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 June 2025. This month’s medical simulation research from the Society for Simulation in Healthcare (SSH) Journal, International Nursing Association for Clinical Simulation and Nursing (INACSL) Clinical Simulation in Nursing Journal, and Society for Simulation in Europe (SESAM) Advances in Simulation Journal. The research topics cover storytelling and scenario re-enactment, psychological safety, integrative simulation, mental health care, standardized patient (SP) education, simulation in Latin America, cybersickness, meta-debriefing, equity, universal design for learning (UDL), and pediatric trauma boot camp.
INACSLโs Clinical Simulation in Nursing Non-Research Article of the Year 2024 – Combining storytelling and a scenario re-enactment of Mt. Everest expeditions to practice cognitive and social skills: Healthcare teams need cognitive skills and social skills in acute care and routine situations. This article describes the use of storytelling and the re-enactment of a real-life event to teach such skills. The authors describe the preparation, conduct, and debriefing of the simulation. In our conduct of the simulation most participants found it valuable, but we also saw a low number of participants, who did not engage a lot in simulation. This concept and the principle of combining story-telling with re-enactment can provide valuable learning opportunities for different target groups in healthcare settings.
INACSLโs Clinical Simulation in Nursing Research Article of the Year 2024 – Enhancing Psychological Safety in Advanced Practice Nursing Student Simulation Using an Innovative Visual Tool: Psychological safety is a foundational element for effective simulation-based experiences across all healthcare education. This project describes a novel tool that the authors developed to visually enhance psychological safety for advanced practice nursing students. The โSimulation Tool to Enhance Psychological Safetyโ (STEPS) is essentially a photo cube with images that depict evidence-based constructs related to psychological safety. STEPS was designed and evaluated by simulation education experts.
Pre and post surveys were conducted using the Psychological Safety Survey and open-ended responses. Findings revealed studentsโ responses on psychological safety improved post the STEPS intervention. Studentsโ comments also reflected they found STEPS valuable for enhancing psychological safety.
Development and evaluation of an integrative-fidelity nursing simulation education program using extended-reality smart glasses: A quasi-experimental study: This study aimed to evaluate the effects of integrative-fidelity nursing simulation education program using extended-reality smart glasses. In this quasi-experimental study, participants were divided into experimental and control groups. In the low-fidelity stage, participants used a head-mounted display to view 360-degree immersive content and practiced neurological assessment and infusion pump operation using a partial model or mannequin. The high-fidelity stage included hybrid simulation using high-fidelity simulator and standardized patient.
The smart glasses provided patient information and nursing records with first-person action recordings used for debriefing. The scores for positive attitudes toward wearable displays, perceived importance, critical thinking disposition, satisfaction, and self-confidence were analyzed. The experimental group had significantly higher scores in positive attitudes toward wearable displays, perceived importance, prudence as a critical thinking subscale, and satisfaction.
Determining the severity and prevalence of cybersickness in virtual reality simulations in psychiatry: The rise in virtual reality (VR) applications in healthcare has introduced immersive VR simulations as a valuable training tool for medical professionals. Despite its advantages, VR use can induce cybersickness, characterized by symptoms such as nausea and disorientation. This study examines the relationship between cybersickness and the degree of physical movement in VR simulations used for psychiatric education. The study involved two VR simulations offered at a Canadian mental health hospital: an opioid overdose response (OO) (high movement VR) and suicide risk assessment (SRA) (low movement VR). Participantsโ experiences were measured using the Simulator Sickness Questionnaire (SSQ) before and after the training sessions. MannโWhitney U-test revealed a significant increase in nausea scores in OO simulation compared to SRA simulation (pโ=โ0.0275), with higher nausea reported in the OO simulation.
No significant increases were found in oculomotor symptoms. Participants in the OO training experienced higher levels of nausea compared to those in the SRA simulation, likely due to increased need for physical movement. These findings underscore the importance of considering the degree of physical movement in the VR training design, specifically the educational value of these movements and the risk of cybersickness negatively impacting VR tolerability for learners.
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The impact of simulated participant simulation on enhancing mental health knowledge, skills and attributes in Diploma of Nursing students: To better meet the mental health training needs of Australian Diploma of Nursing students, it is essential to transition from the current competency-based teaching approach to a more holistic, integrated method using Simulated Participant simulation-based learning. An embedded mixed methods design with multiple case studies was employed. Ten students enrolled in a mental health nursing unit of a diploma of nursing course completed surveys, which included the adapted Health Communication Assessment Tool and the Lasater Clinical Judgment Rubric, both before and after a simulated participant intervention and clinical placement.
Students also completed the Student Satisfaction and Self-confidence in Learning scale and participated in an individual interview following the simulation intervention. The findings of this research revealed that Simulated Participant simulation demonstrated an increase in self-reported knowledge, skills and attributes necessary for working effectively with mental health consumers. Additionally, students felt better prepared for a mental health placement.
