bluuebunny/crossref_metadata_2025_split huggingface dataset:
Celestial Realm, Vegetal Worlds, and the Marvelous in the First Book ofKyranides
Authors: Piperakis Spyros 
Published: November 2022

AbstractThe first book of the Hermetic Kyranides consists of 24 alphabetical chapters, one each listing a plant, a bird, a stone, and a fish, whose names all begin with the same letter of the Greek alphabet, and expounding their medical and magical properties. Even though the book deals entirely with the issue of natural sympathies and antipathies employed to attain various ends, it surprisingly lacks a great number of astrological references. My purpose in this paper is to analyze the rare and quite implicit at times relationships among stars and plants, including plant products, tracked down in the text.
Endoscopic submucosal dissection (esd) training sessions on ex-vivo porcine models
Authors: Thorpe Amelia , Howick Katherine 
Published: November 2022

Endoscopic Submucosal Dissection (ESD) is a technique for removing lesions in the gastro-intestinal tract. It involves precise cutting into the submucosal layer, allowing for the lesion to be removed in one piece, and has been shown to have a high curative resection rate [1]. It is a technically challenging endoscopy technique that requires experience and practice. As one of the common complications from ESD is perforation [2], training on ex-vivo models is becoming popular with 84% of surveyed centres in the UK requiring Endoscopists to complete a number of ESDs on animal models before progressing to train on patients [3]. While training was accessible at other centres, this was infrequent and less accessible.
Sessions were created at the hospital training centre. This was done using decommissioned endoscopy stacks and endoscopes, so that these were always available and designated for ex-vivo use only. The animal model was a porcine oesophagus, stomach, and start of duodenum prepared in a box with a hole for endoscope insertion. The duodenum was clamped to ensure inflation would be possible. The days ran from 0830-1530 with a drop-in option. After 7 sessions were run over 5 months, a survey was sent out to the 8 people that had participated to assess the benefits of the service (including faculty doing the training and trainees).
8 responses (100%) were collected. 62% (n=5) of responders had used ex-vivo models before. 83.3% of trainees (n=5) said they had come to our hospital specifically to train in ESD technique. Responders attended between 1 and 10 sessions at our centre. All trainees and faculty said they found the training extremely beneficial and that they thought the ex-vivo model work well the way it was set up. All responders said they would recommend the sessions to a colleague. All trainees said that training with an experienced Endoscopist was more beneficial than training alone. Suggestions for improvement included a more consistent timetable of when they could access sessions, more accessibility and wider range of endoscopy kit, and involving the wider nursing team in the sessions.
The ex-vivo ESD training sessions were well received by both faculty and trainees and were said to be very beneficial to their training. We will therefore be putting on more of these sessions, taking into account the suggestion for a regular accessible timetable.
1. Ahmed Y, Othman M. EMR/ESD: techniques, complications, and evidence. Current Gastroenterology Reports. 2020;22(8):1–2.
2. Kim SG, Hwang JH. How to decrease the risk of perforation in endoscopic submucosal dissection (ESD). Techniques in Gastrointestinal Endoscopy. 2019;21(2):99–103.
3. Küttner-Magalhães R, Pimentel-Nunes P, Araújo-Martins M, Libânio D, Borges-Canha M, Marcos-Pinto R, Koch AD, Dinis-Ribeiro M. Endoscopic submucosal dissection (ESD): how do Western endoscopists value animal models?. Scandinavian Journal of Gastroenterology. 2021;56(4):492–7.
Scenario template: a welsh perspective
Authors: Jones Bridie , Hawker Clare , Mitra Suman , Cook Sara-Catrin , Diaz-Navarro Cristina , Hoole Alice , Bartholomew Bethan 
Published: November 2022

