BACKGROUND: Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students.
METHODS: A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention.
RESULTS: The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention (p = 0.020), after three months, no difference was observed (p = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group (p = 0.048) or the high-fidelity simulation combined with computer-based simulation group (p = 0.020).
CONCLUSIONS: Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances.
BACKGROUND: This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).

As opposed to those requiring a single action for reward acquisition, tasks necessitating action sequences demand that animals learn action elements and their sequential order and sustain the behaviour until the sequence is completed. With repeated learning, animals not only exhibit precise execution of these sequences but also demonstrate enhanced smoothness and efficiency. Previous research has demonstrated that midbrain dopamine and its major projection target, the striatum, play crucial roles in these processes. Recent studies have shown that dopamine from the substantia nigra pars compacta (SNc) and the ventral tegmental area (VTA) serve distinct functions in action sequence learning. The distinct contributions of dopamine also depend on the striatal subregions, namely the ventral, dorsomedial and dorsolateral striatum. Here, we have reviewed recent findings on the role of striatal dopamine in action sequence learning, with a focus on recent rodent studies.

OBJECTIVE: This study evaluated the efficacy of Virtual Reality-Based Seizure Management Education Program for Parents (VR-ESMEPP) that was designed to improve parents\' knowledge-skill percentage about epileptic seizure, and motivation levels about educational material.
METHODS: The study was conducted at a university hospital\'s pediatric neurology clinic in Turkey and involved both a VR-trained group and a control group. The parents\' knowledge-skill percentage about epileptic seizure, and motivation levels about educational material were assessed before, after, and at 15 days after participating in VR-ESMEPP.
RESULTS: The parents\' knowledge-skill percentage about epileptic seizure increased in the group that participated in the VR-ESMEPP. There was no such increase in the control group. Examination of the scores of the Instructional Materials Motivation Survey (IMMS) for the parents showed that while there was a significant increase between the pre-test and post-test within the group that participated in the VR-ESMEPP, there was no significant difference in the scores of the control group. However, the high IMMS scores obtained by all parents indicate the motivating nature of the education material.
CONCLUSIONS: The study established the efficacy of VR-ESMEPP and demonstrated its ability to enhance parents\' knowledge-skill percentage about epileptic seizure. Despite the absence of a difference in motivation levels between the groups, the high scores obtained by all participants indicate that the program was indeed motivating.

Displaying nonverbal pride after a boxing match leads to judgements of success. However, it is not clear the extent to which this effect generalises nor whether it can override competing information. An experimental design had 214 participants watch two boxing clips that were manipulated so that one was evenly matched and the other had a fighter with an advantage (i.e. demonstrating more skill). Nonverbal behaviour at the completion of the fight varied between fighters (pride versus neutral). When the fight was evenly matched, the fighters displaying nonverbal pride were judged as winning the fight, but the fighter did not garner increased social influence. In contrast, when fighters demonstrated superior skill, the more skilled fighters who displayed neutral postures rather than the less-skilled ones displaying pride were judged as winning the fight, and the skilled fighters garnered increased social influence. These results suggest that in a boxing context, a pride bias works in evenly matched scenarios, but when differences in skill are more clearly present, a skill bias is more pronounced and leads to more social influence. Furthermore, perceptions of skill were associated with judgments of victory across stimuli, suggesting the importance of skill perceptions in such judgments.

