Healthcare Simulation Dictionary 2nd Edition

High-Stakes Assessment

- a type of assessment (sometimes called an evaluation) "associated with a simulation activity that has a major academic, educational, or employment consequence (such as a grading decision, including pass or fail implications; a decision regarding competency, merit pay, promotion, or certification) at a discrete point in time (Hidden curriculum, 2014)" (INACSL Standards Committee, 2016c, p. S41).

Summative Assessment

- a type of assessment (sometimes called an evaluation) "at the end of a learning period or at a discrete point in time in which participants are provided with feedback about their achievement of outcome through preset criteria; a process for determining the competence of a participant engaged in healthcare activity. The assessment of achievement of outcome criteria may be associated with an assigned grade. Performance of the individual is compared to a specific standard

Formative Assessment

- a type of assessment (sometimes called an evaluation) "wherein the facilitator's focus is on the participant's progress toward goal attainment through preset criteria; a process for an individual or group engaged in a simulation activity for the purpose of providing constructive feedback for that individual or group to improve. Often completed at the same time as the instruction development of the individual is the focus for the simulation objectives/outcomes to be reached

Gynecological / Genitourinary Teaching Associate (GTA, GUTA, MUTA) GTA= Gynecological Teaching Associate (GTA) GUTA= Genitourinary Teaching Associate MUTA= Male Urogenital Teaching Associates

A ____ ____ _____ is an individual trained to teach the techniques and protocol for performing the gender-specific physical examination to learners, using himself or herself as a demonstration and practice model. • A Gynecological Teaching Associate (GTA) is a female specifically trained to teach, assess, and provide feedback to learners about accurate pelvic, rectal and/or breast examination techniques. They also address the communication skills needed to provide a comfortable exam in a standardized manner, while using their bodies as teaching tools in a supportive, nonthreatening environment (ASPE). • A _____ ____ ___ ___ (MUTA) is a male specifically trained to teach, assess, and provide feedback to learners about accurate urogenital and rectal examination techniques. They also address the communication skills needed to provide a comfortable exam in a standardized manner, while using their bodies as teaching tools in a supportive, nonthreatening environment (ASPE)

Mixed Reality (XR)

A category that encompasses the hybrid combination of virtual reality environments and reality (e.g., real environment, standardized patient, normal manikin simulator). Often encompasses the definition of Augmented Reality (AR), but has more virtual features than typical AR. The blend of what is physically present to what is 100% computer-generated is expressed in this continuum: Reality——— Augmented Reality——— Mixed Reality——— Virtual Reality (Hsieh and Lee, 2017). • A simulator that combines virtual and physical components

Manikin or Mannequin

A life-sized human like simulator representing a patient for health care simulation and education (Palaganas, Maxworthy, Epps, & Mancini, 2015). • Full or partial body representation of a patient for practice. • Full or partial body simulators that can have varying levels of physiologic function and fidelity.

Assessor

A person who performs assessment of individuals according to pre-established criteria. • ______must have specific and substantial training, expertise, and competency in assessment (Dictionary.com).

Incognito Standardized Patient

A person who plays a role as a patient in real health care situations, while the health care workers in those situations are unaware of the fact that the person is not a real patient (Rethans et al., 2007).

Model (as in Modeling and Simulation)

A representation of an object, concept, event, or system; models can be physical models, computational models, or theories of function (Sokolowski, 2011).

Mobile Simulation/Mobile Simulator

A simulator that can be transported relatively easily. Often refers to digital simulations with minimal equipment, without manikins (Mladenovic et al, 2019)

Artificial Intelligence (AI)

A system of computerized data-gathering and prediction that models human behavior and decision-making with minimal human intervention. In healthcare simulation, ___ ___often refers to underlying programming that provides physiological or system based algorithm changes based on inputs from users and learners. Often paired with machine learning, in which the software is programmed to alter algorithms and predictions based on observed data and results without human intervention. Virtual patients use ____ _____ to react appropriately to the user or learner. (Bennett and Hauser, 2013)

Health Care Simulation

A technique that creates a situation or environment to allow persons to experience a representation of a real health care event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions (Society for Simulation in Healthcare). • The application of a simulation activity to training, assessment, research, or systems integration toward patient safety (Society for Simulation in Healthcare).

High-Fidelity Simulator

A term often used to refer to the broad range of full-body manikins that have the ability to mimic, at a very high level, human body functions. • Also known as a high-complexity simulator. Other types of simulators can also be considered high-fidelity, and that fidelity (realism) has other characteristics beyond a particular type of simulator.

Objective Structured Clinical Examination (OSCE)

An approach to the assessment of clinical or professional competence in which the components of competence are assessed in a planned or structured way with attention being paid to the objectivity of the examination (Harden, 1988). • A station or series of stations designed to assess performance competency in individual clinical or other professional skills. Learners are evaluated via direct observation, checklists, learner presentation, or written follow-up exercises. The examinations may be formative and offer feedback or summative and be used for making high stakes educational decisions (Lewis et al, 2017). • A method of assessment where learners perform specific skills and behaviors in a simulated work environment.

