Claire Mulhall

Background Globally, in excess of one billion children experience violence and abuse every year, leading to upwards of 40,000 deaths. Child safeguarding education typically occurs in professional silos across healthcare, often focusing on specific undergraduate competencies. In practice, however, child safeguarding requires a multi-professional approach, necessitating effective communication in emotionally charged contexts. To address these needs, we designed an interprofessional course using simulation-based education for experienced healthcare professionals working in the emergency department. Methods On three occasions, we delivered an in-person, two-day course with 32 healthcare professionals from medicine, nursing, an in-person two-day course on three occasions with 34 healthcare professionals from medicine, nursing and social work. We collected data using multiple methods including pre and post training surveys (n = 32), observational field notes, individual semi-structured interviews (n = 14) and focus groups (n = 4). We analyzed the data using landscapes of practice theory as a sensitizing concept. Results We integrated the insights gained from the open-ended survey responses with our interview and focus group data to generate three key themes 1) collaborative learning, 2) the medium of language and 3) establishing a safe environment. These themes encapsulate our participants' experiences in navigating interprofessional learning within newly established teams during simulated child safety scenarios in the emergency department. Findings also detail participants’ knowledge gains and confidence in reporting child safeguarding concerns. Conclusions Child safeguarding involves emotional interactions, ambiguity, and multi-professional coordination. Interprofessional simulation-based child safety training enhances knowledge, communication skills, and teamwork. Simulation educators should emphasize psychological safety, flatten hierarchy, and expose participants to the language and perspectives of other professions and simulated parents to make safeguarding a shared, interdependent responsibility. Integrating authentic, psychologically secure, and child-centered simulations into health and social care curricula and reinforcing these lessons in workplace cultures can improve workforce preparedness and child protection outcomes.

Importance: Simulation-based education (SBE) is increasingly used in physical therapist training to address growing student numbers and clinical placement shortages. However, clinical educators’ perspectives on the role of SBE in preparing students for practice remain unexplored. Objective: The objective of this study was to explore physical therapy clinical educators’ perspectives on academic-based SBE, particularly how it can equip students for clinical placement and whether it should contribute to practice education hours. Design: Qualitative interpretive description methodology using semi-structured interviews was used. Setting: Five hospital sites across the island of Ireland engaged in physical therapist practice education. Participants: This study involved 8 physical therapist practice educators and tutors with 6 to 15 years of experience, supervising 2 to 50 students annually. Intervention(s) or Exposure(s): Individual semistructured interviews were conducted exploring participants’ perspectives on SBE’s role in clinical education, lasting 40 to 60 minutes each. Main Outcome(s) and Measure(s): Thematic analysis identified patterns in clinical educators’ perceptions of SBE’s educational value and contribution to practice preparation. Results: Simulation supported the transition to practice by: (1) priming for clinical environments, (2) enhancing feedback literacy in the workplace, and (3) tackling complexity of clinical practice. Specific clinical skills including documentation, basic safety, manual handling, subjective assessment, and understanding the multidisciplinary team’s role were recognized as appropriate for instruction through SBE. Participants reported activities spent in SBE should count toward clinical hours and highlighted that processing feedback during SBE established a foundation for feedback practices in the workplace. Engaging simulated patients in scenarios informed by real patient experiences was proposed as a way of managing complex patient encounters. Conclusions and Relevance: SBE provides a means to scaffold the learning of essential clinical skills before practice placement and contributes to clinical education, though more research is needed to determine the proportion. Future research should examine simulated interventions to boost feedback literacy and readiness for clinical settings. Involving patients and the public in the design of SBE curricula is crucial for relevant and beneficial learning outcomes.

