DOI: 10.6084/m9.figshare.29484040.v1
title: Implementation of hybrid simulation training to promote collective and self-efficacy in medical students: a two-pronged approach

description: Simulation-based training (SBT) is an integral and indispensable component of medical and healthcare education, especially pertinent in acute care. Conventional forms of SBT in acute care primarily involve manikins or task trainers, which are either costly or too task-specific. Recent innovations in virtual patient simulation software (VPS) invites the opportunity for conjoined use with basic manikins, creating a hybrid model for acute-care teaching. This study aimed to: <b>①</b> Assess the impact of hybrid simulation teaching on the collective efficacy (CE) and self-efficacy (SE) of medical students, and <b>②</b> evaluate psychometric measurement scales within the simulation context. A prospective cross-sectional cohort study was conducted between 22 September 2023, and 19 December 2023. Fifth year medical students in an undergraduate medicine program underwent hybrid SBT, incorporating VPS and basic manikin within two separate clinical scenarios. Primary outcome of CE and SE was measured using adapted versions of the <i>Perceived Collective Efficacy (PCE)</i> scale and <i>Motivational Strategies for Learning Questionnaire (MSLQ)</i>. Both scales were distributed to students before and after undergoing hybrid SBT. Data from 94 students were available for pairwise testing. Significant improvements were observed in the CE and SE of students after undergoing hybrid SBT [CE: (12.16 ± 3.86 vs 15.42 ± 2.87); <i>p</i> &lt; 0.001]; [SE: 24(23–32) vs 32(28–34); <i>p</i> &lt; 0.001]. Scale evaluation of <i>Perceived Collective Efficacy (PCE)</i> and <i>Motivational Strategies for Learning Questionnaire (MSLQ)</i> revealed good scale <i>Cronbach α</i> scores [PCE: pretest α = 0.929; posttest α = 0.914]; [MSLQ: pretest α = 0.971.; posttest α = 0.968]. Hybrid SBT facilitated by virtual patient simulator and basic manikin provides a moderate-cost and adaptable approach which positively impacted the CE and SE of medical students. As software development readily adapts in providing point-of-care learner feedback, hybrid SBT should become more widely implemented to fully harness its potential. This study demonstrates that hybrid simulation-based training can enhance both self-efficacy and collective efficacy among medical students, providing evidence that this cost-effective approach can foster critical psychological attributes linked to better team collaboration and clinical performance.By combining virtual patient simulations with basic manikin, this study supports the potential hybrid simulation as a scalable, adaptable and more accessible teaching method for enhancing essential medical competencies.The study also validates the use of adapted scales for measuring collective and self-efficacy in medical education, paving the way for more widespread use of these tools in evaluating simulation-based training. This study demonstrates that hybrid simulation-based training can enhance both self-efficacy and collective efficacy among medical students, providing evidence that this cost-effective approach can foster critical psychological attributes linked to better team collaboration and clinical performance. By combining virtual patient simulations with basic manikin, this study supports the potential hybrid simulation as a scalable, adaptable and more accessible teaching method for enhancing essential medical competencies. The study also validates the use of adapted scales for measuring collective and self-efficacy in medical education, paving the way for more widespread use of these tools in evaluating simulation-based training.