Interprofessional Education /Training/Learning

An educational environment where students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes (World Health Organization Interprofessional Education and Collaborative Expert Panel, 2011). • An initiative to secure learning, and promote gains through interprofessional collaboration in professional practice (Freeth, Hammick, Reeves, et al., 2008).

Embedded Participant

An individual who is trained or scripted to play a role in a simulation encounter in order to guide the scenario, and may be known or unknown to the participants; guidance may be positive or negative, or a distractor based on the objectives, level of the participants, and the needs of the scenario. • A role assigned in a simulation encounter to help guide the scenario. • The embedded participant's role is part of the situation. However, the underlying purpose of the role may not be revealed to the participants in the scenario or simulation (INACSL, 2013).

Operations Specialist

An individual whose primary role is the implementation and delivery of a simulation activity through the application of simulation technologies such as, computers, audio-visual (AV), or networking technologies. • An inclusive "umbrella" term that embodies many different roles within health care simulation operations, including simulation technician, simulation technology specialist, simulation specialist, simulation coordinator, and simulation AV specialist. While many of these individuals also design simulation activities, this term refers to the functional role related to the implementation of the simulation activities (SSH).

Mastery Learning

An instructional philosophy originally proposed by Benjamin Bloom that stated a student must first practice and study to meet the predetermined level criteria (>90%) through the formative assessment of a prerequisite domain prior to advancing in subject matter. If the learner does not achieve the level of mastery, information from the test is used to diagnose areas of deficiency necessary for additional prescriptive support. The student is later tested again. This cycle of feedback and corrective procedures is repeated until mastery is achieved, at which point the student will move on to the next level (Guskey, 2010). • An instructional philosophy that highlights individualized feedback and adequate time, allowing the learner to progress through the subject in a customized manner, generally in smaller units, to master the subject matter. This concept states that nearly all learners can achieve subject or skill mastery utilizing this method (Palaganas, Maxworthy, Epps, & Mancini, 2015).

Interprofessional

Collaborating as a team with a shared purpose, goal, and mutual respect to deliver safe, quality healthcare (Freeth, Hammick, Reeves, Koppel, & Barr, 2005; World Health Organization [WHO], 2010). • ______ is a more contemporary term describing a team effort in healthcare from two or more professions whose members learn about, from, and with each other to improve health outcomes (Nester, 2016).

Immersion

Describes the level to which the learner becomes involved in the simulation; a high degree of _______indicates that the learner is treating the simulation as if it was a real-life (or very close to real-life) event (Society for Simulation in Healthcare). • A state (or situation) in which trainees dedicate most of their time doing something related to or thinking about a simulation, and becomes involved in it; the level of ______ might vary, where a high degree indicates that the trainee is fully involved; for example: realistic environments facilitate a participant´s full _________ in the simulation. • The placing of a human in a synthetic environment through physical and/or emotional means. (M&S Glossary)

Logistics

Details of an entire process. (Merriam Webster) • Ensuring the details, in simulation-based education, such as scheduling of learners, facilitators, moulage, props, scenario preparation and design are all complete.

Evaluation

Determination of the value, nature, character, or quality of something or someone (Merriam Webster) • A broad term for appraising data or placing a value on data gathered through one or more measurements. It involves rendering a judgment, including strengths and weaknesses. ________ measures quality and productivity against a standard of performance. _______ may be formative, summative, high stakes, or related to the simulation program or process. (INACSL Standards Committee, Glossary, 2016c)

Learning Goal

Higher order ambitions for the learners. • Broad, general statements of what is desired for students to learn, and provide direction, focus, and cohesion

High-Fidelity Simulation

In health care simulation, _____ _____ refers to simulation experiences that are extremely realistic and provide a high level of interactivity and realism for the learner (International Nursing Association for Clinical Simulation and Learning, 2013). It can apply to any mode or method of simulation; for example: human, manikin, task trainer, or virtual reality.

Haptic (Haptics)

In health care simulation, refers to devices that providing tactile feedback to the user. ______can be used to simulate touching, palpating an organ, or body part, and the cutting, tearing, or traction on a tissue. • Devices that capture and record a trainee's 'touch' in terms of location and depth of pressure at specific anatomical sites

Non-technical Skills

In the healthcare field, the skills of communication, (patientprovider, team) leadership, teamwork, situational awareness, decision-making, resource management, safe practice, adverse event minimization/mitigation, and professionalism; also known as behavioral skills or teamwork skills (ASSH). • Interpersonal skills that include: communication skills; leadership skills; teamwork skills; decision-making skills; and situationawareness skills (Australian Radiation Protection and Nuclear Safety Agency, n.d.) • Social, cognitive and personal skills that can enhance the way you or your staff carry out technical skills, tasks, and procedures. By developing these skills, people in safety-critical roles can learn how to deal with a range of different situations (Rail Safety and Standards Board, 2019). •____-_____ skills are the cognitive (decision-making, situation awareness) and interpersonal (communication, teamwork, leadership) skills that underpin technical proficiency, and are considered particularly important for preventing errors. ______-_______ skills include communication, leadership and followership, decision-making, situation awareness, and task management (Pires et al., 2017).

