Strategic Realignment in Healthcare Simulation Education: Shifting Focus From Assistants to Technician Training Pathways.

Simulation is vital for healthcare training, yet workforce challenges persist. This article details the development of an undergraduate minor program to address these issues and enhance simulation education. Initially conceived for simulation assistants, the program shifted focus to training simulation technicians. Informed by industry insights, the curriculum aligns with accreditation standards, emphasizing practical knowledge. Integrated knowledge translation (iKT) fosters collaboration, ensuring program relevance. Stakeholder feedback guided program refinement, addressing concerns of role delineation and alignment with certification frameworks. The program's evolution involved enhancing competency frameworks, validation through surveys, and forming partnerships for practical training. A certification committee ensures ongoing alignment with industry standards. This collaborative effort aims to produce graduates prepared for the dynamic field of healthcare simulation technology, thereby improving patient outcomes and advancing simulation education.

Exploring the Distribution of 3D-Printed Simulator Designs Using Open-Source Databases to Facilitate Simulation-Based Learning Through a University and Nonprofit Collaboration: Protocol for a Scoping Review.

BACKGROUND: Advancements in technology have enhanced education, training, and application in health care. However, limitations are present surrounding the accessibility and use of simulation technology (eg, simulators) for health profession education. Improving the accessibility of technology developed in university-based research centers by nonprofit organizations (NPOs; eg, hospitals) has the potential to benefit the health of populations worldwide. One example of such technology is 3D-printed simulators. OBJECTIVE: This scoping review aims to identify how the use of open-source databases for the distribution of simulator designs used for 3D printing can promote credible solutions for health care training while minimizing the risks of commercialization of designs for profit. METHODS: This scoping review will follow the Arksey and O'Malley methodological framework and the Joanna Briggs Institute guidance for scoping reviews. Ovid MEDLINE, CINAHL, Web of Science, and PsycINFO will be searched with an applied time frame of 2012 to 2022. Additionally, gray literature will be searched along with reference list searching. Papers that explore the use of open-source databases in academic settings and the health care sector for the distribution of simulator designs will be included. A 2-step screening process will be administered to titles and abstracts, then full texts, to establish paper eligibility. Screening and data extraction of the papers will be completed by 2 reviewers (MS and SS) for quality assurance. The scoping review will report information on the facilitation of distributing 3D-printed simulator designs through open-source databases. RESULTS: The results of this review will identify gaps in forming partnerships with NPOs and university-based research centers to share simulator designs. The scoping review will be initiated in December 2024. CONCLUSIONS: The information collected will be relevant and useful for stakeholders such as health care providers, researchers, and NPOs for the purpose of overcoming the gaps in research regarding the use and distribution of simulation technology. The scoping review has not been conducted yet. Therefore, there are currently no findings to report on. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/53167.

Identification of a partnership model between a university, for-profit, and not-for-profit organization to address health professions education and health inequality gaps through simulation-based education: A scoping review protocol.

INTRODUCTION: Healthcare providers in rural and remote (R&R) areas of Canada do not have the same access to skills development and maintenance opportunities as those in urban areas. Simulation-based education (SBE) is an optimal technique to allow healthcare providers to develop and maintain skills. However, SBE is currently limited mainly to universities or hospital-based research laboratories in urban areas. The purpose of this scoping review is to identify a model, or components of a model, that outline how a university research laboratory can collaborate with a for profit and not-for-profit organization to facilitate the diffusion of SBE into R&R healthcare provider training. METHODS AND ANALYSIS: This scoping review will be guided by the methodological framework introduced by Arksey and O'Malley in 2005 and the Methodology for Joanna Briggs Institute Scoping Reviews. Ovid MEDLINE, PsycINFO, Scopus, Web of Science, and CINAHL will be searched for relevant articles published between 2000 and 2022, in addition to grey literature databases and manual reference list searches. Articles describing a partnership model or framework between academic institutions and non-profit organizations with a simulation or technology component will be included. Titles and abstracts will be screened, followed by a full-text screening of articles. Two reviewers will participate in the screening and data extraction process for quality assurance. Data will be extracted, charted, and summarized descriptively to report key findings on potential partnership models. CONCLUSION: This scoping review will provide an understanding on the extent of existing literature regarding the diffusion of simulators for healthcare provider training through a multi-institutional partnership. This scoping review will benefit R&R parts of Canada by identifying gaps in knowledge and determining a process to deliver simulators to train healthcare providers. Findings from this scoping review will be submitted for publication in a scientific journal.

