Revisiting Pseudo-Haptics for Psychomotor Skills Development in Online Teaching.

In a centralized model of simulation-based education (Ce-SBE), the trainees practice clinical skills in simulated laboratories based on physical models, while in a decentralized model (De-SBE), the trainees practice these skills outside of these laboratories. Attention to De-SBE has drastically shifted to virtual learning environments (VLEs), serious games, and virtual simulations employing various digital technologies, including virtual, augmented, and mixed reality. In particular, remote learning has grown immensely during the COVID-19 pandemic as traditional in-person teaching and training activities are conducted online as a form of facilitating continuity in education. VLEs allow trainees to learn from virtual simulated health experiences in an interactive, engaging, and ethically safe manner, while providing educators the opportunity to implement simulated experiences to a larger number of learners. Despite these benefits, for certain types of clinical skills, such as psychomotor skills, VLEs have not yet reached their potential. This is primarily due to technical limitations and cost issues with the haptic devices required to simulate the sense of touch. Pseudo-haptic refers to the illusion of haptic stimulation in the absence of mechanical haptic interfaces and often combines the use of a passive input device (e.g., mouse) with visual and auditory feedback to simulate haptic properties (stiffness or friction of an object). Although the application of pseudo-haptics for psychomotor skills development is still in its infancy and currently trending due to the availability of consumer-level technologies, the potential to present haptic cues in the absence of active haptic devices may allow trainees to practice some tasks outside of research and training labs. The implications of pseudo-haptics are tremendous, particularly as remote learning becomes more widespread, and warrant further discussion.

Shifting to Delivering Simulation Virtually Within a Healthcare Education Setting.

The coronavirus disease 2019 (COVID-19) pandemic has changed how healthcare education is being delivered, creating a global shift towards virtual modalities. Various approaches, each with their own benefits and limitations, have been developed to bridge this gap and continue to provide comprehensive education to healthcare students. To understand which approach to implement, we must consider what each can offer and what is best suited for the situation. Much of this will focus on the learning goals and outcomes with research strongly favouring modalities focused on the areas of cognitive, affective, and behavioural skill acquisition as opposed to technical skills.  The use of simulated persons offers the most diverse application for these areas of focus. This approach can provide opportunities for both synchronous and asynchronous learning. While novel in its approach, virtual simulations can leverage existing success and performance indicators used for in-person approaches to best understand the experiences of the learners and the facilitators. Evidence can be compared with outcomes of previous in-person groups to understand how this approach can be best implemented into curricula/programs. Future applications are numerous for this modality and the development of pilot studies focused on smaller groups of learners will provide opportunities for educators and program developers to review and understand the challenges that may arise. Simulation is a widely drawn upon teaching-learning approach deeply rooted in experiential learning. With the purpose of replicating real-world scenarios to increase knowledge transfer and reduce the shock of encountering challenging real-world situations, simulated environments are proven to be an effective tool in building learners' self-confidence and bridging the gap between theory and practice within the healthcare realm. Simulation can be, and is, applied within healthcare-education contexts from undergraduate to graduate levels and into ongoing professional development.

Using Simulation-Based Methods to Support Demonstration of Competencies Required by Micro-Credential Courses.

The rise of the digital revolution has disrupted entire industries and job markets, leading individuals to either upgrade or transfer their skills in order to continue within their designated fields or transition to new workplace contexts. Employers expect their employees to apply their knowledge to real-world settings, analyze and solve problems, connect choices to actions, and innovate and create. Moreover, the COVID-19 pandemic has exacerbated changes to the educational landscape by forcing online and remote contexts; physical distancing and other preventive measures have necessitated a shift towards increasing the use of disruptive digital technologies- extended reality (e.g., virtual and augmented reality), gaming, and additive manufacturing-in simulation delivery. Yet Canada's economic and demographic data suggests that many new graduates struggle to transition from school to working life. The confluence of these factors has led to a need for both individuals and higher education institutions to upgrade and adapt to new digital techniques and modalities. As these needs grow, simulation-based education (SBE) techniques and technologies-already an integral part of training for some professions, including nursing, medicine, and various other health professions-are increasingly being used in digital contexts. In this editorial, we provide our perspective of the socio-technological movement associated with health-professions education (HPE) within the SBE context and examine the application and implementation of micro-credentialing within this field. We also discuss the various levels of expertise that learners may acquire. From this vantage point, we address how SBE can complement the assessment of competencies that learners must demonstrate to attain micro-credentials and explore micro-credentialing's advantages for, and use in, HPE.

A Model for an Online Learning Management System for Simulation-Based Acquisition of Psychomotor Skills in Health Professions Education.

The current coronavirus disease (COVID-19) pandemic has shifted traditional educational approaches in health professions education (HPE) from in-person to remote learning. Although pedagogical strategies have been developed and implemented rapidly to support cognitive and affective domains of learning in HPE, less progress has occurred in psychomotor skills acquisition. Psychomotor skills, referred to as technical skills training, are underpinned by educational theories and conceptual frameworks. Considering the widening gap in learning domains, this editorial provides an overview and recommendations for developing and implementing remote training supported by educational theories, such as deliberate practice, and conceptual frameworks in technical skills acquisition in HPE. We begin by discussing the unique curricular needs for remote psychomotor skills in medical teaching-learning contexts and subsequently present a theory-driven and evidence-based model for remote psychomotor skills acquisition.

Implementing Virtual Simulated Person Methodology to Support the Shift to Online Learning: Technical Report.

The COVID-19 pandemic has dramatically changed how education is delivered worldwide. The resultant rise of e-learning, whereby teaching is undertaken remotely and on digital platforms, has extensively impacted universities and other higher education organizations around the world. One approach to support this change in education delivery is the use of virtual simulation approaches. Our team at SimXSpace has piloted a virtual workshop using Zoom, an online video-conferencing platform, and virtual simulated persons (SPs) to support communication and interpersonal skills among learners. The main objective of the pilot virtual workshop was to develop and implement the SP methodology remotely via the Zoom platform (Zoom Video Communications, San Jose, California) and to evaluate its effectiveness as an immersive environment for simulation. The virtual workshop involved four instructors who intend to implement virtual SPs within their courses, two workshop facilitators, and two SPs. The workshop was conducted synchronously using Zoom features. The workshop followed a predefined structure and was completed as planned. Outcomes suggest that remote simulation delivery using virtual SPs and delivered online via Zoom is feasible and provides an effective environment in which to conduct SP methodology to teach communication and interpersonal skills. The findings suggest that remote simulation and virtual SPs can support experiential education and provide an effective and engaging learning environment. The virtual workshop was successful and laid a foundation for future online training programs for the use of SP methodology. Moreover, it formed an effective outline for subsequent iterations of this virtual training workshop and prompted discussion of plans for future workshops with various programs across a pan-university context.