Interdisciplinary

Involving two or more academic, scientific, or artistic disciplines (Merriam-Webster.com). • The combining of two or more academic disciplines, fields of study, professions, technologies or departments (dictionary. reference.com). • Of or relating to more than one branch of knowledge (oxforddictionaries.com).

Mental Simulation

Mentally rehearsing an action to enhance performance. (Van Meer P., 2009). • Cognitive rehearsal of a task in the absence of overt physical movement that can be used to learn cognitive, kinesthetic, psychomotor, or technical skills. (Driskell, 1994 and Rao, 2015). • Activities that take place in the brain such as "mental imagery, imagination, thought flow, narrative transportation, fantasizing, and counterfactual thinking." These are "specific processes that occur in the brain when an individual is mentally simulating an action or forming a mental image," or are "focused on the consequences of mental simulation processes for affect, cognition, motivation, and behavior" (Markman, Klein, & Suhr, 2009).

In Silico

Performed on computer or via computer simulation; the phrase was coined in 1989 as an analogy to the Latin phrases in vivo, in vitro, and in situ (Sieburg, 1990).

Educator (Simulation Educator)

Person who uses the modality of simulation to educate learners, utilizing evidence -based strategies. • Person who supports healthcare professionals who are learning to manage clinical situations and provide care that is safe, effective, efficient, timely, patient-centered, and equitable. May teach an individual learner or a group of learners practicing to work as a team (Lindell, Poindexter, & Hagler, 2016)

Deterministic

Pertaining to a process, model, or variable whose outcome, result, or value does not depend on chance (Department of Defense Modeling and Simulation Glossary).

Cognitive Load

The amount of information the working memory of the participant and/or facilitator can manage at any given point. The definition is based on the_____ _______ Theory (CLT) proposed by Sweller et al. (1998) based on the working memory model introduced by Baddeley (1992)

Environmental Fidelity

The degree to which the simulated environment (manikin, room, tools, equipment, moulage, and sensory props) replicates reality and appearance of the real environment

Human Factors

The discipline or science of studying the interaction between humans and systems and technology; it includes, but is not limited to, principles and applications in the areas of human engineering, personnel selection, training, life support, job performance aids, and human performance evaluation (M&S Glossary). • The psychological, cultural, behavioral, and other human attributes that influence decisionmaking, the flow of information, and the interpretation of information by individuals or groups (Department of Defense Modeling and Simulation Glossary)

Manual Input

The method of operation in which an operator inputs a value to a given parameter regardless of how it would affect any other parameter. The input of the parameter does not adjust the variables in any physiological manner (Palaganas, Maxworthy, Epps, & Mancini, 2015).

Clinical Scenario

The plan of an expected and potential course of events for a simulated clinical experience. A ____ ____ usually includes the context for the simulation (hospital ward, emergency room, operating room, clinic, out of hospital, etc.). ____ ____ can vary in length and complexity, depending on the learning objectives. • A detailed outline of a clinical encounter that includes: the participants in the event, briefing notes, goals and learning objectives, participant instructions, patient information, environmental conditions, manikin or standardized patient preparation, related equipment, props, and tools or resources for assessing and managing the simulated experience. • A progressive outline of a clinical encounter, including a beginning, an ending, a debriefing, and evaluation criteria (Meakim et al., 2013).

Guided Reflection

The process encouraged by the instructor during debriefing that reinforces the critical aspects of the experience and encourages insightful learning, allowing the participant to link theory with practice and research (INACSL, 2013). • The facilitated intellectual and affective activities that allow individuals to explore their experience in order to lead to new understanding and appreciations (adapted from Boud et al, 1985). • A mentor-facilitated process that allows the learner to "integrate the understanding gained into one's experience in order to enable better choices or actions in the future, as well as enhance one's overall effectiveness" (Rogers, 2001).

Orientation

The process of giving participants information prior to a simulation event to familiarize them with a simulation activity or environment, such as center rules, timing, and how the simulation modalities work, with the intent of preparing the participants. • An activity that occurs prior to a simulation activity in order to prepare the faculty/instructors or learners; for example, a PowerPoint presentation that all participants must review to understand how the center operates, or how the activity is being conducted.

Mixed Reality Human

The use of a technology such as video, augmented reality, or virtual reality in conjunction with a physical manikin to simulate a human. (Costanza, Kunz, and Fjeld, 2009); for example, in team-based training, using TV monitors in portrait mode with interactive videos as a stand-in for a real team member (Palaganas, Maxworthy, Epps, & Mancini, 2015).

