Research in the field of healthcare simulation continues to advance rapidly, transforming healthcare education through groundbreaking findings worldwide. In this monthly HealthySimulation.com article series, Content Manager Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN, highlights key developments in clinical simulation research as of October 2025. This monthโs medical simulation research from the Society for Simulation in Healthcare (SSH) Journal and the International Nursing Association for Clinical Simulation and Nursing (INACSL) Clinical Simulation in Nursing Journal. The clinical simulation research topics cover healthcare simulation standards of best practice, interprofessional education simulation, debriefing, metaverse, domestic violence, haptic feedback, virtual reality, reflective learning, competency, chest tube insertion, airway management, and clinical reasoning.
Design and implementation of a digital medication optimization simulation (SimMed) using healthcare simulation standards of best practice: Medication optimization requires healthcare professionals to develop and maintain safe medicine management skills and work collaboratively. Early exposure to interprofessional learning is essential for nursing students to develop these competencies. SimMed, an interprofessional digital simulation focused on medication safety was developed based on the Healthcare Simulation Standard of Best Practice (HSSOBP) and Agile methodology. SimMed was successfully developed and delivered to 130 students. Key insights included the value of using a standard framework, iterative design, and integration of user feedback. The application of HSSOBP and Agile principles supported the structured, iterative development and successful implementation of an effective and scalable simulation tool for medicines optimization education.
Interprofessional simulation co-debriefing practices: A systematic review: Interprofessional simulation allows healthcare students to practice the role of a professional with students from other professions. Debriefing is essential to the simulation, promoting insight into actions taken and thought processes behind the actions. The impact of co-debrief with interprofessional teams remains in question. This paper aims to explore the impact of co-debriefing on student experiences. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist (PRISMA). Search terms including โinter-professional education,โ โsimulation,โ โco-debriefing,โ and โuniversity studentsโ were undertaken across seven databases. Twenty-seven papers with students from 17 professions were included. Simulations were considered effective, however the impact of co-debriefing on student outcomes was not explored in any studies. Debriefing is imperative to healthcare simulation, yet little evidence is available to support the role of co- debriefing. Further research is required to determine its effectiveness and appropriateness for all inter-professional simulations.
Utilization, application and effectiveness of metaverse in simulation-based nursing education: A systematic review: The Metaverse is an emerging technological innovation with potential applications for healthcare education. The objective of this systematic review was to evaluate the utilization, application, and effectiveness of the Metaverse in simulation-based nursing education. A comprehensive search was conducted across eight electronic databases, yielding 32 studies that met the inclusion criteria. The review identified two main themes: learning outcomes and learner experiences. Learning outcomes included knowledge acquisition, clinical skill development, self-efficacy, confidence, and motivation. Use of Metaverse components, particularly virtual reality (VR), generally improved knowledge and technical skill acquisition, especially in areas such as infection control and neonatal resuscitation. Gains in nontechnical skills, including problem-solving and critical thinking, were also observed. Learner experiences encompassed satisfaction, presence and immersion, usability, acceptability, and anxiety reduction. Overall, participants viewed Metaverse technologies positively for their ability to create immersive, enjoyable, and effective learning experiences. This review highlights the potential of the Metaverse in nursing education, particularly for enhancing learning outcomes and learner experiences. However, the lack of studies on the full application of the Metaverse, including social connectedness, suggests the need for further research to explore its comprehensive role in simulation-based learning.
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Simulation-Based Education for Domestic Violence Detection and Response in Nursing and Midwifery: A Scoping Review: Domestic violence is a critical global health issue, and simulation-based learning is increasingly used to teach complex skills for domestic violence detection and intervention. This scoping review aimed to explore simulation initiatives to raise awareness and improve responses to domestic violence in nursing and midwifery clinical and academic settings. The review followed the Joanna Briggs Institute method and adhered to the PRISMA ScR checklist. The Mixed Methods Appraisal Tool was utilized for formal quality assessment of included studies. Ten studies met the inclusion criteria. The thematic analysis revealed four main themes: confidence, knowledge, and skills in screening and responding to domestic violence; communication and interprofessional collaboration; simulation-based learning and reflection; and attitudes, beliefs, and challenges. Domestic violence is a serious issue impacting societies globally. Nurses and midwives are well placed to identify and respond effectively to those with lived experience of DV. Simulation is a valuable tool in supporting this..
Dual-perspective and haptic feedback virtual reality simulation for labor care: A randomized controlled mixed-methods study: Labor care requires complex decision-making and pain management skills, yet current virtual methods, such as spherical video-based virtual reality (SVVR), lack haptic feedback and interactivity. To evaluate the effectiveness of a virtual reality synchronous haptic feedback system (VR-SHFS) compared with SVVR in improving nursing studentsโ labor care skills, knowledge, and empathy. Randomized controlled mixed-methods study with students. VR-SHFS incorporated haptic feedback and dual-perspective learning, whereas SVVR employed 360ยฐ panoramic videos. Outcomes were assessed at baseline, immediately after the intervention, and at two-month follow-up. VR-SHFS significantly improved labor care skills and empathy, and enhanced knowledge retention, compared with SVVR. Students valued its realism and interactivity, although they noted a need for guidance and familiarization. VR with haptic feedback and dual perspectives enhances labor care training more effectively than SVVR and shows promise for broader clinical education.
