Domain II: Healthcare and Simulation Knowledge/Principles (CHSE Review Book)

The serious game has as its primary purpose:

Educational and professional goals and not entertainment (Hogan, Kapralos, Cristancho, Finney, & Dubrowski, 2011). (C13, pg149)

Inherent within the concept of experiential learning is how _______ contributes to the process of learning.

Experience (C8, pg84)

PTT (Part-task trainers) cannot be incorporated into all levels of education from novice to expert. T/F

False, PTT can be incorporated into all levels of education from novice to expert. (C12, pg139)

Low fidelity is the:

Farthest from realism, showing no physiological change, movement, animation, or progression. (C12, pg140)

A well-trained SP will react _________, determined by the role he or she is playing that day. It is also important that the CHSE keeps the personality, attributes, and capabilities of the SP in mind when writing the scenario.

Naturally (C10, pg106)

One must remember to match the _______ and _______ of moulage with the learning outcomes for the scenario.

Need Type (C9, pg95)

vSim from Laerdal is a virtual learning platform which include: www.nln.org

News release from the National League for Nursing about Laerdal V simulations (C13, pg157)

Kolb's model places the learner into one of four learning styles including:

-Converger, -Diverger, -Assimilator, and -Accommodator (Wain, 2017). (C8, pg83)

Places to buy basic supplies for a moulage kit:

-Halloween stores -Theatrical supply stores -Online stores -Makeup counters -Drug stores, etc. (C9, pg96)

Serious Games and Simulation is a virtual learning platform which uses: :www.3dseriousgamesandsimulations.com/showcase/healthcare-serious-game

3-D technology to create healthcare and nursing games and simulations for the trauma unit (C13, pg157)

For experiential learning to occur it is imperative that there is _______ participation with reflection on decisions made. In simulation, experiences are artificially constructed with the purpose of eliciting defined outcomes. Learning takes place through the simulation experience, during the debriefing process, and when participants conceptualize events and become involved in decision making (Koivisto, Miemi, Multisilta, & Eriksson, 2017).

Active (C8, pg84)

Knowles's _____ _____ ______(1978) can also be applied to the VR environment and development of serious games.

Adult Learning Theory (C13, pg152)

Trust (a components of team training in Human Simulator Simulations) promotes:

An atmosphere of mutual trust should exist in which individuals are able to share knowledge and speak about errors in judgment and action and accept constructive feedback (C8, pg82)

Adult learners practice the concepts of ________ (teaching of adults) in the simulation environment.

Andragogy (C8, pg84)

A VW is a:

3-D computer-based simulated healthcare environment. The environment, or "world," provides an interactive experience based on teacher-designed case scenarios (Bai et al., 2012).

Moulage is:

A French term that means casting or molding; today, it is the art of applying mock injuries for the purpose of training healthcare personnel. (C9, pg93)

A core principle of human simulator education is the concept of deliberate practice (DP). DP is defined as:

A learner's endeavor to practice for the purpose of improving a task or skill beyond the current level of proficiency (Gonzalez & Kardong-Edgren, 2017).(C8, pg80)

What is a MUVE?

A multi-user virtual environment (MUVE) is an immersive 3D virtual learning environment in which an avatar, or graphic representation of the user interacts with other avatars or objects in an immersive visually-rich, simulated world in real time.(C13, pg154- I had to look up)

What is a fully immersive simulation (Scott et al., 2016)?

A physical object or a representation of the full or part task to be replicated used by some specifically to refer to technologies that recreate the full environment in which one or more targeted tasks are carried out. (C12, pg140)

The person conferring the information using ISBAR provides S:

A short, but relevant summary of the current situation (C8, pg83)

When CRM began in which industry?

Aviation (C8, pg82)

High fidelity is the:

Closest to realism, showing physiological change, movement, animation, and progression. (C12, pg140)

What is DP in simulation?

Deliberate Practice (C8, pg80)

Twinity is a virtual learning platform which is a: www.twinity.com

Free virtual 3-D world and 3-D community chats can be created using avatars (C13, pg157)

Typology and mode of simulation that combines live, virtual, and constructive modes of simulation in different combinations:

Hybrid (C11, pg127)

Anatomical fidelity of PTT (part-task trainers) assists students in:

Mastering skills Woo, Malekzadeh, Malloy, & Deutsch, 2017) (C12, pg140)

Divergers (in Kolb's model of experiential learning) are:

More creative and able to form new ideas. (C8, pg84)

What fidelity includes the visual, auditory, kinesthetic or tactile, and spatial surroundings?

Physical fidelity (C8, pg86)

A team is identified as:

Two or more individuals with specific roles and tasks who make decisions by interacting and coordinating with one another (Baker, Gustafson, & Beaubien, 2010). (C8, pg82)

Hybrid patient simulation is an approach that combines various elements of "constructed reality"—__________, __________, and __________—used in an environment that looks and sounds real.

live, computerized, and mechanical (C11, pg126)

Medium-fidelity simulations include:

"Full-body" mannequins, hybrid simulations, or SPs, but in a setting that lacks sufficient cues for the learner to be fully immersed in the situation (C11, pg134)

Within TeamSTEPPs training is a principle known as CUS, which stands for:

"I am concerned! I am uncomfortable! This is a safety issue!" (AHRQ, 2017)(C8, pg81)

Kolb's (1984) experiential learning theory provides a solid platform for the design of VL activities. Kolb described learning:

"as the process whereby knowledge is created through transformation of experience" (p. 41). Kolb suggests that a person learns through a concrete experience, which provides a basis for observation and reflection on the experience in the virtual simulated environment, and discovers new knowledge (Rogers, 2011). Kolb further proposes that reflections are then assimilated into abstract concepts and can be applied to a new experience. This in turn suggests that learning, which has occurred from a simulation in a virtual environment, can be applied to situations encountered in the real world (Rogers, 2011).(C13, pg152)

Simulation education using PTTs allows learners to obtain and/or enhance clinical skills and processes in a safe learning environment.

(C12, pg139)

Simulation is a technique that replicates real-life experiences with scenarios that immerse the learner in an environment that attempts to closely duplicate the clinical environment (Lateef, 2010).

(C8, pg80)

The entire simulation encounter includes (with an SP - Simulated Patient) the:

(a) presimulation briefing; (b) total time the student has to work with the patient; (c) time for the patient to complete the student observation checklist; (d) time for the patient to provide feedback to the student; (e) time after the encounter if you want the participant to do documentation, or a survey, or a posttest; and (f) time for the SP to prepare for the next student. (C10, pg106)

The novice simulation educator needs additional understanding when he states virtual reality (VR) platforms: A. "Are designed for distance education learners" B. "Can be three-dimension (3-D) to enhance immersion" C. "Are a mechanism to teach teamwork" D. "Provide an opportunity for students to manipulate equipment"

***A. "Are designed for distance education learners"—YES, VR platforms can be used by in-class learners also. B. "Can be three-dimension (3-D) to enhance immersion"—NO, this is true. C. "Are a mechanism to teach teamwork"—NO, this is true. D.."Provide an opportunity for students to manipulate equipment"—NO, this is true. (C13, #1, pg158)

The design of a simulation or serious game based on Vygotsky's theory would include: A. An opportunity for social interaction between learners B. Recall of previously learned information C. Development of an avatar by the instructor D. Application of Maslow's hierarchy of needs

***A. An opportunity for social interaction between learners—YES, this is a major part of the theory. B. Recall of previously learned information—NO, experimentation is a part of the theory. C. Development of an avatar by the instructor—NO, this should be done by the student. D. Application of Maslow's hierarchy of needs—NO, this would cause it to be linear. (C13, #8, pg159)

Virtual worlds (VW) provide the learner with all the following elements except: A. Dynamic feedback B. Increased attentiveness C. Creativity D. Decreased anxiety

***B. Increased attentiveness—YES, this is not one of the identified attributes. A Dynamic feedback—NO, VWs provide feedback. C. Creativity—NO, VWs do enhance the learner's ability to be creative. D. Decreased anxiety—NO, this is something that VWs can provide to learners. (C13, #2, pg158)

The main objective of using a virtual patient (VP) in virtual worlds is to: A. Entertain while learning B. Practice clinical decision making C. Practice skills D. Encourage creatively

***B. Practice clinical decision making—YES, this is main objective. A. Entertain while learning—NO, this is not the main objective of this learning platform. C. Practice skills—NO, this is not the main objective of this learning platform. D. Encourage creatively—NO, this is not the main objective of this learning platform. (C13, #3, pg158)

The professor wants to design a scenario on the proper method to use for intubation. Which platform is the best choice for this learning experience? A. Second Life B. Task trainer C. Voki D. SimTab

***B. Task trainer—YES, this will assist to teach a skill. A. Second Life—NO, this does not provide hands-on. C. Voki—NO, this is not the best method to teach a skill. D. SimTab—NO, this is not the best method to teach a skill. (C13, #7, pg159)

During the action phase of the multi-user virtual environment (MUVE), the learner does which of the following? A. Creates her or his avatar. B. Watches videos to familiarize him- or herself with the requirements for the activity. C. Interacts in the environment created in the simulation. D. Discusses what he or she has learned during the game or simulation.

***C. Interacts in the environment created in the simulation.—YES, this is implementation. A. Creates her or his avatar.—NO, this is in the beginning or preparation phase. B. Watches videos to familiarize him- or herself with the requirements for the activity.—NO, this is in the beginning or preparation phase. D. Discusses what he or she has learned during the game or simulation.—NO, this is happens after the experience or the debriefing phase. (C13, #10, pg159)

The primary purpose of a serious game is to: A. Allow entertainment to lower stress. B. Design the learning experience so only one response is correct. C. Meet educational and professional goals. D. Create the game using a one-dimensional approach.

***C. Meet educational and professional goals.—YES, this is the overall purpose. A. Allow entertainment to lower stress.—NO, this is not the purpose. B. Design the learning experience so only one response is correct.—NO, this is restricting learning. D. Create the game using a one-dimensional approach.—NO, it is more than one-dimensional. (C13, #6, pg159)

A novice simulation educator is designing a virtual world, which of the following concepts should not be included: A. There should be a sense of immersion for the participant. B. Real-world scenarios should be replicated. C. No opportunities for social networking are provided so as to keep students on track. D. Learners should be allowed to experiment in the scenario.

***C. No opportunities for social networking are provided so as to keep students on track.—YES, there can be networking for collective knowledge. A. There should be a sense of immersion for the participant.—NO, this is needed. B. Real world scenarios should be replicated.—NO, this can be beneficial. LD. earners should be allowed to experiment in the scenario.—NO, experimentation helps build knowledge. (C13, #5, pg159)

Serious gaming is a method of learning delivery that is associated with which educational theory? A. Behaviorism B. Realism C. Emancipatory D. Constructivism

***D. Constructivism—YES, this theory is learner-centered and encourages students to create knowledge. A. Behaviorism—NO, this theory has to do with observable behavior. B. Realism—NO, this theory implies science can explain all components of learning. C. Emancipatory—NO, this theory is about social justice. (C13, #4, pg159)

When developing a serious game, the first action the teacher must perform is which of the following? A. Determine the platform to use to design the game. B. Require students to have taken a computer course on using the technology. C. Conduct a debriefing about the experience. D. Develop objectives for the activity.

***D. Develop objectives for the activity.—YES, this is where learning starts and provides an assessment mechanism. A. Determine the platform to use to design the game.—NO, this is not the first step. B. Require students to have taken a computer course on using the technology.—NO, this is not the first step. C. Conduct a debriefing about the experience.—NO, this is not the first step. (C13, #9, pg159)

The novice simulation educator needs further understanding when he states: A. "A part-task trainer (PTT) can only be used for simple procedures." B. "PTT can be used in hybrid form." C. "PTT are at times more durable." D. "PTT may jeopardize suspending disbelief."