BACKGROUND: In the wake of challenges brought by the COVID-19 pandemic to conventional medical education, the demand for innovative teaching methods has surged. Nurse training, with its focus on hands-on practice and self-directed learning, encountered significant hurdles with conventional approaches. Augmented reality (AR) offers a potential solution to addressing this issue.
OBJECTIVE: The aim of this study was to develop, introduce, and evaluate an AR-based educational program designed for nurses, focusing on its potential to facilitate hands-on practice and self-directed learning.
METHODS: An AR-based educational program for nursing was developed anchored by the Kern six-step framework. First, we identified challenges in conventional teaching methods through interviews and literature reviews. Interviews highlighted the need for hands-on practice and on-site self-directed learning with feedback from a remote site. The training goals of the platform were established by expert trainers and researchers, focusing on the utilization of a ventilator and extracorporeal membrane oxygenation system. Intensive care nurses were enrolled to evaluate AR education. We then assessed usability and acceptability of the AR training using the System Usability Scale and Technology Acceptance Model with intensive care nurses who agreed to test the new platform. Additionally, selected participants provided deeper insights through semistructured interviews.
RESULTS: This study highlights feasibility and key considerations for implementing an AR-based educational program for intensive care unit nurses, focusing on training objectives of the platform. Implemented over 2 months using Microsoft Dynamics 365 Guides and HoloLens 2, 28 participants were trained. Feedback gathered through interviews with the trainers and trainees indicated a positive reception. In particular, the trainees mentioned finding AR particularly useful for hands-on learning, appreciating its realism and the ability for repetitive practice. However, some challenges such as difficulty in adapting to the new technology were expressed. Overall, AR exhibits potential as a supplementary tool in nurse education.
CONCLUSIONS: To our knowledge, this is the first study to substitute conventional methods with AR in this specific area of critical care nursing. These results indicate the multiple principal factors to take into consideration when adopting AR education in hospitals. AR is effective in promoting self-directed learning and hands-on practice, with participants displaying active engagement and enhanced skill acquisition.
BACKGROUND: ClinicalTrials.gov NCT05629663; https://clinicaltrials.gov/study/NCT05629663.

This study aimed to verify whether peripheral perception, tactical behaviour, and physical performance are influenced by acute physical fatigue in soccer players. The study included 24 trained soccer players (18.6 ± 1.5 years) from two Brazilian clubs. The TSAFT90 test was used to induce acute physical fatigue. The results showed that physical fatigue did not affect peripheral perception (p = 0.360). Regarding tactical behaviour, improved efficiency was observed for the principles of offensive coverage (p = 0.029), width and length with the ball (p = 0.044), and concentration (p = 0.008). On the other hand, a reduction was observed in the number of tactical actions of offensive coverage (p = 0.020) and recovery balance (p = 0.042). Also, improved accuracy in the principles of defensive balance (p = 0.009), recovery balance (p = 0.021) and defensive unity (p = 0.003) occurred under physical fatigue. A reduction in the physical performance outcomes total distance covered (p < 0.001), average speed (p < 0.001), sprints (p = 0.029), number of accelerations (p = 0.008) and decelerations (p = 0.008) were also detected. The internal (p < 0.01) and external (p < 0.01) workload was higher under physical fatigue. Overall, acute physical fatigue did not influence peripheral perception. However, physical performance was reduced under fatigue, the perceived effort increased, and tactical behaviours were affected by decreasing tactical actions performed near the ball, increasing errors in defensive movements in the lateral corridors and the last defensive line, and improving offensive tactical actions performance.

BACKGROUND: Performing CPR (Cardiopulmonary Resuscitation) is an extremely intricate skill whose success depends largely on the level of knowledge and skill of Anesthesiology students. Therefore, this research was conducted to compare the effect of the scenario-based training method as opposed to video training method on nurse anesthesia students\' BLS (Basic Life Support) knowledge and skills.
METHODS: This randomized quasi-experimental study involved 45 nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in 2022-2023. The practical room of the university formed the research environment. The participants were randomly divided into three groups of scenario-based training, video training, and control. Data were collected by a knowledge questionnaire and a BLS skill assessment checklist before and after the intervention.
RESULTS: There was a significant difference between the students\' scores of BLS knowledge and skill before and after the educational intervention in both SG (scenario group) (p < 0.001) and VG (video group) (p = 0.008) (p < 0.001). However, no significant difference was observed in this regard in the CG (control group) (p = 0.37) (p = 0.16). Also, the mean scores of BLS knowledge and skills in the SG were higher than those in the VG (p < 0.001).
CONCLUSIONS: Given the beneficial impact of scenario-based education on fostering active participation, critical thinking, utilization of intellectual abilities, and learner creativity, it appears that this approach holds an advantage over video training, particularly when it comes to teaching crucial subjects like Basic Life Support.