Simulation is an educational approach in health and care that is often used to address patient/service user safety issues, technical and non-technical skills, teamwork, problem solving, and decision-making. The goal of simulation is to create an authentic learning experience. To be effective it needs to be designed and planned appropriately [1]. Following feedback from a health and care simulation community at webinars and other engagement events, a designated simulation team has designed a scenario template to promote the development and sharing of high-quality standardised scenarios.
A scoping exercise was undertaken to review and identify relevant literature and published scenario templates. A database search was undertaken through CINAHL, Pubmed, and Medline using the search terms: simulation, simulation scenarios, scenario template, simulation guidance, using a time-frame of 2010 to 2022.
The lack of breadth of literature on scenario writing was a surprising finding. However, the available literature identifies that an effective robust scenario must consider the prospective learners and the intended learning objectives and outcomes. Additionally, knowledge of educational principles and best practices in both simulation and clinical practice are needed [2]. Scenario design must also consider the modality and fidelity of the simulation, faculty members, use of supplementary resources, moulage, other participants, simulators, and/or standardized patients [3]. An evidence-based scenario template was developed and peer reviewed. It was then presented to and tested by the health and care simulation community during a free, inclusive, and well attended scenario writing online workshop facilitated by a simulation team in collaboration with experts.
The scenario template provides step-by-step guidance on scenario writing best practice and includes a didactic element by signposting to further reading. It was revised based on constructive comments made by the health and care simulation community, which included more prescriptive facilitator guidance, and will be published via simulation web-pages as an open access resource for use by anyone across the health and care simulation education and training workforce (
1. Dieckmann P, Gaba D, Rall M. Deepening the theoretical foundations of patient simulation as social practice. Simulation in Healthcare. 2007;2(3):183–93.
2. Bambini D. Writing a simulation scenario: a step-by-step guide. AACN advanced critical care. 2016;27(1):62–70.
3. Harrington D, Simon L. Designing a Simulation Scenario. Accessed via Designing a Simulation Scenario. 2021. StatPearls, NCBI Bookshelf (nih.gov).
The AWARE project (fAmiliarity with workplace and resuscitation equipment)
Authors: Bhargav Akshay , Harne Anuprita , Higham Helen , Pattanshetty Ravi 
Published: November 2022

Doctors joining Emergency Departments (ED) have individual training needs based on their experience and background of working in different countries or hospitals, and a large proportion of junior doctors work for less than a year in a single ED. We designed the AWARE project to analyse the challenges associated with familiarity with the physical workplace and resuscitation equipment for doctors new to an ED environment. The goals of the project were to assess the diverse learning needs [1], impact of unfamiliarity with environment and equipment on physician confidence, ability to participate in resuscitation scenarios, and to develop a simulation-based intervention to support new doctors in ED.
We developed a questionnaire for multidisciplinary staff to explore problems with workplace unfamiliarity and its impact on different aspects of performance during resuscitation. We included questions (tailored to professional background) about the management of resuscitation and the location of vital equipment under the broad headings of: preparation, airway, breathing, circulation, and other critical interventions.
We collected 104 completed questionnaires (67 from doctors, 37 from nurses). Over 90% of staff felt that lack of workplace familiarity negatively affects performance and leads to delay in performing procedures. 92% of the nurses felt that it was easier and more efficient to work with doctors who were familiar with the workplace. Quantitative data revealed issues with locating equipment such as:
60% Doctors did not know where to find mechanical-CPR device (LUCAS). 81% of the Senior House Officers did not know where to find end-tidal CO
We have identified familiarity with workplace and resuscitation equipment as a key learning need. The data from Phase 1 of the project have informed the development of scenarios for new induction processes in phase 2. Simulation is an important tool for education but also for induction and analysis of systems and pathways [2]. Phase 2 will also use novel technologies including 360° videos to allow staff new to the department to access ED environments and equipment virtually and at their convenience. Future work will involve monitoring the success of the interventions in phase 2.
1. Grant J. Learning needs assessment: Assessing the need. Br Med J. 2002;324(7330):156–9.
2. Health Education England. Simulation immersive technologies.
Does adopting the role of the patient promote positive changes in student empathy, compassion, and communication skills?
Authors: Wallace Rebekah , Lennie Iona , Moulds Yvonne , Bell Linda 
Published: November 2022

