cawsey Emma 
Published: January 2022

Kangaroo Mother Care (KMC) was introduced in the 1970s to keep premature babies warm after birth. There has been growing evidence of multiple benefits including physiological autoregulation, reduced stress, positive attachment, enhanced neurocognitive development, breastfeeding and psychological well-being. Delivery Room Cuddles (DRC) was introduced 15 years ago in Norfolk and Norwich University Hospitals as an extension of KMC. Other units have since reported the successful introduction of the process The aim of the study was to safely introduce DRC as standard practice in our NICU.We obtained feedback on parental and staff experience with DRC. A Failure Mode and Effects Analysis (FMEABefore implementation, 54 medical and nursing staff completed the survey, rating statements on confidence from 1 ‘strongly disagree’ to 5 ‘strongly agree’. Confidence was higher in non-intubated infants 32–34 weeks’ gestation (33/54 rated 5) and lowest in intubated infants <27 weeks’ gestation (10/54 rated 5). Staff reported anxieties around equipment failure, delaying care and adverse events. Thirty-nine parents completed the questionnaire. Thirty-four babies were born locally. Only five babies had DRC, of which four had no respiratory support. Time to first skin-to-skin contact ranged from 2 hours to 17 days (mean of 5 days). DRC is becoming routine practice in our NICU with no adverse events to date. Anecdotally staff and parents report great satisfaction with DRC, although formal outcome assessment is outstanding. Introducing DRC is feasible with adequate process planning and staff training using video simulation and workshops. DRC is cherished by families, rewarding for staff and sets infants up for a positive start in the neonatal journey. With examples of successful DRC practice and emerging safety outcome data, DRC is likely to become routine practice. Using this model of process design and training, other units will also be able to safely introduce DRC.
197 Maintaining Surgical Skills Through Small-Group Simulation During COVID-19 [Quality Improvement Project]
Authors: Kulkarni Shreya 
Published: January 2022

The COVID-19 Pandemic has had a significant disruption to the provision of Surgical Training. Core and Improving Surgical Trainees (CSTs and ISTs) are noted to be a group profoundly affected due to the impact of the pandemic in reducing operative time, cancelled elective procedures and redeployment to other specialities We aimed to evaluate the benefit of Small Group Surgical Simulation teaching for CSTs and ISTs recently deployed in the Norfolk and Norwich University Hospital.Physical simulation models were designed with the use of animal tissue and/or surgical simulators (such as laparoscopic box trainers) to simulate surgical procedures appropriate for the grade of trainees.We designed a monthly Surgical Simulation Programme, which took place in the Surgical Skills Laboratory. Topics were selected from those suitable for Simulation from the Intercollegiate Surgical Curriculum Programme (ISCP) Core Surgical Curriculum Participants felt that the COVID pandemic affected opportunities to perform/assist or observe the surgical skills. Participant comments on COVID affecting opportunities included ‘Reduced opportunities due to cancelled lists’, ‘Fewer elective cases so less opportunity ‘ and ‘Affected in the Peak of COVID but it is improving. Following the session, 100% of participants found the sessions to be effective in improving confidence in performing the surgical skill and 87% found the sessions to be extremely effective. Participants found the teaching sessions to be useful due to the opportunities of ‘Close supervision and direct feedback’, ‘Set of tasks’, ‘Practise with animal models’, ‘Having the tutor there to assist and help us’ and ‘[Discussing] theory prior to learning the procedure’.Surgical simulation provides opportunities for early-year trainees to learn and perform surgical skills during the COVID-19 pandemic. Small-group surgical simulation allows CSTs and ISTs to develop and practise skills under supervision of tutors, with trainees finding real-time feedback useful. In a post-COVID era, a surgical simulation teaching programme could provide an effective training opportunity to shorten the steep learning curve of core surgical training.
151 Comparing Online and Face-to-Face Simulation for Medical Students During their Healthcare of Later Life Placement
Authors: Ludvigsen Anna , Bachra Josh , Junaid Kehinde 
Published: January 2022

As part of their Healthcare of Later Life placement medical students take part in a simulation-based learning (SBL) programme delivered by the Nottinghamshire Healthcare Simulation Centre. Since face-to-face teaching was not possible during the COVID-19 pandemic the programme was instead delivered online.The aim of the study was to compare the feasibility and acceptability of delivering an SBL programme for medical students virtually versus face to face.The existing SBL programme was delivered online while largely keeping the same content and format as for prior, face to face, cohorts. Feedback questionnaires from 136 face-to-face participants (F2F) from the 2019–2020 cohort and 131 virtual participants (V) from the 2020–2021 cohort were compared.Overall, the virtual course was still acceptable to most participants with 99% agreeing or strongly agreeing that the learning objectives were met and 98% indicating they would recommend it to a colleague. However, there was a decrease in Likert scale ratings across all domains in the V group. This was most apparent when examining the ‘strongly agree’ responses: the venue/remote format was suitable for the session 34% decrease, the course length was appropriate 30% decrease, the pace of the course was appropriate 20% decrease, the trainers were well-prepared 15% decrease, the presenters were engaging 10% decrease, the simulation was helpful and relevant 10% decrease, the content of the course was organized and easy to follow 5% decrease, the learning objectives were met 4% decrease. There was a small increase in responses in the strongly disagree and disagree categories.Providing the SBL programme using an online format was feasible while also being acceptable to most participants. However, participants did not rate this experience as highly as face-to-face teaching. An interesting finding is that participants rated the pace and length of the online course as less agreeable, despite the content and scheduling is the same as for the face-to-face group. Analysis of qualitative responses indicated that participants in the V group found it difficult to sustain concentration for the duration of the virtual session. This may relate to a newly emerging phenomenon dubbed ‘Zoom Fatigue’ (Lee, December 2020) which is related to the greater cognitive load required when participating in social interactions in a virtual environment. Based on these findings, face-to-face teaching should resume when practicable. The virtual delivery may be improved if the course length was reduced.