The state of distance healthcare simulation during the COVID-19 pandemic: results of an international survey.

BACKGROUND: The coronavirus pandemic continues to shake the embedded structures of traditional in-person education across all learning levels and across the globe. In healthcare simulation, the pandemic tested the innovative and technological capabilities of simulation programs, educators, operations staff, and administration. This study aimed to answer the question: What is the state of distance simulation practice in 2021? METHODS: This was an IRB-approved, 34-item open survey for any profession involved in healthcare simulation disseminated widely and internationally in seven languages from January 14, 2021, to March 3, 2021. Development followed a multistep process of expert design, testing, piloting, translation, and recruitment. The survey asked questions to understand: Who was using distance simulation? What driving factors motivated programs to initiate distance sim? For what purposes was distance sim being used? What specific types or modalities of distance simulation were occurring? How was it being used (i.e., modalities, blending of technology and resources and location)? How did the early part of the pandemic differ from the latter half of 2020 and early 2021? What information would best support future distance simulation education? Data were cleaned, compiled, and analyzed for dichotomized responses, reporting frequencies, proportions, as well as a comparison of response proportions. RESULTS: From 32 countries, 618 respondents were included in the analysis. The findings included insights into the prevalence of distance simulation before, during, and after the pandemic; drivers for using distance simulation; methods and modalities of distance simulation; and staff training. The majority of respondents (70%) reported that their simulation center was conducting distance simulation. Significantly more respondents indicated long-term plans for maintaining a hybrid format (82%), relative to going back to in-person simulation (11%, p < 0.001). CONCLUSION: This study gives a perspective into the rapid adaptation of the healthcare simulation community towards distance teaching and learning in reaction to a radical and quick change in education conditions and environment caused by COVID-19, as well as future directions to pursue understanding and support of distance simulation.

Assessment of professional nursing students' knowledge and attitudes about patients of diverse cultures.

This study examined personal attitudes of 152 Bachelors of Science in Nursing (BSN), registered nurse (RN) to BSN, and master's students enrolled in a school of nursing in the southwestern United States toward culturally diverse patients and their perceived knowledge of specific cultural practices and culture-specific skills. Three instruments were used to collect data: the Ethnic Attitude Scale-Part I, the Transcultural Questionnaire, and a demographic survey. Findings reveal that students in all three programs had a relatively low knowledge base about specific cultural groups. The only statistically significant difference found in attitudes, perceived knowledge of cultural patterns, or perceived cultural skills by program was the slightly higher perceived ability of generic BSN students to distinguish between concepts such as ethnocentrism and discrimination, intra- and intercultural diversity, and ethnicity and culture. Similar to other studies of measurement of provider attitudes and perceived cultural knowledge, the results of this study reinforce the struggle experienced by educators and the challenges faced by health care administrators grappling with teaching and delivering culturally competent care. The findings imply that nurse educators need to examine alternate models and teaching strategies to move students along the continuum of cultural learning.

Using evidence-based practice to improve intrapartum care.

The Cochrane Data Base (www.cochranelibrary. com/clibhome/clib.htm, retrieved February 23, 2001), a comprehensive international review of current medical and obstetric practices, demonstrates that birth outcomes improve with one-to-one labor support but not necessarily with continuous fetal monitoring. Because of a cultural bias toward technology, however, few extrinsic rewards exist for nurses who provide individualized labor support. Clinical scholarship in the obstetric setting is one way to begin changing ritualized practices, incorporating evidence-based practice, and improving nursing care.

Is it time to change the paradigm?

Published research has suggested that infants whose mothers received opiates, barbiturates, or nitrous oxide gas during labor are significantly more likely to become addicted to opiates if they experiment with drugs in later life. Why has no one further investigated this hypothesis? What if these researchers are correct? In the future will there be class action lawsuits against the medical and nursing research communities for failure to follow up on this question? Is it time to change the research paradigm?