*A. "A part-task trainer (PTT) can only be used for simple procedures."—YES, this is not true it can be used for complex tasks. B. "PTT can be used in hybrid form."—NO, this is true. C. "PTT are at times more durable."—NO, this is true. D. "PTT may jeopardize suspending disbelief."—NO, this is true.(C12, #3, pg144)

To increase fidelity using a part-task trainer (PTT) the simulation educator may consider using a PTT with: A. A standardized patient B. Another PTT C. A high-fidelity mannequin D. A virtual environment

*A. A standardized patient—YES, this is a good way to increase fidelity. B. Another PTT—NO, this is not the best way to increase fidelity. C. A high fidelity mannequin—NO, this is not the best way to increase fidelity. D. A virtual environment—NO, this is not the best way to increase fidelity.(C12, #6, pg144)

Using part-task trainers (PTTs) decreases the risk of: A. Replacing expensive equipment B. Mistakes in procedures C. Simulation burnout D. Test anxiety

*A. Replacing expensive equipment—YES, this is a concern. B. Mistakes in procedures—NO, mistakes can still occur. C. Simulation burnout—NO, burnout can still occur. D. Test anxiety—NO, they will not decrease anxiety.(C12, #9, pg145)

Part-task trainers (PTTs) are considered: A. High fidelity B. Low fidelity C. Midfidelity D. Are not classified

*B. Low fidelity—YES, they are considered low fidelity. A. High fidelity—NO, they are low fidelity when used alone. C. Midfidelity—NO, they are low fidelity when used alone. D. Are not classified—NO, they are low fidelity when used alone.(C12, #7, pg144)

The simulation educator is deciding on the modality of simulation to use to present a set of skills to interprofessional healthcare learners. The first consideration should be: A. The cost of the equipment needed B. The learning level of the students C. How the learning outcomes are met D. How the students responded during a previous simulation

*C. How the learning outcomes are met—YES, he or she should ask whether the simulation matches the goals or the student objectives or learning outcomes. A. The cost of the equipment needed—NO, although this is a consideration it is not the first priority. B. The learning level of the students—NO, although this is a consideration it is not the first priority. D. How the students responded during a previous simulation—NO, although this is a consideration it is not the first priority. (C12, #1, pg144)

An element to consider when using part-task trainers (PTTs) in the simulation laboratory is: A. They are always easy to move. B. They are usually less expensive. C. They may have to be replaced. D. They are usually durable.

*C. They may have to be replaced.—YES, when they are worn they will have to be replaced. A. They are always easy to move.—NO, this makes them easier to use. B. They are usually less expensive.—NO, this makes them easier to use. D. They are usually durable.—NO, this makes them easier to use.(C12, #5, pg144)

A simulation educator is developing a haptic hybrid skill station. In order to do this, she will need: A. A part-task trainer (PTT) and a mannequin B. Two PTTs C. A PTT and a computer D. A PPT with the feel of real anatomy

*D. A PPT with the feel of real anatomy—YES, this will create haptic simulation. A. A part-task trainer (PTT) and a mannequin—NO, this does not ensure the correct tactile stimuli. B. Two PTTs—NO, this does not ensure the correct tactile stimuli. C. A PTT and a computer—NO, this does not ensure the correct tactile stimuli. (C12, #4, pg144)

Simulation educators understand the usefulness of part-task trainer (PTT) mainly because they are: A. Easy to obtain and use B. Anatomically exact C. Travel well D. Have been around many years

*D. Have been around many years—YES, this gives support to their usefulness. A. Easy to obtain and use—NO, they still have to be ordered and paid for. B. Anatomically exact—NO, they are not exact. C. Travel well—NO, most of them not all do travel well. (C12, #8, pg145)

When a part-task trainer (PTT) needs repair the simulation coordinator should: A. Use special chemical to clean it well. B. Order a new one because they are inexpensive. C. Take it apart and check functionality. D. Read the manufacturer's instructions.

*D. Read the manufacturer's instructions.—YES, always follow manufacturer's instructions. A. Use special chemical to clean it well.—NO, this may occur but will not repair the PTT. B. Order a new one because they are inexpensive.—NO, this may occur but trying to read the instructions would be a good first step. C. Take it apart and check functionality.—NO, this may occur but trying to read the instructions would be a good first step. (C12, #10, pg145)

A simulation educator would like to increase fidelity related to cardiac arrest response. The best simulation method to accomplish this would be: A. Using a part-task trainer (PTT) of a torso B. Using a standardized simulated patient C. Using a computer program in "real life" D. Using a mannequin that is fully equipped

*D. Using a mannequin that is fully equipped—YES, this is high fidelity. A. Using a part-task trainer (PTT) of a torso—NO, this is still low fidelity. B. Using a standardized simulated patient—NO, this does not work for cardiopulmonary resuscitation. C. Using a computer program in "real life"—NO, this increases fidelity but not as much as high-fidelity mannequin. (C12, #2, pg144)

What is an example of a commonly used PTT that is attached to a computer program?

*IV PTT that is attached to a computer program. The learner must demonstrate knowledge of the correct procedure on the computer for the PTT to respond to the tourniquet and the arm vein to protrude to accommodate an IV insertion. This may also provide haptic simulation.(C12, pg141)

Of all the simulation methods, _ _ _ _ are probably the least expensive.

*Part-Task Trainers (PTTs) Once the equipment is bought, it can usually be used over and over with very little maintenance. (C12, pg142)

The integration of VR learning is important in the learning environment in order to allow the learners:

--An opportunity to immerse themselves in environments where they can practice skills, --Interact and collaborate with peers or other professionals, --Make decisions related to care and interventions, and --Manipulate equipment without fear of harming an individual. VL simulations can be used in any area of clinical practice, but is especially useful in environments where limited access to the experience is available such as disaster or perioperative nursing.

What are the step to be taken in designing a MUVE according to Rogers, 2011?

--Briefing Stage --Action phase -Debriefing stage (C13, pg154)

What is the Briefing Stage in designing the MUVE? (Rogers, 2011, p. 612).

--Learners create their avatar and familiarize themselves with the platform interface --Learners view the VW videos for an introduction to the scenario and how to interact with and view objects in the scenario and how to communicate with peers or others in the virtual environment for the scenario (C13, pg155)

What is the Action Phase in designing the MUVE? (Rogers, 2011, p. 612).

--Learners enter the VW scenario created for them --Learners are given the scenario for the VL experience --Learners interact in the environment based on the design of the simulation, which may be acting alone or working in teams and collaborating with others (C13, pg155)

There are several issues that need to be considered in order to develop a simulation in the VW using a platform, such as Second Life, in order to enhance teamwork and problem solving for the simulated experience. In order to participate in the VW, the individual:

--Must be able to access the Internet through a high-speed connection. --Creates an avatar the first time the platform is accessed. --Participates in the simulation community through one of two ways: --Types messages as done in texting or online chats. --Communicates using a headset with a microphone or Internet telephone connection. Participates either synchronously (in real time) or asynchronously (virtual time; Billings, 2009). Once the participant enters the simulation or serious game, the participant is able to interact in the environment created in the VW (virtual world) This may include role-playing, practicing skills, decision making, or participating in conferences or classroom activities.(C13, pg154)

VP simulations are case-based educational computer games in which the user progresses through various steps and applies __________ knowledge and critical thinking skills in making judgments about the care and treatment of the VP (Guise et al., 2012).

-Clinical The pathway for clinical decision making may be preprogrammed or may have a branching structure, which allows for several alternative pathways depending on each action taken by the learner. (C13, pg149)

When portraying a clinical role, a ___________ can enter a simulation as a standardized participant playing a clinical role he or she can perform with credibility.

-Clinician This adds verisimilitude (the appearance of being true or read) to the simulation because the clinician can realistically participate and further the action from the inside out. Standardized participants can also "fill in" as simulated team members or clinicians, but their participation will be limited to whatever part they can play realistically. (C11, pg133)

The creation of a serious game is more _________ than a case study or a laboratory simulation designed for a classroom. The serious game is not linear in nature, but rather is a _________ experience in which the player participates in the unfolding of a sequence of problems, and the interaction with the game influences the outcomes (dit Dariel et al., 2013).

-Complex -Dynamic Serious games can be designed so that rules may be broken or the scenario changed based on the decisions made and actions of the learner (Charsky, 2010). Serious games may be designed as a means of summative evaluation based on specific outcomes or provide a means for formative evaluation to determine whether learning is occurring. (C13, pg150)

Second Life is a serious game 3-D software platform, or framework, which delivers:

-Computerized virtual training and research environments (Tiffany & Hoglund, 2014). Scenarios can be constructed by the faculty to design simulations in which the student may practice skills, make decisions, try new ideas, and learn from mistakes in a safe and controlled environment. (C13, pg150)

With serious games, what are the three main theoretical approaches utilized?

-Constructivist theory, -Kolb's experiential learning theory, and -Knowles's adult learning theory. (C13, pg151)

The realism of the SP (standardized patient) encounters relies on:

-Effective case writing -Precise training by Certified healthcare Simulation educator (CHSE) (C10, pg105)

The purpose of CUS is to _________ individuals to speak up if they are concerned about an actual or potential breach in safety. Included in the CUS course of action is a two-challenge rule (AHRQ, 2017). Under this rule, if individuals feel that their concern has not been recognized, they should:

-Empower -Verbalize this concern at least twice. -If, after the second exchange, the team member concludes that the response is not acceptable, the team member is expected to take a different, more assertive course. This alternate course may include following the chain of command to ensure a safe environment. (C8, pg81)

-Starting an intravenous (IV) line on an arm attached to an SP -Suturing a leg wound attached to an SP -Using a pelvic trainer with an SP -Performing a urinary catheterization on a part-task trainer with an SP -Doing a rectal exam on a part-task trainer with an SP

-Examples of part-task trainers, which are hybrids, are the following (C11, pg128)

__________ is another benefit of working with SPs.

-Flexibility During an SP experience, learners practice communication, history taking, and physical examination skills (Rutherford-Hemming & Jennrich, 2013). Different cases may emphasize certain illness manifestations, complications, or ethical challenges. The SP can even be instructed to emphasize his or her attitudes toward health professionals (Wallace, 2007). This attitude could range from a healthy skepticism to mild verbal aggression to contempt. (C10, pg106)

SPs are favorable to work with (regarding moulage) for several reasons including:

-Generally it is easier to produce more realistic results. -Makeup blends more easily and consistently. -Most human-approved adhesives work better. -SPs can be taught to care for or refresh the makeup, shortening the reset time between encounters. -They can assist with cleanup and removal of appliances. (C9, pg97)

Lateef (2010) has identified common problems detected during simulation scenarios involving teams including:

-Group does not understand that each team member has a unique role -Lack of clear role definition resulting in role confusion -No plan in place to use when mistakes or errors occur -No method to measure individual or team performance (C8, pg80)

The key principles of CRM (Crisis Resource Management) are:

-Having a clear leader and well-defined roles -Knowing your environment and resources -Having a plan and sharing and adapting the plan as needed -Requesting help early -Distributing the work and supporting all members of the team -Prioritizing and delegating tasks to others (Joshi, 2013) Using the principles of CRM within a simulation scenario will help the team perform in a coordinated and efficient manner in the care of the simulated patient. (C8, pg82)

SP's role in healthcare simulation education includes:

-Hiring -Orientation to organization, scenarios, and learners -Takes cues from learners and stays "in role" during scenario Assists with feedback from patient's point of view -Evaluate learning (C10, pg121)

The design of a serious game should be based on several key components (Billings & Halstead, 2012) including:

-Identify the content of the lesson. -Identify the information the learner is to receive. -Base the game on objectives and outcomes. (C13, pg150)

The door sign is the sign that will be posted outside the simulation room to provide information to the student. The door sign should include the following:

-Information about the scenario -What you expect the learner to do in the scenario -How much time the learner has to complete the scenario -Reminder to refer to the patient chart if one is included as part of the scenario (C10, pg109)

Task trainers are specific tools that are used to train the professional for a specific purpose. These may include:

-Intravenous (IV) arm for venipuncture -Airway trainers -Blood pressure skills -Femoral artery access -Intubation trainers -Chest-tube insertion -Neonatal procedures (C13, pg151)

Virtual reality fits nicely with ________ (1984) experiential learning theory.

-Kolb's (C13, pg150)

Components of Team Training in Human Simulator Simulations includes:

-Leadership -Peer observation -Flexibility -Group membership -Balance -Trust -Communication (C8, pg82)

Simulations can be divided into four types (Andrews, Brown, Byrnes, Change, & Hartman, 1998) including:

-Live -Virtual -Constructive -Hybrid (C11, pg127)

Suggested Basic Supplies for a Moulage Kit

-Makeup (a bruise wheel and burn wheel) -Sponges (application) -Sponges (stipple) -Cotton-tipped applicators (lots) -Makeup brushes (inexpensive to start) -Liquid latex -Spirit gum -Cold cream -Glycerin -Petroleum jelly -Tongue depressors (lots) -Stage blood, both thick and thin -Cleanup products -Baby wipes -Tissues(C9, pg96)

The training of the SP begins with the specifics of the simulation case, including the:

-Name of the patient -Role of the patient (patient, family member, etc.) -Setting of the scenario (e.g., OB, ED, clinic) -Background of the scenario (i.e., why patient came in) -The information the learner will know before beginning the scenario (such as the door sign) -An opening line or lines to use to begin the scenario (if included in the scenario) -Challenge questions (i.e., a specific question about the condition or chief complaint about the SP's condition if included in the scenario) -Training questions (questions the students might ask and what answer is required) -Checklist items -Feedback (C10, pg119)

Serious games should be designed based on the ___________ for the game, __________ to be met by students, and ___________that have a theoretical basis.

