bluuebunny/crossref_metadata_2025_split huggingface dataset:
47 Improving Technical and Human Factors Skills on the Older Person Unit: An <i>in situ</i> Frailty Simulation Programme
Authors: Dunnell Liam , Chu Katie , Barnard Anna , Walker Grace 
Published: January 2022

Awareness of symptoms associated with frailty is uneven across acute hospital staff The aim of the study was to evaluate the efficacy of simulation was selected to increase accessibility for staff and promote ward team learning. Sessions started in October 2020 on one ward, before moving across other wards. These 1-hour sessions have been delivered weekly with a hiatus due to the second wave of the COVID-19 pandemic. A bank of frailty-based scenarios has been created, ranging from acutely unwell patients to communication with families. Participants have been from across the multi-disciplinary team. Data were collected using pre- and post-session questionnaires – containing the Human Factors Skills for Healthcare Instrument (HuFSHI) and frailty-based knowledge questions with Likert scales. Learning has been disseminated through the department via newsletters.Thirteen sessions have been delivered with 59 participants (23 nurses, 20 doctors, 9 physiotherapists, 6 nursing assistants, 1 occupational therapist). Forty-nine surveys were completed – 100% of participants found the sessions useful. Post-training, staff demonstrated improvement of self-efficacy in 11/12 HuFSHI questions and all frailty questions (Table 1). The most common learning themes were communication (51%), teamwork (43%) and escalation (24%), as well as management of frail patients (35%). Working with the team (47%), the scenarios (18%) and debriefing (12%) were aspects learners most liked about the sessions.An
37 Simulation as a Proactive Patient Safety Tool
Authors: Stevenson Anna , Hester Ben , Newton Steph , Wilson Esther 
Published: January 2022

Traditionally, The aim of the study was to develop a tool to detect latent safety errors during in situ simulation which is fully integrated with existing Trust safety metrics. simulation in a district general hospital across community and acute clinical areas.Multi-professional During the pilot phase, 73 participants took part in 7 simulations on AMU. Facilitators identified 28 latent errors. Comparison with other sources of safety data (formal incident reporting and critical care outreach team data) showed that Latent safety error by incident codeWe have identified three major outcomes: Shared learning: latent safety errors are rarely unique to one clinical area and have the potential to occur elsewhere in the Trust. Wider dissemination of latent safety errors at a directorate level allows proactive interventions to reduce patient harm. A monthly Simulation Safety Outcome Report shared with senior nursing staff at a directorate level is being evaluated. Responsive learning and staff engagement: latent safety errors were discussed at every debrief. Participants provided valuable suggestions often resulting in immediate local interventions. This internal resolution has engaged and empowered clinical staff in patient safety. Targeting resources: Integration of active and latent error data from numerous sources allows Trust safety management structures to target resources to improve patient safety and develop sustainable approaches to risk reduction. National standardization of coding active errors (incidents) and latent errors would broaden the use of
18 SP Training for Transgender Healthcare Stations: What SPS and Program Directors Need to Know
Authors: Simon Erik , Polonko Isle 
Published: January 2022

