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Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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1

Zhang, Wenxi, Inna Lozynska, Wei Li, Nana Cai, and Hongmin Yang. "Benefits and Barriers of Holistic Nursing Training by High-Fidelity Simulation in Obstetrics." Computational and Mathematical Methods in Medicine 2022 (June 28, 2022): 1–5. http://dx.doi.org/10.1155/2022/1848849.

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Background. With the technology of high-fidelity simulates developed, the clinical education route has changed. The nursing school pays attention on the use of high-fidelity simulations in nursing education. However, in China, only a few schools can afford the expensive teaching tools, including SimMom 3G and virtual reality (VR) devices, which also focus on “holistic nursing simulation.” Objective. To explore the evaluation and development of a holistic nursing simulation session for nursing students based on an integrated nursing approach in obstetrics. Methods. This study was based in a rich Chinese nursing school under the medical university that value nursing education. This study is founded on 147 third-year nursing students in obstetrics classes. After the simulation teaching, the teaching effect of the questionnaire was investigated, and the total number of questionnaires was 124 students. Results. Students agreed that the holistic nursing simulation cultivated humanistic care literacy, clinical practice ability, and clinical thinking ability; enhanced teamwork ability; and reinforced professional knowledge. Conclusion. This simulation teaching method helps to cultivate students’ enthusiasm and initiative and fosters their self-learning ability.
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Jang, Seon Mi, Sinwoo Hwang, Yoomi Jung, and Eunyoung Jung. "Educational needs of severe trauma treatment simulation based on mixed reality: Applying focus group interviews to military hospital nurses." Journal of Korean Academic Society of Nursing Education 27, no. 4 (November 30, 2021): 423–35. http://dx.doi.org/10.5977/jkasne.2021.27.4.423.

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Purpose: The purpose of this study is to identify the educational needs of a severe trauma treatment simulation program based on mixed reality which combines element of both virtual reality and augmented reality.Methods: Focus group interviews were conducted with ten military hospital nurses on February 4 and 5, 2021. The collected data were analyzed using a qualitative content analysis. As a framework for data analysis, the educational needs were clustered into the following four categories: teaching contents, teaching methods, teaching evaluation, and teaching environment.Results: The educational needs for each category that emerged were as follows: three subcategories including “realistic education reflecting actual clinical practice” and “motivating education” for teaching contents; five subcategories including “team-based education,” “repeated education that acts as embodied learning,” and “stepwise education” for teaching methods; six subcategories including “debriefing through video conferences,” “team evaluation and evaluator in charge of the team,” “combination of knowledge and practice evaluation” for teaching evaluation; six subcategories including “securing safety,” “similar settings to real clinical environments,” “securing of convenience and accessibility for learners,” and “operating as continuing education” for teaching environment.Conclusion: The findings of this study can provide a guide for the development and operation of a severe trauma treatment simulation program based on mixed reality. Moreover, it suggests that research to identify the educational needs of various learners should be conducted.
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Yoshioka-Maeda, Kyoko, and Kazuko Naruse. "Effectiveness of Health Guidance Simulation in Community Settings for Public Health Nursing Students: A Preliminary Study." SAGE Open Nursing 7 (January 2021): 237796082110013. http://dx.doi.org/10.1177/23779608211001355.

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Introduction Simulation-based learning is a relatively new concept in public health nursing education, and little is known about the efficacy of this approach for teaching of health guidance. Objective The aim of this study was to evaluate the effectiveness of health guidance simulation in community settings for public health nursing students. Methods Using a pre/post-test design, 29 public health nursing students in their third year participated in a high-fidelity simulation program with standardized patients. We developed six scenarios on health guidance for three themes (mother and child, tuberculosis, and adult occupational health) and practice guidelines for the standardized patients to act and assist in understanding of the purpose of the course. Data were collected at baseline and after the simulation sessions through evaluation sheets that the students placed in a designated box on campus. Changes in the level of self-confidence of the students were evaluated based on the “practical skills required for public health nurses and achievement level at graduation” of the Ministry of Health, Labor and Welfare, and the skills in the minimum requirements for public health nurse education defined by the Japan Association of Public Health Nurse Educational Institutions. Results The total score for self-confidence and the mean self-confidence scores for health guidance skills for mother and child, tuberculosis, and adult occupational health nursing were significantly higher post-test compared to pre-test ( p < 0.001). Conclusion These results indicate that high-fidelity simulation focused on health guidance in community settings can bridge the gap between theoretical knowledge and practice of students.
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Uzelli Yilmaz, Derya, Esra Akin, Duygu Yildirim, Sinem Caliskan, and Sevil Hamarat Tuncali. "Nursing Students’ Performance and Satisfaction Regarding the Classification of Pressure Injuries Using Simulation With Moulage." Journal of Client-centered Nursing Care 7, no. 4 (November 1, 2021): 311–18. http://dx.doi.org/10.32598/jccnc.7.4.395.1.

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Background: Simulation-based education is a widely utilized tool for experiential learning in nursing education. The aim of this study was to determine nursing students’ performance and satisfaction in the classification of pressure injuries using simulation with moulage. Methods: It is an evaluation study with a quasi-experimental, single-group, post-test design that was conducted in the spring semester of the 2019-2020 academic year in the Nursing Department of the Faculty of Health Sciences of Izmir Katip Celebi University, Izmir, Turkey. In total, 66 final-year nursing students, voluntarily participated in the Assessment of Pressure Injury Course. A student characteristics form, a Pressure Injury Classification Form, and a Moulage Satisfaction and Evaluation Form were used as data collection tools. Data were entered into SPSS v. 21, and the results of the analysis were described using descriptive statistics. Results: It was found that 67.2% (n=45) of the students correctly assessed all the stages of pressure injury moulages on the standardized patients. Among the students, 62.1% (n=41) strongly agreed that their assessment skills of pressure injury improved after the simulation. The results related to students’ satisfaction indicated that 77.3% (n=51) of the students evaluated the moulages as realistic. The Mean±SD total score of students’ evaluation of moulage simulation sessions on standard patients was 4.56±0.59 (range=1-5). Conclusion: This moulage is a simple, easily accessible, low-cost, and effective tool for teaching pressure injury assessment to nursing students. It can be used in clinical skills training and clinical assessment in nursing education.
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Kwon, Myung Soon, Suhee Kim, and Jeong Soon Yu. "Effects of community health nursing in-school practice education on self-directed learning, core nursing competency, and infection control awareness of nursing school students." Korean Association For Learner-Centered Curriculum And Instruction 22, no. 19 (October 15, 2022): 17–28. http://dx.doi.org/10.22251/jlcci.2022.22.19.17.

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Objectives This study was to investigate effects of community health nursing in-school practice education on self-directed learning, core nursing competency, and infection control awareness of nursing school students. Methods This study was conducted a pre and post quasi experimental study for single-group with 109 students in the 4th grade of Nursing school at H University, located in G province. The in-school practice training lasted 90 hours for two weeks, in parallel with online and offline learnings such as online lectures, home visits, self-learning, face-to-face simulation practice, and core skill evaluation. Data were collected by online questionnaires, and data analysis was performed with the SPSS win 25.0 program and the corresponding sample T-test. Results It was found that the in-school practice education in community health nursing improved the self-directed learning(t=6.22, p=.000) and core nursing competency(t=6.89, p=.000) of nursing students. On the other hand, there was no significant difference in the infection control awareness(t=1.89, p=.062), but there was significant increase of the awareness of the hand hygiene(t=2.44, p=.016) and linen(t=2.69, p=.008) which were listed in the sub-category. Conclusions This study confirmed the positive effects of the in-school practice that integrates the online-learning and face-to-face simulation for community health nursing science while field clinical practice is limited due to the COVID-19 pandemic. In the future, it is necessary to develop more programs that include various contents embracing field practice and in-school practice adjusted with the characteristics of the local community and to study effective teaching methods.
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Kumar, Arunaz, Sam Sturrock, Euan M. Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, and Philip Dekoninck. "Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study." BMJ Open 8, no. 2 (February 2018): e017451. http://dx.doi.org/10.1136/bmjopen-2017-017451.