Rationale and objectives: To define the competencies in ultrasound knowledge and skills that are essential for interventional radiology trainees to master when performing ultrasound-guided renal biopsy, and to design simulation-based training to develop these competencies. Materials and methods: A whole-task training and competency-based assessment methodology was adopted. 42 fellowship-trained interventional radiologists were contacted to participate in the process. An anonymous three-round modified Delphi process was used to identify and assess the crucial procedural steps in performing an ultrasound-guided renal procedure. The primary survey round allowed free text submission of the procedure steps. The primary survey was analysed to identify the common key tasks and these were grouped in procedural domains. For rounds two and three consensus on key steps was evaluated. 75% agreement was required to progress to the final task list. The final task list was reviewed to identify simulation strategies. Results: Nine interventional radiologists completed the three-round modified Delphi process. 24 competencies were determined to be important across the seven procedural domains. One competency identifying contraindications was removed due to disagreement among participants. The educational review of the final task list identified simulation strategies: three domains involving simulated participants and four domains requiring hybrid simulation involving simulated participants, simulator training and interprofessional simulation. Conclusion: Twenty-three competencies were identified in a blueprint for the development of a simulation curriculum to meet the training requirement of radiologists performing ultrasound-guided renal biopsy.

In simulation-based education (SBE), educators integrate their professional experiences to prepare learners for real world practice and may embed unproductive stereotypical biases. Although learning culture influences educational practices, the interactions between professional culture and SBE remain less clear. This study explores how professional learning culture informs simulation practices in healthcare, law, teacher training and paramedicine. Using constructivist grounded theory, we interviewed 19 educators about their experiences in designing and delivering simulation-based communication training. Data collection and analysis occurred iteratively via constant comparison, memo-writing and reflexive analytical discussions to identify themes and explore their relationships. Varied conceptualizations and enactments of SBE contributed to distinct professional learning cultures. We identified a unique 'simulation culture' in each profession, which reflected a hyper-real representation of professional practice shaped by three interrelated elements: purpose and rationale for SBE, professional values and beliefs, and educational customs and techniques. Dynamic simulation cultures created tensions that may help or hinder learning for later interprofessional practice. The concept of simulation culture enhances our understanding of SBE. Simulation educators must be mindful of their uni-professional learning culture and its impacts. Sharing knowledge about simulation practices across professional boundaries may enhance interprofessional education and learners' professional practice.

Providing feedback is a key aspect of simulated participants' (SPs) educational work. In teaching contexts, the ability to provide feedback to learners is central to their role. Suboptimal feedback practices may deny learners the valuable feedback they need to learn and improve. This scoping review systematically maps the evidence related to SPs' role as educators and identifies how SPs prepare for their role and feedback practices. The authors conducted a scoping review and included a group of international stakeholders with experience and expertise in SP methodology. Five online databases were systematically searched and ERIC, MedEdPortal and MedEdPublish were hand searched to identify relevant studies. Inclusion/exclusion criteria were developed. Data screening and subsequently data charting were performed in pairs. The results of data charting were thematically analysed including categories relating to the Association of SP Educators (ASPE) Standards of Best Practice (SOBP). From 8179 articles identified for the title and abstract screening, 98 studies were included. Studies reported the benefit of SPs' authentic role portrayal and feedback interactions for learners and on the reported learning outcomes. Data was heterogeneous with a notable lack of consistency in the detail regarding the scenario formats for communication skills training interventions, SP characteristics, and approaches to training for feedback and role portrayal. The published literature has considerable heterogeneity in reporting how SPs are prepared for role portrayal and feedback interactions. Additionally, our work has identified gaps in the implementation of the ASPE SOBP, which promotes effective SP-learner feedback interactions. Further research is required to identify effective applications of SP methodology to prepare SPs for their role as educators.

Despite the demonstrated value of simulated participant (SP) feedback, we are only beginning to understand how to optimize SPs’ feedback practices for communication skills and strengthen their role...