Recent interest in the United States addressing Lesbian, Gay, Bisexual, Transgender (LGBT) healthcare issues, particularly obstacles faced by transgender individuals, has resulted in newly developed programming addressing these concerns. Training students and faculty on nuances of LGBT patients, with a specific focus on transgender patients, is critical if outcomes for this population are to improve. Data show 23% of survey respondents avoided seeing a doctor when needed, fearing mistreatment as a transgender person The aims of the study were to increase empathy and awareness of LGBT healthcare needs and to improve communication and patient/practitioner relationships through experiential learning with live transgender standardized patients.The programmes developed address fundamentals for healthcare professionals about serving LGBT patients: inclusivity, rapport, effective communication without creating anxiety or offense, language to avoid, and other practical knowledge including various surgeries and gender-affirming care available to transgender individuals. Initial panel discussions with members of the LGBT community have proved very effective in covering realities faced by transgender patients. Implementation of Teaching OSCEs (Objective Structured Clinical Exams) utilizing transgender individuals applies gained knowledge from lectures and discussions. It is critical for learners to experience working with an actual transgender standardized patient to effectively simulate encounters. Only a person from a marginalized community can accurately portray unique experiences affecting that particular community. Advanced medical training has also been developed including training for forensic examiners.These programmes include an LGBT didactic presentation, followed by a moderated panel (conducted virtually or in-person) of transgender individuals from varied backgrounds to share personal experiences receiving healthcare. Trainees are encouraged to ask panellists questions regarding concerns on proper communication, inquire about experiences in receiving gender-affirming care and discuss how to improve healthcare for transgender patients. Subsequently, trainees have the opportunity to participate in scenarios scripted and led by transgender standardized patients (SPs) or Trans Teaching Associates (TTAs). These scenarios can be conducted virtually, focussing on interview/history taking and communication skills, which makes global reach possible. In-person hands-on OSCEs can further assist trainees by providing opportunities to visualize trans anatomy. Learner feedback on improved understanding and empathy has been overwhelmingly positive, proving the necessity of providing training for learners in the care and treatment of transgender patients.
116 Developing a Framework for the Integration of Skills and Simulation: The 5-Stage Approach
Authors: Browne Emily , Phillips Mike 
Published: January 2022

In recent years, there have been many publications providing guidance on simulation-based education and frameworks for development of faculty and delivery of simulation. However, there is not a framework for the integration and delivery of skills and simulation within a pre-registration curriculum. In 2017, Woda The aim of the study was to create a framework that integrates clinical skills and simulation increasing in complexity that can be used for any pre-registration healthcare curriculum. Ability to effectively implement and embed within an existing or new curriculum.We developed a framework using a five-stage approach to scaffold learning. Bringing simulation into the curriculum from the very start with the early introduction of consolidation and simulation allowing for a gradual cognitive load. Our approach builds on technical and non-technical skills alongside an understanding and exposure to simulation, by their final-year students will be debriefing their own teams in simulation and understand the use of simulation debriefing tools. This integration of skills and simulation and move away from ‘task training’ skills teaching aims to create both competence and confidence in students enhancing practice placements and ultimately improving the safety of patients. The approach consists of five stages: (1) online learning; (2) facilitated practical (task training); (3) simulation consolidation (facilitated simulation); (4) simulation days (remote facilitation); (5) clinical practice.The framework is being applied to the 2-year Master's programmes and nursing associate programmes as well as the standard 3-year pre-registration nursing, midwifery, operating department practitioner and paramedic programmes. Skills both technical and non-technical are introduced in years 1 and 2. In year 3, the focus is on knowledge review with a higher expectation of understanding and assimilation into the simulated environments expected. Over the 3 years, facilitation will lessen until students are leading on the simulation delivery and debrief by the end of their course. The same principle is applied to the 2-year programmes. This framework has been applied to all our healthcare courses by mapping the required skills curriculum and using the framework to build the content and set the delivery. The framework has now been adopted by another university.
169 Managing The Acutely Unwell Patient: An Interactive and Gamified Approach to Online Simulation During The COVID-19 Pandemic
Authors: Ogunmwonyi Innocent , Parker Hollie , Adeboye Teniola , Alam Azeem , Mathews Catherine , Simpson Thomas 
Published: January 2022