-Objectives -Outcomes -Processes (C13, pg151)

Four outcomes measured during simulation scenarios are

-Participation -Attitude -Knowledge -Skills (Issenberg, McGaghie, Petrusa, Gordon, & Scalese, 2005). (C8, pg79)

TeamSTEPPs (AHRQ, 2017) is a process of team training designed for healthcare professionals to improve _________ _______ and achieve better _________ _______.

-Patient safety -Patient outcomes (C8, pg81) Simulation aids in the acquisition of team skills by allowing the learner to practice in a simulated, safe environment. Using TeamSTEPPs in simulation is one way to aid in the design, measurement of objectives, and evaluation of team training.

The following list is an outline of required training for standardized participants, depending on how extensive their role will be in the simulation.

-Portraying a nonclinical role -Portraying a clinical role -Skills assessment -Assessing team communication skills -Debriefing and feedback (C11, pg133)

In addition to task and technical skills, SBL can also be used to identify _________-________ and skills.

-Problem-solving -Decision-making Team education, communication, and interpersonal skills are evaluated during SBL. (C8, pg80)

Benefits of VWs (virtual worlds) include:

-Providing dynamic feedback. -Allowing for learner experimentation. -Allowing for creativity. -Providing opportunities for social networking and social interaction. -Facilitating collaboration among participants. -Lowering learner anxiety. VWs allow simulated interaction among a variety of individuals, including students, educators, patients, families, and multidisciplinary professionals (Green et al., 2014). (C13, pg148)(C13, pg148)

When utilizing an SP (Standardized Patient) scenario, the

-SP has a clear focus and objectives -Learner objectives are also linked to the specific course, educational program, or clinical unit of the learner. It is important that the learner be aware of the required objectives or educational goals for the simulation experience. (C10, pg108-09)

Several platforms have been identified for the serious games' simulation environment, also known as MUVEs (Wang & Braman, 2009) including:

-Second Life -Task trainers -vSim by Laerdal -Twinity -Voki Avatar (C13, pg150)

Faculty development can take many forms, for example:

-Seminars, webinars, and discussion of articles. One of the most powerful ways to educate faculty about how simulation works is to take them through actual encounters, experiencing the simulation, assessment, and debriefing process as the learner would. This step helps faculty to understand the needs of learners and the strengths and limitations of simulation learning. Faculty need to understand the curricular, technical, and logistical issues involved in developing simulations to facilitate effective educational programs. These issues become more complicated when developing hybrid scenarios. (C11, pg131)

The VW (virtual world) provides the learner the opportunity to:

-Simulate real-life experiences either synchronously or asynchronously and can be used in various settings in the learning environment. -Development of social and professional relationships, especially in areas of distance learning. -Practice and demonstrate skills and knowledge without the fear of harming a live patient -Be used as an evaluative tool to determine whether learning has occurred.(C13, pg148-149)

One of the most important roles is to educate stakeholders (e.g., learners and clinical faculty) about how patient simulations are used as an educational strategy. Learning topics include:

-Simulation as an educational strategy -Adult learning principles -Simulator applications -Logistics -Developing scenarios -Assessing performance validly and reliably -Debriefing and feedback (C11, pg130)

Some drawbacks to working with live actors (regarding moulage) are that:

-They move (sometimes a lot). -They have to go to the restroom (sometimes a lot). -They may have allergies. -They are sometimes fussy. -It is sometimes difficult to get them to sit still for hours.(C9, pg97)

All simulation scenarios have the ability to be "standardized" (as in standardized test) if the conditions of testing are standardized including:

-Training objectives -Setting, scenario (the vehicle for assessing skills) -Types of simulators used -Timing -Equipment -Performance assessment and debriefing/feedback (C11, pg131)

What is VL in simulation?

-Virtual learning (environments) (C13, pg148)

Part-task trainers replicate the __________, for example, the skin, head, upper and lower extremities, esophagus, and thorax; and in some cases, the__________ of a part of the human body.

-anatomy - physiology (C11, pg128) This allows learners and professionals to practice specific tasks or technical procedures (Aggarwal, Moorthy, & Darzi, 2004) without harming or hurting an actual patient.

The role of the SP must be __________ __________

-clearly identified. The SP can portray a patient, a family member, a student, or any other role imagined.(C10, pg107)

Debriefing and feedback: Standardized participants, who are ___________, as well as simulation __________/__________, are in the best position to explore clinical decision-making issues and identify "performance gaps" during debriefing (Rudolph, Simon, Rivard, Dufresne, & Raemer, 2007).

-clinicians -specialists/facilitators Their clinical knowledge and understanding of the teaching objectives can create a climate of trust and learner engagement. Both clinical and nonclinical standardized participants who have been charged with assessing communication have a role in debriefing communication. Their role may be to challenge learners to maintain both interpersonal and team communication throughout the encounter. (C11, pg133)

Human patient simulation today has two roots:

-computerized mannequins and -SPs. (C11, pg127)

Although SPs are used mostly to teach and assess individual clinician competencies, they can be combined with standardized participants, sometimes referred to as __________, who portray nonpatient roles.

-confederates (C11, pg128) Examples with a hybrid simulation: Learner interacts with an SP, and a standardized participant is a healthcare team member Learner must provide "bad news" to a distraught family member after examining an SP who portrays an end-of-life patient

The SP can be trained to propose a number of challenging situations that the learner might face with a real patient, and the entire group of learners can undergo the same experience because of the __________ and ___________ provided by the SP.

-consistency and -standardization (C10, pg106)

Closed-Loop Communication A sender _______ a message to a receiver. The receiver of the message _______ that the message was received and ascribes meaning to the message. The sender _______ with the receiver to ensure that the expected meaning was conferred through the message. If the sender does not feel that the message was interpreted as intended, the conversation continues until the _______ is closed.

-delivers -acknowledges -communicates -loop (C8, pg83)

The evaluation checklist is a __________ checklist of what you expect the learner to do during the scenario.

-detailed In most institutions, this checklist is completed by the SP immediately after the completion of the scenario and before the patient provides feedback to the learner.(C10, pg109)

Another important aspect of the case development is planning for the SP __________ at the end of the simulation experience.

-feedback A common type of feedback is for the patient to provide interpersonal feedback on how the student made him or her feel as a patient. The feedback can be either very specific or general (see Chapter 18 for extensive information on SP feedback). (C10, pg116)

The SP (Standardized Patient) simulation scenario has to have a clear _________ and __________.

-focus and objectives Is the scenario going to be based on a specific medical diagnosis (asthma, congestive heart failure, shortness of breath, abdominal pain), a mental illness (psychosis, hearing voices), psychosocial challenges (depression, anxiety), ethical situations (do not resuscitate [DNR], organ donation, assisted suicide), or another scenario? This selection will be the basis for writing your case. It is important to include clear information about the selected condition/situation highlighted in the case for the education of the SPs. (C10, pg108)

When designing a serious game using the constructivist theory, it is important to ________ objectives and _________ prior to the development of the scenario for the game.

-formulate -outcomes The level of the learner must also be taken into consideration; for example, a scenario designed for a beginning nursing student may require the instructor to be more actively involved in the game based on limited knowledge of the learner. As the student moves through the curriculum, there is less involvement by the instructor, and eventually the student assumes total control of the decision making for the scenario. This type of design is termed instructional scaffolding (Keating, 2011). (C13, pg152)g (Keating, 2011). (C13, pg151-152)

PTT allows the ability to practice ______-______, ______-______ skills which can enhance the confidence of individuals and teams and assist them to think critically and respond appropriately individually as well as within a team (Brown, 2017).

-high-risk -low-volume (C12, pg139)

Many simulation scenarios find it optimal to combine both the human patient simulator (HPS) and SPs in a simulation scenario. When SPs are used in this fashion, it is referred to as _________ __________ or the SP can be referred to as a __________ in the simulation scenario

-hybrid simulation -confederate (C10, pg121)

Changes are needed in the way learners are educated to meet the demands of complex healthcare settings such as virtual reality. In addition, the complexity of healthcare in today's world is moving toward ___________ collaboration among healthcare providers, _________ teamwork, enhanced __________ __________ skills and clinical judgment, and _________ for skill practice.

-interprofessional -increased -critical thinking -time (C13, pg147)

Parts of the whole task are used to prepare the learner for the whole task (Sinz, 2004). Part-task procedures can improve ___________ efficiency because a specific skill can be practiced multiple times until mastered. They can also reduce __________ costs because the learner would not participate in a full simulation exercise until a particular skill is mastered.

-learning -training (C11, pg128)

Hybrid patient simulations combine a mixture of simulation __________, learning __________, and __________ into a powerful platform for teaching and assessing clinical competencies.

-modalities -strategies -professionals (C11, pg125)

The constructivist theory supports the movement of the learner from the _________ to _______ ________ level, and recognizes that actions by the learner may be determined by previous exposure to a situation as well as the knowledge base of the learner.

-novice -advanced beginner (C13, pg151)

If the simulation is a "high-stakes testing" simulation in which the student has to achieve a specific score to pass, you must also pick a __________ score.

-passing Many programs will pick the lowest score for a full grade of "C" at their school. Or the specific score might be mandated by your licensing agency. (C10, pg109)

When portraying a nonclinical role, Standardized Participants can be trained for a number of roles, such as:

-patient (as part of a two-part sequential simulation [e.g., a live patient who "becomes" a mannequin patient]) -a family member, or -other auxiliary role required of the scenario (e.g., a bystander in a simulation taking place in the field). (C11, pg133)

The development of a serious game should be based on sound theoretical principles and designed around the:

-purpose, -objectives, and -outcomes of the learning exercise. (C13, pg152)

The SP case should also include any questions the learner may ask during the scenario and the __________ the patient is supposed to provide to the learner.

-response Any questions specific to the diagnosis or condition of the patient will need a specific answer, such as symptoms and medications, for example. For other questions that do not have a direct impact on the direction of the scenario, you may have the patients use their own information and not require a specific answer. Depending on the complexity of the case, one must be realistic as to how many specific lines or questions the SP can memorize and portray. (C10, pg109)

Closed-loop communication is a method of communication in which there is a _______ and _______ of a specific message. The receiver of the message confirms the message that was _________ by the sender, thereby _______ that the message was received and understood (Paramalingam et al., 2017).

-sender -receiver -communicated -ensuring (C8, pg83)

Simulation scenarios are vehicles for assessing __________.

-skills All simulations are an opportunity to provide learners a formative or summative assessment and help faculty self-assess the quality of their clinical education. (C11, pg131)

Mannequin-based simulations are used primarily for __________ and ___________ healthcare teams. Depending on the model, these computerized, mechanical high-fidelity mannequins represent patients at various developmental stages (infant, child, adult) and are used for different purposes (e.g., anesthesia training; birthing simulations; and with programmable cardiovascular, respiratory, and neurological responses to clinical interventions). Depending on the model, the ingenuity of the simulation technician, and the condition of the patient, all mannequins can have a "voice." Talking through a microphone and listening though headphones, the patient's voice is usually that of a standardized participant placed at a distance, for example, behind a one-way mirror, and whose role is to answer questions as a patient would.

-training -assessing (C11, pg129) Examples of SPs or standardized participants with hybrid mannequins are as follows: Learners interact with both the SP and the mannequin because they are portraying the same patient Standardized participants are used as Mannequin's voice A family member A healthcare team member

The SP case scenario written by the CHSE is explained to the SPs during the SP __________ ___________ prior to the simulation experience, and ideally in advance of the day of the simulation experience.