Cue/Cueing

To provide information during the simulation that helps the participant progress through the activity to achieve stated objectives. Information provided to help the learner reach the learning objectives (conceptual cues), or to help the learner interpret or clarify the simulated reality (reality cues). Conceptual cues help the learner reach instructional objectives through programmable equipment, the environment, or through responses from the simulated patient or role player, Reality cues to help the learner interpret or clarify simulated reality through information delivered during the simulation

adaptive learning

____ _____incorporates a wide range of technologies and techniques that observes participants and adjusts the learning experience on demand to meet the unique needs of the participants and facilitate the individual/team members in meeting the identified objectives.

CONSORT (Consolidated Standards of Reporting Trials)

____ is a guideline that standardizes the reporting for any randomized control trials. First developed for clinical trials, the guideline has been adopted by the simulation research community. (Cheng et al, 2016)

Immersive Simulation

adj: A real-life situation that deeply involves the participants' senses, emotions, thinking, and behavior; creating an immersive simulation depends on the alignment with learning objectives, the fidelity of the simulation (physical, conceptual, and emotional), and participant´s perception of realism. noun: A simulation session influenced by participants' characteristics, experiences, level of training, and preparation for the case or task,. The perceived physical, conceptual and emotional fidelity, the appropriate level of challenge, and the simulators and actors can all affect the simulation experience (Hamstra et al, 2014; Rudolph et al, 2007).

Back Story or Backstory or Back-story

• "A narrative, which provides a history and/or background and is created for a fictional character(s) and/or about a situation for a SBE (Backstory, n.d.)" (INACSL Standards Committee, 2016c, p.S40). (Ed note: this can include the back story provided to participants, standardized patients, and staff as required to support the simulation activity) • A method, particularly in some game-based simulations, "for creating design prompts, dialogs, and interactions that contain realistic verbal behaviors and variability for multiple avatars or non-player characters (NPCs) . . ." (Zachary, Zachary, CannonBowers, & Santarelli, 2016, p. 207). • Something that is developed by an author in games for characters that gives them their characteristics and memories (Fairclough & Cunningham, 2004).

Never Event

• "A serious and costly" error "in the provision of healthcare services that should never happen" (Centers for Medicare & Medicaid Services [CMS], 2006); an example is when the wrong body part is operated on (Agency for Healthcare Research and Quality [AHRQ], 2019; CMS, 2006). • The term has expanded to mean other serious and most often, preventable errors (AHRQ, 2019). • In relation to simulation-based education, avoidance of such errors is the basis for training and/or assessment.

Negative Learning

• "When stress among students occurs, and when knowledge and abilities are not properly developed" (Dormann, Demerouti, & Bakker, 2017). • "The acquisition of erroneous conceptual and procedural knowledge and understanding from unwarranted information, which leads to faulty mental models and reasoning..." (ZlatkinTroitschanskaia, & Brückner, 2017).

Debrief (Debriefing)

• (noun) A formal, collaborative, reflective process within the simulation learning activity. • An activity that follows a simulation experience and led by a facilitator. • (verb) To conduct a session after a simulation event where educators/instructors/facilitators and learners re-examine the simulation experience for the purpose of moving toward assimilation and accommodation of learning to future situations (Johnson-Russell & Bailey, 2010; National League for Nursing - Simulation Innovation Resource Center, 2013); debriefing should foster the development of clinical judgment and critical thinking skills (Johnson-Russell & Bailey, 2010). • To encourage participants' reflective thinking and provide feedback about their performance, while various aspects of the completed simulation are discussed. • To explore with participants their emotions and to question, reflect, and provide feedback to one another (i.e., guided reflection).

Dryrun

• A "planning meeting with standardized learners" is used to reveal un-intentional problems within the scenario. A designated time to explore the possibility of errors. (Boilat et al, 2012) • A verification period prior to live encounters to ensure a "safe and therapeutic" environment. (Greswell et al, 2018)

Live, virtual, and constructed (LVC) simulation

• A broadly used taxonomy describing a mixture of simulation modalities; a _____simulation involves real people operating real systems; a ______ simulation is where a real person operates simulated systems; and a _______simulation does not involve real people or real systems, but instead consists of computer programs that create an environment. (Sokolowski & Banks,

Fiction Contract

• A concept which implies that an engagement in simulation is a contract between the instructor and the learner: each has to do his or her part to make the simulation worthwhile (Rudolph, Dieckmann, et al.). • The degree of engagement that healthcare trainees are willing to give the simulated event. Also known as the "suspension of disbelief", it is a literary and theatrical concept that encourages participants to put aside their disbelief and accept the simulated exercise as being real for the duration of the scenario.

Physical Fidelity

• A level of realism associated with a particular simulation activity. • The degree to which the simulation looks, sounds, and feels like the actual task (Alexander, Brunyé, Sidman, & Weil, 2005).

advocacy and inquiry

• A method of debriefing in which an observer states what was observed or performed in a simulation activity (______) or shares critical or appreciative insights about it explicitly (______) and then asks the learners for an explanation of their thoughts or actions (_______)(Rudolph et al, 2007). • _______seeks to learn what others think, know, want, or feel; whereas ______includes statements that communicate what an individual thinks, knows, wants or feels (Bolman & Deal, 2013).