The COVID-19 pandemic has necessitated a transition from traditional face-to-face teaching to virtual equivalents, sometimes at the expense of teaching quality and student engagement Our aim was to demonstrate the feasibility of a novel gamified online simulation approach to teaching the management of acutely unwell patients.Using elements of gamification and interactive film, this virtual session was designed to teach prospective medical students the ‘A to E’ approach of managing an acutely unwell patient. The management of an acutely unwell patient is an iterative and dynamic process that requires one to manage uncertainty and constantly re-evaluate the clinical situation. The session was designed using interactive film, with students given the ability to influence a clinician’s actions and subsequent changes of clinical scenario dictated by student live-vote. This interactive and engaging approach allowed students to reflect-in-action and be active learners, in line with an experiential pedagogy Students attended a live session using a video conferencing service (Zoom) and their responses to clinical scenarios were recorded using an online voting tool (Mentimeter). Students were provided with a case history of an unwell patient and presented with an opening video. The session required video options to be pre-recorded to reflect the numerous potential avenues within the scenario as dictated by the students’ chosen actions. Depending on overall student voting consensus, pre-recorded videos of the clinician’s actions and changes to the clinical scenario were subsequently shown. For example, if the appropriate clinical action was selected, students would progress through the A-E approach. Students effectively guided the clinician to manage the unwell patient, with iterative and real-time feedback provided throughout the scenario. The session was concluded with a debrief, explanation of the case and key learning points.
4 Departmental Paediatric Simulation Teaching: How Can we Best Involve Adolescents as Simulated Patients?
Authors: Douch Catherine 
Published: January 2022

Paediatrics requires diverse, adaptable, age and developmentally appropriate communication and clinical skills which HCPs can find challenging, negatively impacting paediatric care. The involvement of simulated patients (SPs) could be used to bridge this gap and bring patient perspectives. To create authentic, high-fidelity paediatric simulations it makes sense that young people should have a role. As a paediatric registrar in a district general hospital, I considered how to involve adolescent SPs in teaching by performing a literature review.On 2 February 2021, an advanced title and abstract search on PubMed: ‘paediatric’/’children’/’adolescent’ AND ‘simulated patient’/’simulated patients’/’standardized patient’/’standardized patients’. In total, 196 results returned which I filtered as per the inclusion and exclusion criteria (Table 1) leaving five articles.Inclusion/exclusion criteriaFindings
Recruitment: SPs were recruited from theatre groups Training: some authors ran didactic teaching about conditions, rehearsals or video training Scenarios: standards of best practice state that simulated patients should be involved in resource writing and evaluation. However, while one group personalized scenarios Feedback: honest feedback from SPs is central to optimizing learning which SPs found challenging. Training to feedback with ‘I’ statements or using ‘the character’ to feedback was useful Positive impact: SPs felt the experience was positive and would be involved again. Positive impacts include: increased trust in HCPs Negative impact: exhaustion, boredom and potential for exploitation (missed schooling) Student learning: real children challenged students’ interpersonal skills and rendered encounters realistic.Implications for practice
‘Do no harm’ remains paramount in medical education. The benefit to society must be weighed against the risks to the child and their best interests must be kept central in educational processes.When planning teaching I will:Run monthly simulation sessions consolidating weekly didactic teachingLimit sessions to 1 hourRecruit young people within the hospital to minimize school absenceInvite collaboration between SPs and students to create scenarios around self-identified learning needs while maintaining psychological safety, allowing for complexity and fidelity that would be impossible if written by facultyTrain SPs to feedback using ‘I’ statementsCollaborate with the Child and Adolescent Mental Health Team prior to mental health scenarios to consider training and debriefingKeep the SPs voice central to the debrief and feedback
94 Phygital Simulation for a Large Group of Learners in a Regional Teaching
Authors: Ojo Stephen , King Amie , Faruqi Faisal 
Published: January 2022

Over the years, knowledge-based simulation has been a valuable way of delivering certain content of the syllabus in medical education. There have been challenges to undertake any form of educational activities during the COVID-19 pandemic due to a global shutdown The aims of the study were to deliver an inclusive and effective simulation session to a large cohort of trainees in emergency medicine and to provide an immersive learning environment to learners by enhancing their feeling of being present in the simulation hub.We delivered a phygital simulation with the aid of digital technology in a way that encouraged participation from all attendees. We sought to overcome known challenges of simulation teaching during the peak period of COVID-19 and identified newer challenges unique to the situation and suggestions for future improvements or simulation.During the simulation, we utilized a standardized patient (SP) (who did not require further training for our method) and various equipment/components of the room including cameras for the different views required. The room had a limit of five persons (as per COVID-19 restrictions) so we designed a teaching method that enabled us to cater efficiently for the remaining 33 participants of the scheduled regional teaching session. A volunteer candidate was chosen from the online audience to lead in the simulation. Prior to selection, all candidates were shown the brief which explained the expectation of leading and the different camera views available to aid their performance. They viewed the whole room with separate focuses on the SP, the device required to perform a procedure, and their appointed physical presence (PP) who they will instruct to perform the procedure. We identified advantages, challenges and areas of future development and believe that this type of teaching can be applied to a wide range of simulations that required demonstration.
103 Unpicking the Mechanisms Used in Simulation-Based Education that Support Undergraduate Students’ Development of their Collaborative Practice Skills
Authors: Ezekiel Leisle , Stiger Robyn 
Published: January 2022