-training session If the training is taking place on the day of the simulation experience, it is important that the learners do not interact with the SPs before the experience to keep the level of realism as high as possible. (C10, pg119)

The patient simulation scenario is a plan indicating how a program will:

-unfold, -how the mannequin will be programmed or operated remotely, and -how standardized participants will be part of the scenario. (C11, pg131)

Applying the general simulation fidelity classifications of Yaeger et al. (2004), hybrid simulation can be labelled in the following manner:

1. Low-fidelity 2. Medium-fidelity 3. High-fidelity(C11, pg134) The preceding items focus on mechanical or "physical fidelity," that is, how closely a simulator resembles the thing being simulated physically and kinesthetically (Salas, Bowers, & Rhodenizer, 1998). By this definition, SPs have the highest fidelity. But from a training perspective, the issue is more complex. A training system is a series of episodes or experiences that systematically build key skills from basic to more complex adaptive skills (Kozlowski, 1998). Low-fidelity simulation, therefore, can be a building block toward higher level functioning that can be practiced and assessed through higher fidelity hybrid simulations.

What are the four simulation education roles in the hybrid simulation?

1. Mannequin-patient simulation specialist: Preferably an individual with a clinical background, for example, physician, nurse, or paramedic. This individual designs healthcare team educational and assessment programs, constructs mannequin-patient scenarios, and participates in debriefing and feedback. 2. Mannequin-patient technician: An individual with both mechanical and computer skills is desirable. The technician works with the specialist to prepare the mannequin for the encounter, troubleshoots mannequin technical/mechanical problems, keeps the mannequins in good repair, and occasionally functions as the mannequin voice or standardized participant. Often, the specialist doubles as the technician. 3. SP educator: Working with the simulation specialist, the SP educator advises how to use people effectively in a scenario, writes standardized participant training notes, and trains them for the scenario. 4. Psychometrician: Designs assessment rubrics and collects, analyses, and reports performance data. (C11, pg130)

There are four kinds of simulated patients used by healthcare educators for teaching and skills evaluation including:

1. Part-task trainers 2. Humans (SPs and standardized participants) 3. Computerized mannequins 4. Virtual (computer-based) patients (C11, pg127)

Hybrid Mannequin With Standardized Participant SCENARIO SUMMARY

1. Scenario name 2. Patient's name, age, gender (mannequin) 3. Scenario setting 4. Condition of the patient at scenario start 5. Educational plan --Learner level --Program goals --Program learning objectives --Methods—e.g., types of simulators used --Intended outcomes --Challenges to the learner (C11, pg132)

Hybrid Mannequin With Standardized Participant: Standardized Participant Information

1. Standardized participant's name(s) and relationship to the patient. 2. Narrative—Describe the scenario, what the standardized participant will know about the patient's condition at the start of the scenario, how the SP will interact with the healthcare team, and how the SP will act. (C11, pg132)

The person conferring the information using ISBAR provides R:

A recommendation for action on the part of the receiver of the information (C8, pg83)

Peer observation (a components of team training in Human Simulator Simulations) uses:

A shared understanding of group dynamics and team roles; is able to recognize errors and openly communicate ideas and suggestions for correction (C8, pg82)

One goal of simulation training, regardless of the simulators used, is to achieve "psychological fidelity," that is:

A situation in which the risks and rewards of learner participation correspond in a convincing way to real-world risks and rewards (Ranney, 2011). Indeed, patient simulations reach their full potential as teaching and assessment opportunities when learners suspend disbelief, immerse themselves in the scenario, and perform as they would in a real-world situation. This can only be achieved with the expertise of the simulation educator who has the ability to construct a realistic work setting from simulation devices, humans, hybrids, environmental cues, and the judicious use of imagination. (C11, pg134)

Hybrid simulation requires the simulation educator to: A. Be proficient in all modes of simulation B. Understand the principles and practices of test development C. Debrief the learners after scenarios D. Manage all technical problems that may arise

A. Be proficient in all modes of simulation.—YES, because more than one mode is used and in different combinations. B. Understand the principles and practices of test development.—NO, this does not guarantee that the simulation educator understands hybrid simulation. C. Debrief the learners after scenarios.—NO, all simulations require debriefing or feedback. D. Manage all technical problems that may arise.—NO, this may be the role of the technician. (C11, #8, pg135)

A standardized participant: A. Can be a faculty member who plays the part of a clinician in a scenario B. Is another term for standardized patient C. Is a simulated patient participating in a standardized examination D. Cannot reliably assess skills because they are too involved with the scenario to pay attention to the learners

A. Can be a faculty member who plays the part of a clinician in a scenario—YES, this may work well for some scenarios. B. Is another term for standardized patient—NO, this is not the same individual. C. Is a simulated patient participating in a standardized examination—NO, this is still acting as a standardized patient not participant. D. Cannot reliably assess skills because they are too involved with the scenario to pay attention to the learners—NO, this is not true they can give good feedback to the learners as perceived by a patient.(C11, #4, pg135)

During a simulation scenario, a member of the team who has been actively engaged in the care of the patient quickly recognizes a change in the patient's condition, calls for rapid response, delegates tasks to the other team members, and administers prescribed medications before the patient's condition deteriorates. Which of Kolb's learning styles is this learner demonstrating? A. Converger B. Diverger C. Assimilator D. Accommodator

A. Converger—YES, this person is a decision maker. B. Diverger—NO, this is not using creativity. C. Assimilator—NO, this is not applying inductive reasoning. D. Accommodator—NO, this is not adapting to a situation, it is taking the lead.(C8, pg86, #10)

Following a simulation experience a learner comes out of the room and appears very upset. The simulation educator should A. Escort the learner out of the simulation lab B. Notify the primary contact for the learner C. Take the learner aside and speak to them privately. D. Speak to the standardized patient

A. Escort the learner out of the simulation lab—YES, first remove the learner from the stimuli. B. Notify the primary contact for the learner—NO, this is inappropriate and a violation of the learners right to privacy in education (Family Educational Rights and Privacy Act [FERPA]). C. Take the learner aside and speak to them privately—NO, it is better to debrief the learners together and not to single out one student. D. Speak to the standardized patient (SP)—NO, the SP may not be the issue. (C10, #10, pg123)

At the completion of an assisted suicide simulation, the simulation educator notices several of the learners are crying. The simulation educator should A. Gather the learners together for a debriefing session B. Do nothing C. Notify the primary contacts for the learners D. Revise the scenario

A. Gather the learners together for a debriefing session—YES, the emotions need to be debriefed. B. Do nothing—NO, the emotions need to be debriefed. C. Notify the primary contacts for the learners—NO, this is inappropriate and a violation of the learners right to privacy in education (Family Educational Rights and Privacy Act [FERPA]). D. Revise the scenario—NO, it may not be a scenario issue it may be level of student or prebriefing issue.(C10, #9, pg123)

Psychological fidelity occurs when: A. The risks experienced through the simulation closely approximate what is experienced in real life. B. Patient safety measures are ensured. C. The learners experience "psychological safety." D. The simulation educator adheres to the training objectives.

A. The risks experienced through the simulation closely approximate what is experienced in real life.—YES, it would produce the same feelings. B. Patient safety measures are ensured.—NO, it pertains to the learners. C. The learners experience "psychological safety."—NO, it is more about realism. D. The simulation educator adheres to the training objectives.—NO, this should be done, but this does not ensure psychological fidelity.(C11, #3, pg135)

Which student is participating in deliberate practice? The student who is: A. Thinking about his mistakes and trying again B. Doing a task over and over again without a break in between C. Reading up on the task that he is about to perform D. Discussing the task with the healthcare simulation educator

A. Thinking about his mistakes and trying again—YES, this is the critical reflective piece associated with deliberate practice. B. Doing a task over and over again without a break in between—NO, this does not permit critical reflection. C. Reading up on the task that he is about to perform—NO, this is not practice. D. Discussing the task with the healthcare simulation educator—NO, this is also not practice. (C8, pg87, #2)

When situational awareness is employed during a scenario, _____ team members are kept informed and updated on the plan of care and all new developments in patient status. Having knowledge of available resources within the simulated environment will reduce the uncertainty of the learner and allows the learner to concentrate on making appropriate decisions (Tanoubi et al., 2016).

All (C8, pg85)

Communication (a components of team training in Human Simulator Simulations) provides that:

All members of the team are able to openly communicate, confirm that their message was heard and understood, and clarify the message if necessary (C8, pg82)

Knowles (adult learning theory, 1978) is applicable to the VR (virtual reality) environment as the learners can:

Apply theoretical principles to the situation and receive immediate feedback on their decisions and actions. Virtual environments can stimulate adult learners to apply their knowledge and experiences to concrete situations in a controlled environment, then consider the consequences of their actions and make changes to future choices. The learner is actively engaged in the learning process through simulated activities and can apply what is learned to real-life situations(C13, pg152)

The first step in team education in simulation is to:

Articulate the specific competencies targeted toward acquiring team-building skills (Salas, Rosen, & King, 2009). Once these competencies are recognized, a level of measurement can be calculated to guide the debriefing process. (C8, pg81)

Knowles (adult learning theory, 1978) proposed that adults learn differently from children, and their learning is dependent on:

Autonomy, Life experiences, Personal goals, and Relevance of the experience. He termed this andragogy. (C13, pg152)

The student demonstrates the proper method of using ISBAR communication in a simulation scenario when he states: A. "I know you can give me an order to help." B. "The current vital signs are 99-92-24-86/40." C. "The past health history of this patient includes all of the following ..." D. "The referrals made so far for this patient's discharge are ..."

B. "The current vital signs are 99-92-24-86/40."—YES, this is an assessment piece. A. "I know you can give me an order to help."—NO, this is not a recommendation. C. "The past health history of this patient includes all of the following..."—NO, this is not necessary for the situation (usually). D. "The referrals made so far for this patient's discharge are..."—NO, this is not necessary for the situation (usually).(C8, pg86, #6)

When considering the recipe for vomit the moulage artist should A. Include some real food products as they can increase the gag factor and do not have any cautions to worry about B. Choose the visual representation to match the simulation learning points and carefully clean up to minimize unwanted growth and contamination in the lab C. Pay attention to the liquid content so that the resulting mixture is soupy and will run easily down the mannequin's face and neck D. Consider that it could possibly block the airway and choke the mannequin

B. Choosing the visual representation to match the simulation learning points and carefully cleaning up to minimize unwanted growth and contamination in the lab—YES, meeting the objectives is important as well as infection control. A. Including some real food products as they can increase the gag factor and do not have any cautions to worry about—NO, this is not the most important element to creating vomit and producing the gag factor is not necessary. C. Paying attention to the liquid content so that the resulting mixture is soupy and will run easily down the mannequin's face and neck—NO, this is not the most important element. D. The possible blockage of the airway and choking of the mannequin—NO, this is not the most important element if it is not a scenario objective. (C9, pg103, #7)

What type of experiential learner would a student be if, during a simulation scenario, he decides to try a new innovative intervention because the patient's condition is worsening using traditional methods? A. Convergent B. Divergent C. Assimilator D. Accommodator

B. Divergent—YES, this is trying something creative. A. Convergent—NO, this is decision making. C. Assimilator—NO, this is applying inductive reasoning. D. Accommodator—NO, this is adapting to a situation.(C8, pg86, #8)

Having a high-fidelity mannequin that can close its eyes during a simulator simulation is an example of what kind of fidelity? A. Physical fidelity B. Functional fidelity C. Task fidelity D. Psychological fidelity

B. Functional fidelity—YES, this has to do with what the equipment can do. A. Physical fidelity—NO, this has to do with the room and space. C. Task fidelity—NO, this has to do with how real the intervention is to reality. D. Psychological fidelity—NO, this has to do with the affective situation of the scenario. (C8, pg86, #7)

During a standardized patient (SP) scenario, the SP notices the learner chewing gum. The SP should A. Do nothing B. Make a note on the student checklist C. Ask the learner why he or she is chewing gum D. Notify the simulation educator

B. Make a note on the student checklist—YES, this should be brought to the learner's attention by the SP so they learn from the experience. A. Do nothing—NO, this is an unprofessional behavior. C. Ask the learner why they are chewing gum—NO, confronting the learner may interrupt the scenario. D. Notify the simulation educator—NO, this can be dealt with during feedback. (C10, #6, pg122)

When considering to use moulage in a simulation scenario, which is the most effective use of time and effort when preparing the moulage for a simulation session? A. Concentrate on the wounds or representation of the illness to save time and reduce the cost of the simulation. B. Strike the best balance between effort on the principal illness or wounds wardrobe and the scene staging to provide the best authenticity. C. Concentrate on the patient, clothing, and monitor settings as that is all the student will focus on. D. Spend most of the time and effort on developing charting materials and wound characteristics that can be documented.

