A new trend in e-learning development is to have subject matter experts use rapid development tools to create training simulations. This type of training is called rapid e-learning simulation training. Though companies are using rapid development tools to create training quickly and cost effectively, there is little empirical research to indicate whether training created in this manner meets the needs of learners. The purpose of this study was to compare user responses to rapid e-learning simulation training to user responses receiving instructor-led training. The target population for this study was employees of a medium size private company in North America. Employees were divided into two groups and either received instructor-led training (comparison group) or received rapid e-learning simulation training (experimental group). The instrument used to measure user response was an adaptation of the technology acceptance model. Three variables were measured: training satisfaction, perceived ease of use, and perceived usefulness. Though no statistical significance was found between the two groups for training satisfaction and perceived usefulness, perceived ease of use was found to be statistically significant. Overall results fail to demonstrate the superiority of rapid e-learning simulation training over instructor-led training; however, this study indicates that rapid e-learning simulation training may be a viable substitute for classroom instruction based on user response.

Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.

No / Aims and specific learning outcomes To examine cultural influences on the adoption of simulation as an educational innovation among health care professionals. Background/ rationale Whilst there has been an increase in research supporting simulation based education and training, there is a notable lack of evidence examining the relationship between culture and simulation, and factors influencing adoption and diffusion of this innovation, Fors (2009), Chung (2013). If cultural factors influence simulation adoption, either as an enabler or a barrier, they are worthy of examination. This literature review aims to examine these important dimensions., Methodology The literature review is being undertaken systematically based on techniques described by Booth et al, (2012).Study selection will be undertaken using the following inclusion criteria: Population: Students and health practitioners engaged in medicine, nursing, midwifery and allied health professional practice, participating in simulations. Intervention: Simulation training and education; relating to: learning, teaching and assessment in clinical practice and in learning environment, technological and non- technological. Outcome: Cultural factors-enable/hinder, voluntary and involuntary uptake or rejection of simulations. Practitioners value/do not value simulations. Study: International research papers, published in English, from 2010 to 2014. Data synthesis Data synthesis will be undertaken using Thematic Synthesis (Thomas, Harden, 2008). Results - To be developed following data synthesis. Conclusions/ recommendations/ take home messages -To be developed following data synthesis

The focus of the research programme within this thesis is an investigation of scenario-based simulation training in undergraduate healthcare education. The aim of the main study was to determine the effectiveness of high-fidelity simulation training with adult branch nursing students. Their acquisition of knowledge and skills was tested using a 15-station Objective Structured Clinical Examination (OSCE) pre- and post- the simulation intervention with randomised control and experimental groups of volunteer students. The results show that simulation training is an effective learning method as students from the experimental group, who were given the opportunity to observe and take part in high-fidelity simulation training followed by debriefing, made significantly higher improvements between their two OSCE performances than students from the control group. The second study focused on interprofessional learning with a randomised control group investigation of the students’ knowledge of the roles and skills of other healthcare professions involved in the same simulation session. The results demonstrate that observing and taking part in multidisciplinary scenarios and their debriefings contributed to the students’ acquisition of knowledge about the roles and skills of other health professionals. The study also showed that students’ perception of multidisciplinary team working was significantly influenced by whether or not they had experienced interprofessional high-fidelity scenario-based simulation training. The main original themes emerging from the research work presented in this thesis comprise the implementation of high-fidelity scenario-based simulation training and debriefing with undergraduate students from a range of healthcare disciplines and the objective measure of the effectiveness of such learning opportunities. This work has now started to impact on simulation practice in undergraduate education within the University and beyond