Virtual Monitoring Technician Performance in High-Fidelity Simulations of Remote Patient Monitoring: An Exploratory Study: Virtual Monitor Technicians (VMTs) play a key role in remotely monitoring patient telemetry, but their workload and performance over time are not well understood. This study used a simulation to assess VMTs’ workload and performance changes. Twelve VMTs participated, and their workload increased significantly, as measured by the NASA-Task Load Index, from 38 to 64 out of 100. Despite the increased workload, their performance remained stable, with a 52% correct response rate to alerts. VMTs responded fastest to urgent alerts, but their accuracy for nonurgent alerts was only slightly better than chance. Future research should focus on improving VMTs’ response accuracy.
Measuring Residents’ Competence in Chest Tube Insertion on Thiel-Embalmed Bodies: Chest tube insertions (CTIs) have a high complication rate, prompting the training of technical skills in simulated settings. However, assessment tools require validity evidence prior to their implementation. This study evaluated the validity of an assessment tool for chest tube insertion skills using Thiel-embalmed bodies. Participants included novices and experienced individuals from surgery, pulmonology, and emergency medicine. They performed chest tube insertions assessed by the ACTION tool, which includes a rating scale and error checklist. The rating scale showed moderate reliability (0.75), while the error checklist was less reliable (0.4). Novices scored lower on the rating scale but did not make significantly more errors. A pass/fail score was set at 47/68. The rating scale is suitable for training, but the error checklist needs improvement for reliable use.
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Achieving Reliable Mastery of Emergency Airway Management Skills Through 4-Component Instructional Design: A Mixed Methods Pilot Evaluation: We used cognitive load theory to design the Queen’s University Airway Mastery (QUMAC) pilot course to work toward reliable mastery of Emergency Airways Management elements in all participants. We describe the process of designing QUMAC using 4-Component Instructional Design to harness the cognitive load theory as a learning tool. We evaluated the effectiveness of QUMAC using an outcome-based mixed-methods approach including Objective Structured Assessment of Technical Skills (OSATS) and two Objective Structured Clinical Examinations (OSCEs) at course completion using blinded expert video review. We also conducted semistructured interviews at course completion and after six months of independent practice. Interviews were analyzed thematically. Participants scored highly on technical skills and clinical exams, with average OSCE scores of 4.1 out of 5 and OSATS scores ranging from 4.0 to 4.4. Interviews revealed themes like increased confidence and reduced cognitive load, which persisted over six months of practice. Key elements contributing to success included high performance expectations, automation, schemas, spaced repetition, and homework. Participants felt more competent and less anxious in their new roles, suggesting the course effectively prepared them for real-world challenges.
An Educational Escape Room’s Influence on Physical Therapy Students’ Perception of Clinical Reasoning Development: A Qualitative Study: Clinical reasoning (CR) is a complex skill that requires great depth of knowledge and practical skills to provide comprehensive care in a dynamic health care setting. Within health care education programs, simulation experiences, such as an educational escape room (EER), create realistic, meaningful, and engaging learning environments that can aid in developing CR. This study explored how educational escape rooms (EERs) can help physical therapy students develop clinical reasoning (CR) skills. Researchers conducted interviews with 17 students after they participated in an EER. They found that four central themes: understand the why, graduate learning experience, application of knowledge, and growth. The EER provided a safe and engaging environment that mimicked real clinical settings, allowing students to practice adapting to new and stressful situations. The study suggests that incorporating EERs early in the curriculum can enhance CR development by offering realistic and meaningful learning experiences.
Reflective Learning as a Pathway to Professional Self-Actualization in Simulation-Based Learning: A Qualitative Case Study: Simulation-based learning (SBL) is essential in health care education, integrating theoretical knowledge with practical experience through reflective learning in debriefs. Although reflective learning during postsimulation debriefs enhances theory-practice integration, its role in fostering intrinsic motivation and professional self-actualization is not fully understood. This study explored how reflective learning during simulation-based training impacts students’ intrinsic motivation and professional growth in a Critical Care Flight Paramedic Program. Using interviews with 11 participants, researchers found that reflective learning enhances self-actualization by promoting autonomy, competence, and relatedness, aligning with Self-Determination Theory. The study underscores the importance of integrating humanistic learning principles into simulation-based education, particularly during debriefs, to effectively bridge theory and practice. This approach helps develop motivated and competent healthcare professionals, supporting their journey toward professional self-actualization.
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