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ObjectivesThe aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick’s framework. We explored participants’ acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants’ perception of usefulness of PROMPT in their clinical practice.Study designMixed methods approach with a pre-test/post-test design.SettingHealthcare network providing obstetric care in Victoria, Australia.ParticipantsMedical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011–2012 (n=15 361 births) and 2014–2015 (n=12 388 births).InterventionAttendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.Main outcome measureClinical outcomes compared before and after embedding PROMPT in educational practice.Secondary outcome measureAssessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.ResultsThere was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.ConclusionParticipants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
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Huang, Cheng-Yi, and Ya-huei Wang. "Toward an Integrative Nursing Curriculum: Combining Team-Based and Problem-Based Learning with Emergency-Care Scenario Simulation." International Journal of Environmental Research and Public Health 17, no. 12 (June 26, 2020): 4612. http://dx.doi.org/10.3390/ijerph17124612.

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Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which aimed to address the weaknesses of traditional teacher-led, lecture-based learning. An 18-week, single-case experimental design, in which 58 senior nursing students at a medical university in central Taiwan participated, was conducted to test the possible benefits of the intervention. The measures included the Scale of Core Nursing Competencies and the Teacher Performance Evaluation Scale. Results: The research results showed that nursing students who received integrative training that combined team-based PBL with emergency-care scenario simulation had stronger mastery over core nursing competencies. At the same time, they also evaluated both the “Emergency Care” course for which the curriculum was used and the teachers’ performance in that course more highly. Conclusions: The findings suggest that an integrative curriculum combining team-based PBL with scenario simulation is worth pursuing. Compared with traditional teacher-led, lecture-based teaching, this curriculum may be more effective in helping nursing students develop core competencies in their field.
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Park, Hayoung, Jinyoung Cho, and Sang Hui Chu. "Interprofessional Education Programs for Nursing Students: A Systematic Review." Journal of Korean Academic Society of Nursing Education 24, no. 3 (August 31, 2018): 235–49. http://dx.doi.org/10.5977/jkasne.2018.24.3.235.

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Purpose: The purpose of this study was to investigate how interprofessional education has been designed, implemented, and evaluated in undergraduate programs in nursing through a systematic review. Methods: The literature was searched using the PubMed, CINAHL, EMBASE, and Cochrane central databases to identify interventional studies including teaching-learning activities among nursing students and other disciplines in English between January 2000 and May 2017. Thirty studies were selected for the analysis. Results: Twenty-four studies out of 30 were designed as a pre-post, no control group, quasi-experimental study design. Interprofessional education learners were primarily engaged in medicine, physical therapy, dentistry, occupational therapy, pharmacy, and respiratory therapy. Patient care related activity was the most frequently selected topic and simulation was the most common teaching-learning method. Evaluation of learning outcomes was mainly based on the aspects of teams and collaboration, professional identity, roles and responsibilities, patient care, and communication skills. Nursing students in 26 out of the 30 reviewed studies were found to benefit from interprofessional education, with outcome effects primarily related to changes in learning outcomes. Conclusion: The development and integration of interprofessional education with collaborative practices may offer opportunities in nursing education for training professional nurses of the future.
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Brown, Janie, Helen Myers, Derek Eng, Lucy Kilshaw, Jillian Abraham, Grace Buchanan, Liz Eggimann, and Michelle Kelly. "Evaluation of the ‘Talking Together’ simulation communication training for ‘goals of patient care’ conversations: a mixed-methods study in five metropolitan public hospitals in Western Australia." BMJ Open 12, no. 8 (August 2022): e060226. http://dx.doi.org/10.1136/bmjopen-2021-060226.

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IntroductionIn partnership with Cancer Council Western Australia (WA), the East Metropolitan Health Service in Perth, WA has developed a clinical simulation training programme ‘Talking Together’ using role play scenarios with trained actors as patients/carers. The aim of the training is to improve clinicians’ communication skills when having challenging conversations with patients, or their carers, in relation to goals of care in the event of clinical deterioration.Methods and analysisA multisite, longitudinal mixed-methods study will be conducted to evaluate the impact of the communication skills training programme on patient, family/carer and clinician outcomes. Methods include online surveys and interviews. The study will assess outcomes in three areas: evaluation of the ‘Talking Together’ workshops and their effect on satisfaction, confidence and integration of best practice communication skills; quality of goals of patient care conversations from the point of view of clinicians, carers and family/carers; and investigation of the nursing/allied role in goals of patient care.Ethics and disseminationThis study has received ethical approval from the Royal Perth Hospital, St John of God and Curtin University Human Research Ethics Committees. The outputs from this project will be a series of research papers and conference presentations.
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Gelmini, And Yara Particelli, Márcio Luís Duarte, André Moreira de Assis, Josias Bueno Guimarães Junior, and Francisco César Carnevale. "Virtual reality in interventional radiology education: a systematic review." Radiologia Brasileira 54, no. 4 (August 2021): 254–60. http://dx.doi.org/10.1590/0100-3984.2020.0162.

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Abstract The aim of this study was to compare virtual reality simulation with other methods of teaching interventional radiology. We searched multiple databases-Cochrane Library; Medline (PubMed); Embase; Trip Medical; Education Resources Information Center; Cumulative Index to Nursing and Allied Health Literature; Scientific Electronic Library Online; and Latin-American and Caribbean Health Sciences Literature-for studies comparing virtual reality simulation and other methods of teaching interventional radiology. This systematic review was performed in accordance with the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Best Evidence Medical Education (BEME) Collaboration. Eligible studies were evaluated by using the quality indicators provided in the BEME Guide No. 11 and the Kirkpatrick model of training evaluation. After the eligibility and quality criteria had been applied, five randomized clinical trials were included in the review. The Kirkpatrick level of impact varied among the studies evaluated, three studies being classified as level 2B and two being classified as level 4B. Among the studies evaluated, there was a consensus that virtual reality aggregates concepts and is beneficial for the teaching of interventional radiology. Although the use of virtual reality has been shown to be effective for skill acquisition and learning in interventional radiology, there is still a lack of studies evaluating and standardizing the employment of this technology in relation to the numerous procedures that exist within the field of expertise.
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Moretza-Bagi, Hamid Reza, Amir Ghaffarzad, Peyman Fathipour, Reza Yazdani, Zhila Khamnian, and Sama Rahnemayan. "The effect of teacher-made simulation moulage on learning cricothyrotomy skills in emergency medicine physicians." Journal of Emergency Practice and Trauma 8, no. 1 (April 9, 2021): 3–7. http://dx.doi.org/10.34172/jept.2021.10.

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Objective: Nowadays, simulation of clinical environment in medical education system (simulation-based learning) has led to a huge revolution in the quality of education and has increased the safety of educators and patients. In this study, we investigated the effect of teacher-made neck and lung simulators in teaching cricothyrotomy skills for emergency medicine residents. Methods: In this pre-post test study, all faculty member of emergency medicine of Tabriz University of medical sciences specialty were invited to participate. After holding an educational and training session for assistants on a teacher-made moulage, all emergency medicine residents performed a tracheostomy on the commercial moulages of the skill lab unit for the second time and their scores were recorded. Results: In this study, 23 emergency medicine residents participated. The mean±standard deviation of age was 35.91±3.57 years. There was a significant difference between the mean duration of cricothyrotomy before and after the training (P value=0.006). There was also a significant difference between the mean scores obtained by residents in the pre-and post-training evaluation (P value<0.001). Conclusion: Findings showed that the moulages constructed by teachers not only can be effective in improving the cricothyrotomy skills in emergency medicine residents but also can reduce the likelihood of failure in performing cricothyrotomy.
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Alexandrou, Evan, Lucie Ramjan, Jeff Murphy, Leanne Hunt, Vasiliki Betihavas, and Steven A. Frost. "Training of Undergraduate Clinicians in Vascular Access: An Integrative Review." Journal of the Association for Vascular Access 17, no. 3 (September 1, 2012): 146–58. http://dx.doi.org/10.1016/j.java.2012.07.001.

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Abstract Introduction: Peripheral venous cannulas are predominantly inserted by nurses and medical practitioners. Placement and related care of such devices are one of the most frequently performed tasks by these staff members. Clinicians in training should be given ample opportunity to practice these skills before patient encounters begin. Aims: To identify the best available evidence on the training of undergraduate clinicians in peripheral venous access. Methods: We used an integrative literature review method that considered both experimental- and nonexperimental-design studies that addressed the issue of clinician peripheral venous access training of undergraduates. The electronic databases Medline, Embase, Ovid Nursing Database, British Nursing Index, Pre Medline, Mosby's Index, and CINAHL were searched using a predetermined search strategy. The Cochrane and Joanna Briggs databases were also searched along with the reference lists of published materials. Results: A total of 56 articles were retrieved using the defined search strategy. There were 11 experimental-design studies and 1 nonexperimental-design study selected for final review after independent assessment for methodologic quality. Retrieved articles found disparity between actual skill and student self-evaluation. Teaching methods varied with the use of traditional task trainers and high-fidelity simulation. No method was found to be superior. Conclusion: Skill acquisition in vascular access is an international issue and one that has been addressed in varying degrees. We identified heterogeneity in training methods that were tailored to institutional requirements and resources. Training in this skill is imperative to ensure competency before patient encounters.
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Araújo, Paula Roberta Silva, Tayse Tâmara Paixão Duarte, and Marcia Cristina Silva Magro. "Efeito da simulação para a aprendizagem significativa." Revista de Enfermagem UFPE on line 12, no. 12 (December 2, 2018): 3416. http://dx.doi.org/10.5205/1981-8963-v12i12a237671p3416-3425-2018.