Bakgrund: I anestesisjuksköterskans ansvar ingår att extubera patienten på ett säkert sätt. I anestesisjuksköterskans arbete fodras ett tvärprofessionellt omhändertagande av patienten inom ett team. Det är ett varierande arbetstempo i en komplex och högteknologisk miljö. Extuberingsprocessen kan medföra många komplikationer som kan ge obehag för patienten som har varit sövd i generell anestesi med endotrachealtub. Extubation ställer därmed höga krav på anestesisjuksköterskan som skall ha fördjupande medicinska och omvårdnadskunskaper vid omhändertagandet av patient. Det saknas forskning kring extubationsprocessen ur en anestesisjuksköterskas perspektiv även om det är ett riskfyllt moment. Syfte: Syftet var att beskriva anestesisjuksköterskors upplevelser och erfarenheter av svårigheter i samband med extubation av patient. Metod: Studien innefattade semistrukturerade intervjuer med nio anestesisjuksköterskor från två sjukhus i Västra Götalandsregionen i Sverige. Datamaterialet analyserades med hjälp av en kvalitativ innehållsanalys. Resultat: Resultatet visade betydande trygghet i att ha utbildning, erfarenhet och kunskap om extubationsprocessen då arbetssättet bygger på erfarenhet. Förmåga att förhålla sig till utmaningar bygger på att anestesisjuksköterskorna upplever en stor respekt för extubationsprocessen eftersom det kan innefatta många risker. Trygghet av att se patientens individuella behov var en betydande faktor för ett komplikationsfritt omhändertagande av patienter. För att främja ett systematiskt och patientsäkert sätt kring patienten, beskrev anestesisjuksköterskorna vikten av utbildning inom extubationsprocessen. Diskussion: I diskussionen jämförs det aktuella resultatet med tidigare forskning. Vidare diskuteras kunskapsbristen och forskning kring fenomenet. Slutsats: Anestesisjuksköterskornas arbete kring extubationsprocessen kräver god kunskap och erfarenhet inom anestesisjukvård. Förmåga till kommunikation och teamarbete är viktiga faktorer för en lyckad extubation.

A concepção de que o uso da simulação realística agrega diferencial ao processo de formação dos enfermeiros tem impulsionado instituições de ensino superior a conhecerem essa estratégia metodológica. Como parte da simulação, o debriefing tem sido apontado como um dos momentos mais privilegiados para a aprendizagem. Com base no pressuposto de que graduandos de enfermagem apresentam melhor desempenho clínico na assistência de enfermagem em sala de vacina, utilizando-se o debriefing após cenários realísticos como método de ensino, esse estudo teve como objetivos comparar o desempenho clínico de discentes que passaram por cenários de aprendizagem com e sem debriefing e verificar sua opinião quanto ao uso de cenários com debriefing. Tratou-se de um e estudo longitudinal, prospectivo, de intervenção, randomizado em crossover, de abordagem quantitativa, do tipo antes e depois, que investigou a ocorrência de diferenças nos resultados dos exames de desempenho realizados por discentes que passaram por cenários com e sem debriefing em um Centro de Simulação. A população do estudo foi composta por 120 alunos do semestre de graduação em Enfermagem de uma Universidade privada. A aleatorização foi realizada com apoio estatístico em dois grupos, experimental e controle, considerando-se como variável interveniente ao processo ensino e aprendizagem os tercis de notas dos alunos no primeiro exame de desempenho clínico. As fases da pesquisa incluíram a ministração de aula teórica e de aula prática demonstrativa sobre imunização infantil e procedimentos para administração de vacinas pela docente da disciplina para todos os alunos. Depois dessa etapa, foi realizado o primeiro exame de desempenho clínico que serviu como medida basal e subsidiou o processo de randomização. Após a randomização, o grupo experimental realizou cenários com debriefing e o grupo controle realizou cenários sem debriefing, e ambos os grupos foram submetidos à intervenção, ou seja, ao segundo exame de desempenho clínico. Por fim, para garantir a igualdade de oportunidade de aprendizagem, foi realizada a troca dos grupos (crossover): o grupo controle passou a realizar cenários com debriefing e o grupo experimental cenários sem debriefing, realizando-se ao final o terceiro exame de desempenho clínico. Os resultados da pesquisa mostraram que houve melhora no desempenho do grupo experimental tanto em relação ao exame medida basal quanto em comparação com o grupo controle (p <0,001), no exame de desempenho pós intervenção e no terceiro exame, após o crossover. Esse resultado permitiu constatar que o debriefing foi eficaz para melhorar a atuação dos alunos nos exames de desempenho clínico na assistência de enfermagem em sala de vacina. Quanto a opinião dos alunos sobre o debriefing, observou-se que a grande maioria (97,1%) considerou essa estratégia importante para o aprendizado, pois oferece a oportunidade de mais esclarecimentos e de reflexão sobre a prática para o aperfeiçoamento da assistência. Diante dos resultados, conclui-se que o uso de cenários com debriefing efetivamente se constitui estratégia facilitadora do processo ensino e aprendizagem na graduação em enfermagem. / The conception of using realistic simulation, which brings a difference to the education process of nurses, has fostered higher education institutions to learn this teaching strategy. As part of simulation, debriefing has been pointed out as one of the most promising learning resources. Based on the assumption that undergraduate nursing students present better clinical performance in nursing care at the vaccination room using debriefing after realistic role playing as a teaching method, this study aimed to compare clinical performance of students who were submitted to learning role playing with and without debriefing and to verify their opinions regarding the use of roles with debriefing. It´s an interventional, prospective longitudinal study, randomized in crossover, of quantitative approach, and before and after type. It sought the occurrence of differences in performance exam results made with students with went through role playing with and without debriefing at a Simulation Center. The population of the study was made of 120 students in the fourth semester of nursing graduation at a private university. Randomization was made with statistical support into two groups, experimental and control, considering as intervenient variable to teaching and learning process one-third of students´ grades from the first clinical performance exam. The phases of research included theoretical and practical classes on childhood immunization and vaccination administration procedures by the subject teacher to all students. After this step, it was made the first clinical performance exam that served as a baseline measure and it subsidized the randomization process. After randomization, the experimental group had role playing with debriefing and the control group had role playing without debriefing, and both groups were submitted to intervention, that is, a second clinical performance exam. At last, to ensure equity of opportunity in learning, the groups took turns (crossover): The control group started role playing with debriefing and the experimental group had role playing without debriefing, having at the end, the third clinical performance exam. Research outcomes pointed out that there was an improvement in performance by the experimental group as much in exam baseline measures as in comparison to the control group (p <0.001) in the performance exam after intervention and in the third exam, after crossover. This result made it possible to verify that debriefing was efficient to improve students´ practice in the clinical performance exams in nursing care at the vaccination room. Regarding the students´ opinion on debriefing, it was observed that most of them (97.1%) considered this strategy important for learning, as it provides an opportunity for further clarifications and for reflections on practice for care improvement. According to these results, it can be concluded that the use of role playing with debriefing proves effectively to be a facilitating strategy in teaching and learning process of nursing graduation.