Annually, approximately 80 undergraduate physiotherapy and occupational therapy students participate in simulation-based learning, as part of a second-year module. The experience provides opportunities for students to achieve core module outcomes, such as developing communication skills, inter-professional practice and clinical reasoning. The simulation is supported by a small team of academic faculty and a professional actor, all trained in simulation and debriefing. The students are required to assess an older person at home as part of an emergency response team. They work in groups of up to eight students, are pre-briefed and given a profession-specific written brief of their role in the scenario. A two-pronged approach to debriefing is used; the origami approach, utilizes pauses to capture teachable moments The aim of the study was to identify the mechanisms used in simulation-based education that support development of collaborative practice skills of undergraduate students.The simulation-based learning scenario was iteratively developed, delivered and evaluated over 3 years. Staff reflection and content analysis of 3 years of feedback from anonymous evaluation questionnaires, and a sample of student assignments, were used to identify aspects of simulation delivery that supported students’ development of collaborative practice.Although students consistently report anxiety about participating in the simulation, they also identify it as one of the most intense but helpful learning experiences of their on-campus degree programme. The use of trained, experienced actors, indistinguishable from service users maximizes student engagement. Effective pre-briefing reduces student anxiety and provides an opportunity to add complexity via the written brief. The student roles as observers and/or participants (in a familiar role) improve students’ experience and support students with diverse needs. Assigning clear staff roles improves delivery and cost-effectiveness. Combining the two approaches to debriefing students was necessary to allow reflection-in-action and -on-action. Thorough debriefing is essential, challenging and requires planning and practice.Simulation is an effective pre-qualifying education tool. Adequate pre-briefing, effective debriefing styles, and clear assignment of staff roles aid in effective delivery. Simulation scenarios need to be carefully constructed and delivered to ensure that all students remain within their optimal learning zone and to support students with diverse needs.
30 Shifting an In-Person Simulation Facilitation Training Program for New Nurse Educators to a Virtual Context
Authors: Dale-Tam Jennifer , Menard Prudy , Ladouceur Natalie 
Published: January 2022

Best practices indicate simulation sessions should be facilitated by a trained instructor to maintain a safe environment for learners. We developed and implemented a successful simulation facilitation training curriculum for nurse educators at our organization in 2018 The aim of the study was to revise our current simulation facilitation curriculum ‘Introduction to Simulation’ with greater emphasis on delivery of the program through virtual processes.Pulling from the educational methodology of the flipped classroom that has many advantages for the practicing professional such as improved learning performance, increased motivation and flexible learning This curriculum has yet to be implemented. We anticipate implementation in September 2021 with a cohort of 5 to 6 new nurse educators. The revised curriculum is anticipated to incorporate 2 hours of independent learning, 4 hours of an interactive webinar and 4 hours of simulation facilitation practice that will allow for the application of knowledge learned and feedback from simulation facilitation experts. After the workshop, we will seek feedback from workshop participants asking if this methodology met their learnings needs. We will use the outcomes of this first cohort to evaluate if this educational strategy is viable for ongoing program delivery.
MATEMATIČKI IZRAZ ZA LOGIČKO-GRAFIČKI IZRAVNATU KRIVU LINIJU
Authors: Lojo Ahmet 
Published: January 2022