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RESUMOObjetivo: investigar o efeito da simulação sobre a aprendizagem significativa em evidências científicas. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa. Buscaram-se os artigos de 2013 a 2017 nas Bases de Dados MEDLINE, BDENF e LILACS. Realizou-se, para a avaliação dos estudos, a leitura integral de artigos e se adotou, para apresentação dos resultados, figura síntese. Resultados: compôs-se a amostra de 13 artigos, a maioria internacional (76,9%), observacional (76,9%) quantitativa e qualitativa. Constatou-se a importância da inserção da simulação no processo de ensino-aprendizagem como ferramenta capaz de melhorar o raciocínio crítico, clínico e reflexivo de estudantes de forma significativa. Conclusão: revelou-se positivamente a integração da simulação no processo de ensino para a aquisição da aprendizagem significativa favorecendo o ganho de diferentes competências, o aprimoramento de conhecimentos e o aumento da autoconfiança dos estudantes de Enfermagem. Destaca-se que a simulação pode ter alguma vantagem sobre outros métodos de ensino, dependendo do contexto de inserção, mas, ao mesmo tempo, a aprendizagem significativa pode ser comprometida pelo risco da ansiedade determinada por essa estratégia. Descritores: Simulação; Aprendizagem; Enfermagem; Educação; Desenvolvimento de Pessoal; Educação em Saúde. ABSTRACT Objective: to investigate the effect of simulation on meaningful learning in scientific evidence. Method: this is a bibliographical study, type integrative review. Articles from 2013 to 2017 were searched in the MEDLINE, BDENF and LILACS Databases. For the evaluation of the studies, the integral reading of articles was carried out and a synthesis figure was used to present the results. Results: the sample consisted of 13 articles, the majority international (76.9%), observational (76.9%) quantitative and qualitative. The importance of the insertion of the simulation in the teaching-learning process as a tool capable of improving the critical, clinical and reflective reasoning of students in a meaningful way was verified. Conclusion: the integration of the simulation in the teaching process was positive for the acquisition of meaningful learning favoring the gain of different skills, the improvement of knowledge and the increase of the self-confidence of Nursing students. It should be emphasized that the simulation may have some advantage over other teaching methods, depending on the context of insertion, but at the same time, meaningful learning can be compromised by the risk of anxiety determined by this strategy. Descriptors: Simulation; Learning; Nursing; Education; Development of Personnel; Health education. RESUMEN Objetivo: investigar el efecto de la simulación sobre el aprendizaje significativo en evidencias científicas. Método: se trata de un estudio bibliográfico, tipo revisión integrativa. Se buscaron los artículos de 2013 a 2017 en las Bases de Datos MEDLINE, BDENF y LILACS. Se realizó, para la evaluación de los estudios, la lectura integral de artículos y se adoptó, para presentación de los resultados, figura síntesis. Resultados: se compuso la muestra de 13 artículos, la mayoría internacional (76,9%), observacional (76,9%) cuantitativa y cualitativa. Se constató la importancia de la inserción de la simulación en el proceso de enseñanza-aprendizaje como herramienta capaz de mejorar el raciocinio crítico, clínico y reflexivo de estudiantes de forma significativa. Conclusión: se reveló positivamente la integración de la simulación en el proceso de enseñanza para la adquisición del aprendizaje significativo favoreciendo la ganancia de diferentes competencias, el perfeccionamiento de conocimientos y el aumento de la autoconfianza de los estudiantes de Enfermería. Se destaca que la simulación puede tener alguna ventaja sobre otros métodos de enseñanza, dependiendo del contexto de inserción, pero al mismo tiempo, el aprendizaje significativo puede ser comprometido por el riesgo de la ansiedad determinada por esa estrategia. Descritores: Simulación; Aprendizaje; Enfermería; Educación; Desarrollo de Personal; Educación en Salud.
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Roizblatt, Daniel, Gilgamesh Eamer, Derek Roberts, Chad Ball, Joanne Banfield, Brittany Greene, Precilla Veigas, et al. "Trauma Association of Canada Annual Scientific Meeting, Westin Calgary Calgary, Alberta, Apr. 10–11, 2015Outcomes and opportunities for improvement in self-inflicted blunt and penetrating traumaAbdominal compartment syndrome in the childActive negative pressure peritoneal therapy after abbreviated laparotomy: The intraperitoneal vacuum randomized controlled trialUse of a novel combined RFA/saline energy instrument for arresting ongoing hemorrhage from solid organ injuriesHealth care costs of burn patients from homes without fire sprinklersPenetrating trauma in eastern Ontario: a descriptive analysisThresholds of rotational thrombelastometry (ROTEM) used for the diagnosis and management of bleeding trauma patients: a systematic reviewA quality indicator to measure hospital complications for injury admissionsThromboelastography (TEG) in the management of trauma: implications for the developing worldPotential role of the rural trauma team development course (RTTDC) in the United Arab Emirates (UAE)Applicability of the advanced disaster medical response (ADMR) course, Trinidad and TobagoInflammatory mediators in intra-abdominal sepsis or injury: a scoping reviewEvaluation of the online Concussion Awareness Training Toolkit (CATT) for parents, players and coachesUltrasound assessment of optic nerve sheath diameter (ONSD) in healthy volunteersThe benefits of epidural analgesia in flail chest injuriesMandatory reporting rates of injured alcohol-impaired drivers with suspected alcohol dependence in a level 1 Canadian trauma centre: a single institution’s experienceSimulation implementation in a new pediatric residency program in Haiti: trauma specificsManagement of skull fractures in children younger than 1 year of ageResource use in patients who have sustained a traumatic brain injury within an integrated Canadian trauma system: a multicentre cohort studyResource use intensity in a mature, integrated Canadian trauma system: a multicentre cohort studyRates and determinants of unplanned emergency department visits and readmissions within 30 days following discharge from the trauma service — the Ottawa Hospital experienceAlcohol — screening, brief intervention and referral to treatment (SBIRT): Is it readily available in Canadian trauma centres?Management of traumatic occult hemothorax: a survey among trauma providers in CanadaAn audit of venous thromboembolism prophylaxis: a quality assurance project at our level 1 trauma centreCatecholamines as outcome markers in traumatic brain injuryAre we missing the missed injury? The burden of traumatic missed injuries diagnosed after hospital dischargeThe use of fibrinogen concentrate in trauma: a descriptive systematic reviewVery early initiation of chemical venous thromboembolism prophylaxis after solid organ injury is safe: a call for a national prospective multicentre studyThe 2 student to 1 faculty (2:1) model of teaching the Advanced Trauma Operative Management (ATOM) courseTrauma transfusion in the elderlyCocaine and benzodiazepines are more predictive of an injury severity score greater than 15 compared to alcohol or tetrahydrocannabinol in trauma patients under 18 years oldAre we missing traumatic bowel and mesenteric injuries?The marriage of surgical simulation and telementoring for damage control surgical training of operational first-respondersAdding remote ultrasound control to remote just-in-time telementored trauma ultrasound: a pilot studyDescriptive analysis of morbidity and mortality associated with falls at a level 1trauma centreDevelopment of an ICU transition questionnaire: evaluating the transfer process from ICU, ward, and patient/family stakeholder perspectivesUse of IO devices in trauma: A survey of trauma practitioners in Canada, Australia and New ZealandTime to reversal of medication-induced coagulopathy in traumatic intracranial hemorrhageMeta-analysis of randomized control trials of hospital based violence interventions on repeat intentional injuryBlunt injury of a horseshoe kidney, case report and review of the literatureLegal consequences for alcohol-impaired drivers involved in motor vehicle collisions: a systematic reviewA characterization of major adult sport-related trauma in Nova Scotia, 2000–2013Is hockey the most dangerous pediatric sport? An evaluation of pediatric sport-related injuries treated in Nova ScotiaInterim results of a pilot randomized control trial of an ED-based violence intervention programPre-intubation resuscitation by Canadian physicians: results of a national surveyFirst-responder accuracy using SALT during mass-casualty incident simulationEmergent endotracheal intubation: medications and device choices by Canadian resuscitation physicians“Oh the weather outside is frightful”: Severe injury secondary to falls while installing residential Christmas lightsCan we speak the same language? Understanding Quebec’s inclusive trauma systemAn unusual segmental