O objetivo do presente estudo foi avaliar as experiências dos alunos de graduação em Odontologia ao realizar tratamentos endodônticos em atividades de Pré-Clínica e avaliar níveis de confiança e o perfil de ansiedade neste grupo de indivíduos. Alunos de Odontologia que frequentavam a disciplina de Pré-Clínica Odontológica foram convidados a participar do estudo. Após o aceite, os participantes preencheram um formulário elaborado para o estudo, contendo perguntas sobre as diferentes etapas do tratamento endodôntico a serem realizadas em dentes monorradiculares, pré-molares e molares. O grau de autoconfiança para cada etapa foi atribuído, por meio de escala Likert de cinco pontos, variando de “muito pouco confiante” a “muito confiante”. Utilizou-se o inventário IDATE Traço e Estado para determinar o perfil de ansiedade dos participantes. Após a aplicação de todos os instrumentos quantitativos, foram sorteados 18 participantes para integrar de uma análise qualitativa por meio de um grupo focal. Foi realizada análise estatística e inferencial. Os dados obtidos no grupo focal foram compilados, e gerou-se uma nuvem de palavras, para representar graficamente os achados. Um total de 39 participantes integrou o estudo. A maioria deles sentia-se “confiante” para realizar as diferentes etapas do tratamento endodôntico simulado, independentemente do grupo dental. Contudo, observou-se que os participantes sentiam-se menos confiantes para realizar a “radiografia de prova do cone de guta-percha” em molares do que em monorradiculares e pré-molares. Não houve diferença estatisticamente significante nos níveis de confiança para realizar as diferentes etapas de um tratamento endodôntico em um mesmo grupo dental. Participantes que tiveram escores de IDATE Traço/Estado acima do terceiro quartil foram categorizados como “altamente ansiosos”, representando 36,11% e 23,07% para IDATE-Traço e IDATE-Estado, respectivamente. Correlação fraca, porém estatisticamente significativa foi encontrada entre níveis de autoconfiança para realizar etapas específicas do tratamento endodôntico, nos diferentes grupos dentais. O grupo focal trouxe informações quanto às dificuldades encontradas pelos alunos na disciplina de Pré-Clínica, na sua percepção quanto ao desenvolvimento das atividades, e também dos sentimentos e expectativas a serem vivenciadas na transição entre os tratamentos laboratoriais e clínicos. Pode-se concluir que foram observados níveis importantes de ansiedade entre os participantes do estudo, conforme determinado pelo IDATE Traço/Estado. Contudo, parece haver fraca correlação entre a confiança em realizar determinada etapa do tratamento endodôntico em atividade Pré-Clínica e o nível de ansiedade. Torna-se importante discutir e considerar as impressões dos alunos ao se adotar abordagens de ensino e aprendizagem em Endodontia Pré-clínica. / The aim of the present study was to evaluate the self-confidence and experiences of dental students and assess their anxiety levels when performing pre-clinical root canal treatment.Undergraduate students answered the STAI-Trait/State and a questionnaire to assess their confidence level to perform each step of pre-clinical root canal treatment in anterior, bicuspid and molars. Further eighteen randomly selected students participated in a focus group aimed at obtaining qualitative data on perception of conducting endodontic treatment and the learning process necessary to perform it in a pre-clinical environment. Statistical analysis was carried out. A total of 39 students joined the study. The majority of the participants reported feeling "confident" to perform the different steps of the simulated root canal treatment, despite the dental group. However, students felt less confident to perform the master cone X-ray for molars than for anterior and bicuspid teeth. There was no statistical difference in the self-reported confidence to perform different steps of the root canal treatment in the same group of teeth. Students who scored above the 3rd quartile of STAI-Trait/State were classified as "highly anxious", and comprised 36.11% and 23.07% and for STAI-Trait and STAI-State, respectively. A weak correlation was observed for the levels of self-reported confidence for specific steps of the root canal treatment and STAI-Trait/State. The focus group brought information on the difficulties that the students faced in the pre-clinical activities, on the perception for the activities development in the classes, and also on the feelings expected in the transition from pre-clinical to clinical activities. It can be concluded that there were considerable levels of anxiety among the students, as determined by the STAI-Trait/State. However, it might weakly influence their confidence to perform simulated root canal treatments, in pre-clinical endodontics. The current findings suggest it might be important to rearrange consider the students perceptions for determining the learning approaches to be adopted in the Pre-clinical activities in endodontics.