Just-in-Time Simulation

• A method of training that is conducted directly prior to a potential intervention (Palaganas, Maxworthy, Epps, & Mancini, 2015). The training that is utilized is "just in time" at the "place near the site of the potential intervention" (Palaganas, Maxworthy, Epps, and Mancini, 2014). • A learning approach that meets the learner's needs during or just before it is needed to maximize an educational outcome (Barnes, 1998). • A cost-reduction method that is derived originally from the Japanese car manufacturing industry where it was a strategy that was utilized to reduce flow times in both production and response time costs (Ohno, 1978).

Fixation Error

• A principle of crisis resource management wherein humans fail to revise a situation assessment in risky and dynamic systems or events (Decker, 2011). • The persistent failure to revise a diagnosis or plan in the face of readily available evidence suggesting that a revision is necessary .

Learning Outcome

• A result of an activity the learners demonstrate by the end of an educational activity in terms of knowledge, skills, and attributes (KSAs) acquired. • "Measurable results of the participants' progress toward meeting a set of objectives." (INACSL Standards Committee, 2016c, December). • "Outcomes include: knowledge, skill performance, learner satisfaction, critical thinking and self-confidence" (Ironside, Jeffries, & Martin, 2009, p.333) • Outcomes are a measurable judgement (Cooke, Stroup, & Harrington, 2019). • Learning outcomes "measure the effect on learning: psychomotor, affective and cognitive skills" (Cant & Cooper, 2017, p.69).

Monte Carlo Simulation

• A simulation in which random statistical sampling techniques are employed such that the result determines estimates for unknown values (Department of Defense Modeling and Simulation Glossary). • A mathematical model using probability distributions to calculate the possible outcomes for a given choice of action. Such a simulation involves many calculations and re-calculations to yield a range of possible outcomes.

Discrete Simulation (Discrete-Event Simulation)

• A simulation that relies on variables changed only at a countable number of points in time; discrete event simulation (DES) is the process of codifying the behavior of a complex system as an ordered sequence of well-defined events. • The operation of a system as a discrete sequence of events in time. Each event occurs at a particular instant in time and marks a change of state in the system.Between consecutive events, no change in the system is assumed to occur; thus the simulation can directly jump in time from one event to the next (Robinson, 2004). • One or more variables that completely describe a system at any given moment in time (Sokolowski & Banks, 2011).

Pilot Test

• A small-scale, short-term effort designed to provide data about the feasibility of a simulation prior to large-scale implementation. • Trial of simulation operations, scenarios, procedures, and teaching methods on a smaller scale to determine acceptability, identify feasibility concerns, and refine processes prior to full implementation. • A phase that includes review of the scenario to gain "clarification from experts and participants" (Rizzolo, 2014, p .114). • Explores the feasibility of the proposed application pertaining to such things as: recruitment, methods, and procedures (Leon, Davis, & Kraemer, 2010). • An assessment of the feasibility and acceptability of the proposed design and procedure (Feeley et al, 2009).

*Modality

• A term used to refer to the type(s) of simulation being used as part of the simulation activity, for example, task trainers, manikinbased, standardized/simulated patients, computer-based, virtual reality, and hybrid (SSH). • A selected type or types of simulation equipment, concept, or technique that constitutes a method of simulation use (Rutherford-Hemming et all, 2019). • Broad description of the simulation experience, consisting of one or more of the following: Computer- or Digital-based simulation; Simulated Patient (SP); Simulated clinical immersion; Procedural simulation (Chiniara et al, 2013).

Deliberate Practice

• A theory of general psychology that states the differences between expert performers and normal adults reflect a life-long period of deliberate effort to improve performance in a specific domain. (Ericsson, K. A). • A systematically designed activity that has been created specifically to improve an individual's performance in a given domain (Ericsson, Krampe, & Tesch-Römer, 1993)

Augmented Reality

• A type of virtual reality in which synthetic stimuli are superimposed on real-world objects, usually to make information that is otherwise imperceptible to human senses perceptible (M&S Glossary). • A technology that overlays digital computer-generated information on objects or places in the real world for the purpose of enhancing the user experience. • The combination of reality and overlay of digital information designed to enhance the learning process. • A spectrum of mixed-reality simulation that is part way between the real world and the virtual world. • A form of virtual reality that includes head-mounted displays, overlays of computer screens, wearable computers, or displays projected onto humans and manikins (D.R. Berryman et al; M. Bajura et al; H. Fuchs et al).