Comparing Learning Outcomes in Cardiopulmonary Resuscitation (CPR) and/or Automated External Defibrillator (AED) Training for Laypeople in Face-to-Face, Online, and Mixed Training Methods: An Integrative Literature Review.

Cardiovascular diseases and cardiac arrest (CA) are the main causes of death worldwide. This review aims to identify publications on the learning outcomes for the use of an automated external defibrillator (AED) and/or cardiopulmonary resuscitation (CPR) to train laypeople (LP), the method of training used, the year of publication and their recommendations. We employed Miller's assessment pyramid to describe learning outcomes as knowledge, skills, and confidence. The methods of training are face-to-face, online, and mixed. The evidence found in this study will be used to support the development and validation of a simulation-based training program to teach LP to operate AEDs delivered by drones in rural and remote (R&R) locations. This article is an integrative literature review with a quantitative and qualitative research design and is composed of seven steps: research question, inclusion and exclusion criteria, search and selection of studies, the role of a second reviewer of the findings, data analysis, interpretation and discussion of the results, and finally knowledge synthesis. The results of this review demonstrate that there are no significant differences in the learning outcomes of the different training methods. Since these findings suggest good results in all methods, the development of a training program based on face-to-face, online, and mixed, especially for places with few resources such as R&R places, indicates all methods can be used as good practices to develop training programs.

Developing a Partnership Model to Address Gaps in Rural Healthcare Provider Training Using Simulation-Based Health Professions Education.

Rural and remote (R&R) healthcare providers experience difficulties accessing continuing medical education, including simulation, to improve their clinical competencies to address the diverse health needs of the rural Canadian population. At the same time, the College of Family Physicians of Canada (CFPC) has identified a need to shift toward a competency-based curriculum to increase access to clinical training using innovative, flexible methods, such as simulation. Simulation is a strategy that can be applied to facilitate this learning by allowing learners to practice clinical skills on a simulator. However, the high cost of simulators is not a practical solution to address the training needs of R&R healthcare providers. In accordance with one of the CFPC's policy considerations, establishing partnerships between relevant sectors such as university research and innovation centers, for-profit organizations (FPO), and not-for-profit organizations (NPOs) to develop and distribute simulators to R&R healthcare providers can help reduce costs and address gaps in health professions education. Modern, Industry 4.0-related technologies such as three-dimensional (3D) printing allow for sustainable and affordable manufacturing of simulators, however, the tools and "know-how" to develop these simulators are currently limited mainly to university research and innovation centers in urban areas. To date, no simulation-focused partnership model exists that addresses how Industry 4.0 augmented simulation technology can make its way from university research and innovation centers into R&R healthcare settings. The proposed solution is to create a simulation-focused partnership model between university research and innovation centers, FPOs, and NPOs to improve the diffusion of Industry 4.0 augmented simulation technology to the R&R Canadian healthcare sector. Diffusing simulators from a research lab to R&R healthcare providers is a sustainable approach aligned with CFPC's policy considerations to strengthen rural medical education, subsequently strengthening rural medical practice.

Hacking Intraosseous Infusion Skills Training With 3D Printing: maxSIMIO Drilling System.

Intraosseous (IO) infusion is an alternative way to access the vascular system to administer drugs and fluids, which is particularly helpful when the commonly used peripheral intravenous route is inaccessible. The IO procedure can be done using a drill that involves disinfecting the area, landmarking the insertion point, seating the needle in a firm and stable position in the bone, and then delivering a smooth fluid flush. However, in the current medical training landscape, access to commercially available IO drills such as the Arrow® EZ-IO® Power Driver (EZ-IO; Teleflex, Morrisville, North Carolina, United States) is difficult, especially for rural and remote areas, due to the high costs. Furthermore, the EZ-IO is not rechargeable and does not clearly indicate the remaining battery life, which could potentially put patients at risk during the IO procedure. This technical report aims to address these concerns by describing the development of an alternative, affordable, and reliable IO drilling system for training use: the maxSIMIO Drilling System. This system consists of a cordless and rechargeable IKEA screwdriver which connects to a conventional, hexagon-shaped 3D-printed drill bit needle adapter. Two needle adapters were created: Version A was designed to use a friction-based mechanism to couple the screwdriver with the EZ-IO training needle, while Version B relies on a magnetic mechanism. The major differences between the EZ-IO and the screwdriver are that a) the EZ-IO has only one rotation to advance the cannula while the screwdriver features both directions, b) the EZ-IO is not rechargeable while the screwdriver is, and c) the EZ-IO has a custom needle holder that can fit any EZ-IO training needle size while the screwdriver needs to have a custom needle adapter made to connect to the EZ-IO training needle. Overall, through this exploration, the features of the maxSIMIO Drilling System in comparison to the EZ-IO appear more accessible for IO training. Future considerations for this development include gathering clinical expertise through rigorous testing of this novel system.