The purpose of business training programs is to improve performance, which improved performance changes leadership behaviors based on the knowledge, skills, and abilities (KSAs) learned in training. One of the most common criticisms of leadership training is the tendency to focus on teaching theory but not on applying theory into practice, that is, transfer of learning. Research usually ends at the point of identifying, describing, or measuring factors that influence transfer. Ongoing research must identify what constructs in the transfer of learning process should be effectively changed or managed. There is a gap in research on the degree to which performance improvement through KSAs learned in a simulation training program actually transfer to the work environment. Additional research is needed that examines the relationship between transfer of learning and intent to transfer, which are critical outcomes in the field of human resource management and development. The purpose of the study was to examine the relationship between intent to transfer and four constructs in the transfer of learning process during a simulation-based leadership training program. Participants completed self-report assessments that measured the relationships between intent to transfer and four constructs: ability, motivation, work environment, and learner readiness. A correlational design was administered using a population of mid-level managers in a telecommunications organization.

Preterm infants have multiple health complications due to their underdeveloped neurological systems. Bottle-feeding difficulties are one complication that leads to pulmonary illness secondary to aspiration. Preterm infants exhibit clinical markers when experiencing distress during bottle-feeding. Training caregivers to identify clinical markers reduces the risk for aspiration. Simulation training provides a safe learning environment without harming patients. Twenty-two speech-language pathology and pre-requisite students divided into two simulation groups, video-simulation (N=12) and in-vivo simulation (N=10), were trained to document clinical markers of distress exhibited by preterm infants and make clinical judgments about bottle-feeding. Students rated their levels of anxiety during simulation training. Results revealed that students trained using video-simulation performed with higher clinical judgment scores and lower anxiety levels than students who received in-vivo training. Students’ knowledge of and ability to identify distress markers in preterm infants during bottle-feeding significantly improved after training in both groups without group differences.

Restoring speech in persons who are tracheostomy and ventilator dependent, through the use of a Passy-Muir Speaking Valve (PMSV), requires specific training. Methods of training interprofessional team members to assess in-line PMSVs are unclear. This study used a pretest/ post-test design to compare effects of online training and online training plus simulation training on knowledge acquisition, skills performance, and comfort levels when working with persons who are tracheostomy and ventilator dependent. Twenty-six students studying either respiratory therapy (N=13) or speech-language pathology (N=13) were assigned to the control group or experimental group. Results revealed that online training proved beneficial for increasing tracheostomy and ventilator knowledge. Participants who underwent simulation training reported greater levels of comfort and demonstrated more efficient skills performance during simulation post-testing. Simulation training is efficacious to train interprofessional teams how to properly assess this population for use of in-line PMSVs.