B. Strike the best balance between effort on the principle illness or wounds wardrobe and the scene staging to provide the best authenticity—YES, this is the best method to increase the effectiveness of the scenario. A. Concentrate on the wounds or representation of the illness to save time and reduce the cost of the simulation—NO, this is not the most effective focus to increase realism. C. Concentrate on the patient, clothing and monitor settings as that is all the student will focus on—NO, this is not the most effective focus to increase realism. D. Spend most of the time and effort on developing charting materials and wound characteristics that can be documented—NO, this is not the most effective focus to increase realism. (C9, pg102, #1)

Two advantages of using moulage on standardized patients (SPs) are: A. Most standardized patients see moulage as fun and make the day of simulation more enjoyable and they don't mind coming in early to prepare. B. The SPs can be taught to care for and protect the moulage before and during the session as well as assisting with cleanup after the session. C. The anatomy of the SPs is very similar to the mannequins so appliances fit well and the adhesives work better on the SPs. D. SPs usually don't move much so the appliances tend not to fall off and the dyes in moulage do not stain the SPs.

B. The SPs can be taught to care for and protect the moulage before and during the session as well as assisting with cleanup after the session.—YES, they should be taught to respect the moulage so it lasts for all learners. A. Most standardized patients see moulage as fun and make the day of simulation more enjoyable and they do not mind coming in early to prepare.—NO, SPs should be paid for their professional time. C. The anatomy of the SPs is very similar to the mannequins so appliances fit well and the adhesives work better on the SPs.—NO, the anatomy of a live actor is not similar. D. SPs usually do not move much so the appliances tend not to fall off and the dyes in moulage do not stain the SPs.—NO, SPs many times have to move to produce realism in the scenario. (C9, pg103, #4)

The most accurate statement regarding odors is: A. They are always required as they help to involve all the senses in a simulation. B. They are wild an uncontrollable and must be used with caution only as the scenario dictates. C. They are easy to find in the correct quantity and quality so that anyone can apply them during the scenario. D. Involving multiple senses does not affect learner engagement so odors are not necessary.

B. They are wild and uncontrollable and must be used with caution only as the scenario dictates.—YES, once used they are difficult to reduce so they need to be used with caution and thought. A. They are always required as they help to involve all the senses in a simulation.—NO, they are not always required. C. They are easy to find in the correct quantity and quality so that anyone can apply them during the scenario.—NO, they are not always easy to find and the quality is not easy to control. D. Involving multiple senses does not affect learner engagement so odors are not necessary.—NO, they do effect the learner's perception of the scenario. (C9, pg103, #6)

The use of simulation to teach essential skills is widespread and deeply embedded into human culture including:

Baby pacifier (imitating breast) War Games Strategic thinking games Aviation (C11, pg126)

Convergers (in Kolb's model of experiential learning) are:

Best at problem solving and making decisions. (C8, pg84)

Complex PTTs used in combination with web-enhanced simulation programs so that physical interaction can occur within the virtual-reality environment may be referred to as _________-_________ _____________ trainers. They can be used for surgical techniques, such as laparoscopic surgery.

Box-type simulation (C12, pg141)

The student understands the goal of crises resource management when she states: A. "I should keep trying to figure out the correct patient intervention." B. "The team members need to provide each other with direction and I will do the intervention." C. "I should request help as soon as possible when a serious situation occurs." D. "I should flex my role during a serious situation and do what is needed."

C. "I should request help as soon as possible when a serious situation occurs."—YES, part of crises resources management is calling for backup. A. "I should keep trying to figure out the correct patient intervention."—NO, crises resource management is a state of awareness of what resources can be used in a serious situation. B. "The team members need to provide each other with direction and I will do the intervention."—NO, in crises resource management there is no time to wait for direction. D. "I should flex my role during a serious situation and do what is needed."—NO, knowing roles and scope of practice is part of crises resource management.(C8, pg86, #3)

The healthcare simulation educator realizes a student needs additional team training when he states: A. "When I become uneasy about an intervention being done, I will say something." B. "My only role is to remain at the bedside and calm the patient and family members." C. "Patient safety includes both physical and psychological safety." D. "Understanding CUS provides me with more autonomy as a practitioner."

C. "Patient safety includes both physical and psychological safety."—YES, the team goal is patient safety. A. "When I become uneasy about an intervention being done, I will say something."—NO, this is something that should be done in team learning. B. "My only role is to remain at the bedside and calm the patient and family members."—NO, this is not being flexible within the team. D. "Understanding CUS provides me with more autonomy as a practitioner."—NO, this is true it provides each member autonomy.(C8, pg86, #4)

One assessment advantage afforded though hybrid simulation is: A. It combines interprofessional groups in a single training program. B. It is primarily used for formative versus summative assessment. C. Assessment can be done by a trained standardized participant. D. Debriefing is optional because scores are given by the standardized participant.

C. Assessment can be done by a trained standardized participant.—YES, a standardized participant can assist in the evaluation process. A. It combines interprofessional groups in a single training program.—NO, this is not assessment. B. It is primarily used for formative versus summative assessment.—NO, it could be used for both types of assessment. D. Debriefing is optional because scores are given by the standardized participant.—NO, debriefing is needed. (C11, #1, pg135)

Which would be the best choice of material to make a bruise on a mannequin? A. Oil-based makeup with high concentrations of red dye B. Wax crayons heated to soften them C. Cream-based theatrical makeup D. Blue and purple crushed grapes

C. Cream-based theatrical makeup—YES, this will remove without damaging the plastic. A. Oil based makeup with high concentrations of red dye—NO, oil based and red dye is difficult to remove. B. Wax crayons heated to soften them—NO, it looks too artificial and blending is more difficult. D. Blue and purple crushed grapes—NO, this may stain permanently. (C9, pg104, #9)

A standardized patient educator: A. Manages the simulation scenario B. Services the mannequins C. Creates standardized patient (SP) cases and trains SPs to participate in hybrid simulation D. Analyzes performance assessment data

C. Creates standardized patient (SP) cases and trains SPs to participate in hybrid simulation—YES, this is part of the role. A. Manages the simulation scenario—NO, this may be done by a technician. B. Services the mannequins—NO, this may be done by a technician. D. Analyzes performance assessment data—NO, this is completed by the simulation educator. (C11, #9, pg135)

The simulation venue: A. Is the best place to conduct debriefing B. Generates different processes and expectations C. Dictates the types of scenario used D. Always utilizes standardized participants

C. Dictates the types of scenario used—YES, it must be logical and fit the environment. A. Is the best place to conduct debriefing—NO, this is done after the simulation and in a different location. B. Generates different processes and expectations—NO, this should be completed before the simulation. D. Always utilizes standardized participants—NO, it does not have to use standardized participants.(C11, #2, pg135)

The healthcare simulation educator allows a learner to repeat a procedure as many times as she would like. Studies demonstrate that "perfect practice" assists students to: A. Memorize procedures. B. Provide efficient patient care. C. Increase self-confidence. D. Decrease healthcare errors.

C. Increase self-confidence.—YES, it increases satisfaction and confidence. A. Memorize procedures.—NO, this is not recommended for deep learning. B. Provide efficient patient care.—NO, efficient care is not as important as safe care. D. Decrease healthcare errors.—NO, studies do not demonstrate this to date.(C8, pg86, #9)

It is important to teach the standardized patient to protect/preserve the moulage because: A. It is extremely expensive. B. It has to be perfect. C. It is very time-consuming to apply. D. It is a work of art.

C. It is very time consuming to apply.—YES, it takes time and effort to redo it if it is not preserved. A. It is extremely expensive.—NO, this is not the most important reason. B. It has to be perfect.—NO, it does not have to be perfect to meet the learning objectives. D. It is a work of art.—NO, this is not the most important reason. (C9, pg103, #3)

To assess skills, it is recommended that the raters: A. Develop the clinical-skills checklists to be used. B. Always participate in the scenarios. C. Know how to perform the skill being assessed, and practice assessing it. D. Develop quality-assurance practices.

C. Know how to perform the skill being assessed, and practice assessing it.—YES, practicing assists learning. . Develop the clinical skills checklists to be used.—NO, this is evaluative only. B. Always participate in the scenarios.—NO, the raters need to observe. D. Develop quality-assurance practices.—NO, this should be done, but does not actually assess skills. (C11, #6, pg136)

What is the best source to acquire makeup for your kit? A. Local drug store B. Local grocery store C. Local theater supply store D. National department store

C. Local theater supply store—YES, this is most likely to contain products that can be easily removed. A. Local drug store—NO, this may not have the correct products needed. B. Local grocery store—NO, this may not have the correct products needed. D. National department store—NO, this may not have the correct products needed. (C9, pg104, #10)

An educator is interested in learning how to write a standardized patient (SP) scenario. What is the best method for the simulation educator to use to provide this training? A. Give the educator a book on SP simulation B. Give the educator a simulation case they can copy C. Provide the educator with a book, a sample case and meet with the educator D. Provide the educator with some helpful websites on SP simulation answer 7.

C. Provide the educator with a book, a sample case and meet with the educator—YES, this will provide the most comprehensive education and provide time for questions. A. Give the educator a book on SP simulation—NO, this may not answer all their questions. B. Give the educator a simulation case they can copy—NO, this may not answer all their questions. D. Provide the educator with some helpful websites on SP simulation—NO, this may not answer all their questions. (C10, #7, pg122)

A simulation educator is planning a simulation to practice therapeutic communication. What type of simulation is most effective for the focus of this scenario? A. Human patient simulator (HPS) simulation B. Computer-based simulation C. Standardized patient (SP) simulation D. Virtual reality

C. Standardized patient (SP) simulation—YES, there will be a real person involved. A. Human patient simulator (HPS) simulation—NO, this is using mannequins. B. Computer-based simulation—NO, this is computer oriented and not person oriented. D. Virtual reality—NO, this is computer oriented and not person oriented.(C10, #1, pg122)

Which one of the following is not a role for standardized participants: A. Standardized patient B. Standardized family member C. Standardized test developer D. Simulated clinician

C. Standardized test developer—YES, this is done by faculty. A. Standardized patient—NO, this is a role if they are trained to assume it. B. Standardized family member—NO, this is a role. D. mulated clinician—NO, this is a role. (C11, 7, pg135)

1. The healthcare simulation educator identifies which common problem during a team-based scenario in which a student does not adequately check a patient's carotid pulse before beginning cardiopulmonary resuscitation (CPR) and another student begins to assist the first student with CPR? A. The group does not understand that each team member has a unique role. B. There was a lack of clear role definition resulting in confusion. C. There was no plan in place to use when errors occur. D. There is no method to use to measure individual or team performance.

C. There was no plan in place to use when errors occur.—YES, the error was allowed to continue and involve other team members. A. The group does not understand that each team member has a unique role.—NO, students may be within their scope of practice. B. There was a lack of clear role definition resulting in confusion.—NO, students are assuming traditional CPR roles. D. There is no method to use to measure individual or team performance.—NO, evaluation is not mentioned.(C8, pg87, #1)

Much of the higher quality makeup is useable with mannequins. . _______ testing in an area that would not be seen if there is staining can produce favorable results and show which makeup can best be used

Cautious (C9, pg99)

What is setting the stage or dressing the set?

Changing the supplies and look of the mannequin to match the scenario. Any items needed for a simulation may be created as well as purchased. One is only limited by resources and imagination. Sometimes simply changing the mannequin's clothes, moving it from a bed to a stretcher, and adding a code cart will add the impression that care is being delivered in an emergency department. (C9, pg100)

How is the mannequin cleaned?

Cleaning materials needed for after the sessions are not much different than those needed for daily cleanup in the simulation laboratory. Sponges and nonbleach-containing wipes are staples. Attention should be paid to items that can be used on humans, gentle cleansing wipes and makeup remover, cold cream, and the like. (C9, pg101)

The role of the learner should also be very __________. Is the learner working in a new graduate nurse role, a physician role, a physician assistant role, or an advanced practice nurse role? The students should be reminded of their roles in the simulation instructions and to observe the door sign so that they function within their scope of practice.

Clear (C10, pg108)

Describe Hybrid Simulation?

Combines live, virtual, and constructive modes of simulation in different combinations. (C11, pg127)

Typology and mode of simulation where learners interact with simulated systems and simulated people, for example, operating room team training using VR in which simulated participants substitute for actual participants (Baydogan, Belfore, Scerbo, & Mazumbar, 2009).