clavicle fracture treated with titanium elastic nailImpact of the age of stored blood on trauma patient mortality: a systematic reviewInterhospital transfer of traumatic brain injury: utilization of helicopter transportCheerleading injuries: a Canadian perspectivePre-hospital mode of transport in a rural trauma system: air versus groundAnalysis of 15 000 patient transfers to level 1 trauma centre: Injury severity does not matter — just drive, drive, drive!The effects of legislation on morbidity and mortality associated with all-terrain vehicle and motorcycle crashes in Puerto RicoAssessing how pediatric trauma patients are supported nutritionally at McMaster Children’s HospitalOutcomes of conservative versus operative management of stable penetrating abdominal traumaS.T.A.R.T.T. — Evolution of a true multidisciplinary trauma crisis resource management simulation courseDevelopment of criteria to identify traumatic brain injury patients NOT requiring intensive care unit monitoringAssigning costs to visits for injuries due to youth violence — the first step in a cost-effectiveness analysisThere’s no TRIK to it — development of the Trauma Resuscitation in Kids courseResilient despite childhood trauma experiencesA five-year, single-centre review of toxic epidermal necrolysis managementAll in the family: creating and implementing an inclusive provincial trauma registryLessons learned from a provincial trauma transfer systemThe NB Trauma Program: 5 years laterProvincial coordination of injury prevention: the New Brunswick (NB) experienceImproving access and uptake of trauma nursing core course (TNCC): a provincial approachULTRASIM: ultrasound in trauma simultation. Does the use of ultrasound during simulated trauma scenarios improve diagnostic abilities?Traumatic tale of 2 cities, part 1: Does being treated by different EMS affect outcomes in trauma patients destined for transport to level 1 trauma centres in Halifax and Saint John?Traumatic tale of 2 cities, part 2: Does being treated by different hospitals affect outcome in trauma patients destined for transport to Level 1trauma centres in Halifax and Saint John?Protective devices use in road traffic injuries in a developing countryFunctional and anatomical connectivity and communication impairments in moderate to severe traumatic brain injuryCaring and communicating in critical cases: Westlock trauma form, a resource for rural physiciansMonitoring of ocular nerve sheath in traumatic raised intracranial pressure (Moonstrip Study): a prospective blinded observational trialEstablishing an alcohol screening and brief intervention for trauma patients in a multicultural setting in the Middle East: challenges and opportunitiesThe poor compliance to seat belt use in Montréal: an 18 461 road user iPhone-based studyAn iPad-based data acquisition for core trauma registry data in 6 Tanzanian hospitals: 1 year and 13 462 patients later“The Triple-Q Algorithm”: a practical approach to the identification of liver topographyA pan-Canadian bicycle helmet use observational studyDoor to decompression: the new benchmark in trauma craniotomiesAre missed doses of pharmacological thromboprophylaxis a risk factor for thromboembolic complications?Complications following admission for traumatic brain injuryExcessive crystalloid infusion in the first 24 hours is not associated with increased complications or mortalitySBIRT: plant, tend, growReal time electronic injury surveillance in an African trauma centreSBIRT in concert: establishing a new initiativeReview of the current knowledge of the pathophysiology of acute traumatic coagulopathy: implications for current trauma resuscitation practicesFactors associated with primary fascial closure rates in patients undergoing damage control laparotomyFree intraperitoneal fluid on CT abdomen in blunt trauma: Is hospital admission necessary?The need for speed — the time cost of off-site helipadsEndovascular management of penetrating Zone III retroperitoneal injuries in selective patients: a case reportMeasured resting energy expenditure in patients with open abdomens: preliminary data of a prospective pilot studyTraumatic inferior gluteal artery pseudoaneurysm: case report and review of literaturePancreatico duodenectomy, SMA, SMV repair and delayed reconstruction following blunt abdominal trauma. A case report with discussion of trauma whipple and complex pancreatico duodenal injuriesA retrospective evaluation of the effect of the Trauma Team Training program in TanzaniaDoes procalcitonin measurement predict clinical outcomes in critically ill/injured adults managed with the open abdomen technique?In trauma, conventional ROTEM and TEG results are not interchangeable but are similar in clinical applicabilitySevere trauma in the province of New Brunswick: a descriptive epidemiological studyPartnering for success — a road safety strategy for London and regionEvaluation of a patient safety initiative of rapid removal of backboards in the emergency departmentActive negative pressure peritoneal therapy and C-reactive protein levels after abbreviated laparotomy for abdominal trauma or intra-abdominal sepsisA comparison of outcomes: Direct admissions vs. interhospital transfers April 2009–March 2014YEE HA or YEE OUCH! A 5-year review of large animal-related incidentsEarly goal-directed therapy for prevention of hypothermia-related transfusion, morbidity and mortality in severely injured trauma patientsImproving care of adolescent trauma patients admitted to adult trauma centres by fostering collaboration between adult and pediatric partnersExpediting operational damage control laparotomy closure: iTClam v. suturing during damage control surgical simulation trainingAre conventional coagulation tests inadequate in the assessment of acute traumatic coagulopathy?Predictors of long-term outcomes in patients admitted to emergency general surgery services: a systematic review of literatureUse of the iTClamp versus standard suturing techniques for securing chest tubes: A randomized cadaver studyiTClamp application for control of simulated massive upper extremity arterial hemorrhage by tactical policeAssessing performance in the trauma roomThe deadly need for methadone/opiate educationTrends in the management of major abdominal vascular injuries: 2000–2014Addressing high school seniors’ risky behaviours through a hospital-based and peer teaching outreach programScreening for risk of post-traumatic stress disorder after injury in acutely injured children: a systematic reviewThe impact of trauma centre designation levels on surgical delay, mortality and complications: a multicentre cohort studyHow many acutely injured children report subsequent stress symptoms?The frequency of coagulopathy and its significance in an emergency neurotrauma facilityPsychosocial care for injured children: The views of 2500 emergency department physicians and nurses from around the worldDevelopment of the Trauma Electronic Document (TED)Development of trauma team activation criteria for an urban trauma centreBrains and brawn: evaluation of a sports skills and concussion awareness campRegional trauma networks: a tale of 2 pilotsContinuous data quality improvement in a provincial trauma registryDoes the Rural Trauma Team Development Course shorten transfer time?Epidemiology of trauma in Puerto RicoCT scans facilitate early discharge of trauma patientsFeasibility of data collection in a conflict zone to assess the impact on emergency health care deliveryConsent for Emergency Research (CONfER): a national survey of Canadian research ethics board practicesMaking handover safer for our trauma patients through the lens of trauma team leadersChallenges and opportunities to improve trauma transitions of care from emergency to intensive care nursingPhysical disorder following major injury: a population-based studyToward an inclusive trauma system: regional trauma system development in OntarioTraumatic brain injury in British Columbia: current incidence, injury patterns and risk factorsAcute cytokine and chemokine profiles in brain-injured patients: relationship to sympathetic activation and outcomeMultidisciplinary trauma simulation training in a tertiary care centreNon-operative management of blunt splenic injuries: routine radiologic follow-up may reduce the time of activity restrictionModified triple layer peritoneal-aponeurotic transposition: a new strategy to close the open abdomenMesenchymal stem cells locate and differentiate to the trauma site in a blunt rat liver trauma model: preliminary resultsThree indications for the “open abdomen”, anatomical, logistical and physiological: How are they different?Development of an urban trauma centre using lean methodologyThe impact of standardized care in 191 patients with chest tube thoracostomyComplex abdominal wall reconstruction: recommendations from the Canadian Abdominal Wall Reconstruction GroupCompensatory behaviours and cognitions in persons with history of traumaDevelopment of the Kenyatta National Hospital — University of Alberta Orthopedic Trauma Assessment Tool: phase 1 resultsRisk-taking behaviour negatively affects outcome in burn patients." Canadian Journal of Surgery 58, no. 2 Suppl 1 (April 2015): S1—S42. http://dx.doi.org/10.1503/cjs.003415.