BACKGROUND: There is little consensus on how to make a diagnosis announcement of severe chronic disease in neurology. Other medical specialties, such as oncology, have developed assessment methods similar to the Objective Structured Clinical Examination (OSCE) to address this issue. Here we report the implementation of an OSCE focused on the diagnosis announcement of chronic disease in neurology by residents.
OBJECTIVE: We aimed to evaluate the acceptability, feasibility and validity in routine practice of an OSCE combined with a theoretical course focused on diagnosis announcement in neurology.
METHODS: Eighteen neurology residents were prospectively included between 2019 and 2022. First, they answered a questionnaire on their previous level of training in diagnosis announcement. Second, in a practical session with a simulated patient, they made a 15-min diagnosis announcement and then had 5mins of immediate feedback with an expert observer, present in the room. The OSCE consisted of 4 different stations, with standardized scenarios dedicated to the announcement of multiple sclerosis (MS), Parkinson\'s disease (PD), Alzheimer\'s disease (AD) and amyotrophic lateral sclerosis (ALS). Third, in a theory session, expert observers covered the essential theoretical points. All residents and expert observers completed an evaluation of the \"practical session\" and the \"theory session\".
RESULTS: Residents estimated their previous level of diagnosis announcement training at 3.1/5. The most feared announcements were AD and ALS. The \"practical session\" was rated at a mean of 4.1/5 by the residents and 4.8/5 by the expert observers, and the \"theory session\" at a mean of 4.7/5 by the residents and 5/5 by the expert observers. After the OSCEs, 11 residents felt more confident about making an announcement.
CONCLUSIONS: This study has shown a benefit of using an OSCE to learn how to make a diagnosis announcement of severe chronic disease in neurology. OSCEs could be used in many departments in routine practice and seem adapted to residents.

UNASSIGNED: To determine the level of knowledge and skill of basic life support (BLS) among undergraduate, postgraduate students, and general practitioners with and without regular attendance of the BLS Healthcare Provider course.
UNASSIGNED: The study was carried out at two intervals with two groups. A random sample involving undergraduate students, postgraduate students, and dental professionals was selected for both study groups. Group 1 with 440 participants had not attended BLS for Healthcare Providers Course in the last two years. Group 2 with 410 participants had attended the BLS for Healthcare Providers course regularly once a year. First, participants in Group 1 were evaluated using an MCQ test with 30 questions about their knowledge and skills in BLS. Then, a well-trained BLS instructor team from Dental College & Hospital offered BLS healthcare provider courses to students and dentists. Subsequently, Group 2 participants who had completed a BLS course for healthcare providers last year were also assessed for their knowledge and skills in BLS using another MCQ test.
UNASSIGNED: The marks obtained in the tests were tabulated and analyzed. To determine the association between variables with respect to mean knowledge score, t-test was employed. Multiple group comparison was made using analysis of variance and P < 0.05 was considered statistically significant. The group 1 participants score a mean of 5.7 marks against the Group 2 with a mean score of 27.4 marks out of 30 marks. Knowledge and skill in BLS skills among those in Group 1 without prior BLS training was mainly low. Dental practitioners performed marginally better than students in both groups.
UNASSIGNED: Based on the results, we make the following observations. With the introduction of BLS training into the academic curriculum and routine BLS hands-on workshops, all healthcare providers will be familiar with the BLS skills to effectively manage the life-threatening emergencies.

With an increase in robot-assisted surgery across all specialties, adequate training and credentialing strategies need to be identified to ensure patients safety. The meta-analysis assesses the transferability of technical surgical skills between laparoscopic surgery, open surgery, and robot-assisted surgery.
A systematic search was conducted in Medline, Cochrane Central Register of Controlled Trials, and Web of Science. Outcomes were categorized into time, process, product, and composite outcome measures and pooled separately using Hedges\'g (standardized mean difference [SMD]). Subgroup analyses were performed to assess the effect of study design, virtual reality platforms and task difficulty.
Out of 14,120 screened studies, 30 were included in the qualitative synthesis and 26 in the quantitative synthesis. Technical surgical skill transfer was demonstrated from laparoscopic to robot-assisted surgery (composite: SMD 0.40, 95%-confidence interval [CI] [0.19; 0.62], time: SMD 0.62, CI [0.33; 0.91]) and vice versa (composite: SMD 0.66, CI [0.33; 0.99], time [basic skills]: SMD 0.36, CI [0.01; 0.72]). No skill transfer was seen from open to robot-assisted surgery with limited available data.
Technical surgical skills can be transferred from laparoscopic to robot-assisted surgery and vice versa. Robot-assisted and laparoscopic surgical skills training and credentialing should not be regarded separately, but a reasonable combination could shorten overall training times and increase efficiency. Previous experience in open surgery should not be considered as an imperative prerequisite for training in robot-assisted surgery. Recommendations for studies assessing skill transfer are proposed to increase comparability and significance of future studies.
PROSPERO CRD42018104507.