Can implementation of in situ simulation support rural emergency provider self-confidence and improve patient safety? A mixed-methods study
Bibliographic record
Abstract
INTRODUCTION: Rural emergency departments across Canada face challenges such as limited access to continuing medical education and resource constraints. Our study evaluates in situ Simulation (ISS) as an educational tool in a small rural emergency department, focusing on participant satisfaction, clinician confidence and the identification of latent safety threats (LSTs). METHODS: Five monthly ISS sessions were conducted during active clinical hours, involving physicians, nurses and nurse practitioners selected through convenience sampling. After each session, participants anonymously completed the validated student satisfaction and self-confidence in learning survey and short-answer questions to identify LSTs. RESULTS: Participants reported high satisfaction with ISS, and high confidence in clinical skills post-simulation. Thematic analysis of short-answer responses identified several LSTs in clinical care systems, which were brought for review by department leadership to improve patient and provider safety. CONCLUSION: ISS is a feasible and valuable educational strategy for rural healthcare providers, promoting participant satisfaction and enhancing confidence in managing acute situations. In addition, it effectively identifies safety issues, contributing to improved patient care. This model can inform similar initiatives in other rural settings facing educational and resource challenges. INTRODUCTION: Les services d'urgence en milieu rural à travers le Canada font face à des défis tels que l'accès limité à la formation médicale continue et les contraintes de ressources. Notre étude évalue la simulation in situ (SIS) comme outil pédagogique dans un petit service d'urgence rural, en mettant l'accent sur la satisfaction des participants, la confiance des cliniciens et l'identification des menaces latentes à la sécurité. MTHODES: Cinq séances mensuelles de SIS ont été réalisées pendant les heures cliniques actives, réunissant des médecins, des infirmières et des infirmières praticiennes sélectionnés par échantillonnage de convenance. Après chaque séance, les participants ont rempli de façon anonyme le questionnaire validé Student Satisfaction and Self-Confidence in Learning Survey (SCLS), ainsi que des questions à réponses courtes visant à identifier les menaces latentes à la sécurité. RSULTATS: Les participants ont rapporté un haut niveau de satisfaction à l'égard de la SIS et une grande confiance dans leurs compétences cliniques après les simulations. L'analyse thématique des réponses courtes a permis d'identifier plusieurs menaces latentes à la sécurité dans les systèmes de soins cliniques, lesquelles ont été soumises à l'examen de la direction du service afin d'améliorer la sécurité des patients et des prestataires. CONCLUSION: La SIS constitue une stratégie pédagogique réalisable et précieuse pour les professionnels de la santé en milieu rural, favorisant la satisfaction des participants et renforçant leur confiance dans la gestion des situations aiguës. De plus, elle permet de cerner efficacement des enjeux de sécurité, contribuant ainsi à l'amélioration des soins aux patients. Ce modèle peut inspirer des initiatives similaires dans d'autres contextes ruraux confrontés à des défis éducatifs et de ressources.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".