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Hoit, G., C. Hinkewich, J. Tiao, V. Porgo, L. Moore, L. Moore, J. Tiao, et al. "Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review." Canadian Journal of Surgery 56, no. 2 Suppl (April 2013): S1—S42. http://dx.doi.org/10.1503/cjs.005813.

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Smith, Sherrill, Sharon L. Farra, and Eric Hodgson. "Evaluation of two simulation methods for teaching a disaster skill." BMJ Simulation and Technology Enhanced Learning, May 18, 2020, bmjstel—2019–000572. http://dx.doi.org/10.1136/bmjstel-2019-000572.

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IntroductionWith increasing use of virtual reality simulation (VRS) in nursing education, there is a paucity of research exploring learning outcomes following training with VRS as compared with traditional mannequin-based simulation. Given the resource intensive nature of mannequin-based simulation, especially for disaster education, understanding outcomes from newer technologies like VRS are needed.MethodsA quasi-experimental design was used to examine the differences in learning outcomes for the disaster skill of decontamination, based on type of simulation. The study was framed by the National Leage for Nursing (NLN) Jeffries Simulation Theory, with participant outcomes identified by the framework (satisfaction, self-confidence and performance). Outcomes were measured using the NLN Student Satisfaction and Self­ Confidence in Learning scale and a Decontamination Checklist. Senior nursing students in the final semester of a baccalaureate nursing programme were recruited to participate during one of their scheduled laboratory days. Following a didactic presentation, students were randomly assigned to one of two treatment groups (VRS or mannequin-based simulation training) to learn the skill of decontamination.ResultsA total of 121 participants took part in the study. No statistically significant results were noted for any of the study outcomes: performance (accuracy and time), satisfaction and self-efficacy. Results of the study demonstrate that VRS is as effective as mannequin-based simulation in training participants for the skill of decontamination.ConclusionsSimulation-based education experiences must be matched to learning outcomes and evaluated for effectiveness. As evidence emerges regarding use of newer technologies, like VRS, educators will have more options for providing students with opportunities that best match available resources.
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Tseng, Li-Ping, Tung-Hsu Hou, Li-Ping Huang, and Yang-Kun Ou. "Effectiveness of applying clinical simulation scenarios and integrating information technology in medical-surgical nursing and critical nursing courses." BMC Nursing 20, no. 1 (November 15, 2021). http://dx.doi.org/10.1186/s12912-021-00744-7.

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Abstract Background To determine the impact of combining clinical simulation scenario training and Information Technology Integrated Instruction (ITII) on the teaching of nursing skills. Methods 120 4th-year students in a nursing program who were enrolled in medical and surgical nursing courses. 61 received innovative instruction (experimental group) and 59 received conventional instruction (control group). The ADDIE model, systematic method of course development that includes analysis, design, development, implementation, and evaluation,was used to build simulation teaching and clinical scenarios and to create and modify objective structure clinical examination (OSCE) scenario checklists for acute myocardial infarction (AMI) care, basic life support and operation of automated external defibrillator (BLS), and subdural hemorrhage (SDH) care. The modified OSCE checklists were assessed for reliability, consistency, and validity. The innovative training included flipped classrooms, clinical simulation scenarios, ITII and blended learning formats. Results The reliability and validity of the OSCE checklists developed in this study were acceptable and comparable or higher than checklists in past studies and could be utilized as an OSCE performance tool. Students in innovative instruction obtained significantly better OSCE performance, lab scores and improvements from the previous year’s grades. Significant differences were found in situational awareness (SA). No strong correlations were found between OSCE scores and clinical internship scores, and no significant differences were found between the groups in overall clinical internship performance. Conclusions Innovative instruction showed better performance than conventional methods in summative evaluation of knowledge components, OSCE formative evaluation and clinical nursing internship scores, as well as improved situational awareness in nursing students.
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Zhou, Xin-yi, Yan-feng Wang, Chun-xia Dou, Xiao-ying Tian, Jin Su, Yan-ya Chen, Feng-xia Yan, Qiao-hong Yang, and Wenru Wang. "Evaluating the effects of simulated interprofessional teaching on the development of clinical core competence in nursing students: a mixed methods study." BMC Nursing 21, no. 1 (December 19, 2022). http://dx.doi.org/10.1186/s12912-022-01108-5.

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Abstract Background While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. Methods A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied “Clinical Critical Thinking Training” together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. Results The students’ interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience. Conclusion SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design.
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Okunji, Priscilla O., and Ihuoma Ezebuihe. "The Infusion of Learning - Transfer Evaluation Model in Undergraduate Nursing Education During COVID-19 Pandemic: Leadership Simulated." Trends in Internal Medicine 1, no. 1 (September 30, 2021). http://dx.doi.org/10.33425/2771-5906.1001.

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Introduction: The Learning-Transfer Evaluation Model (LTEM), is particularly designed to assist institutions and learning professionals to decide if their evaluation methods are effective in providing valid feedback as studies have reported that previous evaluation models have not done so effectively. LTEM is composed of eight levels starting from completely inadequate methods of learning evaluation to the effects of learning transfer. The model is designed to be critical for all learning interventions, including classroom learning, e-learning, mobile learning, on-the-job learning, self-study learning, etc. Hence, the rationale for using this learning model to evaluate an undergraduate Leadership and Management online class during the 2021 Spring semester. LTEM could be used anywhere to evaluate if learning has occurred. The terminology may eventually change evaluation practices; however, the new model is designed to help bring wisdom and knowledge to faculty teaching efforts. Hence, the rationale for using this learning model to evaluate an online class during the COVID-19 pandemic. Methods: Articles were extracted from PubMed and only five articles were chosen for the review prior to designing the online Leadership class. The inclusions were learning interventions, classroom learning, e-learning, mobile learning, distance learning, simulation, hybrid, discussion board. Exclusions were teaching and all non-learning and evaluation activities in higher education. Result: The learning outcomes of the leadership class was analyzed and tabulated according to the LTEM evaluation models (1-8). The results showed that using simulation technique was a very effective way evaluating learning when compared to other teaching methods such as role model, test, quizzes, etc. The rationale being that students were able to think critically and the outcomes of their learning dramatically changed on pre-post evaluation on Leadership and Management cues.
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Moloney, Mairead, Louise Murphy, Liz Kingston, Kathleen Markey, Therese Hennessy, Pauline Meskell, Sandra Atkinson, and Owen Doody. "Final year undergraduate nursing and midwifery students’ perspectives on simulation-based education: a cross-sectional study." BMC Nursing 21, no. 1 (November 6, 2022). http://dx.doi.org/10.1186/s12912-022-01084-w.

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Abstract Background Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support final year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods This study aimed to evaluate a simulation-based education initiative from the perspectives of final year undergraduate nursing and midwifery students (N = 95). An online survey, using the validated Simulation Effectiveness Tool – Modified (SET-M), was distributed to final year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results The results of the study highlight final year nursing and midwifery students’ perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confidence and gain experience in preparation for real-life practice. Students reported feeling more confident in their assessment skills, in providing care and interventions in responding to changes in a person’s health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefing and debriefing sessions were highlighted as important aspects of the simulation which helped to increase student confidence and cultivate meaningful learning. Conclusion Simulation-based education is a valuable teaching and learning modality, particularly for final year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional.
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Ren, Qi, Fang Chen, Huijuan Zhang, Juanhua Tu, Xiaowei Xu, and Caixia Liu. "Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses." BMC Nursing 21, no. 1 (August 1, 2022). http://dx.doi.org/10.1186/s12912-022-00995-y.

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Abstract Background Patients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education. Methods Except for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors. Results All 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice. Conclusion Simulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.
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Lau, Phyllis Min-yu, Robyn Woodward-Kron, Karen Livesay, Kristine Elliott, and Patricia Nicholson. "Cultural respect encompassing simulation training: being heard about health through broadband." Journal of Public Health Research 5, no. 1 (April 26, 2016). http://dx.doi.org/10.4081/jphr.2016.657.

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<em>Background</em>. Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity – defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire – of the streamed simulations. <br /><em>Design and Methods.</em> In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. <br /><em>Results</em>. Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P&lt;0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. <br /><em>Conclusions</em>. Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals’ learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training.
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Mleyhi, S., R. Miri, Z. Daoued, B. Derbel, and R. Denguir. "Supervision by direct observation with video recording in the operating room: educational tool for learning and formative evaluation." European Journal of Cardiovascular Nursing 21, Supplement_1 (July 1, 2022). http://dx.doi.org/10.1093/eurjcn/zvac060.107.