Standardized Patient Education Focused on Equity Deserving Groups – Ten Tips for Educators and ProgramsโA Qualitative Study: Health professions training programs must train future healthcare providers to meet the needs of equity-deserving patient populations. Standardized patient (SP) programs are one mechanism by which this training can occur. Our aim was to develop a set of recommendations for SP programs and educators around planning, organizing, and delivering SP-based education involving equity-deserving groups. We undertook a qualitative analysis of interview transcripts of SPs, educators, and trainers involved in SP work with equity-deserving groups. Subsequently, we conducted a three-stage modified Delphi process to generate recommendations. We derived 10 tips to help stakeholders improve SP-based education involving equity-deserving groups.
Exploring the Meta-debrief: Developing a Toolbox for Debriefing the Debrief: Otherwise known as debriefing the debrief, meta-debriefing describes the practice of debriefing simulation facilitators after they have facilitated, or observed, a debriefing. It is a vital component of enhancing debriefing skills, irrespective of where debriefers may be in terms of their professional development journey from novice to expert. We present the following 4 fundamental pillars, which underpin the creation of an impactful meta-debriefing strategy: theoretically driven, psychologically safe, context dependent, and formative in function. Furthermore, we describe various strategies that contribute to a toolbox of techniques that enable meta-debriefers to develop proficiency and flexibility in their practice. We hope this article stimulates discussion among simulation practitioners, progresses the science and art of meta-debriefing, and prompts further research so that meta-debriefing can become an integral evidence-based component of our faculty development processes.
Characteristics, Impact, and Trends of Healthcare Simulation in Latin America and the Caribbean: A Bibliometric Analysis: This study highlights the growing significance of healthcare simulation in enhancing the quality and safety of patient care across Latin America and the Caribbean, by analyzing bibliometric trends and the impact of publications on simulation-based clinical training between 2012 and 2022. Brazil and the United States emerged as leading contributors, with a primary focus on โsimulation training,โ โclinical competence,โ โmedical education,โ and โeducation.โ
The study observed an uptick in international collaboration, mirroring the increase in document count and citations. This bibliometric review underscores the emphasis on evaluating technical skills and clinical practices as prevailing areas of interest, highlighting Brazil’s significant academic contributions, and suggesting a promising future for the implementation of clinical simulation in the region. The study advocates for continued scholarly output to align with global advancements in medical simulation, aiming to optimize patient outcomes.
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Universal Design for Learning (UDL) in simulation-based health professions education: Ensuring equitable access to education is a fundamental goal in health professions training, particularly in simulation-based learning, where realistic clinical scenarios prepare learners for real-world practice. Universal Design for Learning (UDL) offers a robust framework for creating instructional strategies, materials, and environments that are accessible and effective for all learners. In this article, we provide practical guidance and actionable strategies for incorporating UDL principles into simulation-based activities.
By integrating UDL principles, educators can create a supportive environment that reduces barriers, fosters psychological safety, and ensures that all participants feel empowered to take these risks and fully engage in the learning process. This framework supports opportunities for every learner to partake in meaningful and challenging experiential learning, ultimately preparing them for successful clinical practice. From scenario design to debriefing techniques, this article offers insights and recommendations grounded in evidence-based practices, thereby empowering educators to optimize the effectiveness and accessibility of their simulation programs.
Improving pediatric trauma care at a level 1 pediatric trauma center through the multi-year implementation of a Pediatric Trauma Boot Camp curriculum: Traumatic injuries are a significant contributor to pediatric morbidity and mortality, and trauma care necessitates that providers from different specialties and backgrounds be prepared to work together in high acuity settings to provide optimal care. The objective of this study is to develop an interdisciplinary pediatric trauma curriculum to improve trauma bay teamwork and adherence to ATLS ideals in the clinical environment. We developed a simulation-based pediatric trauma curriculum (Pediatric Trauma Boot Camp) incorporating learners from multiple departments and divisions all of whom care for pediatric trauma patients at our institution. To determine the impact of the curriculum on trauma team clinical performance, videos of trauma activations throughout the multi-year implementation period were reviewed and data abstracted.
Teamwork was assessed using the Trauma NOTECHS scale and ATLS compliance by the presence or omission of eight items of the primary and secondary survey. Out of a maximum of 25, the mean total Trauma NOTECHS score for the pre-pilot videos was 14.0. Post-pilot, the mean total score improved to 16.8 (pโ=โ0.001). Mean secondary survey completion improved from 4.1/8 pre-pilot to 5.4/8 post-pilot (pโ=โ0.039). No significant difference was observed in primary survey completion between the first two cohorts. Following the second year of curriculum implementation, primary survey completion improved to 6.1/8 in the third cohort from 5.5/8 (pโ=โ0.079). Continued improvement in total Trauma NOTECHS scores was observed (meanโ=โ17.7), and improvements demonstrated in secondary survey completion were preserved.