First responders, such as paramedics and firefighters, encounter duty-related traumatic exposures, which can lead to post-traumatic stress (PTS). Although social support protects against PTS, we know little about how first responders’ families, spouses/partners, friends, and care-partners (i.e., ‘trusted others’) provide social support. This narrative review explores support behaviors, coping strategies, and resources trusted others use to support first responders. A structured literature search yielded 24 articles. We used House’s (1981) conceptual framework to inform our analysis. We identified three main themes: providing support, finding support, and support needs. Additionally, we describe trusted others’ self-reported preparedness, coping strategies, and barriers to providing social support. We found that trusted others provided different types of support: (a) emotional (fostering a safe space, giving autonomy over recovery, facilitating coping mechanisms, prioritizing first responders’ emotional needs); (b) instrumental (prioritizing first responders’ practical needs, handling household tasks, supporting recovery); (c) appraisal (active monitoring, verbal reassurance, positive reframing), and (d) informational (seeking informal learning). In their role, trusted others sought formal (organizational) and informal (peer and personal) support and resources, alongside intrapersonal and interpersonal coping strategies. Identified barriers include inadequate communication skills, maladaptive coping, and disempowering beliefs. Thus, we offer practical, treatment, and social support recommendations.

Daily surgical ward rounds shape the quality of postoperative care and contribute to positive patient outcomes. Despite their importance, strategies to facilitate and promote deliberate interdisciplinary collaboration within surgical ward rounds have not been comprehensively investigated. This paper systematically reviews the literature to identify what is known from existing publications about interdisciplinary working on surgical ward rounds. Pubmed, Embase, CINAHL, Scopus, and Web of Science were searched from database inception until May 2021 for studies involving interdisciplinary surgical ward rounds. Also, journal hand searches were undertaken. All potential abstracts and papers were screened independently by two reviewers to determine inclusion. All included papers were assessed for methodological quality using the accepted quality criteria outlined in the BEME No. 1 guide. A modified Kirkpatrick model was employed to analyze and synthesize the included studies. The search identified 1765 studies. Reviews of 861 abstracts resulted in the retrieval of 124 articles for full-text screening. Thirty-two papers met the inclusion/exclusion criteria. The levels of research evidence were low with 11 papers scoring either grade 4 (results are clear and very likely to be true) or grade 5 (results are unequivocal) in accordance with the BEME No. 1 guide. These 11 studies had three foci (1) full teams managing specific medical conditions through deliberate interdisciplinary collaboration on ward rounds (n = 5); (2) suggestions on the best format for interdisciplinary collaboration on ward rounds (n = 3); and, (3) the roles of specific disciplines in a collaborative surgical round (n = 3). Physicians, intensivists, and pediatricians embrace the benefits of interdisciplinary working to facilitate the improvement of communication, collaboration, and patient safety. Yet, persistent hierarchies within surgical wards act as a barrier often preventing allied health professionals from speaking up, thus perpetuating intra disciplinary siloed behaviors. This barrier contributes to a dearth of research evidence to facilitate interdisciplinary collaborative intentionality in surgical ward rounds and surgical education. Given the high-risk nature of surgery, interdisciplinary collaboration is a critical component for patient safety. Our findings serve as a call to action to address the rhetoric of interdisciplinary collaboration on surgical ward rounds. An evidence-base is required to design, educate for and implement interdisciplinary collaborative opportunities in surgical wards so this critical aspect of patient care becomes a reality.

First responders regularly encounter both operational stressors and potentially traumatic events, increasing their risk of mental health issues (Declercq et al., 2011). Due to unique cultural compl... Antecedentes: Los equipos de primera respuesta se encuentran regularmente con estresores operacionales y eventos potencialmente traumáticos, aumentando su riesgo de problemas de salud mental. Debid... 背景：急救人员经常遇到操作应激源和潜在创伤性事件，增加了其出现心理健康问题的风险。由于独特的文化复杂性，他们主要向同龄人寻求早期的社会心理支持。然而，同伴支持和/或心理健康援助可能并不总是可用或容易获得，并且急救人员的心理健康患者很痛苦。目的：我们需要更易得的危机干预途径，以确保急救人员的心理韧性和幸福，以便他们可以继续为公共安全服务。家庭成员和亲密朋友可能处于提供这种即时关心的理想位置。本...