Constructive (C11, pg127)

_______,_______, and _______ of simulation equipment is considered when selecting resources.

Cost Size, and Risk (C12, pg140)

What does CRM stand for when assessing teams?

Crisis Resource Management (C8, pg82)

U An integral component of DP is ________ _________ . A student must recognize a deficit in knowledge in an effort to seek learning opportunities to narrow this gap in knowledge.

Critical reflection (C8, pg80) With the assistance of a healthcare simulation educator, the learner becomes actively engaged in practicing and improving a task, skill, or decision-making process. When a learner engages in DP, feedback from the healthcare simulation educator is necessary to communicate improvement and identify areas that continue to need refinement (Ericsson, 2008). (C8, p80)

Physical fidelity is compromised when: A. The raters are not adequately trained. B. When the simulation is cut short. C. The learners are required to take excessive risks. D. A patient condition cannot be realistically simulated.

D. A patient condition cannot be realistically simulated.—YES, there is no way to get around this and it will compromise physical fidelity. A. The raters are not adequately trained.—NO, this should not effect the environment. B. When the simulation is cut short.—NO, this should not effect the environment. C. The learners are required to take excessive risks.—NO, this should not effect the environment. (C11, #5, pg135)

When developing a standardized patient (SP) simulation scenario, the SP can portray what types of roles? A. Patient B. Family member C. Health professional D. All of the above

D. All of the above—YES, SPs can portray any role. A. Patient—NO, not just patients. B. Family member—NO, not just family members. C. Health professional—NO, not just health professionals. (C10, #3, pg122)

Which items and materials that are found in the kitchen are good for use in moulage? A. Chocolate syrup B. Cherry pie filling C. Clear gelatin D. All of the above

D. All of the above—YES, they all may be used but careful cleanup must also be considered. A. Chocolate syrup—NO, this is not the only material that may be effective. B. Cherry pie filling—NO, this is not the only material that may be effective. C. Clear gelatin—NO, this is not the only material that may be effective. (C9, pg104, #8)

During a simulation scenario, the team leader provides orders to another member who requests clarification of the medication dosage. This is an example of: A. ISBAR communication B. Reflective practice communication C. TeamSTEPPs communication D. Closed-loop communication answer 5.

D. Closed-loop communication—YES, clarifying is part of closed-loop communication. A. Situation, background, assessment, and recommendation (ISBAR) communication—NO, the "R" in ISBAR refers to recommending an intervention. B. Reflective practice communication—NO, this is not a communicative style. C. TeamSTEPPs communication—NO, this is not a communicative style. (C8, pg86, #5)

The degree to which the moulage in a simulation scenario is important to how the learner performs because authenticity will: A. Shock or jar the learner into paying attention to the simulation and give cues for use in the simulation. B. Resonate with the learner and his or her sense of fun and playing along with the simulation. C. Keep the learner on her or his toes and thinking ahead to the next realistic surprise. D. High levels of authenticity have an impact on the learners emotional arousal and engagement in the learning activity.

D. High level of authenticity has an impact on the learner's emotional arousal and engagement in the learning activity—YES, learning engagement will increase the learner reaching the objectives of the A. Shock or jar the learner into paying attention to the simulation and give cues for use in the simulation—NO, this is not the objective of using moulage. B. Resonate with the learner and their sense of fun and playing along with the simulation—NO, this is not the objective of using moulage. C. Keep the learner on their toes and thinking ahead to the next realistic surprise—NO, this is not the objective of using moulage. scenario. (C9, pg102, #2)

When starting out working with moulage the best type of kit to begin with is one that A. Contains one of each of the most commonly used makeups as well as a varied assortment of application tools B. A professionally designed set with an organized case to carry and separate moulage used for mannequins from supplies used on standardized patients C. A kit assembled from the sale items at the makeup shop to keep the cost down in spite of the quality D. Matches the expertise of the user and provides enough variation to meet the objectives of the simulation while growing with the increased experience of the moulage artist

D. Matches the expertise of the user and provides enough variation to meet the objectives of the simulation while growing with the increased experience of the moulage artist—YES, it must meet the objectives of the simulation experience. A. Contains one of each of the most commonly used makeups as well as a varied assortment of application tools—NO, this is not the most important criteria. B. A professionally designed set with an organized case to carry and separate moulage used for manikins from supplies used on standardized patients (SPs)—NO, this is not the most important criteria. C. A kit assembled from the sale items at the makeup shop to keep the cost down in spite of the quality—NO, quality matters for both SPs and mannequins. (C9, pg103, #5)

The standardized patient (SP) is reviewing the list of learners assigned to the room prior to the simulation experience. The SP notices that one of the names on the list is someone he or she might know personally. The SP should A. Do nothing B. Put a note on the checklist C. Notify the simulation educator after the simulation D. Notify the simulation educator immediately

D. Notify the simulation educator immediately—YES, so assignments can be altered. A. Do nothing—NO, the scenario may be interrupted if the student knows the SP. B. Put a note on the checklist—NO, the scenario may be interrupted if the student knows the SP. C. Notify the simulation educator after the simulation—NO, the scenario may be interrupted if the student knows the SP. (C10, #8, pg123)

One of the best ways to educate faculty about how simulation works is to: A. Conduct ongoing faculty development webinars. B. Show videos of actual simulation sessions. C. Observe simulations. D. Participate in simulations.

D. Participate in simulations.—YES, this demonstrates the importance of learning in a hands-on environment. A. Conduct ongoing faculty development webinars.—NO, this is not active participation. B. Show videos of actual simulation sessions.—NO, this is not active participation. C. Observesimulations.—NO, this is not active participation. (C11, #10, pg135)

A simulation educator has hired a new group of standardized patients (SPs) who have minimal or no previous experience. During the training session the majority of the SPs state they are not comfortable with providing feedback. The simulation educator should A. Provide videos for the SPs to review from previous simulations B. Provide each SP with a book and feedback methods C. Provide the SPs extra time to practice and role play D. Provide an education and training session on feedback methods for the SPs

D. Provide an education and training session on feedback methods for the SPs—YES, providing education will be the best method to ensure that the SPs understand appropriate and beneficial feedback. A. Provide videos for the SPs to review from previous simulations—NO, this may not be the most effective method to teach feedback techniques. B. Provide each SP with a book on feedback methods—NO, this may not be the most effective method to teach feedback techniques. C. Provide the SPs extra time to practice and role-play—NO, this may not be the most effective method to teach feedback techniques. (C10, #2 pg122)

During a simulation scenario, the learner, completing the assessment, proceeds to gag the patient with a tongue depressor. The patient should A. Not do anything B. Run out of the exam room C. Scream D. State, "I do not want you to do that to me"

D. State, "I do not want you to do that to me."—YES, this is an appropriate response. A. Not do anything—NO, this does not give the immediate feedback necessary. B. Run out of the exam room—NO, this is over dramatization. C. Scream—NO, this is over dramatization. (C10, #5, pg122)

What is the required length of time for the standardized patient (SP) training session? A. 1 hour B. 2 hours C. 4 hours D. The specific training time is based on the complexity of the case

D. The specific training time is based on the complexity of the case—YES, complex scenarios take longer. A. 1 hour—NO, there is no set time that works for all scenarios. B. 2 hours—NO, there is no set time that works for all scenarios. C. 4 hours—NO, there is no set time that works for all scenarios. (C10, #4, pg122)

What is the Debriefing Stage in designing the MUVE? (Rogers, 2011, p. 612).

Debriefing stage (Billings & Halstead, 2012) --A key feature in designing VWs and should be done after each VL experience --Educators facilitate the reflection (reflective observation) of learners' experiences during the simulation --Meaning (abstract conceptualization) is derived from the experience --Further application of the meaning may be initiated (C13, pg155)

What is the first step in developing a simulation program?

Development of the educational curriculum with its various goals, objectives, methods, and intended outcomes is the first step in developing a program. Done in conjunction with clinical faculty, educators determine what skills are best taught and practiced through simulations and at the appropriate learner level. They have to decide what simulation modalities are best suited to the educational plan and be creative when the desired modality is not available, lacks fidelity, or is in short supply.(C11, pg131)

SimTabis a virtual learning platform which: ww.simtabs.com/

Develops virtual medical simulations and healthcare serious games (C13, pg157)

An avatar is a:

Digitized person created in 3-D, which represents the individual participating in the VW and is created by that person (Anderson, Page, & Wendorf, 2013; Second Life, n.d.). The participant creates the characteristics of the avatar, including eye and hair color, clothing, age, race, ethnicity, and gender. However, it is highly recommended that the learners create an avatar that mimics their own features and appearance. (C13, pg148)

It is often difficult to suspend __________ with PTTs, but they are often used in hybrid formats to increase realism if that is essential to the learning outcomes (Muckler, 2017).

Disbelief (C12, pg140) A hybrid format example is placing a task-trainer arm for an intravenous (IV) line in the shirt sleeve of a standardized patient while the actual arm is concealed under a hospital gown. This can prevent pain while the learner is practicing an IV procedure on the task trainer.

There are many ways to evaluate the student checklist items. Some of the common evaluation methods include:

Done/Not Done/NA Done/Not done/Done but not correctly Likert scale rating Your simulation program may select one way to evaluate all of your simulation experiences or they may be different based on a specific program or course. Another aspect to consider is the value of each checklist item. Is each checklist item of equal value, or are some checklist items worth more points than others? You can also identify specific patient safety checklist items that are critical—if the learner misses that checklist item, he or she automatically fails or has to repeat the experience—such as verifying the patient's identity or checking the ID band.(C10, pg109)

Requires the learner to solve real-world problems by discovering his or her own solutions based on his or her unique knowledge and understanding (Canhoto & Murphy, 2016).

Experiential learning (C8, pg84)

Complex PTTs increase the __________ in the learning experience by allowing the learner to use a PTT along with a computer-simulated environment or different evaluative or technological techniques (Oussi et al., 2018).

Fidelity (C12, pg141) Examples of Complex Part-Task Trainers: *Surgical skills *Central-line catheterization *Scopes, such as bronchoscopes *Chest-tube insertion *Ultrasound techniques

What is especially important before cleaning a mannequin?

Follow the mannequin manufacturer's guidelines on products used for cleanup. And it is always a good practice to test all cleaning materials on a small nonobvious area of the mannequin before large-scale use. Sometimes it is a good idea to put a barrier material on the mannequin to make cleanup of makeup easier. Plastic wraps or adhesive clear dressings work well. Some experimentation may be needed to see what method fits your expertise and budget. (C9, pg101)

Voki is a virtual learning platform which includes a: www.voki.com

Free collection of customizable speaking avatars for teachers and students that enhances classroom instruction, class engagement, and lesson comprehension. (C13, pg156)

Free Nursing Simulation is a virtual learning platform which is a: Scenarioswww.healthysimulation.com/1947/more-free-nursing-simulation-scenarios/

Free library of simulation scenarios designed by nursing faculty for nursing and allied health programs (C13, pg157)

High-fidelity simulations allow for:

Full immersion in settings that could potentially be used for actual patient examination or treatment (C11, pg134)

The goal of experiential learning is to:

Gain new knowledge and understanding of key concepts or principles. During experiential learning, learners are asked to perform within a defined role in an activity that has context and meaning for the learners.(C8, pg84)

What is "physical fidelity"?

How closely a simulator resembles the thing being simulated physically and kinesthetically [learning by doing] (Salas, Bowers, & Rhodenizer, 1998). (C11, pg134)

The common definition of VR is that learners:

Immerse themselves in a multimedia, computer-generated, 3-D-simulated environment that simulates reality and allows learners to interact, practice skills, learn teamwork and collaboration, and manipulate medical equipment. (C13, pg148)

The person conferring the information using ISBAR provides A:

Important assessment findings (C8, pg83)

The success of using simulator scenarios to educate healthcare professionals should be measured in relationship to the:

Improvement in clinical competence and the potential or actual impact on patient safety and outcomes. (C8, pg80)

Assimilators (in Kolb's model of experiential learning) apply:

Inductive reasoning to a situation. (C8, pg84)

The uses of VL and their outcomes are in the ________ stages of development and show much promise in enhancing the learning environment.