Hands-On Practice on Sustainable Simulators in the Context of Training for Rural and Remote Practice Through a Fundamental Skills Workshop.

Simulation-based education (SBE) is a sustainable method to allow healthcare professionals to develop competencies in clinical skills that can be difficult to maintain in rural and remote settings. Simulation-based skills training is necessary for healthcare professionals that experience difficulties accessing skills development and maintenance courses to address the needs of rural communities. However, simulators, a key element of simulation, are often prohibitively expensive and follow a "one-size-fits-all" approach. Using additive manufacturing (AM) techniques, more specifically three-dimensional (3D) printing, to produce inexpensive yet functional and customizable simulators is an ideal solution for learners to practice and improve their procedural skills anywhere and anytime. AM allows for the customization of simulators to fit any context while reducing costs and is an economic solution that moves away from the use of animal products to a more ethical, sustainable method for training. This technical report describes the delivery of a fundamental skills workshop to provide hands-on training to rural and remote healthcare professionals using 3D-printed simulators purposefully designed following design-to-cost principles. The workshop was delivered at a three-hour session hosted at a rural and remote medicine course in Ottawa, Canada. The workshop consisted of four technical skills: suturing, cricothyrotomy, episiotomy, and intraosseous infusion (tibial) (IO) and used a blended learning approach to train healthcare professionals and trainees who practice in rural and remote areas. In addition, the learners were granted access to a custom-designed learning management system, which provided a repository of instructional materials, and enabled them to record and upload personal practice sessions, review other learners' practice sessions, collaborate, and provide feedback to other learners. The feedback collected from participants, instructors, and observations on the delivery of the workshop will help improve the structure and training provided to learners. The delivery of this workshop annually is an ideal solution to ensure parsimonious delivery of simulation training for rural and remote healthcare professionals.

The Development and Initial End-Point User Feedback of a 3D-Printed Adult Proximal Tibia IO Simulator.

Intraosseous infusion (IO) remains an underutilized technique for obtaining vascular access in adults, despite its potentially life-saving benefits in trauma patients. In rural and remote areas, shortage of training equipment and human capacity (i.e., simulators) are the main contributors to the shortage of local training courses aiming at the development and maintenance of IO skills. Specifically, current training equipment options available for trainees include commercially available simulators, which are often expensive, or animal tissues, which lack human anatomical features that are necessary for optimal learning and pose logistical and ethical issues related to practice on live animals. Three-dimensional (3D) printing provides the means to create cost-effective, anatomically correct simulators for practicing IO where existing simulators may be difficult to access, especially in remote areas. This technical report aims to describe the development of maxSIMIO, a 3D-printed adult proximal tibia IO simulator, and present feedback on the design features from a clinical co-design team consisting of 18 end-point users.  Overall, the majority of the feedback was positive and highlighted that the maxSIMIO simulator was helpful for learning and developing the IO technique. The majority of the clinical team responders also agreed that the simulator was more anatomically accurate compared to other simulators they have used in the past. Finally, the survey results indicated that on average, the simulator is acceptable as a training tool. Notable suggestions for improvement included increasing the stability of the individual parts of the model (such as tightening the skin and securing the bones), enhancing the anatomical accuracy of the experience (such as adding a fibula), making the bones harder, increasing the size of the patella, making it more modular (to minimize costs related to maintenance), and improving the anatomical positioning of the knee joint (i.e., slightly bent in the knee joint). In summary, the clinical team, located in rural and remote areas in Canada, found the 3D-printed simulator to be a functional tool for practicing the intraosseous technique. The outcome of this report supports the use of this cost-effective simulator for simulation-based medical education for remote and rural areas anywhere in the world.