Avatar

• A virtual object used to represent a physical object (e.g., a human) in a virtual world. • A graphical representation, typically three-dimensional, of a person capable of relatively complex actions, including facial expressions and physical responses, while participating in a virtual simulation-based experience. The user controls the avatar through the use of a mouse, keyboard, or a type of joystick to move through the virtual simulation-based experience (Riley, 2008). • Controlled avatars may be either 1st-person perspective or 3rd-person perspective in virtual simulations. A 3rd-person perspective places the view and camera so the user and learner can see the controlled avatar (e.g., the player). A 1st-person perspective places the camera such that the user and learner views the world through the eyes of the avatar (i.e., the controlled avatar is never visible on the screen). These perspectives only apply to screen-based simulations using a mouse, keyboard, or joystick. Virtual Reality simulations are almost always 1st-person

Brief (Briefing)

• An activity immediately preceding the start of a simulation activity where the participants receive essential information about the simulation scenario, such as background information, vital signs, instructions, or guidelines. For example, before beginning a session, faculty conduct a briefing about the scenario to review the information being provided to the participants. • The information and guidelines given to faculty or simulated patients participating in a scenario to allow them to fully prepare for interactions with the participants. Briefing materials could include a handover, physician referral letter, or an ambulance call transcript. For example, at the start of the simulation scenario, participants receive a notification from ambulance personnel regarding a patient being transported to their facility with a gunshot wound. (Alinier, 2011; Husebø et al., 2012).

Feedback

• An activity where information is relayed back to a learner; ________ should be constructive, address specific aspects of the learner's performance, and be focused on the learning objectives (Society for Simulation in Healthcare). • Information transferred between participants, facilitator, simulator, or peer with the intention of improving the understanding of concepts or aspects of performance (INACSL 2013). _______ can be delivered by an instructor, a machine, a computer, a patient (or a simulated person), or by other learners as long as it is part of the learning process.

Facilitator (Simulation Facilitator)

• An individual who is involved in the implementation and/or delivery of simulation activities. For example, faculty, educators, etc. • An individual that helps to bring about an outcome (such as learning, productivity, or communication) by providing indirect or unobtrusive assistance, guidance, or supervision. For example: The debriefing facilitator kept the discussion flowing smoothly

Learning Objective

• Expected goal of a curriculum, course, lesson or activity in terms of demonstrable skills or knowledge that will be acquired by a student as a result of instruction. • Measurable results which can be knowledge, skills, or attitudes (KSAs). (INACSL Standards Committee, 2016c, December). • A learning objective guides the debrief activity by supporting what content should be covered or avoided (Szyld & Rudolph, 2014).

Distance Simulation

• Implementing a simulation or training at a physical distance from the participant(s) (LeFlore et al., 2014; von Lubitz et al., 2003). This may include operating a simulator via some type of remote access where the operator remotes into a simulator stationed where the participants are located; otherwise known as remote-controlled (LeFlore et al., 2014). Or, it could be where the participants remote into something like the cameras during a simulation where the simulator is stationed at a different site, which may be called "distance-based high-fidelity human patient simulation training" (von Lubitz et al., 2003, p. 379). Advantages of this method are being able to use experts to run the simulator (LeFlore et al., 2014) or to instruct (von Lubitz et al., 2003) if not currently available at the site where the participants are located.

Participant

• In health care simulation, a person who engages in a simulation activity for the purpose of gaining or demonstrating mastery of knowledge, skills, and/or attitudes of professional practice (INACSL, 2013). • A person engaged in a simulation activity or event and for those involved in simulation research.

Conceptual Fidelity

• In health care simulation, ensures that all elements of the scenario relate to each other in a realistic way so that the case makes sense as a whole to the learner(s) (For example: Vital signs are consistent with the diagnosis). To maximize _______ ________, cases or scenarios should be reviewed by subject matter expert(s) and pilot-tested prior to use with learners

actor

• In health care simulation, professional and/or amateur people trained to reproduce the components of real clinical experience, especially involving communication between health professionals and patients or colleagues (Australian Society for Simulation in Healthcare). See also: EMBEDDED PARTICIPANT, ROLE PLAYER, SIMULATED PATIENT, SIMULATED PERSON, STANDARDIZED PATIENT

Online Simulation

• Interactive simulation experience offered through an online platform that connects participants with other learners in a virtual world to complete assessment, diagnosis, and treatment tasks for virtual patients (Dikshit et al., 2005; Duff et al., 2016). • Online, often multiplayer, simulation exercises involving care for a single patient or multiple patients. Often utilizes gamification concepts to engage and incentivize learners (Evans et al., 2015; Kusumoto et al., 2007).

Cave Automated Virtual Environment (CAVE)

• Large cube wall structure inside which a participant stands; the walls have projected images to simulate an immersive, virtual environment, including shadows cast by the participant. CAVE participants use specialized goggles for the illusion of stereoscopic depth when inside the CAVE. (Cruz-Neira et al,

Patient Simulator

• Life-like, anatomically correct, computer-driven manikin with physiologic responses that mimic real patients (Ober, 2009). • High- or low-fidelity full-body manikins controlled by instructors to create a structured learning environment in a clinically realistic setting where learning can take precedence over patient care (Good, 2003). • Ed note: while these definitions are manikin-oriented, the reader should consider other simulators as meeting the concepts of these definitions

Durational Simulation

• Multiple simulations that build off of one another. This can include a simulation that focuses on an initial assessment of a simulated or standardized patient portraying a patient role and the subsequent simulations are the follow-up visit (e.g., initial visit, one-month visit and six-month visit, etc.). • A _______Simulation is the opposite of a Discrete Simulation in that changes occur in the system between simulations.