Simulation-based education is frequently used to develop empathic behaviours in medical and nursing students [1] however to our knowledge, there is no previous literature that develops such behaviours by allowing students to adopt the role of simulated patient as they are admitted acutely to hospital. The aim of our project was to explore changes in empathy, compassion, and communication styles by asking students to adopt the role of the simulated patient during the undergraduate multidisciplinary simulation.
Undergraduate final and penultimate year medical and nursing students who were undertaking their emergency medicine rotations were asked to participate. The simulation was delivered every 5 weeks, with one student adopting the role of the patient during the scenario. Two other students involved in the scenario adopted the role of the nurse and physician respectively. Data was collected via questionnaires and focus groups which were conducted immediately following the simulation. Questionnaires asked students to rank their agreement to several statements relating to improvements in empathy, compassion, and communication skills using a 1–5 ranking system, with 1 strongly disagreeing and 5 strongly agreeing. Focus groups were used to explore student opinions with the data transcribed and analysed into themes.
61 undergraduate students have participated thus far. 95% of participants agreed that adopting the role of patient provided them with a greater insight into the patient journey through the emergency department. 91% of participants agreed that they felt more empathy towards patients admitted acutely to hospital. Analysis of qualitative data shows improved empathy, compassion, teamwork, and communication with patients and colleagues within the multidisciplinary team. Students also developed a greater insight into how the unfamiliar hospital environment, lack of visitors, and COVID-19 precautions can negatively impact the patient’s journey. Finally, all students commented on how this simulation will positively influence their future practice.
Providing students with the opportunity to adopt the patient’s role has been shown to positively influence their empathy, compassion, teamwork, and communication skills. Future work will focus on whether these changes have been sustained and incorporated into clinical practice.
1. Karvelytė M, Rogers J, Gormley GJ. ‘Walking in the shoes of our patients’: a scoping review of healthcare professionals learning from the simulation of patient illness experiences. Advances in Simulation. 2021;6(1):1–11.
Patient and family involvement in designing and evaluating a simulation programme to combat childhood obesity
Authors: Berg Richard , Nightingale Helen , Mackenzie Megan , Anpananthar Amutha 
Published: November 2022

14.4% enter school reception obese [1]. The Paediatric Emergency Department (PED) offers opportunities for professionals to identify obesity and provide support to children and young people (CYP). Our PED launched an Obesity Toolkit: a medical education project created to help Make Every Contact Count, and to increase opportunistic diagnosis and sensitive communication about obesity (2). This includes teaching resources including communication scenarios and videos. Staff focus groups identified the main barrier for professionals was fear around communicating about obesity in a sensitive way. We aimed to collaborate with CYP to develop our communication simulation programme within the Toolkit. In addition, we aimed to involve families in the evaluation of the project.
We developed written patient leaflets, written and filmed communication scenarios incorporating feedback given by focus groups with Youth Empowerment Squad (YES), our local Trust CYP forum. The feedback included preferred language, which was emphasised in the debriefings of simulated sessions. The educational role-play scenario videos, which can be debriefed in teaching sessions, were filmed with a CYP taking on the role of a patient. After the release of the toolkit and accompanying simulation programme, 10 patients diagnosed as overweight or obese were randomly selected 2 to 4 months after attendance, as part of a patient experience survey. This telephone call explored parent opinions about the obesity discussion.
Learning from CYP in YES helped us explore their preferred language, such as focussing on healthy living over the concept of obesity and explaining what is meant by body mass index (BMI). We included this in our debriefings. Our role-play videos are used in training to give examples of obesity discussions with CYP. These were semi-scripted to allow the CYP to incorporate their own voice and provide their insight into how they or their peers might react. In the patient experience survey, all parents were positive about the approach, rating the conversation on average 7.6/10 for being helpful (10 most helpful). Notable comments from parents included ‘the approach was sensitive, they spoke about positive change, not negative’.
Parents talked positively about conversations that they had about obesity with staff trained using our simulation programme designed following CYP collaboration. It is encouraging that these conversations have been useful for CYP and families. Based on this feedback, we will continue to engage CYP and parents. Feedback from CYP is planned. The Obesity Toolkit is made free and Open Access for any interested departments.
1. NHS Digital. National Child Measurement Programme, England 2020/21 School Year – NHS Digital. NHS Digital. 2022.
2. Health Education England. Making Every Contact Count (MECC). 2022.
Innovation in simulation: reducing the cost
Authors: Mcrae Daniel , Pullen Amy , Reed Juliette , van Santen Isabel , Wilson Anna , Cayuela Hector , Shawcross Noah 
Published: November 2022