Mnoge funkcije rasta koje se koriste u šumarskoj nauci i praksi nemaju matematičku formulu i funkcije su izjednačene na logičko-grafički način.
Zapreminske tablice za običnu jelu (Abies alba Mill.) izrađene na osnovu pet kvalitetnih klasa (Matić, 1963) još uvijek su u upotrebi u šumarskoj praksi u Bosni. Da bi smo uspostavili vrijednost parametara za funkcije rasta, program Microsoft Excel može
koristiti, čime se omogućava lakše izračunavanje podataka u inventarizaciji šuma.
UPOTREBA NOVIH TEHNIKA SADNJE SADNICA KOD POŠUMLJAVANJA EKSTREMNIH STANIŠTA
Authors: Višnjić Ćemal , Mekić Faruk , Balić Besim 
Published: January 2022

UDK 630*233
Eksperimentalno ispitivanje mogućnosti primjene mikorize i sintetskog hidrogela za povećanje otpornosti sadnica zaljeva na ekstremnom mjestu bez vode u ljetnim mjesecima, bio je cilj ovog rada. Mikorizne gljive Paxillus sp. soj korišteni su za povećanje aktivne upijajuće površine korijena presadnica, a sintetički hidrogel „Stockosorb“ za povećanje vododrživosti tla u zoni korijena biljke.Eksperimentalna istraživanja uključuju ispitivanje otpornosti klica (Picea abies L.) na fizički stres od suše. Sadnice su posađene u posude zapremine 2000 cm3, uz različite tretmane (kontrola, štokosorb, mikoriza, stokosorb + mikoriza). Fiziološko stanje presadnica ocjenjivano je mjerenjem potencijala zadržavanja vode i procjenom vitalnosti na ljestvici od 4 stupnja.Rezultati su pokazali da su sadnice s mikorizom i stokosorbom, kao i one s mikorizom, pokazale samo najbolje fiziološko stanje na kraju ispitivanja. Pokus je proveden u stakleniku Instituta za uzgoj šuma Sveučilišta u Göttingenu.
ŠTETE OD MRKOG MEDVJEDA (URSUS ARCTOS L.) NA ŠUMSKIM SASTOJINAMA U SREDNJOBOSANSKOM KANTONU
Authors: Kunovac Saša , Bašić Mustafa , Skrobo Nino , Ličanin Slobodan 
Published: January 2022

UDK 639.111.7:630*45(497.6)
Medvjed mrki (Ursus arctos L.) je najkrupnija vrsta karnivora u Bosni i Hercegovini. Usljed kompeticije za resurse sa ljudima, ova vrsta je nestala iz najvećeg broja evropskih zemalja prije više stotina godina. U Bosni i Hercegovini, intenzivno gazdovanje medvjdom provodi se od 1955. godine. Dopunsko prihranjivanje je bilo glavna karakteristika ovakvog načina gazdovanja, u pokušaju da se reduciraju štete koje medvjedi čine na stoci, usjevima, voćnjacima i pčelinjacima.
Prve značajne štete, uzrokovane guljenjem kore na stablima od medvjeda, zabilježene su 1983. godine. Neki radovi i studije iz tog vremena navodili su na zaključak da je primarni uzrok guljenja kore na stablima nedostatak mineralnih sastojaka u ishrani medvjeda. Drugi navode visoku koncentraciju medvjeda na lokalitetima oko hranilišta kao mogući uzrok guljenja kore na stablima.
Drastična regulacija brojnosti medvjeda u periodu 1992.-1995. godine, i nedostatak bilo kakvog gazdovanja (dopunsko prihranjiivanje), sve do 1998. godine, uzrokovalo je odsustvo šteta na sastojinama ili iste nisu bile registrovane.
Nove, značajne štete registrovane su 2006. godine u području Vlašića i 2008. godine na području Koprivnice.
U ovom radu, prikupili smo i obradili podatke o intenzitetu, vremenu i mjestu nastanka štete od medvjeda na dva lokaliteta u Srednjobosanskom kantonu. Uporedili smo prethodne podatke o štetama (do 1992. godine) sa sadašnjim. Takođe, komentarisani su mogući uzroci, mjere prevencije i zaštite, njihova efikasnost i posljedice po šumske sastojine.