Low-Fidelity

• Not needing to be controlled or programmed externally for the learner to participate; examples include case studies, role playing, or task trainers used to support students or professionals in learning a clinical situation or practice

Assessment

• Refers to processes that provide information about or feedback about individual participants, groups, or programs. Specifically, ______refers to observations of progress related to knowledge, skills, and attitudes (KSA). Findings of assessment are used to improve future outcomes • Involves measurement of the KSAs which can be recorded

Interactive Model or Simulation

• Simulating a situation in which the outcome varies depending on human participation (Thomas). This allows humans to practice different sets of actions in order to learn the correct response to an event. • Modeling that requires human participation (Australian Department of Defense, 2011).

Physical Examination Teaching Associates (PETAs or PTAs)

• Standardized patients who are specifically trained to teach, assess, and provide feedback to learners about physical examination techniques. They also address the communication skills needed to provide a comfortable exam in a standardized manner, while using their bodies to instruct in a supportive, non-threatening environment (Lewis et al, 2017). • An individual who is trained to teach and provide feedback on basic physical exam techniques and process; serves as coach and as a model (is the instructor and patient) (The John Hopkins University, 2019). • The person may also serve in the role as evaluator and is considered under the larger category of simulated participants (Lewis et al., 2017). • Also referred to at some institutions as PTA (____ ___ ____) or PI (Patient Instructors) (East Carolina University, 2019).

In Situ/In Situ Simulation

• Taking place in the actual patient care setting/environment in an effort to achieve a high level of fidelity and realism; this training is particularly suitable for difficult work environments, due to space constraints or noise. For example, an ambulance, a small aircraft, a dentist's chair, a catheterization lab (Kyle & Murray, 2008). This training is valuable to assess, troubleshoot, or develop new system processes.

Gamification

• The application of game design elements (conceptual building blocks integral to building successful games) to traditionally nongame contexts (Rutledge et al, 2018). • The application of the characteristics and benefits of games to real-world processes or problems. "______ differs from serious games in terms of the design intention, with gamification interventions involving the application of game elements with a utilitarian purpose..." (Gentry et al, 2019).

Multidisciplinary

• The combining of professionals with different perspectives to provide a wider understanding of a particular problem (Bray & Hawkins, 2008).

Distributed Simulation

• The concept of simulation on-demand, made widely available wherever and whenever it is required; DS provides an easily transportable, self-contained 'set' for creating simulated environments, at a fraction of the cost of dedicated, static simulation facilities (Kneebone et al, 2010). • A set of simulations operating in a common environment and distributed to learners; a distributed simulation may be composed of any of the three modes of simulation: live, virtual, and constructive, and are seamlessly integrated within a single exercise (Department of Defense Modeling and Simulation Glossary).

Functional Fidelity

• The degree in which the equipment used in the simulation responds to the participant's actions; e.g., a static ventilator would offer low functional fidelity compared to a working ventilator in a simulation requiring a ventilator alarm.

*Fidelity

• The degree to which the simulation replicates the real event and/or workplace; this includes physical, psychological, and environmental elements. • The ability of the simulation to reproduce the reactions, interactions, and responses of the real-world counterpart. It is not constrained to a certain type of simulation modality, and higher levels of fidelity are not required for a simulation to be successful. • The level of realism associated with a particular simulation activity; fidelity can involve a variety of dimensions, including (a) physical factors such as environment, equipment, and related tools; (b) psychological factors such as emotions, beliefs, and self-awareness of participants; (c) social factors such as participant and instructor motivation and goals; (d) culture of the group; and (e) degree of openness and trust, as well as participants' modes of thinking (INACSL, 2013)

Interprofessionalism

• The effective integration of professionals through mutual respect, trust, and support, from various professions, who share a common purpose to mold their separate skills and knowledge into collective responsibility and awareness that can be achieved through learned processes for communication, problem solving, conflict resolution, and conduct.

Debriefer

• The individual who facilitates a debriefing session and is knowledgeable and skilled in performing appropriate, structured, and psychologically safe debriefing sessions (Fanning & Gaba, 2007). • The person who leads participants through the debriefing. Debriefing by competent instructors and subject matter experts is considered important to maximize the opportunities arising from simulation (Raemer et al, 2011).