Simulation equipment is often prohibitively expensive. More so for smaller remote settings and developing countries. Reducing costs is essential to increase widespread uptake of high-fidelity simulation tools.
We describe the evolution of a cooperative simulation model development team incorporating the local Emergency Medicine Department clinical staff and local Secondary school pupils. This was a symbiotic relationship that utilised the clinical expertise of the doctors while giving the students project management experience while using the significant resources of the schools for physical product development. Roughly 15,000 tracheostomies are performed each year in the UK. After looking further in depth at emergency tracheostomies, we recognised a gap in this area of healthcare training [1]. Consequently, developing a surgical airway trainer was selected as the model to produce over the course of an academic year. The partnership project required infrequent visit from the clinical team to inform on clinical particulars and review model progression. Ultimately 2 models were selected from various prototypes to take to completion. These represented 3 core areas we wished to develop. The first model was a high-fidelity model completed using latest technology available in the school’s workshops. The second was built with minimal technology and aimed to be reproducible following simple instructions with widely available materials and be completely biodegradable.
This project resulted in successful development of two surgical airway models – both clinically and anatomically accurate, reusable, which deliver high quality simulation to a group of doctors and students at the local hospital. Both models are easily reproducible with minimal skills, but varied in both the detail and tools required to produce and degree of sustainability. Maximum cost of materials was £15.
Partnership with local schools gives hospitals access to resources not otherwise available that can lead to the development of innovative simulation models that can significantly reduce the cost of simulation. Both parties gain significantly from this partnership. Going forwards we aim to continue the partnership with aims to develop a central line training model over the next academic year.
1. Taylor C. Training for tracheostomy. BJA: British Journal of Anaesthesia. 2013;111(5):842–843.
Using simulation to support a new theatre setup
Authors: Midwinter Elizabeth , Wilson James 
Published: November 2022

Following the redevelopment of the day case theatre complex at Chorley District General Hospital it was identified that new ways of working were required, and changes to patient processes would need to be made. Some of these were normal, expected, adaptations to be made when moving to a new working environment, such as the location and storage of equipment.
The Resuscitation and Simulation Team, led by the associate Clinical Lead for Simulation, modelled the theatre list for the first day using simulated patients and in line with the ASPiH standards [1]. This gave the theatre staff the opportunity to run through cases in real time and gauge when patients needed to be sent for, how long was needed for setting up, and at what time they could safely call for the next patient without causing unnecessary delays or having patients waiting in corridors. Each step in the process was followed by a debriefing so that the actions could be discussed and any changes made.
The feedback was positive and team members found it extremely useful to simulate their upcoming lists. As expected, there were several patient flow related issues raised, mainly around timings and logistics (
Issues identified following simulation of a theatre list
Simulation of normal business can be successfully used to improve patient safety and the confidence of clinical staff when developing new clinical areas.
1. Association for Simulated Practice in Healthcare. Simulation-Based Education in Healthcare. 2016. Standards Framework and Guidance. Association for simulated practice in healthcare (ASPiH) standards for simulation-based education.
Does simulation help medical support workers transition into working in the NHS?
Authors: Thomas Hope , Clarke Ygraine , Karamura Paul , Whittaker-Jain Revathi , Waring Kitt , Nye Abigail 
Published: November 2022

A simulation-based programme was developed for the Medical Support Workers (MSW) within the Trust. The MSW role was created in response to the COVID-19 pandemic, providing an opportunity for doctors seeking GMC registration to gain clinical experience within a supervised NHS placement [1]. This project explored the MSWs’ perceptions and previous experience of simulation and their overall confidence working within the NHS before and after the teaching programme. The aim was to assess if simulation is a useful tool to help international medical graduates transition into working in the NHS.
29 MSWs (28 of whom were from Myanmar) worked in acute and medical specialties across the Trust, performing roles including: writing in medical notes, taking collateral histories, examining patients under supervision, procedures such as venepuncture and writing discharge summaries. Each MSW was invited to attend three training days between January and March 2022. We provided a programme incorporating medical and surgical simulation, communication workshops, and procedural skills, supported by human factors teaching. We delivered the sessions in our learning and research building, including our simulation suite. We collated data by sending out pre- and post-training surveys. There were 22 and 18 responses to the two initial surveys and 20 responses to the post-training survey.
44% had prior experience of clinical simulation and only 9% had previous experience working as a doctor in the NHS. On further analysis, 50% felt either quite unconfident, or neither confident or unconfident working in the NHS. A minority felt confident dealing with medical emergencies (18%) and surgical emergencies (13%) and with their communication (32%) and leadership skills (23%). In the post-simulation feedback, 100% reported that simulation was a useful method to help doctors transition into working in the NHS and felt it improved their confidence in the workplace. Furthermore, 100% stated that the simulation sessions had changed their clinical practice and addressed their learning needs. The participants reported that the sessions had improved their stepwise approach to emergencies (100%), communication (95%), teamwork (100%), leadership (70%), and decision-making skills (95%).
This project demonstrated that simulation is a popular and useful educational resource in helping improve international doctors’ confidence when transitioning into working in the NHS. Given that 100% of our participants wanted further simulation sessions, our Trust plans to employ a dedicated MSW simulation fellow to support further cohorts.
1. Temporary Medical Support Worker (MSW) Secondary Care – Job description and person specification. NHS England and NHS Improvement.