Infancy (C13, pg157)

A VP (virtual patient) is an:

Interactive computer-based simulation of a real-life clinical case scenario. Learners assume the role of the healthcare professional as an avatar, such as a nurse or doctor, and make judgments and clinical decisions based on the assessments made of the VP (virtual patient) (Guise et al., 2012; Patel et al., 2013). Participants learn the role of the professionals they represent with regard to assessment, clinical diagnosis, treatment, and care of the patient, just as they would if interacting with a real-life patient. (C13, pg149)

The acronym ISBAR stands for:

Introduction Situation Background Assessment, and Recommendation. ISBAR communication is an organized, structured method of two-way communication in a healthcare setting. (C8, pg83)

The person conferring the information using ISBAR provides I:

Introduction, or who is providing the report and his or her role(C8, pg83)

What is the most common hybrid simulation?

It involves mannequins and standardized participants. Such hybrids involve four simulation education roles.(C11, pg129)

What is striking the set?

It is a theater term that means to put the performance space back to the condition in which you found it. This means not only cleaning the mannequin and the simulation space, but also putting all the appliances and props away. (C9, pg100)

What did Green et al. (2014)postulate about Vygotsky's (1978) activity theory?

It is important in the relationship of engagement in VWs (virtual worlds). Vygotsky espoused that learning is a social experience and learners should be actively involved in their learning. Vygotsky proposed that social interactions are fundamental to the process of cognitive development, and that connections between people and how learners interact in shared experiences are essential to collaborative learning. The VW is ideal for social interaction with simulated environments (Green et al., 2014).(C13, pg152)

Practicing skills deliberately helps learners:

Know how to respond when a complex emergency occurs (Issenberg et al., 1999). (C12, pg139)

Serious games are computer-based simulations and combine:

Knowledge and skills development with video game-playing aspects, thereby enabling active, experiential, situated, and problem-based learning (dit Dariel et al., 2013; Johnsen et al., 2016). In recent studies, Johnson et al. (2016) and Koivisto et al. (2016) developed a serious game to enhance the clinical reasoning and decision-making skills of nursing students in a realistic, safe environment. (C13, pg149-150)

__________ (1950) developed the concept of andragogy. Adult learners are self-directed and independent and consider that they are responsible for their own learning. Adult learners also have experience and previously learned knowledge that can be used as a resource for future learning (Sanchez, 2017). Ensuring a proper environment for learning is another principle of adult learning. This is also the basis of using simulation to educate healthcare professionals.

Knowles (C8, pg84)

What theory is andragogy associated with?

Knowles (adult learning theory, 1978) (C13, pg152)

_______ model of experiential learning is often applied to simulation learning (Kolb & Fry, 1975).

Kolb's (C8, pg83)

The constructivist learning theory states that: (Keating, 2011).

Learners construct knowledge based on their experiences in relation to an event. (C13, pg151)

Describe Live Simulation?

Learners interact with real systems or people, for example, evaluating patients as SPs or customer exercises in which actors, playing patients, assess reception office staff. (C11, pg127)

Describe Constructive Simulation?

Learners interact with simulated systems and simulated people, for example, operating room team training using VR in which simulated participants substitute for actual participants (Baydogan, Belfore, Scerbo, & Mazumbar, 2009). (C11, pg127)

Describe Virtual Simulation?

Learners interact with simulated systems, for example, training on a computer-based virtual reality (VR) surgical simulation (Gallagher et al., 2005). (C11, pg127)

Hybrid Mannequin With Standardized Participant: Patient Information (Mannequin)

List information the family member(s) will be able to give team members if requested.NOTE: Write the answers to the following information, as the family member would give it. Avoid jargon. -Patient's overall health -Past medical history -Patient's medications and why taken -Past surgical history -Health risk behaviors -Exercise -Diet -Tobacco use -Alcohol use -Substance use -Other pertinent information (C11, pg132)

Typology and mode of simulation where learners interact with real systems or people, for example, evaluating patients as SPs or customer exercises in which actors, playing patients, assess reception office staff

Live (C11, pg127)

What does the term "serious games" define?

Loosely been defined in several contexts, including -technology for professional use, -interactive video simulation, -avatars, and -watching videos (dit Dariel, Raby, Ravuat, & Rothan-Tondeur, 2013). (C13, pg149)

What are types of fidelity which add to the realism for the learner? The higher the fidelity of the simulation, the more human and physical resources and time are needed when preparing and executing the simulator scenario (Alinier, 2011).

Mannequin fidelity Physical fidelity Functional fidelity Psychological fidelity Task fidelity (C8, pg85-86)

What are some basic supplies needed for cleaning the mannequin?

Mannequins may need some additional help, adhesive removers and alcohol, for instance. Some common needs for cleanup are as follows: *Baby wipes: These are particularly helpful when working with actors and for keeping your hands clean during the makeup process. *Alcohol: Any strength is good, but if you are working with liquid silicone compounds, you will need at least 90% as it does a better job of cleaning up the unreacted material. *Adhesive removers: When using adhesive removers, start with the mildest form before using the acetone-based removers, as these may remove the coloring in the mannequin. *Makeup remover or cold cream: This does work best on SP actors, and they can help with the cleanup. Some products can be used on mannequins as well. (C9, pg101)

The session is not over until the cleanup is done, and this can be one of the more challenging aspects of using __________.

Moulage (C9, pg100)

Computer-based simulations using videos, drawings, and animation used to represent the patient have shown promise in developing clinical reasoning skills (Cook & Triola, 2009). Learners interact with the patient by asking questions (typing or speaking); by viewing data from monitors, labs, or x-rays; and by performing diagnostic or therapeutic actions (typically by making choices with the mouse). At a much higher technology level, VR systems allow learners to become immersed in a computer-generated environment with individuals or groups of individuals (Schmorrow et al., 2009).

One purpose of VR is to immerse the user in a computer-generated environment (Pimentel & Teixeria, 1992). The cost of VR systems, however, is high, making their use impractical at this time for most users. Below are examples of hybrid VR: A computer program simulates a living condition of a patient before the learner interacts with the SP or mannequin in the simulation laboratory Use of real-time VR with a group of learners and multiple SPs (C11, pg129-130)

An easy recipe for sweat or diaphoresis is to mix approximately:

One-third glycerine and two-thirds water by volume in a bottle with a spray attachment. This allows easy application on either SP actors or mannequins. The more glycerine used, the more the solution will bead on the skin. As a caution, the glycerine does tend to build up and get gooey and sticky if not cleaned thoroughly at the end of the day. Soap and water are usually all that is necessary for cleanup. As always, care should be taken around the eyes when working with actors. (9, pg95)

Simulation-based learning (SBL) is a process that:

Ooccurs in a safe and carefully controlled setting that enhances skill acquisition and training using a simulated environment as the platform for learning (Lateef, 2010). (C8, pg80)

What are devices that replicate limited aspects of a task, but do not present an integrated experience (Rodriques et al., 2016). Examples include: Intubation mannequins IV arms Female pelvises

Part-Task Trainers (PTTs) (C12, pg140)

_______-______ _______are used in healthcare education and include the anatomical segment relevant to a particular procedural skill.

Part-Task Trainers (PTTs) (C12, pg140)

What can minimize wear and tear of high-fidelity mannequins and are more cost-effective when used for acquisition of skills?

Part-Task Trainers (PTTs) (C12, pg140)

What are probably among the oldest types of healthcare simulations known to professions besides practicing skills on one another?

Part-task trainers (PTTs) (C12, pg139)

PTTs range in complexity from using a piece of fruit to teach injections to using a torso to teach central-line placement and care. They typically do not include ________ ___________.

Patient feedback (C12, pg140)

A novel approach to simulation learning is a methodology termed ______ ______ or do-overs. This process allows the learner to complete a human simulator simulation, discover new knowledge from the debriefing session, and return to the simulated environment to repeat the same simulation with the new insight gained from the debriefing. Ishoy, Epps, and Packard (2010) found increased learner satisfaction and improved self-confidence when learners are permitted to repeat the simulation and are given the opportunity to provide feedback on their repeat performance.

Perfect practice or do-overs. (C8, pg85)

Simulator refers to a:

Physical object or a representation of the full or part task to be replicated. It is used by some specifically to refer to technologies that recreate the full environment in which one or more targeted tasks are carried out. This can also be called fully immersive simulation (Scott et al., 2016).(C12, pg140)

__________, however, should not get in the way or cause distractions, causing the learners to commit errors due to the incorrect representation of the scene.

Props (C9, pg100)

In general, the more "standardized" or replicable the simulation is, the less:

Realistic it may seem because of the need to standardize testing conditions for all. One advantage of hybrid simulations is that higher fidelity simulators (e.g., high-end mannequins and SPs) can balance out the less realistic, low-fidelity simulators. But the so-called "high-fidelity" mannequin simulators only come alive when used with human simulations, for example, by adding a human voice or using standardized participants.(C11, pg133-134)

Fidelity means that a simulator is able to:

Realistically imitate true physiological realism. Fidelity can be defined as the degree to which the appearance and capabilities of the simulator resemble the appearance and function of the simulated system. Low fidelity is the farthest from realism, showing no physiological change, movement, animation, or progression. High fidelity is the closest to realism, showing physiological change, movement, animation, and progression. Anatomical fidelity of PTT (part-task trainers) assists students in mastering skills (Woo, Malekzadeh, Malloy, & Deutsch, 2017).(C12, pg140)

It is very important to be clear on the setting of the scenario to help the learners understand their __________ and what is expected of them during the simulation scenario.

Role (C10, pg106)

The simulation educator, while providing a ________, rich learning environment, must maintain _______ and _______ for the adult learner during simulation and maintain the confidentiality of all involved. In addition, the participants of the simulation must also respect the need to maintain confidentiality of the actions during the simulation scenario and debriefing to protect the privacy of all participants.

Safe Respect Support (C8, pg84)

The "willful suspension of disbelief," a concept described by the poet:

Samuel Taylor Coleridge (1817), is directly applicable to simulation learning. The first task for simulation educators is to get learners to "buy into" a scenario that all know is a construction, a representation of reality. (C11, pg125) Hybrid patient simulation is an approach that combines various elements of "constructed reality"—live, computerized, and mechanical—used in an environment that looks and sounds real. Live participants can be incorporated into a scenario and be given distinct roles to create that "semblance of truth" (Coleridge, 1817, p. 2), which makes learning compelling. (C11, pg126)

A training system is a:

Series of episodes or experiences that systematically build key skills from basic to more complex adaptive skills (Kozlowski, 1998). (C11, pg134)

Second Life is a virtual learning platform which is a: www.secondlife.com

Serious game platform using 3-D technology to create avatars (C13, pg156)

A technique that uses a guided experience to replicate the real world in a manner that is thoroughly interactive.

Simulation (C8, pg84)

The setting is a very important part of scenario planning. Where is your scenario taking place? Is it taking place in a physician's office, in an ED, in a medical-surgical unit, in a critical care unit, in the community, in a patient's home, in a clinic, or in a surgical family waiting room? Ideally, the __________ ___________ should depict this environment or, if that is not possible, a sign should be clearly posted to remind the student of the environment where the scenario is taking place.

Simulation room (C10, pg107)

A method of continuous assessment of the environment. A construct of _______ _________ in team activities is to inform all members about the individual's perception of the situation and environment so that everyone has the same understanding (Green et al., 2017).

Situational Awareness Situational awareness (C8, pg85)

What about standardized participants and assessing team communication skills?

Standardized participants are arguably in the best position to assess team communication because they are participating from within. Their roles may also require them to challenge learners, for example, to be a demanding family member or an incompetent team member. Such challenges are dictated by the training objectives. They are therefore part of their training notes, and they can then judge how well the learners respond to their challenges. Team communication is best assessed through the use of an assessment rubric.(C11, pg133)

What can the standardized participant do regarding Skills Assessment?

Standardized participants, both clinical and nonclinical, can be trained to document when procedures are done in a timely and correct manner (e.g., correctly intubating a mannequin patient or part-task trainer). It is recommended that all charged with this task practice the skill being assessed until mastered, and practice observing, assessing the skill, and remembering it for later documentation during practice encounters. Clinical experience and performance assessment experience are two separate skill domains. (C11, pg133)

Spooner, Hurst, and Khadra (2012) state, " ________ _________are fundamental in the teaching of anatomic landmarks and in enabling learners to acquire, develop, and maintain the necessary motor skills required to perform specific tasks".