Moulage

• The makeup and molds applied to humans or manikins used to portray lesions, skin findings, bleeding, and traumatized areas (Levine et al). • The application of makeup and molds to a human or simulator's limbs, chest, head, etc. to provide elements of realism (such as blood, vomitus, open fractures, etc.) to the training simulation. • Techniques used to simulate injury, disease, aging, and other physical characteristics specific to a scenario; ________supports the sensory perceptions of participants and supports the fidelity of the simulation scenario through the use of makeup, attachable artifacts (e.g. penetrating objects), and smells (INACSL, 2013)

Physiologic Modeling

• The mathematical computer models governing complex human physiology in a simulated patient case so that reasonable responses occur automatically to events inputted into the program. For example: a pharmacodynamic model could predict effects of drugs on heart rate, cardiac output, or blood pressure and display them on a simulated clinical monitor. (Howard Schwid, Rosen, 2013). • A computer model that allows for a method of operation in which an operator inputs a value to a given parameter, and it automatically adjusts the other variables in a physiologically realistic manner (Palaganas, Maxworthy, Epps, and Mancini, 2015).

Computer-Based Simulation

• The modeling of real-life processes with inputs and outputs exclusively confined to a computer, usually associated with a monitor and a keyboard or other simple assistive device (Textbook of Simulation). Subsets of computer-based simulation include virtual patients, virtual reality task trainers, and immersive virtual reality simulation (ibid).

Event

• The occurrences that cause variation or changes in the state of a system (Sokolowski and Banks, 2009); in health care simulation, this term is common when programming manikins and often refers to learner actions. • An _____ is described by the time it occurs and ______ lists can be created to drive changes in a simulation.

Frame(s)

• The perspectives through which individuals interpret new information and experiences for the purpose of decision-making. • Frames are formed through previous experiences and can be based on knowledge, attitudes, feelings, goals, rules, and/or perceptions. • The mindset of the internal participant or facilitator; their knowledge, thoughts, feelings, actions (speech/body language), attitudes (verbal/non-verbal), and perceptions (adapted from Rudolph, J.W. et al, 2007, 2008).

Behavioral Skills

• The range of activities encompassed within the category of interpersonal interaction, including bedside manner, interpersonal, teamwork, leadership and communications. (Murphy, Nestel, & Gormley, 2019) • The decision-making and team interaction processes used during the team's management of a situation. (Gaba et al, 1998)

Modeling and Simulation (M&S) (also Modeling and Simulation)

• The terms modeling and simulation are often used interchangeably. • An academic discipline focused on the study, development, and use of live, virtual, and constructive models, including simulators, emulators, and prototypes to investigate, understand, or provide data. • The use of models, including emulators, prototypes, simulators, and stimulators, to develop data as a basis for making managerial or technical decisions.

Hybrid Simulation

• The union of two or more modalities of simulation with the aim of providing a more realistic experience. • In health care simulation, hybrid simulation is most commonly applied to the situation where a part task trainer (e.g., a urinary catheter model) is realistically affixed to a standardized/simulated patient, allowing for the teaching and assessment of technical and communication skills in an integrated fashion (Kneebone, Kidd et al, 2002). • The use of two or more simulation modalities in the same simulation activity (Zulkepli et al, 2012).

Mixed Simulation (Mixed Methods Simulation)

• The use of a variety of different simulation modalities; this is differentiated from hybrid simulation in that it is not characterized by the combining of one type of simulation to enhance another, but rather the use of multiple types of simulation in the same scenario or place. For example, a standardized patient (SP) and a mannequin are used in a scenario or a task trainer paired with an SP for venipuncture, etc. (SSH).

Manikin-based Simulation

• The use of manikins to represent a patient using heart and lung sounds, palpable pulses, voice interaction, movement (e.g., seizures, eye blinking), bleeding, and other human capabilities that may be controlled by a simulationist using computers and software. • The life-like aspects of people and situations generated by a manikin.

*Multiple Modality (Multi-modal) Simulation

• The use of multiple modalities of simulation in the same simulation activity; differentiated from hybrid simulation in that it is not characterized by the combining of one type of simulation to enhance another, but rather the use of multiple types of simulation in the same scenario or place, e.g., SP and manikin used in a scenario or a task trainer paired with an SP for venipunture, etc. (SSH).

Coaching

• To direct or instruct a person or group of people in order to achieve goals, develop specific skills, or develop competencies.

Interdisciplinary / Interdisciplinary Learning

• noun: The academic disciplines, such as psychology, or subspecialties within professions. For example, within the profession of medicine, anesthesia or cardiology (Barr, Koppel, Reeves, et al., 2005). • adj: Working jointly, but address issues from their individual discipline's perspective (Gray & Connolly, 2008). • Integrating the perspective of professionals from two or more professions by organizing the education around a specific discipline, where each discipline examines the basis of their knowledge" (Bray & Howkins, 2008).

Alpha and Beta Testing

•______- early testing of a product by the developers or programmers, but not by potential users. The purpose of _____-testing is to find and resolve as many 'bugs' or problems in the software that were unanticipated during the design and development. (Lee-Jayaram et al, 2019) • _____- early testing of a software, program, simulation, or game, by potential users. The purpose of _____-testing is identical to ______-testing. (Lee-Jayaram et al, 2019)