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Abstract Funding Acknowledgements Type of funding sources: None. Introduction Directly observed supervision with video recording (DOSVR) is used as a learning method in several countries. This technique has proven itself, but remains little used in Tunisia. On the other hand, the use of DOSVR in surgery is rarely described. The objectives of our work were to describe the development and experimental implementation of DOSVR in surgery and to evaluate the feedback from residents and teachers. Methods This is a prospective, observational and descriptive study concerning the experimentation of DOSVR in five surgical procedures performed by residents of cardiovascular surgery department. These video recordings were followed by a backscatter with self and heteroevaluation. We based ourselves on the methodology of teaching by simulation for the design of the protocol: the Briefing, the scenario and then the debriefing. Results A total of ten took part in this experiment. The average age was 28.5 years [26 -33 years] with a sex ratio F/M of 4. All residents declared that the protocol provided was easy to understand and apply. After obtaining the consent of the patients, five interventions were filmed in whom three were in emergency. Seven residents said that using a smartphone to vdeo recording was not easy and 8 easily got rid of the presence of the camera. All the learners denied having to change their operating techniques because they were being filmed. All the residents agreed that a minimum number of six DOSVR sessions in each residency year is appropriate and praised the technique as a powerful tool for the development of their practical training. Conclusions Our study showed that the application of Directly observed supervision with video recording in vascular surgery is feasible. It is a promising educational tool for the practical learning of residents as well as a tool for the continuous formative evaluation of their progress.
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Rattray, Megan, Andrea P. Marshall, Ben Desbrow, Michael von Papen, and Shelley Roberts. "Assessment of an integrated knowledge translation intervention to improve nutrition intakes among patients undergoing elective bowel surgery: a mixed-method process evaluation." BMC Health Services Research 21, no. 1 (May 27, 2021). http://dx.doi.org/10.1186/s12913-021-06493-2.

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Abstract Background A large evidence-practice gap exists regarding provision of nutrition to patients following surgery. The aim of this study was to evaluate the processes supporting the implementation of an intervention designed to improve the timing and adequacy of nutrition following bowel surgery. Methods A mixed-method pilot study, using an integrated knowledge translation (iKT) approach, was undertaken at a tertiary teaching hospital in Australia. A tailored, multifaceted intervention including ten strategies targeted at staff or patients were co-developed with knowledge users at the hospital and implemented in practice. Process evaluation outcomes included reach, intervention delivery and staffs’ responses to the intervention. Quantitative data, including patient demographics and surgical characteristics, intervention reach, and intervention delivery were collected via chart review and direct observation. Qualitative data (responses to the intervention) were sequentially collected from staff during one-on-one, semi-structured interviews. Quantitative data were summarized using median (IQR), mean (SD) or frequency(%), while qualitative data were analysed using content analysis. Results The intervention reached 34 patients. Eighty-four percent of nursing staff received an awareness and education session, while 0% of medical staff received a formal orientation or awareness and education session, despite the original intention to deliver these sessions. Several strategies targeted at patients had high fidelity, including delivery of nutrition education (92%); and prescription of oral nutrition supplements (100%) and free fluids immediately post-surgery (79%). Prescription of a high energy high protein diet on postoperative day one (0%) and oral nutrition supplements on postoperative day zero (62%); and delivery of preoperative nutrition handout (74%) and meal ordering education (50%) were not as well implemented. Interview data indicated that staff regard nutrition-related messages as important, however, their acceptance, awareness and perceptions of the intervention were mixed. Conclusions Approximately half the patient-related strategies were implemented well, which is likely attributed to the medical and nursing staff involved in intervention design championing these strategies. However, some strategies had low delivery, which was likely due to the varied awareness and acceptance of the intervention among staff on the ward. These findings suggest the importance of having buy-in from all staff when using an iKT approach to design and implement interventions.
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Fredericks, Bronwyn, and Debbie Bargallie. "Situating Race in Cultural Competency Training: A Site of Self-Revelation." M/C Journal 23, no. 4 (August 12, 2020). http://dx.doi.org/10.5204/mcj.1660.