Task trainers Their vital impact on quality patient care and safety is likely to become more prominent as learners are able to demonstrate enhanced psychomotor and cognitive thinking skills. Choosing to use a PTT allows the faculty to validate a skill prior to performing a skill on a real patient. PTTs are affordable, easy to move, skill specific, and allow for standardization of a process. (C12, pg139)

In addition to using simulation pedagogy to teach _______ , it can also be used to develop interpersonal relationships such as caring, compassion, empathy, comfort, and communication (Eggenberger, Krumwiede, & Young, 2015). The challenge for educators using simulation is to convey the importance and value of the experience for the adult learner.

Tasks (C8, pg85)

Leadership (a components of team training in Human Simulator Simulations) delegates:

Tasks to other team members, plans, organizes, and motivates other team members (C8, pg82)

Part-Task Trainers (PTTs) are used to:

Teach novices the basics of psychomotor skills and allow for maintenance and fine-tuning of expert skills. PTTs can be used in situ (in place) in a real clinical environment or set up in a simulated learning environment. The benefit of portability adds value to just-in-time education, education that takes place in relation to a decrease in census and downtime. PTTs minimize wear and tear of high-fidelity mannequins and are more cost-effective when used for acquisition of skills. (C12, pg140)

Team Strategies and Tools to Enhance Performance and Patient Safety, is also know as:

TeamSTEPPs (AHRQ, 2017) (C8, pg81)

What is haptic technology?

Technology that creates an experience of touching by applying motions to the user. Haptic refers to the sense of touch and the meaning of touch (Orledge, Phillips, Murray, & Lerant, 2012). (C12, pg141)

Group membership (a components of team training in Human Simulator Simulations) recognizes:

That the work of the team is paramount and individual goals are secondary (C8, pg82)

Functional fidelity is:

The degree of accuracy in the operation of the simulated system. (C8, pg86)

Psychological fidelity is:

The degree to which the learner perceives the scenario as real. This aspect of simulation fidelity is not always easy to secure. (C8, pg87)

Physical fidelity refers to:

The environment where the simulation takes place. This includes the visual, auditory, kinesthetic or tactile, and spatial surroundings. (C8, pg86)

Simulation fidelity refers to:

The extent to which a simulation or device replicates the environment or a patient's physiological condition (Alessi, 1988). All simulation modalities have "fidelity issues," that is, they are more or less realistic, possessing a "degree of similarity" to actual patients (Hays & Singer, 1989). (C11, pg133)

The SP case development begins with:

The identification of the simulation objectives or educational goals and setting for the simulation scenario (International Nursing Association for Clinical Simulation and Learning [INACSL] Standards Committee, 2016; Alexander et al, 2015; Olive, Elnicki, & Kelly, 1997). (C10, pg106)

What is instructional scaffolding (Keating, 2011)?

The level of the learner must also be taken into consideration; for example, a scenario designed for a beginning nursing student may require the instructor to be more actively involved in the game based on limited knowledge of the learner. As the student moves through the curriculum, there is less involvement by the instructor, and eventually the student assumes total control of the decision making for the scenario. (C13, pg152)

Task fidelity is:

The measure of how authentic the simulated task is to the real task. It is important to match the task to the knowledge of the learner.(C8, pg86)

Fidelity is :

The measure to which the simulator or the simulation match the real environment the scenario is attempting to simulate (Maran & Glavin, 2003). (C8, pg85)

The person conferring the information using ISBAR provides B:

The patient's background relevant to the information exchange (C8, pg83)

A methodology is:

The theoretical analysis of the body of methods and principles associated with a body of knowledge. (C8, pg83)

Hybrid patient simulations are:

The use of two or more patient simulation modalities simultaneously or sequentially. (C11, pg125)

Balance (a components of team training in Human Simulator Simulations) maintains that:

The workload of all team members should be balanced and match the knowledge and skills of each individual (C8, pg82)

How can you extend the useable life of silicone- or latex-molded wounds?

They are cleaned properly, removing excess adhesive and makeup, and stored in an air-tight container with a light dusting of talcum powder (C9, pg100)

Accommodators (in Kolb's model of experiential learning) are:

Those who are actively engaged and able to adapt quickly when the situation changes. (C8, pg84)

_________ should be set aside well in advance of the event to allow for familiarization with the product and the techniques needed to produce a realistic result.

Time (C9, pg96)

Flexibility (a components of team training in Human Simulator Simulations) involves the ability to:

To adapt or change as the scenario unfolds or the group dynamics change (C8, pg82)

Diversity in race, gender, as well as role should be considered for every interprofessional team in order to teach cultural awareness and sensitivity as well as group collaboration. T or F

True (C8, pg81)

Avatars are ______-dimensional in character when used in a game or VW (Anderson et al., 2013).

Two Avatars interact with each other through online chat by typing messages or talking using a headset with a microphone and Internet or telephone connection (Billings, 2009). The avatar can function in the world, move around, perform skills, role-play, and participate in meetings and communicate with other avatars in the world such as patients, doctors, or nurses. (C13, pg148)

Low-fidelity simulations include:

Using part-task trainers that focus on single skills and permit learners to practice in isolation (C11, pg134)

Typology and mode of simulation where learners interact with simulated systems, for example, training on a computer-based virtual reality (VR) surgical simulation (Gallagher et al., 2005).

Virtual (C11, pg127)

What are various terms used to describe

Virtual Reality Simulation (VRS), VR VWs, Virtual Patients (VPs), and Multiuser Virtual Environments (MUVEs). VR (C13, pg148)

Complex task trainers represent both ________ _______ and _________ __________ in healthcare education using computer-based technology.

Virtual reality and Haptic technology (C12, pg141) This equipment tends to be more expensive. Complex task trainers work better in a simulated learning environment related to portability. This type of trainer allows the faculty to clearly see where the learner is applying touch and the amount of pressure applied as well as to assess whether a thorough exam has been done (Hagelsteenet al., 2017). Complex PTTs are used in combination with web-enhanced simulation programs so that physical interaction can occur within the virtual-reality environment. This may be referred to as box-type simulation trainers. They can be used for surgical techniques, such as laparoscopic surgery.

What did Vygotsky propose in their activity theory (1978)?

Vygotsky espoused that learning is a social experience and learners should be actively involved in their learning. That social interactions are fundamental to the process of cognitive development, and that connections between people and how learners interact in shared experiences are essential to collaborative learning. (C13, pg152)

When can learners practice on part- and complex task trainers independently?

When the protocol for the procedure has been taught and is written out. This assists learners in providing self-directed deliberate practice and in being accountable for the learning before it is time for evaluation of knowledge. PTTs are an invaluable asset when setting up a simulation experience for a group of learners. PTTs can be used as an "unmanned station" for learners to practice as long as they are properly prepared. (C12, pg141-142)

The faculty and learners enter the VW, otherwise known as being "in ____________," by creating an avatar.

World (C13, pg148)

What are advantages of Virtual Learning (VL) Environments?

--Provide learning experiences in a safe environment to enhance experiential learning (Herold, 2012). --Provide interactive and innovative educational scenarios that simulate real-world experiences (Tiffany & Hoglund, 2014). --Simulate clinical experiences, have a student-centered approach, and promote active learning (Rogers, 2011). --Provide opportunities for learning, which are not readily available in clinical practice or situations that may be dangerous (Kilmon, Brown, Ghosh, & Mikitiuk, 2010). --Foster collaboration with peers and users from other disciplines, both locally and globally. --Engage students in role-playing in a more natural environment. --Manipulate equipment and perform procedures in a safe environment (Billings & Halstead, 2012). --Incorporate a variety of problems and information the learner can use as part of the assessment phase and test solutions (Hogan et al., 2011). --Reflect on outcomes related to learner actions and propose new strategies or interventions for the situation. --Evaluate student performance to determine whether learning outcomes have been met --Provide opportunities for social interaction, facilitation, and collaboration (Green et al., 2014) --Improve online and distance education by adding a real-life component to relationships between online learners in a virtual world (Tiffany & Hoglund, 2014) --Communicate effectively across disciplines --Useful in a multitude of disciplines and environments such as community health nursing, disaster preparedness, and perioperative areas (Kaplan, Holmes, Mott, & Atallah, 2011; Patel et al., 2013) .(C13, pg153-154)

According to Woolfolk (2010), there are five conditions for learning that are integral to the constructivist theory:

--The learning environment should provide a realistic and relevant learning experience. --Social interactions and peer collaboration are essential to the learning process. --It is important to support multiple perspectives of the experience, especially as the learner gains more knowledge and moves through more complex situations. --Learners must be aware of their own beliefs and knowledge that shapes their learning and assumptions, which allows them to respect that others may have a different perspective of the scenario. --Learners must assume ownership of learning and use multiple resources to enhance learning. (C13, pg151)

What are disadvantages of Virtual Learning (VL)Environments?

--VR (virtual reality) learning environments, such as serious games, are expensive to produce. --Educators and learners must be oriented on how to use the virtual game or task trainer. --Time must be allotted for development of the scenario and creation of avatars (Billings, 2009). --Technological support must be available to users and designers. --Scenario must be relevant for the learning community for which it is designed, and globally relevant if used in a multidisciplinary context (Hogan et al., 2011). --Educators and learners must keep an open mind and be willing to learn how to function within the virtual environment. --Lacks a comprehensive theoretical framework to support and guide the use of simulation in nursing (Guise et al., 2012). --Educators must have a firm understanding and grounding of pedagogical principles in educational theories appropriate for learning in virtual worlds (Green et al., 2014). --There is a lack of empirical evidence on the impact of VL. --Usability issues of serious games can negatively impact a user's experience and intended learning outcomes (Johnsen et al., 2016). --Current research addresses teaching and learning in the affective domain or technological learning domain (Tiffany & Hoglund, 2014). --Computer requirements for VL environments may not be available on entry-level computers (Billings & Halstead, 2012). (C13, pg153-154)

There are concrete advantages to using VL (virtual learning) environments, which include:

--promoting interprofessional collaboration and --providing experiences that mimic real-life situations and are easily transferred to the clinical practice setting.(C13, pg157)

Once the participant enters the simulation or serious game, the participant is able to interact in the environment created in the VW (virtual world). This may include:

--role-playing --practicing skills, --decision making, or --participating in conferences or classroom activities.(C13, pg154)

There are concrete disadvantages to using VL (virtual learning) environments, which include:

--the cost and --extensive faculty development required to design the scenario. The learner must also be oriented to the VL platform in order to be successful in maneuvering within the scenario to enhance the learning experience. (C13, pg157)

Key features of the VR (virtual reality) environment include the:

-3-D immersive experience -The ability to interact with the virtual environment via an avatar -Visual and auditory feedback -Replicate real-world activities (Tiffany & Hoglund, 2014)(C13, pg148)

Some of the issues (moulage) encountered when working with mannequins and makeup include:

-Blending of the makeup is more difficult and the results look less realistic at times. -Some types of makeup can stain easily; this calls for all newly used makeup to be tested on a sample mannequin part or hidden area in advance. -Generally, the softer and more porous the plastic, the greater the chance that staining may occur. -When attaching appliances, some may not fit well unless specifically made for use with the mannequin in question.

The Voki platform allows teachers and students to: (Voki, 2018)

-Build a customizable speaking avatar. -Create a visual representation of a character. -Post a lesson or case study (Anderson et al., 2013). -Share on email, post on Facebook, Twitter, or personal website. (C13, pg151)

The Second Life platform allows faculty and students to perform which activities? (Second Life, n.d.).

-Build an avatar designed by the participant. -Join or create groups. -Develop one's own online community. -Attend or organize events. -Participate in forums. -Use 3-D voice chats, gestures, language, and so on.(C13, pg150-151)

Examples of areas in which VWs have been created include:

-Classrooms -Distance education -Clinical agency -Staff orientation -Operating room (Patel, Aggarwal, Cohen, Taylor, & Darzi, 2013) -Community settings -Disaster training (Farra & Miller, 2013) -Pediatric primary care clinic (Cook, 2012) -Mental health education (Guise, Chambers, & Valimaki, 2012) -Clinical reasoning and decision-making skills (Johnsen, Fossum, Vivekananda-Schmidt, Fruhling, & Slettebo, 2016; Koivisto, Multisilta, Niemi, Katajisto, & Eriksson, 2016) (C13, pg149)

A well-written simulation scenario includes (when thinking about SPs - Standardized Patients - Case Development):

-Clear objectives; -Training materials, including a detailed script; and clear descriptions of medical details that are appropriately described for the SP's use, -Along with enough background to describe the complexity of the patient (Wallace, 2007).(C10, pg106)