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Indigenous cross-cultural training has been around since the 1980s. It is often seen as a way to increase the skills and competency of staff engaged in providing service to Indigenous clients and customers, teaching Indigenous students within universities and schools, or working with Indigenous communities (Fredericks and Bargallie, “Indigenous”; “Which Way”). In this article we demonstrate how such training often exposes power, whiteness, and concepts of an Indigenous “other”. We highlight how cross-cultural training programs can potentially provide a setting in which non-Indigenous participants can develop a deeper realisation of how their understandings of the “other” are formed and enacted within a “white” social setting. Revealing whiteness as a racial construct enables people to see race, and “know what racism is, what it is not and what it does” (Bargallie, 262). Training participants can use such revelations to develop their racial literacy and anti-racist praxis (Bargallie), which when implemented have the capacity to transform inequitable power differentials in their work with Indigenous peoples and organisations.What Does the Literature Say about Cross-Cultural Training? An array of names are used for Indigenous cross-cultural training, including cultural awareness, cultural competency, cultural responsiveness, cultural safety, cultural sensitivity, cultural humility, and cultural capability. Each model takes on a different approach and goal depending on the discipline or profession to which the training is applied (Hollinsworth). Throughout this article we refer to Indigenous cross-cultural training as “cultural competence” or “cultural awareness” and discuss these in relation to their application within higher education institutions. While literature on health and human services programs in Australia, Canada, New Zealand, and other nation states provide clear definitions of terms such as “cultural safety”, cultural competence or cultural awareness is often lacking a concise and consistent definition.Often delivered as a half day or a one to two-day training course, it is unrealistic to think that Indigenous cultural competence can be achieved through one’s mere attendance and participation. Moreover, when courses centre on “cultural differences” and enable revelations about those differences they are in danger of presenting idealised notions of Indigeneity. Cultural competence becomes a process through which an Indigenous “other” is objectified, while very little is offered by way of translating knowledge and skills into practice when working with Indigenous peoples.What this type of learning has the capacity to do is oversimplify and reinforce racism and racist stereotypes of Indigenous peoples and Indigenous cultures. What is generally believed is that if non-Indigenous peoples know more about Indigenous peoples and cultures, relationships between Indigenous and non-Indigenous peoples will somehow improve. The work of Goenpul scholar Aileen Moreton-Robinson is vital to draw on here, when she asks, has the intellectual investment in defining our cultural differences resulted in the valuing of our knowledges? Has the academy become a more enlightened place in which to work, and, more important, in what ways have our communities benefited? (xvii)What is revealed in a range of studies – whether centring on racism and discrimination or the ongoing disparities across health, education, incarceration, employment, and more – is that despite forty plus years of training focused on understanding cultural differences, very little has changed. Indigenous knowledges continue to be devalued and overlooked. Everyday and structural racisms shape everyday experiences for Indigenous employees in Australian workplaces such as the Australian Public Service (Bargallie) and the Australian higher education sector (Fredericks and White).As the literature demonstrates, the racial division of labour in such institutions often leaves Indigenous employees languishing on the lower rungs of the employment ladder (Bargallie). The findings of an Australian university case study, discussed below, highlights how power, whiteness, and concepts of “otherness” are exposed and play out in cultural competency training. Through their exposure, we argue that better understandings about Indigenous Australians, which are not based on culture difference but personal reflexivity, may be gained. Revealing What Was Needed in the Course’s Foundation and ImplementationThis case study is centred within a regional Australian university across numerous campuses. In 2012, the university council approved an Aboriginal and Torres Strait Islander strategy, which included a range of initiatives, including the provision of cross-cultural training for staff. In developing the training, a team explored the evidence as it related to university settings (Anning; Asmar; Butler and Young; Fredericks; Fredericks and Thompson; Kinnane, Wilks, Wilson, Hughes and Thomas; McLaughlin and Whatman). This investigation included what had been undertaken in other Australian universities (Anderson; University of Sydney) and drew on the recommendations from earlier research (Behrendt, Larkin, Griew and Kelly; Bradley, Noonan, Nugent and Scales; Universities Australia). Additional consultation took place with a broad range of internal and external stakeholders.While some literature on cross-cultural training centred on the need to understand cultural differences, others exposed the problems of focusing entirely on difference (Brach and Fraser; Campinha-Bacote; Fredericks; Spencer and Archer; Young). The courses that challenged the centrality of cultural difference explained why race needed to be at the core of its training, highlighting its role in enabling discussions of racism, bias, discrimination and how these may be used as means to facilitate potential individual and organisational change. This approach also addressed stereotypes and Eurocentric understandings of what and who is an Indigenous Australian (Carlson; Gorringe, Ross and Forde; Hollinsworth; Moreton-Robinson). It is from this basis that we worked and grew our own training program. Working on this foundational premise, we began to separate content that showcased the fluidity and diversity of Indigenous peoples and refrained from situating us within romantic notions of culture or presenting us as an exotic “other”. In other words, we embraced work that responded to non-Indigenous people’s objectified understandings and expectations of us. For example, the expectation that Indigenous peoples will offer a Welcome to Country, performance, share a story, sing, dance, or disseminate Indigenous knowledges. While we recognise that some of these cultural elements may offer enjoyment and insight to non-Indigenous people, they do not challenge behaviours or the nature of the relationships that non-Indigenous people have with Aboriginal and Torres Strait Islander peoples (Bargallie; Fredericks; Hollinsworth; Westwood and Westwood; Young).The other content which needed separating were the methods that enabled participants to understand and own their standpoints. This included the use of critical Indigenous studies as a form of analysis (Moreton-Robinson). Critical race theory (Delgado and Stefancic) was also used as a means for participants to interrogate their own cultural positionings and understand the pervasive nature of race and racism in Australian society and institutions (McLaughlin and Whatman). This offered all participants, both non-Indigenous and Indigenous, the opportunity to learn how institutional racism operates, and maintains discrimination, neglect, abuse, denial, and violence, inclusive of the continued subjugation that exists within higher education settings and broader society.We knew that the course needed to be available online as well as face-to-face. This would increase accessibility to staff across the university community. We sought to embed critical thinking as we began to map out the course, including the theory in the sections that covered colonisation and the history of Indigenous dispossession, trauma and pain, along with the ongoing effects of federal and state policies and legislations that locates racism at the core of Australian politics. In addition to documenting the ongoing effects of racism, we sought to ensure that Indigenous resistance, agency, and activism was highlighted, showing how this continues, thus linking the past to the contemporary experiences of Indigenous peoples.Drawing on the work of Bargallie we wanted to demonstrate how Aboriginal and Torres Strait Islander peoples experience racism through systems and structures in their everyday work with colleagues in large organisations, such as universities. Participants were asked to self-reflect on how race impacts their day-to-day lives (McIntosh). The final session of the training focused on the university’s commitment to “Closing the Gap” and its Reconciliation Action Plan (RAP). The associated activity involved participants working individually and in small groups to discuss and consider what they could contribute to the RAP activities and enact within their work environments. Throughout the training, participants were asked to reflect on their personal positioning, and in the final session they were asked to draw from these reflections and discuss how they would discuss race, racism and reconciliation activities with the governance of their university (Westwood and Westwood; Young).Revelations in the Facilitators, Observers, and Participants’ Discussions? This section draws on data collected from the first course offered within the university’s pilot program. During the delivery of the in-person training sessions, two observers wrote notes while the facilitators also noted their feelings and thoughts. After the training, the facilitators and observers debriefed and discussed the delivery of the course along with the feedback received during the sessions.What was noticed by the team was the defensive body language of participants and the types of questions they asked. Team members observed how there were clear differences between the interest non-Indigenous participants displayed when talking about Aboriginal and Torres Strait Islander peoples and a clear discomfort when they were asked to reflect on their own position in relation to Indigenous people. We noted that during these occasions some participants crossed their arms, two wrote notes to each other across the table, and many participants showed discomfort. When the lead facilitator raised this to participants during the sessions, some expressed their dislike and discomfort at having to talk about themselves. A couple were clearly unhappy and upset. We found this interesting as we were asking participants to reflect and talk about how they interpret and understand themselves in relation to Indigenous people and race, privilege, and power.This supports the work of DiAngelo who explains that facilitators can spend a lot of time trying to manage the behaviour of participants. Similarly, Castagno identifies that sometimes facilitators of training might overly focus on keeping participants happy, and in doing so, derail the hard conversations needed. We did not do either. Instead, we worked to manage the behaviours expressed and draw out what was happening to break the attempts to silence racial discussions. We reiterated and worked hard to reassure participants that we were in a “safe space” and that while such discussions may be difficult, they were worth working through on an individual and collective level.During the workshop, numerous emotions surfaced, people laughed at Indigenous humour and cried at what they witnessed as losses. They also expressed anger, defensiveness, and denial. Some participants revelled in hearing answers to questions that they had long wondered about; some openly discussed how they thought they had discovered a distant Aboriginal relative. Many questions surfaced, such as why hadn’t they ever been told this version of Australian history? Why were we focusing on them and not Aboriginal people? How could they be racist when they had an Aboriginal friend or an Aboriginal relative?Some said they felt “guilty” about what had happened in the past. Others said they were not personally responsible or responsible for the actions of their ancestors, questioning why they needed to go over such history in the first place? Inter-woven within participants’ revelations were issues of racism, power, whiteness, and white privilege. Many participants took a defensive stance to protect their white privilege (DiAngelo). As we worked through these issues, several participants started to see their own positionality and shared this with the group. Clearly, the revelation of whiteness as a racial construct was a turning point for some. The language in the group also changed for some participants as revelations emerged through the interrogation and unpacking of stories of racism. Bargallie’s work exploring racism in the workplace, explains that “racism”, as both a word and theme, is primarily absent in conversations amongst non-Indigenous colleagues. Despite its entrenchment in the dialogue, it is rarely, if ever addressed. In fact, for many non-Indigenous people, the fear of being accused of racism is worse than the act of racism itself (Ahmed; Bargallie). We have seen this play out within the media, sport, news bulletins, and more. Lentin describes the act of denying racism despite its existence in full sight as “not racism”, arguing that its very denial is “a form of racist violence” (406).Through enhancing racial literacy, Bargallie asserts that people gain a better understanding of “what racism is, what racism is not and how race works” (258). Such revelations can work towards dismantling racism in workplaces. Individual and structural racism go hand-in-glove and must be examined and addressed together. This is what we wanted to work towards within the cultural competency course. Through the use of critical Indigenous studies and critical race theory we situated race, and not cultural difference, as central, providing participants with a racial literacy that could be used as a tool to challenge and dismantle racism in the workplace.Revelations in the Participant Evaluations?The evaluations revealed that our intention to disrupt the status quo in cultural competency training was achieved. Some of the discussions were difficult and this was reflected in the feedback. It was valuable to learn that numerous participants wanted to do more through group work, conversations, and problem resolution, along with having extra reading materials. This prompted our decision to include extra links to resource learning materials through the course’s online site. We also opted to provide all participants with a copy of the book Indigenous Australia for Dummies (Behrendt). The cost of the book was built into the course and future participants were thankful for this combination of resources.One unexpected concern raised by participants was that the course should not be “that hard”, and that we should “dumb down” the course. We were astounded considering that many participants were academics and we were confident that facilitators of other mandatory workplace training, for example, staff Equal Employment Opportunity (EEO), Fire Safety, Risk Management, Occupational Health and Safety, Discrimination and more, weren’t asked to “dumb down” their content. We explained to the participants what content we had been asked to deliver and knew their responses demonstrated white fragility. We were not prepared to adjust the course and dumb it down for white understandings and comfortabilities (Leonardo and Porter).Comments that were expected included that the facilitators were “passionate”, “articulate”, demonstrated “knowledge” and effectively “dealt with issues”. A couple of the participants wrote that the facilitators were “aggressive” or “angry”. This however is not new for us, or new to other Aboriginal women. We know Aboriginal women are often seen as “aggressive” and “angry”, when non-Indigenous women might be described as “passionate” or “assertive” for saying exactly the same thing. The work of Aileen Moreton-Robinson in Australia, and the works of numerous other Aboriginal women provide evidence of this form of racism (Fredericks and White; Bargallie; Bond). Internationally, other Indigenous women and women of colour document the same experiences (Lorde). Participants’ assessment of the facilitators is consistent with the racism expressed through racial microaggression outside of the university, and in other organisations. This is despite working in the higher education sector, which is normally perceived as a more knowledgeable and informed environment. Needless to say, we did not take on these comments.The evaluations did offer us the opportunity to adjust the course and make it stronger before it was offered across the university where we received further evaluation of its success. Despite this, the university decided to withdraw and reallocate the money to the development of a diversity training course that would cover all equity groups. This meant that Aboriginal and Torres Strait Islander peoples would be covered along with sexual diversity, gender, disability, and people from non-English speaking backgrounds. The content focused on Aboriginal and Torres Strait Islander peoples was reduced to one hour of the total course. Including Aboriginal and Torres Strait Islander peoples in this way is not based on evidence and works to minimise Indigenous Australians and their inherent rights and sovereignty to just another “equity group”. Conclusion We set out to develop and deliver a cross-cultural course that was based on evidence and a foundation of 40 plus years’ experience in delivering such training. In addition, we sought a program that would align with the university’s Reconciliation Action Plan and the directions being undertaken in the sector and by Universities Australia. Through engaging participants in a process of critical thinking centring on race, we developed a training program that successfully fostered self-reflection and brought about revelations of whiteness.Focusing on cultural differences has proven ineffective to the work needed to improve the lives of Indigenous Australian peoples. Recognising this, our discussions with participants directly challenged racist and negative stereotypes, individual and structural racism, prejudices, and white privilege. By centring race over cultural difference in cultural competency training, we worked to foster self-revelation within participants to transform inequitable power differentials in their work with Indigenous peoples and organisations. The institution’s disbandment and defunding of the program however is a telling revelation in and of itself, highlighting the continuing struggle and importance of placing additional pressure on persons, institutions, and organisations to implement meaningful structural change. ReferencesAhmed, Sara. On Being Included: Racism and Diversity in Institutional Life. Duke University Press, 2012.Anderson, Ian. “Advancing Indigenous Health through Medical Education”. Focus on Health Professional Education: A Multi-Disciplinary Journal 13.1 (2011): 1-12.Anning, Beres. “Embedding an Indigenous Graduate Attribute into University of Western Sydney’s Courses”. Australian Journal of Indigenous Education 39 (2010): 40-52.Asmar, Christine. Final Report on the Murrup Barak of Indigenous Curriculum, Teaching and Learning at the University of Melbourne, 2010-2011. Murrup Barak – Melbourne Institute for Indigenous Development, University of Melbourne, 2011.Bargallie, Debbie. Unmasking The Racial Contract: Everyday Racisms and the Impact of Racial Microaggressions on “Indigenous Employees” in the Australian Public Service. Aboriginal Studies Press, 2020. Behrendt, Larissa. Indigenous Australia for Dummies. Wiley Publishing, 2010.Behrendt, Larissa, Steven Larkin, Robert Griew, Robert, and Patricia Kelly. Review of Higher Education Access and Outcomes for Aboriginal and Torres Strait Islander People: Final Report. Department of Employment, Education and Workplace Relations, 2012.Brach, Cindy, and Irene Fraser. “Can Cultural Competency Reduce Racial and Ethnic Health Disparities? A Review and Conceptual Model”. Medical Care Research and Review 57.sup 1 (2000): 181-217.Bond, Chelsea. “When the Object Teaches: Indigenous Academics in Australian Universities”. Right Now 14 (2014). <http://rightnow.org.au/opinion-3/when-the-object-teaches-indigenous-academics-in-australian-universities/>.Bradley, Denise, Peter Noonan, Helen Nugent, and Bill Scales. Review of Australian Higher Education. Australian Government, 2008.Butler, Kathleen, and Anne Young. Indigenisation of Curricula – Intent, Initiatives and Implementation. Canberra: Tertiary Education Quality and Standards Agency, 2009. 20 Apr. 2020 <http://www.teqsa.gov.au/news-publications/publications>.Campinha-Bacote, Josepha. “A Model and Instrument for Addressing Cultural Competence in Health Care”. Journal of Nursing Education 38.5 (1999): 203-207.Carlson, Bronwyn. The Politics of Identity – Who Counts as Aboriginal Today? Canberra: Aboriginal Studies Press, 2016.Delgado, Richard, and Jean Stefancic. Critical Race Theory: An Introduction. New York University Press, 2001.DiAngelo, Robin. “Nothing to Add: A Challenge to White Silence in Racial Discussions”. Understanding and Dismantling Privilege 11.1 (2012). <http://www.wpcjournal.com/article/view/10100/Nothing%20to%20add%3A%20A%20Challenge%20to%20White%20Silence%20in%20Racial%20Discussions>.Frankenburg, Ruth. White Women, Race Matters: The Social Construction of Whiteness. Minneapolis: University of Minnesota Press, 1993.Fredericks, Bronwyn. “The Need to Extend beyond the Knowledge Gained in Cross-Cultural Awareness Training”. The Australian Journal of Indigenous Education 37.S (2008): 81-89.Fredericks, Bronwyn, and Debbie Bargallie. “An Indigenous Cultural Competency Course: Talking Culture, Care and Power”. In Cultural Competence and the Higher Education Sector: Perspectives, Policies and Practice, eds. Jack Frawley, Gabrielle Russell, and Juanita Sherwood, Springer Publications, 295-308. <https://link.springer.com/book/10.1007%2F978-981-15-5362-2>.Fredericks, Bronwyn, and Debbie Bargallie. “‘Which Way? Talking Culture, Talking Race’: Unpacking an Indigenous Cultural Competency Course”. International Journal of Critical Indigenous Studies 9.1 (2016): 1-14.Fredericks, Bronwyn, and Marlene Thompson. “Collaborative Voices: Ongoing Reflections on Cultural Competency and the Health Care of Australian Indigenous People”. Journal of Australian Indigenous Issues 13.3 (2010): 10-20.Fredericks, Bronwyn, and Nereda White. “Using Bridges Made by Others as Scaffolding and Establishing Footings for Those That Follow: Indigenous Women in the Academy”. Australian Journal of Education 62.3 (2018): 243–255.Gorringe, Scott, Joe Ross, and Cressida Fforde. Will the Real Aborigine Please Stand Up? Strategies for Breaking the Stereotypes and Changing the Conversation. AIATSIS Research Discussion Paper No. 28. Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS), 2011.Hollinsworth, David. “Forget Cultural Competence: Ask for an Autobiography”. Social Work Education: The International Journal 32.8 (2013): 1048-1060.hooks, bell. Feminist Theory: From Margin to Centre. London: Pluto Press, 2000.Kinnane, Stephen, Judith Wilks, Katie Wilson, Terri Hughes, and Sue Thomas. Can’t Be What You Can’t See: The Transition of Aboriginal and Torres Strait Islander Students into Higher Education. Final report to the Australian Government Office for Learning and Teaching. Canberra: Office of Learning and Teaching, 2014.Lentin, Alana. “Beyond Denial: ‘Not Racism’ as Racist Violence”. Continuum 32.1 (2018): 1-15.Leonardo, Zeus, and Ronald L. Porter. “Pedagogy of Fear: Toward a Fanonian Theory of ‘Safety’ in Race Dialogue”. Race Ethnicity and Education 13.2 (2010): 139-157.Lorde, Audrey. Sister Outsider: Essays and Speeches. Crossing Press, 1984.McIntosh, Peggy. White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences through Work in Women's Studies. Wellesley College, Center for Research on Women, 1988.McLaughlin, Juliana, and Sue Whatman. “The Potential of Critical Race Theory in Decolonizing University Curricula”. Asia Pacific Journal of Education 31.4 (2011): 365-377.Moreton-Robinson, Aileen. The White Possessive: Property, Power, and Indigenous Sovereignty. University of Minnesota Press, 2015.Sargent, Sara E., Carol A. Sedlak, and Donna S. Martsolf. “Cultural Competence among Nursing Students and Faculty”. Nurse Education Today 25.3 (2005): 214-221.Sherwood, Juanita, and Tahnia Edwards. “Decolonisation: A Critical Step for Improving Aboriginal health”. Contemporary Nurse 22.2 (2016): 178-190.Spencer, Caroline, and Frances L. Archer. “Surveys of Cultural Competency in Health Professional Education: A Literature Review”. Journal of Emergency Primary Health Care 6.2 (2008): 17.Universities Australia. National Best Practice Framework for Indigenous Cultural Competency in Australian Universities. Universities Australia, 2011. <http://www.universitiesaustralia.edu.au/lightbox/1312>.University of Sydney. National Centre for Cultural Competence, 2016. <http://sydney.edu.au/nccc/>.Westwood, Barbara, and Geoff Westwood. “Aboriginal Cultural Awareness Training: Policy v. Accountability – Failure in Reality”. Australian Health Review 34 (2010): 423-429.Young, Susan. “Not Because It’s a Bloody Black Issue! Problematics of Cross Cultural Training”. In Unmasking Whiteness: Race Relations and Reconciliation, ed. Belinda McKay, 204-219. Queensland Studies Centre, University of Queensland Press, 1999.
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